Aesthetic Surgery Research Papers - Academia.edu (original) (raw)

Injection-induced necrosis is a rare but dreaded consequence of soft tissue augmentation with filler agents. It usually occurs as a result of injection of filler directly into an artery, but can also result from compression or injury. We... more

Injection-induced necrosis is a rare but dreaded consequence of soft tissue augmentation with filler agents. It usually occurs as a result of injection of filler directly into an artery, but can also result from compression or injury. We provide recommendations on the use of hyaluronidase when vascular compromise is suspected. Consensus recommendations were developed by thorough discussion and debate amongst the authors at a roundtable meeting on Wednesday June 18, 2014 in Las Vegas, NV as well as significant ongoing written and verbal communications amongst the authors in the months prior to journal submission. All authors are experienced tertiary care providers. A prompt diagnosis and immediate treatment with high doses of hyaluronidase (at least 200 U) are critically important. It is not felt necessary to do a skin test in cases of impending necrosis. Some experts recommend dilution with saline to increase dispersion or lidocaine to aid vasodilation. Additional hyaluronidase shou...

Background Although many interventions are implemented to prevent surgical site infections (SSIs) in plastic surgery, their supporting evidence is inconsistent. Objectives The goal of this study was to assess the efficacy of methods for... more

Background Although many interventions are implemented to prevent surgical site infections (SSIs) in plastic surgery, their supporting evidence is inconsistent. Objectives The goal of this study was to assess the efficacy of methods for decreasing SSIs in plastic surgery. Methods A systematic review and meta-analysis were performed to compare the effects of SSI prevention methods. All the studies were assessed for quality of evidence according to the GRADE assessment. Results Fifty Level 1 randomized controlled trials were included. The most common interventions for preventing SSIs were antibiotic prophylaxis, showering, prepping, draping, and the use of dressings. Current evidence suggests that antibiotic prophylaxis is largely unnecessary and overused in many plastic surgical procedures, with the exception of head and neck oncologic, oral craniofacial, and traumatic hand surgeries. Conclusions Efficacy of antibiotic prophylaxis in plastic surgery is dependent on surgery type. Ther...

A number of authors have proposed retrograde arterial embolism as the responsible mechanism for filler-induced blindness. However, no previous human study has substantiated this proposed mechanism. The aim of this study was to investigate... more

A number of authors have proposed retrograde arterial embolism as the responsible mechanism for filler-induced blindness. However, no previous human study has substantiated this proposed mechanism. The aim of this study was to investigate the pathophysiology of filler-induced blindness using a fresh cadaver perfusion technique. A fresh cadaver head perfusion model that simulates both physiologic blood pressure and flow rate of the carotid artery, ophthalmic artery, supratrochlear artery was used. The common carotid artery was cannulated and the internal jugular vein exposed for open venous drainage. A plasma-based perfusate was circulated through the cadaver head which was connected to a perfusion system consisting of a roller pump, preload reservoir, and pressure monitor. The hyaluronic acid filler mixed with methylene blue was injected into the cannulated superficial branch of the supratrochlear artery. Cadaver dissection, angiographic study, and histology were used to investigate...

Background The usage of the smartphone and social media have introduced paradigm shifts to cosmetic surgery. Much has been studied regarding social media and its influences in plastic surgery, however, little is known about facial editing... more

Background The usage of the smartphone and social media have introduced paradigm shifts to cosmetic surgery. Much has been studied regarding social media and its influences in plastic surgery, however, little is known about facial editing applications and how these relate to plastic surgery practices. Objectives Do face-editing applications influence patients’ pursuit of plastic surgery, and who and why do they use these applications? Methods An anonymous survey was administered between September and December 2019, including questions about demographics, familiarity and utilization of face-editing applications, motivations in usage and influences towards pursuing cosmetic procedures, and attitudes towards applications. Results Seventy patients completed the survey and 32.9% admitted to using face-editing applications. Patients using applications were significantly younger (36.9 years) than those who did not (54 years) (p < .001). Amongst those familiar with applications, women we...

