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Background: Psychological stress of patients with penile cancer arises from the cancer diagnosis itself and the treatment consequences. In addition, there is cancer-specific distress. There is the chance of cure in localized stages and in those with limited regional lymph node metastases but this requires surgery and often adjuvant chemotherapy. This systematic review gives a summary of the existing literature to date., Materials and Methods: A critical database search using Medline was made in Ovid from 1946 to 2017, in the Cochrane Central Register of Controlled Trials (CENTRAL) and in the Web of Science from 1900 to 2017. This was complemented by a search of the World Health Organization's International Clinical Trials Registry Platform Search Portal and ClinicalTrials.gov. The reference lists of the included studies were manually searched for additional references., Results: Selected studies (n = 10) addressed the psychosocial effects of penile cancer treatment on quality of life and sexual function. Due to the heterogeneity of the study designs only a narrative description of the results was possible. Defects or mutilation due to penile cancer cause psychological distress in a significant number of patients. Organ-sparing interventions have a positive impact on quality of life and sexual function., Conclusion: The external genitals are a focus of sexual identity. Mutilating treatment causes significant distress but organ-sparing treatment and reconstruction positively influence quality of life.

More and more children, and even more so adolescents, undergo procedures pertaining to the category of aesthetic surgery and mainly aiming to improve the patient's physical appearance. There is a broad spectrum of possible operations ranging from purely cosmetic procedures to operations with a medical indication., (© Georg Thieme Verlag KG Stuttgart · New York.)

The desire for authenticity is often cited as a motive for making use of plastic surgery. This article aims to elaborate on the meaning of this particular authenticity. At the same time, it discusses reasons that justify or forbid a plastic surgery intervention in the light of ethics. For this purpose, a distinction is made between "objective body" (Körper) and "subjective body" (Leib), and the objectives of medical actions are questioned. Through the terminological differentiation between integrity (Integrität), prosperity (Wohlergehen), and well-being (Wohlbefinden), these objectives are qualified and the limits of medical actions are determined.

The main aim of every aesthetic surgery is to offer patients a subjective benefit. Today, the construct "health-related quality of life" (HRQOL) is considered one of the most important parameters in the evaluation of treatment. Several recent studies using validated tools to measure HRQOL show that otoplasty leads to a significant and long-lasting increase in the HRQOL of children and adults suffering from protruding ears. However, irreversible auricular deformities after failed otoplasty can be more emotionally draining for the patient than the preoperative state. The respective risk is higher when using cartilage rasping or cutting techniques compared with pure suture techniques.

The wish for an attractive appearance is evident in many people. Aesthetic, cosmetic and surgical treatment is willingly made use of in order to fit into the current beauty ideal. A considerable portion of people who decide to follow this path show signs of psychological problems. One has to recognize and evaluate these for the planning or, if necessary, refusal of further treatment. In this article, the most common psychological problems in the cosmetic and aesthetic field of work are presented. A guideline for handling these patients is explained. Thus, a productive and relaxed cooperation will be possible which enables psychological and physical satisfaction for the medical team and the patients.

The construction of facial prostheses is frequently used as a remedial treatment method in otorhinolaryngology. Modern prostheses are often attached to the face via bone anchored titanium implants and magnetic attachments. The use of specialised silicones and colouring techniques produces prostheses which realistically mimic lost facial tissues and significantly enhance patient quality of life. The article provides an overview of the possibilities of modern epithetics in the treatment of facial defects resulting from head and neck tumors., (© Georg Thieme Verlag KG Stuttgart · New York.)

Introduction: Aesthetic surgery is a service which entails a high degree of trust. Service evaluation prior to provision is difficult for the patient. This leads to the question of how to manage the service successfully while still focusing on the medical needs. The decision to undergo an operation is not influenced by the operation itself, but by preoperative events which induce the patient to have the operation done. According to "buying decisions" for products or in service management, the decision for an aesthetic operation is extensive; the patient is highly involved and actively searching for information using different directed sources of information. The real "buying decision" consists of 5 phases: problem recognition, gathering of information, alternative education, purchase decision, and post purchase behaviour., Patients and Methods: A retrospective survey of 40 female patients who have already undergone an aesthetic operation assessed for problem recognition, which types of information were collected prior to the appointment with the surgeon, and why the patients have had the operation at our hospital. They were also asked how many alternative surgeons they had been seen before., Results: Most of the patients had been thinking about undergoing an operation for several years. They mainly used the web for their research and were informed by other (non-aesthetic) physicians/general practitioners. Requested information was about the aesthetic results and possible problems and complications. Patients came based on web information and because of recommendations from other physicians. 60% of all interviewees did not see another surgeon and decided to have the operation because of positive patient-doctor communication and the surgeon's good reputation. Competence was considered to be the most important quality of the surgeon. However, the attribute was judged on subjective parameters. Environment, office rooms and staff were assessed as important but not very important. Costs of surgery were ranked second., Discussion: Influence on patients' decision is only possible by high quality operation results, which in turn lead to good reputation with (non-aesthetic) physicians and patients. In contrast to print advertisements, the provision of information via the internet is of tremendous importance and must be both information and comprehensible. Not only the aesthetic result should be depicted, but also questions such as "when will I be fit after surgery", and possible problems and complications should be described honestly. Besides the described word-of-mouth recommendations web fora resemble a virtual extension of recommendation. Whether such web based fora will prevail as a significant source of information remains unclear. Board certification in plastic and aesthetic surgery ("Facharzt" qualification) was assessed as very important. Thus, this is relevant information which should be emphasized. Most important for the patients' decision, however, was patient-doctor communication. To develop a basis of trust, communication should be open and reliable. An adequate time span has to be planned for the first appointment with the patient. In addition to aesthetic results, risks and possible complications have to be discussed. An open and comprehensible conversation which does not sugar-coat the operation is assessed as very positive. Finally, based on this consultation the surgeon is suggestive of his surgical competence. This underlines that core competence in aesthetic surgery is a medical one., (© Georg Thieme Verlag KG Stuttgart · New York.)

