Daily Cosmetic Research Analysis
Analyzed 29 papers and selected 3 impactful papers.
Summary
Analyzed 29 papers and selected 3 impactful articles.
Selected Articles
1. The HIROSHIMA Study: A High-Volume, Institutional, Retrospective, Observational Study of Hidden Non-Incisional Suture Double Eyelid Surgery for Multivariate Analysis of Crease Loss.
In 513 consecutive non-incisional double eyelid cases, fixation method and eyelid puffiness were the dominant predictors of crease survival, whereas surgeon experience was not independently associated with crease loss. Continuous buried fixation yielded superior outcomes, particularly in patients with puffy eyelids.
Impact: This large cohort clarifies modifiable surgical factors driving long-term outcomes in a highly prevalent cosmetic procedure, directly informing technique selection and training.
Clinical Implications: Prioritize continuous buried fixation, especially in puffy eyelids, and counsel patients that anatomical factors outweigh surgeon case volume for crease durability; standardize technique within training programs.
Key Findings
- Fixation method was the primary determinant of crease retention; continuous buried sutures outperformed other methods.
- Eyelid puffiness significantly increased risk of crease loss.
- Surgeon experience was not an independent predictor of crease survival after adjustment.
Methodological Strengths
- Large consecutive cohort (n=513) with standardized outcome definition
- Time-to-event analysis (Kaplan–Meier, Cox regression) to model crease survival
Limitations
- Retrospective, single-institution design subject to selection and information bias
- Follow-up duration and objective eyelid measurements were not detailed in the abstract
Future Directions: Prospective randomized comparisons of fixation techniques with standardized imaging/anthropometry and patient-reported outcomes; stratified protocols for puffy eyelids.
BACKGROUND: Non-incisional double eyelid surgery is widely performed in East Asia, but crease loss remains a major concern, leading to patient dissatisfaction and revision. The relative impact of surgical technique, anatomical characteristics, and surgeon experience on crease retention has not been fully clarified. METHODS: This retrospective, observational study included 513 consecutive patients who underwent transcutaneous, non-incisional double eyelid surgery between July 2021 and July 2022. Patients were stratified by surgeon experience (<100 vs. ≥100 prior cases). Baseline variables included age, sex, crease design, fixation method, puffy eyelid status, and surgeon experience. Crease loss was defined as the need for revision due to patient-reported fading or disappearance of the crease. Kaplan-Meier analysis and Cox proportional hazards regression were used to evaluate predictors of crease survival, including interaction terms for potential effect modification. RESULTS: Of 513 patients, 264 were treated by beginner surgeons, and 249 by experienced surgeons. Experienced surgeons more frequently used the continuous buried suture method (
2. Evaluation of the Cardiac Status of Patients with Pectus Excavatum in the Pre- and Postoperative Period.
Among 175 patients with pectus excavatum, 70% had preoperative cardiac abnormalities, including 33% with right-ventricular compression. In those reassessed postoperatively (n=61), right-ventricular compression resolved universally, supporting functional benefits of repair beyond cosmetic correction.
Impact: Reframes PE as a condition with frequent, reversible cardiac abnormalities, providing objective justification for surgical correction and standardized cardiac workup.
Clinical Implications: Implement routine preoperative cardiology assessment (echo/ECG) for all PE candidates; counsel families that repair can reverse right-ventricular compression; maintain postoperative follow-up for persistent ECG anomalies.
Key Findings
- Preoperatively, 70% had cardiac abnormalities: valvular lesions 46.3% (mostly mitral prolapse), RV compression 33.1%, incomplete RBBB 17.7%.
- Postoperative reassessment (n=61) showed complete resolution of right-ventricular compression; some ECG anomalies persisted; valvular issues remained in five cases.
- PE severity correlated with the presence of any cardiac abnormality but not with psychological distress.
Methodological Strengths
- Relatively large cohort with multidisciplinary preoperative assessment and CT-based Haller index
- Pre/post design with objective structural and electrophysiologic endpoints
Limitations
- Single-center mixed retrospective/prospective design; limited postoperative reassessment subset (n=61)
- Short-term postoperative data; no randomized comparator
Future Directions: Prospective multicenter studies tracking long-term cardiopulmonary exercise capacity, right-heart remodeling, and quality of life after repair; predictors of persistent ECG changes.
