Daily Cosmetic Research Analysis
Today's most impactful studies in aesthetic medicine span perioperative risk, scar optimization, and minimally invasive therapy for vascular anomalies. A large cohort links any nicotine exposure (including e‑cigarettes and NRT) to markedly higher wound complications after cosmetic surgery; a prospective split‑scar study identifies polydioxanone as superior for long‑term scar aesthetics versus polyester or polyglactin; and a PRISMA‑guided systematic review supports bleomycin electrosclerotherapy
Summary
Today's most impactful studies in aesthetic medicine span perioperative risk, scar optimization, and minimally invasive therapy for vascular anomalies. A large cohort links any nicotine exposure (including e‑cigarettes and NRT) to markedly higher wound complications after cosmetic surgery; a prospective split‑scar study identifies polydioxanone as superior for long‑term scar aesthetics versus polyester or polyglactin; and a PRISMA‑guided systematic review supports bleomycin electrosclerotherapy (B)EST as a promising option for venous/lymphatic malformations and vascular tumors, with manageable safety signals.
Research Themes
- Perioperative risk modification in aesthetic surgery
- Scar optimization via suture selection and tension control
- Minimally invasive therapy for vascular anomalies (electrosclerotherapy)
Selected Articles
1. The Scar-suppressing Efficiency of Three Sutures with Different Degradation Rates: A Prospective Split-Scar Study.
In a prospective, randomized split-scar design, polydioxanone yielded superior 6‑month aesthetic outcomes versus polyester, while polyglactin performed worst at all time points. Parallel murine experiments suggested polyester induces greater local inflammation, offsetting benefits of tension reduction.
Impact: Identifies a practical suture choice to optimize aesthetic scarring and integrates mechanistic evidence linking suture material to inflammation.
Clinical Implications: For intradermal closures where scar aesthetics matter, prioritize polydioxanone to maintain prolonged tension reduction with lower inflammatory drive; avoid polyester for long‑term scar suppression despite initial tension maintenance.
Key Findings
- Polyglactin had the worst scar aesthetics at 1, 3, and 6 months.
- Polydioxanone and polyester were similar at 1–3 months, but polydioxanone was superior at 6 months.
- Murine model showed polyester provoked enhanced local inflammation, counteracting tension-reduction benefits.
Methodological Strengths
- Prospective split-scar, within-subject comparison with randomized segment assignment
- Translational approach combining human outcomes with mechanistic murine validation
Limitations
- Sample size and blinding procedures were not reported in the abstract
- Single incision location; follow-up limited to 6 months; generalizability across body sites uncertain
Future Directions: Multicenter, blinded, adequately powered trials across anatomical sites with ≥12‑month follow-up and human tissue inflammatory profiling to optimize suture selection algorithms.
2. Nicotine Exposure (Including NRT) and Wound Complications in Plastic Surgery: Single-Institution Cohort, 1992-2024.
Among 15,172 cosmetic surgery patients, preoperative nicotine exposure (including e‑cigarettes and NRT) was associated with markedly higher wound complications (15.2% vs 3.8%), with adjusted odds ratios 5.51–13.52 across delivery methods. Findings support perioperative counseling for complete nicotine abstinence.
Impact: Large, methodologically controlled cohort quantifies risk across all modern nicotine delivery methods, directly informing perioperative risk counseling and policy.
Clinical Implications: Implement universal preoperative nicotine screening and counsel complete abstinence irrespective of delivery method (including e‑cigarettes and NRT) before elective aesthetic procedures.
Key Findings
- Wound complications: 15.2% in nicotine users vs 3.8% in non-users.
- Adjusted odds ratios for complications ranged 5.51–13.52 across nicotine delivery methods.
- Complication profiles were similar across delivery methods; direct method-to-method comparisons were not performed.
Methodological Strengths
- Very large cohort with exclusion of major clinical confounders
- Multivariable logistic regression adjusted for age and procedure type; inclusion of multiple nicotine delivery methods
Limitations
- Retrospective design with self-reported nicotine exposure; no biochemical verification
- No head-to-head statistical comparison between delivery methods; single-institution data
Future Directions: Prospective studies with biochemical verification (e.g., cotinine), dose–response evaluation, cessation timing thresholds, and inclusion of broader comorbidity profiles to refine risk models.
3. Simply the (B)EST: what the interventionalist needs to know about (bleomycin) electrosclerotherapy for vascular anomalies.
(B)EST, combining electroporation with intralesional bleomycin, yielded high response rates across 566 patients, including 65–100% complete responses in vascular tumors and up to 100% lesion/symptom reduction in malformations. Safety signals were mainly local (e.g., ulcerations, hyperpigmentation), underscoring the need for standardized protocols and long-term surveillance.
Impact: Synthesizes multi-study evidence for a relatively new, tissue-preserving intervention in difficult vascular anomalies, guiding procedural dosing and risk counseling.
Clinical Implications: Consider (B)EST for slow-flow malformations and select vascular tumors refractory to standard therapy, with counseling on local adverse effects (ulceration, hyperpigmentation) and cumulative bleomycin dose monitoring (e.g., pulmonary risk).
Key Findings
- Across 15 studies and 566 patients, complete response in vascular tumors was 65–100%.
- Lesion volume/symptom reduction in vascular malformations ranged 54.9–100%, mainly in slow-flow lesions.
- Adverse events were mostly local/self-limiting (CIRSE 1a–2); ulcerations (CIRSE 3a) mainly in tumors; hyperpigmentation was frequent but often partially resolved.
Methodological Strengths
- PRISMA-guided systematic review across multiple databases with explicit inclusion/exclusion
- Quantitative synthesis of efficacy and adverse events with procedural dose ranges
Limitations
- Absence of controlled trials; heterogeneity in lesion types, dosing, endpoints, and follow-up
- Potential publication bias; limited long-term outcome data
Future Directions: Prospective, controlled comparative studies to standardize dosing, optimize electroporation parameters per VA subtype, and define long-term outcomes including cosmetic sequelae.