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There is more and more non-invasive treatment proposed in face rejuvenation. However, there are only a few treatments that decrease volume of the tissue efficiently. Submental liposuction is not classically considered as a non-invasive treatment. We reviewed from October 2020 until August 2022; 695 patients were operated by the first author under local anesthesia. Complications exist but are minimal. The most important is irregularity that can be managed by massage and ultrasound treatment. With our experience of over 600 cases, we believe that submental liposuction should be considered and proposed to patient as non-invasive before of this efficiency and very low drawbacks, was presented. [ABSTRACT FROM AUTHOR]

The influence of Instagram, as a social media platform, in shaping perceptions of aesthetic surgery cannot be understated. The idea of a more "aesthetic" self cultivates a desire for cosmetic enhancements. This article underscores the profound impact of Instagram on aesthetic surgery, shedding light on both its fantasies and fallacies. Instagram, a medium for dissemination of content, often blurs the lines between fantasy and reality. Although the intent is to transfer credible information from the provider to the consumer, Instagram often contributes to the distortion of one's self-image and creates unrealistic expectations. Moreover, the glamorization of aesthetic surgery as a fast, effortless fix, often by commercially run enterprises, leads to misconceptions and impulsive decision-making. These fallacies are further compounded by the increase of misinformation and deceptive practices, presenting ethical challenges for influencers and surgeons alike. This study explores the ethical responsibilities of these "Aesthetic Instagrammers," emphasizing the necessity for transparency and ethical guidelines, while analyzing all the social media stakeholders and providing suggestions for better engagement. [ABSTRACT FROM AUTHOR]

From time immemorial, human beings have always tried to decorate themselves to look more beautiful and attractive to an onlooker, in turn improving their own self-esteem. Thus, Ayurveda in India and Ebers Papyrus in Egypt, written thousands of years ago, mention a variety of cosmetics being used for the same. However, operative interventions were mainly reconstructive and any improved aesthetics was a by-product only (e.g., restoration of amputated nose). The surgery for purely cosmetic reasons started less than 150 years ago after the availability of anesthesia and antisepsis. Initially, the medical profession and the common man were skeptical of these interventions and even ridiculed the patient and the clinician. The pioneers were labeled as quacks and working against the law, and some of them had to even commit suicide, while the patients were labeled as "psychiatric." The past 50 years have seen aesthetic procedures, both surgical and nonsurgical, being performed by highly qualified superspecialists. This article attempts to trace this change. [ABSTRACT FROM AUTHOR]

Background and Objectives Convincing a patient who has undergone any aesthetic surgery to come for a long-term follow-up is extremely difficult. The result obtained after rhinoplasty usually stabilizes in the first year and it is unlikely to change after 2 years. The precision carving technique described in 2014 has been employed by us for the last several years. We wish to present long-term results (at least 2 years) obtained using this technique, now renamed as "Nair Hospital Precision Carving technique." The unfavorable effects of warping are most apparent in the dorsum. So, we have chosen to assess results of dorsal onlay grafts only. This article presents the long-term results obtained using favorable warping technique. Materials and Methods We have followed up 45 patients in whom dorsal augmentation was done using rib grafts for various indications like aesthetic, reconstructive rhinoplasty and cleft lip nasal deformity. Grafts were carved using the precision carving technique. Results All patients were assessed at 6 weeks, 6 months, and at subsequent follow-up period of 2 to 10 years and photographs were taken at each visit. There was no major complication and all patients were satisfied with the appearance. Conclusion The Nair Hospital Precision Carving technique utilizes unbalanced yet controlled and precise carving to achieve a variety of natural shapes for the objectives of contour fill and framework reconstruction in rhinoplasty, thus ensuring good long-term results. [ABSTRACT FROM AUTHOR]

The aesthetics of the periorbital region are significantly influenced by the position of the eyebrows, forehead wrinkles, and upper eyelid ptosis, with aging-related eyebrow ptosis playing a major role. Brow lift surgery has seen a marked increase in popularity, driven by a variety of techniques tailored to individual patient needs. The 'gliding brow lift' technique, which employs a minimally invasive subcutaneous approach using a hemostatic net, represents a recent advancement in eyebrow rejuvenation. This article outlines our three-year experience and adaptation with this technique, which is divided into three sequential steps: (1) subcutaneous dissection; (2) internal eyebrow fixation; (3) skin redraping. Our modified gliding brow lift technique combines simplicity, minimal equipment requirements, conservative principles that limit scarring and avoid skin resection, and long-lasting results with few complications, making it an attractive option for brow rejuvenation. [ABSTRACT FROM AUTHOR]

Background: Rhinoplasty, one of the most prevalent facial plastic surgeries, bears both functional and aesthetic import. This literature review examined the psychosomatic dimensions of rhinoplasty and their influence on patients' quality of life and self-care. Rhinoplasty, whether undertaken alone or in conjunction with septoplasty, is intricate and technically demanding, with success being largely contingent upon psychosomatic factors. The popularity of rhinoplasty has burgeoned due to augmented social acceptance and media exposure. Postoperative psychological outcomes vary, with dissatisfaction being frequently linked to pre-existing psychopathology. Men often exhibit higher levels of psychopathology and are less satisfied after surgery comparatively to women. Prudent patient selection, realistic expectations and psychological screening are imperative for successful outcomes. Rhinoplasty affects individuals of all ages, from adolescents to the elderly, with involving unique concerns and benefits. Patient satisfaction hinges on factors such as gender, age, education, culture, ethnicity, occupation, economic profile, psychological profile and expectations. The use of patient reported outcome measures (PROMs) is indispensable for evaluating the health-related quality of life and psychosocial changes following rhinoplasty. Comprehending these dimensions is crucial for enhancing patient satisfaction and ensuring successful outcomes. [ABSTRACT FROM AUTHOR]

Background: Recent data shows a 139.9% global increase in aesthetic procedures since 2011, with a notable 190.5% rise in Germany. This study analyzes the current landscape of plastic surgery in German-speaking European countries, focusing on the range of procedures offered in plastic surgery practices in Germany, Austria and Switzerland. We aimed to provide an overview of the current trends and procedures of plastic surgery in the practice setting in Germany, Austria, and Switzerland. Methods: The information sampled from the websites of n = 511 plastic surgery practices (314 German, 113 Austrian, 84 Swiss) were analyzed with regards to general information, as well as procedures offered on the websites. A set of different procedures, belonging to each pillar of plastic surgery (i.e., Aesthetic, Reconstructive, Hand, Burn surgery) as well as non-surgical aesthetic procedures was analyzed. Results: Aesthetic surgical procedures were offered most often with 98.8% (506) of all websites analyzed, followed by Hand surgery at 29.7% (152), Reconstructive surgery at 27.8% (142) and Burn surgery at 5.7% (29). Reconstructive and Hand surgery were statistically significantly most commonly offered on Austrian plastic surgery websites, with p = 0.011 and p < 0.001, respectively. Among aesthetic surgical procedures, statistically significant regional differences were found for head and neck, body and breast procedures most commonly offered on Swiss plastic surgery with p = 0.041, p = 0.010 and p = 0.003, respectively, while the procedures of the intimate region were most commonly offered on German websites with p = 0.007. Conclusions: Plastic surgery websites in German-speaking European countries predominantly advertise aesthetic surgical procedures, with other domains of plastic surgery such as reconstructive, hand, and burn surgery being less prominent, suggesting an underrepresentation. Regional differences between the countries investigated are evident, underscoring the need for a more balanced approach in plastic surgery care in the practice setting. Level of Evidence: Not gradable [ABSTRACT FROM AUTHOR]

