Daily Cosmetic Research Analysis
Analyzed 27 papers and selected 3 impactful papers.
Summary
Genetic causal inference links specific blood metabolites and ageing phenotypes to hypertrophic scars and keloids, nominating metabolic targets for intervention. A meta-analysis comparing transoral endoscopic versus robotic thyroidectomy clarifies trade-offs in operative time, hospital stay, and transient nerve injury for scarless surgery. A multiplanar 3D virtual reduction workflow for mandibular condylar fractures enables template-free reconstruction with restored symmetry when pre-injury imaging is unavailable.
Research Themes
- Genetic and metabolic determinants of pathological scarring
- Scarless endocrine surgery outcomes (TOETVA vs TORT)
- Virtual surgical planning for craniofacial reconstruction
Selected Articles
1. Deciphering the Causal Links Among Metabolomics, Ageing Phenotypes, and Pathological Scars: A Two-Sample Mendelian Randomization Study.
Using two-sample Mendelian randomization across large European GWAS, the authors identified 30 metabolites causally associated with hypertrophic scars and 49 with keloids. Telomere length was positively associated with both scar types, whereas PhenoAge showed negative correlations; metabolites such as eugenol sulfate and phenylacetylglutamate acted via dual pathways involving telomere length and PhenoAge. Findings nominate metabolic pathways as potential therapeutic targets for pathological scarring.
Impact: Provides genetic causal evidence linking specific metabolites and ageing phenotypes to scar biology, moving beyond correlation and highlighting actionable metabolic targets.
Clinical Implications: Supports risk stratification and future development of metabolically targeted prevention or therapy for hypertrophic scars and keloids; not yet practice-changing pending validation and intervention trials.
Key Findings
- Identified 30 metabolites causally associated with hypertrophic scars and 49 with keloids via two-sample MR.
- Telomere length showed positive correlations with both scar types, while PhenoAge demonstrated negative correlations.
- Metabolites including eugenol sulfate and phenylacetylglutamate influenced scar formation through dual pathways involving telomere length and PhenoAge.
- Applied IVW and Wald ratio methods with Steiger’s, Cochrane’s Q, and MR-Egger tests to address reverse causality, heterogeneity, and pleiotropy.
Methodological Strengths
- Large-scale, multi-trait GWAS integration with two-sample and two-step mediation MR
- Robust sensitivity analyses (Steiger’s, Cochrane’s Q, MR-Egger) to assess assumptions and pleiotropy
Limitations
- Predominantly European ancestry datasets limit generalizability
- Residual pleiotropy and summary-level data constraints; lacks functional validation
Future Directions: Replicate across ancestries, integrate multi-omics and tissue-specific eQTLs, and test metabolite-modulating interventions in prospective studies and trials.
BACKGROUND: Hypertrophic scars (HS) and keloids represent pathological outcomes following cutaneous injury, characterized by complex pathogenesis and suboptimal therapeutic outcomes. The interplay between metabolomics and ageing may offer novel intervention targets for scar formation. OBJECTIVE: This study aimed to systematically investigate the causal relationships between blood metabolites, ageing phenotypes (telomere length, epigenetic age), and HS/keloids through Two-sample Mendelian randomization (MR) and Two-step Mediation MR analysis. METHODS: We integrated large-scale GWAS data from European populations, including 1400 blood metabolites (n=8299), telomere length (n=438,351), epigenetic age (n=41,000), HS (2068 cases/465,673 controls), and keloids (4086 cases/1,278,496 controls). Two-sample MR analysis was performed using inverse-variance weighted (IVW) and Wald ratio methods. Steiger's, Cochrane's Q, and MR-Egger tests were applied to exclude reverse causality, heterogeneity, and pleiotropy. Mediation effects of ageing phenotypes were quantified.
