Otto Placik | Northwestern University (original) (raw)
Papers by Otto Placik
Journal of clinical & experimental dermatology research, Nov 27, 2013
Journal of clinical & experimental dermatology research, Nov 27, 2013
Plastic and Reconstructive Surgery, Feb 1, 1993
ABSTRACT Cryoglobulinemia was initially noted to occur predominantly in patients with myeloma, bu... more ABSTRACT Cryoglobulinemia was initially noted to occur predominantly in patients with myeloma, but it is now being detected in a growing number of infectious, collagen-vascular, and lymphoproliferative disorders. Two patients with leg ulcers due to cryoglobulinemia are presented. The reconstructive surgeon should consider cryoglobulinemia in the differential diagnosis of skin necrosis that is refractory to conventional therapy, since they may be consulted for wound management. In the vast majority of instances, the patient will be referred with a diagnosis of cryoglobulinemia having already been established. In other circumstances, patients may present to the plastic surgeon with no known history of cryoglobulinemia. The informed reconstructive surgeon can make the diagnosis on the basis of clinical findings. Combination therapy (corticosteroid, immunosuppression, and plasmapheresis) may be of use when areas of skin necrosis, typically in the form of leg ulcers, fail to heal with routine measures.
Plastic and Reconstructive Surgery, Jun 1, 2016
Reply: Growing Body of Evidence Supports Safety of Female Genital Cosmetic Surgery Sir: I am hono... more Reply: Growing Body of Evidence Supports Safety of Female Genital Cosmetic Surgery Sir: I am honored to have Dr. Sisti, a surgeon who is well acquainted with labiaplasty and coauthor of a comprehensive review,1 comment on our investigation.2 He discusses two studies of male preferences regarding female genital appearance. These findings confirm the results of an earlier article we have published regarding cultural expectations for the female pudenda as reflected in the media and specifically in the archetypal men’s magazine, Playboy.3 Dr. Sisti similarly echoes the observations of others who also stress the aesthetic goals of labiaplasty as being the preeminent motivating factor for women seeking labiaplasty.4 It is clear that the popularity of the procedure is not limited to the United States; reports from experienced surgeons such as Triana and Robledo,5 Mayer,6 Gress,7 Oranges et al.,1 Veale et al.,8 Giraldo et al.,9 Felicia Yde,10 Choi and Kim,11 and others (e.g., from Colombia, Argentina, Germany, Italy, England, Spain, Brazil, and South Korea), indicate that this specialty is an international phenomenon and has wide appeal to a variety of differing cultures. Dr. Sisti’s commentary resonates with my impression that surgeons experienced in labiaplasty will testify that the vast majority of patients express a high degree of satisfaction that is equal to or exceeds nearly any other aesthetic procedure. Despite the demand and the safety of Regarding the same type of surgery, Dr. Mazloomdoost et al. recently published an article entitled “Survey of Male Perceptions Regarding the Vulva.”2 In that study, men aged 18 to 80 years were recruited by means of e-mails sent by an Internet provider to participate in a 27-question Web-based survey. The questionnaire included images and queried demographics, men’s familiarity with vulvar anatomy, preferences regarding labial appearance, and awareness of labiaplasty. With regard to preferences, more respondents considered smaller labia attractive compared with large labia; multivariable analysis revealed younger age to be associated with preferences for small labia and complete genital hair removal, and familiarity with labiaplasty. In this national survey, the majority of men do not have a preferred appearance for female genitalia, nor do they support female genital cosmetic operations or consider discussing genital surgery with their partner.2 This conclusion is also supported by a recent study on the same topic from Dr. Horrocks et al.3 A total of 500 online surveys were sent out and 248 respondents were included in the study; only 14 percent of men supported genital cosmetic surgery, whereas 29.6 percent are undecided about the practice. The most common preferred pubic hair appearance is completely hairless (45 percent). The problem of hypertrophy of the labia minora arises mainly from the need of the patient herself. The demand for cosmetic surgery for reduction of the labia minora by women is growing. Although women are motivated by functional implications, aesthetic causes, such as appearance, account for almost half of the impetus driving this demand.2 Women prefer a prepubescent aesthetic, with the labia minora tucked within the confines of the labia majora. Psychological counseling is recommended to inform women that surgery is