INTERCORRENCES WITH THE MISUSE OF TYPE A BOTULINUM TOXIN

Botulinum Toxin type A has become a great ally in aesthetic procedures because it is a very efficient non-surgical, aesthetic-therapeutic procedure. Known and much sought after for the result it provides in facial harmonization, by smoothing expression lines caused by repeated contractions carried out over the years, it has increased the demand for the technique, and with that, some complications and light, but transient complications arose. Thus, the objective of this article is to understand the process of application of botulinum toxin type A, its effects and complications (intercurrences) that may arise when not performing the technique as recommended, in addition to reviewing the literature and the protocol for applying the Botulinum toxin type A. The bibliographic research method, literature review of articles from the year 2000, in English and Portuguese, in search platforms of Scielo, Pubmed, Academic Google, atlas, dissertations and theses. Respecting the reapplication time is essential not only for complications, but also the patient's individuality, outlining a safe and effective path to avoid unwanted effects, thus ensuring a successful and attractive procedure both in the eyes of the professional and in the eyes of the clients .

Experiences and attitudes toward aesthetic procedures in East Asia: a cross-sectional survey of five geographical regions

Background The demand for aesthetic procedures continues to grow globally, particularly in East Asian countries. The popularity of specific aesthetic procedures varies, however, depending on the particular East Asian geographical region being studied. This study aimed to evaluate the experiences of and attitudes toward aesthetic procedures in five East Asian countries/regions, including China, Japan, South Korea, Hong Kong, and Taiwan.Methods To recruit participants, an online questionnaire was designed and distributed on social media networks between May 2015 and March 2016. The statistical analysis was conducted using SPSS software, version 22.0.Results A total of 3,088 people responded (approximately 600 in each country/region). Of these, 940 participants (47.8%) responded that they had experienced at least one aesthetic procedure in the past. Taiwan had the highest number of participants who had experienced at least one procedure (264/940, 41%), with primarily non-surgical experiences. Only in South Korea did surgical cosmetic experiences exceed non-surgical cosmetic experiences (55.9% vs. 44.1%). The popularity of particular procedures and the motivation for undergoing aesthetic procedures varied by country.Conclusions The popularity of aesthetic procedures continues to evolve. Similar trends were observed across the East Asian regions; however, each country had its unique demands and preferences. The information provided by this study can help aesthetic plastic surgeons further understand the patients in their corresponding region, customize their practice, and develop the requisite skills.

Aesthetic Surgery Practice Resumption in the United Kingdom During the COVID-19 Pandemic

Background The global COVID-19 pandemic has significantly impacted all aspects of healthcare, including the delivery of elective aesthetic surgery practice. We carried out a national, prospective data collection of the first aesthetic plastic surgery procedures carried out during the COVID-19 pandemic in the United Kingdom. Objectives Our aim was to explore the challenges aesthetic practice is facing and to identify if any problems or complications arose from carrying out aesthetic procedures during the COVID-19 pandemic. Methods Over a 6-week period from June 15 th-August 2 nd, 2020, data was collected using a proforma for aesthetic plastic surgery cases. All patients had outcomes recorded for the audit period of 14 days post-surgery. Results Our results demonstrated that none of the 371 patients audited whom underwent aesthetic surgical procedures developed any symptoms of COVID-19-related illness and none required treatment for any subsequent respiratory illness. Conclusions We found no COVID-19–related cases or complications in a cohort of patients who underwent elective aesthetic procedures under strict screening and infection control protocols in the early resumption of elective service.

Facial Aesthetic Priorities and Concerns: A Physician and Patient Perception Global Survey

