Daily Cosmetic Research Analysis
Evidence from a Level I meta-analysis suggests that subcuticular sutures yield superior scar appearance to tissue adhesives after thyroidectomy, albeit at the cost of longer closure time. A multicenter cohort links breast fibrosis after breast-conserving therapy to poorer health-related quality of life across multiple domains. A randomized, double-blind trial in young adults shows tooth whitening improves color short term, but psychosocial benefits depend on personality traits and may not persis
Summary
Evidence from a Level I meta-analysis suggests that subcuticular sutures yield superior scar appearance to tissue adhesives after thyroidectomy, albeit at the cost of longer closure time. A multicenter cohort links breast fibrosis after breast-conserving therapy to poorer health-related quality of life across multiple domains. A randomized, double-blind trial in young adults shows tooth whitening improves color short term, but psychosocial benefits depend on personality traits and may not persist at one year.
Research Themes
- Scar aesthetics and wound closure strategies
- Oncology survivorship, fibrosis, and quality of life
- Psychological determinants of cosmetic treatment outcomes
Selected Articles
1. Comparative Aesthetic Outcomes of Wound Closure Methods Following Thyroidectomy: A Systematic Review and Meta-Analysis.
Across 12 RCTs and 3 cohorts (n=1131), tissue adhesives produced worse observer-rated scar appearance than subcuticular sutures but enabled faster closure. Compared with staples, tissue adhesives improved the ability to shower. Patient-reported scar scores did not differ between adhesives and subcuticular sutures.
Impact: Level I evidence directly informs routine surgical closure choices to balance cosmetic quality versus efficiency after thyroidectomy.
Clinical Implications: Prefer subcuticular sutures when optimizing scar aesthetics is paramount; consider tissue adhesives for faster closure and earlier showering when workflow or patient preference prioritizes convenience.
Key Findings
- Observer Scar Assessment Scale (OSAS) favored subcuticular sutures over tissue adhesives (MD 4.50, 95% CI 1.83–7.16).
- No significant difference in Patient Scar Assessment Scale (PSAS) between tissue adhesives and subcuticular sutures.
- Tissue adhesives reduced wound closure time versus subcuticular sutures (MD −3.33 minutes, 95% CI −5.88 to −0.78).
- Compared to staples, tissue adhesives markedly improved the rate of excellent ability to shower (RR 5.66, 95% CI 1.87–17.13).
Methodological Strengths
- Included 12 randomized controlled trials complemented by cohort data with standardized outcome scales (POSAS).
- Predefined meta-analytic methods with effect size estimates and confidence intervals across multiple endpoints.
Limitations
- Heterogeneity in closure techniques, operator experience, and follow-up timing across studies.
- Variable reporting of patient-centered outcomes and potential publication bias.
Future Directions: Head-to-head, CONSORT-compliant RCTs with standardized long-term scar assessment and patient-reported outcomes to optimize protocols for different patient subgroups.
BACKGROUND: Thyroidectomy is among the most common surgical procedures worldwide. Despite advancements in surgical techniques, cosmetic outcomes following thyroidectomy continue to be a major concern. One of the key factors that could influence postoperative results is the method of wound closure; however, there is no established consensus on the optimal wound closure approach. Our study aims to compare the cosmetic outcomes of the available wound closure methods in patients undergoing thyroidectomy. METHODS: We conducted an extensive search across four databases until February 2025. We included all studies that evaluate the cosmetic outcomes of various wound closure methods after thyroidectomy. Our primary outcomes were the Patient and Observer Scar Assessment Scales (POSAS), operative time required for wound closure, and the ability to shower. Continuous outcomes were analyzed as mean differences (MD) with their 95% confidence intervals (CI), while dichotomous variables were pooled as risk ratios (RR) with 95% CI. RESULTS: Our review included twelve randomized controlled trials and three observational cohort studies involving 1131 patients who underwent thyroidectomy. The pooled analysis revealed higher OSAS in the tissue adhesive group compared to the subcuticular suture group (MD=4.50, 95% CI [1.83 to 7.16], p=0.001). However, there was no significant difference between the two approaches regarding PSAS scores (MD=4.16, 95% CI [ -4.18 to 12.51], p=0.33). Additionally, tissue adhesives were linked to a shorter wound closure time compared to subcuticular sutures (MD= -3.33, 95% CI [ -5.88 to -0.78], p=0.01). When compared to staples, tissue adhesives exhibited higher rates of excellent ability to shower (RR=5.66, 95% CI [1.87 to 17.13], p=0.001). CONCLUSION: Tissue adhesive is associated with poorer scar appearance but faster wound closure when compared to subcuticular sutures. Moreover, tissue adhesive also showed a better ability to shower compared to staples. 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 .
