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Cosmetic tracheostomy locket: an attempt to improve the aesthetic component of tracheostomy tubes.

This paper demonstrates the need for a cosmetic device as a necessary adjunct to long-term tracheostomy care. Such devices are not available, at present, from tracheostomy tube manufacturers. The cosmetic tracheostomy cover plate is based on a silver Negus tracheostomy tube, to which the silver chain and cover plate (locket) are attached. The result, for the patient who tried it, was excellent.

Adult↗

Cosmetic bilateral leg lengthening: experience of 54 cases.

The Ilizarov method for leg lengthening was used for cosmetic reasons in 54 patients with constitutional short stature. A mean lengthening of 7 cm with a low rate of complications produced an excellent or good outcome in all the patients, including improvement in psychological disturbances related to short stature. Those who undergo the procedure must be highly motivated, fully informed and understand the technique and possible complications. We suggest that the Ilizarov method for cosmetic limb lengthening is a technique without major complications. However, it requires careful follow-up, and the involvement of orthopaedic surgeons who are familiar with use of the circular frame and are experienced in limb lengthening and correction of deformity for pathological conditions.

Adolescent↗

The role of cosmetic dentistry in restoring a youthful appearance.

BACKGROUND: Dentistry is faced with a population that is getting older and keeping more of its natural teeth. Smiles show physical and esthetic signs of aging. Advances in the area of cosmetic dentistry now offer the dental profession new opportunities in conservative and esthetic restorative procedures that have the potential to reverse the signs of dental aging, thereby making patients appear younger. CASE DESCRIPTION: The physical and esthetic attributes of an aged dentition are identifiable. Tooth wear over time alters the appearance of the teeth and smile in a way that is perceptible to dentists and laypeople. Bonding and adhesive ceramic restorative procedures have the potential of reversing the esthetic manifestations of the aging process for teeth. Specific diagnostic tools, including a composite resin mock-up and construction of an incisal putty matrix, allow for previsualization of possible treatment outcomes and allow clinicians to resolve occlusal as well as esthetic treatment concerns before initiating actual treatment. CLINICAL IMPLICATIONS: The ability to make patients look younger through cosmetic enhancement of teeth and smiles has tremendous implications for the future practice of dentistry. Dentists who have the training and skills to meet the increasing demand for esthetic procedures by patients seeking to restore a youthful appearance may find an expanded role within their practices for this type of treatment.

Dental Veneers↗

Colorimetric analysis of silicone cosmetic prostheses for upper-limb amputees.

Every year the Italian National Insurance Institute of Accidents on Work (INAIL) Prosthesis Centre manufactures more than 300 silicone cosmetic upper-limb prostheses that are aesthetically similar to patients' missing limbs; however, the prostheses have the following drawbacks: subjectivity in color choice, high production costs, and long time frames for patient tests and prosthesis production. In an attempt to minimize these factors, we performed a study to test various systems that automatically detect the color of human skin. Such a system would allow us to reproduce a patient's exact skin color for silicone cosmetic prostheses. We analyzed the color identification systems available on the market and assessed the possibility of introducing such a system into the production cycle of the prostheses. We found that because of intrinsic factors of the materials, automatic color detection for prosthesis production is complex. Therefore, any of the systems we tested will require further development for full satisfaction of the needs of prostheses manufacturers.

Amputees↗

Use of a hydroxyapatite orbital implant in a cosmetic corneoscleral prosthesis after enucleation in a horse.

A hydroxyapatite orbital implant was used after enucleation of an eye from a 5-year-old performance horse. A custom-made corneoscleral prosthesis was made and fitted over the hydroxyapatite implant. The implant and surgery were well tolerated. Placement of a cosmetic prosthesis is desired after enucleation of equine eyes to allow horses to return to competition. Synthetic spheres consisting of methylmethacrylate or silicone have been used, although reported complications have included extrusion, infection, and poor cosmetic results. Hydroxyapatite orbital implants made from marine coral allow vascular and fibrous tissue growth from the host orbit into the implant, which decreases the possibility of implant extrusion or infection and allows enhanced healing of defects in the overlying conjunctiva. Extraocular muscle fixation onto the implant permits motility and assists in the prevention of implant extrusion.

Animals↗

Breast retraction assessment. Multiple variable analysis of factors responsible for cosmetic retraction in patients treated conservatively for stage I or II breast carcinoma.

A method for objective evaluation of cosmetic outcome of patients treated conservatively for breast carcinoma allowed the location of the nipples on two coordinates. The method was applied in 41 patients, 5 to 41 months following the completion of radiation therapy. Multiple variable analysis revealed that extensiveness of resection of the primary breast tumor was the major factor associated with breast retraction. The only other factor of significance was patient age at diagnosis. Neither the radiation therapy parameters, the use of adjuvant chemotherapy, nor any other analyzed factor was found to be associated with cosmetic breast retraction.

Adult↗

Cosmetic and functional reconstruction achieved using a split myofascial bone flap for pterional craniotomy. Technical note.

