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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Complications and Risks Associated with the Different Types of Abdominoplasties: An Analysis of 55,956 Patients.

Aesthetic Surgery Journal

Different types of abdominoplasties have been developed to address individual patient characteristics. However, complication rates and risk factors for complications between different types of abdominoplasties has yet to be reported.

The aim of this study was to evaluate the complication rates and risks associated with each type of abdominoplasty.

Using the CosmetAssure database, patients undergoing an abdominoplasty from 2015 to 2022 were identified. Demographic factors and major complications were recorded and analyzed using a chi-square test or ANOVA. A logistic regression was performed to identify the risk associated with each type of abdominoplasty for developing complications.

A total of 55,596 patients underwent an abdominoplasty procedure by any method. The overall complication rate was 2.1%. There was a significant difference in the overall complication rate between all seven types of abdominoplasties (p<0.05), with Fleur-de-lis abdominoplasty having the highest complication rate. The year of surgery, being underweight or morbidly obese, diabetes, and being male placed patients at a significantly higher risk for developing a post-operative complication. Over 15,000 patients (27.2%) had concurrent procedures related to breast surgery, other body contouring, liposuction, or facial surgery. When accounting for various risk factors in a regression model, there was no significant added risk for major complications after a combination procedure with an abdominoplasty compared to abdominoplasty alone.

Among the different types of abdominoplasties, a Fleur-de-lis abdominoplasty has the highest complication rate. Concurrent cosmetic procedures in addition to an abdominoplasty showed no added risk for major complications compared to abdominoplasty alone.

Botulinum Toxin Injection Technique for Reducing the Masseter Size and Enhancing the Jawline.

Aesthetic Surgery Journal

The injection of botulinum toxin into the masseter muscle is an important method used to improve hypertrophy. However, some patients may experience adverse reactions, such as sagging of the lower jaw. Therefore, we proposed a method of injecting botulinum toxin into the masseter and platysma muscles that would reduce masseter size and enhance the jawline.

Reducing the masseter size while enhancing the jawline.

Twenty patients received botulinum toxin injections into the masseter and platysma muscles. Pain levels were evaluated using the visual analog scale. All patients were photographed before and 6 months after treatment. Evaluations were performed based on standardized criteria. The lift index, reduction index, and symmetry index were used to assess the degree of jawline elevation, masseter size reduction, and jawline symmetry before and after treatment, respectively.

The mean visual analog scale score of the 20 patients was 2.80 (±1.24). The mean lift index score decreased from 4.93 (±0.34) to 4.53 (±0.37), P<0.05. The mean reduction index score decreased from 3.13 (±0.27) to 2.74 (±0.27), P<0.05. The mean symmetry index score changed from 0.0393 (±0.0296) to 0.0257 (±0.0246), P<0.05.

Botulinum toxin injections into the masseter and platysma muscles through nerve block reduced the masseter size, elevated the jawline, and improved symmetry.

The Role of Aryl Hydrocarbon Receptor in the Pathogenesis and Treatment of Psoriasis.

Journal of Cutaneous Pathology

The pathogenesis of psoriasis is complex. Aryl hydrocarbon receptor (AhR) is a transcription factor that can be bound and activated by structurally...

Efficacy of Intralesional Candida Antigen Versus Measles, Mumps, and Rubella Vaccine Versus Topical Podophyllin in Treatment of Resistant Genital Warts.

Journal of Cutaneous Pathology

No single treatment is ideal for genital warts with high rate of resistance using conventional modalities as topical podophyllin; however, several intralesional immunotherapies are being tested nowadays, with variable results. In this study, we compared the safety and efficacy of treating resistant and recurrent genital warts by 2 intralesional immunotherapies [Candida antigen and measles, mumps, and rubella (MMR) vaccine] and compared them with topical podophyllin.

A total of 45 patients with resistant or recurrent genital warts were enrolled in this study. Size and number of warts were detected in each patient, patients were divided into 3 groups. Group A injected with intralesional Candida antigen. Group B with intralesional MMR vaccine. Group C were treated with topical 25% podophyllin. Patients received a session every 2 weeks for 3 treatment sessions.

With regard to the reduction in size and number of all warts, the best response was obtained in Candida antigen group where 46.7% showed complete clearance and 40% showed partial response followed by MMR group and the last was the podophyllin group, with no significant difference between them. Complete clearance of mother warts was noticed in 86.7% of Candida group, 53.3% in MMR group, and last 40% in podophyllin group, with a significantly better response in the Candida group (P = .027).

