Aqua Breast Augmentation (ABA): Hydrodissection Breast Augmentation Technique.

INTRODUCTION: Breast augmentation is a prevalent procedure in plastic surgery. In this article we present the Aqua Breast Technique (ABA), an approach aimed at enhancing patient satisfaction and reducing downtime. This technique leverages tumescent anesthesia and a small incision in the inframammary fold, avoiding electrocautery and surgical drains, to fulfill the growing demand for painless procedures with minimal recovery periods. MATERIALS AND METHODS: The study retrospectively analyzed 238 patients who underwent breast augmentation using the ABA technique at Instituto Rubi between 2021 and 2024. The ABA protocol involves detailed preoperative design, local anesthesia, a precise 3-centimeter incision, careful dissection, and specific postoperative care, emphasizing hydrodissection for tissue separation and the use of smooth round silicone implants through a Keller funnel. RESULTS: The application of the ABA technique to 238 patients, with a mean follow-up time 14 months. Ten patients required surgical intervention due to complications. Hematoma and infection rates were 0.42%, while capsulectomies were required in 2.1% of cases. CONCLUSIONS: Aqua Breast Augmentation technique has been successfully applied as a hydrodissection-based breast augmentation technique method, with low complication rates, short downtime, and reduced postoperative pain. Level V, therapeutic study. 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 .

Costs Versus Complications: Public Perspectives on International Cosmetic Surgery Tourism.

Introduction: The purpose of this study was to understand the perceptions of potential complications and motivations among patients willing to travel internationally for cosmetic surgery and to gain insight into public perceptions of cosmetic surgery tourism by surveying a large, cross-sectional sample of the general public. Methods: A cross-sectional survey was performed through Amazon Mechanical Turk regarding cosmetic surgery tourism in adults 18 years and older and currently residing in the United States (US). Results: A total of 484 responses were analyzed. Of those, 45.2% of participants would consider having plastic surgery. Among these participants, 67.1% would consider traveling outside of the US to receive cosmetic surgery. Participants who reported Hispanic or Latino ethnicity had increased odds of considering surgery abroad (OR 3.1, 95% CI 1.1-8.7, P = .030). Participants reported that the top advantages of traveling outside of the US for surgery were the price of surgery internationally, a shorter waiting list for surgery, and privacy during recovery. The top disadvantages were the risk of complications, lack of follow-up or continuity care after surgery, and distance from home. Although the risk of complications was acknowledged as the top disadvantage, the perceived safety of receiving plastic surgery abroad was not related to willingness to consider having surgery abroad (P = .268). Conclusion: These findings support the need for continued awareness of patients considering international travel for cosmetic surgery and increased education of the general public regarding the safety of cosmetic surgery tourism and the importance of selecting board-certified plastic surgeons and accredited facilities.

Introduction: La présente étude visait à comprendre les perceptions des complications potentielles et les motivations chez les patients désireux de se rendre à l'étranger pour subir des chirurgies esthétiques et à connaître les perceptions du public à l'égard du tourisme esthétique au moyen d'un sondage auprès d'un vaste échantillon représentatif du grand public. Méthodologie: Les chercheurs ont procédé à un sondage transversal par l'entremise de la plateforme Amazon Mechanical Turk au sujet du tourisme esthétique chez des adultes de 18 ans et plus qui habitent actuellement aux États-Unis. Résultats: Les chercheurs ont analysé 484 réponses. Au total, 45,2% des participants envisageraient la chirurgie plastique et, de cette proportion, 67,1% envisageraient de sortir des États-Unis pour ce faire. Les participants qui se disaient Hispaniques ou Latinos étaient plus susceptibles d'envisager de se rendre à l'étranger (rapport de cotes 3,1, IC à 95%, 1,1 à 8,7, P = 0030). Les participants indiquaient que le tourisme esthétique hors des États-Unis avait comme principaux avantages le prix des opérations, une liste d'attente plus courte et le respect de la vie privée pendant la convalescence. Le risque de complications, l'absence de suivi ou de continuité des soins après l'opération et la distance de la maison en étaient les principaux désavantages. Même si le risque de complications était reconnu comme le principal désavantage, la perception de sécurité liée à la chirurgie esthétique à l'étranger n'était pas associée à la volonté d'envisager une opération à l'étranger (P = 0268). Conclusion: Ces observations appuient la nécessité de sensibiliser constamment les patients qui envisagent le tourisme esthétique et de mieux informer le grand public de la sécurité du tourisme esthétique et de l'importance de privilégier des plasticiens agréés par l'Ordre et des établissements agréés.

