Why Do Patients Seek Cosmetic Procedures?

MedicalResearch.com Interview with:
Murad Alam, MD Vice-Chair and Professor of Dermatology Chief of Cutaneous and Aesthetic Surgery Northwestern University Feinberg School of MedicineMurad Alam, MD
Vice-Chair and Professor of Dermatology
Chief of Cutaneous and Aesthetic Surgery
Northwestern University
Feinberg School of Medicine

MedicalResearch.com: What is the background for this study?

Response: For the purposes of our study, non-invasive procedures included laser and light treatments (for brown spots, blood vessels, wrinkle reduction, scar treatment, hair removal), chemical peels, and non-surgical skin tightening and fat reduction (with radiofrequency energy, cold treatment, or ultrasound). These noninvasive treatments do not even break the skin, and are applied on top of the skin

Then we have minimally invasive procedures, which include those that just barely break the skin, but are like getting a shot, and don’t require cutting and sewing the skin as in traditional surgery. These minimally invasive procedures include filler and neuromodulator injections to fill out the sagging aging face while reducing lines and wrinkles, as well as liposuction through tiny openings to suck out excess fat. All of these procedures and many more are available but if you do want to have a cosmetic procedure then make sure you seek out a reputable cosmetic surgeon such as Lisa Rush.

In the old days, cosmetic treatments meant getting traditional plastic surgery, like a face lift or tummy tuck. These required general anesthesia, cutting and sewing the skin, significant risk of scarring, and days to weeks of recovery time. More recently, dermatologists have pioneered noninvasive and minimally invasive procedures, such as those I just described, which provide many of the same benefits as traditional plastic surgery without the risk, scars, and downtime, for example, somewhere like Rhinoplasty NYC talk about Rhinoplasties with noninvasive methods. Now these minimally invasive and noninvasive treatments have become more popular than traditional cosmetic surgery. Continue reading

Study Finds SculpSure Can Reduce Fat Under Chin

MedicalResearch.com Interview with:
David H. McDaniel
David H. McDaniel, MD is Board Certified by the American Board of Dermatology. He is a Co-Director of the Hampton University Skin of Color Research Institute, Adjunct Professor in the School of Science, Hampton University. 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The study was designed to evaluate at multiple sites the effects on submental fat of a 1060nm diode laser treatment which was already FDA cleared for non-invasive lipolysis of the abdomen, flanks, back, inner and outer thighs. A total of 19 volunteers were treated at our study site with typically two 25 minute treatments.  There was a 12 week follow-up period after treatment and photography (both 2D and 3D) was used to evaluate with expert physician grader along with other 3D analytics and a subject satisfaction questionnaire.

The main findings were reduction in submental fat both from the expert grader and as well as the 3D metrics.  The 3D metrics also showed a lifting effect.  The study volunteers reported a ‘satisfied’ or ‘extremely satisfied’ score from the subject assessments.

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Facial Fillers Carry Rare But Significant Side Effects and Risks

MedicalResearch.com Interview with:

Boris Paskhover, MD Rutgers New Jersey Medical School Adjunct Instructor,Department of Otolaryngology-Head and Neck Surgery NYU Langone Medical Center

Dr. Paskhover

Boris Paskhover, MD
Associate Professor,Department of Otolaryngology-Head and Neck Surgery
Rutgers New Jersey Medical School

MedicalResearch.com: What is the background for this study? What are the main findings?

Response:  Facial fillers include a wide range of cosmetic products used by physicians for augmenting the face. Some fillers are permanent, while others are temporary. Lip filler material is included in this category. Any physician is allowed to perform these procedures but patient’s need to be aware that these are not benign procedures and have some serious complications. It’s important to always go to an experienced facial plastic surgeon, general plastic surgeon or possibly dermatologist for your aesthetic fillers. Our study detailed a decade-long review of FDA reported complications with aesthetic fillers. Continue reading

Selfies Distort Your Face and Make Your Nose Look Bigger

MedicalResearch.com Interview with:

Boris Paskhover, MD Rutgers New Jersey Medical School Adjunct Instructor,Department of Otolaryngology-Head and Neck Surgery NYU Langone Medical Center

Dr. Paskhover

Boris Paskhover, MD
Rutgers New Jersey Medical School
Adjunct Instructor,Department of Otolaryngology-Head and Neck Surgery
NYU Langone Medical Center

MedicalResearch.com: What is the background for this study?

