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PubMed2001

The value of hair cosmetics and pharmaceuticals.

As early as can be traced, written documents testify endeavors shown by humanity to please by means of the hair. Hair care, color and style play an important role in people's physical appearance and self-perception. Dermatologists should be knowledgeable about the procedures people follow to look their best and should have the competence to provide patients with information on the benefits and hazards of hair cosmetics and pharmaceuticals. Shampooing is the most common form of cosmetic hair treatment. The diversity of qualities expected from a shampoo by today's consumer surpass the primary function of cleansing. Current shampoo formulations are adapted to the variations associated with hair quality, hair care habit and specific problems related to the superficial condition of the scalp. Hand in hand, test methods are developed to evaluate the efficacy of hair care products so that consumers are offered products that perform as claimed. Through the development of cosmetics with pharmaceutically active compounds, products are evolving that are becoming more similar to topical therapeutic agents (cosmeceuticals). The efficacy of cosmeceuticals that claim to act as hair growth stimulants should be measured by the standards set by the drugs minoxidil and, more recently, oral finasteride. Finally, health hazards associated with the use of hair care products, especially rinse-off products, have been overemphasized by the media and need careful correction by opinion leaders.

Dermatitis, Allergic Contact↗
PubMed1983

Personality characteristics of the cosmetic surgical insatiable patient.

It is argued that the personality of the cosmetic surgical patient is undisturbed. Furthermore it is argued that a vast majority of these patients are very pleased with the results of the cosmetic correction. A very small percentage however is dissatisfied (although no surgical-technical mistake was made) and is urging again and again for a repetition of the procedure. The terms in which the personality of the unsatiable patient is described resemble strikingly the description of borderline personality organization. The hypothesis is put forward that the personality of the cosmetic surgical insatiable patient has a borderline organization. A clinical procedure of how to identify preoperatively the insatiable patient is proposed.

Body Image↗
PubMed2001

Method to improve cosmetic outcome following craniotomy.

This technical note describes a simple method for reducing the dead space created by craniotome due to the loss of bone dust and improving the cosmetic outcome following a craniotomy. After drilling the burr holes for the craniotomy, the bone between the holes is drilled away in a standard fashion except that multiple regions of about 1 cm in length are left intact. These intact regions are broken using a periosteal elevator and fixed like a bridge when the bone is replaced. The resulting bone flap is readily returned to its original position without making the dead space created by regular craniotomy. The amount of the dead space caused by losing the bone dust is reduced and a good cosmetic recovery is obtained. This technique is useful for both craniotomy and facial bone surgery, which requires cosmetic results.

Bone and Bones↗
PubMedDate not supplied

Should children with Down's syndrome have cosmetic surgery?

This article explores the rise in the uptake of cosmetic surgery for children with Down's syndrome. The pursuit of such surgical intervention is often a response to society's discriminatory attitude towards Down's syndrome and difference. Such an action raises many ethical concerns, e.g. should a child be subjected to cosmetic surgery when he/she does not understand what is happening to him/her? Much time, effort and resources are needed to work with children with Down's syndrome to ensure their full and active development through childhood. There have been changes in challenging discriminatory attitudes towards people with a disability in society. This, however, is the result of the public coming into contact and building relationships with people with disabilities in the wider community and not cosmetic surgery.

Attitude to Health↗
PubMed1998

Patient sources of information and decision factors in selecting cosmetic surgeons.

This paper presents the results of an exploratory study designed to examine influential information sources and decision factors in the selection of plastic surgeons for cosmetic versus medical procedures. Physician referrals were found to be the most influential sources of information for both groups. Word-of-mouth and magazine and newspaper articles were also important information sources for cosmetic patients. Primary selection factors were significantly different between groups, with board certification the most influential for cosmetic patients and recommendation by physician most influential for medical patients.

Decision Making↗
PubMed2003

Repair of atrial septal defect through a limited right anterolateral thoracotomy in 242 patients: a cosmetic approach?

