Pub Date : 2021-12-14DOI: 10.1177/07488068211065833
M. Stevens, S. Ghasemi, Fargol Mashhadi Akbar Boojar, M. Dashti
Acceptance of the preservation principle in rhinoplasty surgery has increased dramatically, and surgeons worldwide are now performing preservation rhinoplasty, leading to an expanding list of indications and techniques. Rhinoplasty surgeons are increasingly opting for rhinoplasty preservation because of its conservative approach and more predictable outcome. This review aims to evaluate the efficacy of dorsal preservation rhinoplasty, as well as the techniques, indications, surgical protocols, complications, and any practical challenges associated with this type of rhinoplasty. A number of medical databases, including Medline-PubMed, Embase, and Scopus, were searched. These searches were supplemented with a manual search using the keyword “preservation rhinoplasty” (PR) during the 1970 to May 2020 time span. The search strategy was limited to case reports, randomized clinical trials, and prospective studies of preservation dorsal rhinoplasty in journals published in English. A total of 150 articles that incorporated preservation dorsal rhinoplasty as a newer surgical technique were reviewed: 136 from PubMed, 17 experimental studies from Embase, 17 clinical studies from Scopus, and 8 studies identified by data extraction. Preservation rhinoplasty represents a paradigm shift in rhinoplasty philosophy. While techniques continue to improve, the philosophy remains the same: preserving and reshaping the existing nasal structures. Although not all patients benefit from and are satisfied with PR and some may only benefit from partial PR, preserving the anatomy allows for a more intuitive operation and natural results. For a more exhaustive review, readers are encouraged to turn their attention to dorsal preservation as a versatile and adaptable technique. Dorsal preservation avoids long-term issues with the middle vault and keystone area, and the patient benefits from total preservation, as the underlying structure can be reshaped without disruption.
{"title":"Dorsal Preservation Rhinoplasty: A Literature Review","authors":"M. Stevens, S. Ghasemi, Fargol Mashhadi Akbar Boojar, M. Dashti","doi":"10.1177/07488068211065833","DOIUrl":"https://doi.org/10.1177/07488068211065833","url":null,"abstract":"Acceptance of the preservation principle in rhinoplasty surgery has increased dramatically, and surgeons worldwide are now performing preservation rhinoplasty, leading to an expanding list of indications and techniques. Rhinoplasty surgeons are increasingly opting for rhinoplasty preservation because of its conservative approach and more predictable outcome. This review aims to evaluate the efficacy of dorsal preservation rhinoplasty, as well as the techniques, indications, surgical protocols, complications, and any practical challenges associated with this type of rhinoplasty. A number of medical databases, including Medline-PubMed, Embase, and Scopus, were searched. These searches were supplemented with a manual search using the keyword “preservation rhinoplasty” (PR) during the 1970 to May 2020 time span. The search strategy was limited to case reports, randomized clinical trials, and prospective studies of preservation dorsal rhinoplasty in journals published in English. A total of 150 articles that incorporated preservation dorsal rhinoplasty as a newer surgical technique were reviewed: 136 from PubMed, 17 experimental studies from Embase, 17 clinical studies from Scopus, and 8 studies identified by data extraction. Preservation rhinoplasty represents a paradigm shift in rhinoplasty philosophy. While techniques continue to improve, the philosophy remains the same: preserving and reshaping the existing nasal structures. Although not all patients benefit from and are satisfied with PR and some may only benefit from partial PR, preserving the anatomy allows for a more intuitive operation and natural results. For a more exhaustive review, readers are encouraged to turn their attention to dorsal preservation as a versatile and adaptable technique. Dorsal preservation avoids long-term issues with the middle vault and keystone area, and the patient benefits from total preservation, as the underlying structure can be reshaped without disruption.","PeriodicalId":297650,"journal":{"name":"The American Journal of Cosmetic Surgery","volume":"132 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116755094","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 : 2021-12-03DOI: 10.1177/07488068211060958
