Compulsory notification of injuries in aesthetic procedures. Impact on patient safety

Abstract The disparity between the number of aesthetic procedures performed worldwide, and the complications described in the literature is remarkable. Doubts regarding the underreporting are reasonable and should be considered. The aim of this study is to demonstrate the scarcity of scientific publications on complications in aesthetic procedures compared to the abundance of these procedures performed worldwide. Based on this knowledge, it will be demonstrated to the health authorities the importance of compulsory notification of complications in aesthetic procedures that require medical attention so that the available data will allow their prevention. The limitation of knowledge regarding complications was demonstrated in the data collection for the preparation of the thesis ‟Deaths Related to Liposuction in Brazil" presented in 2018 and published in Surgical and Cosmetical Dermatology in 2020. The definition of complication in aesthetic procedures needs to be objective to prevent different and subjective interpretations. With the compulsory notification of complications in aesthetic procedures, it is intended to learn about their causes to develop guidelines for their prevention.

Compulsory notification of injuries in aesthetic procedures. Impact on patient safety.

The disparity between the number of aesthetic procedures performed worldwide, and the complications described in the literature is remarkable. Doubts regarding the underreporting are reasonable and should be considered. The aim of this study is to demonstrate the scarcity of scientific publications on complications in aesthetic procedures compared to the abundance of these procedures performed worldwide. Based on this knowledge, it will be demonstrated to the health authorities the importance of compulsory notification of complications in aesthetic procedures that require medical attention so that the available data will allow their prevention. The limitation of knowledge regarding complications was demonstrated in the data collection for the preparation of the thesis "Deaths Related to Liposuction in Brazil" presented in 2018 and published in Surgical and Cosmetical Dermatology in 2020. The definition of complication in aesthetic procedures needs to be objective to prevent different and subjective interpretations. With the compulsory notification of complications in aesthetic procedures, it is intended to learn about their causes to develop guidelines for their prevention.

Função da blefaroplastia superior no rejuvenescimento facial / Role of upper blepharoplasty in facial rejuvenation

Notável é a gama de tratamentos faciais, com intuito estético, com os quais podemos preservar o equilíbrio da forma ou a beleza de nossos pacientes. Preenchimentos, toxina botulínica, laser e outras tecnologias são amplamente demonstrados à classe dermatológica. As pálpebras também podem ser tratadas com esses e outros recursos terapêuticos. No entanto, a herniação das bolsas de gordura das pálpebras superiores não tem resultados significativos com esses métodos. O avanço das técnicas conhecidas como minimamente invasivas e das tecnologias não supre a contento o tratamento desta unidade estética facial. Pensando no rejuvenescimento global da face é improvável conseguirmos um resultado de excelência sem atuar nas pálpebras. A blefaroplastia superior segue insubstituível e é o tratamento de escolha para redundância da pele e herniação das bolsas de gordura. Esta cirurgia, com amplo histórico na Dermatologia, tem um papel único e fundamental no rejuvenescimento facial. Procuramos neste estudo demonstrar a técnica cirúrgica de blefaroplastia superior de maneira didática e comprovar sua eficácia e segurança, com bons resultados estéticos e funcionais. Com pleno conhecimento desta região anatômica e dos preceitos técnicos, reconhecemos poder realizá-la com segurança.

It is noteworthy the range of facial treatments, with aesthetic purpose, with which we can preserve the balance of the shape or beauty of our patients. Fillers, botulinum toxin, laser, and other technologies are widely used in dermatology. Eyelids can also be treated with these and other therapeutic resources. However, herniation of the fat pockets of the upper eyelids does not present significant results with these methods. The advancement of techniques known as minimally invasive and other technologies does not satisfy the treatment of this facial aesthetic unit. Thinking about the global rejuvenation of the face, it is unlikely that we will achieve a result of excellence without acting on the eyelids. Upper blepharoplasty remains irreplaceable, and it is the treatment of choice for skin redundancy and herniation of fat pockets. This surgery, with a long history in Dermatology, has a unique and fundamental role in facial rejuvenation. In this study, we tried to demonstrate the surgical technique of superior blepharoplasty educationally and to prove its efficacy and safety, with good aesthetic and functional results. With full knowledge of this anatomical region and technical precepts, we recognize that we can perform it safely.

Abordagem Cirúrgica da Ginecomastia Verdadeira / Surgical approach to True Gynecomastia

A ginecomastia verdadeira é uma proliferação benigna do tecido glandular da mama masculina. Em geral, o manejo é conservador, porem se houver o desenvolvimento de fibrose após a fase inflamatória, preconiza-se a cirurgia. Relata-se um caso de ginecomastia verdadeira, em homem com aumento simétrico das mamas desde a adolescência. Frente a este diagnóstico foi realizada cirurgia corretiva com anestesia tumescente e exérese em bloco da glândula mamária.

True gynecomastia is a benign proliferation of the glandular tissue of the male breast. In general, management is conservative, however if there is development of fibrosis after the inflammatory phase, surgery is recommended. The present article describes a case of true gynecomastia with symmetrical enlargement of the breasts since adolescence. In light of this diagnosis, corrective surgery was performed with tumescent anesthesia and exeresis in block of the mammary gland.

Cicatrizaçäo: conceitos atuais e recursos auxiliares - Parte II / Cicatrization: current concepts and auxiliary resourses - Part II

Na Parte I deste artigo, publicada na ediçäo anterior dos Anais Brasileiros de Dermatologia, foram revisados os conceitos de cicatrizaçäo e foi ressaltada a importância da atuaçäo multidisciplinar na abordagem das feridas, compreendendo-se o paciente como um todo. Nesta Parte II säo apresentados os recursos que podem auxiliar o processo de cicatrizaçäo, bem como os diversos tipos de curativos disponíveis e a sua respectiva indicaçäo.

Cicatrizaçäo: conceitos atuais e recursos auxiliares - parte I / Cicatrization: current concepts and auxiliary resouces - part I

O estudo da cicatrizaçäo da pele envolve uma enorme gama de eventos e de situaçöes especiais. Exige conhecimentos básicos de anatomia, histologia, bioquímica, imunologia, farmacologia, entre outras ciências. O artigo faz revisäo dos conceitos de cicatrizaçäo, em seus diversos aspectos, e ressalta a importância da atuaçäo multidisciplinar na abordagem das feridas, bem como a percepçäo do paciente como um todo. Säo abordados os aspectos econômicos que representam as feridas agudas e crônicas. Apresenta ainda os recursos que podem auxiliar o processo de cicatrizaçäo, bem como os diversos tipos de curativos disponíveis.