Pub Date : 2022-03-21DOI: 10.1177/07488068221079445
Samar Arshad, Zachary Sin, David Flores, Sean Satey, A. Mowlavi
Introduction: Performing optimal gluteal augmentation using traditional methods in moderate to severe weight-loss patients poses a surgical challenge as such patients typically present with (1) significant skin redundancy, (2) soft tissues containing higher density of connective tissues, and (3) buttock ptosis. Materials and Methods: Excess skin redundancy and buttock check ptosis require consideration of supplemental excisional tucking to achieve optimal results. In addition, subcutaneous tissues that maintain more connective tissue pose difficulty with fat removal using traditional liposuction techniques. As such, we present a novel surgical technique to optimally augment and shape the buttock in patients who have undergone weight-loss. Results: This procedure uses a modified lateral thigh and buttock tuck excision not only to lift the buttock cheek complex but also to create a dermal fat flap that is transposed into the upper buttock pole to achieve upper buttock fullness. The remainder of the excised tissue undergoes novel ex-vivo liposuction, which allows for simultaneous repair of the created excision line while fat is being harvested. Discussion: We present a new Brazilian buttock lift (BBL) procedure for weight-loss patients using a novel modified lateral thigh and buttock tuck with a dermal fat flap as well as ex-vivo liposuction and fat transfer. The described ex-vivo liposuction technique provides several advantages that include (1) limiting operative time, (2) allowing for maximal fat removal while avoiding unnecessary trauma to the patient, and (3) providing improved quality of fat that is less blood tinged. The lateral thigh and buttock tuck with dermal fat flap is used to eliminate buttock ptosis and augment the upper buttock. The ex-vivo harvested fat to the middle and lower buttock to complete buttock augmentation for the Brazilian buttock lift in a seamless fashion. Conclusions: In summary, we present a novel Brazilian buttock lift technique to augment the buttock in weight-loss patients that maximizes both patient safety and efficacy.
{"title":"Brazilian Buttock Lift for the Weight-Loss Patient","authors":"Samar Arshad, Zachary Sin, David Flores, Sean Satey, A. Mowlavi","doi":"10.1177/07488068221079445","DOIUrl":"https://doi.org/10.1177/07488068221079445","url":null,"abstract":"Introduction: Performing optimal gluteal augmentation using traditional methods in moderate to severe weight-loss patients poses a surgical challenge as such patients typically present with (1) significant skin redundancy, (2) soft tissues containing higher density of connective tissues, and (3) buttock ptosis. Materials and Methods: Excess skin redundancy and buttock check ptosis require consideration of supplemental excisional tucking to achieve optimal results. In addition, subcutaneous tissues that maintain more connective tissue pose difficulty with fat removal using traditional liposuction techniques. As such, we present a novel surgical technique to optimally augment and shape the buttock in patients who have undergone weight-loss. Results: This procedure uses a modified lateral thigh and buttock tuck excision not only to lift the buttock cheek complex but also to create a dermal fat flap that is transposed into the upper buttock pole to achieve upper buttock fullness. The remainder of the excised tissue undergoes novel ex-vivo liposuction, which allows for simultaneous repair of the created excision line while fat is being harvested. Discussion: We present a new Brazilian buttock lift (BBL) procedure for weight-loss patients using a novel modified lateral thigh and buttock tuck with a dermal fat flap as well as ex-vivo liposuction and fat transfer. The described ex-vivo liposuction technique provides several advantages that include (1) limiting operative time, (2) allowing for maximal fat removal while avoiding unnecessary trauma to the patient, and (3) providing improved quality of fat that is less blood tinged. The lateral thigh and buttock tuck with dermal fat flap is used to eliminate buttock ptosis and augment the upper buttock. The ex-vivo harvested fat to the middle and lower buttock to complete buttock augmentation for the Brazilian buttock lift in a seamless fashion. Conclusions: In summary, we present a novel Brazilian buttock lift technique to augment the buttock in weight-loss patients that maximizes both patient safety and efficacy.","PeriodicalId":297650,"journal":{"name":"The American Journal of Cosmetic Surgery","volume":"69 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130335910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-21DOI: 10.1177/07488068221082374
Ariel Luksenburg, J. J. Barcia, J. Gaviria, Roberto Sergio, S. Fernandez, M. Pelosi
