Analysis of modified ilib therapy in patients submitted to plastic surgery.

The sample comprised 44 volunteers who had undergone some surgical procedure and were equally divided into four groups. G1 started the therapy 24 h after the surgical procedure with the device off. G2 followed the same time pattern, 24 h, but with the device turned on. G3 and G4 started therapy three days after the surgical procedure; in G3, the device was turned off, and in G4, the device remained on during therapy; each session lasted 30 min, using 660 nm (red), energy 180 J. For all groups, the therapy started with daily use for seven days and followed the interval use of three times a week until completed 21 days. The revaluation was performed after 7 and 21 days. The results found show changes in HR at rest, systolic and diastolic BP, and in peripheral oxygen saturation, which showed a significant difference in the groups that used on-therapy (p < 0.05). In the MCGILL Scale evaluation, the mean total score showed a more accentuated drop in the groups that used ILIB, (p < 0.05). ILIB may have prevented a more significant evolution of firosis levels; however, no changes were observed in the evaluation of sleep and anxiety. The application of the ILIB in patients undergoing plastic surgery was supported in terms of hemodynamics and pain; in addition, starting the ILIB application 24 h after the procedure proved to be more advantageous.

Facial Gender-Affirming Surgery: Pitfalls, Complications, and How to Avoid Them.

Facial feminization is a complex undertaking requiring skill in both craniofacial and aesthetic plastic surgery. As in aesthetic procedures, understanding the patient's goals and setting realistic expectations in light of an individual's anatomy is critical. Both soft tissue and bone must be addressed to adequately soften masculine facial features. This article delves into specific anatomic areas and delineates some of the pathways to successful outcomes.

The Results of Our Reader Survey Are In!

To become more acquainted with Plastic and Aesthetic Nursing (PAN) readers and help identify the strengths and weaknesses of the PAN journal, I worked collaboratively with representatives from Wolters Kluwer Health to conduct an online survey of plastic and aesthetic registered nurses who are members of the International Society of Plastic and Aesthetic Nurses. This article describes the methods and results of this reader survey.

Clinical Practice Patterns in Abdominoplasty: 16-Year Analysis of Continuous Certification Data from the American Board of Plastic Surgery.

BACKGROUND: The authors evaluated trends in practice patterns for abdominoplasty based on a 16-year review of tracer data collected by the American Board of Plastic Surgery as part of the continuous certification process. METHODS: To facilitate comparison of an equal number of patients over time, tracer data from 2005 to 2021 were split into an early cohort (EC) (from 2005 to 2014) and a recent cohort (RC) (from 2015 to 2021). Fisher exact tests and two-sample t tests were used to compare patient demographics, surgical techniques, and complication rates. RESULTS: Data from 8990 abdominoplasties (EC, n = 4740; RC, n = 4250) were analyzed. RC abdominoplasties report a lower rate of complications (RC, 19%; EC, 22%; P < 0.001) and a lower rate of revision surgery (RC 8%; EC, 10%; P < 0.001). This has occurred despite the increased use of abdominal flap liposuction (RC, 25%; EC, 18%; P < 0.001). There has been a decline in the use of wide undermining (81% versus 75%; P < 0.001), vertical plication of the abdomen (89% versus 86%; P < 0.001), and surgical drains (93% versus 89%; P < 0.001). Abdominoplasty surgery is increasingly performed in an outpatient setting, with increased use of chemoprophylaxis for thrombosis prevention. CONCLUSIONS: Analysis of these American Board of Plastic Surgery tracer data highlights important trends in clinical practice over the past 16 years. Abdominoplasty continues to be a safe and effective procedure with similar complication and revision rates over the 16-year period.

Rhinofiller: Fat Grafting (Surgical) Versus Hyaluronic Acid (Non-surgical).

