Treatment of Complications After Minimally Invasive Breast Augmentation with Aquafilling Gel.

INTRODUCTION: Recent studies have revealed that Aquafilling gel used for breast augmentation causes complications. In this study, we investigated which surgical approach should be used to treat these complications. MATERIALS AND METHODS: This observational cohort study analysed the data of 31 women suffering from complications after breast enlargement with Aquafilling injection who were treated at our department in 2016-2021. Patients underwent either conservative or radical surgery. GraphPad Prism 9 (GraphPad Software, La Jolla, CA, USA) was used for data processing. RESULTS: Approximately 88.89% of patients after conservative surgery required reoperation, while only 22.73% of patients treated radically needed revision surgery. Every patient who underwent an attempt to remove the gel via needle prior to admission required surgery. Seventy-five per cent of them had positive culture swabs, whereas only 26.09% of patients who did not undergo needle aspiration had positive cultures. A positive correlation between the volume of injected filler and the number of symptoms was observed. CONCLUSIONS: In addition to irrigation and drainage, Aquafilling removal should include infiltrated tissue excision during primary surgery. Moreover, needle aspiration of the filler is ineffective, and it may lead to a gel infection. Furthermore, the more filler is injected, the higher the number of complications observed. 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 .

Internet and Social Media as a Source of Information About Plastic Surgery: Comparison Between Public and Private Sector, A 2-center Study.

BACKGROUND: The popularity of social media among plastic surgeons and patients has increased in the last years. We conducted this study to explore the differences in patients' social media habits between public and private aesthetic plastic surgery practice. METHODS: A 2-cohort study was conducted in aesthetic plastic surgery clinic and public department of plastic and surgery by surveying consecutive first-time patients. RESULTS: Two hundred patients completed a 18-question survey at a private aesthetic plastic surgery clinic. The questionnaire was also filled by 113 patients at a public plastic surgery department. Facebook was the most popular social media platform in both groups. Word of mouth from other patients and the clinic's website were the most-valued source of information about the surgeon and surgical procedure for patients of both studied groups. Patients from the aesthetic group were mainly women from small towns; they were significantly younger and better educated and used Instagram more frequently than patients from public group. The aesthetic group patients focused significantly more often on the surgeon's credentials and on before and after photographs. They appreciated social media as a source of information for patients significantly more than public group patients who stated that social media were the worst source of information. CONCLUSIONS: Word of mouth from other patients remains the most-valued source of information about plastic surgery. However, proper use of social media and building online image in a professional manner can provide attract more patients to the aesthetic plastic surgery practice.

Female Sexual Function and Sexual Well-being Before and After Breast Reduction: A Pilot Cross-sectional Study and Review of Literature.

BACKGROUND: Breast reduction is one of the most frequently performed procedures in plastic surgery practice. Patients often undergo this procedure for not only aesthetic but also functional reasons because breast hypertrophy may hinder daily activities because of chronic spinal pain. Breast reduction has a documented impact on quality of life. However, there are only a few reports on the influence of breast reduction on sexuality. OBJECTIVE: The aim of the study was to analyze the impact of breast reduction on female sexual dysfunction and on sexual well-being. METHODS: Ours was a pilot cross-sectional 2-cohort study, including 75 females who had undergone breast reduction (post-BRG) and a preoperative group of 27 females with breast hypertrophy awaiting surgery (pre-BRG). Female Sexual Function Index (FSFI), Sexual Quality of Life-Female, and BREAST-Q Reduction/Mastopexy module were assessed within 12 to 36 months postoperatively via e-mail. A review of literature was performed. RESULTS: The mean total Sexual Quality of Life-Female score was significantly higher in the post-BRG than in the pre-BRG (76.7 ± 11.6 vs 64.4 ± 13.7; P < 0.01). The mean total FSFI score in the pre-BRG was 21 ± 11.4. It was below the FSFI cutoff score for female sexual dysfunction (≤26). In the post-BRG, the total FSFI score was significantly higher (27.4 ± 9.1; P < 0.01). The outcome of the sexual well-being domain of BREAST-Q was significantly higher in the post-BRG (72 ± 14 vs 39.3 ± 14.5; P < 0.01). CONCLUSIONS: Breast reduction procedure has a positive impact on female sexual function, sexual quality of life, and sexual well-being.

Incomplete excision of basal cell carcinoma (BCC) in the head and neck region: to wait, or not to wait?

INTRODUCTION: Recurrence rates for incompletely excised basal cell carcinoma (BCC) vary widely in the literature. Clinical observation is a commonly accepted method of follow up, however such management of these lesions still remains controversial. AIM: To evaluate the rate and factors associated with the recurrence of BCC of the head and neck region after incomplete excision. MATERIAL AND METHODS: Medical records of 135 patients with 156 incompletely excised BCCs of the head and neck region were analyzed retrospectively. The primary outcome was the rate of recurrence. Additionally, a correlation of recurrence to clinical and morphological factors was analyzed. RESULTS: Recurrence occurred in 72 (46%) lesions. The mean interval to recurrence was 20 months. In each category of factors, the highest relative risk of recurrence was correlated to: location on the scalp - 2.27, diameter over 2 cm - 1.21, nodular clinical form - 1.29, morpheaform histopathological type - 1.67, recurrent lesion - 1.88, irradicality of excision in the lateral margin - 1.24 and closure of the skin defect with the split-thickness skin graft - 1.42 relative risk. CONCLUSIONS: Observation is an acceptable management option as less than a half of incompletely excised BCCs recurred and needed further treatment. As 85% of recurrences occur within 3 years after operation, clinical observation should be particularly careful during this period, however long-term recurrence should not be underestimated.