not a definitive solution to treat psychologically based pain or dysfunction.4 To date, there are eight different techniques available for this type of surgical procedure, they have been listed and graphically represented in a recent review.5 In general, a very low complication rate and satisfactory aesthetic outcomes for the patients were reported for all the techniques performed. We regularly perform this type of surgery using the wedge technique and found high satisfaction of patients and a very low complication rate. With this letter, we want to encourage young plastic surgeons and even gynecologists to perform this type of surgery, when requested, because it is simple to implement and relatively safe. DOI: 10.1097/PRS.0000000000002202
Clinics in Plastic Surgery
Plastic and Reconstructive Surgery, Apr 1, 2020
Aesthetic surgery journal, 2020
Aesthetic Surgery Journal
Plastic & Reconstructive Surgery
Aesthetic Surgery Journal
Background Achieving an aesthetic phalloplasty result is important for patients with acquired or ... more Background Achieving an aesthetic phalloplasty result is important for patients with acquired or congenital defects of the penis, or with genital-related dysphoria. However, aside from length and girth, the aesthetic proportions of the male penis have not been defined. Objectives This study aimed to determine proportions of the male penis through photogrammetric analysis of nude male photographs and to verify these proportions with a crowdsourcing-based survey. Methods Nude male photographs (n = 283) were analyzed to define aesthetic proportions of the male penis. Photographs were analyzed for the position of the penis on the torso in relation to the umbilicus and for the ratio of the dorsal and ventral glans of the penis in relation to the entire shaft length. Proportions were then further studied by crowdsourcing 1026 respondents with Amazon mechanical Turk. Results The ideal position of the penis below the umbilicus is about 55% (6/11th) of the distance from the jugular notch to ...
Plastic and reconstructive surgery, Jan 15, 2016
Reply: Growing Body of Evidence Supports Safety of Female Genital Cosmetic Surgery Sir: I am hono... more Reply: Growing Body of Evidence Supports Safety of Female Genital Cosmetic Surgery Sir: I am honored to have Dr. Sisti, a surgeon who is well acquainted with labiaplasty and coauthor of a comprehensive review,1 comment on our investigation.2 He discusses two studies of male preferences regarding female genital appearance. These findings confirm the results of an earlier article we have published regarding cultural expectations for the female pudenda as reflected in the media and specifically in the archetypal men’s magazine, Playboy.3 Dr. Sisti similarly echoes the observations of others who also stress the aesthetic goals of labiaplasty as being the preeminent motivating factor for women seeking labiaplasty.4 It is clear that the popularity of the procedure is not limited to the United States; reports from experienced surgeons such as Triana and Robledo,5 Mayer,6 Gress,7 Oranges et al.,1 Veale et al.,8 Giraldo et al.,9 Felicia Yde,10 Choi and Kim,11 and others (e.g., from Colombia, Argentina, Germany, Italy, England, Spain, Brazil, and South Korea), indicate that this specialty is an international phenomenon and has wide appeal to a variety of differing cultures. Dr. Sisti’s commentary resonates with my impression that surgeons experienced in labiaplasty will testify that the vast majority of patients express a high degree of satisfaction that is equal to or exceeds nearly any other aesthetic procedure. Despite the demand and the safety of Regarding the same type of surgery, Dr. Mazloomdoost et al. recently published an article entitled “Survey of Male Perceptions Regarding the Vulva.”2 In that study, men aged 18 to 80 years were recruited by means of e-mails sent by an Internet provider to participate in a 27-question Web-based survey. The questionnaire included images and queried demographics, men’s familiarity with vulvar anatomy, preferences regarding labial appearance, and awareness of labiaplasty. With regard to preferences, more respondents considered smaller labia attractive compared with large labia; multivariable analysis revealed younger age to be associated with preferences for small labia and complete genital hair removal, and familiarity with labiaplasty. In this national survey, the majority of men do not have a preferred appearance for female genitalia, nor do they support female genital cosmetic operations or consider discussing genital surgery with their partner.2 This conclusion is also supported by a recent study on the same topic from Dr. Horrocks et al.3 A total of 500 online surveys were sent out and 248 respondents were included in the study; only 14 percent of men supported genital cosmetic