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At least 451 records · Page 25Linked to original sources
PubMed2003

Unusual herpes simplex virus infection mimicking foreign body reaction after cosmetic lip augmentation with expanded polytetrafluoroethylene threads.

BACKGROUND: Adverse reactions after cosmetic lip augmentation with synthetic implant materials include inflammation, infection, and extrusion of and foreign body reaction to the implant. Clinically, all of them are characterized by pain, erythema, swelling, and formation of papules and/or pustules. OBJECTIVE: To describe an unusual herpes simplex virus infection in a 48-year-old female patient after cosmetic lip augmentation with expanded polytetrafluoroethylene threads clinically resembling a foreign body reaction. METHODS: Case report and literature review. RESULTS: A histopathologic examination showed no signs of a foreign body reaction. Instead, herpes simplex virus-specific DNA was demonstrated by polymerase chain reaction from lesional tissue. CONCLUSION: Cosmetic lip augmentation with expanded polytetrafluoroethylene threads may be complicated by a delayed local herpes simplex virus infection clinically mimicking a foreign body reaction to the implant.

Female↗
PubMed1999

The cosmetic outcome in early breast cancer treated with breast conservation.

AIMS: To measure the cosmetic outcome of breast-conserving surgery and identify the factors which influence cosmesis. METHODS: A total of 254 patients with primary breast cancer treated by wide local excision, with or without radiotherapy, were subjectively assessed for cosmesis by a six-member panel using photographic evaluation and objectively by an independent observer using specific measurement. RESULTS: Good to excellent cosmetic results were achieved in 184 (72%) patients on panel subjective assessment and 201 (79%) patients on objective assessment. Good correlation (P<0.001) and agreement were found between the panel's subjective photographic assessment and the objective assessment. The main factors found to affect cosmesis negatively were: medially located tumours; weight of specimen; re-excision procedures; radiotherapy; small breasts and longer scars. CONCLUSION: These cosmetic results, combined with a low local recurrence rate following wide local excision, validate the operative method used.

Adult↗
PubMed1999

Does cosmetic outcome from treatment of primary breast cancer influence psychosocial morbidity?

AIMS: To investigate any influence of cosmetic outcome on psychosocial morbidity in patients who have undergone breast-conserving surgery for primary breast cancer. METHODS: Cosmetic outcome was assessed both objectively and subjectively in 254 patients, aged 20-69 years, who underwent breast-conserving surgery for operable primary breast cancer, </=3 cm in diameter; most women also received post-operative intact breast irradiation. Patients completed questionnaires assessing satisfaction with the outcome and assessing other psychosocial morbidity using the Hospital Anxiety Depression scale, the Body Image questionnaire and the Rosenberg Self-esteem scale. RESULTS: Patient satisfaction was high (90.5% of the patients were very or moderately satisfied). There was an excellent correlation between cosmesis and levels of anxiety (r=-0.81, P<0.001) and depression (r=-0.7, P<0.001) and between cosmesis and body image (r=-0.4, P<0.001), sexuality (chi(2)=22, P=0.001) and self-esteem (r=-0.64, P<0.001). CONCLUSIONS: This study has shown that the cosmetic result achieved has a marked bearing on the subsequent development of psychological outcome.

Adaptation, Psychological↗
PubMedDate not supplied

The cosmetic appearance of the biceps muscle after long-head tenotomy versus tenodesis.

