Otto Placik | Northwestern University (original) (raw)
Papers by Otto Placik
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.
Clinics in Plastic Surgery
Journal of clinical & experimental dermatology research, Nov 27, 2013
Plastic and Reconstructive Surgery, Apr 1, 2020
873e Reply: Female Genital and Vaginal Plastic Surgery: An Overview Sir: We are honored to respon... more 873e Reply: Female Genital and Vaginal Plastic Surgery: An Overview Sir: We are honored to respond to the submitted commentary by the venerable Dr. Sisti et al. We regret that we omitted the referenced works by Motakef et al. and Oranges et al. While not an excuse, we were limited in the scope of the article and a comprehensive review of all subjects in sufficient detail was not possible within the very specific confines of a 3500-word article. We leave these exhaustive reviews to textbooks or to the published reports focusing on isolated procedures or anatomy. We were also provided with explicit instructions to discuss and refer to sources with high levels of evidence to the best of our ability. This precluded us from even discussing the effectiveness of energy-based devices at the time of acceptance. We understand and appreciate the tremendous layperson appeal of the G-spot and the many other topics we briefly touched upon, but the G-spot remains a controversial subject among scientists and anatomists,1 as stated in our review.2 As Sisti et al. have mentioned in their earlier work, many investigators prefer to refer to this area of enhanced sexual stimulation as the “clitoris-urethra-vagina” complex.3 In this context, one must acknowledge that there is a distinction between a purported “vaginal” orgasm versus a “clitoral” orgasm and that this may relate to the internal versus the external portions of the clitoris, respectively.4 Furthermore, the area reportedly responsible for the “vaginal” orgasm, commonly termed the G-spot, has not been identified in all individuals in neither a magnetic resonance imaging scan (62 percent) nor an ultrasound (thickness correlation) study.5,6 Our diagram simply referred to the general anatomic area (colloquially known as the G-spot) and its “proximity to clitoral complex and urethral sponge” rather than digress into a discussion of the clitoris-urethra-vagina complex.2 We briefly mention that we believe it to be consistent with an erogenous zone (much as the ear can be) due to the lack of it being a consistent universal finding in all subjects studied.7 We have concerns that Sisti et al. are conflating G-spot augmentation with female genital mutilation, as have many others. We do not advocate nor denounce the procedure but state there is a “lack of data regarding a role of these products for enhancing sexual function.”2 We have addressed the controversy of female genital mutilation versus female genital plastic surgery in the article; however, we are surprised that Dr. Andrea Sisti, as a practitioner of female genital plastic surgery, would raise this criticism, because nearly all the other procedures discussed here could potentially fall into that realm.8 This First, the authors failed to cite two important reviews on labiaplasty surgical techniques: the article by Motakef et al.2 and the article by Oranges et al.3 Furthermore, the authors only briefly mention the G spot and its augmentation, without a proper narrative on these important topics. They correctly represent the G spot area in their Figure 4 without fully describing this anatomical area. On page 287e of their article, they mention how the clitoris may be involved in the orgasmic reaction started in the G spot area, without fully describing the current theories about it. We would add that the G spot has been recently described via sonogram as a unique area on the anterior vaginal wall,4 and its relationship to the vaginal and clitoral orgasm has been questioned. It seems that the G spot is in reality a part of the greater clitourethrovaginal complex: the mechanical pressure given by the penis on the anterior vaginal wall would be transmitted upward to the clitoris, where the orgasm would be finally generated. The augmentation of the G spot has been very controversial, with limited scientific evidence, and it has even been compared to a genital mutilation.5 DOI: 10.1097/PRS.0000000000006659
Plastic and Reconstructive Surgery, 2015
ne of the most common criticisms cited by both the lay public and medical professionals against l... more ne of the most common criticisms cited by both the lay public and medical professionals against labiaplasty (also referred to as labioplasty, simple partial vulvectomy, labia minora reduction, or nymphectomy) is the perceived loss of sensation (hypesthesia) and hypersensitivity along the labial edge. 1-6 Although the increase in or loss of labial sensitivity has been an argument against the procedure, there has not been a study to date to substantiate or disprove these assertions. Conversely, it has been the clinical experience of the lead author (O.J.P.), having performed over 500 labiaplasty procedures, that patients do not report long-term sensory loss or hypersensitivity. Furthermore, these patients report improved or unchanged sexual satisfaction. Of the various labia reduction procedures performed, it is difficult to determine the frequency of the exact techniques used. Reduction by resection of the labial edge, often referred to as the trim technique or despairingly as the "amputation method," has been criticized for clinically significant nerve damage as an unavoidable consequence. 7 Despite a lack of empirical evidence supporting this, alternative approaches to performing labiaplasty that preserve the edge and the sensory nerve endings have been described, including the wedge, modified V wedge, fenestration, Z-plasty, Disclosure: The authors have no disclosure to report and no funding was received to assist in the creation of this article.
