bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgeon-Delivered Sedation for Outpatient Cosmetic Surgery
Authors: Davis Craig 
Published: November 2015

Introduction: Sedation is a valuable anesthetic technique used in settings ranging from hospitals to physicians' offices. This article describes more than 200 sedations given under the direct supervision of the operating surgeon. The main objectives are to evaluate the effectiveness and safety of this technique and to determine whether individualized sedation results in significant differences in medications given. In addition, pre-sedation evaluation, paying particular attention to upper airway assessment, is discussed. Materials and Methods: A retrospective chart review was completed on 150 patient records from a private cosmetic surgery practice. Results: For the period studied, 218 surgeon-supervised sedations provided adequate and safe anesthesia for outpatient facial and body cosmetic surgical procedures. Breast surgeries required significantly higher doses of ketamine and propofol compared with the other procedures. The lowest amounts of ketamine and propofol were used during facial surgeries. Conclusions: In select patients, surgeon-supervised sedations are safe and effective for outpatient cosmetic surgical procedures. Less intense sedation is required for facial surgeries than for other procedures. A pre-sedation evaluation, paying particular attention to upper airway assessment, should be completed by the surgeon.
Buttock Augmentation with Implants and Fat Grafting: A Comparative Study
Authors: Chugay Paul N. , Chugay Nikolas V. 
Published: November 2015

Introduction: We sought to compare our experience in the 2 primary techniques for buttock augmentation and determine if one is clearly superior to the other from the standpoints of complications, postoperative pain, and patient satisfaction. Materials and Methods: A retrospective search of patient records was performed for the period 2008–2011. A total of 129 patients were identified as having undergone buttock augmentation, 33 via fat transfer with stem cell therapy and 96 by way of silicone prosthesis. Complications were tabulated. Medcalc version 12.1 was used for analysis. Results: Over a 4-year period, we found that a total of 96 implant augmentations had been performed versus 33 fat-grafting augmentations. The overall satisfaction of the patients receiving buttock augmentation was 76.0% (73/96) for augmentation with implants and 69.7% (23/33) for augmentation with fat, which was statistically significant ( P < .001; 95% confidence interval [CI], 67.93–71.47). Seroma formation was more prevalent in the implant group (3.0% versus 17.7%; P = .02; 95% CI, 0.070–15.7). Lumps or dents were more prevalent in the fat-grafting group (33.3% versus 2.1%; P < .0001; 95% CI, 17.9–51.8). Complications isolated to those undergoing implant augmentation included dehiscence (14.6%) and contracture (13.5%). Conclusions: Although fat grafting for buttock augmentation is rising in popularity among surgeons, its results are not as consistent as those seen with buttock implant augmentation. This consistency of results is offset by the risk of capsular contracture and dehiscence, which are seen in implant surgery. Cosmetic surgeons should be aware of both techniques in buttock augmentation and their respective risks and benefits.
Retrospective Analysis of Type II Psillakis-like Mini-Abdominoplasties in a Single Cosmetic Surgery Practice: A Pilot Study
Authors: Peterson Jennifer D. , Palm Melanie D. , Goldman Mitchel P. 
Published: November 2015

Introduction: Mini-abdominoplasty is a surgical procedure available to patients with mild skin laxity and no underlying structural deficits including hernias or diastasis recti. This procedure can be performed safely with local anesthesia and minimal recovery time. Materials and Methods: All patients at a single private practice undergoing mini-abdominoplasties between 2005 and 2009 were identified. All procedures were performed using intravenous sedation, tumescent anesthesia, limited undermining, and without rectus plication or umbilical stalk resection. Identified patients were asked to complete a postprocedure questionnaire regarding postoperative complications and patient satisfaction. Results: Eight patients underwent mini-abdominoplasties, 7 of whom had concomitant liposuction. All patients were contacted and completed the questionnaire. No major postoperative complications were reported. Patient-reported pain, bruising, and edema following the procedure were mild in nature. Patient-evaluated overall improvement in the appearance of their abdomen was 78.13%. Conclusions: Type II Psillakis-like mini-abdominoplasty performed with tumescent anesthesia and intravenous sedation offers a safe and effective management of redundant abdominal skin tissue with high patient-reported improvement.
The Latest Advance in Hair Regeneration Therapy Using Proteins Secreted by Adipose-Derived Stem Cells
Authors: Fukuoka Hirotaro , Suga Hirotaka , Narita Keigo , Watanabe Rei , Shintani Satoru 
Published: November 2015

