bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cosmetic Surgery in a Different Voice: The Case of Madame Noël
Authors: Davis Kathy 
Published: January 2017

Cosmetic surgery emerged at the end of the 19th century in the U.S. and Europe. Like most branches of surgery, it is a ‘masculine’ medical specialty, both numerically and in terms of professional ‘ethos’. Given the role cosmetic surgery – and, more generally, the feminine beauty system – play in the disciplining and inferiorization of women's bodies, a feminist cosmetic surgeon would seem to be a contradiction in terms. It is hard to imagine how cosmetic surgery might be practiced in a way which is not, by definition, disempowering or demeaning to women. In this paper, I explore the unlikely combination of feminist cosmetic surgeon, using one of the pioneers of cosmetic surgery, Dr. Suzanne Noël, as an example. She was the first and most famous woman to practice cosmetic surgery, working in France at the beginning of this century. She was also an active feminist. Based on an analysis of the handbook she wrote in 1926, La Chirurgie Esthétique, Son Rôle Social in which she describes her views about her profession, her techniques and procedures, and the results of her operations, I tackle the question of whether Noël's approach might be regarded as a ‘feminine’ or even feminist way of doing cosmetic surgery – in short, an instance of surgery in ‘a different voice’. “The primary requisite for a good surgeon is to be a man – a man of courage.” Edmund Andrews. (1861). The Surgeon. Chicago Medical Examiner “Surgery involves bodies – those of surgeons as well as of patients … What does it mean when the body of the surgeon – the intrusive gazer, the violator, the recipient of sensory assaults – is that of a woman?” Joan Cassell. (1998). The Surgeon in the Woman's Body
Venous Thromboembolism in Abdominoplasty Patients: A Study of Incidence and Prophylaxis Recommendations
Authors: Pancholi Samir , Cuzalina Angelo 
Published: January 2017

Introduction: Pulmonary embolism (PE) and deep vein thrombosis (DVT) comprise venous thromboembolism (VTE). VTE is the most common preventable cause of death in postsurgical hospitalized patients. The literature consistently defines prophylaxis as being integral to avoiding VTE. No study, however, specifically addresses this with abdominoplasty, a high-VTE-risk cosmetic procedure. This study aims to fill this void by providing specific data on VTE incidence and, through comprehensive literature review, providing specific abdominoplasty prophylaxis recommendations. Methods: A retrospective review of 267 patients undergoing abdominoplasty between January 2000 and June 2006 at a fully accredited outpatient surgical facility was performed to assess symptomatic VTE incidence. Analysis reviewed VTE risk factors and current prophylaxis practice. A review of current cosmetic, plastic, and general surgery prophylaxis measures in the literature was performed and correlated with the authors' practice to develop abdominoplasty-specific VTE prophylaxis recommendations. Results: Four of 267 abdominoplasty patients (1.5%) developed VTE (all DVT). None of the 97 patients undergoing abdominoplasty alone developed DVT. Four of 170 abdominoplasty patients undergoing additional cosmetic procedures developed DVTs (23%). Of these, 3 had liposuction and 1 had simultaneous breast augmentation/mastopexy. All patients underwent general anesthesia, received mechanical prophylaxis, and were encouraged to ambulate the morning after surgery. Conclusions: VTE is a real and preventable issue in patient safety. Cosmetic surgery patients frequently are treated with inconsistent and less aggressive VTE prophylaxis than similar noncosmetic surgery patients owing to scant relevant data and/or concerns of problematic bleeding. The authors present abdominoplasty-specific DVT and PE rates of 1.5% and 0%, respectively, when mechanical prophylaxis is used. Although the results mirror those in the literature, the demand for optimal VTE prevention led the authors to increase their current prophylaxis regimen to a higher standard. They soundly use and present a VTE prophylaxis protocol for abdominoplasty patients that includes mechanical as well as pharmacologic prophylaxis.
Effect of Bupivacaine (Marcaine) Injection into the Breast Pocket on Postoperative Pain in Patients Undergoing Augmentation Mammoplasty
Authors: Chao Ronald P. , Begalke Jason J. , Napolez Adolfo , Park Jung I. 
Published: January 2017

