Harnessing Commensal Microflora: A New Paradigm for Minimising Scarring and Inflammation in Medical Aesthetic Procedures - A Systematic Review

Medical aesthetic procedures have become a common practice in the medical field and, post-operative inflammation and scarring are some of the major issues that adversely affect the recovery process and patient satisfaction. Recent developments in microbiome studies have demonstrated the possible importance of commensal microflora as a way to decrease immune reactions, repairing tissues and ensuring homeostasis of the skin. The elicitation of useful microbial communities has, therefore, become a promising treatment approach to support recovery after skin injury. This literature review was a systematic study to identify the research topic, the role of commensal microflora in the minimisation of inflammation and scar reduction during medical aesthetic procedures. A systemic search of the peer-reviewed literature published since 2020 but not earlier was carried out in several scientific databases. A total of fifteen articles were eligible to meet the inclusion criteria and included research of quantitative, qualitative and mixed-methods. The articles included researched microbial-host interactions, microbiome-derived therapies, wound healing processes, strategies to prevent scarring and patient experience of recovery. The results also showed that commensal microflora have a great role in skin homeostasis in terms of immune reaction regulation and microbial balance regulation. Some of the studies described the presence of anti-inflammatory effects in relation to the positive microorganisms, probiotics and postbiotics and the ability to maintain controlled healing conditions. There were also indications that microbial communities mediate wound healing by communicating with regenerative pathways and tissue repair mechanisms. The development of new therapeutic methods, such as designed commensal bacteria, also provided evidence that they could be used to deliver bioactive compounds with an ability to improve the process of healing. Also, qualitative and mixed-method studies demonstrated the great physical, psychological and social effects of scarring, with the need to focus on the type of interventions that can enhance the recovery and cosmetic results. Overall, the review indicates that commensal microflora is a crucial part of skin wellbeing, and can offer innovative opportunities in eliminating inflammation and scarring after medical cosmetic surgery. Despite the need to conduct more clinical trials to determine causal therapeutic uses, microbiome-based approaches have a strong potential of improving the quality of healing, achieve better aesthetic results and aiding patient-centred care in regenerative and aesthetic medicine.