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) severe skin redundancy, (2) soft tissues containing high-density connective tissues than fat content, and (3) ptotic buttock cheeks. Materials and Methods: 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 while remaining sterile, which allows for simultaneous repair of the created excision line. Results: This novel 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 with less blood and fat volumes. This ex vivo fat is then transferred to the mid- and lower buttock to complete buttock augmentation for the Brazilian buttock lift. Discussion: 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. Conclusion: 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":"High-Definition Liposuction Body Scale: Expanding Indications for High-Definition Liposuction","authors":"A. Mowlavi","doi":"10.1177/07488068211060958","DOIUrl":"https://doi.org/10.1177/07488068211060958","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) severe skin redundancy, (2) soft tissues containing high-density connective tissues than fat content, and (3) ptotic buttock cheeks. Materials and Methods: 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 while remaining sterile, which allows for simultaneous repair of the created excision line. Results: This novel 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 with less blood and fat volumes. This ex vivo fat is then transferred to the mid- and lower buttock to complete buttock augmentation for the Brazilian buttock lift. Discussion: 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. Conclusion: 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":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124453431","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 : 2021-11-20DOI: 10.1177/07488068211059009
N. Fakih-Gomez, E. Steward, D. A. Bastidas, R. Manay, Juan Martin Zarate, Ibrahim Fakih-Gomez
Objective: To compare the efficacy of tranexamic acid (TXA) versus etamsylate (ETM) in reducing postoperative ecchymosis in upper blepharoplasty. Introduction: With an increase in demand for shortened recoveries after facial aesthetic surgery, various optional approaches have been sought out. In terms of ecchymosis, TXA and ETM have been most commonly used. Method: A prospective, intrapatient split face study was conducted from January 2020 to January 2021 in 40 patients who underwent upper blepharoplasty under local anesthesia. Two equal anesthetic solutions were prepared; Solution A contained TXA and solution B contained ETM. Solution A was injected in the right eyelid and solution B in the left eyelid. Postoperative ecchymosis was assessed by 2 blinded evaluators, the assisting surgeon (Observer 1) and an external surgeon (Observer 2) at 48 h and on the seventh day using a scale published by Sagiv et al. Results: Postoperative ecchymosis was found to be less at 48 h by both observers with TXA solution. Moreover, at the seventh day, no ecchymosis was found in 32.5% with TXA solution compared to 2.5% with ETM solution. Kappa analysis showed concordance between observers. Conclusion: In our study, TXA solution was a more effective therapy when compared to ETM solution for reducing ecchymosis. Larger case studies are required to prove the difference for validation.
{"title":"Postoperative Ecchymosis in Upper Blepharoplasty: A Split Face Study of Tranexamic Acid Versus Etamsylate","authors":"N. Fakih-Gomez, E. Steward, D. A. Bastidas, R. Manay, Juan Martin Zarate, Ibrahim Fakih-Gomez","doi":"10.1177/07488068211059009","DOIUrl":"https://doi.org/10.1177/07488068211059009","url":null,"abstract":"Objective: To compare the efficacy of tranexamic acid (TXA) versus etamsylate (ETM) in reducing postoperative ecchymosis in upper blepharoplasty. Introduction: With an increase in demand for shortened recoveries after facial aesthetic surgery, various optional approaches have been sought out. In terms of ecchymosis, TXA and ETM have been most commonly used. Method: A prospective, intrapatient split face study was conducted from January 2020 to January 2021 in 40 patients who underwent upper blepharoplasty under local anesthesia. Two equal anesthetic solutions were prepared; Solution A contained TXA and solution B contained ETM. Solution A was injected in the right eyelid and solution B in the left eyelid. Postoperative ecchymosis was assessed by 2 blinded evaluators, the assisting surgeon (Observer 1) and an external surgeon (Observer 2) at 48 h and on the seventh day using a scale published by Sagiv et al. Results: Postoperative ecchymosis was found to be less at 48 h by both observers with TXA solution. Moreover, at the seventh day, no ecchymosis was found in 32.5% with TXA solution compared to 2.5% with ETM solution. Kappa analysis showed concordance between observers. Conclusion: In our study, TXA solution was a more effective therapy when compared to ETM solution for reducing ecchymosis. Larger case studies are required to prove the difference for validation.","PeriodicalId":297650,"journal":{"name":"The American Journal of Cosmetic Surgery","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114419290","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 : 2021-11-15DOI: 10.1177/07488068211058589
T. Brown, T. Murphy
There are numerous measuring systems that practitioners employ as part of their presurgical assessment for breast implant surgery. These range from direct measurements of patients using a tape measure, to assessment of standardized photographs and 3-dimensional scanning technologies. This personal view describes the authors system, developed over 20 years. The data yielded have assisted in assessing breast symmetry, ptosis, and match of implant to patient, with proven benefits for managing patient outcomes and expectations. It is simple, rapid to undertake, and requires inexpensive measuring equipment to provide useful data.