Introduction: Bupivacaine (Marcaine) is known to be an effective local anesthetic agent. The question arises as to whether there is a role for placing this anesthetic into the breast implant pocket in breast augmentation surgery to achieve a greater degree of postoperative pain relief. The purpose of this study was to test the effectiveness of locally administered intraoperative bupivacaine into the breast pocket during augmentation mammoplasty. Materials and Methods: The study group consisted of 62 consecutive female breast augmentation patients ranging in age from 17 to 58 years. The clinical trial took place between December 2003 and March 2005 and was conducted in a prospective, randomized, double-blinded fashion using patient opinion on a postoperative pain scale rated from 1–10. Bupivacaine (150 mg) was placed into the implant pocket of the random test side after implant insertion, while no anesthetic was placed for the control group. Data were collected at time points of 0, 1, 3, and 6 hours after surgery as well as 1 week following surgery. The 0-hour data point was collected as soon as the patient was alert at the end of the procedure. Data were analyzed using paired t tests with the Bonferroni correction applied. Results: Based on the 10-point pain scale, the only statistically relevant difference occurred at the 1-hour postoperative time point, at which the mean pain level for the bupivacaine injected side was 3.0, while the mean pain level for the noninjected side was 4.2 with a P value of .01. There were no dropouts in the study. No hematomas or complications requiring reoperation were noted. Conclusion: The use of locally injected bupivacaine into the breast pocket during breast augmentation may be beneficial in alleviating some of the postoperative pain associated with augmentation mammoplasty.
Safety of Tumescent Liposuction Compared with Liposuction in Systemic Sedation or General Anesthesia—A Review of the Literature
Authors: Boni Roland 
Published: January 2017

Introduction: Liposuction surgery is increasing in frequency and is currently the most commonly performed cosmetic procedure. In tumescent liposuction, the unwanted fat deposits are injected with tumescence fluid containing saline, epinephrine, and lidocaine, the latter used as the only source of pain control. Tumescent liposuction has to be clearly distinguished from liposuction, where tumescent solution is locally applied, but pain is controlled with systemic sedation (oral, intramuscular, or intravenous sedation, rarely spinal sedation), or general anesthesia. Methods: In this study, the different anesthesiologic techniques currently used for liposuction are compared with regard to safety. Reported fatalities attributed to liposuction were reviewed, and it was determined, whether tumescent liposuction was performed or whether liposuction was assisted with systemic sedation or general anesthesia. Results: To date, no fatalities have been reported in tumescent liposuction and only minor complications have been described. The safety of tumescent liposuction could be demonstrated in 396,457 reported cases (including own data) performed in either an office-based or a hospital setting. Fatalities (n = 110), however, have been reported when pain was controlled by systemic sedation or when general anesthesia was applied. A mortality rate of 2.6–19.1 per 100,000 cases was calculated. Conclusion: Based on these findings, it is concluded that tumescent liposuction is currently the safest anesthesiologic technique for liposuction surgery because it is impossible to perform liposuction beyond infiltrated areas and because only smaller volumes of fat can be removed. To ensure safety, lidocaine levels should not exceed limits (35–55 mg/kg body weight). Removal of larger fat volumes should be performed in more than one procedure. Intravenous sedation or general anesthesia should be more carefully considered for this cosmetic procedure.
Complications of Sculptra for Cosmetic Skin Contour Enhancements
Authors: Dreschnack Paul A. , Farber George A. 
Published: January 2017

Background: Five patients presented to the Kenner Dermatology Clinic with granuloma formation after cosmetic augmentation with poly-L-lactic acid (Sculptra). One patient had injections to the dorsum of the hands, and 4 patients had infraorbital skin augmentation. None were immunocompromised. Methods: Literature review and multiple case report. Results: Three patients required surgical excision. One responded to saline dilution therapy, and one is awaiting surgical removal. Conclusion: Although temporary fillers are more costly, permanent fillers can result in granuloma formation over time. If the granulomas do not respond to saline dilution or Kenalog treatment, surgical excision will become necessary.
Two-Year Experience with the Avelar Abdominoplasty
Authors: Lopez Quita 
Published: January 2017