Surgery, gynecology & obstetrics, 1992
The mechanisms underlying the pathogenesis of keloids have not been fully characterized despite e... more The mechanisms underlying the pathogenesis of keloids have not been fully characterized despite extensive past and present research. Results of past and present studies have shown that the immune system is actively involved in the development of these lesions. Future investigations into the biochemistry and immunologic factors of keloids are anticipated and expected to produce additional insight. The inability to identify cellular (fibroblast) abnormalities has led most investigators to focus on the humoral regulators of wound healing, that is, biochemical substances, immunologic mediators and growth factors. Future studies are needed to confirm or refute the presence of AFA. AFA, if they exist, may prove to be useful as immunologic markers of keloids and may help distinguish keloids from hypertrophic scar in the early stages of wound healing. The influence of immunologic mediators may be more impressive early in the development of scars. "Young" or "early" is de...
Plastic and Reconstructive Surgery, 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, 1997
Since the first report of successful microsurgical ear replantation in 1980, there have been 12 o... more Since the first report of successful microsurgical ear replantation in 1980, there have been 12 other cases reported in the English literature. As the number of trained microsurgeons increases, the opportunity to treat the amputated ear with microsurgical techniques should become more common. The reported cases have involved a variety of different mechanisms of injury and methods of treatment. There have been three techniques used to revascularize the amputated ear successfully: primary vascular repair, vein grafting, and use of the superficial temporal vessels as a pedicled vascular leash. Through our own experience and a review of the literature, we have been able to identify certain clinical characteristics that help dictate which technique to use. We report four cases of successful ear replantation, review the various techniques that have been used successfully, and provide treatment recommendations for future consideration.
Plastic and Reconstructive Surgery, 1993
JAMA: The Journal of the American Medical Association, 1994
To the Editor. —I read with interest the article by Drs Levine and Ilowite. 1 I have examined one... more To the Editor. —I read with interest the article by Drs Levine and Ilowite. 1 I have examined one of the children that they evaluated in their study and found evidence of peripheral neuropathy determined by nerve conduction studies and somatosensory evoked responses. It may be that this esophageal motility disorder that the authors found in their study may be related to autonomic neuropathy rather than true muscle dysfunction.
Annals of Plastic Surgery, 1992
Tumors of neurogenic (ectodermal) origin are well-described causes of nasal deformity. We present... more Tumors of neurogenic (ectodermal) origin are well-described causes of nasal deformity. We present a patient with a benign mesodermal tumor (unclassified spindle cell) producing nasal deformity. A retrospective review of the two senior authors' records provided an additional three patients with nonvascular benign mesodermal nasal masses (fibroma and leiomyoma). Benign mesodermal masses can occur in the midline of the nose and need to be differentiated from dermoids and gliomas. Misdiagnosis is the rule. Excisional biopsy is required for definitive diagnosis. In addition, excisional biopsy is curative and can help to minimize the subsequent nasal deformity if performed early in the disease process. Immunohistochemical and electron microscopy may be required for comprehensive diagnosis and treatment.
