Binocularly suppressed stimuli induce brain activities related to aesthetic emotions.

Introduction: Aesthetic emotions are a class of emotions aroused by evaluating aesthetically appealing objects or events. While evolutionary aesthetics suggests the adaptive roles of these emotions, empirical assessments are lacking. Previous neuroscientific studies have demonstrated that visual stimuli carrying evolutionarily important information induce neural responses even when presented non-consciously. To examine the evolutionary importance of aesthetic emotions, we conducted a neuroscientific study using magnetoencephalography (MEG) to measure induced neural responses to non-consciously presented portrait paintings categorised as biological and non-biological and examined associations between the induced responses and aesthetic ratings. Methods: MEG and pre-rating data were collected from 23 participants. The pre-rating included visual analogue scales for object saliency, facial saliency, liking, and beauty scores, in addition to 'biologi-ness,' which was used for subcategorising stimuli into biological and non-biological. The stimuli were presented non-consciously using a continuous flash suppression paradigm or consciously using binocular presentation without flashing masks, while dichotomic behavioural responses were obtained (beauty or non-beauty). Time-frequency decomposed MEG data were used for correlation analysis with pre-rating scores for each category. Results: Behavioural data revealed that saliency scores of non-consciously presented stimuli influenced dichotomic responses (beauty or non-beauty). MEG data showed that non-consciously presented portrait paintings induced spatiotemporally distributed low-frequency brain activities associated with aesthetic ratings, which were distinct between the biological and non-biological categories and conscious and non-conscious conditions. Conclusion: Aesthetic emotion holds evolutionary significance for humans. Neural pathways are sensitive to visual images that arouse aesthetic emotion in distinct ways for biological and non-biological categories, which are further influenced by consciousness. These differences likely reflect the diversity in mechanisms of aesthetic processing, such as processing fluency, active elaboration, and predictive processing. The aesthetic processing of non-conscious stimuli appears to be characterised by fluency-driven affective processing, while top-down regulatory processes are suppressed. This study provides the first empirical evidence supporting the evolutionary significance of aesthetic processing.

Conservative interdisciplinary management for a congenitally missing maxillary lateral incisor in an adolescent patient.

A congenitally missing lateral incisor tooth is commonly associated with both short and long-term clinical dilemmas, particularly for a growing patient. A unilaterally missing maxillary lateral incisor tooth creates a significant dental asymmetry in the critical aesthetic zone of the smile and potentially increases the difficulty of any subsequent orthodontic and restorative treatment. Carefully planned interdisciplinary management is required to address the challenges of anterior dental asymmetry, unilateral orthodontic space closure and to alleviate the concerns that accompany restorative implant placement in the anterior maxilla. The use of skeletal temporary anchorage devices has increased the predictability of orthodontic space closure, particularly for missing maxillary lateral incisor cases which were previously considered to be unsuitable.

'Y' Modification of the Cutaneous Incision of the Preseptal Transconjunctival Approach for the Management of Zygomatico-Maxillary Complex Fractures: A Prospective Clinical Study.

AIM: The purpose of this clinical study was to evaluate the efficacy of the preseptal transconjunctival approach with Y modification of the cutaneous extension for the management of zygomaticomaxillary complex (ZMC) fractures. METHODS: This prospective interventional study was conducted at our institute from 2012 to 2020. The study included patients aged 15-65 years with displaced ZMC fractures. Patients with uncontrolled systemic conditions, infected and/or comminuted fractures were excluded. The variables evaluated were age, gender, mechanism of injury, fracture side, clinical features, surgical exposure time, adequacy of exposure, complications, scar evaluation scores and cosmetic outcomes. The parameters for comparison were operated versus non operated side Eye Fissure Index (EFI) and surgical exposure time was compared with respect to the types of scars. RESULTS: A total of 49 patients were included in this study. The average exposure time was 18.87±1.92 minutes. The exposure of fracture site was excellent in 73.5% and satisfactory in 26.5%. The mean EFI of operated side was 34.2 ±5.04mm while that of non-operated side was 34.22 ±5mm. On comparison of the same there was no significant difference. Invisible scars were noted in 71.4% and barely visible scars in 22.4%. The comparison of exposure time with type of scars showed a significant association(p=0.02). The complications noted were chemosis, lower eyelid edema, conjunctival granuloma and entropion. Cosmetic outcomes were fairly satisfactory. CONCLUSION: The Y modification of the transconjunctival approach can provide excellent surgical exposure without the need for a second incision. Although this approach is technique sensitive and requires experience, the advantages outweigh the learning curve. Since this approach has been widely studied, a systematized review is recommended to further substantiate its reliability and advantages.

