The latest medical research on Cosmetic Surgery
The research magnet gathers the latest research from around the web, based on your specialty area. Below you will find a sample of some of the most recent articles from reputable medical journals about cosmetic surgery gathered by our medical AI research bot.
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Volumetric Assessment of the Anterior Digastric Muscles: A Deeper Understanding of the Volumetric Changes With Aging.Aesthetic Surgery Journal
Recently we have seen an expanding practice of targeting the deeper, subplatysmal structures in the neck. In particular, interventions targeting the "bulky" anterior digastric (AD) muscle have been described with excellent results. However, much remains to be understood about the deep anatomy of the neck and the age-associated changes of the AD.
To examine the relationship between AD volume and age.
This retrospective study calculated the AD volume utilizing MRI segmentation in subjects between the ages of 20-92 with prior MRIs. Those with compromised imaging due to pathology or artifact were excluded. Subjects were divided into four age-defined cohorts for clinical applicability.
This study included 129 patients (male n=64) with a mean age of 52.3. The AD volume of the reference group was 3.2 cm3. A linear decrease in muscle volume was observed with age compared to the reference group: age 45-54 cohort, 2.95 cm3 (p=.3), 55-64 cohort, 2.7 cm3 (p=.05) and >65 cohort, 2.45 cm3 (p<0.001). Male sex (p=.0001) and laterality (p=.003) were associated with significantly larger volumes. Overweight and obese BMI classification was not associated with a significantly different volume than normal or underweight subjects (p=.067).
Our findings suggest an age-associated reduction in AD volume. Gender and laterality significantly affected volume, while BMI did not. While our results do not support the theory of muscular hypertrophy with aging, they reveal that the perceived bulkiness may be due to changes in the surrounding anatomy affecting the morphology of the AD and subsequent blunting of the cervicomental angle.
Enhancing Patient Outcomes in Aesthetic Breast Implant Procedures Using Proven Antimicrobial Breast Pocket Irrigations: A 20 Year Follow-up.Aesthetic Surgery Journal
Capsular contracture (CC) remains the most common complication of implant based aesthetic and reconstructive breast surgery. With subclinical infection being proven to be the primary etiology, antimicrobial breast pocket irrigation has been recommended as the key step to reduce this complication. Despite the data of well proven of anti-microbial breast pocket irrigations, there exists a lack of universal adoption.
The purpose of this study is to perform a review of CC rates using previously described and proven anti-microbial breast pocket irrigations.
Data from patients undergoing cosmetic breast augmentation were recorded prospectively from 1997-2017. The irrigation solutions used was either the betadine containing (50% betadine or "betadine triple") or non-betadine triple antibiotic regimen. The database was assessed to determine the type of implant used, the incidence of CC, and possible contributing factors. The degree of CC was recorded as per Baker classification.
A 20 year prospective data collection yielded 2088 patients with 4176 implants. 826 patients had textured implants and 1262 patients had smooth implants. The rate of grade III/IV CC was found to be 0.57% in all patients undergoing primary breast augmentation. The incidence was found to be 1.21% in textured implants and 0.16% in smooth implants.
This study constitutes the largest and longest review of CC in a controlled, single surgeon setting. The low incidence of CC is low and reinforces the efficacy/utility of anti-microbial breast pocket irrigation. Both the betadine and non-betadine antibiotic regimens were found to be effective, with our preference being the betadine regimen. Universal adoption of betadine containing anti-microbial breast pocket irrigation is recommended to reduce CC and other device-associated infection.
Men's Experiences and Psychological Outcomes of Nonsurgical Medical Penile Girth Augmentation: A Preliminary Prospective Study.Aesthetic Surgery Journal
The popularity of penile augmentation procedures is increasing, but investigation into men's experiences with these procedures and impacts on psychological well-being is lacking.
To investigate men's experiences with non-surgical medical penile girth augmentation and the impacts these procedures have on their psychological well-being using valid psychological measures.
Men seeking to undergo a girth augmentation (n = 19) completed an online questionnaire prior to their procedure and 6 months later containing standardized measures assessing impacts of the procedure, penile size self-discrepancy, body dysmorphic disorder (BDD), psychological distress, self-esteem, and body image related quality of life. Girth size was also measured pre- and 6 months post-procedure for a sub-sample of men.
Almost half of the men reported the positive impacts of "increased self-confidence" and "increased sexual pleasure" after their procedure. Despite a girth increase of 3.29 cm, on average, the men still perceived that their penile girth and length was smaller than what they should be or the ideal size after their augmentation procedure. However, this perceived discrepancy was significantly smaller than before their procedures. Prior to the procedure, the men who met diagnostic criteria for BDD according to self-reported questionnaire (11%, n = 2/19) and clinical interview (7%, n = 1/15) lost this diagnosis at 6 months. There were no changes in psychological distress, self-esteem or body image related quality of life from pre- to post-procedure.