surgery, whereas 29.6 percent are undecided about the practice. The most common preferred pubic hair appearance is completely hairless (45 percent). The problem of hypertrophy of the labia minora arises mainly from the need of the patient herself. The demand for cosmetic surgery for reduction of the labia minora by women is growing. Although women are motivated by functional implications, aesthetic causes, such as appearance, account for almost half of the impetus driving this demand.2 Women prefer a prepubescent aesthetic, with the labia minora tucked within the confines of the labia majora. Psychological counseling is recommended to inform women that surgery is not a definitive solution to treat psychologically based pain or dysfunction.4 To date, there are eight different techniques available for this type of surgical procedure, they have been listed and graphically represented in a recent review.5 In general, a very low complication rate and satisfactory aesthetic outcomes for the patients were reported for all the techniques performed. We regularly perform this type of surgery using the wedge technique and found high satisfaction of patients and a very low complication rate. With this letter, we want to encourage young plastic surgeons and even gynecologists to perform this type of surgery, when requested, because it is simple to implement and relatively safe. DOI: 10.1097/PRS.0000000000002202
Plastic and Reconstructive Surgery, 2016
Aesthetic Surgery Journal
Aesthetic Surgery Journal
Background Heightening interest in labiaplasty has driven potential patients to online forums, pe... more Background Heightening interest in labiaplasty has driven potential patients to online forums, permitting the dissemination of material by potentially unqualified or inexperienced individuals. The discourse surrounding this procedure has been injected with strong opinions that are not entirely consistent with medical best-practice or evidence-based knowledge. Objectives Explore the rationale for ongoing public opposition to labiaplasty and if bringing awareness to the similarities of labiaplasty and breast reduction can alter an individual’s perception. Methods 448 adult women were surveyed concerning their opinion of a surgical procedure to reduce the size of an unspecified organ related to a woman’s sexuality, breast reduction, and labia reduction. Results Reduction of an unspecified organ and breasts were met with significantly greater acceptance than labia reduction (p < 0.0001). Presenting responders with an educational tool comparing each procedure’s indications, risks, and...
Plastic and Reconstructive Surgery
Aesthetic Surgery Journal
Background A significant proportion of patients seeking labiaplasty are nulliparous and may exper... more Background A significant proportion of patients seeking labiaplasty are nulliparous and may experience later changes to their labia following vaginal delivery. Objectives In the present study, the authors reported the long-term outcomes of a single surgeon’s patient cohort who had vaginal delivery after labiaplasty. Methods A retrospective chart review of the senior author’s database was conducted. All patients who underwent in-office labiaplasty from 2007 to 2018 were surveyed. The resulting cohort was stratified into patients who had delivered children prior to labiaplasty and those who delivered after labiaplasty. Results A total of 204 patients responded to a phone survey. Seventy patients had children prior to undergoing labiaplasty, and 33 had children after labiaplasty. The rate of vaginal delivery was lower in the women who had children before labiaplasty (82.6% vs 91.8%, P = 0.015). The tear/episiotomy rate for vaginal deliveries was lower in women who had children prior to...
Aesthetic Surgery Journal
Aesthetic Surgery Journal
As the popularity of female cosmetic genital surgery has grown, so has the number of publications... more As the popularity of female cosmetic genital surgery has grown, so has the number of publications detailing surgical techniques, particularly regarding labiaplasty. As a nascent surgical field, much room remains for finesse and exploration of new techniques to optimize outcomes and patient satisfaction. We present the techniques for anterior and posterior commissuroplasty which the senior author (O.J.P.) has developed. Anterior commissuroplasty is efficacious in addressing a number of anatomic variations to achieve the appearance of a single midline cleft which is commonly requested by patients. Posterior commissuroplasty was developed to address skin excess at the posterior fourchette that may develop as a result of labiaplasty. Either technique may be used in combination with labiaplasty or as a stand-alone procedure. These tools may be a useful addition to the repertoire of a surgeon practicing female genital surgery.