Introduction: Urinary incontinence (UI) is an important clinical problem which affects millions of women worldwide. We describe the Luksenburg system, a minimally invasive procedure for the treatment of UI in women, using platelet-rich plasma (PRP) injections and polycaprolactone (PCL) threads. Material & Methods: A total of 302 patients with UI, mean age 52, were evaluated with detailed history, examination, urinary diary, complete laboratory tests, ultrasonography, urodynamic studies, and completion of International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF). Under local anesthesia, PRP was injected through the anterior vaginal wall, and PCL threads were placed in paraurethral, suburethral, and lateral urethrovaginal spaces, using instruments developed for safe and effective performance. Patients were analyzed at 1, 2, 4, 8 weeks and 6 months posttreatment. Twenty patients were biopsied preoperatively and 60 days after treatment. Results: Symptoms, ICIQ-UI SF score, and postoperative urodynamic studies were significantly improved in 95% of patients with UI grade I, 92% of patients with UI grade II, and in 30% of UI grade III. Biopsies after treatment showed a dense connective tissue 3-dimensional mesh. No complications or adverse effects were observed. All patients declared satisfaction with results, will have the procedure again, and will recommend it. Discussion: The Luksenburg system results in strengthening of the paraurethral, suburethral, and lateral urethrovaginal spaces and the mucosa of the anterior vaginal wall. The combination of PRP injections and the placement of PCL threads create a fibrotic and absorbable mesh-like structure, aimed to increase the urethral resistance, so that under effort the intravesical pressure does not overcome the urethral pressure. Conclusions: These results support that the Luksenburg system is safe and a cost-effective alternative in patients with all grades of UI, reducing the need for invasive surgical procedures.
{"title":"New Insights in the Treatment of Urinary Incontinence: The Luksenburg System","authors":"Ariel Luksenburg, J. J. Barcia, J. Gaviria, Roberto Sergio, S. Fernandez, M. Pelosi","doi":"10.1177/07488068221082374","DOIUrl":"https://doi.org/10.1177/07488068221082374","url":null,"abstract":"Introduction: Urinary incontinence (UI) is an important clinical problem which affects millions of women worldwide. We describe the Luksenburg system, a minimally invasive procedure for the treatment of UI in women, using platelet-rich plasma (PRP) injections and polycaprolactone (PCL) threads. Material & Methods: A total of 302 patients with UI, mean age 52, were evaluated with detailed history, examination, urinary diary, complete laboratory tests, ultrasonography, urodynamic studies, and completion of International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF). Under local anesthesia, PRP was injected through the anterior vaginal wall, and PCL threads were placed in paraurethral, suburethral, and lateral urethrovaginal spaces, using instruments developed for safe and effective performance. Patients were analyzed at 1, 2, 4, 8 weeks and 6 months posttreatment. Twenty patients were biopsied preoperatively and 60 days after treatment. Results: Symptoms, ICIQ-UI SF score, and postoperative urodynamic studies were significantly improved in 95% of patients with UI grade I, 92% of patients with UI grade II, and in 30% of UI grade III. Biopsies after treatment showed a dense connective tissue 3-dimensional mesh. No complications or adverse effects were observed. All patients declared satisfaction with results, will have the procedure again, and will recommend it. Discussion: The Luksenburg system results in strengthening of the paraurethral, suburethral, and lateral urethrovaginal spaces and the mucosa of the anterior vaginal wall. The combination of PRP injections and the placement of PCL threads create a fibrotic and absorbable mesh-like structure, aimed to increase the urethral resistance, so that under effort the intravesical pressure does not overcome the urethral pressure. Conclusions: These results support that the Luksenburg system is safe and a cost-effective alternative in patients with all grades of UI, reducing the need for invasive surgical procedures.","PeriodicalId":297650,"journal":{"name":"The American Journal of Cosmetic Surgery","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126429737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-19DOI: 10.1177/07488068221084471
Audrey Chow, R. Silkiss
Surgeons and surgical staff operating on the face are at risk of respiratory-based infectious transmission given their proximity to the patient’s nose and mouth in the surgical field. We describe a modified sterile draping technique that creates a midface seal with inferior ventilation that minimizes surgeon and staff exposure to patient respiratory emissions and potential transmission of infectious diseases, as well as mitigates fire risk during oculoplastic surgery and other surgeries involving the upper face.