{"title":"Ten Measurements That Can Reduce Anxiety in Physicians and Their Patients Undergoing Breast Augmentation Surgery","authors":"T. Brown, T. Murphy","doi":"10.1177/07488068211058589","DOIUrl":"https://doi.org/10.1177/07488068211058589","url":null,"abstract":"There are numerous measuring systems that practitioners employ as part of their presurgical assessment for breast implant surgery. These range from direct measurements of patients using a tape measure, to assessment of standardized photographs and 3-dimensional scanning technologies. This personal view describes the authors system, developed over 20 years. The data yielded have assisted in assessing breast symmetry, ptosis, and match of implant to patient, with proven benefits for managing patient outcomes and expectations. It is simple, rapid to undertake, and requires inexpensive measuring equipment to provide useful data.","PeriodicalId":297650,"journal":{"name":"The American Journal of Cosmetic Surgery","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129631923","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 : 2021-11-15DOI: 10.1177/07488068211058915
Alannah L. Phelan, P. McAuliffe, Mark G Albert
Brachioplasty is a popular body contouring surgery which treats upper arm deformity related to both aging and massive weight loss. Demand for brachioplasty is growing, as the volume of bariatric surgery performed in the United States has doubled in the last decade.1 Local anesthesia offers multiple benefits for both patients and providers: it avoids anesthetic risks and anesthesia costs, decreases operating room time, and facilitates a more rapid recovery for patients. Brachioplasty is typically performed under general anesthesia or moderate sedation; this study details a successful technique to perform brachioplasty under wide-awake local anesthesia with high patient satisfaction and an excellent safety profile.
{"title":"Wide-Awake Brachioplasty: A Safe and Effective Technique for Local Anesthesia","authors":"Alannah L. Phelan, P. McAuliffe, Mark G Albert","doi":"10.1177/07488068211058915","DOIUrl":"https://doi.org/10.1177/07488068211058915","url":null,"abstract":"Brachioplasty is a popular body contouring surgery which treats upper arm deformity related to both aging and massive weight loss. Demand for brachioplasty is growing, as the volume of bariatric surgery performed in the United States has doubled in the last decade.1 Local anesthesia offers multiple benefits for both patients and providers: it avoids anesthetic risks and anesthesia costs, decreases operating room time, and facilitates a more rapid recovery for patients. Brachioplasty is typically performed under general anesthesia or moderate sedation; this study details a successful technique to perform brachioplasty under wide-awake local anesthesia with high patient satisfaction and an excellent safety profile.","PeriodicalId":297650,"journal":{"name":"The American Journal of Cosmetic Surgery","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128127265","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 : 2021-11-15DOI: 10.1177/07488068211057740
K. Fathimani, J. Perenack, B. Christensen
Introduction: Tranexamic acid (TXA) is a common adjunct to assist in hemostasis in a wide variety of applications. Although TXA has gained more popularity in facial cosmetic surgery, there are limited studies evaluating the effects of TXA in rhytidectomy patients, especially when used in tumescent solution. Purpose: The purpose of this study was to evaluate the effects of TXA on surgical time, postoperative ecchymosis, and need for aspiration when used in tumescent solution during cervicofacial rhytidectomy procedures. Materials and Methods: The authors designed a retrospective cohort study from an eligible population of all patients treated with cervicofacial rhytidectomy using tumescent solution at Williamson Cosmetic Center in Baton Rouge, LA, from January 1, 2019, to December 31, 2019. The outcome variables were surgical time, need for postoperative aspiration, and the duration of bruising postoperatively. The primary predictor variable was the use of TXA in the tumescent solution. Statistical analysis was performed using t tests and chi-square analyses. Results: Overall, 70 patients were included in the study with a mean age of 61.4 ± 7.2 years and 90% were female. Forty-five patients were in the TXA group and 25 in the non-TXA group. The use of TXA in tumescent solution was statistically significant for reducing ecchymosis (p < .001). The majority of patients in the TXA group (60%) had bruising cleared by day 7, whereas the majority of patients in the non-TXA group (52%) had bruising cleared by day 28. There was a statically significant reduction in frequency of postoperative aspiration in the TXA group (8.9% in TXA group vs 40.0% in the non-TXA group, P = .002). The study did not demonstrate a significant difference in surgical time between the two groups. Discussion: Although there is a lack of recognition of the potential benefits of TXA, there has been an increased off-label use by numerous surgical specialties. Routes of administration include topical, oral, intravenous, local infiltrative, and by tumescent anesthesia. Improvements in intraoperative hemostasis and postoperative ecchymosis are some of the main benefits of TXA. Conclusions: Utilizing TXA in tumescent solution in patients undergoing cervicofacial rhytidectomy procedures is associated with an improvement in postoperative ecchymosis duration and a decreased need for postoperative aspiration compared with the non-TXA group.
