Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “COSMETICS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 307 records · Page 17Linked to original sources
PubMed2000

A prospective and randomized study, "SVEA," comparing effects of three methods for delayed breast reconstruction on quality of life, patient-defined problem areas of life, and cosmetic result.

During the last 30 years, many methods for delayed breast reconstruction have been described. There is a lack of prospective randomized trials comparing reconstruction methods. The present study (SVEA), conducted 1995 to 1996, describes the impacts of three methods: the lateral thoracodorsal flap, the latissimus dorsi flap, and the pedicled transverse rectus abdominis muscle flap (TRAM), on important areas of life, patients' perception of cosmetic result, and quality of life. Questionnaires were completed before randomization and at 6 and 12 months postoperatively. The preoperative questionnaire concerned the impact of breast loss and expectations on reconstruction. Follow-up questionnaires dealt with satisfaction with cosmetic result and impact on important areas of life. A health-related quality-of-life questionnaire (SF-36) was completed at all points of assessment. A total of 75 of 87 randomized patients underwent breast reconstruction: 16 patients with the lateral thoracodorsal flap, 30 with the latissimus dorsi flap, and 29 with the TRAM flap. The majority were very satisfied with the cosmetic result. Most women reported improvements in important areas of life, and quality of life in terms of "social functioning" and "mental health" increased significantly after the reconstruction. The latissimus dorsi flap and TRAM flap scored significantly higher as compared with the lateral thoracodorsal flap for similarity with the contralateral breast and reduced problems in social situations. No differences between irradiated and nonirradiated patients were found. All methods were considered to produce good cosmetic results and improvements in patient-defined problem areas of life and quality of life. No negative effects were recorded. Thus, irrespective of method, breast reconstruction is a valuable tool for the mastectomized woman to cope with problems in everyday life.

Activities of Daily Living↗
PubMed2001

Local complications and subsequent symptom reporting among women with cosmetic breast implants.

Epidemiologic studies have found no association between breast implants and cancer or well-defined connective tissue diseases. However, women with cosmetic breast implants continue to report specific as well as nonspecific physical and psychological symptoms after receiving their implants. In an attempt to determine whether local complications of implantation may contribute to this excess of symptom reporting, the authors studied a large cohort of women in Sweden with cosmetic breast implants (n = 1280) and a comparison cohort of women who had cosmetic breast reduction surgery (n = 2211). Both groups of women had operations between 1969 and 1996. Medical record reviews of local complications revealed that approximately 31 percent of the women with cosmetic breast implants had an implant change, implant leakage, or a capsulotomy. Capsulotomies occurred more often in women who were age 35 or older at the time of the operation, had ever smoked, and had implants with a smooth surface. On self-administered questionnaires, symptoms were reported more often by the women who had implants regardless of whether they had local complications. Twenty of the 28 symptoms occurred more frequently among women with local complications and breast implants, compared with the women in the breast reduction comparison group or the women with breast implants but no local complications. This study suggests that local complications, particularly capsular contractures as indicated by capsulotomy, may be an important factor to consider when studying symptom reporting among women with breast implants.

Adult↗
PubMed2002

Cosmetic outcome of scalp wound closure with staples in the pediatric emergency department: a prospective, randomized trial.

OBJECTIVE: The purpose of this study is to compare the cosmetic outcome of scalp wound closure with staples to traditional skin sutures. METHODS: A prospective, randomized trial was conducted using a convenience sample of children (aged 1-16 y) with simple scalp lacerations admitted to the pediatric emergency department. After parental consent was obtained, patients were randomly assigned to either a stapling or suturing procedure. A trained attending physician completed the procedure following a standard protocol. Based on previously published data, a sample size of 18 patients per group was calculated to give 85% power to detect a 10% difference on a visual analogue scale (VAS) score (two-sided alpha 0.05). Initial outcome of wound healing at 7 to 10 days and final cosmetic outcome after 6 to 18 months were estimated using a VAS. Cosmetic outcome was assessed by a physician blinded to the procedure. Data were analyzed using SPSS (Version 8.02; SPSS Inc., Chicago, IL). The VAS scores for the two treatment groups were compared using the two-tailed Student t test. Analysis of age, race, mode of injury, time interval, and size of the wound were performed to estimate the strength of the association of VAS score with the treatment, adjusted for the covariates. RESULTS: A total of 42 patients were enrolled. Of the 42, 38 (90.5%) finished the initial follow-up and 31 of those 38 (81.6%) finished the final follow-up. There were no significant demographic differences between groups at recruitment and first follow-up. Among those patients who completed the final follow-up, 15 underwent stapling, and 16 underwent suturing. There were no significant demographic or baseline differences between the groups. Procedure time was significantly lower in the stapling group (P = 0.001). Final follow-up evaluations were completed in 12 +/- 4 months. The mean VAS scores at first and final follow-up were 78.75 +/- 16.16 and 96.31 +/- 8.06 for the suturing group and 86.67 +/- 9.76 and 97 +/- 7.02 for the stapling group (P = 0.17). There remained no significant difference in the final follow-up VAS score between groups when adjusted for covariates. CONCLUSION: Stapling appears to be a fast and cosmetically acceptable alternative to suturing for simple scalp lacerations.