PURPOSE: This study evaluates the cosmetic appearance of the biceps muscle after arthroscopic, intra-articular biceps tenotomy versus tenodesis by presenting subjective outcome results in patients with refractive bicipital pain. TYPE OF STUDY: Retrospective study evaluating clinical follow-up of patients with refractive and chronic bicipital pain. METHODS: Five consecutive years of patients receiving biceps tenotomy (80 patients; 40 males, 40 females; average age, 58 years) or tenodesis (80 patients; 51 males, 29 females; average age, 54 years) procedures were retrospectively followed-up by grading anterior shoulder pain, muscle spasms in the biceps, and cosmetic deformity of the biceps muscle. Statistics were done by chi(2) analysis. RESULTS: When assessing the follow-up questions, no statistical significance was found between the biceps tenotomy and biceps tenodesis groups. There was also no statistical significance when comparing the biceps tenotomy and biceps tenodesis groups when evaluating only the men, women, and men versus women with respect to the questions assessed. CONCLUSIONS: In the majority of patients in which a biceps tenotomy is performed, we note that the cosmetic appearance of the biceps muscle, the grade of muscle spasms of the biceps, and the level of anterior shoulder pain would present with little difference than if a tenodesis had been performed. Therefore, a biceps tenotomy may be a reasonable alternative to a biceps tenodesis in patients with refractive and chronic bicipital pain.

Adult↗
PubMed2001

Sternomastoid-muscle transposition improves the cosmetic outcome of superficial parotidectomy.

A facial depressed deformity subsequent to superficial parotidectomy is unsightly. Although a facelift incision can improve the cosmetic outcome by concealing the scar, the hollow contour around the angle of the mandible remains conspicuous. We have attempted to mitigate this problem by transposition of the sternomastoid muscle. Transposition of the sternomastoid muscle to cover the parotid bed after superficial parotidectomy for benign tumour was performed in eight consecutive patients. The histopathology and postoperative results, including complications and patient satisfaction, were analysed. The depressed deformity was considerably alleviated in all eight patients. All patients except one, who had a wound infection, were satisfied with the cosmetic outcome postoperatively. The extra operative time required for sternomastoid-muscle transposition was only 10 min. There was no morbidity related to this additional procedure. By combining this simple method with a facelift incision, an appealing cosmetic outcome can be achieved after superficial parotidectomy.

Adenolymphoma↗
PubMed1999

Cosmetic assessment of breast-conserving surgery for primary breast cancer.

The goals of breast-conserving treatment are to achieve local control and survival rates equivalent to mastectomy and to preserve breast cosmetic appearance. This paper specifically addresses the different ways of cosmetic assessment by the observer (subjective and objective assessments) and by the patient (self-assessment), and the factors which influence the cosmetic outcome, based on a review of the current literature.

Journal Article↗
PubMed2001

Depression, anxiety and quality of life among scheduled cosmetic surgery patients: multicentre prospective study.

Objective: To measure cosmetic surgery patients' state of psychological vulnerability. Method: A multicentre prospective study was carried out in three hospital departments. One hundred and three patients scheduled for cosmetic surgery were examined using a structured interview and using three assessment scales: the MADRS (Montgomery and Asberg Depression Rating Scale), the SISST (Social Interaction Self Statement Test) and the EQ-5D (EuroQol) which measures quality of life. Results: The MADRS index was higher than that of the control group (p<0.01) with 20% depressive patients. SISST: the social anxiety was greater than that of the control group (p<0.001). The EQ-5D visual analogue scale average was 77.39% indicating that there was no significant difference when compared with the control group, but the descriptive EQ-5D revealed an over-representation of the anxiety/depression category (p<0.01); 50% had already taken psychotropic treatment of which 27% were an antidepressant. Conclusion: The cosmetic surgery population presents a significant state of psychological vulnerability. Copyright 2001 European Association for Cranio-Maxillofacial Surgery.

Journal Article↗
PubMed2006

[Discrepancy between objective measurement and subjective recognition of sicca syndrome before and after blepharochalasis operation for cosmetic or medical reasons].