2. Perioperative outcomes of transoral endoscopic vs. robotic thyroidectomy: a systematic review and meta-analysis.
Across 1,080 patients in five studies, robotic transoral thyroidectomy (TORT) had longer operative times but shorter hospital stays than TOETVA, and was associated with lower odds of transient recurrent laryngeal nerve injury. Extent of lymph node dissection and most complications were comparable, supporting TORT as a safe scarless option with potential neuroprotection advantages.
Impact: Clarifies head-to-head trade-offs between two widely adopted scarless thyroidectomy techniques, informing surgical selection and patient counseling.
Clinical Implications: For patients prioritizing cosmesis, TORT may offer shorter hospital stay and lower transient RLN injury risk at the cost of longer operative time; surgeons should individualize based on anatomy, expertise, and resource availability.
Key Findings
- Included 5 comparative studies with 1,080 patients (639 TOETVA, 441 TORT).
- TORT had significantly longer operative time (~56.7 minutes) but shorter hospital stay (~0.26 days).
- Transient recurrent laryngeal nerve injury was higher with TOETVA (OR 3.56).
- No significant differences in lymph node dissection extent, permanent RLN injury, hypoparathyroidism, mental nerve injury, seroma, SSI, or hemorrhage.
Methodological Strengths
- Systematic multi-database search with predefined outcomes and random-effects modeling
- Risk of bias assessed using ROBINS-I for nonrandomized studies
Limitations
- Only five studies, mainly retrospective, with potential heterogeneity and learning-curve effects
- Long-term oncologic outcomes and cost-effectiveness not established
Future Directions: Prospective multicenter registries or RCTs with standardized outcomes, longer follow-up, and cost analyses to define patient selection and long-term safety.
BACKGROUND: Transoral endoscopic thyroidectomy vestibular approach (TOETVA) and transoral robotic thyroidectomy (TORT) have emerged as scarless alternatives to conventional open thyroidectomy, offering excellent cosmetic outcomes. However, the comparative perioperative outcomes between these two minimally invasive techniques remain to be systematically evaluated. This meta-analysis aimed to compare the perioperative outcomes of TOETVA and TORT in patients undergoing thyroid surgery. METHODS: A systematic search was performed in PubMed, Embase, the Cochrane Library, and Web of Science from inception to March 1, 2026, for studies comparing TOETVA and TORT. The primary outcomes included recurrent laryngeal nerve injury, hypoparathyroidism, mental nerve injury, seroma, surgical site infection, and postoperative hemorrhage. The secondary outcome included operation time, length of hospital stay, number of lymph nodes dissected, and postoperative pain score. Pooled weighted mean differences (MD) or odds ratios (OR) with 95% confidence intervals (CI) were calculated using a random-effects model. Study quality was assessed using the ROBINS-I tool. RESULTS: A total of 5 studies involving 1,080 patients were included (639 in the TOETVA group and 441 in the TORT group). Compared with TOETVA, TORT was associated with significantly longer operation time (MD = -56.74 min, 95% CI [-73.41, -40.07], p < 0.05) but shorter hospital stay (MD = 0.26 days, 95% CI [0.03, 0.49], p < 0.05). The incidence of transient recurrent laryngeal nerve injury was significantly higher in the TOETVA group than in the TORT group (OR = 3.56, 95% CI [1.14, 11.06], p = 0.03). There were no significant differences between the two groups in the number of lymph nodes dissected, the number of metastatic central compartment lymph nodes, the incidence of permanent recurrent laryngeal nerve injury, mental nerve injury, transient or permanent hypoparathyroidism, seroma, surgical site infection, or postoperative hemorrhage. CONCLUSION: Although TORT is associated with longer operative time, it demonstrates potential advantages in terms of length of hospital stay and neuroprotection.The two procedures are comparable in terms of radicality of lymph node dissection, postoperative pain, and low complication rates. TORT is a safe and effective minimally invasive surgical option with better neural protection, especially suitable for patients prioritizing cosmetic outcomes. Long-term oncological safety still needs to be verified in future multicenter studies with larger samples and longer follow-up durations.