Response: Patient’s and the general public routinely mention that their nose appears large, especially when they look at photos taken with their phone. I realized that patients in general are taking selfies more often nowadays. In my training, we routinely would tell patient’s not to use selfies as a marker of how they look, and we instead would take a 5ft distance photograph since we knew that is more realistic. I looked through the medical literature, and it appeared to me that no one had thoroughly discussed why selfies are a bad when evaluating the nose. I contacted a colleague at Stanford who has a PhD with interest in computer graphics and we developed a model for the face/nose.

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With or Without Reconstruction, Hard To Predict How You Will Feel After Mastectomy

MedicalResearch.com Interview with:
Dr. Clara Nan-hi Lee, MD Comprehensive Cancer Center The Ohio State UniversityDr. Clara Nan-hi Lee, MD
Comprehensive Cancer Center
The Ohio State University 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The decision about breast reconstruction is very challenging because it’s unfamiliar, involves complex risk information, affects very personal concerns, and happens at a stressful time. One of the challenges is to predict how one will feel after the surgery. We know from psychology research that people often mis-predict their future emotions. So we were interested to see how well women predict their future well being after surgery.

The main findings are that patients having mastectomy without reconstruction believed they would be less satisfied than they turned out to be. And patients having mastectomy with reconstruction believed they would be more satisfied than they turned out to be. Continue reading

No Clear Guidelines To Manage Pain After Surgical Procedures

MedicalResearch.com Interview with:
“Surgery” by mrpbps is licensed under CC BY 2.0
Sagar Patel MD
Facial Plastic Surgeon
Board Certified Otolaryngology, Head and Neck Surgeon
Facial Plastic Surgery Associates, Houston, Texas

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: While the majority of diverted opioids that are abused originate from pills prescribed for chronic conditions, with 214,000 rhinoplasties performed in the US in 2015, assessing opioid usage after rhinoplasty is an important view into prescription practices for acute pain after surgical procedures. Opioid use, pain control, and adverse effects were examined and opioid use was compared across patient demographic and surgical procedure characteristics, including rhinoplasty and septoplasty, open vs closed techniques, revision vs primary operations, reduction of turbinates, and use of osteotomies. Opioid use was self-reported as the number of prescribed tablets containing a combination of hydrocodone bitartrate (5 mg) and acetaminophen (325 mg) that were consumed. We them mathematically analyzed.

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Study Compares Three Types of Botulinum Injections For Involuntary Facial Movements

MedicalResearch.com Interview with:

P. Daniel Ward, MD, MS, FACS Facial Plastic Surgeon WardMD Form Medical SpaAdjunct Associate Professor, University of Utah School of Medicine Salt Lake City, Utah 84121

Dr. Ward

P. Daniel Ward, MD, MS, FACS
Facial Plastic Surgeon
WardMD Form Medical SpaAdjunct Associate Professor, University of Utah School of Medicine
Salt Lake City, Utah 84121

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: As a facial plastic surgeon with an interest in finding treatments for patients with facial paralysis, we are always looking for ways to improve the care that our patients receive. One of those treatments is to treat the effects of abnormal and asymmetric facial motion with botulinum, which decreases the deformity that results from facial nerve disorders by decreasing muscular hyperactivity.

This study was based on the fact that there are three commercially available types of botulinum available for treatment of the face. There have been studies that have compared the different types of botulinum for cosmetic purposes, but there have not been any studies that specifically looked to see if there were any differences between the different types of botulinum when used for treatment of facial nerve disorders.

