Daily Cosmetic Research Analysis
A double-blind randomized clinical trial shows stromal vascular fraction (SVF) augments Er:YAG laser outcomes for striae distensae without added safety concerns at 3 months. A PRISMA-compliant systematic review highlights safety risks and insufficient long-term evidence for rib resection in aesthetic body contouring, noting rib remodeling may be safer but unproven. A 199-patient cohort supports a simplified mini-redraping medial epicanthoplasty with lower dissatisfaction and scarring than ellipt
Summary
A double-blind randomized clinical trial shows stromal vascular fraction (SVF) augments Er:YAG laser outcomes for striae distensae without added safety concerns at 3 months. A PRISMA-compliant systematic review highlights safety risks and insufficient long-term evidence for rib resection in aesthetic body contouring, noting rib remodeling may be safer but unproven. A 199-patient cohort supports a simplified mini-redraping medial epicanthoplasty with lower dissatisfaction and scarring than elliptical excision, while significantly reducing intercanthal distance.
Research Themes
- Regenerative adjuncts in laser aesthetic dermatology
- Evidence and safety in rib-based body contouring
- Technique optimization in eyelid cosmetic surgery
Selected Articles
1. Development of a Komagataella phaffii cell factory for sustainable production of ( +)-valencene.
Using CRISPR/Cas9, enzyme fusion, pathway flux enhancement, promoter modulation, and gene copy optimization, the authors engineered K. phaffii to produce (+)-valencene at 173.6 mg/L (82-fold over the starting strain). This advances sustainable fragrance supply for food, beverage, and cosmetics with a modular strategy generalizable to other terpenoids.
Impact: Provides a scalable, sustainable route to a high-value cosmetic fragrance via state-of-the-art synthetic biology, reducing reliance on variable plant sources. The modular engineering framework can seed broader terpenoid biomanufacturing.
Clinical Implications: While not a clinical trial, this work can stabilize fragrance ingredient supply chains for dermatologic and cosmetic formulations, potentially improving consistency, cost, and sustainability of topical products.
Key Findings
- CRISPR/Cas9-enabled introduction of (+)-valencene synthase yielded an initial 2.1 mg/L producer strain.
- Fusion of farnesyl pyrophosphate synthase to valencene synthase increased titers to 8.2 mg/L; overexpression of IDI1, tHMG1, ERG12, and ERG19 further boosted yield by 27%.
- Promoter deletion of ERG9 and optimization to three copies of the fusion construct achieved 173.6 mg/L in shake flasks, an 82-fold increase over the starting strain.
Methodological Strengths
- Stepwise, rational pathway engineering including enzyme fusion, flux control, and promoter modulation.
- Quantitative reporting of titers with clear benchmarking against starting strain and incremental gains.
Limitations
- Results are at shake-flask scale; bioreactor optimization and downstream processing not reported.
- Productivity, yield on substrate, and cost models versus plant extraction are not analyzed.
Future Directions: Scale-up in bioreactors, process intensification, pathway balancing for higher yields, and techno-economic/life-cycle analyses compared with agricultural sourcing.
BACKGROUND: Sesquiterpene ( +)-valencene is a characteristic aroma component from sweet orange fruit, which has a variety of biological activities and is widely used in industrial manufacturing of food, beverage and cosmetics industries. However, at present, the content in plant sources is low, and its yield and quality would be influenced by weather and land, which limit the supply of ( +)-valencene. The rapid development of synthetic biology has accelerated the construction of microbial cell factories and provided an effective alternative method for the production of natural products. RESULTS: In this study, we first introduced the ( +)-valencene synthase into Komagataella phaffii by CRISPR/Cas9 system, and successfully constructed a ( +)-valencene producer with the initial yield of 2.1 mg/L. Subsequently, the ( +)-valencene yield was increased to 8.2 mg/L by fusing farnesyl pyrophosphate synthase with ( +)-valencene synthase using the selected ligation linker. High expression of key genes IDI1, tHMG1, ERG12 and ERG19 enhanced metabolic flux of MVA pathway, and the yield of ( +)-valencene was further increased by 27%. Besides, in-situ deletion of the promoter of ERG9 increased the yield of ( +)-valencene to 48.1 mg/L. Finally, we optimized the copy number of farnesyl pyrophosphate synthase and ( +)-valencene synthase fusion protein, and when the copy number reached three, the yield of ( +)-valencene achieved 173.6 mg/L in shake flask level, which was 82-fold higher than that of the starting strain CaVAL1. CONCLUSIONS: The results obtained here suggest that K. phaffii has the potential to efficiently synthesize other terpenoids.