{"title":"The Effects of Using Tranexamic Acid in Tumescent Solution During Rhytidectomy Surgery","authors":"K. Fathimani, J. Perenack, B. Christensen","doi":"10.1177/07488068211057740","DOIUrl":"https://doi.org/10.1177/07488068211057740","url":null,"abstract":"Introduction: Tranexamic acid (TXA) is a common adjunct to assist in hemostasis in a wide variety of applications. Although TXA has gained more popularity in facial cosmetic surgery, there are limited studies evaluating the effects of TXA in rhytidectomy patients, especially when used in tumescent solution. Purpose: The purpose of this study was to evaluate the effects of TXA on surgical time, postoperative ecchymosis, and need for aspiration when used in tumescent solution during cervicofacial rhytidectomy procedures. Materials and Methods: The authors designed a retrospective cohort study from an eligible population of all patients treated with cervicofacial rhytidectomy using tumescent solution at Williamson Cosmetic Center in Baton Rouge, LA, from January 1, 2019, to December 31, 2019. The outcome variables were surgical time, need for postoperative aspiration, and the duration of bruising postoperatively. The primary predictor variable was the use of TXA in the tumescent solution. Statistical analysis was performed using t tests and chi-square analyses. Results: Overall, 70 patients were included in the study with a mean age of 61.4 ± 7.2 years and 90% were female. Forty-five patients were in the TXA group and 25 in the non-TXA group. The use of TXA in tumescent solution was statistically significant for reducing ecchymosis (p < .001). The majority of patients in the TXA group (60%) had bruising cleared by day 7, whereas the majority of patients in the non-TXA group (52%) had bruising cleared by day 28. There was a statically significant reduction in frequency of postoperative aspiration in the TXA group (8.9% in TXA group vs 40.0% in the non-TXA group, P = .002). The study did not demonstrate a significant difference in surgical time between the two groups. Discussion: Although there is a lack of recognition of the potential benefits of TXA, there has been an increased off-label use by numerous surgical specialties. Routes of administration include topical, oral, intravenous, local infiltrative, and by tumescent anesthesia. Improvements in intraoperative hemostasis and postoperative ecchymosis are some of the main benefits of TXA. Conclusions: Utilizing TXA in tumescent solution in patients undergoing cervicofacial rhytidectomy procedures is associated with an improvement in postoperative ecchymosis duration and a decreased need for postoperative aspiration compared with the non-TXA group.","PeriodicalId":297650,"journal":{"name":"The American Journal of Cosmetic Surgery","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129029544","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 : 2021-10-30DOI: 10.1177/07488068211051859
K. Dastoury, J. Haiavy, J. Petro, Martha Ayewah
Introduction: This study was performed to provide a comprehensive review of the breadth and depth of fellowship training provided by the American Academy of Cosmetic Surgery (AACS), with direct comparison with other current aesthetic surgery training programs available in the United States. We hypothesized that this subspecialty training provides essential experience and confidence to perform aesthetic procedures, which are likely not adequately imparted during traditional residency training. We also address the notion that Cosmetic Surgery is not under the sole ownership of one specialty, but rather a subspecialty that flourishes by collaboration between multidisciplinary surgical backgrounds. Materials and Methods: We performed a cross-sectional study of survey data from 2 distinct groups—current fellows in a 1-year AACS program and surgeons who completed an AACS fellowship between July 2008 and June 2017, who have been in active cosmetic surgery practice ranging from 6 months to over 6 years. A survey was administered via email and distributed by the AACS central office. The responses were compared with data published in the Annals of Plastic Surgery concerning Recent Trends in Resident Career Choices after Plastic Surgery Training. Results: The Accreditation Council for Graduate Medical Education (ACGME) requirements for aesthetic surgical cases in a 6-year Plastic Surgery program are 150 cases, but 50% of graduating seniors feel inadequately prepared to transition straight into aesthetic surgery practice, whereas among AACS graduating fellows, 100% feel very prepared to go on the aesthetic surgery practice, having completed an average of 687 cases within the yearlong training program. We note that the survey response rate was 81% among current fellows versus 35% among practicing surgeons. Discussion: We believe that focused subspecialty training in cosmetic surgery after completion of a primary surgical residency in a form of a structured fellowship through AACS, American Society of Plastic Surgery, American Academy of Facial Plastic and Reconstructive Surgery, Commission on Dental Accreditation, and American Society of Ophthalmic Plastic and Reconstructive Surgery (Oculoplastic) is the ideal preparation for the future. As we learn from each other through fellowship training, academic conferences, and research, this will further advance the subspecialty and ultimately improve patient care and outcomes. There is no evidence that these training programs provide less adequate preparation, although they are not accredited by the ACGME. To the contrary, the additional experience and knowledge gained during these fellowship training programs result in better outcomes and more competent practitioners. Conclusions: The development of subspecialty training and board certification for surgeons committed to cosmetic surgery yields the highest level of qualified providers. The diverse backgrounds of these providers continue to allow us to expand and inn
