Daily Cosmetic Research Analysis
Three studies with direct cosmetic relevance stood out: a large meta-analysis supports tranexamic acid as a safe, effective adjunct in facial aesthetic surgery; a real-world cohort links ultrahypofractionated whole-breast radiotherapy with simultaneous integrated boost to progressive cosmetic deterioration; and a case series demonstrates feasibility of combining latissimus dorsi flap with 3D-printed PEEK for chest wall reconstruction.
Summary
Three studies with direct cosmetic relevance stood out: a large meta-analysis supports tranexamic acid as a safe, effective adjunct in facial aesthetic surgery; a real-world cohort links ultrahypofractionated whole-breast radiotherapy with simultaneous integrated boost to progressive cosmetic deterioration; and a case series demonstrates feasibility of combining latissimus dorsi flap with 3D-printed PEEK for chest wall reconstruction.
Research Themes
- Antifibrinolytics to improve cosmetic surgical outcomes
- Radiotherapy fractionation and long-term cosmesis
- Patient-specific implants for reconstructive aesthetics
Selected Articles
1. Impact of tranexamic acid on postoperative complications and bleeding in facial aesthetic surgery: A systematic review and meta-analysis.
Across 22 studies (n=9005), tranexamic acid reduced intraoperative blood loss, postoperative edema, and ecchymosis in facial aesthetic surgery without significant systemic complications, irrespective of route (intravenous, topical, local). Benefits were particularly consistent in rhinoplasty and rhytidectomy, with decreased drain output and complications; combining TXA with local anesthetics improved hemostatic and anesthetic efficacy.
Impact: This meta-analysis consolidates multi-procedure evidence supporting TXA as an effective, safe adjunct that improves perioperative and cosmetic outcomes in facial aesthetic surgery.
Clinical Implications: Surgeons can incorporate TXA routinely in facial cosmetic procedures to reduce bleeding, edema, and ecchymosis, while developing protocols for standardized dosing and objective outcome grading.
Key Findings
- TXA significantly reduced intraoperative blood loss and postoperative edema and ecchymosis across facial aesthetic procedures.
- Benefits were consistent in rhinoplasty and rhytidectomy, including reduced drain output and fewer complications.
- No significant systemic complications were associated with intravenous, topical, or local infiltration routes.
- Combining TXA with local anesthetics enhanced hemostatic and anesthetic effects.
Methodological Strengths
- PRISMA-guided comprehensive search across multiple databases
- Large aggregated sample size (n=9005) across procedures
- Inclusion of multiple administration routes enabling route-agnostic conclusions
Limitations
- Heterogeneity in dosing regimens, timing, and outcome grading across studies
- Inclusion of observational studies may introduce bias compared with RCT-only syntheses
Future Directions: Prospective, standardized RCTs comparing dosing, timing, and routes with objective bruise/edema scales and patient-reported outcomes to formalize guidelines.
2. Cumulative Risk of Cosmetic Worsening Following Ultrahypofractionated Whole Breast Radiation Therapy With Simultaneous Integrated Boost: The Largest Real-World Data.
In 354 patients receiving uHFRT with SIB, cosmetic deterioration increased over time: 17% at 1 year and 34% at 2 years by physician rating, mirrored by patient-reported and BCCT.core assessments. Higher BMI, postmenopausal status, larger breast volume, oncoplastic surgery, regional nodal irradiation, and the FAST-FORWARD protocol independently associated with greater cosmetic worsening.
Impact: Provides the largest real-world evidence quantifying time-dependent cosmetic deterioration after uHFRT with SIB and identifies modifiable and non-modifiable risk factors.
Clinical Implications: Use these data to inform shared decision-making, risk stratification, and technique selection (e.g., boost planning, regional nodal irradiation) to preserve cosmesis; consider tailored fractionation or supportive measures for high-risk profiles.
Key Findings
- Cosmetic worsening rates were 17% at 1 year and 34% at 2 years by physician ratings; patient and BCCT.core assessments showed similar trends.
- Risk factors included higher BMI, postmenopausal status, larger breast volume, oncoplastic surgery, regional nodal irradiation, and FAST-FORWARD protocol use.
- All patients received SIB (33 Gy FAST; 32 Gy FAST-FORWARD) delivered with electrons or photons.
Methodological Strengths
- Largest real-world cohort (n=354) assessing cosmesis after uHFRT with SIB
- Triangulated cosmesis assessment (physician, patient, BCCT.core)
- Multivariable analysis to identify independent risk factors
Limitations
- Retrospective design with potential selection and information bias
- Median follow-up of 31.31 months limits long-term cosmetic assessment
- Technique heterogeneity (electrons vs photons; protocol differences)
Future Directions: Prospective studies comparing fractionation/boost strategies with standardized cosmetic endpoints and longer follow-up; evaluate interventions to mitigate cosmesis decline in high-risk patients.
3. Combined latissimus dorsi myocutaneous flap and 3D-printed PEEK implant for reconstruction of a large full-thickness chest wall defect: A retrospective study.
Among 12 patients, primary wound healing occurred in 11; one required debridement and resuturing for distal flap necrosis. Over 3–54 months of follow-up, PEEK implants showed excellent stability and integration, with LDMF contour compatibility. Functional outcomes (thoracic wall mobility, respiration, shoulder movement), pain, cosmetic appearance, and quality of life were consistently satisfactory.
Impact: Demonstrates feasibility of combining patient-specific 3D-printed PEEK with LDMF for complex chest wall reconstruction, suggesting a tailored approach that maintains structural support and aesthetics.
Clinical Implications: For large full-thickness chest wall defects post-tumor resection, combining LDMF with custom PEEK may provide durable structural stability and acceptable cosmesis; multidisciplinary planning and implant customization are key.
Key Findings
- Primary wound healing in 11/12 patients; one required secondary intervention due to distal flap necrosis.
- 3D-printed PEEK implants showed excellent stability, structural support, and tissue integration over 3–54 months.
- Functional outcomes, cosmetic appearance, and quality of life were consistently satisfactory.
Methodological Strengths
- Use of patient-specific 3D-printed PEEK implants with detailed surgical and functional follow-up
- Comprehensive reporting of complications and multi-domain outcomes (function, pain, cosmesis, QoL)
Limitations
- Small, single-center retrospective case series without a control group
- Potential selection bias and limited generalizability
Future Directions: Multicenter comparative cohorts or registries versus alternative materials/techniques, biomechanical and cost-effectiveness analyses, and standardized patient-reported outcome measures.