{"title":"A Retrospective Study to Evaluate the Efficacy of a Plasma Energy System (Renuvion) in the Management of Skin Laxity to Improve Tightening at the Time of Standard Liposuction of the Arms","authors":"A. Cuzalina, P. G. Tolomeo","doi":"10.1177/07488068211031096","DOIUrl":"https://doi.org/10.1177/07488068211031096","url":null,"abstract":"The aim of this study was to determine the efficacy of cool atmospheric plasma (Renuvion/J-plasma) in promoting skin tightening and soft tissue contouring following liposuction of the upper extremities. The study was a retrospective review of upper extremity liposuction with associated Renuvion therapy performed by the same surgeon. Patients were made aware of Renuvion therapy to assist with skin laxity and offered adjunctive treatment following liposuction. While a majority of patients elected to have Renuvion therapy performed bilaterally, a small subset of patients elected for unilateral treatment. This subset of patients pursued delayed treatment on the control side. The inclusion criteria for the study included patients with moderate fat excess of the upper extremity with associated mild to moderate cutaneous laxity. Exclusion criteria for the study included severe medical comorbidities, body mass index greater than 35 kg/m2 and those below the age of 30. The study included 5 female patients between the ages of 46 to 52. The method of treatment was liposuction of the bilateral upper extremities with removal of equal proportions of fat. The recipient site for Renuvion treatment was randomly selected by the study coordinator; the surgeon and clinical staff remained blinded to the selection. Following treatment, the patients were evaluated at 1 week, 6 weeks, and 6 months postoperatively to assess surgical outcomes subjectively. The surgeon and clinical staff were unblinded at the final visit. Patients were evaluated based on subjective criteria and photographic evaluation at each postoperative visit. At the 1-week visit, no significant differences were noted in all subjects. At the 6-week visit, two patients demonstrated improved results to the treatment site when compared with the control site. At the 6-month visit, four out of the five patients demonstrated a significant improvement in contour and laxity at the treatment site when compared with the control site. One patient demonstrated equal results on both treatment and control sites with no major abnormalities. Following the final evaluation, the patients underwent a secondary procedure to the control site with Renuvion to obtain similar results as the recipient site. One patient demonstrated equal results on both test and control sites with no major abnormalities. The use of plasma energy via Renuvion in conjunction with liposuction has demonstrated esthetic results with proposed long-term benefits. The plasma energy device, as an adjuvant therapy, may be beneficial in cases where liposuction alone may not address tissue laxity concerns. Additional studies with a larger sample size, objective criteria, and extended follow-ups are necessary to statistically analyze the results and determine its significance.","PeriodicalId":297650,"journal":{"name":"The American Journal of Cosmetic Surgery","volume":"146 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117046218","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}
Manishaben. J. Patel, P. Shah, Stuti P Garg, R. Cristel
{"title":"Readability Analysis of Online Patient Educational Materials on Blepharoplasty","authors":"Manishaben. J. Patel, P. Shah, Stuti P Garg, R. Cristel","doi":"10.1177/07488068211028344","DOIUrl":"https://doi.org/10.1177/07488068211028344","url":null,"abstract":"Blepharoplasty is a common procedure for correction of eyelid appearance. Online educational material among surgical procedures is often written higher than the recommended fifth-grade level. The objective of this study is to evaluate the readability of online patient education materials (OPEMs) available on Google for patients interested in blepharoplasty. Using 6 different pre-established readability scores, the top 100 Google results on blepharoplasty were screened for analysis. A total of 87 OPEMs were found to be relevant yielding an average grade reading level of 11.90 (range 7-20; 95% confidence interval [CI], 11.45-12.33). In addition, OPEMs readability scores were not influenced by whether the author was a medical provider. This study demonstrated the average reading level for available information on blepharoplasty is higher than the recommended fifth-grade reading level. Readability is only one metric for evaluating comprehendible information; however, authors of online medical education need to be more conscious of the public’s ability to comprehend and should tailor their content delivery appropriately.","PeriodicalId":297650,"journal":{"name":"The American Journal of Cosmetic Surgery","volume":"76 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125952815","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}
