Correction to: Can Cosmetics' Advertisements Be An Indicator of Different Perceptions of Beauty Amongst Countries?

Georgia-Alexandra Spyropoulou's name appeared incorrectly in the original publication of this article. It appears correctly here.

Can Cosmetics' Advertisements Be An Indicator of Different Perceptions of Beauty Amongst Countries?

INTRODUCTION: Concepts of beauty are different amongst different cultures and civilizations. The objective of this study was to evaluate beauty perceptions through cosmetic advertisements in an effort to further appreciate beauty understanding amongst lay people in various parts of the world. To achieve these objectives, we reviewed cosmetics' advertisements to study whether the concept of beauty varies amongst different countries. MATERIALS AND METHODS: We used the keywords "cosmetics" and "advertisements" in YouTube search engine in all existing languages in Google translator and came up with advertisements from 18 countries. The faces of the models were compared against Marquardt® beauty mask template in order to have a mean to objectively test symmetry with a mathematical computer model. The weak point of our study is that we can present no model photographs due to General Data Protection Regulation. RESULTS: Advertisements retrieved in total were 257. Characteristics with no statistically significant difference (SSD) amongst models in different parts of the world were: symmetry (p = 0.187), high cheek bones (p = 0.325), small noses (p = 0.72), thin jaws (p = 0.98), lush hair (p = 0.54), clean and smooth skin (p = 0.367), and white toothed smile (p = 0.235). Characteristics with SSD were: in Latin America, USA, and Australia tanned models and fuller lips were preferred (p < 0.001), whilst in Asia milky white skin models and small mouth were preferred. Age ratio (p = 0.022) was lower amongst models in Southeast Asia compared to American, European, Indian, Australian, and Arab models. Arab and Southeast Asia women had intense eyebrows (p < 0.001) and used artificial eyelashes. CONCLUSIONS: All the common characteristics noted by the two independent surgeons (GAS and LP) referred to symmetry, youthfulness, and health. Differences noticed reflected cultural influences in the perception of beauty. 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 .

Autologous free fat transfer in patients with velopharyngeal insufficiency.

AIM: To report our initial experience and preliminary results of autologous free fat transfer to improve speech and hypernasality in patients with velopharyngeal insufficiency (VPI) as a sequela of cleft lip and palate repair. MATERIAL AND METHODS: To date 2 patients with a mean age of 25 years were treated with this method. Both had initially received multiple procedures elsewhere for cleft lip and palate repair. We recorded the number of free fat transfer sessions, anatomical places of placement and volumes injected in-patient stay, occurrence or absence of complications and effectiveness of this operation in terms of clinical speech evaluation, functional velopharyngeal closure measurements and speech improvement percentage by an Ear, Nose and Throat (ENT) specialist. RESULTS: Two autologous free fat transfer sessions per patient were performed. Mean hospitalization time was 1 day per operation. Following liposuction, autologous free fat was transferred to the following anatomical areas: a) Passavant's ridge, b) uvula, c) palatopharyngeal and palatoglossal folds. The volume of fat injected varied from 6.5 cc to 8 cc per session. Postoperative periods were uneventful for both cases in each session. On clinical examination, improvement in speech was noted as well as a reduction in hypernasality with an improvement in articulation and audibility of consonant words, which were also reported by the patients' relatives. This was confirmed by objective nasendoscopy velopharyngeal closure measurements, both during speech and deglutition. CONCLUSION: Augmentation pharyngoveloplasty with autologous free fat transfer in patients with velopharyngeal insufficiency is a safe and innovative alternative, particularly for small to medium degrees of structural velophayngeal dysfunction.

A randomized control study of treating secondary stage II breast cancer-related lymphoedema with free lymph node transfer.

Microsurgical techniques are increasingly used for treating severe lymphoedema cases. The purpose of this study was to evaluate the effectiveness of free vascularized lymph node transfer (LNT) in stage II breast cancer-related lymphoedema patients in comparison with non-surgical management. During the last 3 years, 83 female patients were examined at our lymphoedema clinic. Finally, 36 cases were included in this study and randomly divided in two groups: group A patients (n = 18, mean age 47 years) underwent microsurgical LNT; followed by 6 months of physiotherapy and compression, while group B patients (n = 18, mean age 49 years) were managed by physiotherapy and compression alone for 6 months. Patients of both groups removed their elastic garments after 6 months and were re-examined 1 year later. All the 36 patients had detailed evaluation of the affected extremity including limb volume measurement, infection episodes and scale scoring of pain, feeling of heaviness and functional status both at baseline and 18 month. Limb volume reduction was observed in both groups; mean reduction was greater in group A (57 %) than in group B (18 %). Infection episodes in group A were significantly reduced compared to those in group B patients. All group A patients reported painless and feeling of heaviness-free extremities with overall functional improvement, while the corresponding changes in group B patients were no more than marginal. Moreover, the LNT procedure was estimated as cost effective compared to conservative treatment alone. LNT represents an effective therapeutic approach for stage II lymphoedema patients; it significantly reduces limb volume, decreases recurrent infections and improves the overall function.

The Use of Vascularized Fascia as Carrier in Cases of Prelaminated Fasciocartilaginous and Osseofascial Flaps.