The main finding of the study is that the three different types of botulinum are essentially equivalent with the exception being that one type of botulinum, incobotulinum toxin, was slightly less effective than the other two types of botulinum at the 4-week follow up point. Of note, all three types were equivalent at all other time points.

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Determining the 2-Dimensional Threshold for Perception of Artificial-Appearing Lips

MedicalResearch.com Interview with:

Sang W. Kim, MD Diplomate, American Board of Facial Plastic and Reconstructive Surgery Diplomate, American Board of Otolaryngology - Head and Neck Surgery Natural Face Clinics East Syracuse, NY

Dr. Sang W. Kim

Sang W. Kim, MD
Diplomate, American Board of Facial Plastic and Reconstructive Surgery
Diplomate, American Board of Otolaryngology – Head and Neck Surgery
Natural Face Clinics
East Syracuse, NY

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: There are extensive volume of studies and descriptions in literature describing ideal proportions and measurement of facial features, objective measurements for what constitute “artificial” and “overdone” facial appearance have not been studied extensively.

But as elective and cosmetic treatment for face become more mainstream and push its limits, we felt it is important to investigate objective measurement to determine when certain facial features appear to be “artificial” and “overdone”.

We decided to study the lips because compared to other features of the face, it is more practical to translate in 2-dimension and alter objective measurements such as the height of the lips or the shapes of the curvature.

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Laypeople Perceive Facelift To Give More Youthful, Healthier Appearance

MedicalResearch.com Interview with:
Lisa E. Ishii, MD, MHS
Associate Professor of Otolaryngology – Head and Neck Surgery
John Hopkins Medicine

Lisa Earnest Ishii, M.D. Associate Professor of Otolaryngology - Head and Neck Surgery Johns Hopkins Medicine

Dr. Ishii

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: There was a gap in our knowledge about what the average lay person thought about the impact of a facelift. We had information about what experts in the field like Dr. Swail thought, and some about what patients themselves thought, but nothing about lay people.
Patients who choose to have a facelift are typically concerned about the opinions of:

1) Themselves when they look in the mirror, and

2) Laypeople they encounter socially in society.

Our study showed for the first time that laypeople find people who have had a facelift to appear more attractive, more youthful, healthier and more successful than they were before their facelift.

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Plastic Surgeons Define Ideal Female Lip Dimensions

MedicalResearch.com Interview with:

Brian J. F. Wong, MD, PhD Division of Facial Plastic and Reconstructive Surgery Department of Otolaryngology–Head and Neck Surgery Beckman Laser Institute and Medical Clinic Department of Biomedical Engineering University of California, Irvine

Dr. Brian Wong

Brian J. F. Wong, MD, PhD
Division of Facial Plastic and Reconstructive Surgery
Department of Otolaryngology–Head and Neck Surgery
Beckman Laser Institute and Medical Clinic
Department of Biomedical Engineering
University of California, Irvine

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Research in facial attractiveness is difficult because of the inherent subjectivity of rating. Most people can look at a face and instinctively tell you whether that face is attractive or not, by subconsciously picking up on biologic cues like fertility, coloration, and proportions.

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Technical and Clinical Considerations for Facial Feminization Surgery

MedicalResearch.com Interview with:
Raúl J. Bellinga, MD, FEBOMS

FACIALTEAM Surgical Group, Marbella High Care International Hospital, Marbella, Málaga, Spain

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Feminization rhinoplasty is one of the most common and important procedures in Facial Feminization Surgery. In this study our surgical group has evaluated 200 consecutive feminization rhinoplasties in male to female transgender patients, paying special attention to the frontonasal angle and nasolabial angle. The degree of satisfaction was much better using the Nose Feminization Scale (4 of 5 points).

MedicalResearch.com: What should readers take away from your report?

