Ethnic considerations in buttock aesthetics.

There has been increased interest in buttock contouring and augmentation in recent years, which has translated into increased demand for these procedures. In addition, we are witnessing a growing number of patients from all ethnic groups requesting cosmetic surgery in the United States. Buttock aesthetic surgery today consists of either augmentation or recontouring of the gluteal region by one of three methods: (1) liposuction (if only reductive shaping is required); (2) liposuction and augmentation by micro fat grafting; and (3) gluteal implants. Whereas there certainly exists a "universal ideal" of beauty in buttock augmentation, there are fundamental ethnic differences that must be recognized to achieve a desirable surgical outcome. We present an article reviewing current trends in buttock aesthetic procedures and discuss issues relevant to the ethnic populations.

"Universal" and ethnic ideals of beautiful buttocks are best obtained by autologous micro fat grafting and liposuction.

Recently there has been a dramatic increase in the number of patients seeking buttocks enhancement and in the degree of augmentation requested. To fulfill these requests,aesthetic plastic surgeons must understand the patient's personal requests and ethnic identity, as well as any universal ideal of proportions and contours that create the impression of beautiful buttocks. "Universally" perceived ideal buttocks are 1.4 times the circumference of the waist, which is consistent cross-culturally and throughout history. Beyond this are important ethnic differences in the image of perfect buttocks shape. The combination of autologous micro fat grafting and liposuction is the best and possibly only way to obtain various ideal shapes, and offers a lower incidence of complications compared with buttock implants.

Complications of buttocks augmentation: diagnosis, management, and prevention.

Over the past several years, there has been a tremendous growth and interest in buttocks augmentation in the United States. Surgical techniques have evolved over time to correct anatomical deficiencies and fulfill patient requests, including silicone implant placement (subcutaneous, intramuscular, submuscular, and subfascial) and autologous micro fat grafting. Unfortunately, these techniques have presented great challenges with regard to the incidence, diagnosis, management, and prevention of various postsurgical complications. Extensive collaboration and transparency in discussing complications has resulted in refinement of both surgical technique and medical management,resulting in improved outcomes for patients undergoing buttocks augmentation.

Optimizing wound healing in the face after laser abrasion.

BACKGROUND: Laser resurfacing is a popular procedure to improve the physical signs of photoaging. In addition to improvements in treatment modalities, optimizing posttreatment regimens will enhance patient care. OBJECTIVE: Our purpose was to evaluate the efficacy of two forms of wound care for the face after laser abrasion. METHODS: Forty-two patients received full-face laser resurfacing at two clinics by using either the UltraPulse carbon dioxide (CO(2)) laser (Coherent Laser Corp, Palo Alto, Calif) alone or followed by an erbium:YAG laser (Derma-20, ESC Sharplan, Inc, Needham, Mass) and/or a blended CO(2)/Er:YAG laser (Derma-K, ESC Sharplan) or a variable pulse erbium:YAG laser (Contour, Sciton Laser Corp, Palo Alto). Twenty-one patients were randomly assigned to a postoperative regimen including Silon-TSR (Bio Med Sciences, Inc, Allentown, Pa) for the first 2 to 3 days after laser resurfacing, followed by Aquaphor ointment (Beiersdorf, Charlotte, NC) to complete the first 2 weeks. The other 21 patients received the resurfacing recovery system (RRS, Neutrogena, Los Angeles, Calif) following a specific regimen. The system includes Fibracol wound dressing (Johnson & Johnson, Skillman, NJ) for 2 days, followed by a hydrogel dressing for 1 to 2 days, followed by an ointment to complete the first 2 weeks. Patients were evaluated for wound healing on days 2, 3, 6-10, 14-16, and 28-30. The skin was swabbed for colonization at every visit to determine the quantity of bacteria throughout the healing process. RESULTS: Ninety percent of patients in both groups experienced either "no pain" or "minimal pain" during the first 3 days. Total bacterial counts peaked on days 3 and 6 in the patients managed with the RRS and the Silon-TSR/Aquaphor regimen, respectively. The average day at which patients did not require a dressing was 3.0 days in the group managed with the RRS and 3.7 days in the group managed with the Silon-TSR/Aquaphor dressing regimen (P < or =.05). The average day of complete epithelial regeneration was significantly shorter at 6.3 days using the RRS compared with 7.4 days for patients using the Silon-TSR/Aquaphor regimen (P < or =.02). There was no difference in infection, adverse sequelae, exudate management, or pain in either group. CONCLUSION: Healing was optimized in patients using the RRS after laser resurfacing.