Background This experimental study investigates the use of vascularized fascia as carrier for prelaminated cartilage and bone flaps. Methods A total of 30 male New Zealand white rabbits were divided into two equal groups (A and B). The fascia surrounding the inguinal fat and superficial inferior epigastric vessels was dissected. In group A, the fascia was wrapped around a template (20 × 40 mm) of cartilage harvested from the rabbit's ear. In group B, the fascia was wrapped around a 15 × 35 mm piece of rib cortical bone. After a maturation period of 4 weeks, group A was subdivided into three groups (A1, A2, and A3). In group A1 (six animals) the animals were sacrificed and the flaps were sent for histological examination, in A2 (six animals) the flaps were rotated 180 degrees and anchored at knee level, and in A3 (two animals) the flaps were transferred as free flaps to the right SIE (superficial inferior epigastric vessels). The animals of subgroups A2 and A3 were sacrificed after another maturation period of 2 weeks and the flaps were sent for histological examination. After a maturation period of 6 weeks, group B was subdivided into three subgroups (B1, B2, and B3) corresponding to the cartilage subgroups. Subgroups B2 and B3 were sacrificed after 2 weeks. Results All flaps of groups A and B demonstrated good viability apart from one specimen of subgroup B2. Angiogenesis was present in all groups. Conclusion Meticulously dissected vascularized fascia can be successfully used for prelamination of complex fasciocartilaginous or osseofascial flaps. The required maturation periods are 4 and 6 weeks, respectively.

Assessing an avoidable and dispensable reoperative entity: Self-referred flawed cleft lip and palate repair.

OBJECTIVE: Cleft lip and palate (CLP) is comprised within the wide range of congenital deformities of the maxillofacial region with an overall incidence on the increase from 1:1000 to 1:700 live births thus being the most common congenital birth error. Failure of the lateral and medial nasal processes to fuse with the anterior extension of maxillary processes and of the palatal shelves between the 4th and 8th gestational week results in cleft lip and palate. Clefts include different types with variable severity, confirming the complexity and unpredictable expression of cleft modality and have a multifactorial aetiology. Functional impairment, aesthetic disturbances and psychosocial effects are common sequalae in patients with cleft lip and palate. The main long-term morbidity of this condition may include dysfunctional speech, impaired hearing and communication, as well as dental problems. These complications are followed by unfavourable surgical outcome and aesthetic appearance, which all seem to affect this group of patients significantly and have an impact significantly both quality of life and healthcare. Treatment requirements of cleft patients are multifactorial and a multi-disciplinary approach and intervention at multiple levels is necessary. Yet, in this country, resources available to parents and consistent publicity given to this issue and its treatment are still inadequate in spite of the introduction of "Centres of Excellence" and Unified Hospitalization Coding or DRG equivalents to optimize health management. The multi-disciplinary approach to cleft management has been a reality for over a century while cleft treatment protocols are still being evaluated in order to optimise standards of cleft care. According to relevant guidelines primary surgical management of lip and palate defects is performed during the first 3 to 9 months of life. Secondary operations in the form of revisional lip and nose procedures are performed at later stages aiming with an aesthetically improved outcome. Indications for surgery include widened scars, lip contour deformities, shortened lips, poorly defined and flattened nasal tip, short columella and irregularities of the nostrils (narrow or high-riding) and cartilages. Wound dehiscence, contractures, vermilion notching, white roll malalignment and orovestibular fistulas are possible unfavourable results after cleft lip repair. The psychological status of children and adults with repaired cleft lip and palate has been the subject of extensive research especially regarding the way of their evaluation facial appearance, satisfaction and need for secondary corrective surgical procedures in the hope of increasing their self-esteem and self-confidence. CONCLUSION: The aim of this study was to assess secondary CLP deformity management in an accredited present-day tertiary hospital facility with an existing infrastructure of a specialist teams however not formed in a multidisciplinary group. Equally, to answer questions of specific operation indications and choice as related to prior surgeries, hospitalization time and cost, provision of adequate preoperative information, correlation between paediatric and plastic surgeons and effect of post-plastic surgical care on patients' health and well-being. It also aims at presenting, beyond our current primary cleft lip and palate repair approach, appropriate indications and timing of secondary repair and achieved results.

Microsurgical reconstruction for head and neck cancer in elderly patients.

The purpose of this study is to review our group of elderly patients and examine whether microsurgical reconstruction is safe to perform in these cases. From October 2006 to October 2009, 747 patients with head and neck cancer who underwent free flap reconstruction were divided into two groups: patients younger than 70 years (n = 714) and patients older than 70 years (n = 33). The two groups of patients were compared regarding medical comorbidities, medical/surgical complications, smoke, and alcohol consumption and outcomes. Two deaths occurred in the "elderly" (6% mortality rate) group of patients and two deaths in the "young" group of patients (0.28% mortality rate) in the immediate postoperative period (15 days postoperatively). Thus, mortality rate had a significant difference (p = 0.011) between these two groups. There was no significant difference in morbidity between these two groups of patients regarding the rate of medical complications, surgical complications, flap failure, and reexploration during our 3-month follow-up period. Mortality risk is higher in the elderly group of patients. However, there is no significant difference regarding the free flap success rate between these two groups. Thorough preoperative evaluation and preparation are critical to achieve a favorable outcome in elderly patients.