We conducted a thorough examination of the paper titled " Rhinofiller: Fat Grafting (Surgical) Versus Hyaluronic Acid (Non-surgical)" authored by Gentile et al. in Aesthetic Plastic Surgery with significant interest. The author shared their practical insights gained from employing "fat grafting" and "hyaluronic acid" methods for nasal remodeling in a randomized controlled trial. The research is notably captivating and executed with commendable proficiency. However, we do hold specific reservations concerning the methodologies employed. Precise understanding of the properties of the active substances utilized is fundamental for any medical intervention, and standardization stands as a pivotal element. It is essential to grasp the core characteristics of the administered HAs to potentially uncover links between these attributes, resulting outcomes, and possible complications. In the context of tissue volumization using fillers, rheology-an investigation into material flow and deformation under stress-holds particular importance. Gaining a comprehensive understanding of HA's rheological properties is imperative, especially when selecting an appropriate dermal filler for nasal applications. Among the critical properties of HA are viscosity, elasticity, and cohesiveness. While acknowledging the valuable contributions made by the authors, it is imperative that further analysis takes into account these influential factors during the course of their investigation. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

[Cosmetic facial surgery: a bird's eye view]. / Cosmetische aangezichtschirurgie in vogelvlucht.

Surgical procedures that rejuvenate and/or harmonize the face are known for their long-lasting and clinically relevant positive effects on the psychological well-being and quality of life of the client. Despite the popularity of cosmetic injectables, facelift surgery remains the most powerful and durable treatment for restoring aging symptoms, especially in the female face. Skin correction of the upper eyelids is the most commonly performed aesthetic facial surgery. This article provides an overview of the most important cosmetic surgical procedures for the face, focusing on the facelift, neck lift, forehead lift, upper and lower eyelid correction, subnasal lip lift and rhinoplasty. The indications, contraindications, treatment techniques, advantages and disadvantages are explained. Due to the increasing demand for cosmetic treatments, it is important that dentists and oral and maxillofacial surgeons have knowledge of these procedures in order to provide optimal information, referral or treatment when desired.

The heart of it all: Body dysmorphic disorder in cosmetic surgery.

BACKGROUND: Body Dysmorphic Disorder (BDD) represents a prevalent mental health condition characterized by distress arising from self-perceived physical imperfections. BDD serves as a contraindication to aesthetic surgery. Recognizing BDD holds paramount importance for plastic surgeons, as it is instrumental in averting the exacerbation of this condition while ensuring appropriate referrals. OBJECTIVE: This study aimed to investigate the prevalence of BDD in cosmetic surgery patients and to pinpoint key characteristics associated with BDD. This information provides plastic surgeons with specific factors to consider during preoperative evaluations. METHODS: We employed TriNetX database to identify patients with BDD who underwent cosmetic surgery identified by Current Procedural Terminology codes. Demographics and patient characteristics were identified using the International Classification of Diseases 10 codes. We calculated odds ratios (OR) by using chi-squared tests to assess risk factors among patients with BDD. RESULTS: Of 226,374 patients who underwent plastic surgery between August 2002 and August 2022, fewer than 0.1% were diagnosed with BDD. Of the BDD patients, 52.1% were diagnosed after cosmetic surgery. Compared with the control group, BDD patients were more likely to undergo rhinoplasty (OR=1.784, p = 0.004) and nonlocalized lipectomy (OR=1.448, p = 0.021) and less likely to undergo blepharoplasty (OR=0.451, p = 0.002). Findings indicated a strong association between BDD patients undergoing cosmetic procedures and comorbid psychiatric conditions such as depression (OR=4.279, p < 0.05), anxiety (OR=5.490, p < 0.05), and Attention-Deficit Hyperactivity Disorder (OR=3.993, p < 0.05). CONCLUSIONS: These findings underscore the ongoing significance of BDD in the context of cosmetic surgery, potentially indicating a lower surgery rate among BDD patients compared with previous estimates. Nevertheless, avenues for further improvement persist. Our data affirm the noteworthy occurrence of postsurgery BDD development, thereby highlighting the ongoing necessity for psychiatric evaluation in surgical patients.

Challenges and success in periodontal plastic surgery.

To truly understand a field of study, one must delve into its past and examine the challenges and successes that have shaped its current practices. In the case of periodontal plastic surgery, recognizing how challenges induced changes over the last 70 years-from the 1950s to today-is essential to fully comprehend its evolution. This editorial provides a perspective on the field, highlighting the interrelationships between influential surgical techniques and advancements in research methodology. With each event building upon the last, the evolution of periodontal plastic surgery is a story of scientific progress and ongoing research, fostering a sense of community and shared knowledge.

The Effect of Social Media Usage, Appearance-Related Social Media Pressure and Body Mass Index on Body Appreciation of Cosmetic Procedure Patients.