2. The association between breast fibrosis, cosmetic outcomes, and long-term health-related quality of life after breast-conserving therapy: a multicenter cross-sectional observational cohort study.
In 775 women a median of 4 years after BCT, none/mild breast fibrosis correlated with better HRQoL across most domains, whereas moderate/severe fibrosis was linked to worse HRQoL and more locoregional symptoms and fatigue. Excellent/good cosmetic results were associated with better HRQoL in five of 18 domains.
Impact: Quantifies how fibrosis and cosmetic outcomes after BCT translate into long-term patient-reported quality of life, informing survivorship care priorities.
Clinical Implications: Proactive monitoring and mitigation of breast fibrosis should be integrated into survivorship care, with counseling on expected cosmetic outcomes and targeted rehabilitation to address locoregional symptoms and fatigue.
Key Findings
- None/mild fibrosis was associated with better HRQoL across nearly all domains except sexual functioning/enjoyment and physical/social functioning.
- Moderate/severe fibrosis correlated with increased locoregional symptoms and fatigue.
- Excellent/good cosmetic outcomes were linked to better HRQoL in 5 of 18 domains, but not to symptom domains.
- Objective tools (BCCT.core) and validated PRO instruments (BREAST-Q, EORTC QLQ-BR23/C30) captured associations robustly.
Methodological Strengths
- Large multicenter cohort with standardized fibrosis grading (CTCAE v5) and objective cosmetic analysis (BCCT.core).
- Use of validated patient-reported outcome instruments with multivariable adjustment for key confounders.
Limitations
- Cross-sectional design limits causal inference regarding fibrosis and HRQoL trajectories.
- Potential selection and information biases; heterogeneity in treatment techniques and adjuvant therapy details.
Future Directions: Prospective longitudinal studies to track fibrosis evolution, integrate imaging/biomarkers, and test interventions (e.g., radiotherapy planning, antifibrotics, rehabilitative protocols) to preserve HRQoL.
BACKGROUND: Breast fibrosis is a well-known late side-effect of breast-conserving therapy (BCT) and may lead to breast retraction, asymmetry, and pain. Since life expectancy of breast cancer patients has significantly improved in the past decades, cosmetic outcomes and health-related quality of life (HRQoL) have gained importance. This study aimed to investigate the association between breast fibrosis, cosmetic outcomes, and various HRQoL domains. METHODS: In this multicenter, cross-sectional, observational cohort (STARLINGS study), breast fibrosis was assessed (CTCAE version 5), breast photos were analyzed with BCCT.core software, and participants completed BREAST-Q, EORTC QLQ-BR23/C30, and 9-item cosmetic questionnaire. Associations between breast fibrosis and HRQoL and between cosmetic outcomes and HRQoL, were analyzed using multivariable linear regression, both unadjusted and adjusted for age, smoking and body mass index. RESULTS: A total of 775 patients treated between 2016 and 2020 were included, with median follow-up of 4 years. Compared to patients with moderate/severe breast fibrosis, patients with none/mild breast fibrosis reported better HRQoL on all domains, except Sexual Functioning, Sexual Enjoyment, and Physical and Social Functioning. Patients with excellent/good cosmetic outcomes reported better HRQoL than patients with fair/poor cosmetic outcomes on five out of 18 HRQoL domains, but not on any of the Symptoms domains. CONCLUSION: Our results indicate that breast fibrosis and unfavorable cosmetic outcomes are negatively associated with various HRQoL domains. Additionally, breast fibrosis is associated with locoregional symptoms and fatigue, whereas unfavorable cosmetic outcomes are not. This large multicenter study corroborates the interrelated nature of breast fibrosis, cosmetic outcomes, and HRQoL (ID: NCT05263362).