Journal of clinical & experimental dermatology research, Nov 27, 2013
Journal of clinical & experimental dermatology research, Nov 27, 2013
Plastic and Reconstructive Surgery, Feb 1, 1993
ABSTRACT Cryoglobulinemia was initially noted to occur predominantly in patients with myeloma, bu... more ABSTRACT Cryoglobulinemia was initially noted to occur predominantly in patients with myeloma, but it is now being detected in a growing number of infectious, collagen-vascular, and lymphoproliferative disorders. Two patients with leg ulcers due to cryoglobulinemia are presented. The reconstructive surgeon should consider cryoglobulinemia in the differential diagnosis of skin necrosis that is refractory to conventional therapy, since they may be consulted for wound management. In the vast majority of instances, the patient will be referred with a diagnosis of cryoglobulinemia having already been established. In other circumstances, patients may present to the plastic surgeon with no known history of cryoglobulinemia. The informed reconstructive surgeon can make the diagnosis on the basis of clinical findings. Combination therapy (corticosteroid, immunosuppression, and plasmapheresis) may be of use when areas of skin necrosis, typically in the form of leg ulcers, fail to heal with routine measures.
Plastic and Reconstructive Surgery, Jun 1, 2016
Reply: Growing Body of Evidence Supports Safety of Female Genital Cosmetic Surgery Sir: I am hono... more Reply: Growing Body of Evidence Supports Safety of Female Genital Cosmetic Surgery Sir: I am honored to have Dr. Sisti, a surgeon who is well acquainted with labiaplasty and coauthor of a comprehensive review,1 comment on our investigation.2 He discusses two studies of male preferences regarding female genital appearance. These findings confirm the results of an earlier article we have published regarding cultural expectations for the female pudenda as reflected in the media and specifically in the archetypal men’s magazine, Playboy.3 Dr. Sisti similarly echoes the observations of others who also stress the aesthetic goals of labiaplasty as being the preeminent motivating factor for women seeking labiaplasty.4 It is clear that the popularity of the procedure is not limited to the United States; reports from experienced surgeons such as Triana and Robledo,5 Mayer,6 Gress,7 Oranges et al.,1 Veale et al.,8 Giraldo et al.,9 Felicia Yde,10 Choi and Kim,11 and others (e.g., from Colombia, Argentina, Germany, Italy, England, Spain, Brazil, and South Korea), indicate that this specialty is an international phenomenon and has wide appeal to a variety of differing cultures. Dr. Sisti’s commentary resonates with my impression that surgeons experienced in labiaplasty will testify that the vast majority of patients express a high degree of satisfaction that is equal to or exceeds nearly any other aesthetic procedure. Despite the demand and the safety of Regarding the same type of surgery, Dr. Mazloomdoost et al. recently published an article entitled “Survey of Male Perceptions Regarding the Vulva.”2 In that study, men aged 18 to 80 years were recruited by means of e-mails sent by an Internet provider to participate in a 27-question Web-based survey. The questionnaire included images and queried demographics, men’s familiarity with vulvar anatomy, preferences regarding labial appearance, and awareness of labiaplasty. With regard to preferences, more respondents considered smaller labia attractive compared with large labia; multivariable analysis revealed younger age to be associated with preferences for small labia and complete genital hair removal, and familiarity with labiaplasty. In this national survey, the majority of men do not have a preferred appearance for female genitalia, nor do they support female genital cosmetic operations or consider discussing genital surgery with their partner.2 This conclusion is also supported by a recent study on the same topic from Dr. Horrocks et al.3 A total of 500 online surveys were sent out and 248 respondents were included in the study; only 14 percent of men supported genital cosmetic surgery, whereas 29.6 percent are undecided about the practice. The most common preferred pubic hair appearance is completely hairless (45 percent). The problem of hypertrophy of the labia minora arises mainly from the need of the patient herself. The demand for cosmetic surgery for reduction of the labia minora by women is growing. Although women are motivated by functional implications, aesthetic causes, such as appearance, account for almost half of the impetus driving this demand.2 Women prefer a prepubescent aesthetic, with the labia minora tucked within the confines of the labia majora. Psychological counseling is recommended to inform women that surgery is not a definitive solution to treat psychologically based pain or dysfunction.4 To date, there are eight different techniques available for this type of surgical procedure, they have been listed and graphically represented in a recent review.5 In general, a very low complication rate and satisfactory aesthetic outcomes for the patients were reported for all the techniques performed. We regularly perform this type of surgery using the wedge technique and found high satisfaction of patients and a very low complication rate. With this letter, we want to encourage young plastic surgeons and even gynecologists to perform this type of surgery, when requested, because it is simple to implement and relatively safe. DOI: 10.1097/PRS.0000000000002202