Hyperdiluting Calcium Hydroxylapatite With Platelet-Rich Plasma and Hyaluronidase for Improving Neck Laxity and Wrinkle Severity.

The two cases discussed in this report investigate the efficacy and safety of a novel injectable therapy for treating neck wrinkles and skin laxity, utilizing a combination of hyperdiluted calcium hydroxylapatite (CaHA), platelet-rich plasma (PRP), and hyaluronidase. Two patients presenting with moderate neck wrinkles and laxity underwent treatment and were evaluated several months later. The combined therapy demonstrated improvements in skin texture and laxity following a single treatment. The rationale behind incorporating PRP and hyaluronidase was their potential to amplify the regenerative effects of CaHA. PRP contains growth factors that stimulate collagen production and tissue regeneration while hyaluronidase facilitates the breakdown of hyaluronic acid, promoting better diffusion and more even product dispersion. The findings from these cases provide emerging preliminary evidence supporting the safety and efficacy of this innovative combination therapy for addressing neck wrinkles and laxity. This is the first documented instance of skin priming CaHA with hyaluronidase and PRP. Future investigations are warranted to explore the application of this treatment for other anatomical regions and to delineate the role of each injected component.

The role of sexual partner in women's seeking for labiaplasty: a systematic review and meta-analysis.

BACKGROUND: The primary reasons for labiaplasty usually revolve around aesthetic, sexual, and functional concerns. Upon delving deeper into these issues, it becomes apparent that sexual partners play a controversial role in influencing women's decisions to undergo surgery. AIM: This study aimed to investigate the impact of sexual partners on women's choices to pursue labiaplasty. METHODS: A comprehensive search was conducted across electronic databases covering the period from January 2000 to February 2024. After removing duplicates, a total of 931 articles were retrieved by searching keywords in titles and abstracts. OUTCOMES: The meta-analysis revealed that 36.7% of women who sought labiaplasty cited their partners' negative comments as a factor influencing their decision. RESULTS: After applying the eligibility criteria and excluding irrelevant articles, a total of 12 articles involving 962 participants were included in the analysis. With the exception of 2 articles, the majority of the studies suggested a discernible influence of male partners on women's decisions to seek labiaplasty. Frequently, sexual partners are not the primary decision makers, nor do they exert significant pressure when it comes to seeking labiaplasty. In certain instances, women seeking labiaplasty acknowledged that their sexual partners did influence their decisions, either by making disparaging comments about their genitalia or by directly pressuring or requesting them to undergo labiaplasty. Additionally, women might opt for labiaplasty out of fear of their partner's negative remarks or to enhance sexual pleasure for their partners. For a more accurate result, a meta-analysis was conducted noting a considerable heterogeneity. CLINICAL IMPLICATIONS: The findings of this study can be applied in prelabiaplasty counseling sessions to acknowledge and explore the role of the sexual partner in women's decision making. STRENGTHS AND LIMITATIONS: This study stands as the inaugural systematic review examining the impact of sexual partners on women seeking labiaplasty, encompassing all original studies exploring the role of the sexual partner. However, a notable limitation lies in the varied interpretations of the sexual partner's role, that the heterogeneous nature of these interpretations poses a challenge to providing a more precise answer through meta-analysis. CONCLUSION: Based on the findings of this systematic review, it is evident that sexual partners exert multifaceted influences on women's decisions to seek labiaplasty. While not serving as the primary decision makers, women opt for labiaplasty with the aim of enhancing attractiveness in sexual relationships and mitigating potential negative comments from their partners.

Immediate Latissimus Dorsi Flap Reconstruction: Assessing Aesthetic Outcomes Following Mastectomy in Breast Cancer Patients.

