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Egg-shell powder was added to cosmetics in quantity up to 10%. Such cosmetics did not irritate and sensitize the skin, and had a positive influence on allergologic status of animals.
Cosmetic camouflaging techniques can be used to minimize the appearance of facial scarring due to trauma and/or surgery. Facial pigmentation defects are minimized through the application of facial foundations of complimentary colors. Principles of high-lighting and shadowing are used to conceal surface contour defects by combining opaque facial foundations with colored cosmetics.
This article reviews the correlation between the nature of cosmetic products and the location of lesions in cases of contact dermatitis. It also reviews the nature of the most common allergenic products and substances and offers guidelines for testing cosmetics in cases of contact allergy.
An alternative method was developed for counting viable microbial contaminants in pharmaceuticals and cosmetics with insoluble materials and low bioburden. The method uses triphenyltetrazolium chloride (TTC). The inhibitory effect of TTC on microbial growth observed by others was eliminated by adding it as an overlay, after incubation of sample in culture medium for 48 h. Six samples of pharmaceutical suspensions and 6 samples of cosmetics were evaluated by most-probable number (MPN) and pour-plate techniques with TTC in comparison with MPN with subculturing. The equivalence between MPN technique with TTC and subculturing was demonstrated for all samples and between pour-plate and subculturing for 10 samples. The differences were probably due to some error inherent in both techniques and not from application of TTC. Comparison of coefficients of variation showed that plate countings were more precise than the MPN method, as expected.
Modern Dead Sea cosmetics have developed in order to meet the demands of new regulations, technical opportunities, and today's consumer expectations for higher quality standards and proven performance. As an example of the application of this approach, the authors describe the development of a new cosmetic formulation, based on "Osmoter", a special Dead Sea mineral composition, and the evaluation of this formulation's effect on the depth of skin wrinkles, by a controlled assay. Possible mode of action is discussed.
The synthesis of nine quaternary ammonium iodides derived from omega-dialkylaminoethyl ethers of 5-(arylmethylene)-1,3, 3-trimethyl-2-oxabicyclo[2.2.2]octan-6-hydroxyimines, as potential cosmetic ingredients, is described. They are routinely prepared starting from cineole aminoethers by reaction with iodoethane and their physics-chemical data are reported. These substances were studied for their UV absorption and three of these compounds were also submitted to microbiological assays on five test organisms. The substances have their UV absorption maxima at 284-321 nm, and one compound is active on Staphylococcus aureus, Streptococcus faecalis and Candida albicans. These preliminary findings seem to indicate that some of these compounds could be considered as potential UV sunscreens; one compound, having a moderate antimicrobial activity, could be considered a potential active compound in cosmetics as deodorants, toothpastes, mouthwashes and other oral care products.
BACKGROUND: The development of granulomatous lesions within tattoos is a well-recognized occurrence in individuals with sarcoidosis. The characteristic histopathological finding of sarcoidosis is the presence of noncaseating granulomas; however, similar histopathogical findings may be seen in foreign body granulomas. Several reports have challenged the assertion that the presence of foreign material within sarcoidal granulomas is incompatible with a diagnosis of sarcoidosis. OBSERVATIONS: We describe a patient who had multiple linearly arranged papules along her eyebrows and the vermillion border of her upper lip. She had had cosmetic tattooing performed on these areas 3 year prior to presentation. Histopathologic examination revealed sarcoidal granulomas, polarizable foreign material, and pigment granules. Hilar adenopathy was noted on a chest radiograph. After 4 months of treatment with a midpotency topical steroid and doxycycline, she experienced complete clearance of her cutaneous lesions and normalization of chest x-ray film findings. CONCLUSIONS: This case demonstrates a unique adverse result after cosmetic tattooing and highlights the concept that granulomatous histopathologic findings containing foreign material should not be an exclusionary criterion for the diagnosis of sarcoidosis. In this setting, further investigation for the presence of systemic disease is indicated.