Annals of Plastic Surgery, 1993
We report traumatic necrotizing periorbital cellulitis attributed to group A beta-hemolytic strep... more We report traumatic necrotizing periorbital cellulitis attributed to group A beta-hemolytic streptococci in a 4-year-old child. The infection was successfully treated via surgical cleansing, drainage, and grafting. The virulence of this organism requires an aggressive approach to the patient with periorbital cellulitis, which is refractory to intravenous antibiotics. Early treatment may limit extensive eyelid necrosis, the resultant secondary deformity, and the need for multiple reconstructive procedures.
Annals of Plastic Surgery, 1995
The Journal of Sexual Medicine, 2010
ABSTRACTIntroductionFemale Genital Plastic Surgery, a relatively new entry in the field of Cosmet... more ABSTRACTIntroductionFemale Genital Plastic Surgery, a relatively new entry in the field of Cosmetic and Plastic Surgery, has promised sexual enhancement and functional and cosmetic improvement for women. Are the vulvovaginal aesthetic procedures of Labiaplasty, Vaginoplasty/Perineoplasty (“Vaginal Rejuvenation”) and Clitoral Hood Reduction effective, and do they deliver on that promise? For what reason do women seek these procedures? What complications are evident, and what effects are noted regarding sexual function for women and their partners? Who should be performing these procedures, what training should they have, and what are the ethical considerations?AimThis study was designed to produce objective, utilizable outcome data regarding FGPS.Main Outcome Measures1) Reasons for considering surgery from both patient’s and physician’s perspective; 2) Pre-operative sexual functioning per procedure; 3) Overall patient satisfaction per procedure; 4) Effect of procedure on patient’s se...
Aesthetic surgery journal / the American Society for Aesthetic Plastic surgery, 2014
Aesthetic vulvovaginal procedures are being performed with increased frequency. Many experts have... more Aesthetic vulvovaginal procedures are being performed with increased frequency. Many experts have suggested that the growing demand for these procedures relates to the availability and revealing nature of nude images on the Internet and in other media. The authors examined chronologically organized nude photographs from a popular magazine and objectively measured the position of the vulva relative to the center of focus to observe trends for the past 6 decades. Playboy magazine centerfold photographs from 1954 to 2013 were analyzed and categorized. The positions of the vaginal area (V-line) and the breast area (N-line) were measured in relation to the horizontal midline of the photograph. Images also were assessed for degree of grooming and exposure of the breast and pubic areas, as well as visibility of the pudendal cleft, labia majora, and labia minora. Four hundred ninety images met inclusion criteria for the analysis. Full exposure of the V-line increased from 0 instances in the...
Plastic and Reconstructive Surgery
LEARNING OBJECTIVES After studying this article and viewing the video, the participant should be ... more LEARNING OBJECTIVES After studying this article and viewing the video, the participant should be able to: 1. Accurately describe the relevant aesthetic anatomy and terminology for common female genital plastic surgery procedures. 2. Have knowledge of the different surgical options to address common aesthetic concerns and their risks, alternatives, and benefits. 3. List the potential risks, alternatives, and benefits of commonly performed female genital aesthetic interventions. 4. Be aware of the entity of female genital mutilation and differentiation from female genital cosmetic surgery. SUMMARY This CME activity is intended to provide a brief 3500-word overview of female genital cosmetic surgery. The focus is primarily on elective vulvovaginal procedures, avoiding posttrauma reconstruction or gender-confirmation surgery. The goal is to present content with the best available and independent unbiased scientific research. Given this relatively new field, data with a high level of evidence are limited. Entities that may be commonly encountered in a plastic surgery practice are reviewed. The physician must be comfortable with the anatomy, terminology, diagnosis, and treatment options. Familiarity with requested interventions and aesthetic goals is encouraged.