BACKGROUND:  Breast Cancer has now become the leading cause of cancer-related deaths among women. In a traditional radical mastectomy, there can be complications that may affect the physiological characteristics of the breast and subsequently cause profound psychological stress to the patients. Hence, latissimus dorsi (LD) flap reconstruction provides an aesthetic approach in patients undergoing mastectomy. The goal is to maximize the flap's soft tissue coverage while minimizing the magnitude of donor site defect and complication. METHODS: A prospective observational study was conducted in the Department of General Surgery, Safdarjung Hospital, New Delhi, India, where 30 breast cancer patients were enrolled and had undergone mastectomy with immediate LD flap reconstruction. Cosmetic assessments using BREAST-Q questionnaires were conducted postoperatively at various intervals starting from postoperative day one, week two, and week six. The subjective evaluation was done by the patient, while a blinded nurse and surgeon did the objective assessment. RESULT:  The majority (n=23, 76.7%) were aged 31-50 years. Initial postoperative BREAST-Q scores declined but significantly improved by week six, attributed to gradual wound healing over time, resulting in improved breast shape and contour. The objective scoring done by the blinded surgeon and nurse improved at six weeks compared to two weeks postoperatively. Almost similar outcomes were observed between preoperative and six-week postoperative scores with a significant overall p-value of <0.001. No significant statistical differences were noted between blinded surgeons and nurses for objective scoring. CONCLUSION:  The rising trend of breast cancer in younger demographics emphasizes the importance of balancing cosmetic satisfaction with oncological outcomes. Immediate LD flap breast reconstruction provides a reliable means for soft tissue coverage with acceptable perioperative morbidities for patients undergoing mastectomy. Complication rates were acceptable, with donor site seroma, surgical site infection (SSI), and shoulder weakness among them. They could be prevented or treated (prolonged drain in situ, quilting sutures, and seroma aspiration) or resolved with time (SSI and shoulder function).

Artificial intelligence in cosmetic dermatology.

BACKGROUND: Cosmetic dermatology is a growing field as more patients are seeking treatments for esthetic concerns. Traditionally, practitioners and patients utilize their own perceptions, current beauty standards, and manual observation to determine their satisfaction with cosmetic interventions. Artificial intelligence (AI) can be introduced into cosmetic dermatology to provide objective data-driven recommendations to both dermatologists and patients. OBJECTIVE: The purpose of this paper is to compose a unified review that illustrates the various facets of artificial intelligence and formulate a hypothesis regarding the new implications of artificial intelligence in cosmetic dermatology specifically. METHODS: A comprehensive search on PubMed was conducted to identify the available information related to AI in cosmetic dermatology. The search was conducted using a combination of keywords including "cosmetic dermatology" and "artificial intelligence." RESULTS: The current literature indicates that AI models offer personalized, efficient, and result-driven outputs that can enhance cosmetic outcomes, patient satisfaction, and overall experience. CONCLUSION: Artificial intelligence integration in cosmetic dermatology shows a promising future, offering the ability to analyze vast data sets and deliver a tailored patient experience. By incorporating AI into cosmetic dermatology, there is an opportunity to balance evidence-based decision-making with the artistic human touch of cosmetic dermatologists.

Selfie-loving mothers and children in China: The relationship between the selfie-related behaviors of mothers and adolescents' cosmetic surgery consideration.

The current study examined the relationship between mothers' selfie-related behaviors and adolescents' cosmetic surgery consideration, as well as the mediating effects of the adolescents' selfie-related behaviors, body surveillance, and facial dissatisfaction. A total of 541 mother-child dyads with adolescents averaging 16.55 years old, was recruited. The path analysis revealed that mothers' selfie-related behaviors were not directly related to adolescents' consideration of cosmetic surgery, but the link was mediated by the adolescents' selfie-related behaviors, body surveillance, and facial dissatisfaction. Specifically, there was a mediating effect of adolescents' facial dissatisfaction, as well as serial mediating effects of adolescents' selfie-related behaviors and facial dissatisfaction, of adolescents' selfie-related behaviors and body surveillance, and of adolescents' selfie-related behaviors, body surveillance and facial dissatisfaction. Additionally, we did not find a significant gender difference in the model. These findings provide further insights into the association between a mother's selfie activities and adolescent children's cosmetic surgery consideration.

Evaluation of the antioxidant and antityrosinase activities of Prosopis juliflora fruit extract as a novel multifunctional bioactive ingredient and its potential applicability in pro-ageing and skin colour harmonization cosmetic products.

