Pre-/postprocedure measures for laser/energy treatments: A survey.

BACKGROUND: Laser and energy-based devices may be used for many cutaneous indications, including facial resurfacing, improving skin conditions, and reducing signs of photoaging. Currently, no consensus papers or guidelines exist concerning peri-operative agents and specifically their use for laser skin resurfacing and their potential/possible role in prevention or treatment of side effects. AIM: To explore current practice using laser and energy devices, a survey was developed to identify the trends in pre- and postprocedural treatment measures. METHODS: The survey was sent out digitally to 300 randomly selected US dermatologist and plastic surgeon physicians practicing medical esthetics using laser and other energy devices treatment for facial rejuvenation. The survey gathered information on demographics, types of devices used in the clinic and pre-/postprocedural measures for facial laser, and other energy-based devices treatment. RESULTS: The survey was active from June 15, to July 15, 2018, and fifty-eight dermatologists and plastic surgeons completed the survey (19.3% response rate, 58/300). The results showed inconsistency in skin preparation strategies and postprocedure wound care. The majority of survey participants (55/58 [96%]) reported prophylactic oral antiviral use pre- and post-treatment; however, there was inconsistency about when to start and when to stop the use. A similar inconsistency existed in the recommended period of post-treatment sun protection before and after treatment. CONCLUSION: The results of the survey confirmed the lack of consistency in the types and duration of pre- and postprocedural measures-emphasizing the need for evidence-based recommendations to optimize outcomes, prevent infection, enhance comfort, and reduce downtime.

Prevalence of Body Dysmorphic Disorder and Surgeon Diagnostic Accuracy in Facial Plastic and Oculoplastic Surgery Clinics.

IMPORTANCE: Body dysmorphic disorder (BDD) is a relative contraindication for facial plastic surgery, but formal screening is not common in practice. The prevalence of BDD in patients seeking facial plastic surgery is not well documented. OBJECTIVE: To establish the prevalence of BDD across facial plastic and oculoplastic surgery practice settings, and estimate the ability of surgeons to screen for BDD. DESIGN, SETTING, AND PARTICIPANTS: This multicenter prospective study recruited a cohort of 597 patients who presented to academic and private facial plastic and oculoplastic surgery practices from March 2015 to February 2016. METHODS: All patients were screened for BDD using the Body Dysmorphic Disorder Questionnaire (BDDQ). After each clinical encounter, surgeons independently evaluated the likelihood that a participating patient had BDD. Validated instruments were used to assess satisfaction with facial appearance including the FACE-Q, Blepharoplasty Outcomes Evaluation (BOE), Facelift Outcomes Evaluation (FOE), Rhinoplasty Outcomes Evaluation (ROE), and Skin Rejuvenation Outcomes Evaluation (SROE). RESULTS: Across participating practices (9 surgeons, 3 sites), a total of 597 patients were screened for BDD: 342 patients from site 1 (mean [SD] age, 44.2 [16.5] years); 158 patients, site 2 (mean [SD] age, 46.0 [16.2] years), site 3, 97 patients (mean [SD] age, 56.3 [15.5] years). Overall, 58 patients [9.7%] screened positive for BDD by the BDDQ instrument, while only 16 of 402 patients [4.0%] were clinically suspected of BDD by surgeons. A higher percentage of patients presenting for cosmetic surgery (37 of 283 patients [13.1%]) compared with those presenting for reconstructive surgery (21 of 314 patients [6.7%]) screened positive on the BDDQ (odds ratio, 2.10; 95% CI, 1.20-3.68; P = .01). Surgeons were only able to correctly identify 2 of 43 patients (4.7%) who screened positive for BDD on the BDDQ, and the positive likelihood ratio was only 1.19 (95% CI, 0.28-5.07). Patients screening positive for BDD by the BDDQ had lower satisfaction with their appearance as measured by the FACE-Q, ROE, BOE, SROE, and FOE. CONCLUSIONS AND RELEVANCE: Body dysmorphic disorder is a relatively common condition across facial plastic and oculoplastic surgery practice settings. Patients who screen positive on the BDDQ have lower satisfaction with their facial appearance at baseline. Surgeons have a poor ability to screen for patients with BDD when compared with validated screening instruments such as the BDDQ. Routine implementation of validated BDD screening instruments may improve patient care. LEVEL OF EVIDENCE: NA.

Bioestimulación cutánea periocular con plasma rico en plaquetas / Cutaneous biostimulation using platelet-rich plasma

La presente revisión fue realizada con el objetivo de ampliar los conocimientos sobre el envejecimiento cutáneo y los tratamientos restitutivos empleados en la cirugía plástica ocular, especialmente la bioestimulación cutánea con plasma rico en plaquetas, como alternativa novedosa de rejuvenecimiento periocular. Se realizó una búsqueda bibliográfica amplia y actualizada en bases de datos que ofrece Infomed, como Ebsco, Hinari, Pubmed, Google académico y textos básicos de Oftalmología y Cirugía Estética. El plasma rico en plaquetas es un preparado biológico efectivo para la bioestimulación cutánea; incrementa la producción de colágeno; elastina y ácido hialurónico, proporciona una piel con más brillo, mejor textura, hidratación y elasticidad; presenta múltiples ventajas y mínimas complicaciones, lo que contribuye a elevar la calidad de vida de los pacientes(AU)

The objective of this review was to expand knowledge on skin aging and restorative treatments used in ocular plastic surgery, especially cutaneous biostimulation with platelet-rich plasma, as a novel alternative of periocular rejuvenation. A comprehensive literature search was performed in updated databases that Infomed provides such as Ebsco, Hinari, Pubmed and Google and basic academic texts of cosmetic surgery and ophthalmology. The platelet-rich plasma is an effective biological preparation for skin biostimulation, increases the production of collagen, elastin and hyaluronic acid, and provides a brighter skin, improved texture, hydration and elasticity. It really has many advantages and minimal complications, thus contributing to raise the quality of life of patients(AU)