Child↗
PubMed2001

Adolescents undergoing surgery for idiopathic scoliosis: how physical and psychological characteristics relate to patient satisfaction with the cosmetic result.

STUDY DESIGN: Patient satisfaction with the cosmetic result of spinal fusion surgery was studied in 42 cases of adolescent idiopathic scoliosis. Neutral or dissatisfied patients were compared with satisfied patients on several physical and psychological characteristics. OBJECTIVES: To determine whether adolescents generally report satisfaction with the postoperative appearance of their back after the correction of severe curves and whether preoperative medical and/or psychological factors distinguish between patients who will report satisfaction with the cosmetic surgical result from those who will report neutrality or dissatisfaction. SUMMARY OF BACKGROUND DATA: Previous reports emphasize the need for medical outcomes research that evaluates both patient satisfaction and technical success. Patient satisfaction with spinal surgery has largely been evaluated in retrospective studies and most consistently related to postoperative cosmesis and degree of curve correction. METHODS: Forty-two adolescents with idiopathic scoliosis without comorbidity, who were 12 years 6 months of age or older, and who did not require both anterior and posterior spinal fusion, were studied preoperatively and postoperatively by physical and psychological measurements. RESULTS: Of patients undergoing surgical correction of severe curves, 73% reported satisfaction with the cosmetic result. Neutral or dissatisfied patients were more likely than satisfied patients to have a lower body mass index (P < 0.05), to be younger in menarcheal status (P < 0.05), and have a King II or King III curve type. Preoperative psychological difficulties (P < 0.05) and unmet expectations regarding the postoperative cosmesis (P < 0.05) were more common among neutral or dissatisfied patients. CONCLUSIONS: Most adolescents with idiopathic scoliosis expressed satisfaction with the cosmetic surgical result. Preoperative physical characteristics, psychological difficulties, and unrealistic expectations regarding postoperative cosmesis are associated with patient neutrality or dissatisfaction.

Adolescent↗
PubMed2005

Current trends in local anesthesia in cosmetic plastic surgery of the head and neck: results of a German national survey and observations on the use of ropivacaine.

BACKGROUND: The goal of this study was to evaluate at the national level the current practice in the use of local anesthetics in cosmetic head and neck surgery and to compare the results with the novel local anesthesia technique used in the authors' department over the past 2 years. METHODS: A questionnaire was posted to all 211 board-certified members of the Association of German Plastic Surgeons. The questions related to the daily practice in rhinoplasty, blepharoplasty, otoplasty, face lift, and forehead lift. The focus was laid on anesthesia techniques, local anesthetics, vasoconstricting agents, dosages, activity onset, observed side effects, mean duration of each procedure type, and surgeon satisfaction with the anesthetic used. RESULTS: A total of 86 questionnaires (40.8 percent) were returned. The overall analysis revealed that local anesthetics were used in 88.9 percent of all cosmetic procedures of the head and neck. Prilocaine 1% (Xylonest; AstraZeneca, Wedel, Germany) was the most frequently used local anesthetic (32.0 percent), followed by lidocaine 1% (Xylocaine; AstraZeneca) and mepivacaine 1% (Scandicaine; AstraZeneca). Ropivacaine 0.2% (Naropin; AstraZeneca) was used only by 1.1 percent and ropivacaine 0.75% only by 0.9 percent (including two of the authors). Approximately half of the respondents (47.2 percent) used epinephrine 1:100,000 for vasoconstriction. In face lifts, the necessity of repeated "top-up" infiltration was reported in more than half (54.7 percent) of the procedures. Ten percent of surgeons surpassed the maximum recommended dosages when working without ropivacaine. Overall adverse cardiovascular effects were reported in 5.9 percent of rhinoplasties and 8.1 percent of face lifts performed mostly with prilocaine and lidocaine. No adverse cardiovascular reactions or overdoses were noticed with the use of ropivacaine. CONCLUSIONS: The survey showed a clear trend toward the increasing use of local anesthetics in cosmetic surgery of the head and neck. Although the use of prilocaine and lidocaine prevailed, adverse cardiovascular reactions in up to 8.1 percent seem high for cosmetic procedures. Furthermore, the need of additional intraoperative top-up infiltration adds to an uncontrolled cumulative effect and patient discomfort. On the basis of their positive 2 years of experience with ropivacaine, the authors strongly believe that ropivacaine offers significant advantages, both in efficacy and prolonged duration of analgesia, while reducing the risk for adverse side effects due to lesser toxicity. This observation deserves further investigation in an established comparative study.