{"title":"High Eyelid Crease Deformity in Asians: A Clinical Evaluation and Corrective Strategies","authors":"P. Saonanon","doi":"10.1177/07488068211026719","DOIUrl":"https://doi.org/10.1177/07488068211026719","url":null,"abstract":"The aim of this study was to describe the manifestations of post-blepharoplasty high eyelid crease patients and to propose steps of clinical evaluation and corrective operations. High eyelid crease patients were categorized into 3 groups, including pre-existing ptosis (PP), surgical induced levator compromised (SI), and high eyelid crease alone (HC), based on their MRD1 and signs of compromised levator muscle. The primary outcomes were the type and success rate of the operative techniques. The secondary outcomes were the complications. A total of 131 patients were enrolled, 7 males and 124 females, with an average age of 39.7 years. The mean scar height in the HC, SI, and PP groups were 10.4 ± 2.2, 12.8 ± 2.6, and 9.0 ± 2.0 mm, respectively. The scar height in the SI group was statistically differently higher than the other groups (mean: 1.7 mm, 95% CI: [0.91, 2.43]; P < 0.001). In total, 117 eyes of 67 patients underwent corrective operations with significant lower eyelid fold height and an 83.6% success rate. There were 6 re-operation eyes, 5 in the SI group and 1 in the PP group. High blepharoplasty incision scar can lead to surgical induced levator compromise and ptosis. Systematical evaluation and optimal corrective operations are needed to achieve targeted outcome.","PeriodicalId":297650,"journal":{"name":"The American Journal of Cosmetic Surgery","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115104906","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}
Paul von Waechter-Gniadek, T. Kündig, P. Johansen, R. Boeni
{"title":"Safety and Satisfaction in High-Definition Power-Assisted Liposculpture in Men Under Local Anesthesia","authors":"Paul von Waechter-Gniadek, T. Kündig, P. Johansen, R. Boeni","doi":"10.1177/07488068211024761","DOIUrl":"https://doi.org/10.1177/07488068211024761","url":null,"abstract":"In high-definition liposculpture (HDL), the body is shaped in such a way that an athletic appearance and a defined, contoured look is created. Typical areas in the male patient include arms, pectoralis region, the area over the serratus muscle, lower back, as well as medial and lateral abdomen. This procedure is sometimes combined with fat grafting to areas over the deltoid muscle and/or pectorals. The objective was to evaluate the safety and satisfaction of HDL in a large series of patients using reciprocating power-assisted liposuction under local anesthesia. In this bicenter study, we performed HDL on 82 male patients using reciprocating power-assisted liposuction under tumescent local anesthesia with both lidocaine and prilocaine. No drains were used. Intraoperative and postoperative data were collected, and complication and satisfaction rates were evaluated after 6 months. All overall patients’ satisfaction was high. There were no major complications. Minor complications included seroma (n = 4), and 3 patients required touch-up surgery. There were no side-effects from the anesthesia, and there was no fluid overload. High-definition liposculpture using reciprocating power-assisted liposuction in local anesthesia is a safe procedure with a high satisfaction rate.","PeriodicalId":297650,"journal":{"name":"The American Journal of Cosmetic Surgery","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116827132","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}