Both intralesional Candida antigen and MMR vaccine are simple, safe, and effective treatment options with comparable results and better response than topical podophyllin.

Lower Eyelid Dark Circles (Tear Trough and Lid-Cheek Junction): A Stepwise Assessment Framework.

Aesthetic Surgery Journal

Despite increasing popularity, the use of hyaluronic acid (HA) fillers for the correction of dark under eye shadows remains challenging. Specific guidance on patient assessment is limited.

To develop a stepwise assessment framework for lower eyelid dark shadows to help practitioners to classify patients based on their underlying problems and facilitate a more strategic approach to treatment.

Literature review and peer collaboration informed the current availability of educational material for use by experienced injectors when assessing patients presenting with dark circles. A practitioner survey provided insight into current practices. A focus group convened to review the survey results and discuss best practice approaches to patient assessment.

Surveyed practitioners (n = 39) reported patient concern about under eye hollows (91%), dark eye circles (80%) and looking tired (60%). All (100%) agreed that mid-cheek volume was critical when treating tear trough depression, only 26% reported use of a tear-trough classification system. The focus group developed a framework for assessing tear trough depression and the lid-cheek junction in patients presenting with dark circles. Key factors within this framework include the importance of appropriate lighting when conducing a visual inspection, regional inspection of the cheek and tear trough, palpation of the orbital rim and soft tissues, determination of the orbital vector and assessment of lower eyelid pigmentation/skin quality.

Careful step-by-step assessment can reduce the challenges of treating dark circles by identifying patients in whom dark eye circles may be improved without the need to directly inject filler into the tear trough.

The Oncological and Surgical Outcomes of Immediate Oncoplastic Breast Reconstruction With Contralateral Breast Adjustment.

Aesthetic Surgery Journal

Oncoplastic surgery is an expanding approach for managing breast conservation because it offers improved cosmetic outcomes while maintaining oncological safety.

This study aimed to assess the oncological and surgical outcomes of patients who underwent oncoplastic procedures at a single institution.

The study population includes all consecutive breast cancer patients who underwent lumpectomy followed by immediate oncoplastic breast reconstruction with contralateral breast adjustment between 2010 and 2021. Following IRB approval, patient demographics, tumor characteristics, surgical details, complications, and follow-up were evaluated for this group. Quality of life (QOL) and patient-reported outcome measures were assessed through questionnaires.

Following multidisciplinary tumor board discussion, 77 patients (82 breasts) underwent oncoplastic surgery. Of these, 92.2% underwent breast MRI prior to surgery with mean mass enhancement of 2.35 cm (range, 0-8.5 cm) and non-mass enhancement of 5.77 cm (range, 0-14 cm), and 44% presented with multifocal disease. The final positive surgical margin rate was 2.4%, and all conserved breasts received adjuvant radiation therapy. The 5-year local recurrence rate for invasive tumors was 4.1%. QOL scores were generally high, with most patients reporting good to excellent cosmetic outcomes and high personal satisfaction with breast appearance and softness. Physicians reported breast symmetry in 89.5%.

The findings suggest that oncoplastic surgery with contralateral breast adjustment is safe, effective, and an excellent option for breast cancer patients wishing for breast conservation even for large or multifocal masses, with favorable oncologic and cosmetic outcomes. The QOL analysis indicates high patient satisfaction. These results support the use of oncoplastic surgery in the management of breast cancer.

Long-Term Effects and Prognosis Following Suction Blister Epidermal Grafting in Vitiligo Patients.

Journal of Cutaneous Pathology

Suction blister epidermal grafting (SBEG) is currently one of the most prevalent surgical methods for stable vitiligo.

To investigate the long-term outcomes of vitiligo patients who underwent SBEG and to explore risk factors associated with postoperative relapse.

A retrospective cohort study was conducted in patients who underwent SBEG in our department between January 2016 and December 2022. Treatment outcomes, including repigmentation rate, adverse events, and postoperative relapse, were surveyed via telephone interview or out-=patient visit. Multivariate logistic regression models were used to assess the potential risk factors for postoperative relapse. Statistical significance was assumed at P < .05.

A total of 253 patients were included with a repigmentation rate of 96% (243/253) after grafting. Common adverse events included cobblestone-like appearance (73.1%, 185/253) in the donor site, perigraft halo (46.2%, 117/253), and cobblestone-like appearance (26.1%, 66/253) in the recipient site. Postoperative relapse occurred in 20.1% of patients over a mean time of 29.7 months after grafting. Nonsegmental type of vitiligo and coexistence of autoimmune diseases were risk factors for postoperative relapse.

