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September 14, 2026Journal of Cutaneous and Aesthetic SurgeryOpen Access

Conservative treatments are preferred for CIED scars, while energy-based devices risk electromagnetic interference and dysfunction.

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Population

Patients with cardiac implantable electronic devices experiencing discomfort or dissatisfaction related to…

Design

Review

Key result

Conservative treatments are the preferred first-line therapy for CIED pocket scars, while energy-based devices generating electromagnetic interference should be strictly avoided to prevent device dysfunction.

Authors

LPLuca Panchetti

Discussion

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Overview

Esthetic CIED scar discomfort merits assessment in symptomatic patients; leaves open optimal cosmetic interventions without controlled data.

Key Points

  • To review conservative and procedural scar management techniques for surgical pockets in patients with cardiac implantable electronic devices, specifically addressing safety hazards related to infection and electromagnetic interference.
  • Conducted a narrative review using targeted PubMed/MEDLINE searches alongside manual screening of manufacturer manuals, consensus documents, and reference lists.
  • Evaluated dermatologic and esthetic modalities—including lasers, injectables, cryotherapy, microneedling, and ultrasound—for tissue trauma, infectious potential, and electromagnetic disruption.
  • Identified pocket infection and electromagnetic interference as the critical safety determinants when evaluating cosmetic chest interventions near implanted hardware.
  • Proposed a tailored management algorithm guided by implantation timeline, scar phenotype, individual infection risk, patient-reported symptoms, and device sensitivity.
  • Concluded that clinical practice should prioritize minimum effective interventions over aggressive scar revision to preserve skin barrier integrity and device stability.

Structured PICO

P
Population
Patients with cardiac implantable electronic devices (CIEDs) experiencing discomfort or dissatisfaction related to surgical pocket scars and device prominence.
I
Intervention
Conservative and procedural approaches to scar treatment (including intralesional corticosteroids, 5-fluorouracil, botulinum toxin type A, fractional lasers, pulsed dye laser, mechanical microneedling, cryotherapy, chemical peels, fillers, lipofilling, and high-intensity focused ultrasound).

This review provides a pragmatic framework for managing surgical pocket scars in CIED patients, balancing esthetic improvement with the critical safety concerns of pocket infection and electromagnetic interference.

Limitations

  • Lack of direct evidence specific to the CIED pocket setting, relying on extrapolation from broader scar-management literature.
  • Absence of prospective registries and CIED-specific safety outcomes for esthetic procedures.

Cite This Study

Luca Panchetti (2026) conducted a review in Surgical pocket scars in patients with cardiac implantable electronic devices (CIEDs). Esthetic scar management procedures was evaluated. Conservative treatments are the preferred first-line therapy for CIED pocket scars, while energy-based devices generating electromagnetic interference should be strictly avoided to prevent device dysfunction.

synapsesocial.com/papers/6aa7afef79e9260bc85aaca5https://doi.org/10.25259/jcas_97_2026
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