Background: Metformin, an oral antidiabetic drug widely used for over 60 years, has been recognized for its safety and effectiveness in the treatment of Type-2 Diabetes Mellitus (T2DM). In addition to the anti-diabetic properties, recent studies have shed light on its anti-aging, healthspan and longevity promoter potentials. This review aims to explore the anti-aging role of metformin and identify its unconventional fields of application. Methods: A systematic review was conducted using the PubMed (MEDLINE) library from January 2001 to July 2023, focusing on terms related to plastic surgery, aesthetic surgery, anti-aging, rejuvenation, lifespan, healthspan, anti-inflammatory, aesthetic medicine, and metformin. Eligibility criteria included original studies addressing metformin as anti-aging and healthspan-promoting therapies in humans. Results: The final synthesis included 29 articles categorized by topic into studies on the mechanisms underlying the anti-aging effects of metformin and studies on its potential therapeutic applications. Metformin, by activating 5'-AMP-activated protein kinase (AMPK), appears to influence cellular aging, oxidative stress, gut microbiota and epigenetics, potentially resulting in anti-aging effects. Furthermore, the present review includes evidence for the role of metformin in age-related diseases, such as cardiovascular disease (CVD) and neurodegeneration, suggesting potential benefits in preventing CVDs and preserving cognitive functions. Moreover, despite controversial data, metformin may also have an influence on cancer. Conclusions: Metformin is an effective drug in both diabetic and pre-diabetic patients. Moreover, it appears to exert multiple preventive actions, potentially resulting in an anti-aging drug, influencing both episodic and linear components of aging with promising off-label applications. In consideration of its well-established safety profile, future research should explore its implications also in healthy populations. Level of Evidence: Not gradable. [ABSTRACT FROM AUTHOR]

The article discusses a case of allergic contact dermatitis in a healthy female in her 30s who developed eczema on her face and neck after a surgical brow lift with titanium screws. Despite trying various treatments, the eczema persisted until the titanium screws were removed, resulting in complete resolution of symptoms. This case highlights the importance of considering allergic reactions to titanium in aesthetic procedures and the need for comprehensive exposure assessment in patients with similar symptoms. [Extracted from the article]

Body modifications have been present in the history of humanity, in the search to restore and preserve the beauty of the human body. It has been a very long road that has been taken so that, whoever today performs an Aesthetic and Reconstructive Plastic Surgery procedure, is a medical professional with long, punctual and highly specialized training; However, and unfortunately, under unsound arguments, due to the lack of inclusion of the word "Aesthetics" within the global name of the specialty, as occurred until November 11, 2023, by the University Council of the National Autonomous University of Mexico, for many decades, centers and schools have emerged that have given rise to the so-called teachers in Aesthetic Surgery, who do not comply with the legal requirements established in the General Health Law, thereby incurring a frank intrusion within Plastic Surgery. Aesthetics and Reconstructive in our country. [ABSTRACT FROM AUTHOR]

Background: The popularity of gluteal augmentation has surged in recent decades, primarily due to satisfactory aesthetic results. Objectives: The primary goal of this retrospective analysis was to present the key characteristics of a large patient cohort from Europe, comprising 185 female patients who underwent gluteal augmentation with ultrasound-guided fat grafting. Methods: A retrospective analysis was conducted on 185 female patients who underwent gluteal augmentation with ultrasonic liposuction and fat grafting from February 2020 to July 2023. The procedures were performed in accordance with the latest safety recommendations. Results: Information concerning the patient demographic, volume of fat graft, and complications was analyzed. Additionally, patient satisfaction was evaluated through a questionnaire. The mean Body Mass Index (BMI) of the patients was 23.00 kg/m2 (SD = 2.62). Furthermore, the volume of transferred fat graft ranged from 500.00 mL to 800.00 mL, with a mean of 596.75 mL (SD = 67.29). The most frequent complication was the formation of seroma (5.41%). All complications were treated successfully. Conclusions: Using ultrasonic liposuction and ultrasound-guided fat grafting to enhance buttock contours is a reliable technique. Nevertheless, it is crucial to exert caution and take all necessary steps to reduce the risk of potentially life-threatening complications. [ABSTRACT FROM AUTHOR]

Although permanent fillers have been introduced in order to get long-lasting results, many studies have shown numerous severe and disfiguring complications. Nonsurgical procedures may mitigate those adverse events but the only way to remove the filler previously injected is represented by surgical excision. We present a pathway of facial surgical accesses to be performed achieving two goals: permanent filler removal and restore facial aesthetic balance. The proposed surgical accesses are already standardized in aesthetic surgical practice in order to avoid direct excision and unpleasant facial scar. A total of 231 patients underwent surgery for permanent filler removal and aesthetic restoration of the involved facial area, represented by forehead, glabella, nose, cheeks, eyelids, chin, jawline, and lips. Magnetic resonance evaluation was performed with the exception of lip patients who were evaluated with ultrasound. Postoperative follow-up was 12 months to 6 years. Subjective and objective methods were used for outcome evaluation according to the FACE-Q questionnaire. Functional and aesthetic correction was scored using the patient-graded Global Aesthetic Improvement Scale (GAIS), overall patient satisfaction was assessed by a five-point scale questionnaire. Functional and aesthetic restoration was globally recognized as improved according to the GAIS. Patients reported high levels of satisfaction assessed by a five-point scale questionnaire. A very good satisfaction level was registered in both subjective and objective judgment scores. To the best of our knowledge, we present the largest case series regarding surgical removal of permanent facial fillers. A proper preoperative evaluation, filler removal followed by restorative facial aesthetic surgery technique is paramount to approach challenging cases. [ABSTRACT FROM AUTHOR]

The present study was performed to describe how much affordable, feasible, and straightforward is the approach the authors called "single-stage full-face surgical profileplasty," tailored to greatly improve the surgery of the facial profiling setting and achieve complete profile correction at the same time. From January 2010 to May 2019, 113 patients (95 females and 18 males; aged 19 − 63 years) were surgically treated for full-face profile amelioration. Profile correction was performed by using a combination of five procedures out of other various previously experienced: forehead fat grafting, rhinoplasty, lip fat grafting, genioplasty, and submental liposuction. All patients were assessed at 1, 3, 6, and 12 months following surgery for assessing the surgical profile treatment (SPT) outcome and any possible side effects of the combined treatment. Facial profile stability at 1 year was taken as the completion point of this treatment. Arnett et al's "Soft Tissue Cephalometric Analysis" (1999) was used to clinically evaluate the soft tissues before and after the SPT. Patients' satisfaction was measured with the Client Satisfaction Questionnaire-8" at 3 and 12 months after surgery. Statistics were used for Arnett et al's evaluation. Almost all the values were consistent and reached the normal ranges indicated by Arnett et al (p < 0.001), confirming that the desired results of the surgical profileplasty have been achieved. Single-stage full-face surgical profile treatment helps in correcting faults of the global facial deformity, in every single treated area, providing an overall improvement in facial aesthetics and harmony. Obtaining the simultaneous correction in the whole face has also the advantage of avoiding multiple surgical procedures, reducing postoperative discomfort, and the overall risks for the patient due to multiple surgical and anesthetic procedures. [ABSTRACT FROM AUTHOR]