BACKGROUND: The repair of atrial septal defects (ASD) is often safely performed as a routine procedure in the young and asymptomatic patient. The purpose of this study is to evaluate the feasibility and especially the cosmetic result of this repair performed through a limited right anterolateral thoracotomy (RALT), with the complete cannulation and aortic cross-clamping conducted through the same incision. METHODS: From January 1980 to June 2001 in our hospital, 242 patients (210 female) with atrial septal defects and a mean age of 26.2 +/- 12.0 years underwent operations through a RALT. Repaired defects included 235 ostium secundum defects and 7 sinus venosus defects with partial anomalous pulmonary venous connection (SV). Patients were contacted by phone to evaluate their satisfaction with the thoracic scar. RESULTS: There was neither operative nor early mortality. All of the mentioned defects were successfully corrected. Mean bypass times were 12.37 +/- 4.9 minutes for ASD defects and 47.5 +/- 6.4 minutes for SV defects. The mean stay in the intensive care unit was 1.3 +/- 0.5 days. Most of the patients (86.3%) were fully satisfied with the cosmetic result. CONCLUSIONS: The right anterolateral thoracotomy incision provides a safe and effective approach for the correction of the ASD. This approach can be safely performed without any new instruments and without peripheral incisions, provides good exposure for the surgeon to work comfortably, and achieves a cosmetically superior result in selected cases.

Adolescent↗
PubMed2003

Suicide among women with cosmetic breast implants: a review of the epidemiologic evidence.

Recent epidemiologic studies of women with cosmetic breast implants indicate a statistically significant 2- to 3-fold increase in suicide risk when compared with the general population. Over the last decade, of the large number of epidemiologic studies on various long-term adverse health outcomes among implant recipients, this excess of suicide is the only serious adverse effect supported by credible research. But an association of suicide with cosmetic breast implants based on comparisons with the general population does not by itself support a cause-and-effect relationship regarding the role of implants. Etiologic epidemiologic research is urgently needed to evaluate whether the association between breast implants and suicide is spurious (e.g., reflecting increased prevalence of underlying psychopathology and other risk factors for suicide in women seeking implants) or reflects an actual role for implants in suicide. As a first step, sound epidemiologic nested case-control studies are required to characterize the preimplant psychiatric history of women with implants who commit suicide compared with women with implants from the same cohort who do not commit suicide. Second, large-scale retrospective cohort studies are needed to compare suicide rates among women with implants versus those among women without implants matched on preimplant diagnoses of psychiatric disorders, year of diagnosis, year of birth, family history of psychiatric admissions, and other relevant factors that influence suicide risk. This type of large-scale complex epidemiologic research may be difficult to complete in countries with restrictive privacy laws and widespread litigation, but only after such appropriate etiologic research is completed can any credible cause-effect inference be made regarding the role, if any, of cosmetic breast implants in suicide.

Adult↗
PubMed1995

The estimated frequency of cosmetic breast augmentation among US women, 1963 through 1988.

Estimates ranging from 1 to 2 million have been used to describe the number of women in the United States who have had cosmetic breast implants. Original data from a historical cohort study of women with breast augmentation were combined with simulation techniques to compute new estimates grounded on a more objective set of information and assumptions than previous attempts. It was estimated that the number of women who had cosmetic augmentation mammoplasty between 1963 and 1988 was 894,206 (range = 437,602 to 2,035,783). The number of women ever treated with cosmetic augmentation mammoplasty may be substantially smaller than previously reported.

Breast Implants↗
PubMed1993

Cosmetic mastoidectomy for the combined supra/infratentorial transtemporal approach. Technical note.

The authors describe a cosmetic mastoidectomy technique for use when performing a combined supra/infratentorial craniotomy and transtemporal exposure. The technique involves a single temporal suboccipital bone flap and cosmetic mastoidectomy, removing the outer table of bone for later replacement. Replacement of the outer table of mastoid bone enables tamponade of a fat graft against the dura to reduce the risk of postoperative cerebrospinal fluid leaks. The technique has been performed in eight patients treated for petroclival meningiomas with excellent cosmetic results.

Bone Transplantation↗
PubMed2000

[Oxidizing agents in hair cosmetic products and methods of their identification and determination].

Hydrogen peroxide and oxidazing agents are used in hair lightening products, in oxidants of permanent wave products, hair dyeing products and toothpastes. In accordance with the Cosmetic Directive of the European Union (Council Directive of 27 July 1976 r. Annex III p. 12) maximum permitted concentration in the finished above mentioned cosmetic products is 12% in hair care preparations, 4% in skin-care preparations, 2% in nail hardening. The method identification and determination hydrogen peroxide and oxidazing agents is very useful for control cosmetic products on market.

Europe↗
PubMed2000

Cancer occurrence after cosmetic breast implantation in Denmark.

