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At least 649 records · Page 36Linked to original sources
PubMed2005

[Objective assessment of cosmetic outcome of scars].

AIM OF THE STUDY: Cosmetic outcome of surgical treatment in the facial region is influenced by the appearance of the scar. The purpose of this investigation was to evaluate the objectivity and validity of various methods for the assessment of scars. MATERIAL AND METHODS: 45 patients undergoing facial surgery were examined three months after surgery. Three maxillofacial surgeons evaluated the wounds in a blinded manner using a visual analog scale (VAS). The patients also used the VAS for evaluation of their own scar. The surface of the scars was also measured by optical profilometry. Finally, the colour of the scars was analysed using both the RGB colour model and the HSV colour model. RESULTS: Interestingly, there was no significant correlation between the values of R (red) as assessed by the three surgeons. However, there was a very strong correlation between the values of H (hue) as assessed by the three raters. The appearance of the surface was more important in the patients' evaluation than in the raters' assessment. CONCLUSION: The hue of a scar as measured in terms of the H value in the HSV colour model is an objective and reliable measure for assessing the cosmetic outcome of facial surgery.

Adult↗
PubMed2004

Cosmetic approach for correction of simple congenital heart defects in female patients.

OBJECTIVE: Much more concern is recently paid to the cosmetics when simple congenital heart defect is repaired. Here we present the reversed U-shaped skin incision with lower partial sternotomy for juvenile or adult female patients. METHODS: Four patients with atrial septal defect (ASD) and one patient with ventricular septal defect underwent the operation with this method. Patients' ages ranged from 5 to 46 years old. RESULTS: Postoperative recovery in all cases was uneventful. Only the middle portion of the operative scar was visible when the breast was well developed. The scar was completely covered by the brassiere. A numbness of the upper medial portion of the left breast was recognized in one initial patient, who underwent ASD closure and concomitant right-side Maze procedure, necessitating a wider dissection than that used for other patients. CONCLUSION: A reversed U-shaped skin incision with a lower sternotomy could provide relatively comfortable operative fields for cardiac surgeons, and be cosmetically appealing to female patients who require a repair of simple congenital heart defect.

Adolescent↗
PubMed1991

Cosmetic approach for placement of the automatic implantable cardioverter-defibrillator in young women.

A surgical approach is described for a more cosmetically acceptable placement of the automatic implantable cardioverter-defibrillator in young women. The transvenous sensing lead and the vena caval spring electrode are placed through a small subclavicular incision. The left ventricular patch electrode is placed through an anterior minithoracotomy in the crease under the left breast. A small transverse incision in the left lower quadrant is used to place the generator under the external oblique fascia in the low abdominal wall. Minimal cosmetic impairment from incisions and hardware results.

Adult↗
PubMed1992

Partial median sternotomy for repair of heart defects: a cosmetic approach.

A modified median sternotomy incision that results in a cosmetically appealing scar is described. It includes the use of a low-lying short skin incision and partial transection of the sternum. The outcome in 182 infants and children indicates that this approach is safe, provides adequate exposure, and has excellent cosmetic results.

Adolescent↗
PubMed1975

The incidence of schizophrenia and severe psychological disorders in patients 10 years after cosmetic rhinoplasty.

Body image disturbance may be an early sign of schizophrenia. The significance of this and dysmorphophobia with relation to patients seeking cosmetic rhinoplasty is discussed. Results of a follow-up of patients 10 years after cosmetic surgery to see whether they developed schizophrenia or serious psychological disorder are presented. The literature, significance of the findings and the clinical implications are all discussed.

Body Image↗
PubMed1984

Psychological aspects of cosmetic rhinoplasty.

This paper summarises some of the major findings of a doctoral research entitled "Psychological Aspects of Cosmetic Rhinoplasty" carried out when the author was working in the United Kingdom on a thesis that was accepted for the degree of PhD by the University of London. From the point of view of the clinical psychologist there can be no doubt that cosmetic rhinoplasty does have largely beneficial short- and long-term psychological and behavioural effects on patients who request the operation and several observations and experiments are described to account for the efficacy and therapeutic value of this operation.

