Employing a teaching module improves patient satisfaction in facial rejuvenation.

BACKGROUND AND OBJECTIVES: The purpose of this study was to determine whether a teaching module for facial rejuvenation improved patient satisfaction and enhanced practice growth in a cosmetic surgery office. An educational module was designed to review soft-tissue anatomy and physiology, treatment options, and outcomes. MATERIALS AND METHODS: During the initial office consultation, the module was utilized in group A (50 patients) but not in group B (50 patients). Satisfaction surveys were taken from all patients following the consultation. Patients from both groups who scheduled procedures were surveyed following completion of treatment. RESULTS: The surveys indicated a statistically significant higher level of satisfaction with the consultation, a better understanding of treatment options, and a greater percentage of treatment scheduling in group A patients (P < 0.05). Furthermore, patients in group A who underwent treatment indicated greater satisfaction with treatment outcome when compared to those treated patients in group B (P < 0.05). CONCLUSIONS: We conclude that use of a well-designed teaching module helps patients better understand the concepts behind facial rejuvenation and leads to increased procedure scheduling and greater patient satisfaction following treatment.

Celecoxib reduces narcotic use and pain following augmentation mammaplasty.

BACKGROUND: Narcotics have traditionally been used to control pain after augmentation mammaplasty, but they have adverse side effects, including addiction potential, clouded sensorium, nausea, and respiratory depression. Alternative strategies for managing postoperative pain are expensive, cumbersome, and also have their own risks. While long-term use of celecoxib has been associated with an increased risk of serious adverse cardiovascular effects, no problems have been reported with short-term use. OBJECTIVE: The purpose of this study was to determine whether the addition of celecoxib, a selective nonsteroidal anti-inflammatory, to an analgesic regimen reduced narcotic use and pain following augmentation mammaplasty. METHODS: One hundred patients underwent submuscular augmentation mammaplasty with smooth saline-filled mammary prostheses using an intravenous sedation technique. Group A (N = 50) used hydrocodone to manage postoperative pain. Group B (N = 50) used celecoxib 400 mg 1 to 2 hours before surgery and then daily in addition to hydrocodone postoperatively. Narcotic use, incidence of nausea, and complications were recorded. Pain was assessed daily with a Likert pain scale from 0 (no pain) to 10 (severe pain). RESULTS: Group A used 110 +/- 34 mg hydrocodone during the immediate 7-day postoperative period and reported an average pain scale score of 5.1. Group B, which used celecoxib, used 34 +/- 22 mg hydrocodone during the same period with an average pain scale score of 3.3. These differences were statistically significant (P < .05). Group B experienced 53% less nausea than Group A. There were no significant differences between the groups regarding age, implant size, or complications. CONCLUSIONS: Perioperative celecoxib administration in patients undergoing augmentation mammaplasty significantly reduced postoperative narcotic use, pain, and nausea. Its use should facilitate the patient's ability to resume everyday activities following surgery.

Digital ultraviolet reflectance photography can be used to quantify improvements in photodamage.

OBJECTIVE: Increasing attention has focused on the treatment and reversal of ultraviolet- induced photodamage. This study was designed to determine whether ultraviolet reflectance photography could quantify the clinical effects of erbium:YAG laser resurfacing on photoaged skin. METHODS: Twenty patients (ages 46-67) with moderate to severe photodamage underwent dual-mode variable pulsed erbium:YAG laser facial resurfacing. Pretreatment and post-treatment evaluations at 3 and 6 months were performed clinically and photographically with white and ultraviolet reflectance photography. RESULTS: Image conversion of the ultraviolet reflectance imaging data demonstrated an average of 36% and 42% reduction in photodamage at 3 and 6 months, respectively. This correlated well with the wrinkle reduction and correction of dyspigmentation observed in all patients following laser resurfacing. Histologic examination confirmed a thicker, more orderly epidermis and dermal collagen remodeling after treatment. CONCLUSION: Reduction in photodamage using the dual-mode variable pulsed erbium:YAG laser can be quantitatively measured with ultraviolet reflectance photography using digital imaging. This model should prove useful in developing treatment regimens for photodamage.