OBJECTIVE: Prosopis juliflora, commonly known as algaroba or mesquite, was introduced and has since proliferated throughout the semi-arid region of the Caatinga biome. Various studies have documented its properties, including antimicrobial, antioxidant, and antitumor activities, attributed to the presence of diverse secondary metabolites such as alkaloids, terpenoids, tannins, and flavonoids. The objective of this study was to evaluate the antioxidant and antityrosinase activities of P. juliflora fruit extract as a multifunctional active ingredient, and to develop cosmetic formulations containing this vegetal extract for potential applications in skincare products targeting pro-ageing and skin colour homogenization properties. METHODS: The extraction process followed established protocols. Chemical characterization of the extract involved quantification of total flavonoids and phenolic compounds, along with Liquid Chromatography-Mass Spectrometry (LC-MS) analysis. In vitro antioxidant activity was assessed using different methods. Antityrosinase activity was determined by employing enzymatic assays. Cosmetic formulations containing Disodium EDTA, Phenoxyethanol (and) Ethylhexyl Glycerin, Distilled Water, Sodium Acrylates Copolymer Lecithin, Polyacrylamide (and) C13-14 Isoparaffin (and) Laureth-7, and 3.0% of the investigated plant extract were subjected to preliminary and accelerated stability tests. RESULTS: The extract demonstrated a concentration of total flavonoids (1.71 ± 0.26 µg EQ/mg) and exhibited concentrations of phenolic compounds at 0.21 ± 0.01 mg EAG/g. Metabolites such as flavonoids and saponins were annotated, as well as some of their respective glycosidic derivatives. The extract showed antioxidant potential and the ability to inhibit the oxidation cascade in both the initiation and propagation phases. Moreover, the extract exhibited noteworthy inhibition of antityrosinase activity, presenting 62.48 ± 2.09 at a concentration of 30.00 mg/mL. The formulations were stable in accelerated stability tests over a 60-day period. CONCLUSION: This research not only demonstrates scientifically by demonstrating the potential of a plant from the Caatinga biome with antioxidant and antityrosinase properties in the development of cosmetic products aimed at pro-ageing effects and skin colour harmonization, but also adds value to the P. juliflora production chain. This valorization encompasses various aspects which include environmental, social, and biodiversity responsibilities.

OBJECTIF: Prosopis juliflora, communément appelée algaroba ou mesquite, a été introduite et s'est depuis proliférée dans la région semi­aride du biome de la Caatinga. Diverses études ont documenté ses propriétés, y compris des activités antimicrobiennes, antioxydantes et antitumorales, attribuées à la présence de divers métabolites secondaires tels que les alcaloïdes, les terpénoïdes, les tanins et les flavonoïdes. L'objectif de cette étude était d'évaluer les activités antioxydantes et antityrosinases de l'extrait de fruit de P. juliflora en tant qu'ingrédient actif multifonctionnel, et de développer des formulations cosmétiques contenant cet extrait végétal pour des applications potentielles dans des produits de soins de la peau ciblant les propriétés anti­âge et d'homogénéisation de la couleur de la peau. MÉTHODES: Le processus d'extraction a suivi des protocoles établis. La caractérisation chimique de l'extrait a impliqué la quantification des flavonoïdes totaux et des composés phénoliques, ainsi qu'une analyse par chromatographie liquide­spectrométrie de masse. L'activité antioxydante in vitro a été évaluée en utilisant différentes méthodes. L'activité antityrosinase a été déterminée en utilisant des essais enzymatiques. Les formulations cosmétiques contenant du Disodium EDTA, du Phenoxyethanol (et) Ethylhexyl Glycerin, de l'Eau Distillée, du Copolymère de Sodium Acrylates Lecithin, du Polyacrylamide (et) C13­14 Isoparaffin (et) Laureth­7, et 3.0 % de l'extrait végétal investigué ont été soumises à des tests de stabilité préliminaires et accélérés. RÉSULTATS: L'extrait a montré une concentration totale de flavonoïdes (1.71 ± 0.26 µg EQ/mg) et des concentrations de composés phénoliques à 0.21 ± 0.01 mg EAG/g. Des métabolites tels que les flavonoïdes et les saponines ont été annotés, ainsi que certains de leurs dérivés glycosidiques respectifs. L'extrait a montré un potentiel antioxydant et la capacité d'inhiber la cascade d'oxydation tant dans les phases d'initiation que de propagation. De plus, l'extrait a présenté une inhibition notable de l'activité antityrosinase, avec un résultat de 62.48 ± 2.09 à une concentration de 30.00 mg/mL. Les formulations ont été stables lors des tests de stabilité accélérés sur une période de 60 jours. CONCLUSION: Cette recherche démontre scientifiquement le potentiel d'une plante du biome de la Caatinga avec des propriétés antioxydantes et antityrosinases dans le développement de produits cosmétiques visant les effets anti­âge et l'harmonisation de la couleur de la peau, tout en ajoutant de la valeur à la chaîne de production de P. juliflora. Cette valorisation englobe divers aspects incluant des responsabilités environnementales, sociales et liées à la biodiversité.

