Does NAD+ Have a Role in Aesthetic Plastic Surgery? An Evidence-Based Review.

Nicotinamide adenine dinucleotide (NAD+) is an essential metabolic coenzyme that has gained substantial attention in recent years, driven by claims of anti-aging, metabolic, and neurocognitive benefits. Its use has expanded beyond medical spas and wellness clinics, and NAD+ is now being incorporated into some aesthetic plastic surgery practices, where it is marketed for "improved postoperative healing" and "enhanced recovery". However, support for these claims in surgical and aesthetic contexts remains largely anecdotal, drawn primarily from preclinical, non-surgical data, and patient testimonials rather than clinical studies. Nevertheless, NAD+ therapy continues to rise in popularity, making an objective evaluation of its relevance to plastic surgery timely and necessary. This narrative review provides plastic surgeons with an evidence-based overview of NAD+, including its mechanism of action, claimed benefits, available clinical evidence, safety and regulatory issues, and ethical considerations to clarify its current role within aesthetic plastic surgery.