Objective: To evaluate our 2-year experience with a modified Avelar abdominoplasty in an outpatient office surgery center setting and to compare our complication rate with other studies reported in the literature. Methods: A retrospective review of the medical charts of 80 patients who underwent a modified Avelar abdominoplasty between June 2005 and June 2007. Seventy-seven patients underwent full abdominoplasties and 3 patients had mini abdominoplasties. Patients included 79 women and 1 man. Their ages ranged from 24 to 76 years. Mean age was 44 years. Of the patients, 47 (59%) had tumescent local anesthesia with conscious sedation. The remaining 33 (41%) patients had tumescent infiltration with general anesthesia. Surgical Technique: The technique presented modifies the Avelar technique by using tumescent anesthesia infiltration and conscious sedation, the Mangubat disruptor, less aggressive liposuction in the lower abdomen, subcutaneous excision of the lower flap down to the fascia in larger patients, a different technique for umbilical transposition, and platelet-rich plasma is sprayed in the flap closure and on the incision to promote healing. With liposuction to help mobilize the skin, the upper flap undermining can be limited to the midline, and blood vessels in the area can be preserved. Results: Most patients were happy with their results, and they especially liked the body sculpting with additional liposuction of their flanks. In the 80 patients who underwent the modified Avelar abdominoplasty, there were 3 cases of skin necrosis (3.7% incidence), 10 seromas (12.5 % incidence), 1 episode of aspiration of gastric contents, and 1 episode of postoperative urinary retention requiring Foley catheter placement for 2 days. There were no cases of significant blood loss and no incidence of deep vein thrombosis. Most patients had significantly less pain than occurred with traditional abdominoplasty and most returned to work in 10 to 14 days. Discussion: The Avelar abdominoplasty is touted as a safe procedure with fewer complications than the traditional abdominoplasty because the perforator vessels, nerves, and lymphatics are not damaged during the operation. The few published studies using only the Avelar technique or a modification of it have demonstrated a low complication rate. The seroma rate found in this study of 12.5% falls within the reported rates of 0 to 32%. Skin necrosis is caused by profound devascularization in the area between the umbilicus and the horizontal scar. Even with sparing of the superior axial vasculature, this area is susceptible to skin necrosis. In the current study 3 patients developed skin necrosis in this area. One patient was a heavy smoker. The second patient was exposed to significant secondhand smoke; and the third patient was obese and had chronic hypertension. All patients had limited dissection in the midline. Conclusion: In the current study, where modifications of the Avelar technique was used, the complication rate was in the low range compared with the complication rates reported in the literature.
Mammograms in Cosmetic Breast Surgery
Authors: Shiffman Melvin A. 
Published: January 2017

Introduction: The use of preoperative and postoperative mammograms in cosmetic surgery has never been standardized. This article discusses the medical benefits and legal issues of preoperative and postoperative mammograms in cosmetic breast surgery. Method: Review of the literature and a retrospective review of case. Results: The purpose of a preoperative mammogram is to detect any significant disorder of the breast(s) before cosmetic surgery so that the problem can be resolved before or during surgery. After cosmetic breast surgery, routine mammograms (6 to 12 months after surgery) help to formulate a baseline for the future detection of breast cancer. The changes that result from cosmetic breast surgeries, such as architectural scars, calcifications that form around an implant or around fat necrosis, and tissue thickenings make it more difficult to distinguish surgery artifacts from cancerous tumors. Discussion: It is the surgeon's choice whether to order a mammogram before cosmetic breast surgery on a patient under the age of 40. Patients under the age of 40 who refuse to have a requested preoperative mammogram may be safely operated upon, but the refusal should be noted in the medical record. This will help to protect the physician if there is future litigation. It is also the physician's choice whether to do cosmetic breast surgery on patients over the age of 40 who refuse a preoperative mammogram. Conclusion: Whether a mammogram is performed or not, the patient should be fully informed of the possible consequences of missing a significant abnormality early before surgery and that an implant or cosmetic surgery may reduce the chance of early detection of cancer.
Three Important Considerations in Posttraumatic Rhinoplasty
Authors: Low Brian , Massoomi Nima , Fattahi Tirbod 
Published: January 2017