Generational Exploration on Aesthetic Medicine Products: Influence of Social Media, Reviews, and Brand Identity-GEMS Bond Survey.

INTRODUCTION: The study investigates the impact of social media reviews and brand identity on consumer preferences in the non-surgical aesthetics products across different generations. It highlights the evolving landscape of aesthetic medicine and surgery, driven by technological advancements and a cultural shift towards individual well-being. The research aims to explore the interplay between generational preferences, the influence of social media, and the role of brand identity in shaping consumer decisions. METHODS: A cross-sectional study design was employed, with a sample size of > 5000 participants stratified across various generational cohorts. The study utilized an online questionnaire to capture both quantitative and qualitative insights into consumer behaviour, with statistical analysis performed to identify patterns and relationships. RESULTS: Analysis of 5850 responses revealed distinct generational preferences and behaviours. Social media engagement varied significantly across generations, with younger cohorts placing a higher emphasis on online reviews. The study also found that brand identity's influence is diminishing in decision-making processes, with consumers increasingly relying on peer reviews and social media content. CONCLUSION: The findings highlight a pivotal shift in the non-surgical aesthetics consumer market, emphasizing the growing importance of social media and peer reviews over traditional brand identities. Importantly, the study underscores the critical need for integrating patient safety and evidence-based practice within marketing strategies. As consumer preferences evolve towards valuing transparency and authenticity, non-surgical aesthetics providers must prioritize these elements, ensuring that their services are not only appealing but also grounded in safety and scientific validity. 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 ."

Persistent lactation in bilateral breast implant augmentation: A case report and review of the literature.

Background: Persistent lactation, or galactorrhoea, is a common problem which is infrequently seen in the setting of aesthetic surgery. Increasing frequency of aesthetic breast surgery such as breast augmentation suggests a need for improved understanding of the effect of galactorrhoea on surgical outcomes. Case Report: A 34-year-old patient underwent day-case bilateral breast reduction/mastopexy combined with sub-muscular implant augmentation, abdominoplasty and bilateral liposuction to the flanks. She reported to have stopped breastfeeding more than 6 months prior. Intraoperatively, the breast tissue was noted to be lactating. The procedure was completed as planned and a routine postoperative plan was followed including oral antibiotics, analgesia and compression garments. The patient was discharged, however reattended on postoperative day 10 with breast pain and fevers. She was treated for right breast surgical site infection and required washout and implant removal. She was referred to Endocrinology for treatment of galactorrhoea with Bromocriptine and Cabergoline. She subsequently underwent revision implant augmentation with good outcomes. Discussion: This case highlights the increased likelihood of post-operative infection in galactorrhoea associated with breast implant augmentation. It is important to exclude lactation preoperatively and avoid a prosthesis in this situation, to minimise this risk and optimise surgical outcomes. Conclusion: Aesthetic breast surgeons must be aware of the incidence of galactorrhoea, and its possible effects on risks of postoperative complications and poor aesthetic outcomes. The authors suggest deferring implant augmentation until complete resolution of lactation where possible.

The Biological Role of Platelet Derivatives in Regenerative Aesthetics.

Bioproducts derived from platelets have been extensively used across various medical fields, with a recent notable surge in their application in dermatology and aesthetic procedures. These products, such as platelet-rich plasma (PRP) and platelet-rich fibrin (PRF), play crucial roles in inducing blood vessel proliferation through growth factors derived from peripheral blood. PRP and PRF, in particular, facilitate fibrin polymerization, creating a robust structure that serves as a reservoir for numerous growth factors. These factors contribute to tissue regeneration by promoting cell proliferation, differentiation, and migration and collagen/elastin production. Aesthetic medicine harnesses these effects for diverse purposes, including hair restoration, scar treatment, striae management, and wound healing. Furthermore, these biological products can act as adjuvants with other treatment modalities, such as laser therapy, radiofrequency, and microneedling. This review synthesizes the existing evidence, offering insights into the applications and benefits of biological products in aesthetic medicine.

Comprehensive Evaluation of Titanium, Zirconia, and Ceramic Dental Implant Materials: A Comparative Analysis of Mechanical and Esthetic Properties.