{"title":"Cosmetic Surgery: A Subspecialty That Needs Specialized Training and Recognition","authors":"K. Dastoury, J. Haiavy, J. Petro, Martha Ayewah","doi":"10.1177/07488068211051859","DOIUrl":"https://doi.org/10.1177/07488068211051859","url":null,"abstract":"Introduction: This study was performed to provide a comprehensive review of the breadth and depth of fellowship training provided by the American Academy of Cosmetic Surgery (AACS), with direct comparison with other current aesthetic surgery training programs available in the United States. We hypothesized that this subspecialty training provides essential experience and confidence to perform aesthetic procedures, which are likely not adequately imparted during traditional residency training. We also address the notion that Cosmetic Surgery is not under the sole ownership of one specialty, but rather a subspecialty that flourishes by collaboration between multidisciplinary surgical backgrounds. Materials and Methods: We performed a cross-sectional study of survey data from 2 distinct groups—current fellows in a 1-year AACS program and surgeons who completed an AACS fellowship between July 2008 and June 2017, who have been in active cosmetic surgery practice ranging from 6 months to over 6 years. A survey was administered via email and distributed by the AACS central office. The responses were compared with data published in the Annals of Plastic Surgery concerning Recent Trends in Resident Career Choices after Plastic Surgery Training. Results: The Accreditation Council for Graduate Medical Education (ACGME) requirements for aesthetic surgical cases in a 6-year Plastic Surgery program are 150 cases, but 50% of graduating seniors feel inadequately prepared to transition straight into aesthetic surgery practice, whereas among AACS graduating fellows, 100% feel very prepared to go on the aesthetic surgery practice, having completed an average of 687 cases within the yearlong training program. We note that the survey response rate was 81% among current fellows versus 35% among practicing surgeons. Discussion: We believe that focused subspecialty training in cosmetic surgery after completion of a primary surgical residency in a form of a structured fellowship through AACS, American Society of Plastic Surgery, American Academy of Facial Plastic and Reconstructive Surgery, Commission on Dental Accreditation, and American Society of Ophthalmic Plastic and Reconstructive Surgery (Oculoplastic) is the ideal preparation for the future. As we learn from each other through fellowship training, academic conferences, and research, this will further advance the subspecialty and ultimately improve patient care and outcomes. There is no evidence that these training programs provide less adequate preparation, although they are not accredited by the ACGME. To the contrary, the additional experience and knowledge gained during these fellowship training programs result in better outcomes and more competent practitioners. Conclusions: The development of subspecialty training and board certification for surgeons committed to cosmetic surgery yields the highest level of qualified providers. The diverse backgrounds of these providers continue to allow us to expand and inn","PeriodicalId":297650,"journal":{"name":"The American Journal of Cosmetic Surgery","volume":"62 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128894587","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 : 2021-10-27DOI: 10.1177/07488068211045521
J. Petro
{"title":"Book Review: Practical Guide to Hair Transplantation: Interactive Study for the Beginning Practitioner, by Robert H. True","authors":"J. Petro","doi":"10.1177/07488068211045521","DOIUrl":"https://doi.org/10.1177/07488068211045521","url":null,"abstract":"","PeriodicalId":297650,"journal":{"name":"The American Journal of Cosmetic Surgery","volume":"72 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126445782","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 : 2021-10-25DOI: 10.1177/07488068211051277
Monique Carole Arnold, Sanjeev Tomar, Adam Honeybrook
Background: Social media is a mainstream method for patient reporting of satisfaction with cosmetic procedures, but few studies have reported on this for subnasal lip lifts. Methods: We performed a social media analysis to identify patient satisfaction with subnasal lip lifts using 578 consecutive reviews on the RealSelf Web site from lip lift surgery patients between January 2010 and June 2019. Reasons for choosing a surgeon and liking the surgical outcome, surgical and demographic variables, cost, and overall “worth it” scores were recorded, and data analyses were conducted. Results: Most reviewers were female (526, 97.2%). Predominant reasons for choosing surgeons related to favorable surgeon personality (214, 37.0%) and skillset/artistry (125, 21.6%), and positive rapport established during consultation (88, 15.2%). The aggregate “Worth It Rating” of lip lift surgery using RealSelf’s methodology was 91.6%. The main reasons for liking surgical outcome were that they looked younger, more feminine, and “balanced” (97, 16.8%); they liked the new shape and fullness of their lips (58, 10.0%); and they liked that their teeth showed when smiling (30, 5.2%). Conclusions and relevance: Overall satisfaction with lip lift surgery is high. Many patients chose their surgeon based on favorable personality traits, emotional connections, and surgeon skillset.