Men report positive impacts on their lives after penile girth augmentation, but impacts on broader psychological well-being are mixed.
Intradermal Botulinum Toxin A Injection for Scalp Sebum Secretion Regulation: A Multicenter, Randomized, Double-Blinded, Placebo-Controlled, Prospective Study in Chinese Subjects.Aesthetic Surgery Journal
Although botulinum toxin type A (BTX-A) injection has been proved to reduce topical sebum secretion, the impact of intradermal BTX-A injection on scalp sebum production has never been reported.
The purpose of this study was to investigate the efficacy and safety of intradermal BTX-A treatment for scalp sebum secretion regulation, in comparison with intradermal normal saline (NS) injection.
This multi-center, randomized, double-blinded, prospective study recruited patients complaining of oily scalp and/or hair. The patients were randomized to either one session of intradermal BTX-A or NS injection. The baseline and post-treatment scalp sebum secretion on 24-, 48-, 72-, and 96-hours post-shampooing was measured using the Sebumeter SM815 (Cutometer dual MPA 580, Courage & Khazaka, Cologne, Germany). on 1, 3, 4, and 6 months after the treatment. The patients' comments, satisfaction, and adverse events (AEs) were evaluated and compared.
Twenty-five and 24 patients in the BTX-A group and NS group completed the follow-up, respectively. For the treated region, compared with NS, intradermal 50-65 U BTX-A treatment significantly reduced the scalp sebum secretion on 24-, 48-, and 72-hours post-shampooing on the 1- and 3-month follow-up visits (P < 0.05). No significant difference between the two groups was observed on 4 and 6 months after the treatment. The patients' satisfaction ratings were significantly higher for the BTX-A treatment (P = 0.000). No serious AEs occurred.
Compared with NS, one session of intradermal 50-65 U BTX-A injection effectively and safely reduced scalp sebum secretion and greasiness perception in the treated region on 24 and 48 hours post-shampooing for 3 months.
CD30 Regulation of IL-13-STAT6 Pathway in Breast Implant Associated Anaplastic Large Cell Lymphoma.Aesthetic Surgery Journal
Breast implant associated anaplastic large cell lymphoma (BIA-ALCL) is a rare usually indolent CD30+ T cell lymphoma with tumor cells, often surrounded by eosinophils, expressing IL-13 and pSTAT6.
To understand the unique tumor pathology and growth regulation of BIA-ALCL leading to potential targeted therapies.
We silenced CD30 and analyzed its effect on IL-13 signaling and tumor cell viability. IL-13 signaling receptors of BIA-ALCL cell lines were evaluated by flow cytometry and pSTAT6 detected by immunohistochemistry. CD30 was deleted by CRISPR/Cas9 editing. Effects of CD30 deletion on transcription of IL-13, IL-4, and phosphorylation of STAT6 were determined by RT-PCR and Western blotting. The effect of CD30 deletion on p38 MAPK phosphorylation was determined. Suppression of IL-13 transcription by a p38 MAPK inhibitor was tested. Tumor cell viability following CD30 deletion and treatment with a pSTAT6 inhibitor were measured in cytotoxicity assays.
BIA-ALCL lines TLBR1 and TLBR2 displayed signaling receptors IL-4Rα, IL-13Rα1 and downstream pSTAT6. Deletion of CD30 by CRISPR/Cas9 editing significantly decreased transcription of IL-13, less so Th2 cytokine IL-4, and phosphorylation of STAT6. Mechanistically, we found CD30 expression is required for p38 MAPK phosphorylation and activation, and IL-13- STAT6 signaling was reduced by an inhibitor of p38 MAPK in BIA-ALCL tumor cells. Tumor cell viability was decreased by silencing of CD30, and a specific inhibitor of STAT6, indicating STAT6 inhibition is cytotoxic to BIA-ALCL tumor cells.
These findings suggest reagents targeting the IL-13 pathway, pSTAT6 and p38 MAPK may become useful for treating BIA-ALCL patients.
Practical Guidelines for Managing Patients With Hidradenitis Suppurativa: An Update.Journal of Cutaneous Pathology
Hidradenitis suppurativa (HS) is a chronic, inflammatory skin disease that is characterized by the formation of comedones, papules, nodules, absces...
Draping in Dermatology: A Patient's Perspective.Journal of Cutaneous Pathology
Patient dignity is a core component of the Canadian health care system; however, there may be challenges to maintaining patient dignity in clinical settings requiring total body skin examination (TBSE) for adequate assessment and diagnosis. As standardized TBSE draping practices have not been investigated in a dermatology setting, we sought out to investigate subjective patient experiences of draping practices.
A cross-sectional study was performed using a paper survey in dermatology hospital clinics over a 6-month period to 150 patients.
