Daily Cosmetic Research Analysis
A randomized trial in Plastic and reconstructive surgery shows a semi-endoscopic trans-axillary approach for breast augmentation reduces key complications versus a blind technique. A mechanistic study links common cosmetic UV filters to disrupted neural lineage commitment via WNT signaling, and a prospective cohort study finds bikini line sleeve gastrectomy improves scar satisfaction without sacrificing weight-loss efficacy.
Summary
A randomized trial in Plastic and reconstructive surgery shows a semi-endoscopic trans-axillary approach for breast augmentation reduces key complications versus a blind technique. A mechanistic study links common cosmetic UV filters to disrupted neural lineage commitment via WNT signaling, and a prospective cohort study finds bikini line sleeve gastrectomy improves scar satisfaction without sacrificing weight-loss efficacy.
Research Themes
- Optimization of aesthetic surgical techniques
- Safety and toxicology of cosmetic ingredients
- Minimally invasive access routes and scar outcomes
Selected Articles
1. Trans-axillary breast augmentation: a Randomized Controlled Trial comparing a new semi-endoscopic video-assisted technique versus the blind technique.
In a randomized trial of 118 patients, a semi-endoscopic video-assisted trans-axillary approach for breast augmentation reduced deformities (bottoming out, double bubble, animation deformity) and capsular contracture versus a blind approach, albeit with longer operative time. Findings support endoscopic assistance to improve aesthetic and reconstructive outcomes while maintaining acceptable efficiency.
Impact: This is a randomized comparative evaluation of a widely used cosmetic breast augmentation access, demonstrating clinically meaningful reductions in complications with a practical, scalable modification.
Clinical Implications: Endoscopic assistance can be integrated into trans-axillary augmentation to reduce asymmetry, animation deformity, and capsular contracture, with counseling on modestly longer operative times and potential learning curve.
Key Findings
- Randomization of 118 patients to blind versus semi-endoscopic video-assisted trans-axillary augmentation (2019–2022).
- Semi-endoscopic approach reduced asymmetries/deformities (bottoming out, double bubble, animation deformity).
- Lower capsular contracture incidence observed with endoscopic assistance.
- Operative time increased with the semi-endoscopic technique.
Methodological Strengths
- Randomized controlled design with direct head-to-head comparison of techniques.
- Clinically relevant complication endpoints aligned with aesthetic outcomes.
Limitations
- Single-center trial with no blinding reported.
- Follow-up duration and patient-reported outcomes were not detailed in the abstract.
Future Directions: Multicenter CONSORT-compliant RCTs with standardized follow-up, cost-effectiveness analyses, and assessments of learning curves and patient-reported outcomes.
BACKGROUND: The pursuit of optimal aesthetic outcomes in breast surgery has led to the evolution of various surgical techniques. The trans-axillary approach for breast surgery leads to a high patient satisfaction due to its aesthetic advantage of avoiding visible scars on the breast. [1] This approach was firstly described by Hoechler in 1973.[2]It is particularly used in procedures such as breast augmentation and more recently in reconstructive surgery after breast cancer, where achieving an optimal cosmetic outcome is crucial. The aim of our study is to compare the trans-axillary blind approach with our new "semi-endoscopic" video-assisted trans-axillary approach analyzing the benefits and limitations of each method. METHODS: A total of 118 patients were randomized to either the trans-axillary blind approach or the semi-endoscopic video-assisted trans-axillary approach for breast augmentation, from April 2019 to December 2022. RESULTS: The results indicate that the semi-endoscopic video-assisted approach was associated with a lower incidence of complications such as asymmetries, attributed to bottoming out, double bubble and breast animation deformity, as well as capsular contracture even if it requires longer operative times. CONCLUSIONS: This randomized trial shows the advantages and limitations of each technique, highlighting how the endoscopic assistance could significantly help improving surgical outcomes while maintaining an acceptable surgical time.
2. Environmental UV filters threaten human neurodevelopment: Disruption of central and peripheral nervous system lineage commitment via WNT signaling dysregulation.
Using hESC differentiation models, representative UV filters (BP-3, UV-328, BEMT) skewed CNS/PNS lineage commitment by dysregulating WNT signaling. UV-328 at 10 nM impaired neural crest cell proliferation/migration by preventing E-cadherin downregulation, and multiple UVFs drove aberrant midbrain patterning while suppressing dopaminergic specification (TH).
Impact: Identifies a mechanistic link between widely used cosmetic UV filters and human neurodevelopmental risk via WNT pathway disruption, informing risk assessment and regulatory policy.
Clinical Implications: While preclinical, data support counseling to minimize UVF exposure during pregnancy and lactation and motivate regulatory review of UVFs with high bioaccumulation, alongside exploration of safer alternatives.
Key Findings
- UV-328 disrupted PNS development by inhibiting neural crest cell proliferation and migration at 10 nM via blocking E-cadherin downregulation.
- BP-3, UV-328, and BEMT upregulated midbrain markers (FOXA2, LMX1A, CORIN, OTX2, EN1) but downregulated TH, impairing dopaminergic neuron specification.
- Mechanistic implication of WNT signaling dysregulation in UVF-induced developmental neurotoxicity.
Methodological Strengths
- Human embryonic stem cell models enabling parallel CNS and PNS lineage tracking.
- Multi-chemical evaluation with pathway-level mechanistic readouts.