{"title":"“Micro Botulinum Toxin” for the Treatment of a Deep Dermal Burn After Single IPL and a Second Combined IPL/Nd: YAG Laser Treatment for Skin Rejuvenation and Discoloration","authors":"Karen Soika","doi":"10.1177/07488068211012875","DOIUrl":"https://doi.org/10.1177/07488068211012875","url":null,"abstract":"Botulinum toxin (BTX) is a neurotoxin derived from the Clostridium botulinum bacterium that inhibits the release of acetylcholine at the neuromuscular junction. Botox is not new, and it has been used for many years to treat a variety of muscular/neuromuscular conditions and now more popularly for cosmetic use. Botulinum toxins use has been experimented in some dermatological conditions, which include Rosacea and facial flushing treatment with positive outcomes. The complex mechanism underlying those results is not completely understood but was proposed that a release inhibition of acetylcholine from peripheral autonomic nerves of the cutaneous vasodilatory system combined with the blockade of substance P and calcitonin gene-related peptide (CGRP), thus modulating vasodilatation of blood vessels as the likely mechanism of action. In cosmetic and aesthetic medicine, thermal burns from laser-type treatments are the number 1 lawsuit in this field. However, seldom are reports shared on management of these patient’s burns. This is a case report of such a patient who had a deep dermal burn after 2 consecutive treatments for the goal of correcting skin discoloration and sun damage.","PeriodicalId":297650,"journal":{"name":"The American Journal of Cosmetic Surgery","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129732785","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}
{"title":"Liposuction and Lipoinjection in Defining the Interactive Areas of the Back, Thighs, and Buttocks, for a More Enhanced Gluteoplasty","authors":"N. Elmelegy","doi":"10.1177/0748806820951412","DOIUrl":"https://doi.org/10.1177/0748806820951412","url":null,"abstract":"The measurements of beautiful buttocks have varied according to patient preference, different cultures, and ethnicity. There are great differences in the ideal aesthetic measurements of the buttocks among ethnic groups. In this work, the authors introduce an easy and versatile method for the assessment of “Gluteal-Related Aesthetic Subunits.” This method works as a tool to perform liposuction and lipoinjection, to treat the variety of differences in patients’ racial, cultural, personal preferences, and ethnic-related demands, thus improving the results of gluteal aesthetic surgery. This study was carried out on 148 patients, at plastic and reconstructive surgery department, Tanta University hospitals, and in private practice, in the period between 2010 and 2018. The aesthetic assessment and surgical planning were performed according to the criteria suggested by the authors of this work. Patient’s satisfaction showed excellent results in 104 (70.2%) patients, good results in 39 (26.4%) patients, fair results in 5 (3.4%) patients, and no poor results. Clinical assessment showed excellent results in 96 (64.8%) patients, good results in 44 (29.7%) patients, fair results in 8 (5.5%) patients, and no poor results were reported. (1) We believe that this classification of buttock areas is a valuable step that could help in achieving the required results that are more satisfactory to different types of patients. (2) Despite all the merits of this analytical tool and the advantages of the innovations in liposuction, some limitations remain. Fat transfer alone will not treat and even may worsen ptosis.","PeriodicalId":297650,"journal":{"name":"The American Journal of Cosmetic Surgery","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132943910","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}
{"title":"A Hybrid Filler: Combining Calcium Hydroxylapatite and Hyaluronic Acid Fillers for Aesthetic Indications","authors":"J. Kadouch, N. Fakih-Gomez","doi":"10.1177/07488068211016135","DOIUrl":"https://doi.org/10.1177/07488068211016135","url":null,"abstract":"Limited data are available describing the use of calcium hydroxylapatite (CaHA) and hyaluronic acid (HA) in combination. The aim of this study is to investigate the safety of premixing CaHA and HA fillers before injection. The authors performed a retrospective chart review of patients injected with a premixed combination of CaHA and a cohesive polydensified matrix (CPM®) HA in the authors’ aesthetic practices. Patients records were evaluated for adverse events at 1-3 month, 5-7 month and >12-month posttreatment follow-up visits. The retrospective chart review identified 134 patients who had been treated with premixed CaHA: HA, most of whom were female (95%). Most patients were treated for multiple facial areas. Injections were subcutaneous and performed with 25G 38- or 50-mm cannulas, using a fanning injection technique. Injection volumes and product ratios depended on the number of areas being treated and severity of the aesthetic defect. Only 2 adverse events were reported which comprised slight cases of overcorrection at 1-3 months, both of which resolved with hyaluronidase. No other adverse events were reported. This combined evaluation of the published literature and retrospective examination of case reports raised no concerns about the use of premixed CaHA and CPM-HA (Hybrid) fillers for the treatment of a range of facial aesthetic indications.","PeriodicalId":297650,"journal":{"name":"The American Journal of Cosmetic Surgery","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123335679","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}