Clinics in Plastic Surgery
Plastic and Reconstructive Surgery, Apr 1, 2020
Aesthetic surgery journal, 2020
Aesthetic Surgery Journal
Plastic & Reconstructive Surgery
Aesthetic Surgery Journal
Background Achieving an aesthetic phalloplasty result is important for patients with acquired or ... more Background Achieving an aesthetic phalloplasty result is important for patients with acquired or congenital defects of the penis, or with genital-related dysphoria. However, aside from length and girth, the aesthetic proportions of the male penis have not been defined. Objectives This study aimed to determine proportions of the male penis through photogrammetric analysis of nude male photographs and to verify these proportions with a crowdsourcing-based survey. Methods Nude male photographs (n = 283) were analyzed to define aesthetic proportions of the male penis. Photographs were analyzed for the position of the penis on the torso in relation to the umbilicus and for the ratio of the dorsal and ventral glans of the penis in relation to the entire shaft length. Proportions were then further studied by crowdsourcing 1026 respondents with Amazon mechanical Turk. Results The ideal position of the penis below the umbilicus is about 55% (6/11th) of the distance from the jugular notch to ...
Plastic and reconstructive surgery, Jan 15, 2016
Reply: Growing Body of Evidence Supports Safety of Female Genital Cosmetic Surgery Sir: I am hono... more Reply: Growing Body of Evidence Supports Safety of Female Genital Cosmetic Surgery Sir: I am honored to have Dr. Sisti, a surgeon who is well acquainted with labiaplasty and coauthor of a comprehensive review,1 comment on our investigation.2 He discusses two studies of male preferences regarding female genital appearance. These findings confirm the results of an earlier article we have published regarding cultural expectations for the female pudenda as reflected in the media and specifically in the archetypal men’s magazine, Playboy.3 Dr. Sisti similarly echoes the observations of others who also stress the aesthetic goals of labiaplasty as being the preeminent motivating factor for women seeking labiaplasty.4 It is clear that the popularity of the procedure is not limited to the United States; reports from experienced surgeons such as Triana and Robledo,5 Mayer,6 Gress,7 Oranges et al.,1 Veale et al.,8 Giraldo et al.,9 Felicia Yde,10 Choi and Kim,11 and others (e.g., from Colombia, Argentina, Germany, Italy, England, Spain, Brazil, and South Korea), indicate that this specialty is an international phenomenon and has wide appeal to a variety of differing cultures. Dr. Sisti’s commentary resonates with my impression that surgeons experienced in labiaplasty will testify that the vast majority of patients express a high degree of satisfaction that is equal to or exceeds nearly any other aesthetic procedure. Despite the demand and the safety of Regarding the same type of surgery, Dr. Mazloomdoost et al. recently published an article entitled “Survey of Male Perceptions Regarding the Vulva.”2 In that study, men aged 18 to 80 years were recruited by means of e-mails sent by an Internet provider to participate in a 27-question Web-based survey. The questionnaire included images and queried demographics, men’s familiarity with vulvar anatomy, preferences regarding labial appearance, and awareness of labiaplasty. With regard to preferences, more respondents considered smaller labia attractive compared with large labia; multivariable analysis revealed younger age to be associated with preferences for small labia and complete genital hair removal, and familiarity with labiaplasty. In this national survey, the majority of men do not have a preferred appearance for female genitalia, nor do they support female genital cosmetic operations or consider discussing genital surgery with their partner.2 This conclusion is also supported by a recent study on the same topic from Dr. Horrocks et al.3 A total of 500 online surveys were sent out and 248 respondents were included in the study; only 14 percent of men supported genital cosmetic surgery, whereas 29.6 percent