Abstract
<title>Abstract</title> <p>Background The terms “regeneration” and “rejuvenation” in aesthetic medicine are used without standardized evidentiary criteria. This review quantified the gap between regenerative claims and biological evidence. Methods A PROSPERO-registered living systematic review (PubMed, Embase, Web of Science; January 2001 to June 2026) applied the Matrisome Profiling Standard (MPS) a 22-point framework operationalizing the Vacanti and Langer tissue-engineering criteria across seven domains: gene expression, protein synthesis, structural assembly, functional biomechanics, homeostatic regulation, cellular rejuvenation, and epigenetic reactivation to 136 publications. Results No study scored above 5.0 of 22, a maximum achieved by an in vitro study; the highest in vivo clinical score was 4.0. Of fully reconciled primary-study records, 76.5% provided inadequate evidence (0–0.5). Assessment concentrated on collagen type I and III abundance; elastin expression, ultrastructure, biomechanics, homeostatic regulation, cellular senescence, and epigenetics were largely absent. Poly-L-lactic acid and calcium hydroxylapatite biostimulators scored 0 to 3.0 and 0 to 1.5, respectively. Conclusions Current aesthetic interventions demonstrate palliation rather than regeneration. The MPS provides an objective evidentiary standard for research design, peer review, regulatory oversight, and informed consent.</p>