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Cosmetic Procedures (cosmetic + procedure)
Selected AbstractsVitiligo koebnerized by eyebrow plucking by threadingJOURNAL OF COSMETIC DERMATOLOGY, Issue 4 2002S B Verma Summary, Koebnerization is a well-known phenomenon in diseases like vitiligo and psoriasis. Eyebrow plucking is a common procedure, which induces some trauma. This is a report of a woman with vitiligo whose vitiligo spread to the eyebrow area after eyebrow plucking by threading in a beauty parlour. This is an example of an unusual koebnerization of vitiligo by a very common cosmetic procedure. [source] Cryolipolysis for Noninvasive Fat Cell Destruction: Initial Results from a Pig ModelDERMATOLOGIC SURGERY, Issue 10 2009BRIAN ZELICKSON MD BACKGROUND Liposuction is one of the most frequently performed cosmetic procedures in the United States, but its cost and downtime has led to the development of noninvasive approaches for adipose tissue reduction. OBJECTIVE To determine whether noninvasive controlled and selective destruction of fat cells (Cryolipolysis) can selectively damage subcutaneous fat without causing damage to the overlying skin or rise in lipid levels. METHODS Three Yucatan pigs underwent Cryolipolysis at 22 sites: 20 at cooling intensity factor (CIF) index 24.5 (,43.8 mW/cm2), one at CIF 24.9 (,44.7 mW/cm2), and one at CIF 25.4 (,45.6 mW/cm2). Treated areas were evaluated using photography, ultrasound, and gross and microscopic pathology. Lipids were at various times points. One additional pig underwent Cryolipolysis at various days before euthanasia. RESULTS The treatments resulted in a significant reduction in the superficial fat layer without damage to the overlying skin. An inflammatory response triggered by cold-induced apoptosis of adipocytes preceded the reduction in the fat layer. Evaluation of lipids over a 3-month period following treatment demonstrated that cholesterol and triglyceride values remained normal. CONCLUSIONS Cryolipolysis is worthy of further study because it has been shown to significantly decrease subcutaneous fat and change body contour without causing damage to the overlying skin and surrounding structures or deleterious changes in blood lipids. [source] Body Dysmorphic Disorder and the Liposuction PatientDERMATOLOGIC SURGERY, Issue 5 2005Dee Anna Glaser MD background. Body dysmorphic disorder (BDD) is an under-recognized disorder that affects a sizeable number of patients who seek cosmetic enhancement, in particular liposuction. Understanding and recognizing BDD can positively impact the care delivered to patients. objective. To familiarize physicians with the presenting signs of BDD and present strategies for caring for BDD patients in a liposuction and/or cosmetic surgery practice. methods. Review of currently available literature and diagnostic criteria. results. BDD affects approximately 1% of patients in the United States, but as many as 7 to 15% of patients seeking cosmetic surgery. Patients with BDD will usually demonstrate an obsession with the area they seek treatment of. In addition, patients with BDD present a unique challenge to the liposuction surgeon. conclusions. Physicians who care for patients seeking liposuction or other cosmetic procedures should learn to recognize those who have BDD. Proper recognition and counseling of BDD patients can have a significant positive impact on not only their care but also on the patient-physician relationship. Failure to recognize BDD can, and often does, lead to patient dissatisfaction, as well as difficult future interactions with the BDD patient. [source] A Case of Aptos Thread Migration and Partial ExpulsionDERMATOLOGIC SURGERY, Issue 3 2005José G. Silva-Siwady MD Background In our practice, the use of dented polypropylene suture has become a very simple, conservative, and effective procedure for lifting flabby ptosed facial tissue, improving it without surgery. As with some cosmetic procedures, we have seen complications with this technique. Objective To present a case report of migration and partial expulsion of Aptos thread (TOTAL Charm, Moscow, Russia). Methods After successful fixation of facial tissue with 10 Aptos threads (5 on each side, 3 in the upper and central cheek, and 2 in the mandibular area), the patient returned 28 days later owing to migration and partial expulsion of one of the Aptos threads. Results The expulsed thread was easily removed, and the patient was treated with antibiotic therapy without further complications. Conclusion After this experience, we can conclude that Aptos threads are an additional tool in our arsenal for the treatment of facial aging. We must be especially cautious and aware that our patients can present with previously unknown complications secondary to newly described