Daily Cosmetic Research Analysis
Three studies shape cosmetic and reconstructive practice today: a large prospective study shows that automated, rule-based screening robustly identifies body dysmorphic disorder risk in aesthetic surgery candidates; a PRISMA-compliant systematic review of randomized trials supports adipose-derived therapies for improving wound healing, scars, and patient-reported outcomes; and a 60-case series demonstrates the safety, feasibility, and oncologic adequacy of a retroauricular robotic neck approach
Summary
Three studies shape cosmetic and reconstructive practice today: a large prospective study shows that automated, rule-based screening robustly identifies body dysmorphic disorder risk in aesthetic surgery candidates; a PRISMA-compliant systematic review of randomized trials supports adipose-derived therapies for improving wound healing, scars, and patient-reported outcomes; and a 60-case series demonstrates the safety, feasibility, and oncologic adequacy of a retroauricular robotic neck approach that preserves cosmesis.
Research Themes
- Automated psychological risk screening in aesthetic surgery
- Adipose-derived therapies for wound and scar management
- Cosmesis-preserving robotic approaches in head and neck surgery
Selected Articles
1. Prospective Evaluation of an Automated Rule-based Screening Tool for Body Dysmorphic Disorder in Aesthetic Surgery.
In a prospective cohort of 3722 elective cosmetic patients, an automated rule-based system integrating the BDDQ flagged 29.0% as at risk for body dysmorphic disorder. Only eight BDD-positive patients proceeded to surgery after psychological evaluation, and 75% reported high satisfaction at a mean 15.7-month follow-up. Inter-rater agreement for classification, exclusion, and satisfaction was strong (κ 0.79–0.86).
Impact: This study operationalizes scalable, structured psychological screening in aesthetic surgery with large-sample, prospective data and strong reliability metrics, directly addressing safety and satisfaction risks linked to undiagnosed BDD.
Clinical Implications: Standardizing preoperative BDD screening (e.g., BDDQ plus rule-based algorithms) with mental health referral pathways may reduce postoperative dissatisfaction and complications by identifying high-risk patients before surgery.
Key Findings
- 3722 cosmetic surgery candidates were screened; 29.02% tested positive for BDD risk.
- Only 8 BDD-positive patients underwent surgery after psychological evaluation; 75% reported high satisfaction at mean 15.7 months.
- Strong inter-rater reliability for BDD classification (κ=0.86), exclusion decisions (κ=0.81), and satisfaction ratings (κ=0.79).
Methodological Strengths
- Large prospective cohort with standardized online dynamic questionnaire incorporating BDDQ
- Robust inter-rater reliability metrics across key decision points
Limitations
- Single-center practice limits generalizability and may introduce selection bias
- Rule-based algorithm requires external validation and calibration across diverse settings
Future Directions: Conduct multicenter validation with diverse populations, evaluate impact on adverse events and medico-legal outcomes, and refine algorithm thresholds to balance sensitivity/specificity.
2. Adipose tissue and fat-derived products in wound, ulcer, and scar management: a systematic review.
Following PRISMA, this systematic review identified 16 randomized clinical trials showing that adipose-derived therapies improve wound healing, reduce pain, and enhance cosmetic appearance, satisfaction, and health-related quality of life versus conventional care. Efficacy was observed across various wound and scar types, with a favorable safety profile, though standardized protocols and larger RCTs are needed.
Impact: Aggregating randomized evidence, this review elevates adipose-derived therapies from promising innovations to interventions with comparative benefits on healing and patient-centered outcomes, guiding protocol development and trial design.
Clinical Implications: Clinicians may consider adipose-derived cell or tissue products as adjunctive options for complex wounds and scars within standardized protocols or clinical trials, counseling patients on potential benefits and current evidence limitations.
Key Findings
- Sixteen randomized clinical trials were included after screening 589 records.
- Adipose-derived therapies improved wound healing rates, reduced pain, and enhanced cosmetic appearance, patient satisfaction, and HRQoL versus conventional care.
- Favorable safety was observed across different wound and scar types.
Methodological Strengths
- PRISMA-compliant methodology with multi-database search and PROSPERO registration
- Focus on randomized clinical trials enhances internal validity
Limitations
- Heterogeneity of interventions, comparators, and outcome measures limits meta-analytic synthesis
- Long-term safety and durability data remain sparse
Future Directions: Develop standardized protocols, core outcome sets, and conduct adequately powered multicenter RCTs with long-term follow-up to confirm effectiveness and safety.
3. Robotic neck surgery using retroauricular approach - Experience of 60 procedures.
In a retrospective series of 60 retroauricular robotic neck procedures (32 patients), complication rates, hospital stay (median 2 days), lymph node yields, and 3-year regional control (94.7% in malignant cases) were comparable to conventional approaches. Conversion occurred in 6.7% of cases, and complications were mostly transient and conservatively managed, supporting safety and feasibility with improved scar concealment.
Impact: This experience report provides medium-term oncologic outcomes and operative metrics supporting a cosmesis-preserving retroauricular robotic route as a safe alternative comparable to conventional neck surgery.
Clinical Implications: For appropriately selected head and neck cases, a retroauricular robotic approach can achieve hidden scars without compromising oncologic adequacy or safety, warranting inclusion in surgical planning where expertise and resources exist.
Key Findings
- Sixty retroauricular robotic procedures were performed in 32 patients; 62.5% had malignant disease.
- Median hospital stay was 2 days; conversion to open approach occurred in 6.7% of cases.
- Three-year regional control in malignant cases was 94.7%, with acceptable complication profile and high lymph node yields.
Methodological Strengths
- Comprehensive operative and oncologic metrics including lymph node yields and multi-year follow-up
- Real-world series demonstrating feasibility across diverse neck procedures
Limitations
- Retrospective single-institution design with potential selection bias
- No direct comparator arm or patient-reported cosmetic outcome measures
Future Directions: Prospective comparative studies incorporating patient-reported aesthetic outcomes, cost-effectiveness analyses, and learning-curve assessments are needed.