Introduction: Adipose-derived stem cells (ADSCs) that can be harvested from fat cells are one of the latest breakthroughs in the aesthetic field. In addition, basic studies have reported that ADSC conditioned medium (ADSC-CM) promotes skin and hair regeneration. We validate our novel approach, known as hair regenerative therapy, for hair growth treatment using ADSC-CM. Materials and Methods: ADSCs were cultured and expanded in hypoxic culture conditions, and ADSC-CM was collected. ADSC-CM includes various cytokines and growth factors that influence hair regrowth, to which we added buflomedyl, cysteine, coenzyme Q10, and vitamins. Protein solution from ADSC-CM was applied 4 to 6 times every 3 to 5 weeks by mesotherapy techniques such as nappage and papule injections. Satisfactory results of hair regenerative therapy in 12 women and 13 men were determined with a visual analog scale. Results: All patients experienced increased hair growth from the treatments with ADSC-CM. Four treatment sessions performed within 3 to 4 months provided especially good results. Scores on the visual analog scale increased with treatment frequency. Statistical significance was determined by Friedman's 2-way analysis of variance (P < .01) and Wilcoxon's signed rank test (P < .01). Discussion: ADSCs secrete cytokines, such as keratinocyte growth factor, vascular endotheliatl growth factor, platelet-derived growth factor, hepatocyte growth factor. Those cytokines and growth factor are very important for hair growth. Our new therapy with ADSC-CM does not require specialized facilities, such as a cell-processing center, and can be a valuable treatment.
High-Pressure Injection and Suction Curettage: A Novel Treatment for Lipoma
Authors: Boeni Roland 
Published: November 2015

Introduction: Lipomas present as soft, mobile subcutaneous benign tumors. Liposuction is performed on medium to large lipomas, but extraction of the whole capsule through a slit incision is often difficult. This study aims to evaluate a novel approach in the treatment of lipoma. Materials and Methods: Twelve encapsulated lipomas (range, 4–16 cm) were treated using a high-pressure injection technique with an injection pump, followed by suction curettage. The capsule's remnants were not extracted. Patients were followed up after 2 years. Results: High-pressure injection facilitated identification and handling during suction curettage. There were no recurrences after 2 years. Conclusions: Lipoaspiration is limited to medium to large lipomas. This novel approach allows for the treatment of lipomas without extracting the capsule. Intralesional pressure not only facilitates suction curettage but might also be a contributing factor to the capsule's breakdown.
Review of Facial Fillers and Injectable Neurotoxins
Authors: Ferneini Elie , Boynton Tyler , Almunajed Husam , Dimitrov Kroum , Banki Mohammad 
Published: November 2015

Introduction: Noninvasive cosmetic techniques continue to increase in popularity. In particular, dermal fillers and botulinum toxin injectables have consistently shown a rise in demand. Pharmaceutical companies have spent millions of dollars to develop these products to produce more achievable, predictable, and long-lasting results. As a result, multiple products were developed that differ in their physical and chemical properties. By understanding these characteristics, the cosmetic surgeon will achieve more safe and reliable results. Materials and Methods: A literature search on dermal fillers and botulinum toxin injectable treatments was completed from 2005 to 2013. Results: Injectables are a great resource for clinicians to improve a patient's appearance in a short time with relatively little discomfort to the patient. With a rise in the number of patients requesting these treatments, it is crucial that the surgeon and patient are aware of all of the risks and benefits of treatment. As the quest for the youthful image continues in our society, anti-aging therapies will continue to improve. Conclusions: Patients and cosmetic surgeons will continue to work with these and more advanced products as they are approved. With proper training and experience, the surgeon should be able to provide treatments that consistently benefit their patients. It is the purpose of the paper to provide the cosmetic surgeon with a description of the current products available as well as the complications that can arise when using these materials.
Multimodal Treatment of Hypertrophic and Keloidal Scars
Authors: Lack Edward B. 
Published: November 2015