procedures, as with this recent technique. JOSé G. SILVA-SIWADY, MD, CELINA DÍAZ-GARZA, AND JORGE OCAMPO-CANDIANI, MD, HAVE INDICATED NO SIGNIFICANT INTEREST WITH COMMERCIAL SUPPORTERS. [source] Patient Injuries from Surgical Procedures Performed in Medical Offices: Three Years of Florida DataDERMATOLOGIC SURGERY, Issue 12p1 2004Brett Coldiron MD, FACP Background. Many state medical boards and legislatures are in the process of developing regulations that restrict procedures in the office setting with the intention of enhancing patient safety. The highest quality data in existence on office procedure adverse incidents have been collected by the state of Florida. Objective. The objective was to determine and analyze the nature of surgical incidents in office-based settings using 3 years of Florida data from March 2000 to March 2003. Methods. An incidence study with prospective data collection was performed. Individual reports that resulted in death or a hospital transfer were further investigated by determining the reporting physician's board certification status, hospital privilege status (excluding procedure specific operating room privileges), and office accreditation status. Results. In 3 years there were 13 procedure-related deaths and 43 procedure-related complications that resulted in a hospital transfer. Seven of the 13 deaths involved elective cosmetic procedures, 5 of which were performed under general anesthesia and 2 of which were performed with intravenous sedation anesthesia. Forty-two percent of the offices reporting deaths and 50% of the offices reporting procedural incidents that resulted in a hospital transfer were accredited by an independent accreditation agency. Ninety-six percent of physicians reporting surgical incidents were board-certified, and all had hospital privileges. Conclusions. Restrictions on office procedures for medically necessary procedures, such as requiring office accreditation, board certification, and hospital privileges, would have little effect on overall safety of surgical procedures. These data also show that the greatest danger to patients lies not with surgical procedures in office-based settings per se, but with cosmetic procedures that are performed in office-based settings, particularly when under general anesthesia. Our conclusions are dramatically different from those of a recent study, which claimed a 12-fold increased risk of death for procedures in the office setting. [source] Treatment of Pigmented Hypertrophic Scars with the 585 nm Pulsed Dye Laser and the 532 nm Frequency-Doubled Nd:YAG Laser in the Q-Switched and Variable Pulse Modes: A Comparative StudyDERMATOLOGIC SURGERY, Issue 8 2002Leyda Elizabeth Bowes MD background. Pigmented hypertrophic scars are a difficult condition to treat. They may result from traumatic injuries or from surgical and cosmetic procedures. The 585 nm flashlamp-pumped pulsed dye laser (FLPDL) has been used to treat this condition, with significant improvement of varying degrees. It remains to be determined whether other laser modalities may have a similar or even greater success in the treatment of pigmented hypertrophic scars. objective. To determine the efficacy of the 532 nm frequency-doubled Nd:YAG laser in the treatment of pigmented hypertrophic scars as compared to the 585 nm FLPDL. methods. Six patients with pigmented hypertrophic scars and skin phototypes II,IV were chosen. A scar was selected for treatment in each patient and divided into four equal 2 cm segments. Three segments were each treated with a different laser modality and one was left untreated to serve as the control. A 585 nm FLPDL was used with an energy of 3.5 J, a pulse duration of 450 ,sec, and a 10 mm spot size. A 532 nm Q-switched frequency-doubled Nd:YAG laser was set to an energy of 2.8 J, a 10-nsec pulse, and a 3 mm spot size. The same 532 nm laser was set to the variable pulse mode to treat a 2 cm scar segment, with an energy of 9.5 J, a 10-msec pulse, and a 4 mm spot size. An average of 3.3 treatments were performed on each scar segment, at intervals of 4,6 weeks and long-term follow-up at 22 weeks. Treatment outcome was graded by a blind observer using the Vancouver General Hospital (VGH) Burn Scar Assessment Scale. A SigmaStat t -test was used to determine the statistical significance of the values obtained. results. Treatment of pigmented hypertrophic scars with the 532 nm Q-switched Nd:YAG laser led to a significant improvement of 38% in the VGH scores when compared to baseline (P = .005). The 585 nm FLPDL also had a favorable effect on the scars, with an average improvement of 36.1% in the VGH scores. There was no significant difference noted between the outcome of treatment with either of these two lasers. Treatment with the 532 nm variable pulse Nd:YAG laser led to