The junction between upper and lower lateral cartilages, known as "the scroll area," is an important determinant of the spatial relationship between the middle and lower nasal thirds. We offer a graduated and reproducible... more

The junction between upper and lower lateral cartilages, known as "the scroll area," is an important determinant of the spatial relationship between the middle and lower nasal thirds. We offer a graduated and reproducible surgical technique of scroll area management that takes into consideration anatomic, functional, and aesthetic relationships. This study was a retrospective review of the recorded intraoperative information to investigate the frequency of the use of scroll reconstruction techniques and perioperative parameters that relate to unintended component alterations in the scroll area. A total of 364 consecutive primary open approach rhinoplasty cases performed by the first author (O.B.) between July 2011 and September 2015 were included in the study. Of the 364 cases who underwent primary open approach rhinoplasty, 329 received some form of scroll reconstruction. Scroll reconstruction was performed in all deviated cases, and 88% of straight noses. The most common...

Poly-L-lactic acid (PLLA) is a synthetic, biocompatible, biodegradable polymer. For soft-tissue augmentation, the size and chemical attributes of the PLLA microparticles are central to this agent's ability to promote a subclinical... more

Poly-L-lactic acid (PLLA) is a synthetic, biocompatible, biodegradable polymer. For soft-tissue augmentation, the size and chemical attributes of the PLLA microparticles are central to this agent's ability to promote a subclinical inflammatory response that stimulates deposition of collagen in the extracellular matrix. The resultant restoration of facial volume occurs in a controlled, predictable manner and is long lasting. The unique physiochemical and biostimulatory properties of PLLA differentiate it from other available treatments and are the foundation of the unique treatment methodology required for optimal results.

Breast augmentation is one of the most popular aesthetic surgical procedures. The only potential alternative is autologous fat grafting (AFG), which is not new in principle. This procedure has been used on native breasts since 2009,... more

Breast augmentation is one of the most popular aesthetic surgical procedures. The only potential alternative is autologous fat grafting (AFG), which is not new in principle. This procedure has been used on native breasts since 2009, following the recommendations of some learned societies. We performed a systematic review to determine the current worldwide status of fat grafting for aesthetic breast augmentation. A systematic review of the literature following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis criteria was conducted using the PubMed, EmBASE, and Cochrane library databases. This protocol was registered at the National Institute for Health Research, Prospective Register of Systematic Reviews. A total of 42 articles published between 1987 and July 2014 were included. Most of the studies had a low level of evidence, with only one level 2 study, published by Spear (2014), a prospective cohort study which included 10 patients. The publications were from...

The Atlanta Institute for Facial Aesthetic Surgery is considered one of the most advanced facial plastic surgery centers in Atlanta, specializing in rhinoplasty, facelift and neck lift surgery, and more. Atlanta facial plastic surgeon Dr.... more

The Atlanta Institute for Facial Aesthetic Surgery is considered one of the most advanced facial plastic surgery centers in Atlanta, specializing in rhinoplasty, facelift and neck lift surgery, and more. Atlanta facial plastic surgeon Dr. Sinha is board-certified and specializes in aesthetic surgery of the face, neck, hands and skin to help you look and feel younger.

Cumulative long-term exposure to solar ultraviolet radiation promotes premature skin aging characterized by wrinkle formation and reduced skin elasticity. In this study, we assessed whether microfat transfer could improve dermal and... more

Cumulative long-term exposure to solar ultraviolet radiation promotes premature skin aging characterized by wrinkle formation and reduced skin elasticity. In this study, we assessed whether microfat transfer could improve dermal and subcutaneous tissue thickness loss associated with photoaging. Twenty-one patients affected by facial photoaging (photodamage grade II–IV; age range 35–62 years; 19 females, 2 males; all of Caucasian origin) were treated using minimally invasive autologous dermal white fat transfer harvested with a recently designed microcannula. The results were determined by clinical assessment and patient self-evaluation and quantified by the Antera 3D® dermal digital device for noninvasive, objective, reliable, and accurate assessment of facial skin texture, color, and wrinkle characteristics. Compared with the pretreatment condition, the increment in soft tissue volume and improvement in skin quality and texture were assessed by a dermatologist after treatment. In addition, instrumental evaluation by digital skin profilometry of the treated areas revealed a 41% reduction in average wrinkle depth (7.29 ± 1.04 × 10−2 mm pretreatment vs. 4.31 ± 1.16 × 10−2 mm at 90 days posttreatment; p < 0.001), improved skin texture, more homogeneous and uniform skin color, and declined facial hemoglobin and melanin concentrations. The majority of patients (above 90%) reported improvements in self-perception. No significant complications were reported throughout the study. In conclusion, by using digital profilometry analysis as an objective and innovative tool to determine the outcome of treatment, we demonstrated that autologous microfat transfer is a safe and well-tolerated procedure with measurable beneficial effects on facial skin aging.