Response: As the nose plays a crucial role in facial aesthetics, feminization rhinoplasty in combination with the forehead reconstruction is key to modify the gender identity or recognition.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: It is important to create protocolized guidelines of treatment for people diagnosed of gender dysphoria. Surgical reassignment of facial gender or Facial Feminization Surgery must be considered as a vital part of the transitioning process in combination with hormonal treatment and Sex Reasignment Surgery (SRS).

MedicalResearch.com: Is there anything else you would like to add?

Response: Many negative stereotypes and prejudices exist with regard to this group and, in general, transgender people are met with an attitude that is frivolous or whimsical and ignores the true underlying question of gender identity. Trans people want to be recognized for themselves, to have the gender identity they identify with be accepted, and to fulfill a social role in the gender they feel, not the sex assigned to them at birth. For this reason, Facial Feminization Surgery must be considered as an essential part in this process. Fortunately, political and legislative steps are beginning to be taken, although substantial progress needs to be made before full social acceptance is reached. 

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

Bellinga RJ, Capitán L, Simon D, Tenório T. Technical and Clinical Considerations for Facial Feminization Surgery With Rhinoplasty and Related Procedures. JAMA Facial Plast Surg. Published online December 15, 2016. doi:10.1001/jamafacial.2016.1572

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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About 3% of Rhinoplasty Surgeries Require Revision

MedicalResearch.com Interview with:

Shaun C. Desai, MD Assistant Professor Facial Plastic and Reconstructive Surgery Department of Otolaryngology - Head & Neck Surgery Johns Hopkins University School of Medicine

Dr. Shaun Desai

Shaun C. Desai, MD
Assistant Professor
Facial Plastic and Reconstructive Surgery
Department of Otolaryngology – Head & Neck Surgery
Johns Hopkins University School of Medicine

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Desai: Estimates of the rate of revision septorhinoplasty and the risk factors associated with revision are unknown because the current published literature is limited to small, retrospective, single-surgeon studies with limited follow-up time. The purpose of this study is to determine the overall revision rates of patients undergoing a septorhinoplasty procedure (for functional or cosmetic reasons) and to determine risk factors for the revision. We found that the overall revision rate was 3.3% (5,775 patients of a total of 175,842 patients undergoing the procedure) with an average time to revision at 1 year. Risk factors for revision surgery included female gender, younger age, a history of anxiety or autoimmune disease, cosmetic indications, and more complicated initial surgery (i.e. cleft rhinoplasty).

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NYU Plastic Surgeon Discusses Science and Art of Breast Reconstruction Surgery

Mihye Choi, M.D., F.A.C.S. Associate Professor of Surgery NYU Plastic Surgery NYU Langone Medical CenteMedicalResearch.com Interview with:
Mihye Choi, M.D., F.A.C.S.
Associate Professor of Surgery
NYU Plastic Surgery
NYU Langone Medical Center

Medical Research: Would you tell us a little about yourself and your interests in plastic surgery?
Dr. Choi: I wanted to be a surgeon first, then I fell in love with plastic surgery after seeing a cleft lip repair as a medical student.  It was amazing to watch the ingenuity of the design and the skills needed to repair a baby’s face.  I felt that it was the highest gift a doctor can bestow, so that a child can go forward with life in confidence and all the promise that life holds.  After finishing plastic surgery training, I developed expertise in breast reconstruction over the years.  I feel breast reconstruction combines the science and art of surgery.

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3-D Imaging Allows Better Surgical Planning

Nolan S. Karp, MD Associate Professor, Hansjorg Wyss Department of Plastic Surgery NYU Langone

Dr. Nolan S. Karp

MedicalResearch.com Interview with:
Nolan S. Karp, MD 
Associate Professor, Hansjorg Wyss Department of Plastic Surgery
NYU Langone

Medical Research: What is the background for Three-dimensional imaging?

Dr. Karp: This was really developed for industry in product engineering.  We and others applied this to medicine.

Medical Research: What kind of technology is required?

Dr. Karp: This is a fancy picture.  We obtain a 3D surface scan of the person or an object, which corresponds to a digital data set.

Medical Research: How does Three-dimensional imaging help the physician and patient plan for better surgical outcomes?