2. Is There Scientific Evidence on the Practice of Rib Resection or Remodeling for Body Contouring Purposes?-A Systematic Review.
This PRISMA-compliant review of 12 studies finds heterogeneous techniques and outcomes, with rib resection carrying notable risks (e.g., pneumothorax, chronic pain) and rib remodeling showing fewer complications. However, the absence of randomized trials and long-term follow-up limits definitive conclusions, underscoring the need for high-quality studies to guide practice.
Impact: Addresses a fast-growing but controversial cosmetic procedure, providing evidence synthesis that may temper practice and prioritize patient safety.
Clinical Implications: Clinicians should counsel patients on the nontrivial risks and evidence gaps for rib resection; rib remodeling may be considered when indicated, with careful selection and standardized outcome tracking.
Key Findings
- Across 12 studies, techniques and outcomes were heterogeneous with variable patient selection and endpoints.
- Rib resection was associated with complications including pneumothorax and chronic pain; rib remodeling (e.g., green-stick fractures, shaving) showed fewer reported complications.
- Long-term safety and efficacy data and randomized clinical trials are lacking, precluding definitive recommendations.
Methodological Strengths
- PRISMA-compliant systematic search and selection.
- Risk of bias assessed with ROBINS-I.
Limitations
- Underlying evidence consists mostly of observational studies with heterogeneity.
- No pooled meta-analysis due to variability; long-term follow-up sparse.
Future Directions: Prospective registries and randomized trials comparing rib resection vs. remodeling with standardized outcomes (waist metrics, pulmonary function, pain, satisfaction) and long-term safety surveillance.
INTRODUCTION: Rib resection and remodeling have gained attention as cosmetic procedures to enhance body contours, particularly waist-to-hip ratio. Historically, rib resection has been used for medical reasons; however, plastic surgeons have recently adopted it for aesthetic purposes. However, concerns remain regarding the safety and effectiveness of the procedure, particularly due to the potential for complications, such as pneumothorax, chronic pain, and impaired respiratory function. This systematic review aimed to assess the existing evidence on rib resection or remodeling for body contouring. METHODS: A systematic review was conducted following PRISMA guidelines. Databases including PubMed, EMBASE, Cochrane, and others were searched for studies involving rib resection or remodeling for aesthetic purposes. Studies were selected based on predefined inclusion criteria, including adult patients and outcomes related to waist circumference reduction, adverse events, and patient satisfaction. Risk of bias was assessed using the ROBINS-I tool. RESULTS: This review included 12 studies that revealed variability in techniques, patient selection, and outcomes. Rib resection was associated with significant risks such as pneumothorax and chronic pain; however, newer rib remodeling techniques, such as green-stick fractures and rib shaving, showed fewer complications. Despite promising results in some cases, the lack of long-term studies and randomized clinical trials limits the ability to draw definitive conclusions regarding the efficacy and safety of these procedures. CONCLUSION: Rib remodeling appears to offer a less invasive alternative to full-rib resection, with a reduced risk of complications. However, the current literature is insufficient to provide conclusive evidence regarding the long-term safety and efficacy of these procedures. Further high-quality studies, including randomized trials, are needed to inform surgical practices and patient decision-making regarding rib-based body contouring. LEVEL OF EVIDENCE I: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
3. Evaluation and Comparison of the Efficacy and Safety of Erbium YAG Laser Along With Normal Saline vs. Its Combination With Stromal Vascular Fraction (SVF) and Platelet-Rich Plasma (PRP) in the Treatment of Striae Distensae: A Double-Blind Randomized Clinical Trial.