OBJECTIVE: To test 4 previously published outcomes instruments (the Facelift Outcomes Evaluation, the Rhinoplasty Outcomes Evaluation, the Blepharoplasty Outcomes Evaluation, and the Skin Rejuvenation Outcomes Evaluation) in terms of their reliability and validity in assessing patient-related outcomes of surgical intervention. DESIGN: A prospective pilot study of 78 patients in 3 similar private cosmetic surgery centers undergoing a total of 100 face-lift, rhinoplasty, blepharoplasty, and skin rejuvenation procedures. Patients were evaluated at 2 preoperative and 1 postoperative time points and the instruments were analyzed with regard to their test-retest reliability, internal consistency, and responsiveness to change. RESULTS: All 4 outcomes instruments had excellent reliability, consistency, and validity scores. Test-retest reliability was 0.74 to 0.83 (Pearson correlation coefficients), internal consistency scores were.83 to.88 (Cronbach alpha), and responsiveness to change was statistically significant for each instrument tested (P< or =.001). In addition, patients experienced significant quality of life improvement, with overall satisfaction increasing on average from 37% to more than 84% after these procedures. CONCLUSIONS: These 4 instruments are reliable and valid and can be used to accurately assess patient-related satisfaction in studies of face-lift, rhinoplasty, blepharoplasty, and skin resurfacing outcomes. These brief questionnaires provide the cosmetic surgeon with quantitative tools to evaluate otherwise subjective and purely qualitative outcomes and are recommended for use in future prospective studies.
Surgical excision of extracranial arteriovenous malformations may be indicated for cosmetic or urgent medical reasons, such as haemorrhage or high output cardiac failure. However, serious haemorrhage, incomplete removal and poor cosmetic results are well-known complications encountered after this operation. Preoperative embolization under angiographic control is recommended to reduce the incidence of these problems.
BACKGROUND: The objective of this study was to assess the cosmesis and toxicities in patients with early-stage breast carcinoma who received treatment with accelerated partial breast irradiation (APBI) using interstitial brachytherapy. METHODS: From April 1993 to December 2001, 199 patients with Stage I-II breast carcinoma received breast-conserving therapy with APBI to the tumor bed alone through a low-dose-rate (LDR) or high-dose-rate (HDR) implant. A template guide was used. The LDR dose was 50 Gray (Gy) over 96 hours; the outpatient HDR implant delivered 32 Gy in 8-Gy or 34 Gy in 10-Gy twice-daily fractions. Cosmesis (Harvard criteria) and toxicities (Radiation Therapy Oncology Group guidelines) were assessed at < or = 6 months, 2 years, and 5 years. RESULTS: The median follow up was 6.4 years. Breast pain, edema, erythema, and hyperpigmentation all diminished over time. Breast fibrosis and hypopigmentation increased until the 2-year mark and then stabilized. Fat necrosis and telangiectasia increased over time, with a fat necrosis rate of 11% at 5 years. Nearly all telangiectasias (34% at 5 yrs) were Grade 1 (< 2 mm). The remaining toxicities were Grade 1 at all follow-up intervals. Infections (11%) occurred predominantly within the first month after treatment. Good-to-excellent cosmetic outcomes were noted in 95-99% of patients over time; cosmetic results stabilized at 2 years with excellent results increased out to 5 years. CONCLUSIONS: APBI with interstitial brachytherapy resulted in mild chronic toxicities, the majority of which diminished or reached a plateau over time. Long-term cosmesis was good to excellent in 95-99% of patients and stabilized at 2 years.
The available epidemiologic evidence does not support a carcinogenic effect of silicone breast implants on breast or other cancers. Data on cancer risk other than breast cancer are limited and few studies have assessed cancer risk beyond 10-15 years after breast implantation. We extended follow-up of our earlier cohort study of Danish women with cosmetic breast implants by 7 years, yielding 30 years of follow-up for women with longest implant duration. The study population consisted of women who underwent cosmetic breast implant surgery at private clinics of plastic surgery (n = 1,653) or public hospitals (n = 1,110), and a control group of women who attended private clinics for other plastic surgery (n = 1,736), between 1973-95. Cancer incidence through 2002 was ascertained using the Danish Cancer Registry. Risk evaluation was based on computation of standardized incidence ratios (SIR) and Cox proportional hazards models, adjusting for age, calendar period and reproductive history. We observed 163 cancers among women with breast implants compared to 136.7 expected based on general population rates (SIR = 1.2; 95% confidence interval [CI] = 1.0-1.4), during a mean follow-up period of 14.4 years (range = 0-30 years). Women with breast implants experienced a reduced risk of breast cancer (SIR = 0.7; 95% CI = 0.5-1.0), and an increased risk of non-melanoma skin cancer (SIR = 2.1; 95% CI = 1.5-2.7). Stratification by age at implantation, calendar year at implantation and time since implantation showed no clear trends, however, the statistical precision was limited in these analyses. When excluding non-melanoma skin cancer, the SIR for cancer overall was 1.0 (95% CI = 0.8-1.2). With respect to other site-specific cancers, no significantly increased or decreased SIR were observed. Similar results were found when directly comparing women who had implants at private clinics with women who attended private clinics for other plastic surgery, with rate ratios for cancer overall, breast cancer and non-melanoma skin cancer of 1.1 (95% CI = 0.8-1.6), 0.7 (95% CI = 0.4-1.3) and 1.5 (95% CI = 0.8-2.7), respectively. In conclusion, our study lends further support to the accumulating evidence that silicone breast implants are not carcinogenic. Reasons for the consistently reported deficit of breast cancer among women with breast implants remain unclear, whereas increased exposure to sunlight may explain the excess occurrence of non-melanoma skin cancer. We found no indication of delayed diagnosis of breast cancer due to the presence of breast implants.