3. Effect of personality characteristics on perception of tooth whitening outcome in young adults in long-term: a randomised, double-blind, placebo controlled trial.
In a 50-participant randomized, double-blind, placebo-controlled trial, whitening improved tooth color short term and remained better than baseline at one year. Psychosocial benefits were transient and moderated by personality: lower neuroticism and higher perfectionism enhanced short-term gains, while higher conscientiousness supported longer-term benefits.
Impact: Highlights individualized psychological modifiers of cosmetic dental outcomes using a rigorous RCT design, guiding personalized counseling and expectation management.
Clinical Implications: Incorporate brief personality screening and expectation-setting into whitening consultations; consider maintenance plans and counseling for patients with higher neuroticism who may perceive relapse despite objective improvements.
Key Findings
- Light-activated whitening produced greater immediate color change than placebo and remained improved over baseline at 1 year.
- Short-term psychosocial benefits were observed in the active group but largely waned by one year.
- Lower neuroticism and higher perfectionism were linked to enhanced short-term benefits; higher conscientiousness correlated with more sustained long-term benefits.
- Participants had limited accuracy in perceiving objective color change, often noting perceived relapse.
Methodological Strengths
- Randomized, double-blind, placebo-controlled design with trial registration (NCT03380702).
- Objective spectrophotometric color measurement plus validated psychosocial and personality instruments with 1-year follow-up.
Limitations
- Small, single-center sample of young adults limits generalizability.
- Potential attrition and limited power for subgroup analyses of personality traits.
Future Directions: Larger, diverse RCTs integrating maintenance protocols and testing targeted psychoeducational interventions to sustain psychosocial benefits.
BACKGROUND: Tooth whitening is a popular cosmetic procedure; however, its perceived effectiveness and long-term psychosocial impact remain underexplored. This study investigated perceptions of tooth color change and the associated psychological and social effects over a one-year period, with particular attention to the role of individual personality traits. METHODS: Fifty participants aged 19 to 28 were randomly assigned to either an experimental group or a control group. The experimental group received a light-activated whitening gel, while the control group received an inactive gel. Evaluations were conducted at baseline, one week post-treatment, and one year post-treatment. Tooth color was measured using spectrophotometry. Standardized questionnaires were employed to assess psychosocial effects and personality traits. Data were analyzed using analysis of variance with Bonferroni post hoc tests and independent samples t-tests. RESULTS: The experimental group showed a significantly greater improvement in tooth color shortly after treatment compared to the control group. Although this improvement diminished over time, it remained above baseline levels at the one-year follow-up. In the short term, participants in the experimental group reported reduced psychological and social concerns, while the control group reported a decrease in psychological impact only. After one year, the experimental group experienced a return of psychosocial concerns, whereas the control group continued to report improvements. Personality traits influenced these outcomes: lower neuroticism and higher perfectionism were associated with enhanced short-term benefits, while higher conscientiousness was linked to more sustained long-term improvements. CONCLUSIONS: Participants demonstrated limited ability to accurately perceive improvements in tooth color, often noticing relapse over time. The psychosocial impact of tooth whitening was influenced by personality traits, highlighting the importance of a personalized approach in cosmetic dental treatments. Practitioners should consider individual psychological profiles when managing patient expectations. TRIAL REGISTRATION: This clinical trial was prospectively registered with ClinicalTrials.gov (Identifier NCT03380702) on December 21, 2017.