Introduction: Many factors must be considered when performing a posttraumatic rhinoplasty. Since nasal fractures are the most common fractures in the adult facial skeleton, many patients who suffer midface trauma also suffer from nasal deformity/deviation and nasal airflow impedance. There are three specific regions within the nose which may impede airflow: nasal septum, internal nasal valves, and inferior turbinates. Each component of functional and posttraumatic rhinoplasty has been studied independently. However, a review of posttraumatic rhinoplasty procedures in which multiple regions of the nasal anatomy were addressed, when indicated, has not been elucidated much in the literature. Materials and Methods: A retrospective review of the medical charts and operative reports of 42 consecutive patients who underwent a post-traumatic rhinoplasty from July 2002 to December 2006 by the same surgeon was undertaken to determine which specific regions of the nose required secondary repair. Postoperative results were then reviewed to determine objective complications and subjective complaints. The specific techniques employed in the each operative procedure were then analyzed and objective complications and subjective complaints were recorded. Results: The most common preoperative patient complaint included difficulty breathing and nasal complex deformity followed by difficulty breathing alone and isolated deviation/deformity. The most common preoperative objective findings included airflow obstruction and nasal deformity, followed by isolated airflow obstruction, and isolated deviation/deformity with no air flow disturbance. All patients underwent a secondary posttraumatic septorhinoplasty. Septoplasty was performed in 78.6% of the patients; spreader grafts were used in 74% of the patients, and inferior turbinate surgery was done in 62% of the patients. Postoperatively, subjective findings revealed no complaints in 38 patients (90.5%). Two patients had complaints of persistent nasal deformity and air flow obstruction; 1 patient had persistent nasal deformity, and another patient had persistent air flow obstruction. Objectively, 5 patients had persistent nasal deformity, 2 patients had persistent air flow obstruction, and two patients had persistent airflow obstruction and nasal deformity. Conclusion: When indicated, by appropriately addressing the key regions of the nasal complex, including the septum, internal nasal valves, and inferior turbinates, the majority of patients (90.5%) will have no subjective complaints of difficulty breathing or a nasal complex deformity.
Revision Rhinoplasty—Open Approach
Authors: Glasgold Alvin I. 
Published: January 2017

Revision rhinoplasty has always been a great challenge. Often the difficulty is related to the inability to ascertain the cause of the problem. Sometimes correction is unreliable because of changes occurring during the healing process. Because of this, many qualified rhinoplastic surgeons shy away from revision surgery. In many cases an unsatisfactory result is left uncorrected, resulting in an unhappy patient. The open approach to revision rhinoplasty has greatly enhanced the predictability of the results, particularly in tip revision. This occurs because the open technique exposes the cause of the problem directly and allows for a more accurate assessment of the means to be instituted in correcting the problem.
Unusual and Late Complication of Polyurethane-Coated Prosthesis—Intraprosthetic Hematoma
Authors: Jackson Robert F. , Jackson Robert F. 
Published: January 2017

This case report deals with what we believe to be a previously unreported complication using the polyurethane-coated breast implants. Our patient presented with unilateral intraprosthetic breast prosthesis enlargement resulting in pain and excessive stretching of the skin. The focus of this study is to present the history, treatment, and possible explanations for the findings in this case. Many have proposed the polyurethane-covered breast implants as the answer to the plaguing problems of contracture and firmness as well as recommending them for general use in augmentation mammoplasty. As use of the polyurethane-coated implants increases, there will no doubt be an increase in complications with these implants. In our experience of over 2 years with 60 patients, 120 implants total, with the Meme and Replicon implants, we have encountered only one major complication. Although nearly all of our patients have had satisfactory results, the one significant complication encountered was that of a unilateral, intraprosthetic enlargement 14 months postoperatively, resulting in intractable breast pain and excessive stretching of the skin. After failure at conservative therapy, surgery was required, and it was possible to examine the prosthesis and shed some light on the plausible causes of this phenomenon.
Suction-Assisted Lipectomy: A New Way to Prevent Postsurgical Skin Waves
Authors: Botti Giovanni 
Published: January 2017

