Daily Cosmetic Research Analysis

IMPORTANCE: Currently, there are no standardized outcome domains or measures in clinical trials for facial aging. Heterogeneity in outcome domains and measurement instruments across clinical trials creates difficulty in directly comparing interventions, determining superior therapies, and developing high-quality meta-analyses. OBJECTIVE: To develop a core outcome set (COS) of essential domains to be reported in clinical trials evaluating the efficacy of interventions for facial aging. EVIDENCE REVIEW: PubMed/Medline, Embase, Cochrane Central Register of Controlled Trials, and CINAHL were searched from September 2005 to September 2015. An updated search of the same databases was performed from September 2015 to February 2026. Studies were included if (1) they were randomized clinical trial or controlled clinical trial in design, (2) they assessed the efficacy or safety of an intervention for facial aging, (3) they were published in English, and (4) they involved human participants. Complementary sources, including patient interviews, were used to capture further relevant outcomes. Two rounds of Delphi surveys, followed by consensus meetings, were used to identify outcome domains considered most important by both patient and physician stakeholders. FINDINGS: The final COS consists of 6 outcome domains: (1) overall convenience of treatment; (2) time to return to normal work and social activity; (3) overall assessment of focused area of treatment (at the point in time when treatment is expected to provide peak benefit); (4) duration of treatment effect; (5) severity of persistent local or systemic adverse events, including pigmentary change, skin texture change, delayed healing, scarring, and serious adverse events; and (6) patient satisfaction with treatment. CONCLUSIONS AND RELEVANCE: The 6 outcome domains identified through a Delphi consensus are recommended for reporting in future facial aging trials to ensure that outcomes that matter most to patients and clinicians are measured and that results are comparable across interventions.

OBJECTIVE: This study aimed to evaluate the impact of spreader graft placement during cosmetic rhinoplasty on both objective acoustic measures and subjective voice quality. METHODS: In this prospective, double-blind, controlled study, volunteers who underwent open structural rhinoplasty by the same surgeon between September 2022 and January 2025 were included. Participants were divided into two groups: Group A (with spreader grafts) and Group B (without spreader grafts). Voice recordings were obtained preoperatively and three months postoperatively in a dedicated voice and speech laboratory. All participants provided informed consent and completed the Turkish version of the Voice Handicap Index-10 (VHI-10) before and after surgery. Objective voice analysis was conducted using the Computerized Speech Lab (CSL) system and Multi-Dimensional Voice Program (MDVP) software (Kay Elemetrics Corp., Lincoln Park, NJ, USA). Acoustic parameters ‒ fundamental frequency (f0), jitter, jitter percentage, shimmer, shimmer percentage, and Noise-to-Harmonics Ratio (NHR) ‒ were measured from sustained /a/ phonations. Spectrographic analysis assessed formant frequencies (F1-F4) during production of nasal consonants (/m/, /n/) and the nasalized vowel /i/ in the word mini. RESULTS: In Group A, significant postoperative differences were observed only in F3 and F4 formant values for /m/. In Group B, significant changes were detected in shimmer (dB), jitter, and formant values (F2, F3, F4 for /n/ and F3, F4 for /m/). Postoperative group comparison revealed significant differences in F4 for /m/, F3 for /n/, and F3 for the nasalized vowel /i/. Regarding subjective measures, VHI-10 scores significantly increased postoperatively only in Group B. Preoperative VHI-10 scores did not differ significantly between groups, while postoperative scores showed significant differences. CONCLUSION: Cosmetic rhinoplasty may affect voice parameters, particularly formants F3 and F4, essential components of the singer's and actor's formant cluster. Spreader grafts appear to preserve these frequencies, suggesting their importance in patients who professionally rely on voice quality. LEVEL OF EVIDENCE: According to the Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence, this study qualifies as Level 1b evidence, as it is a prospective, double-blind, randomized controlled trial evaluating the effectiveness of an intervention.

BACKGROUND: Remote-access thyroidectomy techniques such as the transoral endoscopic thyroidectomy vestibular approach (TOETVA) and bilateral axillo-breast approach (BABA) offer cosmetic advantages, yet multicentre evidence comparing perioperative safety, operative efficiency, and histopathological integrity is limited. METHODS: This retrospective multicentre cohort study included consecutive adult patients who underwent TOETVA or BABA at four tertiary referral centres between 1 January 2020 and 31 December 2022. Surgeons had surpassed the learning curve. Propensity score matching (1 : 1) was performed based on demographic and clinical variables. Patients with < 12 months follow-up were excluded. Data on operative time (total and phase-specific), postoperative pain, complications, specimen integrity (fragmentation and capsule status), length of hospital stay, reoperations, and mid-term outcome measures, including recurrence, were collected. RESULTS: For 507 eligible patients (TOETVA, 216; BABA, 291), matching achieved balanced baseline characteristics. TOETVA had longer operative time than BABA (125.6 versus 97.7 minutes; P < 0.001), with faster flap creation but slower thyroidectomy. Complication rates were similar for TOETVA and BABA, including vocal cord palsy (1.1% versus 2.8%, respectively) and hypoparathyroidism (2.2% versus 3.3%, respectively). TOETVA had higher rates of specimen disruption (12.8% versus 6.1%; P = 0.031), whereas tumour capsule integrity was comparable. Bilateral thyroidectomy independently prolonged operative time in both groups; tumour size and male sex also increased operative time in BABA. Mid-term recurrence was uncommon, although recurrence after BABA more often required open or chest wall incisions, whereas recurrence after TOETVA was managed through a limited cervical approach. CONCLUSION: TOETVA and BABA are safe and effective remote-access thyroidectomy options, each with distinct technical considerations. TOETVA offers a scarless mid-line corridor with less postoperative discomfort but carries a higher risk of specimen disruption, whereas BABA provides broader exposure and shorter thyroidectomy time but is more affected by anatomical and tumour factors. These findings support evidence-based surgical planning and individualized patient counselling.