Introduction: Hypertrophic and keloidal scars are unwanted sequelae of wound healing. As multiple pathologic progenitors and mediators are responsible for these abnormal scars, single modality therapy is only intermittently successful. Multiple empiric therapies are now available which can be applied concomitantly or sequentially to address these uncomfortable and unsightly conditions. Materials and Methods: A 76-year-old woman underwent a rhytidectomy and blepharoplasty followed by perioral ablative laser resurfacing. During the ensuing 4 months, she developed circumferential perioral hypertrophic scars with foci of keloidal scar formation plus secondary evolution of microstomia. Results: Over an 18-month period, the patient received a single course of imiquimod cream, multiple injections of 5-fluorouracil and triamcinolone, multiple intense pulsed light treatments, and multiple nonablative fractional laser resurfacing treatments. At the conclusion of therapy, the patient achieved more than 90% resolution of hypertrophic and keloidal scarring. Conclusions: While knowledge of the pathogenesis of hypertrophic and keloidal scarring is evolving, at tempts at its resolution are empirical. Not surprisingly, the processes by which various therapies are effective continue to be argued. Nonetheless, administering multimodal therapy in an artful sequence can ameliorate many if not most hypertrophic and keloidal scars when treated at a relatively early stage.
Zigzag Genioplasty; Patients Evaluation, Technique Modifications and Review of the Literature
Authors: Keyhan Seied Omid , Khiabani Kazem , Raisian Shahrokh , Bohlouli Behnam , Feizbakhsh Masoud , Hemmat Seifollah , Mehmandoost Meghdad Khanian , Varedi Payam , Shirafkan Saeed , Hoseini Elham 
Published: November 2015

Introduction: The purpose of our study was to evaluate patients and technique and complete a review of the literature related to Zigzag genioplasty. Materials and Methods: To address the research purpose, the investigators designed and implemented a prospective clinical trial study. Seven osteotomy types (I–VII) are proposed for genioplasty that will permit one to decrease the 3-dimensions of the chin. These osteotomy designs are based on the displacement of bone fragments on the slopes of an inclined plane with a superior-medial direction. Results: All of the patients were satisfied with the esthetic results of their osteotomy. Based on presurgical and post-surgical facial analysis and clinical evaluations, no patients who received a Zigzag osteotomy suffered from permanent neurosensory deficiency, infection, hardware failure, severe pain, asymmetry, necrosis, massive hematoma, relapse, or suprahyoid muscle dysfunction. Conclusions: As a result, on the basis of our experience with 23 patients and after at least 1 year of follow-up with each one, the authors concluded that this technique is simple and easy to implement.
Photodynamic Therapy (PDT) Utilizing Multiple Light Sources Significantly Improves Clinical Efficacy and Subject Satisfaction with a Review of PDT Mechanisms of Action
Authors: Thornfeldt Carl 
Published: November 2015