Background: Genioplasty as an isolated surgical technique is a highly demanded procedure in the maxillofacial surgery area. Advances in facial reconstructive surgery have been associated with less morbidity and more predictable results. In this paper, "conventional" genioplasty and genioplasty by means of virtual surgical planning (VSP), CAD-CAM cutting guides, and patient custom-made plates are compared. Methods: A descriptive observational study was designed and implemented, and 43 patients were treated, differentiating two groups according to the technique: 18 patients were treated by conventional surgery, and 25 patients were treated through virtual surgical planning (VSP), CAD-CAM cutting guides, STL models, and titanium patient-specific plates. Results: The operation time ranged from 35 to 107 min. The mean operative time in the conventional group was 60.06 + 3.74 min.; in the custom treatment group it was 42.24 + 1.29 min (p < 0.001). The difference between planned and obtained chin changes in cases of advancement or retrusion was not statistically significant (p = 0.125; p = 0.216). In cases of chin rotation due to asymmetry, guided and personalized surgery was superior to conventional surgery (p < 0.01). The mean hospital stay was equal in both groups. A decrease in surgical complications was observed in the group undergoing VSP and customized treatment. Conclusions: Multi-stage implementation of VSP with CAD-CAM cutting guides, STL models, and patient-specific plates increased the accuracy of the genioplasty surgery, particularly in cases of chin asymmetry, reducing operation time and potential complications. [ABSTRACT FROM AUTHOR]

Introduction Aesthetic surgery is a rapidly evolving subspecialty in high demand worldwide. To be considered a fully trained plastic surgeon, all the requirements of the curriculum must be met through to successful completion, including aesthetic surgery. At present, a disparity exists between the demand and provision of aesthetic surgery training in India. This survey evaluation highlights the responses, concerns, and possible solutions regarding training and practice of cosmetic surgery in India. Methods A meticulously crafted survey comprising of 19 questions discussing the background, training, and practice of cosmetic plastic surgery, was sent across to all accessible plastic surgeons trained or training in India. A total of 506 responses were received. The responses were analyzed and have been presented in this study. Results The survey was completed with all participants answering all the questions. Pertinent questions regarding practice setup, percentage of aesthetic work in practice, exposure of trainees to aesthetic procedures, and merits of an aesthetic fellowship revealed a lot about aesthetic training in India. The participants also expressed their level of satisfaction with their principal plastic surgery training. Summarizing these findings, suggestions for improvements in training were made. Conclusion Plastic surgery residency programs need to ensure that residents receive comprehensive exposure to both surgical and nonsurgical cosmetic procedures to ensure maintenance of service standards and optimum patient care. The information collected can help us formulate strategies to improvise the current cosmetic surgery training across India. Steps taken toward the same are also highlighted in the study. [ABSTRACT FROM AUTHOR]

Objective: With more than 1.5 million performed procedures, liposuction was the second most performed esthetic surgical procedure all over the world in males and in females in the year 2020. The objective of this open‐label, evaluator‐blinded study was to assess the efficacy and safety of an energy‐based device that combines multipolar radiofrequency with pulsed electromagnetic field (PEMF) in patients that underwent liposuction. Materials and Methods: A total of 30 subjects, of whom 24 were females (80%), with a mean age of 48.4 ± 11.0 years (range: 27–69 years) and a mean weight of 69.5 ± 11.7 kg underwent unilateral treatment with radiofrequency and application of PEMF after bilateral liposuction. One month after the last of a total of six weekly treatments, skin elasticity, visco‐elasticity and net elasticity, as well as subject reported satisfaction on a 5‐point scale ranging from −1 (worse) to 3 (very much improved) and esthetic improvement ranging from 0 (very unsatisfied) to 4 (very satisfied) rated by three independent reviewers were assessed. Results: Three independent and blinded reviewers rated the improvement of the treated side on average as 1.17 + 0.07 compared with baseline. Subjects were very satisfied with their treatment, with a mean score of 3.24 (0.03) out of 4 at the 1‐month follow‐up visit. Cutometer measurements showed no significant changes. Conclusion: This study revealed that the subjective satisfaction with the results of the application of RF and PEMF after liposuction is high, while at the same time the esthetic appearance as rated by independent raters improved on the treated side. [ABSTRACT FROM AUTHOR]

With the continuous development of aesthetic surgery, a large number of excellent publications have been reported on aesthetic surgery. However, no relevant studies have reported the latest advancements and hot trends in aesthetic surgery in recent years. In this study, we extracted relevant publications from four authoritative aesthetic surgery journals (Plastic and Reconstructive Surgery, Aesthetic Surgery Journal, Aesthetic Plastic Surgery, and Journal of Cosmetic Dermatology) and used bibliometrics to comprehensively analyze current hot trends. We found a significant increase in the number of quality studies in aesthetic surgery, and the USA was the leading country in the field of aesthetic surgery, as evidenced by the fact that it ranks first worldwide for the total number of publications and citations. Currently, the prevention and treatment of complications related to aesthetic surgery remain research hotspots. Meanwhile, androgenetic alopecia, hyperplastic scarring, and stem cell research are hot directions for future research, and more research is required for exploration. [ABSTRACT FROM AUTHOR]

Midazolam and fentanyl, in combination, are the most commonly used medications for conscious sedation in day aesthetic surgeries. Dexmedetomidine is popularly used in the sedation protocol of our hospital due to its reduced respiratory depression. However, its sedation benefits in facial aesthetic surgeries, like blepharoplasty, have not been well-evaluated. We retrospectively compared individuals sedated with midazolam and fentanyl bolus injection (N = 137) and those sedated with dexmedetomidine infusion (N = 113) to determine which is more suitable for blepharoplasty with a mid-cheek lift. The total amount of local anesthetic (p < 0.001), postoperative pain (p = 0.004), ketoprofen administration (p = 0.028), and the number of hypoxia episodes (p < 0.001) and intraoperative hypertension (p = 0.003) were significantly lower in the dexmedetomidine group. Hypoxia severity (p < 0.001) and minor hematoma formation (p = 0.007) were also significantly lower in the dexmedetomidine group. Sedation with dexmedetomidine infusion is associated with less hematoma formation than sedation with midazolam and fentanyl bolus pattern due to hemodynamic stability and analgesic effects. Dexmedetomidine infusion may be a good alternate sedative for lower blepharoplasty. [ABSTRACT FROM AUTHOR]

Background and objective. A variety of surgical fields are collected under the specialty Plastic, Aesthetic and Reconstructive Surgery, however, in the authors' opinion, population's perception about this area has been distorted over the years. The aim of this study is to know the perception of the Spanish non-health population about the specialty of Plastic Surgery. Methods. An observational, descriptive, cross-sectional study, was carried out through a questionnaire of 21 questions aimed at a Spanish non-health population or whose work activity was not carried out in a hospital. Results. Participate in the study 1038 people, 80% female gender and 18% male. The age distribution was similar in all groups except for those aged 25-34 who had a higher representation. The majority had higher education. There were participants from all the Autonomous Communities, Galicia being the most represented with 53%. Twelve per cent of participants had a history of interventions by Plastic Surgery in public or mutual health, while Aesthetic Surgery was 14%. Most of the participants (69%) contemplate the subspecialization in Plastic Surgery after finishing the specialty in General Surgery as one of the ways to obtain the title, whereas less than 40% of the participants knew the real ways of access to the specialty. More than a quarter of the participants thought that Plastic Surgery and Aesthetic Medicine were the same, and only half were aware of the existence of plastic surgeons in public hospitals and knowing what their field of work is. Conclusions. In our study, most of the participants had a misconception of obtaining the title of Plastic Surgery specialization in Spain and a restricted knowledge about which areas the specialty encompass. The profiles related to Aesthetic Surgery were more popular on social networks than those of Reconstructive Surgery; both fields were interesting for most participants for future outreach campaigns, and social networks were the preferred media. [ABSTRACT FROM AUTHOR]

