The Influence of Photo Editing Applications on Patients Seeking Facial Plastic Surgery Services.

BACKGROUND: The utilization of the smartphone and social media have introduced paradigm shifts to cosmetic surgery. Much has been studied regarding social media and its influences in plastic surgery; however, little is known about facial editing applications and how these relate to plastic surgery practices. OBJECTIVES: The authors sought to discover if face-editing applications influence patients' pursuit of plastic surgery, who utilizes these applications, and why. METHODS: An anonymous survey was administered between September and December 2019, including questions about demographics, familiarity, and utilization of face-editing applications, motivations in utilization and influences towards pursuing cosmetic procedures, and attitudes towards applications. RESULTS: Seventy patients completed the survey and 32.9% admitted to utilizing face-editing applications. Patients utilizing applications were significantly younger (36.9 years) than those who did not (54 years [P < 0.001]). Among those familiar with applications, women were significantly more likely than men to utilize them (100% vs 78.6%, respectively [P = 0.047]). Social media was the most common influence for utilizing apps (87%). The majority confirmed that these applications played a role in pursuing cosmetic procedures (56.5%). Most patients did not regret their utilization of these applications (87%). CONCLUSIONS: Face-editing applications serve a role regarding patient decision-making to pursue cosmetic surgery. Several motivators exist for application utilization, the largest of which is social media. Younger females are the most likely demographic to utilize applications and generally do not express regret in doing so. Plastic surgeons would benefit by understanding patient motivations and expectations created by utilizing these applications.

Tranexamic Acid in Aesthetic Facial Plastic Surgery: A Systematic Review of Evidence, Applications, and Outcomes.

BACKGROUND: Tranexamic acid (TXA) is an antifibrinolytic that has become widely used in aesthetic facial plastic surgery, although its efficacy has not been well investigated. OBJECTIVES: To evaluate the existing evidence for use of TXA in aesthetic facial plastic surgery, highlighting routes of administration, dosing, surgical applications, and clinical outcomes. METHODS: Systematic review of primary literature evaluating TXA in aesthetic facial plastic surgery. RESULTS: Eleven studies met inclusion criteria: 8 prospective randomized controlled trials, 2 retrospective case series/cohort studies, and 1 clinical opinion. Six studies evaluated TXA in rhinoplasty, 4 in rhytidectomy, and 1 in blepharoplasty. Significant reductions in intraoperative blood loss were found in 5 rhinoplasty studies. Three rhinoplasty and 2 rhytidectomy studies found significantly reduced postoperative edema and ecchymosis. One rhinoplasty and 1 rhytidectomy study reported reduced operative time and time to achieve hemostasis. One rhytidectomy study reported reduced postoperative drain output and faster time to drain removal. No studies reported an adverse outcome directly related to TXA. CONCLUSIONS: Existing literature investigating TXA in aesthetic facial plastic surgery is sparse with varying levels of evidence and heterogeneous data. Literature suggests systemic TXA reduces intraoperative blood loss during rhinoplasty, although the clinical significance of this blood loss reduction is unclear. TXA may also reduce postoperative edema and/or ecchymosis in rhytidectomy and rhinoplasty, although the lack of validated grading scales yields insufficient evidence to support this claim. Topical and subcutaneously injected TXA are emerging administration routes in rhytidectomy, with evidence suggesting TXA mixed with tumescent may reduce postoperative drain output, thereby expediting drain removal.

Factors Important in Facial Plastic and Reconstructive Surgery Fellowship Program Selection.

Facial plastic and reconstructive surgery (FPRS) training programs offer exceptional exposure to the most current techniques in the field. However, applicants have many factors to weigh when ranking programs. Therefore, it is important to examine the factors that applicants believe to be the most critical when choosing an FPRS fellowship. This is an anonymous online survey of FPRS fellows between the years 2018 and 2020 (total 147). Respondents were asked to rate importance of program factors on a Likert scale (1-5). Of 147 applicants, 63 (43%) responded. Applicants found the type of practice, academic or private, equally important, with score averages of 3.02 and 3.25, respectively. The two most important program factors to applicants were exposure to the business of medicine/practice management (3.94) and location (3.4). The two most important areas of surgical exposure include rhinoplasty (4.54) and aging face (4.44). Of 63 applicants, 41 (65%) were interested in private practice, with 51% seeking a facial plastics/plastic reconstructive surgery group setting versus solo practice, general otolaryngology group, or dermatology group practice. Of 61 applicants, 48 (76%) wanted a mix of cosmetic/reconstructive surgery in their first 5 years of practice. Finally, applicants were not interested (average: 1.94) in keeping general otolaryngology as part of their practice. Applicants want strong exposure to the business of medicine, rhinoplasty, aging face, all while in their preferred location. Additionally, the majority of applicants seek employment in a plastic surgery focused group practice, with the sole focus being the breadth of FPRS.