Introduction: Many topically applied devices and medicaments have been developed to give hope to people who want to reduce the signs of visible aging. All modalities have benefits and risks, and no single modality produces complete resolution of photoaging. Although approved by the US Food and Drug Administration for treatment of epithelial neoplasia, photodynamic therapy (PDT) is also reported to produce significant benefits in reducing photoaging. The goal of this study was to determine if clinical response and subject satisfaction can be improved for PDT while reducing downtime and increasing activation of the photosensitizer. Materials and Methods: In a regimen administered monthly for 3 treatments, 14 subjects participated in a prospective intervention pilot trial using an 830 nm light-emitting diode (LED), a 540 nm advanced fluorescence technology laser, a 570 nm advanced fluorescence technology laser, and a 633 nm LED. The photoactivation phase was initiated with the 830 nm LED 10 minutes after application of 20% 5-aminolevulinic acid, followed by each modality in listed order. Baseline global extrinsic aging scores were compared with scores 1 month after the final treatment. Subject satisfaction scores were also obtained 1 month after the final treatment. Results: Twelve subjects completed this trial. The global extrinsic aging score improved from a baseline of 3.3 to 1.0. Of these 12 subjects, 10 (84%) indicated that they were satisfied or very satisfied with the results 1 month after completion of the treatment. Conclusions: This photodynamic therapy regimen is very effective while being better tolerated and involving less downtime. The treatment can also be completed in a shorter time than regimens requiring a longer incubation time.
Quadriceps Implant: Cosmetic Improvement to the Anterior Thigh Region in a Patient Suffering from HIV Muscle Wasting
Authors: Chugay Nikolas V. , Chugay Paul N. 
Published: November 2015

Introduction: Muscle wasting is a known complication of HIV and the highly active antiretroviral therapy (HAART) therapy employed to treat HIV/AIDS. To date, there has been no good solution for patients suffering from muscle wasting in the anterior thigh region. We have developed a custom silicone prosthesis to help those who suffer from inadequacy of the anterior thigh/quadriceps. Materials and Methods: A custom-designed silicone prosthesis was placed via an incision in the anterior thigh beneath the fascia of the quadriceps muscle to augment the anterior thigh. Results: A single patient underwent quadriceps augmentation with a semisolid silicone prosthesis and has had an excellent cosmetic result 3 months postoperatively. Conclusions: Because of HIV or HAART therapy, a patient may suffer from wasting in the legs, and placement of a silicone prosthesis may help to restore a patient's confidence and improve the cosmetic appearance of the anterior thigh/quadriceps region. This procedure may have application in the realm of non-HIV patients seeking cosmetic augmentation of the anterior thigh, and further research is warranted.
Successful Management of Delayed-Onset Complications from a Dermal Filler of Unknown Provenance
Authors: Munro Drew , Ehrlich Michael , Woodward Julie 
Published: November 2015

Introduction: A 52-year-old woman presented with delayed-onset nodules in the malar and glabellar regions approximately 16 months after undergoing facial augmentation via injection of an unknown substance in China. Medical records for the procedure were not available. The authors performed an investigative review of fillers used abroad to determine possible treatment options for the patient. After discussion with general plastic surgeons in China, a treatment plan was initiated. Materials and Methods: Computed tomography of the head with 3-dimensional reformatting was performed to characterize the nature and extent of the interventions performed. The study revealed significant amounts of a subdermal substance in the malar and glabellar regions. Results: A cycle of treatment was performed involving the injection of lidocaine, triamcinolone, and fluorouracil into the affected areas accompanied by interspersed daily massage. The regimen proved effective, and there was clear reduction in the size and inflammation of the nodules. Conclusions: The modern age of facial rejuvenation features an increasing array of soft tissue fillers available to physicians performing facial augmentation. The expansion of available filling agents and the rising costs of domestic health care have resulted in an increase in the number of patients seeking elective cosmetic procedures abroad, and patients presenting with complications from cosmetic tourism are increasingly a part of the modern aesthetic practice. Maintaining a solid awareness of current usage trends of injectable filling agents and a thorough understanding of the management options for delayed-onset nodules are essential for mitigating complications from soft tissue fillers of unknown provenance.
A Review of New Facial Filler Techniques for Facial Rejuvenation
Authors: Ferneini Elie , Jackson Terri , Ferneini Christina , Banki Mohammad 
Published: November 2015