BACKGROUND: Dental implant materials play a pivotal role in the success of restorative dentistry. This study comprehensively compares the mechanical and esthetic properties of three commonly used dental implant materials: titanium, zirconia, and ceramic. OBJECTIVE: This study aimed to provide insights into the suitability of titanium, zirconia, and ceramic for various clinical applications within implant dentistry. METHODS: Ninety dental implants, 30 for each material, were selected based on their well-established usage in dental implantology. Mechanical properties, including tensile strength, modulus of elasticity, and fatigue resistance, were assessed using state-of-the-art testing machines. Esthetic properties, such as color stability and translucency, were scrutinized through immersion in staining solutions and spectrophotometer measurements. Fracture properties and biocompatibility were also evaluated. RESULTS: Mechanical testing revealed that titanium exhibited the highest tensile strength (810 ± 55 MPa), while zirconia demonstrated the highest modulus of elasticity (208 ± 8 GPa). Titanium also displayed the greatest fatigue resistance (1,010,000 ± 95,000 cycles), whereas zirconia had the highest hardness (1190 ± 45 Vickers hardness number (VHN)). Esthetically, zirconia showed superior color stability (ΔE: 1.7 ± 0.2), while ceramic exhibited the highest translucency (TP%: 15.3 ± 1.7). Zirconia presented the lowest surface roughness (0.28 ± 0.04 µm). CONCLUSION: This study provides insights into potential dental implant material performance, with zirconia emerging as a promising alternative. Future research should validate these findings in clinical settings, considering a broader array of variables and long-term outcomes.

Aesthetic Preferences for Beautiful Buttocks in Female: A Study on the Chinese Population.

BACKGROUND: Many theories referring to the conception of a beautiful buttock have been put forward, but little has been proved, especially in the Asian group. OBJECTIVE: To analyse the aesthetic preference for aesthetically pleasing characteristics in the Chinese population. METHODS: In the survey, we computerized the buttock image of a Chinese female through the Photoshop software (Adobe Photoshop CS5; Adobe Systems, Inc., San Jose, Calif), and buttocks with and without four features were attained. An online questionnaire was made to rank the most aesthetic buttocks. The data for the various demographic groups were compared using the Pearson Chi-square test. A value of p < 0.05 was used for statistical significance. RESULTS: In total, 2348 responses were collected. Over half of the respondents prefer without supragluteal fossettes (56.9%), V-shaped crease (60.4%) and lateral depression (90.1%). The most attractive infragluteal fold option was short type (34.9%), followed by median infragluteal fold (32.7%) and long infragluteal fold (32.4%). Supragluteal fossettes, median or long infragluteal fold and V-shaped crease were more preferred among young people. CONCLUSION: Supragluteal fossettes, V-shaped crease and lateral depressions were not preferred in over half of the respondents. The aesthetic preference was influenced by the gender and age. The plastic surgeons should consider the variabilities above when establishing aesthetic aim for beautiful buttocks in gluteoplasty. 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.

"Ice cream cone" design of forearm free flap for orbital exenteration reconstruction.

BACKGROUNDS: Reconstruction post-orbital exenteration serves the dual purpose of expediting healing, laying the groundwork for cosmetic restoration, and minimising complications such as orbitosinusal fistulae. The aim of this study was to introduce a modified "Ice cream cone" (ICC) design of the Radial Forearm Free Flap (RFFF) technique used for reconstruction of orbital exenteration cavity, along with the oncological, functional, and aesthetic outcomes. METHODS: The authors conducted a retrospective study between January 2005 and December 2020. Inclusion criteria encompassed patients treated for orbitosinusal malignancies undergoing exenteration with subsequent ICC design of RFFF reconstruction. RESULTS: Twenty-two patients underwent exenteration with the ICC design of RFFF. At the follow-up conclusion, 65% of patients regularly used orbital prosthesis. The average waiting time until the prosthesis was 10 months. Quality of life questionnaires yielded average RFFF POSAS scores of 23.5 (SD 13,6), cervical POSAS scores of 8 (SD 13,2), and orbital cavity rehabilitation scores of 5.9 (SD: 3,32). CONCLUSIONS: ICC design of RFFF is a reliable technique. It can be proposed in cases of extended exenteration with a high risk of cerebrospinal fluid (CSF) but more generally in cases of total exenteration. This technique facilitates optimal postoperative wound healing and accommodates early radiotherapy. Importantly, the bowl-shaped aspect of the orbital socket supports effective prosthetic rehabilitation for patients opting for orbital prosthesis post-surgery.