{"title":"Letter to the Editor: Botulinum Toxin Dilution With Lidocaine","authors":"J. Schwember, A. Kurtzig","doi":"10.1177/07488068211012857","DOIUrl":"https://doi.org/10.1177/07488068211012857","url":null,"abstract":"","PeriodicalId":297650,"journal":{"name":"The American Journal of Cosmetic Surgery","volume":"63 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124577298","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}
N. Fakih-Gomez, R. Manay, A. Bastidas, Ibrahim Fakih-Gomez
{"title":"Modified Suture Technique to Improve Cosmetic Appearance and Wound Dehiscence in Upper Blepharoplasty","authors":"N. Fakih-Gomez, R. Manay, A. Bastidas, Ibrahim Fakih-Gomez","doi":"10.1177/07488068211010077","DOIUrl":"https://doi.org/10.1177/07488068211010077","url":null,"abstract":"The objective of the study was to compare wound dehiscence in upper blepharoplasty between the traditional suturing technique and the modified suturing technique in split-face study. A prospective, intrapatient split-face study was conducted from October 2019 to August 2020 in 40 patients who underwent upper blepharoplasty. The incision was made on both eyes, where the left eye received 3 subcutaneous buried sutures (6-0 polyglactin) before interrupted 6-0 nylon skin closure (modified technique), and the right eye underwent skin closure only (traditional technique). At 3 months, the aesthetic results using Hollander wound scale were evaluated by patients and an independent surgeon blinded to the method of closure. The study included 40 patients with an average age of 45 years. At 3 months, 39 patients (97.5%) recorded lateral wound dehiscence on the right eye and 0 patients (0%) on the left eye. The patient was scored 2 on the right eye and 5 on the left eye by the surgeon, whereas the patient scored 3 on right eye and 5.5 on left eye on Hollander wound scale. The modified technique in upper blepharoplasty proved to be a more aesthetically appealing and effective method to achieve a better scar in inverted canoe-shaped incisions with high-tension closure in well-positioned eyebrow.","PeriodicalId":297650,"journal":{"name":"The American Journal of Cosmetic Surgery","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123824696","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}
N. Homer, Aliza Epstein, J. Shore, Marie B. Somogyi
{"title":"Oculoplastic Surgeons’ Surgical, Clinical, and Management Experiences During the COVID-19 Crisis","authors":"N. Homer, Aliza Epstein, J. Shore, Marie B. Somogyi","doi":"10.1177/07488068211009062","DOIUrl":"https://doi.org/10.1177/07488068211009062","url":null,"abstract":"During the COVID-19 crisis, the American Society of Ophthalmic Plastic and Reconstructive Surgeons (ASOPRS) recommended cessation of all nonurgent oculofacial services, imparting unprecedented challenges in patient care and practice management. An anonymous survey was performed to assess surgeons’ surgical, clinical, and financial experiences during the COVID-19 restrictions. Results were collected from April 20 to May 1, 2020 and analyzed. A total 112 ASOPRS members participated. A significant majority (81.52%) performed surgeries during the COVID-19 restrictions. Fourteen percent did not allow trainee participation. While operating, 34.41% always wore an N-95 mask. Preoperative patient COVID-19 testing was mandated in 37.21% of practices. Fewer than half of surgeons were required to leave the operating room during intubation. A large majority (88.76%) of ASOPRS members used telemedicine, with most finding the virtual platform to function moderately well (62.92%) for oculofacial evaluations. Senior ASOPRS members were less interested in continuing virtual patient encounters in the future (P = .0130). Nearly all private practice surgeons (95.38%) had applied for federal funding and 83.51% expressed concern about the long-term financial well-being of their practice. ASOPRS surgeons have provided emergency oculofacial patient care during COVID-19, though often without proper safety precautions. New virtual patient evaluation platforms and financial practice hardships have posed additional challenges.","PeriodicalId":297650,"journal":{"name":"The American Journal of Cosmetic Surgery","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128942262","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}