3. Overcoming the absence of pre-traumatic imaging: a multiplanar three-dimensional virtual reduction workflow for mandibular condylar fractures.
In 45 unilateral mandibular condylar fractures, a multiplanar virtual reduction performed directly on post-traumatic CT restored symmetry without relying on contralateral mirroring. Linear and angular metrics (e.g., ramus height, gonial angle) showed no significant differences versus mirrored controls, supporting a template-free workflow when pre-injury imaging is unavailable.
Impact: Introduces and validates a practical, template-free virtual reduction strategy that addresses a pervasive limitation in craniofacial reconstruction, particularly relevant to bilateral or contralaterally compromised cases.
Clinical Implications: Enables patient-specific implant planning and reduction without contralateral mirroring, potentially improving aesthetic symmetry and workflow feasibility in complex condylar fractures.
Key Findings
- Consecutive series of 45 unilateral mandibular condylar fractures analyzed with a multiplanar virtual reduction workflow.
- No significant differences between virtually reduced and mirrored contralateral sides across key metrics (e.g., median ramus height 61.5 mm vs 61.0 mm; gonial angle 116.6° vs 116.2°).
- Fracture distribution: condylar head 28.9%, neck 37.7%, sub-condylar 33.4%.
Methodological Strengths
- Standardized segmentation and split-mask workflow with objective linear and angular measurements
- Within-patient mirrored control and non-parametric paired testing (Wilcoxon signed-rank)
Limitations
- Validation performed in unilateral fractures; bilateral cases not directly tested
- Retrospective planning analysis without functional or patient-reported outcomes
Future Directions: Prospective validation in bilateral/complex fractures, linkage to occlusal/function and aesthetic outcomes, and semi-automated/AI augmentation of the workflow.
BACKGROUND: A fundamental challenge in condylar fracture reconstruction with patient-specific implants is the absence of a pre-traumatic baseline, making direct intra-individual comparison impossible. Several virtual reduction workflows for mandibular condylar fractures have been introduced, but all currently available approaches rely on mirroring the healthy, unaffected condyle as a template for the affected side. However, contralateral mirroring is not feasible in bilateral fractures or cases with contralateral compromise. To address this limitation, the present study introduces a three-dimensional virtual reduction workflow for mandibular condylar fractures in situations where pre-injury imaging data are unavailable or the contralateral side is compromised. METHODS: This study included 45 consecutive patients with unilateral mandibular condylar fractures. Post-traumatic computed tomography data were imported into Mimics Medical software to generate a 3D bone model of the skull. Image segmentation was performed using the default bone threshold. A split mask approach was applied twice: first to separate the mandible from the maxilla and craniofacial bones, and second to isolate the fractured fragment from the residual mandibular portion. Virtual reduction of the fractured fragment was performed directly on the post-traumatic CT scan using the three orthogonal imaging planes, rather than on the 3D model. All linear and angular measurements were obtained from the 3D-reconstructed mid-sagittal slice of the hemimandible using the caliper and angle tools in Slicer software. The Wilcoxon signed-rank test was used to compare paired measurements. RESULTS: The study included 45 patients with unilateral condylar fractures (64.5% male, 35.5% female). Fracture distribution was as follows: 28.9% involved the condylar head, 37.7% the condylar neck, and 33.4% the sub-condylar region. No statistically significant differences were found between the virtually reduced side and the mirrored contralateral control side. The median total ramus height was 61.5 mm versus 61.0 mm, gonial angle was 116.6° versus 116.2°, head-notch angle was 100.7° versus 101.0°, and head-coronoid process distance was 40.8 mm versus 41.0 mm. CONCLUSION: The findings demonstrate that the multiplanar virtual reduction workflow restores ramus symmetry and condylar position. It offers a feasible alternative to pre-traumatic imaging in the management of condylar fractures, as it does not rely on mirroring the contralateral side.