{"title":"Enhanced Draping for Oculoplastic Surgery to Minimize Respiratory Exposure During the COVID-19 Pandemic","authors":"Audrey Chow, R. Silkiss","doi":"10.1177/07488068221084471","DOIUrl":"https://doi.org/10.1177/07488068221084471","url":null,"abstract":"Surgeons and surgical staff operating on the face are at risk of respiratory-based infectious transmission given their proximity to the patient’s nose and mouth in the surgical field. We describe a modified sterile draping technique that creates a midface seal with inferior ventilation that minimizes surgeon and staff exposure to patient respiratory emissions and potential transmission of infectious diseases, as well as mitigates fire risk during oculoplastic surgery and other surgeries involving the upper face.","PeriodicalId":297650,"journal":{"name":"The American Journal of Cosmetic Surgery","volume":"515 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116379598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-14DOI: 10.1177/07488068211066161
Jack Pardo, Vicente Solá, Hernán Guzmán, Isabel Oporto
Introduction: Although cosmetic gynecological procedures have been reported since antiquity, recent expansion made the cosmetogynecology becomes a recognized subspecialty. Presently, minimally invasive surgeries allow some of them to be performed under local anesthesia (LA). We present our preliminary experience using LA, highlighting safety and advantages. Methods: A total of 246 surgeries under local anesthesia on 185 median age patients, 39 years old (range: 14-80) between July 2020 and July 2021 in a Chilean aesthetic gynecology center, were retrospectively reviewed. Results: The most common surgery was Labiaplasty Type I, covering 40% (n = 99). Twenty percent of all patients (n = 38) underwent multiple surgeries in one surgical act. Minor complications were observed in 8% (n = 20) of surgeries, with satisfactory resolutions, without complications inherent to the use of LA or vasoconstrictors. Patients reported high degree of satisfaction, even in cases followed by labiaplasty repair or minor complication. Labiaplasty-related costs were considerably reduced compared with usual anesthetic procedure in more complex centers. Conclusion: This is the first South American report of various aesthetic genital procedures carried out under local anesthesia. In our experience, local anesthesia provided safe and effective results.
{"title":"Cosmetogynecological Surgery With Local Anesthesia: Preliminary Experience","authors":"Jack Pardo, Vicente Solá, Hernán Guzmán, Isabel Oporto","doi":"10.1177/07488068211066161","DOIUrl":"https://doi.org/10.1177/07488068211066161","url":null,"abstract":"Introduction: Although cosmetic gynecological procedures have been reported since antiquity, recent expansion made the cosmetogynecology becomes a recognized subspecialty. Presently, minimally invasive surgeries allow some of them to be performed under local anesthesia (LA). We present our preliminary experience using LA, highlighting safety and advantages. Methods: A total of 246 surgeries under local anesthesia on 185 median age patients, 39 years old (range: 14-80) between July 2020 and July 2021 in a Chilean aesthetic gynecology center, were retrospectively reviewed. Results: The most common surgery was Labiaplasty Type I, covering 40% (n = 99). Twenty percent of all patients (n = 38) underwent multiple surgeries in one surgical act. Minor complications were observed in 8% (n = 20) of surgeries, with satisfactory resolutions, without complications inherent to the use of LA or vasoconstrictors. Patients reported high degree of satisfaction, even in cases followed by labiaplasty repair or minor complication. Labiaplasty-related costs were considerably reduced compared with usual anesthetic procedure in more complex centers. Conclusion: This is the first South American report of various aesthetic genital procedures carried out under local anesthesia. In our experience, local anesthesia provided safe and effective results.","PeriodicalId":297650,"journal":{"name":"The American Journal of Cosmetic Surgery","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130380496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-04DOI: 10.1177/07488068211070103