Background and Purpose: The increasing cost of cosmetic procedures, long elective waiting times in the public system and affordability of procedures offered abroad has driven the rapid growth of cosmetic tourism. The incidence and cost of patients presenting to the Irish health service with complications related to cosmetic procedures carried out in overseas institutions is largely unknown. This heterogenous group of patients is challenging to identify. Limited data exists for this patient group in the Irish context. We aimed to perform a multicentre audit and cost analysis of patients presenting to Irish health services with complications related to cosmetic procedures performed in overseas institutions over a 2 year period.Methods: Patients presenting to two University Hospitals from March 2019-April 2021 with complications after a cosmetic surgical procedure was performed abroad were studied. The HPO ABF 2020 price list data was used to calculate the inpatient and procedure cost for each subject.Main Findings: 14 (13/92.8% female, mean age 43 ± 11.85 years) patients presented during the study period. Countries of cosmetic operation included: Belgium (6/46.2%), the UK (2/15.4%), Latvia, Turkey, Poland, Lithuania, and Estonia (1 patient/7.7% each country). All required a re-operative procedure. These interventions included: removal of infected implant (n = 1), adjustment or removal of a gastric band (n = 9) and debridement of an infected/necrotic wound (n = 3). Mean length of stay was 9.14 ± 7.48 (range 2-28) days. Five (38.4%) patients required vac dressing. The mean cost of the cohort for the interventional procedure and in-patient stay was €15912.53 (+/- €6388). The sum total of all the costs for the cohort was €231038.60.Conclusions: Significant costs were associated with prolonged hospital admissions, operative interventions, intravenous antibiotics, VAC dressing application and follow up visits. Complications from procedures performed in overseas institutions account for a significant cost burden to health services in Ireland. [ABSTRACT FROM AUTHOR]

Objective. The aim of this review was to present the vascular pattern of the STA, as well as anatomical variations, and to accentuate the areas which should be taken into consideration during manipulations along the course of the artery. Background. The STA may be encountered during several aesthetic procedures on the face, and iatrogenic trauma could be an incriminating factor of diverse sequelae. The constant increase in demand for facial aesthetic procedures has rendered it imperative to maximize safety and patient satisfaction. Methods. We conducted a narrative literature review using the electronic databases of PubMed and Google Scholar, retrieving studies concerning the anatomy and variations of the STA. Moreover, we identified registered clinical cases presenting complications which involved the artery. Discussion. The anatomic morphology of the STA is described and classification systems summarized, on the basis of the studies retrieved. In addition, the STA is related to defined landmarks, and specific danger zones are emphasized. Finally, the clinical significance of the artery is reflected in registered cases of adverse events following specific aesthetic surgeries. Conclusion. Thorough knowledge of the anatomical variability of the STA, and awareness of the danger zones involved in aesthetic procedures, combined with intraoperative vigilance could increase safety and minimize the advent of relevant sequelae. [ABSTRACT FROM AUTHOR]

Abdominoplasty is a popular procedure in plastic surgery providing aesthetic, functional and psychological relief for patients suffering from excess abdominal tissue. Correct umbilical positioning is crucial for a successful aesthetic surgical outcome. This study aims to assess the most attractive position of the umbilicus by means of subjective and objective outcome measures. 58 Caucasian study participants with a mean age of 36.87 (15.6) years rated eight different umbilical positions. The various positions were determined based on the ratio of the distance between the xiphoid process and the umbilicus and the distance between the umbilicus and the infra-umbilical crease: 1:1, 1.25:1, 1.5:1, 1.75:1, 2:1, 2.5:1, 3:1 and 5.5:1. Semi-quantitative scoring of attractiveness based on a 5-point Likert scale and eye tracking analyses were utilized. The results revealed that the volunteers perceived as most attractive the ratio of 2:1 with 4.32 (out of possible 5.0). The ratio of 5.5:1 received the lowest rating with 1.8. The results of the objective eye tracking analyses confirmed the subjective rating as the 2:1 ratio was fixated last amongst all other displayed ratios with 1.85 s whereas the 5.5:1 ratio had the shortest interval between image display and first stable eye fixation with 0.94 s. The study confirms the concept of 'internal representation of beauty'. Abdominoplasty procedures could rely on this easy to perform ratio by dividing the distance into thirds and using the boundary between the inferior and middle third as a clinically reliable landmark. [ABSTRACT FROM AUTHOR]

There is widespread consensus that there is no indication for postoperative antibiotic administration after elective surgery. However, medial thigh lift (MTL) remains a procedure with a notoriously high rate of wound-healing disorders and infections. This study investigates the correlation between prolonged antibiotic administration and complications after MTL in massive weight loss patients. We performed a single-institution retrospective review of 121 patients undergoing MTL between 2009 and 2020. Data on postoperative outcome, demography, surgery and comorbidities were collected. All patients received intravenous antibiotics preoperatively. One group was continued on oral antibiotics for two weeks postoperatively. Complications and surgical site infections were observed and evaluated. There was no difference between the groups regarding age, BMI, or presence of obesity-associated risk factors. We observed complications in 76 patients (71%), with 60 (56%) minor and 16 (15%) major complications. The group without prolonged antibiotic administration had a higher number of total complications (OR 3.5; p = 0.0037), major complications (OR 4; p = 0.01), and wound infections (OR 6.8; p = 0.0004). Logistical regression analysis showed that this effect was independent of type of weight loss, resection volume, and age. Reduction of major infections by prolonged antibiotics was, however, dependent on BMI Δ. No side-effects associated with antibiotics were registered in this series. This study suggests that prolonged antibiotic administration may decrease complications in MTL. We thus continue to use prolonged antibiotic administration after MTL. Further research is needed to determine the optimal duration of antibiotic treatment. Level of Evidence: Level IV: therapeutic study [ABSTRACT FROM AUTHOR]

The interest in gluteal augmentation using minimally invasive techniques has been increasing rapidly. Despite the fact that Aquafilling filler was described as biocompatible with human tissues, the number of associated complications has been rising. We present an exceptional case of a 35-year-old female patient, who suffered major long-term complications in association with Aquafilling filler injections in the gluteal region. The patient was referred to our center with signs of recurrent inflammation and severe pain focusing on the left lower extremity. A computed tomography (CT) scan showed multiple, communicating abscess formations all the way from the gluteal region to the lower leg. Therefore, an operative debridement was accomplished in the operating theater. Finally, this report emphasizes the severity of possible long-term complications when using Aquafilling filler especially in larger areas. Furthermore, the oncogenicity as well as toxicity of polyacrylamide, the core material of Aquafilling filler, remains uncertain, which is why further research is urgently required. [ABSTRACT FROM AUTHOR]

Neurotoxin procedures have been increasing in popularity since they were approved for cosmetic use in 2002, with predominately women being treated. Our objectives were to determine likelihood of neurotoxin treatment in television journalists based on demographics and social media popularity. Likelihood of neurotoxin treatment was determined from by grading forehead and glabellar rhytides in videos using a standardized scale. A greater percentage of women vs. men were "likely/highly likely" to have had glabellar (23% vs. 17%, respectively) and forehead neurotoxins (42% vs. 13%, respectively) neurotoxins (both P < 0.05). A greater proportion of anchors vs. non-anchors were "likely/highly likely" to have had glabellar neurotoxins (37% vs. 11%; P < 0.05). In sum, we found that women broadcasters are more likely to pursue neurotoxin treatments compared to male broadcasters and uncovered potential gender-based aesthetic treatment biases in the media industry. [ABSTRACT FROM AUTHOR]

