Daily Cosmetic Research Analysis

BACKGROUND: Our previous study demonstrated that prolonged tension reduction results in satisfactory scar suppression during modified intradermal suturing. The type of suture used in intradermal sutures is crucial for tension preservation, wherein suture degradation results in tension reduction. However, evidence revealing the optimal suture to confront local tension for a prolonged period of time is lacking. OBJECTIVE: To compare the aesthetic outcomes associated with three sutures: polyglactin acid and polydioxanone, which are absorbable sutures with tension-maintaining times of 1 and 3 months, respectively, and the nonabsorbable suture polyester. METHODS: We evenly divided a hypogastric incision into three segments before randomly stitching them with three different sutures. After 1, 3 and 6 months, the aesthetic outcomes of the scars brought by each suture were evaluated by scar assessment scales. RESULTS: Polyglactin acid had the worst aesthetic outcome at 1, 3 and 6 months. Polydioxanone and polyester had similar aesthetic outcomes at 1 and 3 months. However, at 6 months, polyester showed unsatisfying scar inhibition compared to that of polydioxanone. To explore the underlying mechanism, we repeated the above process in mice and found enhanced inflammation in tissues stitched using polyester. The inflammation neutralized the anti-scarring efficiency of reduced tension. CONCLUSION: Our study revealed that prolonged reduction in local tension plays an important role in inhibiting scarring, and the ability of sutures to induce local inflammation cannot be ignored. LEVEL OF EVIDENCE II: 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.

BACKGROUND: Plastic-surgery guidance recommends complete preoperative abstinence from all nicotine products. We evaluated whether preoperative nicotine exposure-across delivery methods including e‑cigarettes and NRT-was associated with postoperative wound complications in cosmetic surgery. METHODS: Single-institution retrospective cohort (July 1992-February 2024). We identified adults undergoing cosmetic procedures, classifying preoperative nicotine status (single delivery method for ≥2 months) and excluding major confounders (e.g., diabetes, peripheral vascular disease, corticosteroids, antineoplastic therapy, BMI>30). Primary outcome was any wound complication. Logistic regression adjusted for age and procedure type. RESULTS: Of 15,172 patients, 1,184 (7.8%) reported nicotine use. Any complication occurred in 15.2% of nicotine users vs 3.8% of non‑users. Adjusted odds of complication were higher for nicotine users (odds ratios across delivery categories 5.51-13.52). Complication profiles were similar across delivery methods; pre-specified head-to-head comparisons among methods were not performed. CONCLUSIONS: Preoperative nicotine exposure is associated with substantially higher postoperative wound‑complication risk in cosmetic surgery. Signals were consistent across delivery methods, supporting perioperative counseling that emphasizes complete nicotine abstinence in elective aesthetic procedures.

BACKGROUND: Vascular anomalies (VAs) require specialized multidisciplinary management. Bleomycin electrosclerotherapy (B)EST combines electroporation with intralesional bleomycin to enhance drug uptake while preserving surrounding tissue. Its role in treating VAs remains largely unexplored. OBJECTIVE: This systematic review evaluates the efficacy, safety, and procedural protocols of BEST in VA treatment. MATERIALS AND METHODS: Following PRISMA guidelines, a systematic search was conducted in PubMed, Web of Science, and Scopus. Inclusion criteria included peer-reviewed studies on (B)EST for VAs, excluding reviews, editorials, and animal studies. RESULTS: Among 1237 records, 15 studies met the inclusion criteria, published between 2012 and 2025, primarily from Europe (13/15). A total of 566 patients were treated, including 445 with vascular malformations and 121 with vascular tumors (Kaposi sarcoma, angiosarcoma). (B)EST was mainly applied to slow-flow malformations. Across VA types, lesion-volume or symptom reduction rate was high, with five studies each reporting a 100% rate. Complete response in vascular tumors ranged from 65 to 100%. Most studies followed current guidelines, with bleomycin doses between 200 and 10,000 IU per session. Adverse effects were primarily local and self-limiting (Cardiovascular and Interventional Radiological Society of Europe classification CIRSE 1a-2); ulcerations occurred mainly in vascular tumors (CIRSE 3a); and skin hyperpigmentation (CIRSE 1a) was observed frequently, often partially resolving over time. CONCLUSION: BEST shows promise for VA treatment, particularly venous and lymphatic malformations. While results suggest efficacy and safety, treatment heterogeneity and long-term outcomes require further investigation. Optimizing tailored protocols for each VA subtype and presentation is essential for defining (B)EST's role in VA management. KEY POINTS: Question What is the role and efficacy of (bleomycin) electrosclerotherapy (B)EST in managing vascular anomalies resistant to conventional treatments, including tumors and malformations? Findings (B)EST demonstrated significant efficacy, achieving 65-100% complete responses in vascular tumors and 54.9-100% lesion or symptom reduction in vascular malformations. Clinical relevance (B)EST offers an option for patients with treatment-resistant or recurrent vascular anomalies, improving symptom-related outcomes. This is tempered by the absence of controlled trials, the need for cumulative dose pulmonary monitoring and the potential cosmetic burden of hyperpigmentation.