BACKGROUND: This study was designed to examine if patients undergoing the same operative procedure (blepharochalasis operation) have different subjective recognition of dry eye problems depending n whether they had he operation for cosmetic or medical reasons. PATIENTS AND METHOD: The study included 32 patients (25 women, 7 men, mean age 57.8 +/- 12.1 years), who underwent blepharochalasis operation between 1/2005 and 5/2005. In 17 patients (group 1) the operation was done for cosmetic reasons, in 15 patients we found a medical indication (group 2). We evaluated the subjective discomfort from the lid problems as well as the satisfaction with the operation in general and pre- or postoperative recognition of dry eye problems (all done by scales). Additionally we measured tear secretion by Schirmer's test and break-up time before and after operation. RESULTS: The subjective recognition of a dry eye was stronger in group 1 than in group 2 before and after operation (p < 0.005), but objective data were nearly identically (BUT, Schirmer's test). CONCLUSION: When operated due to cosmetic reasons the stronger recognition of sicca problems (while objectively lacking) is may be caused by a stronger fixation on the lid disease itself. It seems necessary to document objective data for that reason.

Blepharoplasty↗
PubMed2006

Psychiatric conditions in cosmetic surgery patients.

Beauty is important. As psychiatrists, we see the interface of beauty with mental health, self-esteem, and mental illness. As physicians who enhance cosmetic appearance, you encounter a broad spectrum of patients ranging from those with a healthy pursuit of enhanced appearance to those whose behavior is extremely maladaptive. This article provides some examples of unhealthy pursuit and how to recognize patients who may be inappropriate for cosmetic procedures. Patients with body dysmorphic disorder and narcissistic and histrionic personality disorders are suffering from psychiatric illnesses that interfere with their judgment and can lead them to make poor choices when considering cosmetic procedures. Clinicians who acquire a basic understanding of these psychiatric conditions can properly screen their patients and enhance their understanding of their patients' goals, both realistic and unrealistic, thus saving them from performing inappropriate procedures that cause frustration to both the clinician and the patient.

Histrionic Personality Disorder↗
PubMed2004

Upper lid loading with gold weights in paralytic lagophthalmos: a modified technique to maximize the long-term functional and cosmetic success.

PURPOSE: To describe a modified fixation technique to improve the long-term functional and cosmetic success of upper lid loading with gold weights. METHOD: A retrospective single surgeon study of combined upper pre-tarsal and direct levator fixation of the gold weight. The minimum follow-up period was 12 months. RESULTS: Gold weights were implanted with the modified technique into 29 patients. The gold weight was removed in two cases due to infection and in one case due to ptosis. There was no loss of function over the follow-up period and the cosmetic outcome was good or very good in all cases. The follow-up ranged from 12 to 84 months with a mean of 40 months. CONCLUSIONS: Combined upper pre-tarsal fixation and direct levator fixation is effective in maximizing both the long-term functional and cosmetic success of upper lid loading with gold weights in paralytic lagophthalmos.

Adult↗
PubMed1986

The psychology of cosmetic surgery: a critical overview of the literature 1960-1982--Part I.

In this communication I attempt to clarify some of the important concepts in the psychology of cosmetic surgery by providing an overview of American and European literature with special emphasis on controlled studies. A brief survey of the literature is presented and critically discussed. Topics include the personal impact of a deformity, differences between subjective and objective assessment of the cosmetic defect, the patient's personality, sex differences in relation to outcome, external versus internal motivation for surgery, severity of cosmetic defect and postoperative psychological results, postoperative patient satisfaction, and psychological complications. Finally, the question is addressed as to whether surgery or psychotherapy is the more appropriate treatment modality.

Attitude to Health↗
PubMed1986

The psychology of cosmetic surgery: old problems in patient selection seen in a new way--Part II.

Numerous patient referrals and discussions with the plastic surgeons of the Zurich University Hospital, and the lack of "hard" data in the literature motivated me to delve more into the problems of patient selection in cosmetic surgery. The first section of this article consists of a discussion of the selection criteria in the literature. Although they may be important in single cases, none of the criteria proves to be statistically significant in regard to the outcome of cosmetic surgery. After a short outline of the development of research in cosmetic surgery, a systemic-interactional model of thinking is introduced and applied to the patient selection process. The sections on coping, the patient/surgeon/psychiatrist triangle, and management of the patient in the screening interview illustrate that the systemic hypothesis can enhance the understanding of patient attitudes and behaviors. Practical implications are discussed.