Hymenoplasty is a controversial surgical procedure that begets many ethical questions both socially,culturally and medically. Virginity in females is a highly prized commodity in certain cultures and carries familial honor where... more

Hymenoplasty is a controversial surgical procedure that begets many ethical questions both socially,culturally and medically. Virginity in females is a highly prized commodity in certain cultures and carries familial honor where non-virgins face prejudice,social ostracization and even death as they are considered bringing shame to the family. The notion of “one size fits all” approach in condemning or criticizing hymenoplasty as a frivolous procedure that promotes deceit and encourages female oppression fails to identify socio-cultural aspects that are prevalent in the patient group seeking hymenoplasty. This paper explores the socio-cultural and religious factors involved in women seeking hymen reconstruction and the medicolegal and ethical principles that guide surgeons in offering and performing hymenoplasty. Proper training in hymen reconstruction should be offered to plastic surgeons and gynaecologists as hymenoplasty should not be trivialized as a simple, risk free surgery.
Keywords- plastic surgery, gynaecology, medical ethics, medicolegal, hymen restoration, hymenoplasty, revirgination, virginity, cultural oppression.

RESUMEN El objetivo de la presente investigación consistió en estudiar la imagen del cuerpo y pulsión de muerte en un caso de cirugía estética de una mujer de 38 años a través del modelo psicodinámico. Se utilizó un estudio de caso. Los... more

RESUMEN
El objetivo de la presente investigación consistió en estudiar la imagen del cuerpo y pulsión de muerte en un caso de cirugía estética de una mujer de 38 años a través del modelo psicodinámico. Se utilizó un estudio de caso. Los instrumentos de evaluación constan de 15 entrevistas y test proyectivos (TAT y Machover). Los resultados muestran conflictos con la figura paterna. Inseguridad de sí misma y del ambiente, dependencia a la figura materna conservadora y sobreprotectora. Esto nos permitió concluir que las cirugías se relacionan con una autoagresión, mostrando pulsión de muerte relacionada con el rechazo de la figura paterna, que la mantiene en búsqueda de aceptación propia y del padre, sosteniéndose de la madre y la intelectualización.
Palabras clave: Imagen, Cuerpo, Pulsión de muerte, Cirugía estética, Ideal del yo.
ABSTRACT
The aim of this research was to study the image of the body and death drive in a case of plastic surgery of a 38 years old woman through the psychodynamic model. A study case was used. Examination instruments consist of 15 interviews and projective tests (TAT and Machover). The results indicate conflicts with the father figure. Insecurity of herself and the environment, dependence of a conservative and overprotective mother figure. This allowed us to conclude that surgeries are associated with self-aggression, showing related death instinct with the rejection of the father figure that keeps her looking for acceptance of her’s-self and her father, holding on the mother and intellectualization.
Key words: Image, Body, Death drive, Aesthetic surgery, Ideal ego.

Since the concept of surgical and nonsurgical facial rejuvenation has been introduced, scientists have developed a wide range of agents that can treat an aging face. With the high bill of surgical manoeuvres, most of the antiaging... more

Since the concept of surgical and nonsurgical facial rejuvenation has been introduced, scientists have developed a wide range of agents that can treat an aging face. With the high bill of surgical manoeuvres, most of the antiaging procedures are nonsurgical. A fair knowledge of nonsurgical facial rejuvenation is as important as the surgical tools to the practice of plastic surgeon or a dermatologist who offers cosmetic surgery. Nonsurgical facial rejuvenation has gained its popularity owing to the low-cost, quicker recovery and guaranteed results but with short-lasting effect. In this review article, the basics of different modalities of nonsurgical facial rejuvenation are reviewed regarding the concept behind them and their advantages and disadvantages. With the successful integration of each of these modalities, a complete facial regimen can be achieved, and patient satisfaction can be maximized.