Aesthetic Surgery Journal
Aesthetic Surgery Journal
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.
Clinics in Plastic Surgery
Journal of clinical & experimental dermatology research, Nov 27, 2013
Plastic and Reconstructive Surgery, Apr 1, 2020
873e Reply: Female Genital and Vaginal Plastic Surgery: An Overview Sir: We are honored to respon... more 873e Reply: Female Genital and Vaginal Plastic Surgery: An Overview Sir: We are honored to respond to the submitted commentary by the venerable Dr. Sisti et al. We regret that we omitted the referenced works by Motakef et al. and Oranges et al. While not an excuse, we were limited in the scope of the article and a comprehensive review of all subjects in sufficient detail was not possible within the very specific confines of a 3500-word article. We leave these exhaustive reviews to textbooks or to the published reports focusing on isolated procedures or anatomy. We were also provided with explicit instructions to discuss and refer to sources with high levels of evidence to the best of our ability. This precluded us from even discussing the effectiveness of energy-based devices at the time of acceptance. We understand and appreciate the tremendous layperson appeal of the G-spot and the many other topics we briefly touched upon, but the G-spot remains a controversial subject among scientists and anatomists,1 as stated in our review.2 As Sisti et al. have mentioned in their earlier work, many investigators prefer to refer to this area of enhanced sexual stimulation as the “clitoris-urethra-vagina” complex.3 In this context, one must acknowledge that there is a distinction between a purported “vaginal” orgasm versus a “clitoral” orgasm and that this may relate to the internal versus the external portions of the clitoris, respectively.4 Furthermore, the area reportedly responsible for the “vaginal” orgasm, commonly termed the G-spot, has not been identified in all individuals in neither a magnetic resonance imaging scan (62 percent) nor an ultrasound (thickness correlation) study.5,6 Our diagram simply referred to the general anatomic area (colloquially known as the G-spot) and its “proximity to clitoral complex and urethral sponge” rather than digress into a discussion of the clitoris-urethra-vagina complex.2 We briefly mention that we believe it to be consistent with an erogenous zone (much as the ear can be) due to the lack of it being a consistent universal finding in all subjects studied.7 We have concerns that Sisti et al. are conflating G-spot augmentation with female genital mutilation, as have many others. We do not advocate nor denounce the procedure but state there is a “lack of data regarding a role of these products for enhancing sexual function.”2 We have addressed the controversy of female genital mutilation versus female genital plastic surgery in the article; however, we are surprised that Dr. Andrea Sisti, as a practitioner of female genital plastic surgery, would raise this criticism, because nearly all the other procedures discussed here could potentially fall into that realm.8 This First, the authors failed to cite two important reviews on labiaplasty surgical techniques: the article by Motakef et al.2 and the article by Oranges et al.3 Furthermore, the authors only briefly mention the G spot and its augmentation, without a proper narrative on these important topics. They correctly represent the G spot area in their Figure 4 without fully describing this anatomical area. On page 287e of their article, they mention how the clitoris may be involved in the orgasmic reaction started in the G spot area, without fully describing the current theories about it. We would add that the G spot has been recently described via sonogram as a unique area on the anterior vaginal wall,4 and its relationship to the vaginal and clitoral orgasm has been questioned. It seems that the G spot is in reality a part of the greater clitourethrovaginal complex: the mechanical pressure given by the penis on the anterior vaginal wall would be transmitted upward to the clitoris, where the orgasm would be finally generated. The augmentation of the G spot has been very controversial, with limited scientific evidence, and it has even been compared to a genital mutilation.5 DOI: 10.1097/PRS.0000000000006659
Plastic and Reconstructive Surgery, 2015
ne of the most common criticisms cited by both the lay public and medical professionals against l... more ne of the most common criticisms cited by both the lay public and medical professionals against labiaplasty (also referred to as labioplasty, simple partial vulvectomy, labia minora reduction, or nymphectomy) is the perceived loss of sensation (hypesthesia) and hypersensitivity along the labial edge. 1-6 Although the increase in or loss of labial sensitivity has been an argument against the procedure, there has not been a study to date to substantiate or disprove these assertions. Conversely, it has been the clinical experience of the lead author (O.J.P.), having performed over 500 labiaplasty procedures, that patients do not report long-term sensory loss or hypersensitivity. Furthermore, these patients report improved or unchanged sexual satisfaction. Of the various labia reduction procedures performed, it is difficult to determine the frequency of the exact techniques used. Reduction by resection of the labial edge, often referred to as the trim technique or despairingly as the "amputation method," has been criticized for clinically significant nerve damage as an unavoidable consequence. 7 Despite a lack of empirical evidence supporting this, alternative approaches to performing labiaplasty that preserve the edge and the sensory nerve endings have been described, including the wedge, modified V wedge, fenestration, Z-plasty, Disclosure: The authors have no disclosure to report and no funding was received to assist in the creation of this article.