Self-mutilations are one of the major characteristics of patients with borderline personality disorder (BPD). Thermal injuries of BPD should be treated by a plastic surgeon who is faced to a challenge in the plastic-reconstructive strategy because of the most complex psychiatric disease. This means the need of a multidisciplinary strategy. Based on 3 case reports such conflict between best plastic reconstructive treatment of the burns wound and the psychiatric limit with the appropriate therapy options are presented., (George Thieme Verlag KG Stuttgart · New York.)

Background: The improvement of psychosocial well being in patients with microtia after ear reconstruction with rib cartilage is mainly assessed clinically. There are first prospective studies with established psychological questionnaires showing promising results but these tests are too extensive for everyday-use in clinical routine. Therefore, we examined a self-designed short version for the specific use in the head-neck-region., Methods and Patients: The clinically established psychological questionnaire "Frankfurter Selbstkonzeptskalen/FSKN" consists of 78 items for self-assessment of performance abilities, self-esteem, and psychosocial attitude. We downsized the FSKN to 13 items that might be relevant for plastic reconstructive surgery in the head-neck-region. The pre- and postoperative development after ear reconstruction with rib cartilage was analyzed retrospectively in 68 patients and prospectively in 21 patients. The preoperative data of the prospective study group were compared with the results of 23 patients with microtia who declined any type of reconstruction after consultation., Results: Especially the results of the psychosocial competence improved after ear reconstruction as well in the retrospective (median values 138,5 to points; p<0,01) as well as in the prospective study group (median values 126 to 141 points; p=0,01). We were able to demonstrate changes in the short version of the FSKN (median values 51,5 to 58,5 points; p<0,01 respectively, 50 to 56 points; p=0,02). Patients who declined ear surgery showed higher values in psychosocial competence (median values 126 to 154 points; p<0,01). Again, the short form displayed this difference clearly (median values 50 to 65 points; p<0,01)., Conclusions: The short version of the FSKN has promising potential for the preoperative assessment and the documentation of psychological changes following reconstructive surgery. Further studies are necessary to validate the new instrument to obtain a valuable test for use in clinical routine in plastic surgery in the head-neck-region.

Purpose: The aim of this study was to evaluate the quality of life of women after a breast cancer surgery. The question was if women which had reconstructive breast cancer surgery experience a higher quality of life than women who, for various distinct reasons, had not undergone reconstruction., Patients and Methods: The participants of this study were women who had either received a mastectomy or those who at the same time underwent a breast reconstruction using implants during the time period from 1/1/2000 until 31/10/2003 at the University Hospital for Women of Heidelberg and Mannheim. With the help of three standardised questionnaires, the women could describe their post-surgical physical and psychological condition as well as the perceived quality of life. The study included 33 patients who had received breast implants and 31 patients without reconstruction., Results: Women who had breast cancer surgery with reconstruction through implants had less problems and restrictions concerning their physical condition as well as their functional status. Moreover, compared to those participants with no reconstruction, their cognitive and emotional burdens were not as pronounced and they also they were able to better cope with the disease. Thus, their overall quality of life was superior than that of the other women., Conclusion: Breast reconstruction after primary and secondary mastectomy is an important contribution in order to improve the self-esteem and quality of a patient's life. Furthermore, it plays an essential role in coping with the psychological effects of breast cancer.

In a prospective longitudinal study, 26 patients with facial-profile changes by surgery in the upper and/or lower jaw were evaluated concerning motivational factors and the outcome of surgery. Subjective criteria, i.e., expectations of surgery, social support and personality factors, are subject to the evaluation of the outcome. To reduce failure there should be a small amount of psychological screening in advance.