Vascular anomalies of the limb and trunk in children: a retrospective comparative study of endoscopic surgery and open surgery.

BACKGROUND: Endoscopic resection has been reported for vascular anomalies (VA) previously. However, there is no study comparing endoscopic resection surgery (ERS) with open resection surgery (ORS) in children. We aimed to compare clinical and cosmetic outcomes between two approaches in pediatric VA. METHODS: Between June 2018 and June 2023, 138 pediatric VA patients undergoing ERS or ORS were retrospectively reviewed. Propensity score matching (PSM) was performed to minimize selection bias. The Scar Cosmesis Assessment and Rating (SCAR) Scale and numerical rating scale (NRS) based on patient satisfaction were used for cosmetic assessment. RESULTS: After PSM for age, depth of lesion, size of lesion, and site of surgery, 72 patients (ERS = 24, ORS = 48) were analyzed. Patients undergoing ERS had longer operative time (164.25 ± 18.46 vs. 112.85 ± 14.26 min; P < 0.001), less estimated blood loss (5.42 ± 2.15 vs. 18.04 ± 1.62 ml; P < 0.001), and shorter median hospital stay (4.50 [3.00-5.00] vs. 6.00 [5.00-6.00] days; P < 0.001). The follow-up time was 8.04 ± 1.23 month for ERS group and 8.56 ± 1.57 month for ORS group. For aesthetic results, the median overall SCAR score in ERS was lower than that in ORS (2 [1-3] vs. 5 [4-5]; P < 0.001), and the subscales of "scar spread," "dyspigmentation," "track marks or suture marks," and "overall impression" were better. The median NRS score was higher (8 [7-8] vs. 6 [5-6]; P < 0.001) and length of scars was shorter (2.18 ± 0.30 vs. 8.75 ± 1.98 cm; P < 0.001) in ERS group than those in ORS group. The incidences of total complications and recurrence showed no significant difference between two groups. CONCLUSIONS: Endoscopic surgery can be a safe and effective option for pediatric VA in the limbs and trunk. It offers the advantages of improving aesthetic outcomes and reducing postoperative wound healing time.

In vitro, ex vivo, instrumental and clinical evaluation of a topical cream on the signs of periorbital ageing.

OBJECTIVE: Periorbital skin ageing signs are multidimensional, highly visible and a concern for many. We evaluated the potential efficacy of an eye cream to diminish these signs. METHODS: Biological markers associated with ageing, barrier function and homeostasis were analysed in vitro to determine the effects of topically applied eye cream, compared to those of a placebo using human skin tissue models and/or explants. Collagen IV, elastin and bone morphogenic protein 4 (BMP4) expression was investigated by immunohistochemical labelling, while filaggrin, kallikrein 7 (KLK7) and HB-EGF were evaluated by RT-qPCR. IL-1α and melanin levels in darkly pigmented skin models were also quantified. The protective effect of the cream on glycation was assessed by a non-enzymatic assay. Finally, the benefits of twice-daily applications of the eye cream for 56 days were instrumentally and clinically evaluated on 33 women. RESULTS: Only the eye cream, not the placebo, stimulated collagen IV and BMP4 protein expression, as well as increased elastin fibre length. It also led to higher HB-EGF, filaggrin and KLK7 mRNA levels. The placebo and the eye cream did not induce changes in IL-1α and melanin levels, but both reduced non-enzymatic glycation. When assessing the in vivo effects of the cream, short-term results indicated skin hydration, transepidermal water loss (TEWL) and skin profilometry improvement within 15 min. Instrumental evaluations of wrinkles showed a reduction after 7 days, which was clinically perceivable after 28 or 56 days. The eye-opening angle and eyelid sagging also improved after seven and 28 days, respectively. Finally, dark circles became lighter within 7 days (instrumental measurement) or 28 days (clinical assessment). CONCLUSION: The instrumental and clinical evaluations revealed that the eye cream reduced all periorbital ageing signs evaluated. Its effects are supported by the in vitro and ex vivo analyses of molecular markers.