Surgery, gynecology & obstetrics, 1992
The mechanisms underlying the pathogenesis of keloids have not been fully characterized despite e... more The mechanisms underlying the pathogenesis of keloids have not been fully characterized despite extensive past and present research. Results of past and present studies have shown that the immune system is actively involved in the development of these lesions. Future investigations into the biochemistry and immunologic factors of keloids are anticipated and expected to produce additional insight. The inability to identify cellular (fibroblast) abnormalities has led most investigators to focus on the humoral regulators of wound healing, that is, biochemical substances, immunologic mediators and growth factors. Future studies are needed to confirm or refute the presence of AFA. AFA, if they exist, may prove to be useful as immunologic markers of keloids and may help distinguish keloids from hypertrophic scar in the early stages of wound healing. The influence of immunologic mediators may be more impressive early in the development of scars. "Young" or "early" is de...
Plastic and Reconstructive Surgery, 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, 1997
Since the first report of successful microsurgical ear replantation in 1980, there have been 12 o... more Since the first report of successful microsurgical ear replantation in 1980, there have been 12 other cases reported in the English literature. As the number of trained microsurgeons increases, the opportunity to treat the amputated ear with microsurgical techniques should become more common. The reported cases have involved a variety of different mechanisms of injury and methods of treatment. There have been three techniques used to revascularize the amputated ear successfully: primary vascular repair, vein grafting, and use of the superficial temporal vessels as a pedicled vascular leash. Through our own experience and a review of the literature, we have been able to identify certain clinical characteristics that help dictate which technique to use. We report four cases of successful ear replantation, review the various techniques that have been used successfully, and provide treatment recommendations for future consideration.
Plastic and Reconstructive Surgery, 1993
JAMA: The Journal of the American Medical Association, 1994
To the Editor. —I read with interest the article by Drs Levine and Ilowite. 1 I have examined one... more To the Editor. —I read with interest the article by Drs Levine and Ilowite. 1 I have examined one of the children that they evaluated in their study and found evidence of peripheral neuropathy determined by nerve conduction studies and somatosensory evoked responses. It may be that this esophageal motility disorder that the authors found in their study may be related to autonomic neuropathy rather than true muscle dysfunction.
Annals of Plastic Surgery, 1992
Tumors of neurogenic (ectodermal) origin are well-described causes of nasal deformity. We present... more Tumors of neurogenic (ectodermal) origin are well-described causes of nasal deformity. We present a patient with a benign mesodermal tumor (unclassified spindle cell) producing nasal deformity. A retrospective review of the two senior authors' records provided an additional three patients with nonvascular benign mesodermal nasal masses (fibroma and leiomyoma). Benign mesodermal masses can occur in the midline of the nose and need to be differentiated from dermoids and gliomas. Misdiagnosis is the rule. Excisional biopsy is required for definitive diagnosis. In addition, excisional biopsy is curative and can help to minimize the subsequent nasal deformity if performed early in the disease process. Immunohistochemical and electron microscopy may be required for comprehensive diagnosis and treatment.