Amides↗
PubMed2006

Top-10 list of herbal and supplemental medicines used by cosmetic patients: what the plastic surgeon needs to know.

BACKGROUND: Widespread use of herbal medications/supplements among the presurgical population may have a negative effect on perioperative patient care. Thus, the authors' goal was to identify the prevalence of such use in a cosmetic surgery patient population compared with use among the general public; to assess physician awareness of proper management of these herbal medications/supplements; and to review the literature to provide rational strategies for managing perioperative patients taking these remedies. METHODS: To assess patient (n = 100) and general public (n = 100) usage rates, open-ended lists of (1) the most common herbal medications/supplements and (2) homeopathic treatments were compiled. Board-certified plastic surgeons (n = 20) were then given the same list of herbs/supplements and surveyed on their awareness of these treatments and perioperative side effects. RESULTS: The usage rate for cosmetic versus public surveys for herbal medicines/supplements was 55 percent versus 24 percent (p < 0.001), with 35 percent versus 8 percent (p < 0.001) engaging in homeopathic practices, respectively. Cosmetic patients' top four herbal/supplements of usage were chondroitin (18 percent), ephedra (18 percent), echinacea (14 percent), and glucosamine (10 percent). The top four used by the general public were echinacea (8 percent), garlic (6 percent), ginseng (4 percent), and ginger (4 percent). The physician survey demonstrated awareness of 54 percent of the listed supplements/herbal medicines, 85 percent of which were not suggested to be discontinued preoperatively, with only ephedra achieving 100 percent physician discontinuation preoperatively. CONCLUSIONS: Herbal medicines and supplements displayed greater prevalence in the cosmetic surgery population than in the population at large. Furthermore, side effects and potential complications warrant addressing these remedies as pharmaceuticals rather than as safe and "natural." Thus, a descriptive "top-10" list with perioperative recommendations was compiled for the plastic surgeon.

Adult↗
PubMed2003

Attitudes of adolescents about cosmetic surgery.

Although the number of teenagers choosing to have cosmetic procedures is increasing at a rapid rate, few studies have been published describing their attitudes about aesthetic surgery. To understand better their beliefs about cosmetic surgery, voluntary, confidential surveys were sent to the entire junior class of a suburban high school. Although two thirds of the respondents knew someone who had undergone cosmetic surgery, only one third would choose it for themselves. Those who desired aesthetic surgery described people who have cosmetic procedures as "motivated," whereas those who would not choose this option believed individuals who do so are "vain." The most desired procedures were liposuction, rhinoplasty, and breast augmentation. The main reasons for not proceeding were health risks, cost, and fear of a bad result. The most common source of information about plastic surgery among the students was teen magazines and television.

Adolescent↗
PubMed2003

Causes of death among Finnish women with cosmetic breast implants, 1971-2001.