Adaptation, Psychological↗
PubMed1995

Free fat autotransplantation for the cosmetic treatment of first web space atrophy.

The results of free fat autotransplantation for the correction of first web space atrophy were reviewed for 25 patients who sustained war injuries resulting in ulnar nerve palsies. In anticipation of partial graft resorption, a 30% overcorrection of the first web space deformity was performed compared with the normal hand. Average follow-up was 5 years. All patients were satisfied with their cosmetic results. Whereas 21 patients (84%) demonstrated less bulk when compared to their normal side, 4 (16%) retained slight overcorrection of the web space. After 1 year of follow-up, there was no further evidence of graft resorption. There were no long-term complications. We conclude that free fat autotransplantation for the cosmetic correction of atrophy of the first web space is a safe and effective procedure. Although graft resorption was encountered, overcorrection provided patients with dramatic cosmetic improvement.

Adipose Tissue↗
PubMed1998

Cosmetic sequelae after conservative treatment for breast cancer: classification and results of surgical correction.

After conservative treatment for breast cancer, 20% to 30% of patients have a residual deformity that sometimes requires surgical correction. Thirty-five of these patients were operated between 1990 and 1995 at the Institut Curie. The authors classify these sequelae into three types: type I, asymmetrical breasts with no deformity of the treated breast; type II, deformity of the treated breast, compatible with partial reconstruction and breast conservation; and type III, major deformity of the breast, requires mastectomy. Fourteen patients had a type I deformity; all but 1 patient were treated with mammaplasty. Seventy-one percent underwent unilateral surgery contralateral to the irradiated breast; 80% had a satisfactory cosmetic result (good or very good). Seventeen patients had a type II deformity. They were treated by various techniques (implant, mammaplasty, latissimus dorsi flap, or transverse rectus abdominis musculocutaneous flap). Only 43.8% of patients in this group had a late satisfactory cosmetic result. Four patients had a type III deformity. They were treated with mastectomy and immediate reconstruction using a musculocutaneous flap. All 4 patients had a very good cosmetic result. This classification is a valuable guide for technique selection. For type I deformities, surgery to the irradiated breast should be avoided when possible. Type II deformities raise the most difficult therapeutic problems. Because they are mainly postoperative, optimal treatment should be preventive--by performing immediate remodeling of the treated breast before radiotherapy. This pleads for integration of plastic surgical techniques at the time of the original lumpectomy, thus reducing the need for delayed reconstructive surgery.

Adult↗
PubMed2000

Characteristics of women with cosmetic breast augmentation surgery compared with breast reduction surgery patients and women in the general population of Sweden.

To determine whether women with cosmetic breast implants have distinct demographic, lifestyle, and reproductive characteristics that put them at increased risk for subsequent morbidity, the authors compared 1,369 such women to 2,211 women who had undergone breast reduction surgery, and to a random sample of 49,262 women from the general population of Sweden. Information was collected through self-administered questionnaires, and comparisons were made using the prevalence odds ratio. Women with cosmetic breast implants were significantly (p <0.05) more likely to be current smokers, have a lower body mass index, have had a prematurely terminated pregnancy (induced abortion or miscarriage), and have had fewer live births than either women who underwent breast reduction or women from the general population. Type of implant (silicone gel or saline) did not modify the associations. Regardless of the comparison group used, studies of the health effects of breast implants need to consider that women who undergo cosmetic breast implantation have certain distinct characteristics.

Adult↗
PubMed2001

Offspring health risk after cosmetic breast implantation in Sweden.