Dr. Karp: It lets you simulate the surgery.  For the surgeon, we can plan the surgery better.  For the patient, they can see the expected outcome better, before surgery.

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Which Breast Is Best For Reconstruction? Autologous or Implant?

Dr. Y. Eltahir University Medical Centre Groningen Department of Plastic Surgery Groningen, The NetherlandsMedicalResearch.com Interview with:
Dr. Y. Eltahir
University Medical Centre Groningen
Department of Plastic Surgery
Groningen, The Netherlands

Medical Research: What is the background for this study? What are the main findings?

Dr. Eltahir: There are different options for breast reconstruction. They are divided into two main groups; autologous or implant breast reconstructions. all may have their effect on the quality of life and might have surgical complications. We were interested to know which breast reconstruction method may provide a better quality of life. However, we wanted to know this information from the patients point of view, that’s why we used the Breast-Q which is a case specific instrument, to compare the two groups.

We found out that women with autologous breast reconstruction were more satisfied their breast than the implant group. However, this group has more secondary corrections than the control group. Further were no differences between the two groups.

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Sculptra Injections: More Lumps If Patients Massage Skin

Dr. Tanveer Janjua MD Janjua Facial Surgery, Bedminster, New JerseyMedicalResearch.com Interview with:
Dr. Tanveer Janjua MD

Janjua Facial Surgery,
Bedminster, New Jersey

Medical Research: What is the background for this study? What are the main findings?

Dr. Janjua: This study was conducted to determine if massage plays an important role in the prevention of lumps and nodules that can occur after injection of PLLA (Poly-L Lactic Acid), i.e., Sculptra. The study revealed a higher incidence of lump formation in patients who massaged. This goes against the commonly held belief that massage is critical in after care of Sculptra injections.

Medical Research: What should clinicians and patients take away from your report?

Dr. Janjua: The clinicians should continue to address all factors that play a role in lump formation after Sculptra injections, namely the technique and dilution of the product and not just rely on massage to prevent nodule formation.

The patients should understand that risk of nodules is inherent to the injection of Sculptra and massage alone will not prevent lump formation. They need to seek physician injectors with significant experience with Sculptra to minimize their risk.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Janjua: It will be very helpful to have a future prospective study that looks at increased levels of dilution of up to 20ml per injection and compare it with smaller dilution of 8ml. It will also be helpful to look into possibly prolonged pre-hydration at the time of manufacturing the product.

Citation:

Role of Massage in Preventing Formation of Papules and Nodules After Injecting Poly-L-Lactic Acid

Janjua TA. Role of Massage in Preventing Formation of Papules and Nodules After Injecting Poly-L-Lactic Acid. JAMA Facial Plast Surg. 2014;16(6):457. doi:10.1001/jamafacial.2014.1173.

 

New Plastic Surgery Approach Allows For Total Face Rejuvenation

Achih H. Chen, MD, FACS, FAACS Georgia Center for Facial Plastic Surgery, Evans, Ga and the Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology–Head and Neck Surgery Georgia Regents University, August, GaMedicalResearch.com Interview with:
Achih H. Chen, MD, FACS, FAACS
Georgia Center for Facial Plastic Surgery, Evans, Ga and the Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology–Head and Neck Surgery
Georgia Regents University, August, Ga

Medical Research: What is the significance of the study?

Dr. Chen : This is the first time that facial rejuvenation surgery using surgical approaches in three planes combined with ablative resurfacing has been reported in the medical literature. This approach was not previously thought possible in a single surgical setting because of the concern about disrupting the facial blood supply that may result in loss of the skin. The study demonstrates the safety of this “Total Face” approach. This approach allows simultaneous tightening of the jawline and neck, recreating the lost youthful volume of the midface region, and restoring of the smooth skin texture so characteristic of a young face. This allows for a more complete or “Total Face Rejuvenation” for patients while allowing them the flexibility for a single recovery period or downtime.
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