Adult↗
PubMed1991

The influence of cosmetic additives on the acceptability of alcohol-based hand disinfectants.

A prospective, randomized double-blind study with intra-individual comparison of the results was undertaken with 20 volunteers to assess the influence of cosmetic additives on the acceptability of a mixture of n-propanol (50% v/v) and isopropanol (30% v/v) for hand disinfection. Three to 5 ml of antiseptic was rubbed into the hands until dry 15 times a day, 5 days a week and for 2 weeks per preparation. For self-assessment the parameters 'appearance', 'intactness', 'turgor' and 'sensation' were evaluated weekly by visual analogue; for assessment by a dermatologist the same parameters except 'sensation' were used. Each score was compared before and after treatment. The antimicrobial efficacy of the alcoholic mixture was equivalent to or better than the standard (isopropanol 60% v/v, 1 min). The frequent application of these antiseptic preparations caused a slight but significant deterioration of the skin condition as judged by both self-assessment and dermatologist; however, this was significantly less when the antiseptic contained cosmetic additives. It is concluded that the addition of suitable emollients can significantly increase the acceptability of alcoholic disinfectants.

1-Propanol↗
PubMed1985

Patient self-evaluation of cosmetic outcome of breast-preserving cancer treatment.

Thirty-two patients with Stage I or II breast cancer who had completed conservative breast-preserving treatment were asked to rate their cosmetic outcomes. Within this group, extent of the surgical excision of the breast tumor varied, with biopsy scars ranging from 2 to 19.5 cm. All patients had received external beam radiotherapy, with local boost doses in 17 cases. The average interval between self-evaluation and the completion of radiotherapy was 19 months. Patients completed a questionnaire rating the appearance of the treated breast, the degree of difference between breasts and overall satisfaction with cosmesis. They were asked to describe differences between breasts and to make any additional comments. Appearance of the treated breast was rated good to excellent by 94%, although 88% noted a difference of slight to moderate degree between treated and untreated breasts. Overall, 78% of patients were very to extremely satisfied, while moderate satisfaction was reported by 19%. Reports of breast differences included reduced size of the treated breast (44%), increased firmness (31%), elevation (25%), and skin color changes (22%). Reasons for dissatisfaction included chronic breast pain in 3 patients, breast edema in one and arm edema in one. Two patients wanted the untreated breast reduced in size. Statistically significant inverse relationships were found between the length of the biopsy scar and patient ratings of both appearance of the treated breast and overall satisfaction. These results indicated that although most patients were satisfied with cosmetic results of breast-preserving treatments, they are quite discriminating in their evaluations of differences between breasts. Functional factors such as pain and edema had a negative impact on satisfaction with cosmesis.

Adult↗
PubMed1988

Cosmetic results in early breast cancer treated with lumpectomy, peri-operative interstitial irradiation, and external beam radiation.

Patients with operable breast cancer were treated at the University of Kansas Medical Center with lumpectomy, peri-operative interstitial Iridium, and external beam radiotherapy, and concomitant adjuvant chemotherapy in a majority of node positive cases. Examination of the cosmetic results in 85 breasts followed for at least 2 years, at a median of 41 months revealed 20% to be excellent, 44% to be very good, 24% good, 9% fair, and 4% to have poor results. In this paper cosmesis is analyzed with reference to the size of the primary, its location, age of the patient, whether the patient received adjuvant chemotherapy, and whether the regional nodes were treated. In this group of patients, the size and the site of the primary, patient's age, and whether adjuvant chemotherapy was administered or not, did not adversely affect the aesthetic outcome. Treatment of the regional nodes gave a worse mean cosmetic score compared to the group in whom only the breast was treated (37.51 vs. 58.98 respectively, p less than 0.001). Among the 11 patients with fair/poor cosmesis, all had regional nodal treatment, 7/11 had inner quadrant lesions, and 7/11 had lesions greater than T1. Further follow-up and accrual would be needed to confirm our results and affirm if other factors would change.

