Daily Cosmetic Research Analysis
Three cosmetic-surgery–relevant studies stand out today: a surgeon survey links prior collagen biostimulators/threads to increased difficulty and complications in subsequent facelifts; a technical report introduces a pedicled deep temporalis muscle flap to enable safe reconstruction after endoscopic transorbital skull base surgery with improved cosmetic outcomes; and a subbrow blepharoplasty case series in Caucasian patients shows high satisfaction and low complication rates.
Summary
Three cosmetic-surgery–relevant studies stand out today: a surgeon survey links prior collagen biostimulators/threads to increased difficulty and complications in subsequent facelifts; a technical report introduces a pedicled deep temporalis muscle flap to enable safe reconstruction after endoscopic transorbital skull base surgery with improved cosmetic outcomes; and a subbrow blepharoplasty case series in Caucasian patients shows high satisfaction and low complication rates.
Research Themes
- Impact of biostimulators and threads on subsequent facelift surgery
- Minimally invasive skull base surgery with improved cosmetic reconstruction
- Outcomes of subbrow blepharoplasty for brow ptosis
Selected Articles
1. The Pedicled Deep Temporalis Muscle Flap in Endoscopic Transorbital Approach: How I Do It.
The authors describe a reconstruction method using a pedicled deep temporalis muscle flap to support the endoscopic transorbital skull base approach, emphasizing reduced morbidity and improved cosmetic outcomes. Both preclinical and clinical experience support feasibility and safety, suggesting broader adoption.
Impact: Introduces a practical, reconstructive solution that can expand indications for minimally invasive skull base surgery while maintaining cosmetic outcomes.
Clinical Implications: For skull base cases approached transorbitally, surgeons can consider a pedicled deep temporalis muscle flap to reinforce reconstruction, potentially reducing morbidity and optimizing cosmetic results.
Key Findings
- Endoscopic transorbital approach (TOA) can reduce morbidity and improve cosmetic outcomes compared with open techniques.
- A pedicled deep temporalis muscle flap is introduced as a novel reconstruction option tailored to TOA.
- Preclinical and clinical experience support feasibility and safety, indicating potential for broader adoption.
Methodological Strengths
- Combines preclinical and clinical implementation to demonstrate feasibility.
- Focus on reconstructive detail directly applicable to surgical practice.
Limitations
- Lack of comparative or randomized data versus alternative reconstructions.
- Unspecified sample size and limited long-term functional and cosmetic outcome data.
Future Directions: Prospective comparative studies with standardized cosmetic and functional endpoints and long-term follow-up.
2. Assessment of the Possible Impacts of Collagen Biostimulators on Surgical Facelift.
In a survey of 63 facial surgeons, prior collagen biostimulators and threads were commonly perceived to delay or complicate facelift surgery, with higher reported dissection difficulty, skin irregularities, and prolonged inflammation. Many surgeons modified their approach, particularly when fibrosis was present, and procedures within 6 months of biostimulator placement were considered more challenging.
Impact: Addresses a rapidly growing clinical scenario with direct implications for safety, operative planning, and patient counseling in aesthetic surgery.
Clinical Implications: Obtain detailed histories of biostimulators/threads, anticipate fibrosis and dissection challenges, consider longer operative time, and discuss elevated complication risks. When feasible, consider delaying facelift beyond 6 months after biostimulator placement and adjust technique accordingly.
Key Findings
- 59% of surgeons believed biostimulators could delay facelift surgery.
- 84.4% reported increased complication rates; common issues included dissection difficulty (91.8%), postoperative skin irregularities (73.3%), and prolonged inflammation (57.4%).
- 50.8% observed longer operative times; 43.8% modified surgical approach, especially with fibrosis.
- Type of biostimulator influenced difficulty (97%); intraoperative recognition was highest for threads (76.6%) and CaHA (57.8%).
- Procedures performed within six months of biostimulator use were perceived as more challenging.
Methodological Strengths
- Includes a multi-specialty cohort of facial surgeons reflecting real-world practice.
- Quantifies specific operative challenges and complications with itemized frequencies.
Limitations
- Survey-based perceptions may be subject to recall and selection bias; no patient-level outcomes.
- No standardized definitions or time-to-event analyses; causality cannot be inferred.
Future Directions: Prospective registries and controlled studies to define timing, risk stratification, imaging/ultrasound mapping, and technique modifications for facelift after biostimulators.
3. Subbrow blepharoplasty for mild and moderate brow ptosis in Caucasians.
In 33 Caucasian patients with mild to moderate brow ptosis, subbrow blepharoplasty achieved high satisfaction (75.7% reporting significant/considerable improvement) with minimal early complications and rare visible scarring at 6 months. No sensory deficits, lagophthalmos, or significant brow descent were observed; visual field metrics improved in function-focused cases.
Impact: Provides focused outcomes data for subbrow blepharoplasty in a Western population, supporting its dual functional and cosmetic value and informing patient selection and counseling.
Clinical Implications: Subbrow blepharoplasty can be considered for Caucasian patients with brow ptosis and lateral hooding seeking functional visual field improvement and cosmetic rejuvenation, with low risk of visible scarring at 6 months when appropriately planned and executed.
Key Findings
- High patient satisfaction, with 75.7% reporting significant or considerable improvement at 6 months.
- Visual field metrics improved in cases with functional emphasis.
- Early complications were minimal (transient redness/swelling), and visible scarring at 6 months was rare.
- No cases of sensory deficits, lagophthalmos, or significant brow descent were observed.
Methodological Strengths
- Prospective assessment with standardized 6-month follow-up.
- Patient-centered outcomes including satisfaction and functional visual field metrics.
Limitations
- Single-arm case series without a comparator group and small sample size.
- Limited to Caucasian patients; generalizability to other ethnicities is uncertain.
Future Directions: Randomized or matched comparative studies versus alternative approaches (e.g., direct brow lift, upper blepharoplasty) with longer-term aesthetic and functional endpoints.