A. Borba, Matheus Rodrigues
The eyebrow position is a determining factor related to facial expression, especially concerning the anatomical relationship of the eyebrow with the eyelid. The changing position of the eyebrows with aging influences the individual’s expression and can give negative emotions such as loss of vitality, sadness, and tiredness, and influence facial beauty. Numerous procedures are available to the surgeon to prevent the eyebrows from falling after upper blepharoplasty or lift them in isolation. Despite the various surgical techniques undertaken to manage the eyebrow, conventional approaches are usually more aggressive procedures involving extensive skin resection at the hairline or scalp, endoscopic elevation, and temporal and coronal approaches. Given the growing search for less aggressive procedures that patients better tolerate, this study aims to describe a less invasive variation of the Castañares technique, focused on the elevation of the eyebrow’s tail, which may or may not be associated with blepharoplasty, the Surgical Fox Eye. The technique removes an ellipse of skin above the distal third of the eyebrow close to the hair bulbs and then sutures with a direct elevation of the eyebrow tail. The technique described is ideal for several cases, as it presents predictable and satisfactory clinical outcomes as to the patients’ expectations. It also presents easy healing with extensive durability with minimal chance of complications. Level of evidence: Level V—Opinions of respected authorities, based on clinical experience, descriptive studies, or reports of expert committees.
{"title":"Fox Eye Effect Using a Transcutaneous Mini-Eyebrow Tail Lift","authors":"A. Borba, Matheus Rodrigues","doi":"10.1177/07488068211070103","DOIUrl":"https://doi.org/10.1177/07488068211070103","url":null,"abstract":"The eyebrow position is a determining factor related to facial expression, especially concerning the anatomical relationship of the eyebrow with the eyelid. The changing position of the eyebrows with aging influences the individual’s expression and can give negative emotions such as loss of vitality, sadness, and tiredness, and influence facial beauty. Numerous procedures are available to the surgeon to prevent the eyebrows from falling after upper blepharoplasty or lift them in isolation. Despite the various surgical techniques undertaken to manage the eyebrow, conventional approaches are usually more aggressive procedures involving extensive skin resection at the hairline or scalp, endoscopic elevation, and temporal and coronal approaches. Given the growing search for less aggressive procedures that patients better tolerate, this study aims to describe a less invasive variation of the Castañares technique, focused on the elevation of the eyebrow’s tail, which may or may not be associated with blepharoplasty, the Surgical Fox Eye. The technique removes an ellipse of skin above the distal third of the eyebrow close to the hair bulbs and then sutures with a direct elevation of the eyebrow tail. The technique described is ideal for several cases, as it presents predictable and satisfactory clinical outcomes as to the patients’ expectations. It also presents easy healing with extensive durability with minimal chance of complications. Level of evidence: Level V—Opinions of respected authorities, based on clinical experience, descriptive studies, or reports of expert committees.","PeriodicalId":297650,"journal":{"name":"The American Journal of Cosmetic Surgery","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130064691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-28DOI: 10.1177/07488068221074123
Dax Demaree, R. Deal, Vincent Gardner, Carey J. Nease
This article describes the mastopexy technique as used by multiple physicians at Southern Surgical Arts. The procedure is based off the tailor-tacking technique that has been modified to improve efficiency and consistency in obtaining cosmetically pleasing results. The procedure has proven to be safe when performing in combination with augmentation and other cosmetic procedure.