Tip rhinoplasty is a key component of aesthetic rhinoplasty. An understanding of the correlation between tip surface aesthetics and the underlying anatomic structures enables proper identification and correction of tip abnormalities.... more

Tip rhinoplasty is a key component of aesthetic rhinoplasty. An understanding of the correlation between tip surface aesthetics and the underlying anatomic structures enables proper identification and correction of tip abnormalities. Surface aesthetics of the attractive nose are created by certain lines, shadows, and highlights with specific proportions and breakpoints. In this Featured Operative Technique, the authors describe a stepwise process for tip rhinoplasty that conceptualizes aesthetic subunits as geometric polygons to define the existing deformity, the operative plan, and the aesthetic goals. Tip rhinoplasty is described in detail, from initial markings through incisions and dissection. The autorim graft concept is explained, and lateral crural steal and footplate setback techniques are described for the attainment of symmetric domes with correct lateral crural resting angles. Methods in columellar reconstruction are described, including creating the columella (C') br...

Developing cartilage constructs with injectability, appropriate matrix composition, and persistent cartilaginous phenotype remains an enduring challenge in cartilage repair. Fourteen patients with minor contour deformity were treated with... more

Developing cartilage constructs with injectability, appropriate matrix composition, and persistent cartilaginous phenotype remains an enduring challenge in cartilage repair. Fourteen patients with minor contour deformity were treated with fluid cartilage filler gently injected as autologous fluid graft in deep planes of defect of the nose that were close to the bone or the cartilage. A computerized tomographic scan control was performed after 12 months. Pearson's Chi-square test was used to investigate differences in cartilage density between native and newly formed cartilages. The endpoints were the possibility of using fluid cartilage as filler with aesthetic and functional improvement and versatility. Patients were followed up for two years. The constructs of fluid cartilage graft that were injected in the deep plane resulted in a persistent cartilage tissue with appropriate morphology, adequate central nutritional perfusion without central necrosis or ossification, and further augmented nasal dorsum without obvious contraction and deformation. This report demonstrated that fluid cartilage grafts are useful for cartilage regeneration in patients with outcomes of rhinoplasty, internal nasal valve collapse, and minor congenital nose aesthetics deformity

Oggi la società dello spettacolo ha ridato nuova centralità al corpo e alla sua bellezza. Ciò trova riscontro non solo nei modelli imposti dagli schermi televisivi, ma anche dalla maggiore attenzione che le donne prestano al proprio... more

Oggi la società dello spettacolo ha ridato nuova centralità al corpo e alla sua bellezza. Ciò trova riscontro non solo nei modelli imposti dagli schermi televisivi, ma anche dalla maggiore attenzione che le donne prestano al proprio corpo, ricorrendo sempre più spesso alla chirurgia estetica. Questo intervento, a partire dalle teorie del filosofo americano Richard Shusterman, fondatore della somaestetica, vuole indagare la centralità del corpo nella riflessione estetica contemporanea, prendendo spunto da una famosa artista francese della seconda metà del Novecento: Madame Orlan. Questa artista, che ha operato nell’ambito della Body Art, ha sottoposto a dura critica il modello occidentale di bellezza e, aprendosi a una pluralità di esperienze e culture, ha affermato la relatività del bello. Inoltre sottoponendosi a diversi interventi di chirurgia estetica, ha rivendicato la possibilità di "ricostruirsi" per far riflettere sui cambiamenti che la tecnologia moderna ci può far assumere.

Interview with the founding father of Plastic Surgery, Professor Ivo Pitanguy. Pitanguy speaks about the evolution of the specialty, his teachers, his thoughts on current trends in plastic surgery, the concept and philosophy of beauty,... more

Interview with the founding father of Plastic Surgery, Professor Ivo Pitanguy. Pitanguy speaks about the evolution of the specialty, his teachers, his thoughts on current trends in plastic surgery, the concept and philosophy of beauty, and what matters most to him. This interview is vintage Pitanguy.

Adipose tissue is accessible with minimally invasive procedures, is abundant, and is replenishable. It consists of a heterogeneous cell population including preadipocytes, mature adipocytes, fibroblasts, vascular smooth muscle cells,... more

Adipose tissue is accessible with minimally invasive procedures, is abundant, and is replenishable. It consists of a heterogeneous cell population including preadipocytes, mature adipocytes, fibroblasts, vascular smooth muscle cells, endothelial cells, resident macrophages, and cells composing the stromal vascular fraction. This fraction contains multipotent cells with the same mesenchymal origin and similar biological and immunological characteristics of bone marrow stroma. On the other hand, adipose-derived stromal cells are easier to harvest and culture in comparison to bone marrow-derived ones. The authors discuss the microenvironment where are the stem cells is the niche, adipose tissue, and adipose tissue-derived stromal cell transplant for the treatment of epithelial pathologies, wound healing, diabetic foot, and other disorders.