Most studies on cancer incidence after breast implantation have focused on breast cancer, while the risk of cancers at other sites has been less well investigated. We examined cancer incidence among 1,653 women who underwent cosmetic breast implant surgery at private clinics of plastic surgery in Denmark and 1,736 women attending the same clinics for other reasons during the period 1973-1995. Furthermore, we updated previously reported results among 1,114 women who received implants for cosmetic indications at public hospitals. All women were followed for cancer through the Danish Cancer Registry. In comparison with the general female population, the overall standardized incidence ratio (SIR) for cancer among women who received implants in private clinics was 1.65 [95% confidence interval (CI) = 1.17-2.27]. This elevated SIR reflected increased incidence ratios for almost all major cancer sites; however, only for non-melanoma skin cancer was there an excess of more than 2 cases. No significant excess of cancer was observed among women who received implants in public hospitals (SIR = 1.10, 95% CI = 0.76-1.52) or among women attending the private clinics for other problems (SIR = 1.10, 95% CI = 0.78-1.52). The SIRs for breast cancer after breast implantation were 1.1 (95% CI = 0.5-2.2) among private clinic patients and 0.9 (95% CI = 0.4-1.7) among public hospital patients. The overall findings of these 2 implant cohorts and results from other investigations suggest that cancer risk is probably not increased among women receiving cosmetic breast implants. The inconsistent results for private clinics and public hospitals are likely related to selection bias and confounding among the private clinic patients, but our data did not permit exploration of these possibilities. Further research into the determinants of these inconsistencies is warranted.

Adolescent↗
PubMedDate not supplied

[Cosmetic results of posttraumatic eyeball subatrophy surgical treatment using "alloplant" biomaterials with subsequent use of prostheses].

A complex of surgical operations making use of Alloplant biomaterials, performed in 47 patients with initial posttraumatic subatrophy and 79 patients with well-developed and far advanced stages of this condition, helped preserve the eye as anatomical organ in 97.5% patients, with enlargement of the eyeball in two-thirds of patients and stabilization in one-third. Optic reconstructive operations were later performed and visual acuity improved in patients with the initial stage of subatrophy. Use of allotransplant for eyeball bandage in order to create a carcass for the sclera helped conceal the cicatricial deformation of the sclera and repair the shape and volume of the eyeball in patients with initial subatrophy, due to which a good cosmetic result was attained. In well-developed and far advanced subatrophy use of biomaterial for bandage created optimal conditions for thin-wall cosmetic prostheses, ruled out the irritating effect of the prosthesis in cases when corneal sensitivity was retained and/or there were coarse corneaoscleral cicatrices, and thus extended the indications for cosmetic prostheses of subatrophic eyes.

Adolescent↗
PubMed1998

[Factors influencing the cosmetic outcome in early breast cancer patients following salvage surgery and radioisotope teletherapy].

It is the purpose of the report to analyze the factors exerting effect on the cosmetic outcome in breast cancer patients (I-II clinical stage), following organ-salvaging operation in conjunction with telegammatherapy. Assessment of the cosmetic results in 100 female patients with early mammary gland cancer is done 5 years after complex treatment (conservative surgery, postoperative radiotherapy, and chemo- and/or hormonotherapy when indicated). The influence of eight factors on the cosmetic outcome attained is evaluated through correlative statistical analysis, namely: breast size, scope of the surgical intervention, number of lymph nodes dissected, type of operative cicatrix, dose exposure of the entire mamma, homogeneity of radiation dose distribution in tre entire mammary gland, dose exposure of the tumor bed and adjuvant therapy. The analysis performed points to the important practical implications of three of the factors: size of operative intervention (axillary dissection range), breast volume and homogeneity of the irradiation dose in the entire breast.

Axilla↗
PubMed2001

Form or function? Part 1. Subjective cosmetic and functional correlates of quality of life in women treated with breast-conserving surgical procedures and radiotherapy.