{"title":"The Southern Surgical Arts Staple-Shape Mastopexy: A Technique for Improving Breast Ptosis","authors":"Dax Demaree, R. Deal, Vincent Gardner, Carey J. Nease","doi":"10.1177/07488068221074123","DOIUrl":"https://doi.org/10.1177/07488068221074123","url":null,"abstract":"This article describes the mastopexy technique as used by multiple physicians at Southern Surgical Arts. The procedure is based off the tailor-tacking technique that has been modified to improve efficiency and consistency in obtaining cosmetically pleasing results. The procedure has proven to be safe when performing in combination with augmentation and other cosmetic procedure.","PeriodicalId":297650,"journal":{"name":"The American Journal of Cosmetic Surgery","volume":"65 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132336274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-23DOI: 10.1177/07488068221079076
{"title":"Accepted Abstract Presentations","authors":"","doi":"10.1177/07488068221079076","DOIUrl":"https://doi.org/10.1177/07488068221079076","url":null,"abstract":"","PeriodicalId":297650,"journal":{"name":"The American Journal of Cosmetic Surgery","volume":"67 18","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"113933117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-10DOI: 10.1177/07488068221079449
E. Ferneini, S. Halepas
{"title":"Competency Matters Most","authors":"E. Ferneini, S. Halepas","doi":"10.1177/07488068221079449","DOIUrl":"https://doi.org/10.1177/07488068221079449","url":null,"abstract":"","PeriodicalId":297650,"journal":{"name":"The American Journal of Cosmetic Surgery","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124755670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-28DOI: 10.1177/07488068221074125
Alison H. Watson, Hannah L. O’Mary, Z. Cui, S. Baer, Marie B. Somogyi, N. Homer, S. Blaydon, Jonathan Huggins, J. Shore, V. Durairaj, Tanuj Nakra
Purpose: Microneedling has been shown to enhance the efficacy of topical 5-fluorouracil (5-FU) for the treatment of dermatologic malignancies that along with our anecdotal clinical success of combination treatments for scar modification led the authors to investigate the effect of 5-FU and microneedling on wound healing. The current study evaluates the clinical and histological impact of topical 5-FU and microneedling therapy, separately, and in combination in a murine model. Methods: This is a randomized controlled trial in which 20 mice were randomized to 4 treatment groups: group 1 (n = 5) controls, group 2 (n = 5) microneedling alone, group 3 (n = 5) 5-FU alone, and group 4 (n = 5) combination 5-FU and microneedling. The interventions of interest were carried out on postoperative day 5, 10, 15, and 20 after wound induction. The clinical and histological wound appearance was graded by blinded oculoplastic surgeons and a blinded dermatopathologist, respectively. Statistical analysis was performed using a Kruskal-Wallis test with Dunn test for individual comparisons of treatment groups. Results: Blinded grading of the wound healing appearance at early, intermediate, and late healing time points demonstrated a statistically significant difference at the intermediate time point only. Histological analysis demonstrated a relative increase in epidermal thickness, dermal inflammation, and fibrosis in the combination treatment group. Statistically significant differences among the groups were identified in the degree of lymphocytic inflammation and for the amount of granulomatous inflammation. Discussion: This study was the first of its kind to investigate combination treatment with 5-FU and microneedling on a histopathologic level. In a murine model, this combination treatment resulted in increased degrees of wound inflammation and fibrosis relative to controls, and each treatment alone suggesting a histological basis that may relate to clinical impact, although future study in this area, to better understand the impact of these changes, is needed. Conclusion: Combination treatment with 5-FU and microneedling results in a histological increase in the degree of wound inflammation and fibrosis relative to controls and each treatment alone.