Adult↗
PubMed1993

Therapeutic factors influencing the cosmetic outcome and late complications in the conservative management of early breast cancer.

PURPOSE: To investigate the impact of clinical and physical parameters on the cosmetic result and complications, in cancer breast treated with conservative surgery and definitive irradiation. METHODS AND MATERIALS: Between October 1980 and December 1990, 289 patients were treated with lumpectomy and/or axillary dissection, radical irradiation with or without adjuvant therapy. The radiation therapy technique consisted of external beam therapy followed by an Ir-192 implant or electron beam boost. Univariate and multivariate analysis were used to evaluate the correlation between multiple factors affecting the cosmetic outcome and the complications. RESULTS: Of 289 patients, cosmesis was evaluable in 285 and recorded as excellent to good in 226 (79%), fair in 35 (12%), and poor in 24 (9%). On multivariate analysis of these results, a high dose per fraction (p = .0018), and use of electrons as boost to the tumor bed (p = .001) were found to be significant. When patients boosted with electrons were excluded, a high boost dose (p = .0433) was also found significant. Fifteen (5%) patients developed severe late radiation sequelae and 14 (5%) moderate or severe arm edema. On multivariate analysis only dose per fraction of 2.5 Gy (p < .0001) and higher boost doses (p = .017) were significant. CONCLUSION: In 289 patients of early breast cancer treated with conservative surgery and radical irradiation, multivariate analysis suggests that higher dose per fraction with teletherapy and higher brachytherapy boost dose adversely affect cosmesis and contribute to the late complications.

Adult↗
PubMed1995

Appearance scales to measure cosmetic outcomes of healed lacerations.

To develop an appearance scale that will allow the objective and scientific comparison of the cosmetic results of healed lacerations, 33 photographs of healed lacerations and incisions with variable cosmetic results were shown to four plastic surgeons. These plastic surgeons were asked to independently rate the photographs on two separate occasions using two scales, a Visual Analogue Scale and a Categorical Scale. Interobserver and intraobserver agreement were determined for each scale. Comparison of the scales with each other was done to assess consistency. The Visual Analogue Scale showed good interobserver agreement with an Intraclass Correlation Coefficient of 0.75. Intraobserver agreement was also high across the four observers with Pearson correlation coefficients ranging from 0.73 to 0.87. The agreement of the categorical scale was also good with a kappa coefficient for interobserver agreement of 0.53. The kappa coefficient for intraobserver agreement ranged from 0.48 to 0.72. Because the visual analogue scale and categorical scale showed good interobserver and intraobserver agreement, both may be considered good measurement tools in the comparison of alternate methods of laceration care.

Adult↗
PubMed2003

[Aesthetic snapshot: study about cosmetic surgical procedures and complications].

A questionnaire was addressed to 600 members of the French Society of Plastic Reconstructive and Aesthetic Surgery. Out of 19,000 interventions, thanks to the analysis of 112 answers, we were able to get a good picture of the activity in aesthetic surgery, showing the number and type of complications experienced during each intervention. Cosmetic surgical procedure represents 35% of global surgical activity of the French plastic surgeon. The most frequent interventions are liposuction (19%), breast augmentation (16%), eye-lid surgery (14%), abdominoplasty (12%), mammaplasty (10%), facelift (10%) and rhinoplasty (8%). The techniques for which we register more than 10% of problems are: abdominoplasty and mammaplasty. The techniques for which we register between 5% and 10% of problems are: rhinoplasty, facelift and breast augmentation. The techniques for which we register less than 5% of problems are: liposuction and eye-lid surgery. On average, the most frequent cosmetic surgical procedures give rise to 7% of complications.

