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PubMed1959

PLASTIC surgery.

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Nasal Surgical Procedures↗
PubMed2004

The minimal approach: an innovation in facial cosmetic procedures.

Plastic surgery is a rapidly growing field, particularly the use of less invasive procedures such as biodegradable dermal fillers and botulinum toxin. Aging is a complex process involving two important factors: volume loss throughout the face, and repetitive muscle movements that cause wrinkles and folds. Dermal fillers work by providing support for facial structures, whereas botulinum toxin reduces the mimetic effects. In combination, these products can be used effectively to reshape and rejuvenate the face and neck. Dermal fillers can be used throughout the face to raise the eyebrows, fill the tear trough, reshape the nose, lift the nose tip, fill nasolabial folds and oral comissures, fill the cheeks, raise the cheekbones, reshape the jaw line, and rejuvenate the neck area. This "minimal approach" offers a faster, less painful, and less costly alternative or complement to surgical facelifts. A variety of biodegradable injectable products are currently available, the most common of which are collagen- or hyaluronic acid-based. Using these products in combination takes advantage of their hydrophobic and hydrophilic properties and can provide better and longer-lasting results. The addition of botulinum toxin can further extend the duration of results by reducing the mimetic stress that can break down the polymers. With regular maintenance treatments, the minimal approach using dermal fillers and botulinum toxin can give patients a "whole new look" with a fast and relatively painless lunchtime procedure.

Absorbable Implants↗
PubMed1993

[Three-dimensional computerized modelling of anatomical structures by computerized tomography imaging].

The authors built an automatic CT-driven device by which 3D models of biologic structures can be obtained. Original bidimensional densitometric data are recorded on tape and transferred to a mechanical computer-driven arm capable of cutting polystyrene slices reproducing the original biologic structures by means of an original software. The aim of our research was to assess the feasibility of such a device from a practical point of view and to analyze and solve related problems, in order to use the experience thus gained to develop more complex systems. We deliberately set up a device both technologically advanced and simple to be used even by non-specifically trained operators. The system capabilities open new perspectives in many application fields, such as surgery (stereotactic procedures, the making of personalized prostheses, plastic surgery, procedures planning and simulation), treatment (stereotactic radiotherapy), diagnostics (stereotactic biopsy) and educational use.

Humans↗
PubMed2003

An outcome study comparing intravenous sedation with midazolam/fentanyl (conscious sedation) versus propofol infusion (deep sedation) for aesthetic surgery.

The purpose of this study was to determine the differences in measurable outcomes following aesthetic procedures performed under intravenous sedation with incremental doses of midazolam and fentanyl and those performed under propofol infusion. The authors' hypothesis was that the differences in these outcome parameters are not significant between these intravenous sedation protocols. All intraoperative and perioperative records of 84 consecutive patients having aesthetic surgery under a conscious sedation protocol using incremental doses of intravenous midazolam and fentanyl were retrospectively reviewed and compared with the records of a second group of 85 patients having aesthetic surgery under a deep sedation regimen based primarily on propofol infusion. All procedures were hospital based and performed by two surgeons. Twenty-eight different parameters were examined by chart review. In addition, a patient questionnaire was used to assess patient satisfaction and patient recall of operative and perioperative pain, anxiety, nausea, and vomiting. Multivariate statistical analysis was conducted. The two sedation groups were similar with regard to aesthetic procedures performed and patient demographics. The mean duration of operative time was statistically equivalent (152 minutes and 153 minutes). In both groups, there were minor adverse intraoperative events reported but no significant complications. Transient hypotension was more common in the propofol infusion group (12.9 percent versus 2.4 percent, p = 0.018), but no patient required intervention beyond reducing the sedative agent or increasing intravenous fluids. The amount of supplemental fentanyl given intraoperatively was significantly higher in the group whose primary agent for sedation was propofol infusion than the group who received midazolam/fentanyl (209 mug and 143 mug, respectively). The overall questionnaire response rate was 80 percent for both groups. The midazolam/fentanyl sedation group had more recall of "unpleasant intraoperative events" (17 percent versus 3 percent, p = 0.007). However, both groups had low recall of intraoperative pain, anxiety, and nausea. The propofol infusion group experienced significantly more nausea in the recovery room (p = 0.002), nausea at the time of discharge (p = 0.009), and nausea the evening after the operation (p = 0.013). Greater than 90 percent of the patients in both groups would have the same anesthetic in the future rather than undergo general anesthesia. Patient safety, outcomes, and satisfaction are similar in plastic surgery procedures performed under sedation protocols using either incremental doses of midazolam and fentanyl or propofol infusion. All operative and postoperative outcomes for pain, anxiety, and vomiting were similar in the two groups except for immediate postoperative nausea, which was higher in the propofol infusion group. The overall satisfaction of patients undergoing plastic surgery procedures under these intravenous sedation protocols appears very high.

Adult↗