{"title":"Combination 5-Fluorouracil and Microneedling Therapy for Wound Modification: A Histological Murine Study","authors":"Alison H. Watson, Hannah L. O’Mary, Z. Cui, S. Baer, Marie B. Somogyi, N. Homer, S. Blaydon, Jonathan Huggins, J. Shore, V. Durairaj, Tanuj Nakra","doi":"10.1177/07488068221074125","DOIUrl":"https://doi.org/10.1177/07488068221074125","url":null,"abstract":"Purpose: Microneedling has been shown to enhance the efficacy of topical 5-fluorouracil (5-FU) for the treatment of dermatologic malignancies that along with our anecdotal clinical success of combination treatments for scar modification led the authors to investigate the effect of 5-FU and microneedling on wound healing. The current study evaluates the clinical and histological impact of topical 5-FU and microneedling therapy, separately, and in combination in a murine model. Methods: This is a randomized controlled trial in which 20 mice were randomized to 4 treatment groups: group 1 (n = 5) controls, group 2 (n = 5) microneedling alone, group 3 (n = 5) 5-FU alone, and group 4 (n = 5) combination 5-FU and microneedling. The interventions of interest were carried out on postoperative day 5, 10, 15, and 20 after wound induction. The clinical and histological wound appearance was graded by blinded oculoplastic surgeons and a blinded dermatopathologist, respectively. Statistical analysis was performed using a Kruskal-Wallis test with Dunn test for individual comparisons of treatment groups. Results: Blinded grading of the wound healing appearance at early, intermediate, and late healing time points demonstrated a statistically significant difference at the intermediate time point only. Histological analysis demonstrated a relative increase in epidermal thickness, dermal inflammation, and fibrosis in the combination treatment group. Statistically significant differences among the groups were identified in the degree of lymphocytic inflammation and for the amount of granulomatous inflammation. Discussion: This study was the first of its kind to investigate combination treatment with 5-FU and microneedling on a histopathologic level. In a murine model, this combination treatment resulted in increased degrees of wound inflammation and fibrosis relative to controls, and each treatment alone suggesting a histological basis that may relate to clinical impact, although future study in this area, to better understand the impact of these changes, is needed. Conclusion: Combination treatment with 5-FU and microneedling results in a histological increase in the degree of wound inflammation and fibrosis relative to controls and each treatment alone.","PeriodicalId":297650,"journal":{"name":"The American Journal of Cosmetic Surgery","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131237070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-07DOI: 10.1177/07488068211070113
Lindsay Y Chun, Paul O. Phelps
Melkersson-Rosenthal syndrome (MRS) is an uncommon disorder with presenting symptoms that typically involve the face and orofacial structures. It is a difficult diagnosis to make, as it may present with a protracted course of seemingly unrelated dermatological, ocular, and neurological findings. This case report reviews the presentation, workup, and diagnosis of a 75-year-old woman who presented with orofacial swelling, facial palsy, and tongue fissuring that had intermittently recurred over 10 years without a unifying diagnosis. Extensive medical history, photography, laboratory workup, and radiographic imaging were performed to identify the diagnosis of MRS in this patient. Our case highlights the challenge and importance of critically evaluating and consolidating a patient’s history of their present illness, physical examination, and ancillary testing to successfully establish a unifying diagnosis, especially when the diagnosis is relatively rare and diverse in its range of affected populations and symptomatology.
{"title":"A Case of Unrelenting Facial Swelling","authors":"Lindsay Y Chun, Paul O. Phelps","doi":"10.1177/07488068211070113","DOIUrl":"https://doi.org/10.1177/07488068211070113","url":null,"abstract":"Melkersson-Rosenthal syndrome (MRS) is an uncommon disorder with presenting symptoms that typically involve the face and orofacial structures. It is a difficult diagnosis to make, as it may present with a protracted course of seemingly unrelated dermatological, ocular, and neurological findings. This case report reviews the presentation, workup, and diagnosis of a 75-year-old woman who presented with orofacial swelling, facial palsy, and tongue fissuring that had intermittently recurred over 10 years without a unifying diagnosis. Extensive medical history, photography, laboratory workup, and radiographic imaging were performed to identify the diagnosis of MRS in this patient. Our case highlights the challenge and importance of critically evaluating and consolidating a patient’s history of their present illness, physical examination, and ancillary testing to successfully establish a unifying diagnosis, especially when the diagnosis is relatively rare and diverse in its range of affected populations and symptomatology.","PeriodicalId":297650,"journal":{"name":"The American Journal of Cosmetic Surgery","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130541188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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