BACKGROUND: The number of cosmetic procedures has increased in recent years. Social media use and its effects on plastic surgery decisions are among the most widely discussed topics. This study aimed to test a research model that explores the relationship between social media usage frequency, appearance-related social media pressure, and body mass index (BMI) on the body appreciation of patients undergoing cosmetic procedures, and to evaluate their clinical impacts. METHODS: In total, 136 participants were included in this study, which met and exceeded the sample size requirement. The questionnaire was designed by using reliable scales and demographic data. Partial least squares structural equation modeling was used to test the hypothesized research model. RESULTS: The mean age of the participants was 35 years, and 70% had normal BMI scores. Among them, 59.6% underwent invasive procedures and 40.4% underwent minimally invasive procedures. BMI negatively affected body appreciation (ß = 0.199, p < 0.05). Social media did not have a significant effect on appearance-related social media pressure (ß = 0.001, p > 0.05). Appearance-related social media pressure negatively affected body appreciation (ß = - 0.280. p > 0.05). CONCLUSION: Social media is not only an information source but also creates pressure on appearance. Therefore, plastic surgeons should use social media and consider the psychology of patients during their communication. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Subtractive thinking: A novel combined application of antihelix reconstruction and outer helix reconstruction to treat mild cases of type I to II conchal microtia.

BACKGROUND: The management of mild cases of type Ⅰ to Ⅱ conchal microtia involves grafting cartilage to the affected ear to increase the cartilaginous area and transfer more skin to cover the larger cartilage. Herein, we performed a novel combined surgical procedure based on "subtractive thinking" that included antihelix reconstruction and outer helix reconstruction that was successful in patients with mild type I to II conchal microtia. METHODS: From January 2018 to September 2022, 65 patients with mild, unilateral, type I to II conchal microtia were enrolled in this study. All patients were treated with a novel method at the Plastic Surgery Hospital of Peking Union Medical College. The perimeters, widths, and lengths of the healthy and affected ears were measured both preoperatively and postoperatively. Patients' levels of satisfaction were determined based on postoperative results. RESULTS: The mean postoperative follow-up duration was 14.9 ± 2.65 months. All patients experienced no complications. Analysis revealed that our surgical method could effectively treat mild type I to II concha microtia irrespective of the auricular perimeter, width, and length (p < 0.0001). Furthermore, the patient satisfaction rate was 100%. CONCLUSION: The combined surgical procedure, which includes antihelix and outer helix reconstructions, is a viable method of reconstructing type I to II auricular concha microtia.

Applications of Machine Learning in Facial Cosmetic Surgeries: A Scoping Review.

OBJECTIVE: To review the application of machine learning (ML) in the facial cosmetic surgeries and procedures METHODS AND MATERIALS: Electronic search was conducted in PubMed, Scopus, Embase, Web of Science, ArXiv and Cochrane databases for the studies published until August 2022. Studies that reported the application of ML in various fields of facial cosmetic surgeries were included. The studies' risk of bias (ROB) was assessed using the QUADAS-2 tool and NIH tool for before and after studies. RESULTS: From 848 studies, a total of 29 studies were included and categorized in five groups based on the aim of the studies: outcome evaluation (n = 8), face recognition (n = 7), outcome prediction (n = 7), patient concern evaluation (n = 4) and diagnosis (n = 3). Total of 16 studies used public data sets. ROB assessment using QUADAS-2 tool revealed that six studies were at low ROB, five studies were at high ROB, and others had moderate ROB. All studies assessed with NIH tool showed fair quality. In general, all studies showed that using ML in the facial cosmetic surgeries is accurate enough to benefit both surgeons and patients. CONCLUSION: Using ML in the field of facial cosmetic surgery is a novel method and needs further studies, especially in the fields of diagnosis and treatment planning. Due to the small number of articles and the qualitative analysis conducted, we cannot draw a general conclusion about the impact of ML in the sphere of facial cosmetic surgery. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Capitalizing on social media: An evaluation of the public's preferences for plastic surgery social media content.