Background: The internet has become a powerful tool for disseminating medical information. Social media platforms have gained popularity among medical professionals to connect with patients and promote their work and practices. We aimed to understand who is posting about facelift procedure on Instagram. Methods: Sprinklr, a social listening platform, was used to compile conversations that were posted on Instagram between January 1, 2021, and February 28, 2021, and contained hashtags #facelift, #necklift, #plasticsurgery, #plasticsurgerybeforeandafter, and #platysmabands. English and Spanish language posts were analyzed for positive sentiment. Based on the number of likes, the top 100 English and Spanish posts were selected. Posts were categorized based on primary specialty of the poster as plastic surgeon, non-plastic surgeon, country of active clinical practice, board certification, and members of international plastic surgery societies. Results: A total of 5099 posts with a total of 11,918 mentions were collected. Of the top 100 English posts, the countries most represented were the USA (59%), followed by Turkey (6%). Physicians made up 48% of the top English posts, of whom 42% were US board-certified plastic surgeons. By contrast, of the top 100 Spanish posts, the countries most represented were Mexico (29%) and Colombia (25%). Physician posters constituted 78%, of whom 38.5% were plastic surgeons certified by their country of practice. Conclusions: Plastic surgeons have become more active in creating popular content related to facelift on Instagram over the past few years. However, a significant percentage of IG content on #facelift, a surgical procedure, was made by non-physicians and non-plastic surgeons in 2021. Level of evidence: Not gradable. [ABSTRACT FROM AUTHOR]

Background and objective. A standardized photographic gallery with high clinical value depends on a correct technique, adequate selection of technology and the understanding of these by the physician. Smartphones and their digital cameras have advantages of versatility, omnipresence and accessibility with the same level of quality required for clinical photography, they also offer an alternative at a reasonable cost and being more practical, however, they have some limitations. The objective of the paper is to propose strategies to overcome these limitations and thus remain within the guidelines of standardization in clinical photography. Methods. The current literature on the use of smartphones with digital cameras in Medicine is described; articles with multiple guidelines on standardization and recommendations regarding clinical photography were taken. The manuals and characteristics of an iPhone 8s Plus® smartphone and a Sony® SLT A55V Digital SLR (Single Lens Reflex) camera were searched, their characteristics, differences were studied, Results. Comparing both technologies, the differences and their individual limitations were identified with which a series of recommendations were proposed which allow to obtain photographic shots by means of a smartphone with a digital camera of scientific type and quality within the current standardization parameters. Conclusions. Smartphone with a digital camera is a versatile, portable, useful and easy-to-use electronic device for high-quality scientific photographic taking, as long as you have an adequate level of understanding of the technology in use to overcome its limitations without risk of bias. [ABSTRACT FROM AUTHOR]

Web-based health information plays an increasingly vital role in spreading health information. Many patients interested in aesthetic surgery study the procedure on the Internet. This study aims to evaluate the quality of online health information on injectable fillers using the modified "Ensuring Quality Information for Patients" (EQIP) tool. Nine different search terms, including "fillers," "fuller cheeks," "wrinkle removal," and "antiwrinkle treatment" were identified and queried on Google. Unique links from the first three pages of each search term were identified and evaluated if the contents were in English language and were for general non-medical public use. A total of 172 websites were analyzed, with a median EQIP score of 20. In total 129 websites belonged to aesthetic practitioners, of which 81 were operated by medical doctors. Eighty-three percent of websites disclosed some forms of postoperative complications, most commonly edema (74%) and bruising (73%). Blindness and tissue necrosis were only mentioned by 12 and 10% of the websites, respectively. The current health information available on injectable fillers is of poor quality. While many do provide some information on risks, the majority of websites fail to disclose severe complications and quantifying risks. This poses a barrier against informed decision-making and may lead to unrealistic expectations. Patient satisfaction and expectations may be improved by developing better online education resources on fillers. [ABSTRACT FROM AUTHOR]

Background: The BDDQ-AS (Body Dysmorphic Disorder Questionnaire—Aesthetic Surgery) is a simple and reliable patient-reported outcome measure. It can be used as a screening tool for body dysmorphic disorder (BDD) in patients undergoing aesthetic rhinoplasty. The aim of this study was to translate and culturally adapt the Mandarin version of the BDDQ-AS (M-BDDQ-AS) and evaluate its selected psychometric validation in patients after rhinoplasty. Method: According to international guidelines, the BDDQ-AS questionnaire was translated from English to Mandarin. Twenty Mandarin-speaking rhinoplasty patients were interviewed in order to evaluate the understandability and acceptability of the translation and produce a final version. It was then administered to 137 patients with a mean age of 38.75 ± 6.24 years. Psychometric validation were evaluated using reliability (internal consistency, test–retest reliability) and item-reponse theory (IRT) test. Result: High internal consistency of 0.823 was found using Cronbach's α coefficient. Reliability of the M-BDDQ-AS resulted in Intraclass Correlation Coefficient (ICC) = 0.863. Besides, based on IRT analysis, the discrimination abilities of all the items were good (over 2.0), and their difficulty estimates were reasonable. Conclusion: The M-BDDQ-AS is a reliable and valid self-reported questionnaire that can be used in rhinoplasty patients. The very good psychometric validation of the M-BDDQ-AS indicates that it can be used in clinical practice and scientific research. [ABSTRACT FROM AUTHOR]

Introduction Breast surgeries with the use of implants constitute one of the most frequently performed plastic surgeries in women. They are conducted for both aesthetic and oncological reasons. Therefore, due to the interdisciplinary nature of these procedures, not only the performing plastic surgeon, but also the nursing staff should have extensive knowledge regarding the procedures. Aim A questionnaire survey was conducted to verify the knowledge level of nurses working in the Lower Silesian Region. Material and methods The questionnaire consisted of 32 questions. Quantitative data was automatically collected in a spreadsheet available in the Google tool. 110 nurses participated in the study. Results Based on the analysis of the obtained data, it can be concluded that the level of nurses' knowledge concerning breast implants procedures is good. Conclusions Despite a good level of knowledge among the nurses regarding the use of breast implants in surgical procedures, there is also room for improvement. Nurses who work in surgical wards present a wider range of knowledge on the abovementioned topic than nurses working in conservative wards. Thus, it seems reasonable to conduct a multi- -center study, analyzing the level of nurses' knowledge about breast implants procedures all over Poland. [ABSTRACT FROM AUTHOR]

Background: On March 11, 2020, the World Health Organization (WHO) announced the COVID-19 outbreak as a new pandemic. In the meantime, plastic surgeons postponed their appointments due to the fair and rational allocation of medical supplies. These limitations made all junior and senior residents perform operations only on traumatic patients rather than those needing reconstructive procedures. This study aims to determine the effects of the COVID-19 pandemic on plastic surgery training programs in Iran. Also, the number of canceled surgeries will be determined to see the effects of the pandemic on the patients. Methods: This retrospective case study considers a six-month timeframe in two consecutive years before and after the COVID-19 pandemic. For this purpose, the researchers evaluated the number of surgeries, types of procedures, age distribution, and gender distribution. The training program data of plastic surgery residents were collected from their logbooks and then analyzed in IBM SPSS Statistics 26. Differences were considered significant if p < 0.05 at a 95% confidence level. Results: The total number of surgeries decreased by 23.5% after the COVID-19 outbreak (p < 0.05). There was a 29.9% reduction in trauma cases, -78.9% in aesthetic surgeries, -17.7% in reconstructive surgeries, -51.8% in craniofacial surgeries, and -59.5%in microscopic surgeries for each resident. Conclusions: This study provides an insight into the severity of the pandemic effects on the plastic surgery training programs and the patients. The reduced number of surgeries led to a depletion in surgical skills training. These effects will not wear off immediately after the pandemic; therefore, it is necessary to observe whether the pandemic will have any lasting effects on this subspecialty. Level of evidence: Level IV, risk/prognostic study [ABSTRACT FROM AUTHOR]