Although suction-assisted lipectomy (SAL) is becoming widely used, problems still arise from it. The occurrence of postsurgical skin waves clearly causes difficulties for surgeons. A surgical approach is presented that prevents these irregularities in the treated areas. For the past 10 years, suction-assisted lipectomy (SAL) has proved to be one of the most effective techniques in solving the problem of localized adiposity. SAL is a simple procedure which is becoming widespread throughout the world. It is also associated with other surgical operations such as face and neck lifts, abdominal lifts, thigh lifts, and breast reduction. This technique has become increasingly refined so that it produces very effective and exciting results. Nevertheless, an unsolved problem persists: the possibility of creating unattractive depressions or holes in the treated areas. As is known, cosmetic surgical operations are performed not out of urgency or because of a need to treat a physical disease, but for aesthetic purposes. For this reason, any iatrogenic damage to the patient is of great concern, and doctors who perform such operations are oriented toward avoiding these complications. The problem of skin waves which many physicians face today needs to be addressed. Although waves may appear after an operation and disappear quickly thereafter, in many cases a permanent mark in the skin occurs and is not easily remedied after the operation.
Benign Breast Calcifications
Authors: Johnson Gerald W. 
Published: January 2017

Benign calcifications in the breast have been observed following breast biopsy, trauma, abscess, augmentation with prosthetic devices, reduction mammoplasty and mastopexy, and augmentation with autogenous fat grafts. These calcifications are generally thought to follow fat necrosis. However, fat necrosis in the breast is more likely to result in calcifications than similar necrosis elsewhere in the body. The author offers a theory that trauma, whether accidental or surgical, can cause not only fat necrosis, but also glandular damage or necrosis that releases an unknown mammary factor (tentatively called Factor MX) that promotes calcium concentration and reacts with the fatty acids to form calcifications. The literature on breast calcifications following surgery is reviewed, and four case reports are presented. The author makes the point that the use of fat injection techniques for breast augmentation has not been proved to be any more likely to result in eventual breast calcifications than are numerous other surgical procedures. Therefore, criticism of this technique based on the potential for unnecessary biopsies at a later date is unwarranted. Benign calcifications have been observed following breast biopsy, trauma, abscess, augmentation using prosthetic devices, reduction mammoplasty, mastopexy, and augmentation with autogenous fat graft. These calcifications are usually thought to follow fat necrosis. We present a summary of the literature and four case reports of benign breast calcifications, three involving patients who developed calcifications following augmentation with silicone prosthetic devices and the fourth, a patient who developed a calcification 4 years after an augmentation using autogenous fat.
Expanded Bilateral Advancement Transposition (BAT) and Triple Advancement Transposition (TAT) Flaps for Treatment of Male Pattern Baldness
Authors: Anderson Richard D. 
Published: January 2017

The purpose of this paper is to present and describe the Anderson Expanded Bilateral Advancement Transposition (BAT) Flap and Triple Advancement Transposition (TAT) Flap techniques for elimination of moderate and extensive degrees of male pattern baldness. The advantages, disadvantages, and results will also be presented. At the present time, despite claims of success with various medical treatments, there is no nonsurgical method that will predictably reverse balding or stimulate the growth of new hair. The best results for the treatment of male pattern baldness and the popularity and predictability of hair replacement surgical techniques have advanced dramatically in recent years. Scalp expansion definitely ranks as one of the most significant advances in surgical hair replacement in the last century. The goal of all our hair replacement surgery techniques is the most efficient and effective use of the remaining hair follicles to cover the bald or balding area. Expanded scalp flaps accomplish this goal in an effective and efficient manner.