Background Minimally invasive and noninvasive facial aesthetic treatments are increasingly popular, and a greater understanding of patient perspectives on facial aesthetic priorities is needed. Objectives To provide data to aesthetic physicians that may be useful during patient consultations in increasing post-treatment satisfaction by surveying facial aesthetic concerns, desires, and treatment goals of aesthetically conscious men and women, and physicians, in 18 countries. Methods A global, internet-based survey on desired appearance and experiences with, or interest in, facial aesthetic treatments. Eligible survey respondents were aesthetically conscious adults (21-75 years). Eligible aesthetic physicians were required to see ≥30 patients/month for aesthetic reasons, have 2-30-years’ experience in clinical practice, and spend ≥70% of time in direct patient care. Results A total of 14,584 aesthetically conscious adults (mean age, 41 years; 70% women) and 1,315 aesthetic physicians (mean age, 45 years; 68% men) completed the survey. Most surveyed respondents (68%) reported that aesthetic procedures should be sought in their 30s-40s, while surveyed physicians recommended patients seek treatment earlier. Respondents expressed greatest concern over crow’s feet lines, forehead lines, facial skin issues, hair-related concerns, and under-eye bags or dark circles; in contrast, physicians tended to underestimate patient concerns about under-eye bags or dark circles, mid-face volume deficits, and skin quality. While both physicians and respondents cited cost as a major barrier to seeking aesthetic treatments, respondents also emphasized safety, fear of injections or procedure-related pain, and concern about unnatural-looking outcomes. Conclusions This large, global survey provides valuable insight into facial aesthetic concerns and perspectives of aesthetically conscious patients that may be implemented in patient education and consultations to improve patient satisfaction following aesthetic treatments.

Efficacy and Safety of Topical Dexpanthenol-Containing Spray and Cream in the Recovery of the Skin Integrity Compared with Petroleum Jelly after Dermatologic Aesthetic Procedures

Moisturizers are commonly prescribed after laser and chemical peel aesthetic procedures, but the evidence regarding their efficacy and safety of such use is scarce. We conducted four single-blind, three-week, controlled studies to evaluate the efficacy and safety of topical Dexpanthenol-containing products (Bepantol® spray and Bepantol® cream) using petroleum jelly as a positive control. Skin recovery was assessed after four aesthetic procedures: (1) non-ablative facial laser resurfacing, (2) laser depilation on the external genital and inguinal regions, (3) chemical peel on the external genital and inguinal regions, and (4) ablative facial laser resurfacing. Efficacy was assessed through transepidermal water loss (TEWL) combined with clinical assessment of the skin by the investigators and the participants. In studies (1) and (4), the erythema intensity was evaluated by measuring dermal temperature with a thermal imaging camera. Safety was assessed through adverse event reporting and acceptability through a questionnaire. Dexpanthenol-containing products significantly decreased TEWL and dermal temperature, therefore maintaining skin integrity, promoting its recovery, and reducing erythema. No statistical differences with the positive control were observed. In addition, Dexpanthenol-containing products were well appreciated by the participants from a sensory perspective. These findings suggest that these Dexpanthenol-containing products are adequate for post-procedural care in aesthetic dermatology.

Evaluating Facelift Complications and the Effectiveness of the Smasectomy Technique: A Single Center’s 15-Year Experience

Background Facelift continues to be one of the most common aesthetic procedures performed in the United States. Although there exist many techniques and variations, SMAS manipulation, by way of plication, overlap or SMASectomy are common and have been shown to result in favorable cosmesis and durability. However, there is a lack of current complications data in the discussion of this technique. Objectives To assess the benefits and risks of the SMASectomy technique. Methods The records of all patients who underwent a facelift procedure between December 2004 and March 2019, were reviewed for this study. All procedures were performed at an AAAASF-accredited outpatient facility in Marina Del Rey, CA. This represents data on 241 total patients. Retrospective chart review was performed to include data on patient characteristics, operative technique, and complications. Results Average operative time of 152.68 ± 51.50 minutes and anesthesia time of 175.00 ± 54.07 minutes was observed amongst those patients that underwent SMASectomy. This was significantly lower (p < 0.000001) than those that did not undergo SMASectomy (average operative time of 265.25 ± 85.25 minutes and anesthesia time of 294.22 ± 85.31 minutes). There were no observed facial nerve injuries among patients that underwent SMASectomy. No DVT events were observed in this patient population. Conclusions In the hands of an experienced surgeon, the SMASectomy facelift technique offers the unique advantage of significantly reducing operating time and anesthesia time and can provide extremely favorable and long-lasting aesthetic results.

Abdominoplasty

The abdominoplasty or ‘tummy tuck’ is one of the most commonly requested aesthetic procedures and refers to a variety of surgical techniques. A detailed understanding of the surgical anatomy, deformity, the components that need redress, and the clinical decision-making algorithms are essential. Meticulous attention to perioperative optimization mitigates risk and complications. The evolution of the surgical techniques is ongoing particularly following the increased demand from massive weight-loss patients.