Introduction: Over the recent years, the use of facial fillers for rejuvenation of the aging face has continued to increase in popularity. As the demand for noninvasive cosmetic enhancements increases, so does the need for new cosmetic techniques that will increase patient satisfaction while decreasing complications. In the past, facial fillers were mostly used for lip augmentation, nasolabial folds, and marionette lines. However, because of advances in cosmetic techniques and types of dermal fillers, cosmetic surgeons today are able to correct lines, wrinkles, and volume loss seen in crow's feet, around the eyes, chin, and cheeks. Materials and Methods: A literature search was performed from 2006 to 2013 to determine new cosmetic techniques used for facial rejuvenation of the aging face. Results: Advances in facial rejuvenation are helping to give cosmetic surgeons better results with little discomfort when using dermal fillers around the eyes, cheeks, and chin to improve the overall look of wrinkles and volume loss. Conclusions: The development of new techniques and injectable dermal fillers will continue to advance with the increasing demand for a youthful appearance. Up until recently, facial fillers were used mainly to improve the effects of aging seen around the lips, nasolabial folds, and marionette lines. Today, because of advances in the type of facial filler and used techniques, facial fillers can be used to improve volume loss, lines, and wrinkles around the eyes, cheeks, and chin.
Nasal Tip Reconstruction with Replacement of Lower Lateral Cartilage during Revision Rhinoplasty
Authors: Moina Daniel G. , Moina Gabriel , Ripetta Luis Maria 
Published: November 2015

Introduction: Nasal tip revision remains one of the most challenging procedures for plastic surgeons. Performing 3-dimensional anatomic nasal tip reconstruction by complete replacement of alar cartilages with ear cartilage allows optimal nasal tip correction in patients with severe alar distortion. We aim to describe this reconstructive surgical technique and report our experience with this procedure. Materials and Methods: We performed a retrospective analysis of patients who underwent complete replacement of alar cartilages as part of a revision rhinoplasty. Results: From January 2010 to December 2014, 569 patients underwent revisions, 20 (3.5%) of them with complete alar replacement. Additional grafts used were as follows: 8 columellar struts, 6 onlay grafts, and 3 spreader grafts. There were no in-hospital complications. At follow-up (mean 24 months), all patients reported satisfaction with the esthetic outcome and improvement in functional symptoms. No patient underwent further augmentation or repeat revision. Conclusions: Complete replacement of alar cartilages is an efficient surgical alternative for nasal tip reconstruction during revision rhinoplasty. This technique recreates the severely injured alar cartilage structure and returns the original nasal tip appearance.
Surgical Correction of Facial Skeletal Deformity of Patients with Thalessemia
Authors: Badri Amir Ali , Keyhan Seied Omid , Jalalian Faranak , Fallahi Hamid Reza , Asayesh Mohammad Ali , Khiabani Kazem 
Published: November 2015

Introduction: Our primary intention is to review the literature that has been published in this field and to report some cases of surgical correction of facial and skeletal deformities in patients with thalassemia. Thalassemia is widespread, and about 5% of the world population is affected. Management of facial and skeletal deformity is a major concern in patients with thalassemia, and numerous surgical approaches have been advocated to correct facial deformities, although the type of treatment remains in dispute. Materials and Methods: We report the cases of 3 specific patients who were treated with uncommon surgical procedures after the hematologic condition was corrected. Results: No signs of relapse or maxillary bony overgrowth have occurred in these patients. No massive bleeding occurred during the procedures, and the patients tolerated the surgical approach very well. Complicated surgical procedures, such as bimaxillary segmental osteotomies with 2 or more pieces have been done in patients who had proper systemic conditions without any complications. Conclusions: Maintaining a hemoglobin level of approximately 10 g/dL decreases the risk of preoperative hemorrhage and complications of anesthesia. A complicated surgical approach and more instability during surgery is expected in patients with higher degree of systemic problems. We found that preoperative facial analysis was important in guiding our surgical planning and would benefit the cosmetic outcome as well. Attention to cardiac dysfunction, osteoporosis, vitamin D deficiency, and type of hemoglobin deficiency must be kept in mind, though more surgical cases must be treated before reaching a definitive conclusion.