OBJECTIF: Les signes de vieillissement de la peau périorbitaire sont nombreux, très visibles et préoccupent de nombreuses personnes. Nous avons évalué l'efficacité potentielle d'une crème pour les yeux pour atténuer ces signes. MÉTHODES: Les marqueurs biologiques associés au vieillissement, à la fonction barrière et à l'homéostasie de la peau ont été analysés in vitro pour évaluer l'efficacité d'une crème pour les yeux appliquée localement. Ces effets ont été comparés à ceux d'un placebo, sur des modèles et/ou des explants de tissus cutanés humains. L'expression du collagène IV, de l'élastine et de la protéine morphogénique osseuse 4 (BMP4) a été étudiée par marquage immunohistochimique. Celle de la filaggrine, de la kallikréine 7 (KLK7), et du HB­EGF par RT­qPCR. Les niveaux d'IL­1α et de mélanine dans un modèle de peau pigmentée ont également été quantifiés. L'effet protecteur de la crème sur la glycation a été évalué par un test non enzymatique. Enfin, les bénéfices d'une application biquotidienne de la crème pour les yeux ont été évalués instrumentalement et cliniquement sur 33 femmes pendant 56 jours. RÉSULTATS: Seule la crème pour les yeux a stimulé l'expression du collagène IV et de BMP4 en comparaison avec le placebo. La crème est aussi la seule à augmenter la longueur des fibres d'élastine. Elle a également entraîné une augmentation des niveaux d'ARNm de HB­EGF, de la filaggrine et de KLK7. Le placebo et la crème pour les yeux n'ont pas modifié les niveaux d'IL­1α et de la mélanine, mais ont tous deux réduit la glycation non enzymatique. Lors de l'évaluation des effets in vivo, les résultats à court terme ont montré une amélioration de l'hydratation de la peau, de la Perte Insensible en Eau (PIE) et du profil de la peau en 15 min. Les évaluations instrumentales de la profondeur des rides ont indiqué une réduction après 7 jours d'application, réduction cliniquement perceptible après 28 ou 56 jours. La crème périorbitale induit également une amélioration de l'angle d'ouverture des yeux et de l'affaissement des paupières respectivement après 7 et 28 jours. Enfin, les cernes sont devenus plus clairs après 7 jours (mesure instrumentale) ou 28 jours (évaluation clinique). CONCLUSION: Les évaluations instrumentales et cliniques ont révélé que la crème pour les yeux réduisait tous les signes de vieillissement périorbitaires évalués. Ses effets sont confirmés par les analyses in vitro et ex vivo des marqueurs moléculaires.

Perception Toward Cosmetic Surgeries Among Adults in Saudi Arabia and Its Associated Factors: A Cross-Sectional Study.

OBJECTIVE: This study assessed the acceptance of cosmetic surgery among the Saudi population and examined its relationship with body dysmorphic disorder and the participants' demographic characteristics. METHODS: A cross-sectional study was conducted between June 2023 and February 2024. A sample of 1368 participants were recruited from hospitals, clinics, and public places such as malls, parks, and universities and were asked to complete a self-administered, pre-validated, and open-access questionnaire about the presence of body dysmorphic disorder using the BDD scale and the acceptance of cosmetic surgery using the ACSS scale, analyzed using IBM Corp. Released 2015. IBM SPSS Statistics for Windows, Version 23.0. Armonk, NY: IBM Corp. RESULTS: More than half of the participants were female, single, and had a higher educational level. Only 3.0% of the participants had previously undergone cosmetic surgery (CS). Rhinoplasty was the most common cosmetic surgery performed by both genders. More than half of the participants indicated that they had concerns about their appearance, which caused them distress, torment, or pain. However, only one-third of the participants demonstrated acceptance toward CS. There was a significant positive correlation between body dysmorphic disorders (BDD) and acceptance of the cosmetic surgery scale (ACSS). Moreover, higher significant acceptance for CS (p-value is <0.001) was observed in females, south region, 32- to 40-year-olds, postgraduate degrees of education, married persons, and those undergoing previous cosmetic surgery. CONCLUSION: Concerns about appearance causing distress were prevalent among participants, yet acceptance of cosmetic surgery was moderate. Individuals with higher levels of BDD symptoms are more inclined to view cosmetic surgery as a viable solution to their perceived concerns about their appearance. Moreover, being female, from the southern region, aged 32 to 40 years, with postgraduate education, married individuals, and having prior cosmetic surgery experience are motives to accept CS. These findings underscore the complex interplay between psychological factors and demographic characteristics in shaping the acceptance of cosmetic surgery.

From Cosmetic Surgery to Critical Care: Clinical Mimicry of Acute Respiratory Distress Syndrome Following Gluteal Augmentation Surgery.