BACKGROUND: The effectiveness of utilizing social media platforms to promote clinical practices and attract patients has been well established. This study aimed to assess what plastic surgery social media content and educational material the public is most responsive to. METHODS: An anonymous 25-question survey was distributed using REDCap and Amazon's Mechanical Turk to ascertain demographic information, patterns of social media use, levels of interest in plastic surgery, and preferences for plastic surgery content. RESULTS: Of 401 participants, the typical respondent was between 25 and 34 years old and on social media daily. Almost half of the respondents (46.1%) have intentionally viewed plastic surgery content on social media, of which most used Instagram (71.1%) and Facebook (55.4%). Participants grouped as either younger or older than 35 years old were equally likely to have viewed plastic surgery content (p = 0.33). Content categories with the highest interest were before and after results (mean Likert weight 4.00 ±â€¯1.10), patient testimonials (3.73 ±â€¯1.15), and recovery process (3.67 ±â€¯1.14). Content on celebrities (2.89 ±â€¯1.17), comedic videos (2.79 ±â€¯1.19), and surgeons' private lives (2.51 ±â€¯1.08) received negative interest. Photo posts (51.4%) were preferred more than video posts (27.2%). Before and after results on social media were the most influential factor in the selection of a plastic surgeon (45.9%). CONCLUSIONS: The importance of social media for plastic surgeons to be able to interact with patients is at unprecedented heights. Understanding patterns of the public's social media content preferences will help plastic surgeons optimize their social media reach and influence their target audience.

Changing Aesthetic Surgery Interest in Men: An 18-Year Analysis.

BACKGROUND: Historically, men have been shamed if they cared seemingly too much about their appearance and especially, if they pursued aesthetic surgery. However, due to the changing landscape of the culture, this stigma has seemed to decrease. Men have diverse and quickly changing interests in particular procedures that have not been readily explored in the currently available reports. To examine this, we analyzed interest in specific plastic surgery procedures in men over the last two decades using the Google Trends tool. METHODS: The most common cosmetic procedures were chosen from the American Society of Plastic Surgeons website and served as the search terms for the Google Trends tool from 2004 to 2021. All 19 procedures were examined for overall trends and for changes in the last decade through comparing the data in bisected time periods. RESULTS: Interest in all plastic surgery procedures in men increased since 2004 except for breast reduction. Most notably, jawline filler, Botox, microneedling, lip filler, chemical peel, CoolSculpting, and butt lift had the largest trend increases. In the last decade, all procedures showed a significant increase in interest. CONCLUSIONS: While surgical volume data are valuable, our study shows that Google Trends is a beneficial tool to predict quickly changing and specific trends, especially as the patient population of plastic surgery grows with increased diversity and generational changes. Our study shows that there is an increase in male-centered plastic surgery procedures, especially nonsurgical facial procedures. Male interest in plastic surgery will continue to increase with time. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors   www.springer.com/00266 .

The Artificial Intelligence application in Aesthetic Medicine: How ChatGPT can Revolutionize the Aesthetic World.

Aesthetic medicine is witnessing a growing importance of ChatGPT and artificial intelligence (AI) technologies, as highlighted by the pioneering work of Xie et al. in their article, "Aesthetic Surgery Advice and Counseling from Artificial Intelligence: A Rhinoplasty Consultation with ChatGPT." These advancements promise to revolutionize patient consultations, treatment planning, and follow-up care. AI-driven chatbots, such as ChatGPT, can enhance patient consultations by providing accurate and reliable information on aesthetic procedures, their risks, benefits, and potential outcomes, enabling well-informed decisions and improved treatment outcomes. Furthermore, AI can personalize treatment plans by analyzing patient data, leading to increased precision and satisfaction. AI-powered platforms can also streamline patient follow-up and monitoring, improving patient outcomes and resource utilization, while serving as a valuable educational tool for clinicians. Despite these benefits, AI integration in aesthetic medicine raises concerns about data privacy, security, and potential biases in AI algorithms. To address these challenges, the aesthetic medicine community must establish ethical guidelines, adopt stringent security protocols, and ensure diverse and representative datasets for AI training. Additionally, maintaining the personal connection between patients and providers is crucial for preserving the human touch in patient care.Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors https://www.springer.com/00266 .

The Impact of COVID-19 on Plastic Surgery Residents Across the World: A Country-, Region-, and Income-level Analysis.