Cosmetic deformities that appear following pterional craniotomy are usually caused by temporal muscle atrophy, injury to the frontotemporal branch of the facial nerve, or bone pits in the craniotomy line. To resolve these problems during pterional craniotomy, an alternative method was developed in which a split myofascial bone flap and a free bone flap are used. The authors have used this method in the treatment of 40 patients over the last 3 years. Excellent cosmetic and functional results have been obtained. This method can provide wide exposure similar to that achieved using Yaşargil's interfascial pterional craniotomy, without limiting the operative field with a bulky temporal muscle flap.

Bone and Bones↗

Comparison of cosmetic results in frontalis sling operations: the eyelid crease incision versus the supralash stab incision.

PURPOSE: In addition to ptosis, the lack of eyelid crease is one of the main cosmetic problems of patients with poor levator function. In this study, we aimed to evaluate the effect of the incision site on ptosis correction and eyelid crease formation in frontalis sling operations. MATERIALS AND METHODS: Photographs and charts of 27 patients (45 eyelids) who underwent frontalis sling operations were retrospectively reviewed. All patients had congenital ptosis with poor levator function ranging from 0 to 4 mm. In group I (15 eyelids), 3 supralash eyelid skin incisions were performed and the sling material was threaded along the tarsal surface. In group 11 (30 eyelids), the eyelid crease approach was used with the suturing of the sling material directly to the tarsus. RESULTS: Although lid contour and lid crease symmetry were good in 46.6% of the cases in group I, eyelid crease formation was not satisfactory in any of the cases. Lid contour and lid crease symmetry were good in 76.6% of the cases in group II. CONCLUSION: Our results indicated that the eyelid crease approach provided better functional and cosmetic results than did the supralash stab incision in frontalis sling operations. The passage of the sling material behind the orbital septum by direct visualization in the eyelid crease approach is one of the main factors affecting the surgical success of the frontalis sling operation.

Adolescent↗

Cosmetic use of alpha-hydroxy acids.

Frequent and daily use of cosmetic and skin-care products that contain alpha-hydroxy acids (AHAs) moisturizes the skin and produces smoother, less-wrinkled skin surfaces. The cosmetic products developed as astringents and exfoliants diminish skin scales and remove excess skin oil. New studies suggest that photodamaged skin improves with AHA treatment.

Beauty Culture↗

Study of the colors and retention of over-the-counter cosmetic veneers.

The purpose of this study was to observe the tooth colors and retention of a cosmetic veneer Fiche Pearl On containing shellac and five experimental formulations containing benzoin gum and ethyl cellulose. Tooth color was measured with a spectrophotometer before and after application of the veneers to the buccal or labial surface of experimental teeth. Through both in vitro and in vivo studies, the retention rates of veneers were assessed. In terms of color difference (deltaE*ab) between before and after veneer application, it ranged from 4.3 (Fiche Pearl On) to 15.0 (experimental formulation White Plus). In terms of retention rate, in vitro test found the retention rate of experimental formulation White Plus was significantly higher than that of Fiche Pearl On. In in vivo test where subjects were permitted to drink water and tea, it was found that the retention rate after two hours ranged from 94.0 to 98.5%. In conclusion, teeth applied with the experimental cosmetic veneer formulations showed better color and retention than teeth with Fiche.

Analysis of Variance↗

Formation of neoclitoris from glans penis by reduction glansplasty with preservation of neurovascular bundle in male-to-female gender surgery: functional and cosmetic outcome.

PURPOSE: During male-to-female gender reassignment surgery we used an abdominal pedicled inverted penile skin technique to create a vagina and extra folds of skin to create a clitoral hood. Although patients had orgasms with that technique, there was a general request for the placement of a sensate, erectile clitoris. Therefore, in 10 such patients undergoing transsexual surgery a neoclitoris was fashioned from the glans penis. Surgical technique and results are described. MATERIAL AND METHODS: From 1980 to 1995, 57 male-to-female gender surgeries were performed at our university center. In the last 10 such patients undergoing transsexual surgery a neoclitoris was created. Glans volume is reduced to match that of a normal size clitoris and the entire length of the dorsal neurovascular bundle is preserved. The neoclitoris is placed through a buttonhole in the newly constructed introitus. There was minimal bleeding from the bundle intraoperatively. RESULTS: In 8 of 10 patients the neoclitoris remained intact postoperatively with good sensation to touch, vibration and light pressure (sexual sensation). The cosmetic and functional appearance was that of a normal clitoris, and patients were satisfied. In 2 patients the results were not satisfactory because of necrosis of the neoclitoris. CONCLUSIONS: This technique has excellent functional and cosmetic results in the majority of patients. Preservation of the somatic, tactile and vibratory sensation of the neoclitoris is surgically practical, and can afford the patient the possibility of a more functional outcome of gender reassignment surgery.

Adult↗

[Lower mid-line skin incision and minimal sternotomy in pediatric open heart surgery--an alternative cosmetic approach].

