Motivational Factors in Women Seeking Augmentation Mammoplasty Across Different Age Groups: A Cross-Sectional Survey.

BACKGROUND: Augmentation mammoplasty is one of the most common esthetic procedures worldwide. A wide range of motivations leads women to undergo this procedure, among them socioeconomic status and age group. The aim of this study was to identify the motivation spectrum for augmentation mammoplasty through different age groups. METHODS: We conducted a cross-sectional prospective survey given to Israeli women seeking augmentation mammoplasty consults in a hospital and private clinic settings, using a 17-item Motivation for Augmentation questionnaire. Three motivation domains were examined: appearance, sexuality and social. Study participants were divided into three age groups: 18-29, 30-39 and over 40 years. RESULTS: A total of 101 women participated in the study. Motivations were rated similar among all age groups. Appearance and sexuality domains were rated significantly higher compared with the social domain throughout all age groups (3.28 ± 0.91 and 3.15 ± 1.03 vs. 1.88 ± 1.16, p < 0.001, respectively). CONCLUSIONS: Motivations in Israeli women seeking breast augmentation do not change with age. The desire to improve one's appearance and sexuality is more prominent than improving social and work status. 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 .

MRI in detecting facial cosmetic injectable fillers.

BACKGROUND: Despite being considered a non-invasive procedure, injections can cause adverse outcomes including infections, overfilling, asymmetry, foreign body granulomas, and reactions that lead to scarring. Complications may be associated with the procedure itself, the physician's technique, and/or the type of agent injected. In these instances, it is important to be able locate and identify the substance used. This study investigated the viability of using MRI to correctly identify injected substances, their symmetry of distribution, and related complications. METHODS: Fourteen patients with suspected injectable filler complications were identified by our institution's plastic surgery service. All subjects were scanned with MRI, using highly specific face-oriented sequences at high resolution with small field of view and thin slices across the axial and coronal planes by T1 Dixon non-contrast, T2 Dixon, and T1 Dixon after gadolinium injection. Two independent and blinded radiologists evaluated the images and reported (1) the likely injected substance, (2) symmetry, and (3) complications. These radiological results were compared against clinical data provided by the plastic surgery service. RESULTS: Ten patients (83 %) presented objective injectable complications: 4 had abscess, 4 granulomata, and 2 had allergic reactions to the injected substance. The Fleiss Kappa for inter-rater agreement on substances was 0.80. Asymmetry was identified in six patients (50 %) with a Kappa between radiology evaluators of 1. MRI characteristics of these common fillers are summarized in table form. CONCLUSIONS: Given the growing awareness among referring physicians of the value of dedicated facial MRI, utilization of this imaging technique may lead to discovery of the injected substance's true identity, evaluation of symmetry and/or complications.

A new instrument for rhinoplasty: the osteotome with protector and internal guide.

Rhinoplasty is a surgical procedure that demands a high level of intraoperative precision as well as maximum vigilance and control. Hump reduction is the most common maneuver in aesthetic rhinoplasty, but it is also the most sophisticated, dangerous, and difficult to learn. In this article, the authors describe the application of an osteotome with a protector and internal guide, which aids in achieving the necessary accuracy for hump reduction in safe, easy, and gentle manner.