In a double-blind split-lesion RCT (12 patients, 36 lesions), Er:YAG laser combined with SVF significantly outperformed PRP and saline in improving epidermal/dermal density and thickness measures, with the highest patient and physician satisfaction at 3 months and no significant complications. PRP also improved dermal and total density versus saline.
Impact: Demonstrates a regenerative adjunct (SVF) that measurably augments laser outcomes for striae distensae, informing protocol design for a challenging cosmetic condition.
Clinical Implications: Consider combining SVF with Er:YAG laser for striae distensae to enhance structural and biomechanical outcomes; larger, multi-session trials are warranted to confirm durability and generalizability.
Key Findings
- SVF + Er:YAG significantly increased epidermal density (45.95 to 51.19; p=0.001) and outperformed PRP and saline in multiple thickness and density metrics.
- All groups improved in thickness indices (complete, epidermal, dermal) and R5 cutometer, indicating laser benefit; PRP exceeded saline in dermal/total density.
- Patient and physician satisfaction were highest in the SVF group (p=0.001), with no significant post-treatment complications reported.
Methodological Strengths
- Double-blind randomized split-lesion design controls for patient-level confounders.
- Objective multimodal biometric assessments with trial registration (IRCT20200127046282N14).
Limitations
- Small sample size (12 patients) and single-session treatment limit generalizability.
- Short follow-up (3 months) without histologic correlation or long-term durability data.
Future Directions: Larger, multi-center trials with multiple sessions, longer follow-up, standardized PROMs, and histologic endpoints to validate efficacy and durability.
BACKGROUND: There is no definitive solution for the treatment of striae distensae (SD), and effectiveness of each treatment method remains controversial. We aimed to investigate and compare the efficacy of the combination of Erbium YAG (Er:YAG) laser and stromal vascular fraction (SVF), the combination of Er:YAG laser and platelet-rich plasma (PRP) and Er:YAG laser plus saline in the treatment of SD. MATERIALS AND METHODS: In 12 participating patients with at least three lesions (36 lesions in total), each lesion was treated with an Er:YAG laser. SVF was randomly injected intradermally for the first lesion, PRP for the second lesion, and normal saline as placebo for the third lesion. Treatment duration was one session, and the safety and efficacy of the treatment was assessed 3 months later using the following items: evaluation of biometric parameters including corneometery, erythema, melanin, tewametery, color, cutometery, complete thickness, epidermal thickness, dermal thickness, complete density, epidermal density, and dermal density; assessment of patient and physician satisfaction using Likert score; and recording of adverse effects of treatment. RESULTS: The study involved 12 patients (evaluating 36 lesions in total), predominantly women (83%), with an average age of 39.16 years. The analysis revealed significant improvements in biometric indices, including complete thickness, epidermal thickness, dermal thickness, and R5 cutometer readings across all groups after the intervention. Notably, the SVF and PRP groups showed statistically significant enhancements in dermal and complete density compared to the placebo group. The SVF group demonstrated a significant increase in epidermal density (from 45.95 to 51.19, p = 0.001), unlike the PRP and placebo groups which showed nonsignificant changes. Comparing the average changes in biometric factors, the SVF group exhibited significantly greater increases in complete thickness, dermal thickness, complete density, epidermal density, and dermal density than the other groups. Both patient and physician satisfaction scores were highest in the SVF group (p = 0.001), with no significant posttreatment complications reported. CONCLUSION: Our results showed that the combination of Er:YAG laser and SVF injection could be considered an effective and safe treatment method in the treatment of SD. TRIAL REGISTRATION: IRCT20200127046282N14.