Mortality patterns among women with cosmetic breast implants have not been well characterized. We examined cause-specific mortality among women who underwent cosmetic breast implantation at major public hospitals and private clinics in Finland from 1970 through 2000. Causes of death through 2001 were identified through the national mortality register. Expected numbers of deaths were calculated on the basis of mortality rates in the general female population, and standardized mortality ratios (SMR), i.e. ratios of observed to expected deaths, and 95% confidence intervals (CI) were calculated. Among the 2166 women with cosmetic breast implants, we observed 31 deaths versus 32.1 expected. Overall disease mortality was below expectation, mainly due to low mortality from diseases of the circulatory system (SMR, 0.28; 95% CI, 0.03-1.02). Mortality from cancer was close to expectation. There was a statistically significant excess of suicide, based on 10 deaths, which was most pronounced during the first 5 years of follow-up (SMR, 4.26; 95% CI, 1.56-9.26). In conclusion, although based on small numbers, women with cosmetic breast implants did not experience higher mortality overall than women in the general population. The high suicide risk supports other studies and warrants further detailed investigation.

Adult↗
PubMed2005

Circular belt lipectomy: a retrospective follow-up study on perioperative complications and cosmetic outcome.

The purpose of this study was to evaluate the perioperative complications and cosmetic outcomes of circumferential belt lipectomy in patients with evident truncal excess. In 21 women, a circumferential belt lipectomy was performed between April 2002 and March 2004. The mean weight loss before surgery was 44 kg, and the mean body mass index before surgery was 28.1 (range, 22.3-36.5). Patients scored cosmetic results on a visual analog scale. The average reduction weight was 3616 g (2110-7525 g). The average duration of the operation was 132 minutes (range, 79-210 minutes). Patients were discharged from the hospital between postoperative days 6 and 10 (average, day 8). Minor complications occurred in 7 patients and major complications in one. Smoking was a statistically significant cause of postoperative complications. The majority of patients judged the cosmetic outcome as good to excellent (15 patients > or =8, 5 patients = 7, 1 patient =6). Patients with truncal skin and fat excess on both the ventral and dorsal side can obtain a good cosmetic result with a circular belt lipectomy.

Abdomen↗
PubMed1993

Cosmetic tattooing as a treatment of port-wine stains.

BACKGROUND: Medical treatment for port-wine stains frequently is cosmetically unsatisfactory. An alternative possibility is cosmetic medical tattooing. METHODS: By means of a traditional Japanese tattooing technique, five patients were treated in multiple sessions until the color of the lesion matched that of the surrounding skin. RESULTS: The results were excellent, the skin texture remained normal, and the patients could discontinue cosmetic camouflage. DISCUSSIONS: Cosmetic medical tattooing when carefully done is a valuable addition to the medical armamentarium and may replace more aggressive techniques.

Adolescent↗
PubMed1996

A comparative study of the cosmetic appeal of abdominal incisions used for hysterectomy.

OBJECTIVE: To assess the cosmetic appeal of abdominal incisions used for hysterectomy. DESIGN: A comparative study. SETTING: St James's University Hospital, Leeds. PARTICIPANTS: One hundred women, including 50 consecutive women attending a gynaecology clinic for the first time and 50 hospital staff. RESULTS: Sixty-eight percent of women preferred a Pfannenstiel incision as the incision of first choice, while 31% chose the laparoscopic assisted vaginal hysterectomy incisions (LAVH). When women who had undergone previous abdominal surgery were compared with women with no previous surgery, there was a significant difference in their choice (80% Pfannenstiel, 18% LAVH compared with 54% Pfannenstiel, 45% LAVH). CONCLUSIONS: In gynaecological surgery there is already a cosmetically-favoured incision. One cannot assume that if a gynaecologist uses a minimally invasive surgical technique at hysterectomy that this will be cosmetically acceptable to the woman. Gynaecologists should not use cosmetic appeal in counselling women for LAVH and should concentrate on the other proven benefits of minimally invasive surgery.

Abdominal Muscles↗
PubMedDate not supplied

Cosmetic dehorning in goats.