Draping was considered important by over 50% of patients surveyed (54.7%). Respondents who indicated that draping impacted their comfort level "a lot" or "very much" had a mean age of 52 and were more likely to be females (P < .05). Females were also more likely to answer that their body weight/shape (P < .05), physician of same (P < .01) or opposite sex (P < .001), and the degree of privacy offered by drapes (P < .001) impacted their comfort level when undressing for a TBSE. Respondents who reported that any assessed factor impacted their comfort during a TBSE were also younger (P < .05), suggesting that younger and female patients were more likely to have comfort concerns than males.
Our study confirmed that most patients surveyed considered draping to be important. Our findings highlight the importance of adequate draping practices to maintain patient privacy and dignity for all patients, with special attention to younger female patients to ensure they feel as comfortable as possible. Future research should focus on how these identified patient comfort factors can be implemented into medical education.
The Social and Psychological Impact of Acne Treatment: A Cross-Sectional Study of Blood Donors.Journal of Cutaneous Pathology
Acne in adolescence and adulthood is believed to have a long-term impact on socioeconomic status (SES) and health-related quality-of-life (HRQoL) in adults.
To estimate the cross-sectional prevalence of medically treated (MedTreAc) and untreated acne (UnTreAc) and to characterize its long-term impact in adults.
A nationwide cross-sectional study on 17 428 blood donors aged 18-35 was performed. Associations among acne and HRQoL, depressive symptoms, total income, and SES were investigated via linear/logistic/multinomial logistic regression analyses adjusted for relevant covariables. HRQoL was measured by the Short Form-12, and depressive symptoms by the Major Depression Inventory. The data were self-reported.
Of the participants, 3591 (20.6%) and 1354 (7.8%) identified as the MedTreAc and UnTreAc phenotype, respectively. Neither phenotype was associated with a long-term impact on total income, but the MedTreAc group was associated with being an apprentice/student (OR = 1.26; 95% CI: 1.12, 1.42; P = 1.3×10-4) or high skill-level employee (OR = 1.22, 95% CI: 1.07; 1.39, P = .0023), while self-employment was more common for those with UnTreAc (OR = 1.53; 95% CI: 1.12, 2.06, P = .0061). Additionally, the UnTreAc group was associated with a lower mental HRQoL (SF-12 mental component summary score -1.05, 95% CI: -1.56, -0.54; P = 1.4×10-9) and increased odds ratio of depressive symptoms (OR = 1.44; 95% CI: 1.00, 2.02, P = .046).
In this population of blood donors, the cumulative prevalence of MedTreAc and UnTreAc were 20.6% and 7.8%, respectively. Untreated acne had a long-term impact on psychosocial well-being in adulthood. It was associated with lower mental HRQoL and higher occurrence of depressive symptoms. Acne was not associated with a lower salary or SES.
Microbes, Histology, Blood Analysis, Enterotoxins, and Cytokines: Findings From the ASERF Systemic Symptoms in Women-Biospecimen Analysis Study: Part 3.Aesthetic Surgery Journal
There has been an increasing need to acquire rigorous scientific data to answer the concerns of physicians, patients, and the FDA regarding the self-reported illness identified as Breast Implant Illness (BII). There are no diagnostic tests or specific laboratory values to explain the reported systemic symptoms described by these patients.
This study aims to determine if there are quantifiable laboratory findings that can be identified in the blood, capsule tissue pathology, or microbes that differentiate women with systemic symptoms they attribute to their implants from two control groups.
A prospective blinded study enrolled 150 subjects into three cohorts: (A) women with systemic symptoms they attribute to implants who requested implant removal, (B) women with breast implants requesting removal or exchange who did not have symptoms attributed to implants, and (C) women undergoing cosmetic mastopexy who have never had any implanted medical device. Capsule tissue underwent detailed analysis and blood was sent from all three cohorts to evaluate for markers of inflammation.
No significant histologic differences were identified between the cohorts except there were more capsules with synovial metaplasia in the Non-BII Cohort. There was no statistical difference in TSH, Vitamin D levels, or CBC with differential between the cohorts. Next Generation Sequencing (NGS) revealed no statistically significant difference in positivity between Cohort A and B. Of the 12 cytokines measured, 3 cytokines, IL-17A, IL-13 and IL-22 were found to be significantly more often elevated in sera of subjects in Cohort A than in Cohorts B or C. The enterotoxins data demonstrated an elevation in IgG a-SEA in Cohort A. There was no correlation between the presence of IgE or IgG anti Staph antibody and a positive NGS result.
This study adds to the current literature by demonstrating few identifiable biomedical markers to explain the systemic symptoms self-reported by patients with BII.