Adult↗
PubMed2006

Radiation effects on the cosmetic outcomes of immediate and delayed autologous breast reconstruction: an argument about timing.

OBJECTIVE: To conduct a systematic review to gather the available evidence on the optimum timing of the radiotherapy in relation to autologous breast reconstruction. MATERIAL AND METHODS: The data was extracted from scientific databases, and a manual follow-up of references. The studies were selected which included at least 20 patients with any method of autologous breast reconstruction who were treated with adjuvant radiotherapy either before or after their reconstruction, and had addressed the effects of radiotherapy on the cosmetic outcome in their results. The principal outcome was cosmetic appearance. Secondary outcomes were immediate and delayed complications. RESULTS: We could not find any randomised controlled trial on this topic. Ten studies were included, most were retrospective, heterogeneous in terms of control groups, radiation doses, follow-up duration, and outcome measurements. Two studies included no control groups, and four studies compared the outcomes of patients with radiotherapy either before (n=3) or after (n=1) autologous breast reconstruction. The overall incidence of complications was increased in patients with radiotherapy in three out of these four studies. Only four studies directly compared the outcomes of patients who received radiotherapy before with patients who received radiotherapy after autologous breast reconstruction and two out of these reported worse outcomes associated with post-reconstruction radiotherapy. CONCLUSIONS: Despite the paucity of the published data, the current evidence suggests that the radiation has a deleterious effect on autologous flap reconstruction. Until better methods of radiation delivery can be devised to minimise the long term radiation sequelae in the irradiated tissue, delayed reconstruction seems to be a safe option in most of the cases. However, the findings from these studies should be interpreted with great caution before generalising from their results.

Adult↗
PubMed2004

Cosmetic globe surgery in the horse.

Effects of traumatic injury or inflammation on the equine eye can be catastrophic. These ocular conditions can frequently result in blindness or chronic pain. In addition to blindness and pain, permanent unsightly cosmetic defects can occur. This article addresses options available for improved cosmetic outcome in horses with ocular scars or requiring enucleation. Many of these options have been described in detail previously. New information has been added to the discussion of each option where pertinent.

Animals↗
PubMed2004

Cosmetic blepharoplasty.

Cosmetic blepharoplasty is the hallmark of facial rejuvenation and is rewarding for the surgeon and patient. No other cosmetic procedure is more common in the 40- to 65-year age group. This procedure carries a steep learning curve, but the training of an oral and maxillofacial surgeon is adequate to begin learning this procedure. Proper diagnosis and adherence to strict preoperative, intraoperative, and postoperative protocols are paramount to avoiding complications that may be serious. The author, like many surgeons, enjoys this procedure and believes that its place in the contemporary scope of oral and maxillofacial surgery is well established.

Adipose Tissue↗
PubMed2005

Left heart atrial and ventricular epicardial pacing through a left lateral thoracotomy in children: a safe approach with excellent functional and cosmetic results.

OBJECTIVE: Left heart atrial and ventricular epicardial pacing through a left lateral thoracotomy is an alternative approach for lead insertion in children, avoiding venous access complications and right ventricular stimulation, without compromising sporting or musical activities. We analyzed the survival and performance of left atrial and left ventricular epicardial pacing leads, and present mid-term follow-up data. METHODS: Seventy-five bipolar steroid eluting pacing leads (Medtronic CapSure Epi 4968) were implanted in 41 children, aged 8.6+5.1 years. Pacing systems included 34 DDDR and 7 VVIR. Pacing leads were inserted through a muscle-sparing left lateral thoracotomy, and sutured to the left atrial appendage or atrium, and to the left ventricle. The generators were buried behind the abdominal muscles or between the thoracic muscle layers. Congenital heart disease with previous cardiac surgery was present in 25 children. Indications for pacing were post-operative heart block (n=14), sinus node disease (n=13), congenital heart block (n=9), and various (n=5). Threshold values and measured data were obtained at 6-month intervals. The mean follow-up was 3.8+2.9 years. RESULTS: There was no mortality or major morbidity, with excellent functional and cosmetic results. Lead survival was 94 and 86% for atrial leads, and 97 and 86% for ventricular leads, at 1 and 5 years, respectively. There were five reoperations for lead fracture (n=2), insulation break (n=1), oversensing (n=1), and infection (n=1). Device reprogramming was required in three instances. In the absence of acute lead failure, mid-term follow-up shows very satisfactory and stable lead performance. CONCLUSIONS: Left heart atrial and ventricular epicardial pacing leads inserted through a left lateral thoracotomy demonstrate a high probability of survival, with favorable pacing characteristics, and optimal sensing thresholds at mid-term follow-up. Epicardial left heart pacing is reliable, and easy access can be achieved through a cosmetic and functional muscle-sparing left lateral thoracotomy.