OBJECTIVE: This article describes a technique using primary closure when dehorning goats, and report the results of 22 cases. STUDY DESIGN: Medical records of goats that had cosmetic dehorning were reviewed. ANIMALS OR SAMPLE POPULATION: Twenty-two goats. METHODS: The medical records of 22 goats, not previously dehorned by other methods, that were cosmetically dehorned between January 1988 and September 1995 were reviewed. Data retrieved from the medical record included age, breed, sex, surgical technique used for dehorning, and any complications that occurred after surgery. All clients were contacted by telephone to determine the course of postoperative healing for each goat. A surgical technique to remove the horns and close the defect primarily was described. RESULTS: The mean age of the goats, all male Nubian or Nubian-Spanish cross, was 6.9 months (range, 2 to 24 months). Horn base diameter ranged from approximately 2 to 4 cm. Mean time from surgery until follow-up was 12.9 months (range, 3 to 57 months). All incisions healed by first intention in 10 to 14 days. Clinical signs of sinusitis were not noted, and owners were pleased with the healing time and cosmetic result obtained. CONCLUSIONS: Primary closure of skin defects after dehorning of goats can be achieved with minimal postoperative care and excellent cosmetic appearance. CLINICAL RELEVANCE: Primary closure after dehorning in mature goats reduces aftercare.

Animals↗
PubMed1995

Poor correlation of short- and long-term cosmetic appearance of repaired lacerations.

OBJECTIVE: To describe the consistency of a cosmetic scale for repaired lacerations and to determine whether the appearance of lacerations at the time of suture removal correlates with the appearance six to nine months later. METHODS: A convenience sample of patients who had lacerations repaired in a university teaching hospital were evaluated at the time of suture removal and six to nine months following repair. All lacerations were assigned 0 or 1 point each for the presence or absence of a step-off borders, contour irregularities, margin separation, edge inversion, excessive distortion, and overall appearance. A total cosmetic score (0-6) was calculated by adding the scores for the categories above. The consistency of the cosmetic scale was assessed by comparison of scores given by two different practitioners evaluating each patient at suture removal and long-term follow-up. The 38 evaluating practitioners were assigned based on availability and did not necessarily perform serial evaluations of the same patient. RESULTS: The 41 participating patients had a median age of 19 years (range, 2-82 years). Wounds were located predominantly on the head (73%) and upper extremity (22%). Long-term follow-up was performed at a median of 219 days (range, 155-280 days) after suture removal. Interpractitioner concordance regarding optimal appearance (score of 6 vs < or = 5) was moderate (kappa = 0.52) at the time of suture removal and substantial at the time of long-term follow-up (kappa = 0.68). However, the correlation of actual scores at the time of suture removal vs at long-term follow-up was poor (r = 0.17, p = 0.29). CONCLUSION: For our clinicians, the six-item categorical scale appears consistent as a tool for the assessment of the cosmetic appearance of wounds. However, correlation between laceration appearance at the time of suture removal and six to nine months later is poor.

Adult↗
PubMed1988

Analysis of the factors involved in cosmetic failure following excision of the eye.

We graded the overall cosmetic outcome of 56 patients who required excision of the eye. Each patient was then subjected to a more detailed analysis of the specific abnormalities associated with excision of the eye in order to discover which are associated most consistently with a poor cosmetic result. The only factor showing a statistically significant variation with the overall cosmetic outcome was the degree of upper lid sulcus. Taken individually the other features showed no statistically significant correlation. When each finding was scored, the averaged sum of the scores was related to cosmetic outcome with statistical significance. A method of quantifying orbital volume loss is described.

Adult↗
PubMed1998

Contemporary ethical dilemmas in psychotherapy: cosmetic psychopharmacology and managed care.

Two contemporary ethical dilemmas facing psychotherapists have been noted and described: cosmetic psychopharmacology and the practice of psychotherapy in a managed care environment. Regarding cosmetic psychopharmacology: It was noted that whether a psychotherapist endorses the use of psychotropic agents for cosmetic purposes, such as self-transformation, seems to be a function of the severity of the client/patient symptoms as well as the psychotherapist's view of human nature and the human condition. However, recent research indicates that certain traits or reflections of the human condition, such as irritability, may actually be neurotransmitter deficiencies that are responsive not only to psychotropic agents but also to non-drug interventions. These findings add an additional dimension to discussions of the ethics of cosmetic psychopharmacology. Regarding psychotherapy in a managed care environment: Several ethical dilemmas, including confidentiality, were discussed. These dilemmas were outlined rather than analyzed in detail. Some of them will become major "thorns" of concern for the practice of psychotherapy. Others will be less consequential. Of critical concern is that limitations by managed care on the technique and optimal length of treatment of psychotherapy can conceivably lessen its efficacy for some patients and could possibly eliminate this powerful treatment procedure for others.

