Electro-Aesthetic Regulation Enabled by Piezoelectric Signaling

Aesthetic and reconstructive repair requires biomaterials that restore tissue architecture while controlling contour fidelity, scar quality, mechanical compliance, and long-term morphological stability in dynamically loaded environments. However, conventional fillers, scaffolds, and wound-care materials largely act as passive supports and offer limited capacity to adaptively regulate the regenerative microenvironment. In this Review, we present piezoelectric signaling as a mechanoelectrical strategy for electro-aesthetic regulation, whereby endogenous tissue motion or externally applied mechanical energy is converted into localized bioelectrical cues. We establish a bioelectrical information framework in which mechanical inputs are encoded into spatiotemporally organized electrical signals and biologically decoded through ion-channel activation, Ca^{2 +} signaling, cytoskeletal remodeling, immune regulation, angiogenesis, and extracellular matrix reorganization. We further examine how molecular polarity, crystalline phase, structural architecture, and interfacial coupling govern signaling across naturally derived biomolecules, synthetic polymers, inorganic materials, and hybrid piezoelectric systems. Representative applications include dermal repair and scar modulation, PLLA-based regenerative fillers and emerging injectable electroactive platforms, craniofacial reconstruction, multimodal stimulation, and sensing-enabled closed-loop bioelectronics. Key translational challenges include signal dosimetry, hydrated-state stability, degradation-dependent performance, biosafety, structural fidelity, and standardized aesthetic evaluation. Piezoelectric signaling may therefore shift aesthetic and reconstructive repair from passive structural restoration toward adaptive, bioelectrically mediated, and feedback-guided regulation.