Fat Juice: A Novel Approach on the Usage and Preparation of Adipose Tissue Byproducts.Aesthetic Surgery Journal
The adipose tissue is considered to be naturally rich in a range of bioactive substances that may be extracted directly for therapeutic use without the need for cell isolation or culture.
To introduce a novel approach of using stromal vascular fraction (SVF) in conjunction with fat extract (FE), termed the "fat juice," via comprehensive biochemical analysis in relation to potential clinical relevance of this new combination.
A total of 11 samples were analyzed in terms of quantity and viability of stem cell, presence and quantification of connective tissue fibers on histopathological examination and interleukin-6 (IL-6), mannose receptor C-type 1 (MRC 1), and vascular endothelial growth factor (VEGF) levels via enzyme linked immunosorbent assay (ELISA) method.
Total stem cell amount ranged from 0.14 to 1.31 × 10^5, while cell viability rates varied between 20 to 67.9%. IL-6 protein and VEGF expressions were highest in sample 3, while staining intensity was highest in sample 4. For collagen-I, collagen-III and elastin, highest expressions were observed in samples 4 and 8, in sample 3 and in samples 2 and 4, respectively.
Our findings revealed the potential utility of fat juice in skin rejuvenation and regeneration due to the combined properties of the SVF and FE. Fat juice mixture is an easy to inject concentration of adipocyte/preadipocytes, red blood cells, adipose-derived stem cells, endothelial-derived cells and cell residues. Prepared through an easy isolation process enabling abundant availability, fat juice seems to be an effective skin quality enhancer with a potential of widespread use in the fields of plastic surgery, dermatology and aesthetic/regenerative medicine.
Deep Subcutaneous Gluteal Fat Compartments: Anatomy and Clinical Implications.Aesthetic Surgery Journal
Advances in gluteal fat grafting have improved our understanding of the regional anatomy and technical nuances to diminish risk. To date, there are no anatomical studies identifying presence or absence of buttock fat compartments.
The authors performed a cadaveric study to identify and characterize the deep subcutaneous gluteal fat compartments to further our understanding of the nuanced differences between the deep subcutaneous and the superficial subcutaneous fat layers.
A cadaveric study was performed to identify the fat compartments. Iliac artery and vein latex injection prepared 4 fresh (N = 8 hemibuttock) hydrated cadaver dissections. Preliminary work identified the likely position of deep gluteal fat compartments. The cannula was positioned under ultrasound guidance in between the superficial and deep gluteal. Cadaveric buttocks were infiltrated using the static (SIME) technique with dyed human fat, dyed apple sauce, and dyed saline in an attempt to identify the gluteal deep subcutaneous fat compartments.
Dissection identified and characterized 7 discrete deep gluteal fat compartments. These include 3 medial fat compartments (superior, middle, and inferior); a central fat compartment; and 3 lateral (superior, middle, and inferior) deep fat compartments.
We present our findings of 7 deep gluteal fat compartments that have distinct boundaries and maintain injected contents separate from each other above the gluteal muscle fascia. These compartments can be selectively expanded for buttock augmentation. Knowledge of these compartments enables surgeons to perform gluteal augmentation using static infiltration, under ultrasound guidance in the deep subcutaneous fat layer using autologous fat, while optimizing aesthetic considerations.
Restoration Liposuction of the Abdomen: High-definition Liposuction With Umbilicus and Lower Abdomen Improvement Using PDO Threads.Aesthetic Surgery Journal
Abdominal high-definition liposuction has been practiced for many years. However, problems such as low-lying, "sad-looking" umbilici and lower abdominal "pooches" remain unresolved. Additionally, waistline, as the pivotal point connecting the chest and hips, deserves more attention and improvement.
Using PDO threads after liposuction: 1) to improve the shape and position of the umbilicus permanently; 2) to tighten the lower abdomen permanently; 3) to redefine "High-Definition" liposuction.
All patients had high-definition liposuction of the abdomen and waist. After liposuction, bi-directional, barbed PDO threads were placed in the upper central abdomen. The threads were pulled to cinch the upper abdominal skin and then tied. The resulting umbilicus elevation was measured up to 12-month. Higher waistlines were also created to match higher-positioned umbilici.
Fifty-two female subjects were included. The range of umbilicus elevation was 0.8 to 3.6 cm at 12 months. Most umbilici were converted to vertical orientation, and the lower abdomens became lengthened, flattened, and tightened. Moreover, the enhanced waistlines and body curves created better body proportions.
This technique uses barbed PDO threads to engage the upper abdominal skin after high-definition liposuction, causing the tissues to heal at an elevated level. The effect is permanent elevation and shape enhancement of both umbilicus and lower abdomen. Further, because the umbilicus is raised, a higher waistline could be created without any discordance, making the lower limbs appear longer. Together, all the maneuvers contributed to the restoration/rejuvenation of the abdomen and better overall body shape and proportion.