Gluteal augmentation surgery, commonly known as the Brazilian Butt Lift (BBL), has become increasingly popular and is offered at numerous surgical centers. Typically performed on an outpatient basis, the procedure takes less than four hours, making it an appealing option for many patients. However, BBL is associated with multiple complications, some of which can be severe, resulting in high mortality rates. Most such post-operative adverse events necessitate urgent transfer to hospitals for optimal care, with post-operative respiratory distress being one such critical sign. Fat embolism syndrome (FES) is a notable complication of BBL. The diagnosis of FES is primarily clinical, supported by imaging studies such as chest X-rays and CT scans. FES often goes underdiagnosed due to the lack of definitive diagnostic criteria and its clinical and radiological similarities to other conditions. Despite its underdiagnosis, FES is reported in approximately 0.06% of patients undergoing BBL. Failure to diagnose it early can lead to complications from empiric treatment of other suspected conditions, potentially worsening the prognosis. Our patient developed respiratory failure within an hour after undergoing BBL. The time to symptom onset and the patient's agitation before the respiratory episode broadened the differential for her condition. This case report highlights the importance of recognizing FES and exploring potential preventive measures, including advancements in surgical techniques and prophylactic strategies.

Drains in Abdominoplasties: The Less the Better?

BACKGROUND: Drains are traditionally inserted during surgery for reduction of fluid accumulation in the post-operative period. The appearance of drained fluids and their quantity can be early predictors of complications. Over the years, several studies have been conducted in attempt to determine the optimal number of drains that result in low rates of fluid accumulation with minimal impairment of quality of life. PURPOSE: Determine the optimal number of suction drains in abdominoplasty procedures. METHODS: Retrospective cohort study, analyzing all abdominoplasty patients operated by a single surgeon. Patients were stratified into 3 groups based on number of drains inserted at the end of the procedure. Rate of complications was compared between the groups and a multivariate logistic regression model was computed for the development of complications. RESULTS: Seven-hundred and forty three patients were included in the analysis of this study. No drains were inserted in 355 patients (45%), whereas a single drain was inserted in 153 (20.6%) 2 drains in 255 patients (34.4%). Patients for whom a single drain was inserted intra-operatively, experienced at a statistically significant lower rate, surgical site infections (OR = 0.235), hypertrophic scars (OR = 0.326), wound dehiscence (OR = 0.272), as compared to patients with no drains. On the contrary, insertion of single drain was associated with a statistically significant higher risk for development of seroma (OR = 6.276) and the need for revision surgery (OR = 2.452). CONCLUSION: Insertion of a single drain is associated with a lower risk of SSI and wound- dehiscence, but a greater risk for seroma development that requires surgical intervention. LEVEL OF EVIDENCE II: 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.

Role of cosmetic camouflage in improving quality of life in dermatological disorders: A narrative review.

Camouflage is a system of techniques using cosmetics to conceal, diminish and disguise visible disfigurements of pigment or texture of skin mainly over visible areas. A wide variety of options are available which can be used as camouflage cosmetics. Over the years many authors have published studies highlighting the importance of camouflage in different dermatological disorders like pigmentary, vascular, scars, acne vulgaris and many more. In this review we present 15 such studies assessing QOL in patients of dermatological diseases who were given camouflage therapy. The evidence presented here gives us an insight into the positive effects of camouflage/cover up make up when offered to patients with different dermatological conditions.

Investigation of Mercury Contamination in Lipstick Sold in the Saudi Market and the Potential Health Risk.

Environmental contamination is a significant global health issue, with cosmetics and pharmaceuticals being major polluters. High concentrations of heavy metals, such as Hg, have been found to have toxic effects and may pose a threat to human health. This study aimed to determine the concentration of mercury (Hg) in lipsticks available in the Saudi Arabia market. In this study, 12 lipstick samples from three colours were analysed using inductively coupled plasmaoptical emission spectrometry (ICP-OES) to measure the content of Hg. The concentration range of Hg was 0.004-0.296 ppm. Moreover, the systemic exposure dosage of mercury in the lipstick samples examined in this study ranged from 5.01x10-8 to 1.43x10-6 µg/kg bw/day, while the range of the margin of safety was from 7.3 x 109 to 2.2 x 108.The Hg concentration in all analysed samples was less than 0.50 and 1 ppm, which indicated that the Hg level was within acceptable limits according to Saudi Standards, Metrology and Quality Organization (SASO) and the United States Food and Drug Administration (US FDA), respectively.On the other hand, the calculated margin of safety values for mercury exceeded the safe standard established by the WHO. The results derived from using hazard quotient (HQ) indices depict the potential carcinogenic health risk posed to consumers who employ red-coloured lipsticks.