Evaluation of the skeletal and dental effects of a hybrid aesthetic functional appliance (HAF) in skeletal class II division 1 malocclusion: A prospective uncontrolled clinical trial.

Background: The present study investigated the skeletal and dental effect in class II division I growing patients due to mandibular deficiency treated with the hybrid aesthetic functional (HAF) appliance. Methods: A sample of 16 growing patients (5 boys and 11 girls; mean age: 9.50 years, standard deviation: 1.15) with class II division I malocclusion were treated using the HAF appliance for an average period of 10±3 months. For each patient, a cephalometric radiograph was taken before and after treatment, and digital analysis was applied using the WebCeph program. The statistical analysis was performed to evaluate dental and skeletal changes associated with the HAF appliance and determine if there were any statistically significant variations in anatomical measurements between the start and completion of the treatment. Results: The data showed a significant increase in SNB angle (P=0.002), leading to a significant decrease in ANB angle (P=0.001). The mandibular length significantly increased (P=0.008), the lower incisors were flared significantly (P=0.028), and the lower molars were extruded significantly (P≤0.001). Also, this study revealed a significant decrease in Wits appraisal (P≤0.001), overjet (P≤0.001), and overbite (P=0.041). Additionally, a significant increase in lower anterior facial height (P≤0.001), total facial height (P=0.001), and posterior facial height (P=0.037) were observed. Conclusion: The HAF appliance showed that it could be used to correct class II division 1 skeletal discrepancy by mandibular advancement. The HAF appliance increased all facial heights significantly.

Aesthetic Procedures and Psychological Wellbeing in Saudi College Students: An In-Depth Exploration.

Purpose: Minimally invasive aesthetic procedures are widely popular among the youth. Despite their prevalence, there is a significant gap in the research concerning the relationship between these procedures and psychological wellbeing, as well as an insufficient exploration of the barriers and motivators influencing their adoption, this study aims to address these gaps. Methods: This cross-sectional study has utilized a secure online survey directed at Saudi university students as the target population. The survey was consisting of 18-item electronic questionnaire including of 4 parts (demographical data, history of psychological illness and screening of current psychological wellbeing using WHO-5 well-being tool, history of doing cosmetic procedure, or willingness to do in the future, barriers and motivators to do cosmetic procedures), and it was distributed across multiple social media platforms. Results: A total of 8443 college students completed the study questionnaire. Exactly 1096 (13%) of the students underwent a cosmetic procedure. The most reported procedures were laser hair removal (9.1%), filler (5.3%), skin boosters (2.8%), and Botulinum toxin A injections (Botox) (2.6%). The most ranked motivators were being painless, with no side effects (8.8 out of 10), followed by being free (8.0 out of 10) and enhancing self-confidence (7.4 out of 10). Conclusion: No significant difference recorded at the overall psychological well-being score between who underwent cosmetic procedures and who did not.

Fracture resistance of CAD/CAM milled versus direct hand-made interim laminate veneers.

Background: Comparative studies of interim veneer restorations crafted using subtractive computer-aided manufacturing (s-CAM) milling technology and traditional direct hand-made approaches are needed. Purpose: This comparative in vitro study evaluated the fracture resistance of two types of provisional veneer restorations for maxillary central incisors: milled (s-CAM) and traditional direct hand-made bis-acryl veneers. Materials and methods: Fifty maxillary right central incisor veneers (25 specimens per group) were fabricated and divided according to the fabrication method: (1) s-CAM milled (Structure CAD, VOCO Dental); and (2) hand-made (Protemp Plus, 3M). The restorations were cemented onto 3D-printed resin dies using temporary cement and subjected to 1000 cycles of thermal cycling between 5° and 55 °C. These restorations subsequently were subjected to compressive loading until fracture occurred. Images of the fractured samples were captured using a scanning electron microscope (SEM). Statistical analysis was performed using the one-way ANOVA test and the Mann-Whitney U test. Results: Significant differences (p < 0.001) in the fracture resistance were observed between the two groups. s-CAM milled interim veneers displayed higher fracture resistance values (439.60 ± 26 N) compared to the traditional method (149.15 ± 10 N). Conclusion: The manufacturing method significantly influences the fracture resistance of interim veneer restorations. s-CAM interim laminate veneer restorations for maxillary central incisors exhibit a fracture resistance superior to that of the traditional method using bis-acryl.Clinical relevanceClinicians should consider CAD/CAM milled veneers for scenarios demanding long-term interim restoration and the withstanding of high occlusal forces.