SBEG is an effective surgical treatment for vitiligo with high repigmentation rate and good safety profile. Nonsegmental vitiligo and comorbid autoimmune diseases may increase the risk of postoperative relapse.

A Novel Approach to Shaping the Lateral Abdomen: Simultaneous Application of High-Intensity Focused Electromagnetic (HIFEM) Therapy and Synchronized Radiofrequency at the Flanks: A Multicenter MRI Study.

Aesthetic Surgery Journal

An accumulation of adipose tissue on the lateral abdomen (flanks) coupled with muscle deconditioning negatively affects core stability, muscular balance, and the intrinsic strength essential for maintaining optimal body mechanics and posture. This lateral fat accumulation and diminution of muscle result in an unfavorable abdominal profile and present challenges in finding appropriately fitting attire.

The aim of this study was to explore the effectiveness and safety of the simultaneous application of high-intensity focused electromagnetic (HIFEM) therapy and synchronized radiofrequency for sculpting the lateral abdomen.

All patients were scheduled to undergo four 30-minute treatments at approximately weekly intervals and then subsequent follow-up visits at 1 month and 3 months after the last treatment. The primary evaluation assessed changes in the oblique muscles, adipose tissue thickness, and cross-sectional area (CSA) by MRI performed at baseline and follow-ups. The secondary outcomes included digital photographs of the treated areas, a Subject Satisfaction Questionnaire, and a Therapy Comfort Questionnaire. Adverse events and side effects were monitored throughout the study duration.

The muscle tissue showed a substantial increase in thickness (+27.2%) and CSA (+29.0%). The adipose tissue measurements showed a decrease of -30.5% in CSA and -28.8% in thickness. As secondary outcomes, 81.8% of patients reported feeling more toned, and 84.9% of patients found the treatment comfortable and reported less than mild pain.

Based on the evaluation, the study suggests that the simultaneous application of HIFEM and synchronized radiofrequency is safe and effective for reducing adipose tissue and strengthening muscle in the area of the lateral abdomen.

Long-term Insights: Histopathological Assessment in Polyurethane Implant Capsules up to 24 Years.

Aesthetic Surgery Journal

Polyurethane (PU)-coated breast implants are known for their strong integration into breast tissue and the formation of capsules around them. However, capsular contracture can pose both aesthetic and clinical challenges.

To analyze the biological and morphological characteristics of the capsular tissue surrounding PU-coated implants, irrespective of their contracture status, and to assess their potential suitability as a flap in revision breast surgery for capsular contracture.

A total of 23 tissue samples were harvested from the capsules surrounding PU-coated breast implants in 12 female patients during replacement or revision surgery. We evaluated collagen abundance, cellular and vascular density, inflammation, collagen band types and alignment, synovial metaplasia, capsule thickness, and the expression of inflammatory biomarkers and myofibroblasts using immunohistochemical techniques. Scanning electron microscopy was used to assess implant surface characteristics over time.

We found a significant association of capsule contraction with longer implantation durations and greater implant surface roughness (p = 0.018 and p = 0.033, respectively). Synovial metaplasia was significantly more frequent in noncontracted capsules (p = 0.0049). Both capsule types consisted of paucicellular, type I collagen-rich compact fibrous tissue with low vascularization. There was a marked reduction in inflammatory cells within the foreign body granuloma. The expression of inflammatory biomarkers in the capsular tissue was negligible.

Given the reduced levels of inflammatory and vascular components within the dense, fibrous capsular tissue, we consider them to be viable alternatives for use as capsular flaps in revision surgery. This strategy has the potential to mimic the reconstruction achieved with acellular dermal matrix.

A 7-Year Retrospective Analysis of Hymenoplasty: Profiles From a Specialized Gynecological Cosmetic Surgery Practice.

Aesthetic Surgery Journal

Hymenoplasty, the surgical hymen reconstruction, is on the rise in Turkey, reflecting the enduring importance of virginity rooted in sociocultural and religious beliefs. Demographic factors shape women's decisions for this procedure. A seven-year retrospective analysis of 4259 patient records at a private clinic explores motivations and societal pressures, emphasizing the need for understanding and support amidst the cultural fixation on virginity.