Background: The presentation of medical topics in the cinema can greatly influence the public's understanding and perception of a medical field, with regard to the doctors and surgeons, medical diagnosis, and treatment and outcome expectations. This study aims to evaluate the representation of plastic surgery in commercial films that include a character with a link to plastic surgery, either as a patient or surgeon. Methods: The international film databases Internet Movie Database (IMDb), The American Film Institute (AFI), and British Film Institute (BFI) were searched from 1919 to 2019 to identify feature-length films with a link to plastic surgery. Movies were visualized and analyzed to identify themes, and the portrayal of plastic surgery was rated negative or positive, and realistic or unrealistic. Results: A total of 223 films were identified from 1919 to 2019, produced across 19 countries. Various genres were identified including drama (41), comedy (25), and crime (23). A total of 172 patient characters and 57 surgeon characters were identified as major roles, and a further 102 surgeons as minor roles. Disparities were noted in presentation of surgeons, both in terms of race and gender, with the vast majority of surgeons being white and male. In total only 11 female surgeons were portrayed and only one black surgeon. Thirteen themes emerged: face transplantation, crime, future society, surgeon mental status, body dysmorphic disorder, vanity, anti-aging, race, reconstructive surgery, deformity, scarring, burns, and gender transitioning. The majority of films (146/223) provide an unrealistic view of plastic surgery, painted under a negative light (80/146). Only 20 films provide a positive realistic image (24/77). Conclusions: There exists a complicated relationship between plastic surgery and its representation on film. Surgical and aesthetic interventions are portrayed unrealistically, with surgeons and patients presented negatively, perpetuating stigma, particularly with regard to cosmetic surgery. Cinema is also characterized by lack of representation of female and non-white surgeons. Recruitment of surgeons as technical advisors would help present a more realistic, representative view, without necessarily sacrificing creativity. Level of evidence: Not ratable. [ABSTRACT FROM AUTHOR]

As our previous studies have shown, cosmetic surgery has a positive correlation with postoperative well-being. The aim of this study was to prospectively examine the postoperative changes in quality of life (QoL) after a rhinoplasty. Thirty-four patients who underwent septorhinoplasty performed by a single surgeon from July 2015 to October 2018 reported in indication-specific self-developed and different validated questionnaires (FLZM or Fragen zur Lebenszufriedenheit Module, Freiburg Personality Inventor, Rosenberg self-esteem scale, Functional Rhinoplasty Outcome Inventory 17 [FROI-17], and Glasgow Benefit Inventory [GBI]) on the status of their QoL preoperatively (T0) and 6 months' follow-up (T1). Our goal was to assess the difference in psyche and self-esteem and to get objective insights into the effect of the operation. Significant improvements in QoL in terms of general module, health, and appearance were noted. The general part of the FLZM showed increasing T1 values in the sum scores ( p  = 0.005). With regard to the item "health," T1 was better than the norm data ( p  = 0.003). The statistically significant improvement for the item nose appearance ( p  < 0.0001) after operation and T1 versus reference data ( p  < 0.010) should be highlighted. The subjective patient ratings showed statistically significant T1 improvements for all items of the FROI-17: overall nose ( p  < 0.0001), nasal function ( p  = 0.001), general/further symptoms ( p  = 0.006), and confidence increased by aesthetic changes ( p  < 0.0001). Furthermore, the GBI score shows an improved QoL after rhinoplasty ( p  < 0.0001). Based on the assessment of a variety of disease- and nondisease-specific validated questionnaires, numerous improvements in the QoL of the patients were observed. Therefore, we support septorhinoplasty as a meaningful procedure regarding QoL improvement. The level of evidence is Level II prospective cohort study. [ABSTRACT FROM AUTHOR]

Objective: This study was conducted to evaluate various influences of media on body image and attitude of Kashmiri educated females towards cosmetic surgery. Methods: A questionnaire-based study was done among educated females involved in different walks of life. A total of800 questionnaires were distributed and 584 were received back with complete information forevaluation. Results: 584 educated females, aged between 18 and 54 years (Mean 34.37 years) participated in the study. 360 females (61.6%) were economically independent. 70.75% agreed that media influences attitude about body image. 80% of females were confident about their abilities although 60% thought they are not good at studies. 75% want to be known by what they are and only 20% think that they cant take criticism about themselves. 53.6% felt that cosmetic surgery is good and an efficient tool to attractiveness, but only 7.2% were ready to actually undergo the procedure. Conclusion: The media in its various forms like newspaper, magazines, internet and especially television play an important role in educating the public especially females on day to day issues which include fashion and body image. The attitude towards cosmetic surgery has been negative across cultures and a stigma is still attached to cosmetic surgery procedures but nevertheless the acceptance of cosmetic surgery is slowly but surely increasing across the globe. [ABSTRACT FROM AUTHOR]

Background: Excessive blood loss, during or after surgery, remains a major surgical concern despite the continuous improvement of surgical standards. Tranexamic acid (TXA), an anti-fibrinolytic, is a potential agent that has been used in a variety of methods to mitigate blood loss. In addition, TXA shows additional anti-inflammatory effects which may be of particular interest. The objective of this study is to review clinical studies involving the use of TXA in plastic surgery related procedures. Methods: We carried out a literature search of Google Scholar, PubMed, Ovid Medline, and Cochrane databases since their inception for relevant clinical studies on TXA use (dosages/routes of administration) in plastic surgery–related procedures. Results: Forty-five articles were included in this review. These included studies assessing the use of TXA in craniofacial surgery (15 studies), aesthetic and breast-related surgeries (23 studies), burn care (4 studies), and microsurgery (3 studies). For each sub-set, study design, study sample size, surgical procedure performed, TXA route of administration, dosage, study outcomes, and adverse events were summarized and reported in a separate section. Conclusions: TXA is widely studied in the field of craniofacial surgery, specifically craniosynostosis surgery. Intravenous administration of TXA is the most commonly studied route of administration. Topical formulations seem to be on the rise and the added local anti-inflammatory effects and safety profile of topical use add significant appeal. Moreover, evidence on appropriate dosage protocols is scarce. The variable approach in dosing warrants further trials to assess the clinical implications, as well as potential benefit in using TXA more efficiently in the field of plastic surgery, as a whole. Level of evidence: Not ratable [ABSTRACT FROM AUTHOR]

Although the cancellation of elective procedures due to the COVID-19 outbreak has been a vital precaution, it has resulted in the suspension of aesthetic procedures and surgeries worldwide. Consequently, this postponement and other factors might have a negative impact on patients planning to undergo aesthetic procedures. Understanding the changes in patient motivation and perception in comparison to the prepandemic period is imperative for proper adjustment of plastic surgery clinics. A prospective questionnaire study was conducted on patients with cancelled aesthetic surgeries or procedures to determine the effects that coronavirus disease 2019 (COVID-19) had on patient motivation regarding cosmetic surgery and procedures and to establish a relationship between patient characteristics and the overall effect of pandemia on the perception of cosmetic surgery. Although most patients felt angry or frustrated due to the cancellation of their surgeries or procedures, the majority accepted that it was a necessary precaution. Patients with a history of previous minimally invasive procedures had a significantly higher ratio of acceptance for cancellations, whereas single patients were more likely to want to have their treatments done if the decision were left up to them. A subset of patients considered undergoing additional cosmetic procedures in the setting of self-isolation, and all patients stated that they would reschedule once the pandemia was under control. Patients with established motivation for plastic surgery and minimally invasive procedures ultimately plan to resume their normal treatments alongside others after the pandemia subsides. Plastic surgeons must actively communicate with their patient population during this time to properly educate, embrace, and direct them under scientific guidelines. [ABSTRACT FROM AUTHOR]