BACKGROUND: Quality of life (QOL) after a diagnosis of cancer varies considerably across individuals. Treatment-related factors that predict QOL for women who are diagnosed with breast carcinoma require further specification. This study was designed to develop a measure of perceived aesthetic (e.g., breast shape) and functional status (e.g., pain, mobility) after breast-conserving surgical treatment (BCT) and radiotherapy, to examine the relations of these indicators with patient QOL, and to determine whether these relations varied as a function of diagnosis duration. METHODS: Women (n = 185 patients) who underwent BCT and radiotherapy for Stage 0-II disease for whom the diagnosis duration ranged from 3 months to 18 years completed assessments of background information, perceived cosmetic and functional treatment outcomes, and QOL. Medical data also were obtained from medical charts. RESULTS: The Breast Cancer Treatment Outcome Scale (BCTOS) produced a coherent factor structure and three internally consistent subscales (i.e., cosmetic status, functional status, and breast specific pain) that demonstrated predictive validity. With patient age, diagnosis duration, and other BCTOS subscales controlled, greater breast specific pain predicted greater depressive symptoms (P < 0.01) and lower QOL related to mental health (P < 0.05) and physical health (P < 0.05). Cosmetic status predicted QOL related to physical health (P < 0.05). The relations of breast specific pain with QOL indicators varied somewhat as a function of diagnosis duration. CONCLUSIONS: Although considerable research on treatment-relevant outcomes has addressed appearance-related concerns, functional parameters have not been explored fully. Findings suggest that functional consequences of treatment, and particularly breast specific pain, also are significant influences on patient QOL.

Breast Neoplasms↗
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 overrepresentation 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.

Adolescent↗
PubMed2002

A cosmetic access for minimally invasive aortic valve replacement without sternotomy in women.

BACKGROUND: Different methods of replacing the aortic valve via a minimally invasive access have been reported in the recent literature. Although these strategies have clear advantages in terms of reduced surgical trauma, no further refinements in terms of cosmetic results have been made for women. METHODS: Aortic valve replacement was performed in 4 women via a right anterior submammary minithoracotomy without rib resection. The incision was made along the breast fold. The extracorporeal circulation was connected through the same access. Standard surgical technique and equipment were employed. RESULTS: No intraoperative complications or hospital deaths occurred. The 4 patients could be discharged home on the sixth postoperative day. The cosmetic result was excellent and the wound completely disappeared within the breast fold. CONCLUSIONS: The advantages of the present method include the preservation of sternal integrity, early mobilization and rehabilitation and an excellent cosmetic result for women.

Adult↗
PubMed2000

Cosmetic dentistry for patients who can't afford it.

As I noted earlier, all things being equal, patients prefer tooth-colored restorations. This technique has removed virtually all the barriers to treatment and makes things a lot more equal. There's the cost factor (Dramatically reduced!) There's the fear-of-needle factor (Gone!) There's the time factor (Minimized!). In fact, prepping and placing these occlusal veneers is so fast I can now do 8 to 10 amalgam rehabs in one appointment. Doing so many in a short time is extremely profitable, even at the reduced fee. This technique certainly does not qualify as "great dentistry," but it brings "desire-motivated" cosmetic dentistry to an entirely new universe and those patients are appreciative. They're even referring their friends! In my practice, veneering amalgam has brought cosmetic dentistry to many patients who would never agree to have their restorations replaced with traditional composite resin. And it has brought me several additional thousand dollars in collections each month. So this is a classic "win-win" situation. Patients are getting cosmetic restorations they didn't think they could afford, and I'm making a great profit doing it.

Acid Etching, Dental↗
PubMed2002

Incidence of breast and other cancers among Finnish women with cosmetic breast implants, 1970-1999.

Epidemiologic evidence does not point to a carcinogenic effect of silicone implants on the breast, and evidence for or against a carcinogenic effect at sites other than the breast is limited. To examine subsequent cancer risk among women with cosmetic breast implants, we conducted a cohort study of 2171 women in Finland identified from operation diaries of major hospitals and private clinics, 1970-1999. The nationwide population and health outcome registries in Finland were used to trace these women for cancer incidence through 1999. Standard statistical techniques were used to compute expected values based on general population rates. The measure of risk was taken as the ratio of observed to expected cancers, that is, the standardized incidence ratio (SIR) and its 95% confidence interval (CI). Among the 2171 women with cosmetic breast implants, 30 developed cancer against 33.7 expected (SIR = 0.9,95% CI = 0.6-1.3). There was no evidence for an increase in breast cancer risk (SIR 0.5, 95% CI, 0.2-1.0), even among those followed for more than 10 years (2 observed, 4.6 expected). Stage at breast cancer diagnosis did not differ from that expected nor did incidence of any other cancer. Although hindered by small numbers, the consistency of our results with those of other Nordic studies leads us to conclude that cosmetic breast implants are not a cause of cancer and that they do not appear to delay the detection of breast cancers.

Adult↗