Annals of Plastic Surgery, 1993
We report traumatic necrotizing periorbital cellulitis attributed to group A beta-hemolytic strep... more We report traumatic necrotizing periorbital cellulitis attributed to group A beta-hemolytic streptococci in a 4-year-old child. The infection was successfully treated via surgical cleansing, drainage, and grafting. The virulence of this organism requires an aggressive approach to the patient with periorbital cellulitis, which is refractory to intravenous antibiotics. Early treatment may limit extensive eyelid necrosis, the resultant secondary deformity, and the need for multiple reconstructive procedures.
Annals of Plastic Surgery, 1995
The Journal of Sexual Medicine, 2010
ABSTRACTIntroductionFemale Genital Plastic Surgery, a relatively new entry in the field of Cosmet... more ABSTRACTIntroductionFemale Genital Plastic Surgery, a relatively new entry in the field of Cosmetic and Plastic Surgery, has promised sexual enhancement and functional and cosmetic improvement for women. Are the vulvovaginal aesthetic procedures of Labiaplasty, Vaginoplasty/Perineoplasty (“Vaginal Rejuvenation”) and Clitoral Hood Reduction effective, and do they deliver on that promise? For what reason do women seek these procedures? What complications are evident, and what effects are noted regarding sexual function for women and their partners? Who should be performing these procedures, what training should they have, and what are the ethical considerations?AimThis study was designed to produce objective, utilizable outcome data regarding FGPS.Main Outcome Measures1) Reasons for considering surgery from both patient’s and physician’s perspective; 2) Pre-operative sexual functioning per procedure; 3) Overall patient satisfaction per procedure; 4) Effect of procedure on patient’s se...
Aesthetic surgery journal / the American Society for Aesthetic Plastic surgery, 2014
Aesthetic vulvovaginal procedures are being performed with increased frequency. Many experts have... more Aesthetic vulvovaginal procedures are being performed with increased frequency. Many experts have suggested that the growing demand for these procedures relates to the availability and revealing nature of nude images on the Internet and in other media. The authors examined chronologically organized nude photographs from a popular magazine and objectively measured the position of the vulva relative to the center of focus to observe trends for the past 6 decades. Playboy magazine centerfold photographs from 1954 to 2013 were analyzed and categorized. The positions of the vaginal area (V-line) and the breast area (N-line) were measured in relation to the horizontal midline of the photograph. Images also were assessed for degree of grooming and exposure of the breast and pubic areas, as well as visibility of the pudendal cleft, labia majora, and labia minora. Four hundred ninety images met inclusion criteria for the analysis. Full exposure of the V-line increased from 0 instances in the...
Plastic and Reconstructive Surgery
LEARNING OBJECTIVES After studying this article and viewing the video, the participant should be ... more LEARNING OBJECTIVES After studying this article and viewing the video, the participant should be able to: 1. Accurately describe the relevant aesthetic anatomy and terminology for common female genital plastic surgery procedures. 2. Have knowledge of the different surgical options to address common aesthetic concerns and their risks, alternatives, and benefits. 3. List the potential risks, alternatives, and benefits of commonly performed female genital aesthetic interventions. 4. Be aware of the entity of female genital mutilation and differentiation from female genital cosmetic surgery. SUMMARY This CME activity is intended to provide a brief 3500-word overview of female genital cosmetic surgery. The focus is primarily on elective vulvovaginal procedures, avoiding posttrauma reconstruction or gender-confirmation surgery. The goal is to present content with the best available and independent unbiased scientific research. Given this relatively new field, data with a high level of evidence are limited. Entities that may be commonly encountered in a plastic surgery practice are reviewed. The physician must be comfortable with the anatomy, terminology, diagnosis, and treatment options. Familiarity with requested interventions and aesthetic goals is encouraged.
Aesthetic Surgery Journal
Aesthetic Surgery Journal