This investigation delves into multifaceted perceptions around virginity and hymenoplasty in Turkey, examining the impact of sociocultural and religious beliefs on women's decisions. It also explores demographic influences, offering insights into the societal and cultural backdrop of hymenoplasty.

A retrospective analysis of 4259 patient records (2015-2022) at a private clinic was conducted, meticulously analyzing data for demographics and shared decision-making dynamics using statistical tools.

In the examined cohort (83.3%), permanent hymenoplasty was prevalent among individuals aged 14-49, with 58.6% being engaged and seeking the procedure a week before marriage. Notably, 91.0% were accompanied by friends during consultations, and a minority disclosed childbirth history or forced intercourse experiences. An increasing trend in first-time and post-assault hymenoplasty procedures was observed in 2021. Geographically, the majority resided in Istanbul, representing all Turkish regions. Additional procedures like vaginoplasty were common, with mostly successful postprocedural outcomes and minor complications.

This study highlights the enduring social importance of virginity in Turkey, emphasizing hymenoplasty as a coping strategy for psychological and societal challenges. It calls for comprehensive patient support and societal progress in respecting women's bodily autonomy, urging a shift away from the cultural fixation on virginity.

Collaborative Approach toward Transplant Candidacy for Obese End-Stage Renal Disease Patients.

American College of Surgeons

An elevated Body Mass Index (BMI) is a major cause of transplant preclusion for patients with End Stage Renal Disease (ESRD). This phenomenon exacerbates existing socioeconomic and racial disparities and increases the economic burden of maintaining patients on dialysis. Metabolic Bariatric Surgery (MBS) in such patients is not widely available. Our center created a collaborative program to undergo weight loss surgery before obtaining a kidney transplant.

We studied the outcomes of these patients post MBS and transplant surgery. One hundred and eighty-three ESRD patients were referred to the bariatric team by the transplant team between Jan 2019 through June 2023. Of these, 36 underwent MBS (20 RYGB, 16 SG), and 10 underwent subsequent transplantation, with another 15 currently waitlisted. Both surgical teams shared resources, including dieticians, social workers, and a common database, for easy transition between teams.

The mean starting BMI for all referrals was 46.4 kg/m2 and was 33.9 kg/m2 at the time of transplant. The average number of hypertension medications decreased from 2.0 (range 2.0 to 4.0) pre-surgery to 1.0 (range 1.0 to 3.0) post-surgery. Similarly, HbA1C levels improved, with pre-operative averages at 6.2 (range 5.4 to 7.6) and postoperative levels at 5.2 (range 4.6 to 5.8) All transplants are currently functioning, with a median creatinine of 1.5 (1.2 - 1.6) mg/dl (GFR 46 (36.3 - 71.0)).

A collaborative approach between bariatric and transplant surgery teams offers a pathway toward transplant for obese ESRD patients, and potentially alleviates existing healthcare disparities. ESRD patients that undergo MBS have unique complications to be aware of. The improvement in comorbidities may lead to superior post-transplant outcomes.

Barriers to Black Medical Students and Residents Pursuing and Completing Surgical Residency in Canada: A Qualitative Analysis.

American College of Surgeons

The limited available data suggest that the Canadian surgical workforce does not reflect the racial diversity of the patient population it serves, despite the well-established benefits of patient-provider race concordance. There have been no studies to date that characterize the systemic and individual challenges faced by Black medical students in matching to and successfully finishing training in a surgical specialty within a Canadian context that can explain this underrepresentation.

Using critical qualitative inquiry and purposive sampling to ensure gender, geographical, and student/trainee year heterogeneity, we recruited self-identifying Black medical students and surgical residents across Canada. Online in-depth semi-structured interviews were conducted and transcribed verbatim. Transcripts were analyzed through an inductive reflexive narrative thematic process by four analysts.

27 participants including 18 medical students and 9 residents, were interviewed. The results showed three major themes that characterized their experiences: journey to and through medicine, perceptions of the surgical culture, and recommendations to improve the student experience. Medical students identified lack of mentorship and representation, as well as experiences with racism as the main barriers to pursuing surgical training. Surgical trainees cited systemic racism, lack of representation and insufficient safe spaces as the key deterrents to program completion. The intersection with gender exponentially increased these identified barriers.

Except for a few surgical programs, medical schools across Canada do not offer a safe space for Black students and trainees to access and complete surgical training. An urgent change is needed to provide diverse mentorship that is transparent, acknowledges the real challenges related to systemic racism and biases, and is inclusive of different racial and ethnic backgrounds.