Adolescent↗
PubMed2006

Intraoperative radiotherapy given as a boost for early breast cancer: long-term clinical and cosmetic results.

PURPOSE: The standard radiotherapy (RT) of breast cancer consists of 50 Gy external beam RT (EBRT) to the whole breast followed by an electron boost of 10-16 Gy to the tumor bed, but this has several cosmetic disadvantages. Intraoperative radiotherapy (IORT) could be an alternative to overcome these. METHODS AND MATERIALS: We evaluated 50 women with early breast cancer operated on in a dedicated IORT facility. Median dose of 10 Gy was delivered using 9-MeV electron beams. All patients received postoperative EBRT (50 Gy in 2 Gy fractions). Late toxicity and cosmetic results were assessed independently by two physicians according to the Common Terminology Criteria for Adverse Event v3.0 grading system and the European Organization for Research and Treatment of Cancer questionnaires. RESULTS: After a median follow-up of 9.1 years (range, 5-15 years), two local recurrences were observed within the primary tumor bed. At the time of analysis, 45 patients are alive with (n = 1) or without disease. Among the 42 disease-free remaining patients, 6 experienced Grade 2 late subcutaneous fibrosis within the boost area. Overall, the scores indicated a very good quality of life and cosmesis was good to excellent in the evaluated patients. CONCLUSION: Our results confirm that IORT given as a boost after breast-conserving surgery is a reliable alternative to conventional postoperative fractionated boost radiation.

Adult↗
PubMed2006

Cosmetic applications of selected traditional Chinese herbal medicines.

Because tyrosinase catalyzes melanin synthesis, tyrosinase inhibitors are important in cosmetic skin-whitening. Oxidative stress contributes to skin aging and can adversely affect skin health, which means antioxidants active in skin cells may support skin health. We examined 25 traditional Chinese herbal medicines that might be useful for skin-whitening and skin health. Extracts (100microg/mL) were tested for cytotoxicity on human epidermal melanocytes (HEMn); 12 exhibited low cytotoxicity. Their effects on tyrosinase and melanin inhibitory activities and free radical scavenging activities were further assessed. Phenolic contents were evaluated using Folin-Ciocalteu reagent. Four herbs, Pharbitis nil, Sophora japonica, Spatholobus suberectus, and Morus alba, exhibited potent inhibitory effects on tyrosinase (IC(50) values 24.9, 95.6, 83.9, and 78.3microg/mL, respectively). Melanin inhibition was not dose-dependent. Sophora japonica (IC(50): 14.46microg/mL, 1,1-diphenyl-2-picrylhydrazyl (DPPH); 1.95microg/mL, hydroxyl radical) and Spatholobus suberectus (IC(50): 10.51microg/mL, DPPH; 4.36microg/mL, hydroxyl radical) showed good antioxidative activities and high phenolic contents (255 and 189mg of gallic acid/g extract, respectively). Among active anti-tyrosinase extracts, Sophora japonica and Spatholobus suberectus were especially potent in HEMn cells in terms of free radical scavenging effects and high phenolic contents, making them the strongest candidates for cosmetic application found in the current study.

Biphenyl Compounds↗