Introduction and Purpose: The aim of this study is to investigate the factors affecting University students' attitudes toward aesthetic surgery. Materials and Methods: This descriptive study was carried out in the spring semester of the 2018-2019 academic year with the students of the nursing Karabuk University. A form determining the sociodemographic characteristics of the students, the Cosmetic Surgery Acceptance Scale, and the Social Appearance Anxiety Scale were used to collect the study data. Results: The mean age of the students participating in the study was 21 ± 1.9 years, the mean body mass index was 22.54 ± 3.8, 72.5% were female, and 97.2% were single. The mean scores of the students obtained from the Cosmetic Surgery Acceptance Scale and Social Appearance Anxiety Scale were 45.73 ± 17.68, 34.85 ± 10.05, respectively. A significant relationship was determined between the mean of the Cosmetic Surgery Acceptance Scale and the ages of the students (P < 0.0001). In addition, there was a positive and strong relationship between the mean scores of the sub-dimensions of the Cosmetic Surgery Acceptance Scale (personal, social, and intellectual levels) and the mean score of the Social Appearance Anxiety Scale (P < 0.0001). Conclusion: In this study, it was determined that age and social appearance anxiety among university students are the factors that increase the possibility of opting for aesthetic surgery. Before aesthetic surgery interventions, determining psychological factors such as aging anxiety and social appearance anxiety that affect attitude toward aesthetic surgery in psychosocial evaluations and integrating the necessary interventions into nursing care will be beneficial in evaluating the suitability of patients for surgical intervention more accurately, applying more qualified nursing care, and increasing patient satisfaction. [ABSTRACT FROM AUTHOR]

Background and objective. Aesthetic Plastic Surgery has been suspended in many regions of the world due to the COVID-19 pandemic. The preservation of available hospital resources for the care of patients seriously affected by this disease and the morbidity attributable to the inadvertent performance of an optional surgical act in a patient with asymptomatic infection, as well as the risk of bidirectional infection in health institutions, support massive cancellations of procedures with aesthetic fines. The reactivation of these services must consider the risk/benefit balance with the different phases of the pandemic and local epidemiology. Assuming the reopening of Aesthetic Surgery services, it is possible to propose a significant number of aesthetic procedures that have low risks of complications, and may be capable of being treated safely. Methods. Descriptive and retrospective study in patients operated on in an outpatient Aesthetic Surgery center, who required medical attention for associated complications in a previous COVID-19 period of 36 months, in order to identify variables and frequency of complications susceptible to commit additional hospital medical resources. Results. In a 3-year period, a total of 13.411 aesthetic surgeries were performed; 67.5% of the procedures were unique and in 32.5% two or more procedures were processed in the same anesthetic act. In the first 30 postoperative days, 244 complications were observed for a 1.8% complication rate in 3 years. At the moment, the average surgical time was 200 minutes, 44 patients (18%) were managed at the hospital level and 200 (82%) were ambulatory. Conclusions. Consider that the reestablishment of elective Aesthetic Surgery services in the COVID-19 context it should start with single surgeries, short times of duration and less than 2 hours, in order to decrease the need for additional hospital resources. [ABSTRACT FROM AUTHOR]

Treatment with botulinum toxin is widely viewed as safe, effective and largely devoid of serious side effects. There are two classes of Botox-related adverse events - transient and benign events, and potentially serious events. The aim of this study was to provide an overview of Botox-related side effects and advise potential management and preventive strategies. Benign side effects are well-localized, reversible and self-limited complications which develop within a few days of the injection, and they usually disappear without any treatment. The aesthetic and functional adverse effects are associated with different muscle responses to botulinum toxin or with misplacement of botulinum toxin. The serious events are sequelae due to the systemic spread of toxin leading to botulism. [ABSTRACT FROM AUTHOR]

Aesthetic surgery tourism is a growing phenomenon, with a steady increase of people travelling abroad for surgical procedures. In our hospital, a relevant number of patients consulted the emergency department for complications after cosmetic surgery performed in foreign countries. This progressively increasing trend leads to multiple outpatient clinic consultations and surgical re-operations. We investigated this phenomenon at Lausanne University Hospital from May 2015 to December 2018, with the aim to give a review of the surgical and hospital care costs, finally affecting the Swiss insurance system. [ABSTRACT FROM AUTHOR]

In this article, we will provide the reader with the anatomical and embryologic evidence supporting the use of the deep-plane approach in rhytidectomy and insight into the evolution of the technique into the vertical platysma advancement. The original description of the deep-plane technique only described a basic superficial muscular aponeurotic system dissection in the midface with the ability to use tension on the flap without aesthetic consequences. This plane of dissection provides additional advantages not previously described, including access to deeper anatomical structures such as the buccal fat pad, and allows in vivo assessment and treatment of jowling. We describe how extension of this dissection and selective release of facial ligaments allows us to optimize treatment outcomes and longevity, especially in cases of difficult anatomy or revisions. Further advancements include case-specific facial volume enhancement, created by complex flap design, and facial narrowing by preauricular contouring and parotid hypertrophy treatment. Insights into anatomical landmarks, technical nuances, and alternative approaches for facial variations are presented. [ABSTRACT FROM AUTHOR]

Recently there is a surge in cosmetic and aesthetic surgery procedures. Several patient seeking various cosmetics procedures present to aesthetic surgery clinics and demanding procedures which are out of proportion. Several of these patients have under‐recognized or untreated psychiatric disorders. Proper screening and evaluation of these patients could save money and resources. This brief review focuses on current trends, clinical and psychological assessment and expectations on the part of patients and recommendations regarding management of these patients. [ABSTRACT FROM AUTHOR]

This study aims to investigate the relationship between individuals' attitudes about acceptance of aesthetic surgery (e.g. rhinoplasty, autoplasty, blepharoplasty, and mammaplasty) and some of the worship practices in Islamic religion such as performing prayer, fasting, and going to pilgrimage. Although many people think that aesthetic surgery is inappropriate in Islamic religion, no studies in the literature were found to have investigated this issue. This study collected data through a questionnaire administered to 96 patients who applied to our Plastic Surgery Clinic and underwent various surgical operations and 96 patients who were recommended plastic surgery but rejected to have one; the questionnaire aimed to identify the participants' frequency of religious worship practices and appropriateness of aesthetic surgery to their beliefs. The participants responded on the frequency of religious worship levels according to the options in the questionnaire. The "Acceptance of Cosmetic Surgery Scale" was utilized in order to identify their attitudes towards aesthetic surgery. Levels of performing prayers, fasting, and going to pilgrimage in the groups that accepted surgery and in the groups that rejected surgery were significantly different (p < 0.001, p = 0.008, p < 0.001). In two different groups, the Acceptance of Aesthetic Surgery Scale scores were significantly different within the prayer groups and fasting groups (p < 0.001, p < 0.001, p = 0.001, p < 0.001). While the group that accepted surgery indicated no significant differences between those who thought about going to pilgrimage and who did not (p = 0.650), there was a significant difference in the group that rejected surgery (p < 0.001). While 14.6% of the participants in the group that accepted surgery considered aesthetic surgery a sin, this proportion was 56.3% in the group that rejected surgery, and this difference was significant (p < 0.001). In both surgery groups, there were differences in the scale scores of those who considered aesthetic surgery a sin and those who did not (p < 0.001, p < 0.001). There was a significant relationship between worship practices, one of the biggest indicators of the level of belief in Islamic religion, and aesthetic surgery attitudes. However, despite the fact that belief levels affect the decision of having an operation in plastic surgery, in case of serious health problems, the decision of having an operation becomes more important religious beliefs. [ABSTRACT FROM AUTHOR]