Combined Modality Therapy↗
PubMed2003

Growing old disgracefully: the cosmetic use of botulinum toxin.

The explosive growth in the use of botulinum toxin for cosmetic purposes has undoubtedly had an impact on the number of animals used in the potency testing of this product. The test used is a classical LD50, a severe procedure during which animals experience increasing paralysis until the occurrence of death. The enthusiastic adoption by the general public of the use of botulinum toxin as an anti-wrinkle treatment has, at least in Europe, paradoxically taken place against a background of moves to stop animal testing of cosmetics and cosmetic ingredients. There appears to be a dearth of information aimed at the public concerning botulinum toxin testing. Botulinum toxin does have important medical applications; however, the question arises whether a blanket licence for the testing can be justified, when a large proportion of the product is being used cosmetically. A further question is why death continues to be the endpoint of the potency test, when a more-humane endpoint has been proposed. In addition, a number of alternative methods have been developed, which could have the potential to replace the lethal potency test altogether. These methods are discussed in this paper, and the importance of establishing a strategy for their validation is emphasised, a need that has become even more urgent in the light of the recently published draft monograph on botulinum toxin by the European Pharmacopoeia Commission.

Animal Experimentation↗
PubMedDate not supplied

Body dysmorphic disorder. A guide for dermatologists and cosmetic surgeons.

Patients with body dysmorphic disorder (BDD) often present to dermatologists and cosmetic surgeons. BDD is a relatively common yet underrecognized disorder that consists of a distressing or impairing preoccupation with an imagined or slight defect in appearance. Although any body area can be the focus of concern, preoccupation with the appearance of the skin, hair, and nose are most common. Typical associated behaviors include skin picking, mirror checking, and camouflaging (e.g., with a hat or makeup). Reassurance seeking is another common behavior that may be enacted with surgeons and dermatologists. BDD is associated with marked impairment in functioning, notably poor quality of life, and a high suicide attempt rate. The disorder appears relatively common in dermatologic and cosmetic surgery settings; in fact, dermatologists may be the type of practitioner most often consulted by patients with BDD. Psychoeducation is an important element in the treatment of BDD. For patients who compulsively pick at their skin, it is generally ineffective to simply advise them to stop picking. Educating them that the picking is a symptom of BDD, and is treatable, can be helpful. For skin pickers, a combination of psychiatric and dermatologic treatment may be best. It is probably best to avoid cosmetic procedures. Although definitive data on the treatment outcome of surgery and dermatologic treatment for BDD are lacking, and although no one can predict how a given patient will respond to such treatment, available data suggest that these treatments are unlikely to be successful and may even make the patient's condition worse. Rather than referring the patient to another dermatologist or cosmetic surgeon, we recommend attempting to refer the patient to a psychiatrist for cognitive-behavioral therapy or pharmacotherapy. Available data indicate that serotonin (5-hydroxytryptamine; 5-HT) reuptake inhibitors are often effective for BDD. In recent years, BDD has gone from being a neglected psychiatric disorder to one that is becoming better recognized and understood. Nonetheless, research on this disorder is still in its early stages, and much more investigation of BDD is needed, especially in surgical and dermatologic settings. Treatment recommendations will be modified in the future as more research is done. In the meantime, it is important that dermatologists and surgeons screen patients for BDD and accurately diagnose this condition, as available psychiatric treatments are very promising for patients with this distressing and sometimes disabling disorder.

Dermatology↗
PubMed1984

Interobserver variation and cosmetic result of submuscular breast reconstruction.

Four experienced plastic surgeons judged the results of 6 different variables in 99 breast reconstructed women. In the range good to poor the observers assessed symmetry of size, position of the submammary fold, symmetry of shape, nipple-areola reconstruction and scars. The grand mean for total cosmetic results was 2.16 (2 = good, 3 = acceptable). Our material shows a great variance between patients in the total cosmetic result. We considered that no variable here shown has unacceptable reliability in terms of interobserver within patients and interpatients within observers variance ratio. The strongest correlations to the total cosmetic result were shown by symmetry of shape, position of the submammary fold and symmetry of size. Thus, in order to improve the total cosmetic result it is important to focus attention on these three aspects.

Adult↗