Limitations
- In vitro models without in vivo validation or epidemiological correlation.
- Limited concentration ranges and mixture effects not fully characterized.
Future Directions: Validate findings in animal models and prospective birth cohorts, quantify human-relevant exposure-response, and assess safer UV filter substitutions in consumer products.
Ultraviolet filters (UVFs) are extensively employed in personal care products, coatings, and food packaging materials, raising increasing concerns regarding developmental vulnerability due to their frequent detection in breast milk and amniotic fluid. This study systematically evaluated the developmental neurotoxicity of representative benzophenone, benzotriazole, and triazine UVFs using human embryonic stem cell (hESC) differentiation models. The dynamic trajectories of both central and peripheral nervous system (CNS and PNS) development were tracked, revealing that UVFs induced an imbalanced CNS/PNS lineage commitment, with UV-328 particularly causing disruptions through direct modulation of the WNT signaling pathway. In the PNS, 10 nM UV-328 significantly inhibited proliferation and migration in neural crest cells by preventing E-cadherin downregulation. Conversely, in the CNS, BP-3, UV-328, and BEMT promoted aberrant midbrain differentiation by upregulating FOXA2, LMX1A, CORIN, OTX2, and EN1 expression, while impairing late-stage dopaminergic neuron specification by downregulating TH. These findings elucidate the molecular mechanisms underlying benzophenone, benzotriazole, and triazine UVF-induced developmental neurotoxicity and underscore the critical need to evaluate the environmental impact and safety of UVFs during sensitive developmental stages. Additionally, this study highlights the potential links between UVF exposure and neurological disorders, emphasizing the importance of continued investigation in this field to inform environmental policies and public health strategies.
3. Three-Port Bikini Line vs. Conventional Sleeve Gastrectomy: A Prospective Cohort Study on Safety, Efficacy, and Aesthetic Outcomes.
In a 24-month prospective cohort (n=85), three-port bikini line sleeve gastrectomy achieved significantly higher scar satisfaction than conventional LSG, while maintaining comparable excess weight loss at 6–24 months and low complication rates. Lower abdominal port placement posed modest ergonomic challenges but did not compromise safety.
Impact: Demonstrates that a cosmetically favorable access strategy in bariatric surgery preserves metabolic efficacy, informing shared decision-making for patients prioritizing scar outcomes.
Clinical Implications: Bikini line port placement can be offered to appropriately selected patients seeking improved scar concealment, with counseling about ergonomic nuances and equivalent weight-loss outcomes.
Key Findings
- Prospective cohort of 85 patients with 24-month follow-up comparing three-port BLSG (n=40) vs conventional LSG (n=45).
- No significant differences in excess weight loss at 6, 12, 18, and 24 months.
- BLSG yielded significantly higher patient satisfaction with scar appearance.
- Low complication rates in BLSG despite modest ergonomic challenges of lower abdominal access.
Methodological Strengths
- Prospective design with 24-month follow-up and predefined outcomes.
- Comparative analysis including both clinical efficacy and aesthetic satisfaction.
Limitations
- Nonrandomized allocation based on anthropometrics introduces selection bias.
- Single-center, modest sample size limits generalizability.
Future Directions: Multicenter randomized trials to validate aesthetic and metabolic outcomes, ergonomic optimization, and assessment in higher BMI/abdominal girth populations.
BACKGROUND: Sleeve gastrectomy becomes increasingly popular worldwide, with ongoing efforts to minimize abdominal trauma and postoperative pain and enhance aesthetic outcomes. Bikini line sleeve gastrectomy (BLSG) is a novel technique that achieves improved cosmetic results while maintaining the fundamental goal of effective weight loss. We aim to evaluate the feasibility and safety of three-port bikini sleeve gastrectomy in achieving both aesthetic satisfaction and weight reduction. METHODS: A prospective cohort study included 85 patients who underwent laparoscopic sleeve gastrectomy between October 2018 and October 2019 at Ain Shams University Hospitals, with 24-month follow-up. Based on BMI and defined anthropometric criteria, patients were allocated to Group I (n = 40), who underwent laparoscopic bikini line sleeve gastrectomy (BLSG), while Group II (n = 45), who underwent conventional laparoscopic sleeve gastrectomy (LSG). Outcomes assessed included patient satisfaction with scar appearance, percentage of excess weight loss, and early and late postoperative complications. Statistical analyses used chi-square and t-tests, with significance at p < 0.05. RESULTS: There was no statistically significant difference in weight loss outcomes between groups at any of the measured time points (6, 12, 18, and 24 months). The bikini line sleeve gastrectomy group reported significantly higher satisfaction with scar appearance. Despite the modest ergonomic challenges of the lower abdominal access in the bikini group, BLSG demonstrated low complication rates, confirming its safety. CONCLUSIONS: In appropriately selected patients, three-port bikini line sleeve gastrectomy demonstrates a favourable safety profile and significantly enhances patient satisfaction while maintaining comparable clinical efficacy. Large multicentre randomized trials are warranted to further validate these outcomes. Key Points • In selected patients, three-port BLSG is reliable technique without compromising weight loss efficacy. • Three-port BLSG provides enhanced cosmetic satisfaction for patients prioritizing aesthetic outcomes. • With proper patient selection, the procedure can be safely integrated into routine practice • Future advancements in technique and instrumentation may broaden the application of three-port BLSG to patients with higher BMI and larger abdominal dimensions.