There is an increasing interest in the effects of preoperative anxiety on the course and outcomes of surgical treatments and also in the studies about the anxiety-decreasing interventions. The present study aims to identify the relationship between the preoperative anxiety level of the individuals prior to aesthetic surgery operations such as nose, ear, eyelid, and mammoplasty and religious rituals such as performing prayers, fasting, and going to pilgrimage. The frequency of performing the religious rituals was identified through a questionnaire. The questionnaire included questions about the religious rituals such as performing prayers, going to a pilgrimage, and fasting as well as questions about sociodemographic features such as gender, age, and education level of the patients. Preoperative anxiety level was measured using the "Anxiety Specific to Surgery Questionnaire." The nonparametric Mann–Whitney U test was used for the scale score comparisons of the two independent groups. The scale score comparisons of more than two groups were performed using the Kruskal–Wallis test. The relationships between age and scale scores were analyzed using the Spearman's correlation coefficient. The study involved 117 patients who were planned to undergo an aesthetic surgery operation. The scale scores were significantly different according to the pilgrimage groups (p = 0.004). The scale scores were significantly different according to the level of fasting (p = 0.022). No significant differences were found between the scales scores of the groups who reported the frequency of performing prayer as never, sometimes or five times (p = 0.515). In conclusion, the present study found that Muslim people who performed religious rituals more often experienced less preoperative anxiety levels in plastic surgeries, which indicates that the belief level is an effective factor in preoperative anxiety levels. The findings of the present study indicate that patients' beliefs and worship practices should be taken into consideration by doctors, operating room personnel, and even all health workers in order to decrease the anxiety levels of patients who will undergo surgery. [ABSTRACT FROM AUTHOR]

Background/Objective: Online physician‐rating websites are being increasingly used by patients to gauge physicians' quality of service. The objective of this study is to assess the impact of residency training background of hair restoration surgeons and to identify themes of patient reviews using online physician‐rating portals. Method: From July 1, 2018 to July 18, 2018, a list of American Board of Hair Restoration Surgery (ABHRS) physicians was compiled. Each member's name was searched on Healthgrades.com and Yelp.com websites, and profile reviews were analyzed for themes of patient satisfaction and dissatisfaction. Results: Eighty‐six ABHRS‐certified surgeons were identified on the ABHRS physician directory practicing in the United States. Eleven different residency training backgrounds are represented. Surgeons were given significantly higher ratings on Healthgrades (4.63 vs 3.77, P < 0.001), and nonsurgeons were given significantly higher ratings on Yelp (4.31 vs 4.11, P = 0.036). A total of 567 five‐star reviews and 59 one‐star reviews were analyzed for content across both physician review portals. The most commonly cited topics included results, office staff, physician's bedside manner, comfort during procedure, patient‐perceived physician's honesty, patient‐perceived physician's knowledge, cost/financing options, recovery time, and wait time/scheduling. Conclusions: Significant, yet inconsistent differences in ratings were found between surgical and nonsurgical residency backgrounds across online physician‐rating portals. Understanding drivers of positive and negative reviews may help surgeons improve patient satisfaction. [ABSTRACT FROM AUTHOR]

Background As the demand for cosmetic surgery continues to rise, plastic surgery programs and the training core curriculum have evolved to reflect these changes. This study aims to evaluate the perceived quality of current cosmetic surgery training in terms of case exposure and educational methods. Methods A 16-question survey was sent to graduates who completed their training at a U.S. plastic surgery training program in 2017. The survey assessed graduates' exposure to cosmetic surgery, teaching modalities employed and their overall perceived competence. Case complexity was characterized by the minimum number of cases needed by the graduate to feel confident in performing the procedure. Results There was a 25% response rate. The majority of respondents were residents (83%, n=92) and the remaining were fellows (17%, n=18). Almost three quarters of respondents were satisfied with their cosmetic training. Respondents rated virtual training as the most effective learning modality and observing attendings' patients/cases as least effective. Perceived competence was more closely aligned with core curriculum status than case complexity, i.e. graduates feel more prepared for core cosmetic procedures despite being more technically difficult than non-core procedures. Conclusions Despite the variability in cosmetic exposure during training, most plastic surgery graduates are satisfied with their aesthetic training. Incorporation of teaching modalities, such as virtual training, can increase case exposure and allow trainees more autonomy. The recommended core curriculum is adequately training plastic surgery graduates for common procedures and more specialized procedures should be consigned to aesthetic fellowship training. [ABSTRACT FROM AUTHOR]

Cosmetic procedures, especially cosmetic minimally invasive treatments, are rising in popularity, despite societal perception that these procedures may not improve patient health. The purpose of this study was to conduct a systematic review and controlled meta-analysis to compare the effects of cosmetic procedures and antidepressant treatment on health-related quality-of-life improvement. The PubMed database was queried in two independent searches to identify peer-reviewed cosmetic and antidepressant articles published between 1996 and 2017 that prospectively assessed the impact of the treatment on quality of life. All results were screened using defined exclusion and inclusion criteria and data were extracted using a standardized protocol. The meta-analysis was performed using a random-effects model. Five of 2,788 cosmetic studies and eight of 2,312 antidepressant studies met all inclusion criteria and utilized the 36-Item Short Form Health Survey (SF-36) measure. Except for the physical functioning scale, when compared with the cosmetic studies, antidepressant studies had significantly lower median baseline and post-treatment follow-up scale scores with larger median score improvement ( p  < 0.05). Positive effect sizes following treatment were observed for all eight SF-36 scales (range: 0.32–1.16; p  < 0.05). This meta-analysis provides evidence that cosmetic procedures objectively improve a patient's health-related quality of life. While antidepressant studies exhibited greater SF-36 score improvement except for the physical functioning scale, both treatment groups demonstrated the greatest improvement in mental health and role emotional scales. As previously suggested, a disconnect exists between score improvement and clinical improvement due to baseline severity, ceiling effect, and regression to the mean effects. [ABSTRACT FROM AUTHOR]

Breast augmentation remains one of the most commonly performed aesthetic procedures in the United States and worldwide. Throughout the last few decades, the implants used for this procedure have undergone significant advancements, which has allowed surgeons to provide safer and more aesthetically pleasing outcomes. This article discusses the history of breast implants since their invention in 1962. Particular emphasis is given to the evolution of silicone implants with its many challenges, which has resulted in the development of the currently used fourth- and fifth-generation devices. Knowledge of these advances will allow physicians to more critically evaluate their results, and also will encourage them to provide more up-to-date scientific data on these devices to further improve the clinical outcomes of their patients. [ABSTRACT FROM AUTHOR]

Medical treatment by Muslim doctors will sometimes be influenced by Islamic law and ethics rather than solely medical consideration. Muslim patient's sometimes need reassurance that modern medicine that offered to them is also acceptable by Islamic law. Orthognathic deformities are condition which associated with discrepancies of the jaw. These deformities resulted from different rates of growth of the maxilla, the mandible or both. Performing cosmetic surgery seems to change the creation of Allah and the original law of changing Allah's creation is prohibited. In assessing the orthognathic surgery law for patients with this dentofacial defect, the researcher found that the main issues that need to be investigated are the difficulties existed (Masyaqqah) and the level of patient harm in addition to the intention or purpose of performing orthognathic surgery. However, according to the principles of the Islamic jurisprudence, orthognathic surgery is permitted based on the principles such as ad-darar yuzal, al-musyaqqah tajlibu al-taisir, al-darurat tuqaddiru biqadaruha, irtikab akhaf al-dhararain, al-darurat tubihu mahzurat and al-umur bimaqasidiha. Orthognathic surgery can be done because the purpose is to treat defects and restore function. This objective is very consistent with the fiqh rules that stated, every harm and distress should be eliminated. [ABSTRACT FROM AUTHOR]