Full median sternotomy has been the standard approach for open heart surgery. However, it leaves an unsightly surgical scar. We therefore designed a lower mid-line skin incision and minimal sternotomy approach as a cosmetic alternative. Since February 1993, 78 pediatric patients with congenital heart disease have undergone this open heart surgery procedure. Their ages ranged from 1 month to 13 years (median: 2 years and 7 months) and body weights ranged from 2.4 to 43 kg (median: 11.5 kg). Thirty-one patients had atrial septal defect, 34 perimembranous ventricular septal defect, 9 subpulmonary ventricular septal defect, and 4 other cardiac anomalies. All cannulations for cardiopulmonary bypass could be performed through this approach. No patients required conversion to standard median sternotomy and no peri- or postoperative complications related to this approach, such as injury to the great artery and vein, air embolism, or sternal deherence, were noted. This approach is technically easy and an excellent cosmetic approach in pediatric open heart surgery.

Adolescent↗

Liposuction and other cosmetic surgery: where do they fit; what are the risks for hospitals?

The boom in cosmetic surgery, best exemplified by the rapid increase in one of the most popular procedures, liposuction, provides some lessons for hospitals. The qualifications of staff who request privileges to perform cosmetic surgery must be scrutinized carefully. Oversight of physician advertising and selection of patients may also be necessary.

Adipose Tissue↗

Cosmetic aspects in minimally invasive cardiac surgery.

The initial focus of the pioneering cardiac surgeons was appropriately centered on survival as opposed to cosmetic results. A variety of minimally invasive techniques have been introduced to perform cardiac operations through a limited incision. As the results in cardiac surgery improved, cosmetic and psychological implications of surgery become more important in the evaluation of the morbidity of these procedures. Future comparative studies will be mandatory to show whether these small incisions have an actual advantage on recovery or morbidity or whether their interest is entirely aesthetic.

Adolescent↗

Cosmetic oral and maxillofacial surgery.

The dental specialty of oral and maxillofacial surgery over the last fifteen years has been intimately involved in not only altering the bony facial skeleton, but also the esthetic defects of the facial soft tissue drape. These procedures are currently being taught, in many of our residency programs, along side the art and science of dentoalveolar surgery. When one combines the modification of both the skeletal and soft tissues, the resultant effect can be greater than the sum of its parts. Should one take this a step further and add to the list, proper arch form as prepared by the orthodontist along with cosmetic shape and appearance of the dentition by the restorative dentist using the latest in cosmetic dental techniques, what transforms is a result that has never been seen heretofore in the annals of dentofacial care. To follow are a number of case reports illustrating some salient points.

Adult↗

Baby boomers make cosmetic dentistry boom.

Baby Boomers want to stay younger longer. As they age, a healthy attractive smile becomes much more important to their appearance. Nothing conveys good health and maintenance like aesthetically pleasing teeth. Because the timing is perfect for cosmetic dentistry, there is no reason for people to not have a great smile. Smile-Vision and the latest cosmetic dentistry techniques and materials helped the case patient first see and then become the person he wanted to be. His teeth look and feel better, resulting in a more confident appearance. (Figures 14 through 16).

Adult↗

Ethics and aims of cosmetic surgery: a contribution from an analysis of claims after minor damage.

MAIN OBJECTIVES: Cosmetic surgery raises the ethical problem of the balance of risks and benefits of an operation the benefit of which is psychological and difficult to evaluate. The aim of this study is to improve the understanding of the factors that influence an unsatisfactory outcome. In this context, we have analyzed complaints from patients the alleged damage to whom proved to be ultimately non-existent or minimal. METHODS: Review of the case notes of 20 patients who had sought damages through the French judicial system for minimal or non-existent alleged damage. Data were collected in 1999. FINDINGS: We found fifteen complaints of insufficient results, two for cause and effect relations with pathologies without any connection, and three for lack of information. 5 patients received compensation, the rest having been ruled out of court. The gender ratio (17 F/3 M), the average age (38 years old), the distribution of the operations and the socio-professional categories reflect the characteristics of a standard cosmetic surgery population. The average period of time between an operation and a complaint was 4.3 years (SD = 4.2). Among the medical histories we found two cases of depression, one treatment "for the nerves", one suicide attempt, and two cases of alcoholism without possible interpretation in the framework of this study. In six cases, the surgeon's qualification was not appropriate to the type of operation. The unprofessional conduct of colleagues had an influence on the effect of the procedure as an independent factor. CONCLUSION: These results call for more responsibility from professionals and encourage the undertaking of prospective complementary studies in order to evaluate more precisely the balance of risks and benefits.

Adult↗

The role of lasers in cosmetic dentistry.

Dental lasers contribute significantly to the field of cosmetic dentistry, providing an invaluable resource for clinicians who perform different types of esthetic procedures. Practitioners in this specialized field not only help patients acquire beautiful and ideal smiles and dental health, but also they assist patients in benefiting from tremendous clinical advantages, such as sterile surgical sites and increased comfort levels. Tooth whitening will always be an important component of cosmetic dentistry. Developing the most efficient and safe method of tooth whitening is the goal of power bleaching. Currently the argon laser has proved to be the most valuable energy source for power bleaching. Clinicians need to learn more about constantly updated technology and apply newly discovered methods and protocols to clinical situations to benefit patients and clinicians.

Adolescent↗