Delayed breast reconstruction with autologous free flap after radiation therapy: vascular complications and aesthetic outcomes.

BACKGROUND: The safety and outcome of breast reconstruction after radiotherapy are controversial, and the aesthetic aspects have not been studied extensively. We compared the results of vascular anastomosis, the incidence of postoperative complications, and aesthetic appearance between patients who had and had not received radiotherapy who then had undergone delayed breast reconstruction with autologous free flaps from the abdomen, thighs, and buttocks. METHODS: In total, 257 flaps in 241 patients were investigated; 194 and 63 flaps implanted in patients who did not receive radiotherapy and who received radiotherapy before breast reconstruction, respectively. Of the 257 flaps, 221, 20, 14, and 2 came from the abdomen, thighs, buttocks, and other anatomic locations, respectively. We evaluated aesthetic outcomes in 105 patients who had not received radiotherapy and 35 who had. RESULTS: We found no significant differences between the two groups in the incidence of vascular reanastomosis, the time required for anastomosis, or the incidence of unplanned reoperation. Complications such as flap necrosis were rare in both groups. Aesthetic outcomes were significantly better in the patients who had not received radiotherapy. CONCLUSIONS: Breast reconstruction with autologous free flaps can be performed safely in patients who have received radiotherapy, but the aesthetic result is slightly inferior to that in patients who had not received radiotherapy.

Aesthetic Evaluation of Facial Scars in Patients Undergoing Surgery for Basal Cell Carcinoma: A Prospective Longitudinal Pilot Study and Validation of POSAS 2.0 in the Lithuanian Language.

Facial basal cell carcinoma (BCC) surgery enhances the quality of life (QoL) but leaves patients with inferior QoL, presumably caused by scarring, emphasizing the need to understand post-surgery aesthetic satisfaction. This study aimed to validate the Lithuanian version of the Patient and Observer Scar Assessment Scale (POSAS) 2.0 and utilise it to identify scar evaluation differences and correlations among POSAS scores and specific aesthetic facial regions, age, gender, surgery types, and short- and long-term QoL. Employing a prospective longitudinal design, 100 patients with facial scars after surgical BCC removal were enrolled. The validation phase confirmed the translated POSAS 2.0 psychometric properties, while the pilot phase used statistical analyses to compare scores among demographic and clinical groups and evaluate correlations between scar assessment and QoL. The findings indicate that the translated Lithuanian version of POSAS 2.0 exhibits good psychometric properties, revealing insights into aesthetic satisfaction with post-surgical facial scars and their impact on QoL. The Lithuanian version of the POSAS 2.0 was established as a valid instrument for measuring post-surgical linear scars. QoL with scar assessment statistically significantly correlates, 6 months after surgery, with worse scores, particularly notable among women, younger patients, and those with tumours in the cheek region.

Fat management in upper blepharoplasty: Addition or subtraction blepharoplasties, how and when.

BACKGROUND: As one of the most common aesthetic surgical procedures carried out today, blepharoplasty should be in the repertoire of every plastic surgeon. The term blepharoplasty encompasses a wide range of techniques and options that must be tailored to the specific defect and patient one has to treat. A sound knowledge of the upper and lower eyelids' anatomy is essential for proper surgical execution. Trends have shifted towards more conservative methods (especially of the fat compartment) and sometimes in combination with augmentation techniques, helping to reach a rejuvenated appearance. AIM: To present an overview of the surgical techniques considered for upper lid blepharoplasty and fat pad management, in addition to information on how a surgeon may approach the best treatment for his patient based on current publications in literature. METHODS: We searched the literature published between 2013, to 2023 using Medline and Reference Citation Analysis. The database was searched using the keywords "upper blepharoplasty" AND "fat". Papers without full text/abstracts and reviews were excluded. The search strategy followed the PRISMA. The American Society of Plastic Surgeons guidelines for Therapeutic Studies checklist was used to assess all articles. Two authors individually reviewed each article and rated them for importance and relevance to the topic. A consensus was sought and the most relevant studies. RESULTS: After the application of the selection criteria used in our review, 13 publications were found to address upper lid blepharoplasty specifically. Three of these studies were reviews and three were retrospective studies. Five publications were comparative studies and a further two were clinical trials. CONCLUSION: The tendency of modern surgery is to be conservative, by removing adipose tissue only if strictly necessary and restoring the volume of the upper eyelid in a concept of beauty that espouses a "full" sight. There is no gold standard technique to achieve younger and enhanced eyelids. Long-term prospective comparative studies are fundamental in understanding which path is the best to follow.