Integration of plastic surgery is currently widely practiced in cases of mastectomy. Immediate breast reconstruction with an implant or autologous tissue procedures is frequently proposed to the patient before the mastectomy. However, breast conserving surgery (BCS) is recognized as the treatment of choice in most cancers: breast conservation is proposed in more than 70% of the patients with primary cancer treated at the European Institute of Oncology in Milan. This high percentage of preservation has been made possible by the integration of plastic surgery at the time of primary surgery. The size of the tumorectomy remains a matter of discussion. Based on the Milan II trial and Holland's pathological studies, Veronesi recommended so-called "local radical surgery." For a tumor 1 cm in size, a free margin of 2 cm produces a final specimen at least 5-6 cm in diameter. In small or medium-sized breasts, such a resection results in a wide glandular defect and poor esthetic results if direct closure is carried out. Plastic surgery derived from reduction mammaplasty procedures allows much better final cosmetic results, which is the goal of conservative treatment. In 25% of our patients treated with BCS, the plastic surgeon is called upon by the general surgeon to close the glandular defect. However, such glandular remodeling changes the size and position of the breast. Therefore, in 15% of these cases a symmetry procedure is performed on the opposite breast. The reduction procedure in the opposite breast should be taken as a good opportunity to check the glandular tissue. Special attention should therefore be given to the contralateral mammogram in order to focus the glandular resection on the most dubious areas. Occult carcinomas, half of them infiltrating, were found in 4% of a series of 350 symmetry procedures performed during breast reconstruction at the Gustave Roussy Cancer Institute. In conclusion, close collaboration between oncologists and plastic surgeons is required not only to obtain the best cosmetic results but also to allow improved radicality of the tumor resection and a histological check-up of the contralateral breast.
Breast conserving surgery and radiation therapy (RT) can achieve a more favorable cosmetic outcome than mastectomy in patients with early breast cancer. However, it is widely recognized that RT is an impediment to improving the cosmetic outcome. Between 1985 and 1993, 113 patients were enrolled in a prospective randomized study to examine whether or not RT could be avoided following sector resection in patients with Stage I and II (UICC) invasive breast cancer. There was no significant difference in the 8 year local recurrence free survival rate between the RT and non-RT groups (92.3% versus 89.8% respectively). The characteristics of suitable patients would be negative nodes and microscopically negative resection margins. In conclusion, sector resection without RT is a reasonable option for some patients with early breast cancer.
PURPOSE: To investigate the feasibility of applying exclusive intraoperative radiation therapy (IORT) after conservative surgery in limited-stage breast carcinoma and to evaluate late effects and cosmetic results after this new conservative treatment. PATIENTS AND METHODS: From October 2000 to November 2002, 47 consecutive patients with unifocal breast carcinoma up to a diameter of 2 cm received conservative surgery followed by IORT with electrons as the sole adjuvant local therapy. Three different dose levels were used: 20 Gy (seven patients), 22 Gy (20 patients), and 24 Gy (20 patients). Patients were evaluated using RTOG/EORTC scale to assess the incidence of late complications. During follow-up, a radiologic assessment with mammography and sonography was periodically performed and any breast-imaging alterations were reported. RESULTS: After a follow-up ranging from 36 to 63 months (median, 48 months), 15 patients developed breast fibrosis (grade 2 in 14 patients, grade 3 in one patient), two patients presented with grade 3 skin changes, one patient developed a clinically relevant fat necrosis, and one patient showed breast edema and pain. Two patients developed contralateral breast cancer and one distant metastases; no local relapses occurred. Asymptomatic findings of fat necrosis were observed at mammography in twelve patients (25.5%), while an hypoechoic area was revealed by sonography in ten patients (21.5%). In four patients (8%), mammographic and sonographic findings suggested malignant lesions and required a rebiopsy to confirm the benign nature of the lesion. CONCLUSION: IORT in breast carcinoma is still an experimental treatment option for select patients with breast cancer and its application should be restricted to prospective trials. Although preliminary data on local control are encouraging, a longer follow-up is needed to confirm the efficacy of IORT in breast cancer and to exclude that severe late complications compromise the cosmetic results or modify the radiologic breast appearance during follow-up increasing the need for additional investigations.