SkinCom, a synthetic skin microbial community, enables reproducible investigations of the human skin microbiome.

Existing models of the human skin have aided our understanding of skin health and disease. However, they currently lack a microbial component, despite microbes' demonstrated connections to various skin diseases. Here, we present a robust, standardized model of the skin microbial community (SkinCom) to support in vitro and in vivo investigations. Our methods lead to the formation of an accurate, reproducible, and diverse community of aerobic and anaerobic bacteria. Subsequent testing of SkinCom on the dorsal skin of mice allowed for DNA and RNA recovery from both the applied SkinCom and the dorsal skin, highlighting its practicality for in vivo studies and -omics analyses. Furthermore, 66% of the responses to common cosmetic chemicals in vitro were in agreement with a human trial. Therefore, SkinCom represents a valuable, standardized tool for investigating microbe-metabolite interactions and facilitates the experimental design of in vivo studies targeting host-microbe relationships.

Pathological findings in enucleated eyes of patients with neurofibromatosis type 1: report of a case with 15-year follow-up and review of 14 patients in the literature.

BACKGROUNDS: Iris nodules are frequently noted as clinical manifestations of neurofibromatosis type 1 but the other intraocular manifestations are rare. The purpose of this study is to present a patient with a phthisic eye who underwent enucleation for a cosmetic reason after 15-year follow-up and also to review 14 patients with enucleation described in the literature. CASE PRESENTATION: A 17-year-old man with neurofibromatosis type 1 from infancy underwent the enucleation of phthisic left eye and also had the resection of eyelid subcutaneous mass lesions on the left side for a cosmetic reason. He had undergone four-time preceding surgeries for eyelid and orbital mass reduction on the left side in childhood and had developed total retinal detachment 10 years previously. Pathologically, the enucleated eye showed massive retinal gliosis positive for both S-100 and glial fibrillary acidic protein (GFAP) in the area with involvement of the detached retinal neuronal layer, together with a more fibrotic lesion along the choroid which were, in contrast, negative for both S-100 and GFAP. The choroid, ciliary body, and iris did not show apparent neurofibroma while episcleral neurofibroma was present. LITERATURE REVIEW: In review of enucleated eyes of 14 patients in the literature, buphthalmic eyes with early-onset glaucoma on the unilateral side was clinically diagnosed in 9 patients who frequently showed varying extent of hemifacial neurofibromatosis which involved the eyelid and orbit on the same side. Pathologically, neurofibromas in varying extent were found in the choroid of 12 patients. One patient showed choroidal malignant melanoma on the left side and fusiform enlargement of the optic nerve on the right side suspected of optic nerve glioma. The phthisic eye in another patient showed massive retinal gliosis similar to the present patient. CONCLUSIONS: In summary of the 15 patients with neurofibromatosis type 1, including the present patient, buphthalmic or phthisic eyes with no vision were enucleated for cosmetic reasons and showed choroidal neurofibroma in most patients and massive retinal gliosis in two patients including the present patient.

Genital Cosmetic Surgery in Women of Different Generations: A Qualitative Study.

BACKGROUND: Individuals from different generations are interacting more and more today, and while each generation exists with its own characteristics, this situation causes intergenerational differences in every issue in social life. Considering the characteristics of different generations, it is predicted that individuals' views on genital cosmetic surgery may differ. OBJECTIVE: This study was conducted to examine the views of women of different generations on genital cosmetic surgery and to determine their perspectives on genital cosmetic surgery. METHODS: The population of the study consists of women from different generations. The sample of the study was formed using typical case sampling from purposive sampling methods. Data saturation was reached by conducting qualitative interviews with 15 women by selecting the snowball sampling method. Data were collected using a semi-structured individual interview form, and data analysis was performed using MAXQDA 2020. RESULTS: The opinions of women of different generations about genital cosmetic surgery were analysed under four themes and 13 categories as "Perception of Beauty", "Perception of Health", "Perception of Society" and "Perception of Need". The opinions of women of different generations about genital cosmetic surgery differ. It is thought that these differences may be caused by factors such as psychosocial, economic, environment, media, technological developments and culture. 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 .