Modified Palatal Roll Flap: A Novel Technique for Horizontal Ridge Augmentation.

The Abrams' palatal roll technique has undergone significant changes over time and is routinely utilized to widen peri-implant soft tissues in the maxillary aesthetic zone. The described technique involves the use of a de-epithelized pedicled connective tissue flap from the palate and rolling it under the labial oral mucosa to increase the soft tissue bulk. It is an easy and efficient technique that improves gingival thickness and contour in the aesthetic region and is a great substitute for areas lacking gingival soft tissue. Furthermore, this technique eliminates the need for a second surgical site to harvest the connective tissue graft for soft tissue augmentation. This study reports a clinical case where the modified roll technique was used for horizontal ridge augmentation.

Exploring the Personality Characteristics of Rhinoplasty Patients: Perfectionism, Rumination, and Self-Compassion.

OBJECTIVE: This study investigates differences in personality characteristics, including perfectionism, ruminative thinking style, and self-compassion, between individuals who have undergone rhinoplasty and a control group without any history of cosmetic surgery. METHODS: The study included 33 adult patients who underwent rhinoplasty between 2021 and 2023 at Bursa Uludag University Faculty of Medicine Hospital and 33 adult patients who visited our centre for other complaints as a control group. The rhinoplasty group consisted of primary surgical patients with functional and cosmetic concerns, excluding those who sought revision surgery or had only functional problems. The control group consisted of individuals with no prior cosmetic surgery history and no expectations of aesthetic interventions. Psychiatric analysis was performed using Frost multidimensional perfectionism scale, ruminative thinking style questionnaire, and self-compassion scale. RESULTS: This research revealed that individuals who had rhinoplasty scored higher in perfectionism 109.3 (±23.3) and ruminative thinking 87.9 (±22) compared to those who did not undergo surgery 94.15 (±22.2) and 77.7 (±23), respectively. Additionally, the rhinoplasty group had lower self-compassion scores, 80.4 (±17.3), than the control group, 86.1 (±11.2). Statistically significant differences were observed in perfectionism between the groups (p = 0.009). In rhinoplasty patients, a notably positive correlation was found between perfectionism and ruminative thinking scores (r = 0.482; p = 0.005), while a moderately significant negative correlation was observed between self-compassion and ruminative thinking scores (r = - 0.465; p = 0.006). CONCLUSION: Individuals who undergo rhinoplasty generally show increased levels of perfectionism and are more prone to ruminative thinking. They also demonstrate reduced self-compassion compared to non-surgical control groups. Cosmetic surgeons should be aware of these psychological trends and consider using appropriate scales during pre-surgery consultations and follow-up visits. Adopting this informed approach can improve the surgeon-patient relationship and help overcome communication challenges. LEVEL OF EVIDENCE III: 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 cost of cosmetic surgery tourism complications to the NHS: A retrospective analysis.

INTRODUCTION: Medical tourism refers to the process of patients travelling outside of their native country to undergo elective surgical procedures and is a rapidly expanding healthcare phenomenon [1-3]. Whilst a multitude of established Private Healthcare Providers (PHPs) offer cosmetic surgical procedures within the United Kingdom (UK), a growing number of patients are opting to travel outside of the UK to undergo cosmetic surgery. AIM: To assess the number of patients presenting to the Canniesburn Plastic Surgery Unit, with cosmetic surgery tourism complications, from outside of the UK, and the associated costs to NHS Scotland over a five-year period. METHODS: A retrospective case review of a prospectively maintained trauma database, which records all acute referrals, was undertaken analysing patients referred from January 1st 2019 to December 31st 2023 inclusive. RESULTS: 81 patients presented over five years with complications of cosmetic surgery tourism. The most common presenting complaints were wound dehiscence (49.4%) or wound infection (24.7%). The total cost to NHS Scotland was £755,559.68 with an average of £9327.90 per patient. CONCLUSION: This is the largest single centre cohort of cosmetic surgery tourism complications reported within the NHS to date; with rates on the rise, demand grows for increased patient information regarding healthcare tourism risks, a national consensus on the extent of NHS management and urgent international collaboration with policymakers is required to address this issue across borders.