are undecided about the practice. The most common preferred pubic hair appearance is completely hairless (45 percent). The problem of hypertrophy of the labia minora arises mainly from the need of the patient herself. The demand for cosmetic surgery for reduction of the labia minora by women is growing. Although women are motivated by functional implications, aesthetic causes, such as appearance, account for almost half of the impetus driving this demand.2 Women prefer a prepubescent aesthetic, with the labia minora tucked within the confines of the labia majora. Psychological counseling is recommended to inform women that surgery is not a definitive solution to treat psychologically based pain or dysfunction.4 To date, there are eight different techniques available for this type of surgical procedure, they have been listed and graphically represented in a recent review.5 In general, a very low complication rate and satisfactory aesthetic outcomes for the patients were reported for all the techniques performed. We regularly perform this type of surgery using the wedge technique and found high satisfaction of patients and a very low complication rate. With this letter, we want to encourage young plastic surgeons and even gynecologists to perform this type of surgery, when requested, because it is simple to implement and relatively safe. DOI: 10.1097/PRS.0000000000002202
Plastic and Reconstructive Surgery, 2016
Aesthetic Surgery Journal
Aesthetic Surgery Journal
Background Heightening interest in labiaplasty has driven potential patients to online forums, pe... more Background Heightening interest in labiaplasty has driven potential patients to online forums, permitting the dissemination of material by potentially unqualified or inexperienced individuals. The discourse surrounding this procedure has been injected with strong opinions that are not entirely consistent with medical best-practice or evidence-based knowledge. Objectives Explore the rationale for ongoing public opposition to labiaplasty and if bringing awareness to the similarities of labiaplasty and breast reduction can alter an individual’s perception. Methods 448 adult women were surveyed concerning their opinion of a surgical procedure to reduce the size of an unspecified organ related to a woman’s sexuality, breast reduction, and labia reduction. Results Reduction of an unspecified organ and breasts were met with significantly greater acceptance than labia reduction (p < 0.0001). Presenting responders with an educational tool comparing each procedure’s indications, risks, and...
Plastic and Reconstructive Surgery
Aesthetic Surgery Journal
Background A significant proportion of patients seeking labiaplasty are nulliparous and may exper... more Background A significant proportion of patients seeking labiaplasty are nulliparous and may experience later changes to their labia following vaginal delivery. Objectives In the present study, the authors reported the long-term outcomes of a single surgeon’s patient cohort who had vaginal delivery after labiaplasty. Methods A retrospective chart review of the senior author’s database was conducted. All patients who underwent in-office labiaplasty from 2007 to 2018 were surveyed. The resulting cohort was stratified into patients who had delivered children prior to labiaplasty and those who delivered after labiaplasty. Results A total of 204 patients responded to a phone survey. Seventy patients had children prior to undergoing labiaplasty, and 33 had children after labiaplasty. The rate of vaginal delivery was lower in the women who had children before labiaplasty (82.6% vs 91.8%, P = 0.015). The tear/episiotomy rate for vaginal deliveries was lower in women who had children prior to...
Aesthetic Surgery Journal
Aesthetic Surgery Journal
As the popularity of female cosmetic genital surgery has grown, so has the number of publications... more As the popularity of female cosmetic genital surgery has grown, so has the number of publications detailing surgical techniques, particularly regarding labiaplasty. As a nascent surgical field, much room remains for finesse and exploration of new techniques to optimize outcomes and patient satisfaction. We present the techniques for anterior and posterior commissuroplasty which the senior author (O.J.P.) has developed. Anterior commissuroplasty is efficacious in addressing a number of anatomic variations to achieve the appearance of a single midline cleft which is commonly requested by patients. Posterior commissuroplasty was developed to address skin excess at the posterior fourchette that may develop as a result of labiaplasty. Either technique may be used in combination with labiaplasty or as a stand-alone procedure. These tools may be a useful addition to the repertoire of a surgeon practicing female genital surgery.