{"title":"Subnasal Lip Lift: A RealSelf Social Media Analysis","authors":"Monique Carole Arnold, Sanjeev Tomar, Adam Honeybrook","doi":"10.1177/07488068211051277","DOIUrl":"https://doi.org/10.1177/07488068211051277","url":null,"abstract":"Background: Social media is a mainstream method for patient reporting of satisfaction with cosmetic procedures, but few studies have reported on this for subnasal lip lifts. Methods: We performed a social media analysis to identify patient satisfaction with subnasal lip lifts using 578 consecutive reviews on the RealSelf Web site from lip lift surgery patients between January 2010 and June 2019. Reasons for choosing a surgeon and liking the surgical outcome, surgical and demographic variables, cost, and overall “worth it” scores were recorded, and data analyses were conducted. Results: Most reviewers were female (526, 97.2%). Predominant reasons for choosing surgeons related to favorable surgeon personality (214, 37.0%) and skillset/artistry (125, 21.6%), and positive rapport established during consultation (88, 15.2%). The aggregate “Worth It Rating” of lip lift surgery using RealSelf’s methodology was 91.6%. The main reasons for liking surgical outcome were that they looked younger, more feminine, and “balanced” (97, 16.8%); they liked the new shape and fullness of their lips (58, 10.0%); and they liked that their teeth showed when smiling (30, 5.2%). Conclusions and relevance: Overall satisfaction with lip lift surgery is high. Many patients chose their surgeon based on favorable personality traits, emotional connections, and surgeon skillset.","PeriodicalId":297650,"journal":{"name":"The American Journal of Cosmetic Surgery","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123939341","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 : 2021-10-25DOI: 10.1177/07488068211052800
Aatin K. Dhanda, Christopher C. Tseng, Jeff Gao, Guy Talmor, B. Paskhover
Introduction: Blepharoplasty is a commonly performed cosmetic procedure which can help reduce age-related changes around the eyes. Like other surgical procedures, patient satisfaction is highly correlated with physician responsiveness to questions. As social media becomes more popular, patients are increasingly turning to online sources of information such as Realself.com, a website where patients can ask questions to verified physicians. We extracted and analyzed blepharoplasty-related questions on Realself to gain greater understanding of commonly asked pre- and postoperative questions. Materials and Methods: A Web crawler was used to gather the text for each question under the search term “eyelid surgery.” Questions were individually assigned by the authors to respective pre- or postoperative categories. Preoperative categories included eligibility for surgery, nonsurgical options, potential adverse effects, surgeon recommendations, surgical techniques and logistics, ability to pursue other surgeries following blepharoplasty, cost, and miscellaneous. Postoperative question categories included symptoms after surgery, appearance, behavior allowed/disallowed, options to revise surgery, and miscellaneous. Machine learning was then utilized to establish the most common pre- and postoperative questions. Results: 2009 blepharoplasty questions were extracted in total. A total of 60.93% of questions were preoperative related and 39.07% of questions were postoperative related. Preoperative questions were predominantly about eligibility for surgery (43.85%), while the majority of postoperative question were related to symptoms after surgery (17.42%) and appearance (10.80%). Machine learning analysis showed that most preoperative questions inquired about the possibility of correcting specific features, whereas most postoperative questions focused on resolving complications following surgery. Conclusion: As health information becomes more prevalent online, our results underscore the need for greater awareness about frequently asked questions to help surgeons preemptively address patient concerns about blepharoplasty. Our 10 most common questions can be used in the clinical setting as a patient educational handout to augment the preoperative experience.
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