Puzzle Facelift: A non-surgical, whole treatment for facial modelling and rejuvenation

The assessment of correct anatomy of face and the evaluation of the dynamic interplay between anatomy and function, in order to get an overall improvement, is a leading topic in aesthetic surgery and has increased its impact in the recent years. A non-surgical impact technique reduces both post-treatment discomfort and the overall cost. Obtaining the simultaneous correction in forehead, nose, lips and chin means obtaining an overall improvement in face view. Likewise, the high predictability of the procedure and the absence of alloplastic implant, bone re-absorption and scars have to be considered in non-surgical aesthetic medicine. In conclusion, a single-session of profile correction using HA filler should be proposed to patient, every time the aesthetic practitioner sees a coexistence of forehead, nose lips and chin defects.

AESTHETIC SURGERY: IMPACT ON QUALITY OF LIFE

Objective: To determine the impact of aesthetic surgery on quality of life. Study Design: Cross-sectional study. Place and Duration of Study: The departments of Psychiatry, Plastic Surgery and ENT, Combined Military Hospital Multan, from Jan to Nov 2020. Methodology: Seventy-four patients were enrolled for this study. They underwent aesthetic surgery. A standard questioner was designed for these patients and response was obtained before undertaking the procedure and then after six months postoperatively. The questions were designed keeping in mind the specific type of surgery. Questions on Life Satisfaction, and the Patient Health Questionnaire (PHQ-4) were asked. The data were collected and analyzed by using SSPS-25. Results: There is high satisfaction postoperatively after aesthetic surgery. There are improvements in quality of life (p=0.03), physical well-being (Health) (p=0.03), body image (p=0.02), emotional stability (p<0.01) and emotional distress (Depression) (p=0.04 and anxiety (p=0.01) were noted to be reduced. Conclusion: Aesthetic surgery leads to higher satisfaction in physical appearance, health, emotional stability and reduction of anxiety.

Patient Counselling and Medicolegal Aspects of Hair Transplant Surgery

Hair transplantation being an elective aesthetic surgery, the importance of informed consent cannot be overstated. Explaining the condition of hair loss, the causes, progress, prognosis, and all available treatment options is a part of this process. Providing conflict-free information, ensuring that the patient comprehends this information, and allowing him/her to make the decision to authorize the surgeon to perform the procedure is the moral obligation of the hair transplant surgeon. The benefits of this approach are noticeable and one of the most effective ways to have a satisfied patient and reduce the possibility of claims.

EFFICIENCY OF ANESTHESIA DURING RECONSTRUCTIVE AND AESTHETIC SURGERY ON THE BREAST

The purpose of the study – to perform a comparative analysis of anesthesia effectivenessduring reconstructive surgery on the mammary glands.Material and methods. 120 women undergoing aesthetic intervention were divided intoanesthesia groups: intravenous anesthesia with propofol; inhalation with sevoflurane,combined with opioids; combined anesthesia with PECS-block.Results. It has been found that the group of combined anesthesia with PECS- block required the least time for analgesia (p<0,05). The greatest depth of medication sleepwas in the group of propofol, the smallest - in the combination of general anesthesia withPECS-block (p <0,05).It was verified that the largest number of patients with unstable hemodynamics wasin the group of propofol (33,3%), and the smallest number - in the group of combinedanesthesia with opioids (6,7%). Predisposition to tachycardia has been reported withthe use of propofol and the combination of sevoflurane with opioids. Bradycardic type ofsinus rhythm was observed in the group of combined anesthesia with PECS-block.Conclusions. In reconstructive interventions on the mammary glands, combinedinhalation anesthesia with sevoflurane in combination with opioids or single-stage PECSI block is promising.

Entering the Misinformation Age: Quality and Reliability of YouTube for Patient Information on Liposuction

Background: YouTube is currently the most popular online platform and is increasingly being utilized by patients as a resource on aesthetic surgery. Yet, its content is largely unregulated and this may result in dissemination of unreliable and inaccurate information. The objective of this study was to evaluate the quality and reliability of YouTube liposuction content available to potential patients. Methods: YouTube was screened using the keywords: “liposuction,” “lipoplasty,” and “body sculpting.” The top 50 results for each term were screened for relevance. Videos which met the inclusion criteria were scored using the Global Quality Score (GQS) for educational value and the Journal of the American Medical Association (JAMA) criteria for video reliability. Educational value, reliability, video views, likes, dislikes, duration and publishing date were compared between authorship groups, high/low reliability, and high/low educational value. Results: A total of 150 videos were screened, of which 89 videos met the inclusion criteria. Overall, the videos had low reliability (mean JAMA score = 2.78, SD = 1.15) and low educational value (mean GQS score = 3.55, SD = 1.31). Videos uploaded by physicians accounted for 83.1% percent of included videos and had a higher mean educational value and reliability score than those by patients. Video views, likes, dislikes, comments, popularity, and length were significantly greater in videos with high reliability. Conclusions: To ensure liposuction-seeking patients are appropriately educated and informed, surgeons and their patients may benefit from an analysis of educational quality and reliability of such online content. Surgeons may wish to discuss online sources of information with patients.

Current and Future Photography Techniques in Aesthetic Surgery

Background The rapidly increasing modalities and mediums of clinical photography, use of 3D and 4D patient modeling, and widening implementation of cloud-based storage and artificial intelligence call for an overview of various methods currently in use as well as future considerations in the field. Objectives Through a close look at the methods used in aesthetic surgery photography, clinicians will be able to select the modality best suited to their practice and goals. Methods Review and discussion of current data pertaining to: 2D and 3D clinical photography, current photography software, augmented reality reconstruction, artificial intelligence photography, and cloud-based storage. Results Important considerations for current image capture include a device with a gridded viewing screen and high megapixel resolution, a tripod with leveling base, studio lighting with dual-sourced light, standardized matte finish background, and consistency in patient orientation. Currently, 3D and 4D photography devices offer advantages such as improved communication to the patient on outcome expectation and better quality of patient service and safety. Artificial intelligence may contribute to post-capture processing and 3D printing of post-operative outcomes. Current smartphones distort patient perceptions about their appearance and should be used cautiously in an aesthetic surgery setting. Cloud-based storage provides flexibility, cost, and ease of service while remaining vulnerable to data breaches. Conclusions While there are advancements to be made in the physical equipment and preparation for the photograph, the future of clinical photography will be heavily influenced by innovations in software and 3D and 4D modeling of outcomes.

Postoperative Ecchymosis in Upper Blepharoplasty: A Split Face Study of Tranexamic Acid Versus Etamsylate

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.