BACKGROUND: The COVID-19 pandemic has upended graduate medical education globally. We investigated the COVID-19 impact on learning inputs and expected learning outputs of plastic surgery residents across the world. METHODS: We administered an online survey capturing training inputs before and during the pandemic and retrieved residents' expected learning outputs compared with residents who completed their training before COVID. The questionnaire reached residents across the world through the mobilization of national and international societies of plastic surgeons. RESULTS: The analysis included 412 plastic surgery residents from 47 countries. The results revealed a 44% decline (ranging from - 79 to 10% across countries) and an 18% decline (ranging from - 76 to across 151% countries) in surgeries and seminars, respectively, per week. Moreover, 74% (ranging from 0 to 100% across countries) and 43% (ranging from 0 to 100% across countries) of residents expected a negative COVID-19 impact on their surgical skill and scientific knowledge, respectively. We found strong correlations only between corresponding input and output: surgeries scrubbed in with surgical skill (ρ = -0.511 with p < 0.001) and seminars attended with scientific knowledge (ρ = - 0.274 with p = 0.006). CONCLUSIONS: Our ranking of countries based on their COVID-19 impacts provides benchmarks for national strategies of learning recovery. Remedial measures that target surgical skill may be more needed than those targeting scientific knowledge. Our finding of limited substitutability of inputs in training suggests that it may be challenging to make up for lost operating room time with more seminars. Our results support the need for flexible training models and competency-based advancement. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266 .

Aesthetic Surgery Before-and-After Photography Bias on Instagram.

PURPOSE: This study aims to systematically assess body and facial aesthetic surgery before-and-after photography bias on Instagram. METHODS: An Instagram search using the term "plastic surgeon" was conducted on October 2020. The top 11 plastic surgeons' accounts were selected, and the first 15 images were selected from these profiles pertaining to different anatomical locations. Each photo was analyzed by a blinded board-certified plastic surgeon utilizing a 5-domain clinical photography bias score. The domains covered: (1) photo quality; (2) photo background; (3) position; (4) exposure/coverage; (5) bias. RESULTS: The search strategy identified a total of 161 sets of before and after. The most common anatomical site posted was the nose (n=47), followed by breasts (n=37). The most common angles posted were anterior-posterior view (n=61). The majority of images showed bias toward the post-operative image (70.8%). The main culprit with photo characteristics occurred due to there being a different post-operative background which was more flattering for the post-operative result (n=46, p=0.006) and a different view or angle, which again, flattered the post-operative image (n=36, p=0.02). Other factors that influenced the post-operative bias included photos of the patient covered with clothing (n=15, p=0.014) or standing (n=20, p=0.001), compared to a supine pre-operative image. CONCLUSION: Before-and-after photography conditions in aesthetic surgery is biased toward the post-operative result on Instagram. This observation was noticed across all surgical anatomical areas. Accounts photographer tends to misrepresent the photo background, view of angle, patients pose or position, or covering certain body parts. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Achieving optimal clinical outcomes in autologous fat grafting: A systematic review of processing techniques.

BACKGROUND: Autologous fat grafting (AFG) is a versatile technique in reconstructive and cosmetic surgery. Graft processing is a key source of variability resulting in unreliable clinical outcomes, with no consensus on the optimal methodology. This systematic review identifies the evidence base supporting different processing paradigms. METHODS: A systematic literature search was conducted using the PubMed, Scopus and The Cochrane Foundation databases. Studies comparing AFG processing methods and reporting long-term patient outcomes were identified. RESULTS: Twenty-four studies (2413 patients) were identified. Processing techniques evaluated included centrifugation, decantation, washing, filtration, gauze rolling, as well as commercial devices and adipose-derived stem/stromal cell (ASC) enrichment methods. Objective volumetric and subjective patient-reported outcomes were discussed. There was a variable reporting of complications and volume retention rates. Complications were infrequent; palpable cysts (0-20%), surgical-site infections (0-8%) and fat necrosis (0-58.4%) were the most reported. No significant differences in long-term volume retention between techniques were found in AFG in the breast. In head and neck patients, greater volume retention was documented in ASC enrichment (64.8-95%) and commercial devices (41.2%) compared to centrifugation (31.8-76%). CONCLUSIONS: Graft processing through washing and filtration, including when incorporated into commercial devices, results in superior long-term outcomes compared to centrifugation and decantation methods. ASC enrichment methods and commercial devices seem to have superior long-term volume retention in facial fat grafting.