a 19% improvement in the VGH scores of scars, which did not differ significantly from the 16.1% improvement observed in control scars on the last follow-up visit. No side effects or complications from treatment were noted or reported during the course of the study. At the conclusion of the study, five of six patients chose the segment treated with the 532 nm Q-switched Nd:YAG laser as the best segment overall. conclusion. The 532 nm Q-switched Nd:YAG laser and the 585 nm FLPDL offer comparable favorable results in the treatment of pigmented hypertrophic scars. The 532 nm Q-switched Nd:YAG laser may be preferred by patients particularly distressed by the dark color of their scars. [source] Aging well , the role of minimally invasive aesthetic dermatological procedures in women over 65JOURNAL OF COSMETIC DERMATOLOGY, Issue 1 2010Uwe Wollina MD Summary Background, The western world is getting older. Aging well has become the new target of preventative medicine. Aesthetic dermatology can contribute to this quest. Females over 65 represent an important and growing group of consumers of cosmetic procedures. In this group, there is a paucity of scientific evaluation of aesthetic procedures. Objective, To review the use of minimally invasive procedures for facial rejuvenation in women over 65. Methods, Drawing from both the literature and personal experience, the opportunities, modifications, and limitations of minimally invasive techniques for facial rejuvenation in older women are considered. Results, In this older age group, dermal fillers, chemical and laser peels, and nonablative photorejuvenation remain useful and can each be used as stand-alone treatments. In this age group, botulinum toxin (BTX) injections are more often used in combination with other procedures. Conclusions, With respect to aesthetic procedures, women over 65 are different from younger women. More scientific investigation is necessary to better meet needs of this growing part of the population. Available data suggest that aesthetic dermatology can make a major contribution to the complex matter of aging well. [source] Legal considerations in cosmetic laser surgeryJOURNAL OF COSMETIC DERMATOLOGY, Issue 2 2006David J Goldberg MD Summary Cosmetic laser surgery is a continuously evolving field of medicine. According to the American Society for Dermatologic Surgery, over 100 million laser and light source cosmetic procedures were performed by its members. Procedures including hair removal, nonablative treatments, as well as removal of pigmented lesions, tattoos, and unwanted vascular lesions have revolutionized this field. With an increasing number of physicians and nonphysicians performing these procedures, and with the availability of increasingly powerful laser technologies, the potential for problems and their legal consequences continue to increase. This chapter will deal with the concept of negligence and the potential for a resultant medical malpractice that may arise in such a setting. An understanding of the basic principles of a cause of action in medical malpractice will likely protect a physician from losing such a case in a court of law. [source] The Pathology of Adulterated Injected Cosmetic Filler MaterialsJOURNAL OF CUTANEOUS PATHOLOGY, Issue 1 2005M. Pulitzer MD We report five cases of illicit injections of filler-substances for cosmetic purposes in non-medical clinics. The first two patients, a mother and 30-year-old daughter, presented with skin lesions in both legs after calf-augmentation by paraffin injection 4 years prior. One week later calf hyperpigmentation and induration developed, with progression up the legs, and eventual purulent draining ulceration (daughter). The third patient, a 34-year-old female, presented with pink-brown macules on both buttocks after receiving silicone injections 9 months earlier. The fourth patient, a 31-year-old female, developed skin lesions on the buttocks after silicone injections. The fifth patient, a 43-year-old female, developed sclerodermoid plaques on the buttocks after silicone injection. The first two biopsies showed large spaces in tissue, calcinosis cutis, dermal sclerosis, granulation tissue, and lymphedema. The third biopsy revealed foreign body reaction to non-polarizing material, the fourth lipogranulomatous reaction, and the fifth microvacuolar change with scar. Biopsies post-injection of cosmetic filler materials typically show macrovacuolar "swiss cheese" changes, and later microvacuolar changes with considerable granulomatous reaction. The reactions here were clinically severe, and may reflect adulteration of injected materials. We believe these cases augur a public health epidemic given a proliferation of non-medical cosmetic "mills" which offer illicit cosmetic procedures. [source] | ||||||||||