BACKGROUND: Although there are patients who want cosmetic lateral canthoplasty to lengthen the lateral palpebral fissure of the lateral canthal area, no recommendable operational procedure exists that results in an acceptable scar formation. Because of the round eyeball shape, lengthening and widening of the lateral palpebral fissure should not be in the lateral direction, but rather in the posterior direction to keep the surface between the bulbar conjunctiva and the palpebral conjunctiva in contact. METHODS: The authors believed that using an upper crus flap of the upper eyelid margin as a transposition flap would enable lengthening of the lower eyelid width and posterior deepening of the lateral canthal area. This was thought possible by transverse back-cutting of the palpebral conjunctiva on the lateral fornix area. RESULTS: The authors have performed cosmetic lateral canthoplasty in more than 200 cases to increase the width of the lateral palpebral fissure. All the results were satisfactory and aesthetically acceptable. CONCLUSIONS: The reported surgery makes the eyes appear larger and brighter. The authors think this procedure is a good and convenient method although it is not perfect.
This study was the first empirical investigation of body image dissatisfaction in male cosmetic surgery patients. Thirty men completed two body image measures prior to their initial consultation. Results were compared to the norms for each of the measures and with a sample of 30 women seeking similar cosmetic procedures. Results indicated that patients did not demonstrate greater dissatisfaction with their overall appearance than men in a normative sample. However, when asked about the bodily feature they were considering for surgery, they reported significantly greater levels of dissatisfaction than the normative sample. As compared to male patients, female patients reported a greater investment in their physical appearance. Implications of these findings are discussed with respect to the nature of body image dissatisfaction and the relevance of body image in the psychology of male plastic surgery patients.
BACKGROUND: The size of laparoscopic instruments has been reduced for use in abdominal video endoscopic surgery. However, it has yet to be proven that microlaparoscopic surgery will actually result in clinically relevant benefits for patients. METHODS: Fifty patients were randomized in a blinded fashion to receive either elective laparoscopic (MINI), (n = 25) or microlaparoscopic (MICRO) (n = 25) cholecystectomy. Pulmonary function (FVC, FEV (1)), analgesic consumption during patient-controlled analgesia (PCA), pain perception by visual analogue score (VAS), and the cosmetic result (by the patient's self-assessment) were evaluated postoperatively as clinically relevant end points. RESULTS: Age, sex, body mass index (BMI), preoperative pulmonary function, pain perception, and operative time were similar for the two groups. At 8:00 PM on the day of surgery, FVC (MINI: 1.96 L [range, 1.48-2.48]; MICRO: 2.13 L) [(range, 1.61.-2.50)] and FEV (1) (MINI: 1.17 L/sec) [range, 0.87-1. 48]; MICRO: 1.34 L/sec [range, 1.05.-2.14] were also similar (each p = 0.5). From surgery to the 3rd postoperative day, cumulative PCA morphine doses were comparable (MINI: 0.15 mg/kg bw [range, 0.09-0. 23]; MICRO: 0.21 mg/kg bw [range, 0.10-0.42]; p = 0.4), but overall VAS scores for pain while coughing were higher in the laparoscopic group (406 [range, 358-514]) than in the microlaparoscopic group (365 [range, 215-427]; p = 0.02). The cosmetic result was judged to be slightly superior by the microlaparoscopic patients (10 [range, 9-10]), as compared to those in the laparoscopic (9 [range, 8-10]) group (p = 0.04). CONCLUSION: Because microlaparoscopic cholecystectomy has some minor advantages over laparoscopic surgery, it should be considered for use in selected patients.
BACKGROUND: Since its introduction in 1987, the technique of laparoscopic cholecystectomy has continued to undergo evolution. One area of refinement has been the optimization of cosmetic results. Surgeons have reduced port size and number or both in attempts to achieve this goal. In this report, we describe a method of adjusting port position to obtain more discreet scars. METHODS: Minilaparoscopic cholecystectomy is performed using three 5-mm ports. One port is placed in the umbilicus. Instead of placing the two additional ports in the right subcostal and subxiphoid positions, they are moved to either side of midline at the level of the pubic hairline. RESULTS: The result is one scar hidden in the umbilicus, with the two other scars located below the bikini line. These scars are nearly undetectable when the patient is wearing minimal clothing. CONCLUSION: We conclude that, in addition to minimizing port size and number, positioning of ports can be used to optimize cosmetic results.