Case reports have suggested that children born to women with silicone breast implants may have an excess risk of rheumatic disease and/or esophageal disorders. In Sweden, the authors conducted a retrospective cohort study of 5,874 children born to women with cosmetic breast implants and 13,274 children born to women who had breast reduction surgery. Using national registers, they computed hospitalization rates for rheumatic and esophageal disorders, incidence rates for cancer, and prevalence rates for congenital malformations and perinatal death. Relative to children of women who had breast reduction surgery, children born to women who had cosmetic breast implants were not at excess risk of rheumatic disease (relative risk [RR] = 1.1; 95% confidence interval [95% CI], 0.2-5.3), esophageal disorders (RR = 1.0; 95% CI, 0.7-1.6), cancer (RR = 0.3; 95% CI, 0.0-2.5), congenital malformations in total (RR = 1.0; 95% CI, 0.6-1.5), or specifically involving the digestive organs (RR = 0.5; 95% CI, 0.2-1.3) or perinatal death (RR = 0.9; 95% CI, 0.5-1.8). The rates of these health outcomes among children born after a mother's implant surgery were also not significantly higher than among children born before a mother's implant surgery. This study provides no evidence that certain hypothesized health outcomes are more likely among the children of women with cosmetic breast implants.

Breast↗
PubMedDate not supplied

Assessment of cosmetic and functional results of conservative versus surgical management of facial burns.

This study was undertaken to determine whether tangential excision and thick split-thickness skin grafting (STSG) of deep facial burns give a better cosmetic and functional result than conservative management. Forty patients (28 adults, 12 children) treated for facial burns between July 1989 and July 1991 were evaluated in follow-up (mean 18.3 +/- 8.3 months). The patients were categorized into the following groups according to depth and management of their facial burns: (A) healed without surgery in less than 21 days (n = 13), (B) healed without surgery in 21 days or more (n = 11), (C) early debridement and thick STSG in 18 days or less after the burn (n = 6), and (D) delayed debridement and thick STSG in more than 18 days after the burn (n = 10). Facial esthetics were evaluated by use of a modified scar assessment scale [range 0 (normal) to 16 (multiple abnormalities)], and functional problems of the face and neck were evaluated by use of physical examination. Group A patients had a significantly better overall rating on the scar assessment scale (2.1 +/- 2.9) than the patients in the other groups that required more than 21 days to heal, B (8.0 +/- 2.7), C (7.3 +/- 2.9), and D (5.7 +/- 2.5) (p < 0.01, analysis of variance). Also, skin-grafted areas in the surgically treated groups C and D had a significantly better scar rating than wounds that healed spontaneously in group B (5.7 +/- 4.0 vs 8.0 +/- 2.7, p < 0.05; and 5.1 +/- 2.6 vs 8.0 +/- 2.7, p < 0.05). There was no significant difference among groups B, C, and D when the total number of persistent functional problems after treatment were compared. The most common functional problems for these patients were microstomia (17/27) and eyelid ectropion (17/27). Patients with superficial facial burns that heal in less than 21 days appear to heal with generally very acceptable cosmetic and functional results. However, in those patients with deep facial burns that require prolonged periods for spontaneous wound healing, tangential excision of the wound and resurfacing with thick STSG appear to give better cosmetic results than conservative management, with no greater incidence of functional complications.

Adult↗
PubMed1996

Cosmetic reconstruction after mastoidectomy for the transpetrosal-presigmoid approach: technical note.

OBJECTIVE: We describe the technique of cosmetic reconstruction after mastoidectomy in the transpetrosal-presigmoid approach for petroclival lesions. TECHNIQUES: This technique involves raising a single temporo-occipital bone flap and cosmetic mastoidectomy, removing the mastoid bone fragments (by means of a rongeur instead of an air drill) for later reconstruction. Replacement of the bone fragments mixed with fibrin glue enables tamponade against the dura to be achieved without a fat graft. RESULTS: Computed tomographic scans and plain cranial films taken a few years later showed successful reconstruction of the mastoid bone with a good appearance of the retromastoid area in seven patients who underwent this procedure. The only complication was infection in one patient from cerebrospinal fluid leakage from the wound. CONCLUSION: We have developed a simple and easy technique of cosmetic reconstruction after the transpetrosal-presigmoid approach.

Bone Transplantation↗