BACKGROUND/PURPOSE: Pectus excavatum (PE) is the most common chest wall deformity in youth. Although often considered cosmetic, studies report cardiopulmonary consequences (e.g., right-ventricular compression, conduction abnormalities) that may vary with age. The minimally invasive Nuss procedure is now predominant. Objective assessment of PE's functional burden and the benefits of surgery is clinically important. To compare pre- and postoperative cardiac status in PE patients and quantify physiologic burden and surgical benefit. METHODS: Single-center cohort of 175 patients undergoing chest wall reconstruction (retrospective 2010-2020; prospective from 2020). Preoperative work-up included pediatric surgery, pulmonology, cardiology, and CT-based Haller index. Patients with abnormal preoperative cardiology underwent postoperative reassessment (n=61). Associations were tested with Chi-square and McNemar's tests (significance set at p<0.05). RESULTS: Patients were 86.3% male; mean age 16.1 years. By Haller index: severe 61.1%, moderate 16.6%, mild 22.3%; 59.4% were asymmetric. Psychological distress was reported by 63.6%. Preoperatively, 70% showed cardiac abnormalities-valvular lesions 46.3% (81/175, predominantly mitral prolapse), right-ventricular compression 33.1% (58/175), and incomplete right bundle-branch block 17.7% (31/175). Postoperatively (n=61), right-ventricular compression resolved in all; some ECG anomalies persisted; valvular abnormalities remained in five. PE severity correlated with the presence of any cardiac abnormality, but not with psychological distress; severity did not correlate with individual abnormality types. CONCLUSIONS: Cardiac abnormalities are common in young patients with PE and are more frequent in severe deformity. Surgical correction yields marked early improvement in structural cardiac abnormalities, supporting routine cardiac evaluation and follow-up in all patients considered for PE repair. LEVEL OF EVIDENCE: III.
3. Evaluation of 30% Urea Pretreatment in Enhancing the Efficacy of Photodynamic Therapy for Actinic Keratoses of the Scalp.
In a split-scalp comparison, 14-day 30% urea pretreatment increased PpIX fluorescence and improved clinical clearance of scalp actinic keratoses—especially Olsen II grade—without worsening local reactions or patient satisfaction, though pain scores were slightly higher.
Impact: Demonstrates a simple, low-cost keratolytic pretreatment that objectively enhances MAL-PDT delivery and outcomes, offering a practical alternative to curettage.
Clinical Implications: Consider prescribing 30% urea cream for 14 days before MAL-PDT for scalp AKs—particularly Olsen II lesions—to enhance efficacy; anticipate slightly higher pain and counsel patients accordingly.
Key Findings
- Urea pretreatment significantly increased PpIX fluorescence (P=0.0128), indicating improved MAL penetration.
- Clinical reduction of AKs improved, especially in Olsen II lesions (P<0.0001).
- Pain scores were modestly higher with urea (P=0.029), while local skin reactions, cosmetic results, and satisfaction were similar between sides.
Methodological Strengths
- Intraindividual split-scalp design controlling for patient-level confounders
- Objective fluorescence (PpIX) measurement alongside clinical and patient-reported outcomes
Limitations
- Sample size and duration of follow-up were not specified in the abstract
- Single-center design may limit generalizability
Future Directions: Randomized, adequately powered trials across anatomical sites and keratosis grades; optimization of urea concentration/duration; evaluation of cost-effectiveness and pain mitigation strategies.
INTRODUCTION: The use of curettage to reduce the hyperkeratotic component of actinic keratoses is a recommended step prior to photodynamic therapy (PDT); however, the procedure may not be well tolerated by the patient. Due to these drawbacks, alternative approaches aimed at reducing lesion hyperkeratosis and optimizing PDT effectiveness have been studied. OBJECTIVE: The aim of the present study was to assess whether a 14-day pretreatment with 30% urea cream enhanced the penetration of methyl aminolevulinate (MAL) and improved clinical outcomes of photodynamic therapy (PDT) in the treatment of scalp actinic keratoses (AKs). METHODS: A split-scalp design was used on adult patients with multiple AKs. One half received 30% urea emollient cream for 14 days before conventional MAL-PDT. Outcomes included PpIX fluorescence, AK reduction, pain scores, local skin reaction (LSR), cosmetic results, and patient satisfaction. RESULTS: PpIX fluorescence was significantly higher in the urea-treated area (P=0.0128), indicating enhanced MAL penetration. Urea pretreatment yielded significant reductions in AKs, particularly for OLSEN II grade lesions (P<0.0001). Pain scores were slightly higher in the urea group (P=0.029), while overall LSR, cosmetic outcomes, and patient satisfaction were comparable between the two sides. CONCLUSION: Pretreatment with 30% urea cream significantly improves MAL uptake and clinical response in PDT for scalp AKs without compromising tolerability or patient satisfaction.