Lellouch, Alexandre G.

Abstract The age-related decline in tissue regenerative capacity drives demand for interventions restoring physiological repair mechanisms. Glycyl-L-histidyl-L-lysine-copper (GHK-Cu) has demonstrated significant regenerative, anti-inflammatory, and antioxidant properties in preclinical models, prompting its increasing integration into aesthetic practice despite a paucity of standardized clinical guidelines. This systematic review evaluates the efficacy, safety, and regenerative mechanisms of GHK-Cu in aesthetic medicine to clarify its clinical utility and inform future research. A systematic search of PubMed, Embase, and Cochrane CENTRAL was conducted from database inception through March 2026, following PRISMA guidelines. Eligible studies included clinical and preclinical models investigating GHK-Cu as a standalone intervention for aesthetic applications. 20 studies (18 preclinical; 2 RCTs) were included. Preclinical data consistently demonstrated that GHK-Cu enhances extracellular matrix synthesis (type I collagen and glycosaminoglycans), modulates metalloproteinase activity, and promotes angiogenesis and cellular proliferation. It also exhibited significant anti-inflammatory effects by suppressing TGF-β and IL-6. Clinically, GHK-Cu improved patient-reported satisfaction after laser resurfacing and significantly reduced wrinkle volume and depth compared with controls. Additionally, advanced delivery systems, including microneedles and liposomes, markedly improved its transdermal bioavailability and efficacy. GHK-Cu demonstrates a reasonable biological basis for use as a regenerative agent in aesthetic medicine, supported by available preclinical data. Nevertheless, the findings reported across studies were constrained by methodological variability and a limited number of well-designed clinical trials. Future research incorporating larger, controlled trials with standardized formulations, dosing regimens, and delivery methods will be necessary to close the translational gap and inform the development of consistent therapeutic protocols in clinical practice.

Background: Massive weight loss after bariatric surgery (BS) often results in excess skin, leading to physical discomfort and impaired quality of life (QoL). Body contouring surgery (BCS) addresses these issues by restoring body image, improving function, and enhancing overall QoL, but its added value on patient-reported outcome measures (PROMs) remains underexplored. Methods: A systematic search of PubMed, Scopus, Embase, Web of Science, and Cochrane databases was conducted from inception to March of 2025. Studies comparing PROMs between patients undergoing BS alone and those undergoing BS + BCS were included. Retrieved studies were assessed using the Risk of Bias in Nonrandomized Studies of Interventions (ROBINS-I) tool. Outcomes were pooled using random effects models. Results: Fifteen non-randomized studies involving 7339 patients were included (BS, 4339 [59.1%]; BS + BCS, 3000 [40.9%]). Patients undergoing BS + BCS had a significantly greater percentage of total weight loss (mean difference [MD], 4.40% [95% CI, 1.69, 7.10]; P < 0.01). BODY-Q improvements favored the BS + BCS group in body image, physical, psychological, sexual, and social function (MD, 16.07 [95% CI, 12.14, 20.0]; P < 0.01). Among patients receiving only BS, those desiring BCS reported lower body satisfaction (MD, −0.40 [95% CI, −0.70, −0.10]; P < 0.01) and lower appraisal of excess skin scores (standardized MD, −1.09 [95% CI, −1.83, −0.36]; P = 0.02) than those without desire for BCS. Conclusions: BCS after BS yields substantial improvements in overall QoL. These findings highlight the importance of BCS as a fundamental element of comprehensive postbariatric care that significantly enhances long-term patient satisfaction and drives durable multidimensional recovery.