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Mutagenicity of azo dyes used in foods, drugs and cosmetics before and after reduction by Clostridium species from the human intestinal tract.

Various azo dyes currently approved by the US FDA for use in foods, drugs and cosmetics are reduced by anaerobic bacteria from the human intestinal tract. These bacteria with azoreductase activities include several Clostridium species. Seven of these azo dyes and their reduction products following incubation with a Clostridium sp. were evaluated for mutagenicity in Salmonella typhimurium strains TA98 and TA100. No mutagenicity was induced in either TA98 or TA100 by any of the seven azo dyes or the reduced metabolites when tested at concentrations as high as 200 microg/plate, with or without exogenous metabolic activation by rat liver fraction S-9.

Animals↗

Effect of hair care and hair cosmetics on the concentrations of fatty acid ethyl esters in hair as markers of chronically elevated alcohol consumption.

Fatty acid ethyl esters (FAEE) can be used as alcohol markers in hair. It was investigated in this study whether this diagnostic method is disturbed by hair care and hair cosmetics. Traces of ethyl myristate, ethyl palmitate, ethyl oleate and ethyl stearate were detected in all of 49 frequently applied hair care products by headspace solid phase microextraction (HS-SPME) and gas chromatography-mass spectrometry (GC-MS). The highest concentration was 0.003% in a hair wax. From experiments with separated hair samples of alcoholics as well as from the evaluation of the FAEE concentrations and the data about hair care of 75 volunteers (alcoholics, social drinkers and teetotalers) follows that usual shampooing, permanent wave, dyeing, bleaching or shading are of minor importance as compared to the drinking amount and other individual features. However, false positive results were found after daily treatment with a hair lotion containing 62.5% ethanol, with a deodorant and with a hair spray. As an explanation, it is assumed that FAEE are formed in the sebum glands also after regular topical application of products with a higher ethanol content.

Alcohol Drinking↗

Patients' psychological and cosmetic experience after immediate breast reconstruction.

Immediate breast reconstruction was introduced in 1990 at the Karolinska Hospital. A semistructured interview with 20 patients operated on between 1991 and 1994 was undertaken to evaluate patients' degrees of satisfaction regarding pre-operative information, the need for psychological support and the opinion about the cosmetic outcome. During the pre-operative period, 18 patients felt that they were engaged in the decision-making whereas two patients felt that the surgeon alone was responsible for the decision. Regarding pre-operative information given, 7/20 were satisfied, 5/20 were mostly satisfied, 5/20 were unsatisfied and 3/20 had no opinion. During the early post-operative period (<3 months), five patients felt anxiety or depression and 10 patients felt a need of additional psychological support. Within 6 weeks 19/20 patients returned to their occupational level. During the late post-operative period (>3 months), 19/20 patients were generally satisfied with the reconstructive procedure. Eight patients thought the final result exceeded their initial expectations and 11/17 accepted the new breast as an integrated part of their body. The results confirm that immediate breast reconstruction plays an important role in the surgical management of breast cancer. The need for pre-operative information and continuous psychological support in terms of an empathetic behaviour cannot be underestimated.

Adult↗

Cosmetic amputation of the long finger with carpal osteotomy.

Amputations of the third digital ray leave a central gap which can usually be closed by shifting either the second or the fourth digital rays medially. This however calls for an osteotomy with it usual hazards. To avoid metacarpal osteotomy, we have completed the amputation of the long finger in six cases with a central carpal osteotomy through the capitate. This enables the second and fourth rays to be moved intact medially and to close the gap, thus providing a cosmetic three fingered hand.

Amputation, Surgical↗

A severe fibrotic reaction after cosmetic liquid silicone injection. A case report.

A case of a severe, locally aggressive fibroblastic reaction to cosmetic silicone injection involving the orbital cone and anterior cranial base is presented. Included is a brief history and description of silicone injection and its complications. Though many facts remain to be discovered, speculation into the possible pathogenesis, with a review of the literature, shows that while silicone continues to be a useful tool for the plastic surgeon, an awareness of the risks, as well as a search for clues to avoid complications, must continue before further liberal use of this material is encouraged.

Facial Bones↗

Ultra-thin needle thoracoscopic surgery for hyperhidrosis with excellent cosmetic effects.

BACKGROUND: In spite of its cosmetic benefits over open surgical techniques, endoscopic sympathectomy using 5 mm or larger instruments still has the problems of operative scar as well as pain on the trocar sites. Recently we have begun using 2 mm endoscopic instruments. The purpose of this study was to confirm the safety and feasibility of fine needle endoscopic instruments in thoracic sympathetic ablation. METHODS: We have exclusively used 2 mm endoscopic instruments since January 1997, and from that time to May 1999 417 patients were underwent surgical procedures for hyperhidrosis. T2 or T2/T3 sympathectomy was performed for the first 56 patients, after June 1997, in 361 patients the interconnecting sympathetic trunk was divided instead of ganglion resection, and this procedure was named sympathicotomy. Palmar hyperhidrosis was presented in 375 patients (89.9%) and facial in 28 (6.7%) and axillary in 14 (3.4%). The level of division or resection of the ganglion differed according to the patient's symptoms. RESULTS: Sympathicotomy and sympathectomy were successful and all patients were satisfied with immediate dryness of affected sites. There were not any cases of bleeding or reoperation or hospital mortality. A large endoscope was required to eliminate the pleural adhesion in fourteen cases (7.7%). Thoracotomy conversion was required in two pleural adhesion cases. Minor complications were occurred in 17 patients (4.1%); such as closed thoracostomy in ten cases, peripheral nerve injury in three, pulmonary parenchymal injury in two, Horner's syndrome in two and atrial fibrillation in one. We have five cases of recurrent symptoms (1.2%). CONCLUSION: Our experience indicates that, for the treatment of hyperhidrosis, 2 mm ultra-thin needle endoscopic instruments are safe and effective to operate on palmar and facial hyperhidrosis patients.

Adolescent↗

The cosmetic aspects of neurosurgery.

The cosmetic aspects of neurosurgery are important and make a considerable difference to the patient's quality of life. In general, the saying is true that "at a cocktail party, the patient should not be recognized as having had neurosurgery, or, even better, the patient's own neurosurgeon should not be able to detect which side the patient was operated on when the patient is seen in the office 6 months later without looking at the chart."

Cranial Nerves↗

The therapeutic dilemma: treating subtle seizures or indulging in electroencephalogram cosmetics?

The treatment of epileptiform abnormalities in the absence of obvious seizures has, in the past, been dismissed as "EEG cosmetics." The work on transitory cognitive impairment has highlighted the importance of asking the question: "What is a seizure?" The extent to which epileptiform discharges cause temporary or permanent impairment, profoundly influences decisions on whether to treat with antiepileptic medication or surgery.

Anticonvulsants↗

Stage of breast cancer at diagnosis among women with cosmetic breast implants.

Concern has been raised about the potential delay in breast cancer diagnosis in the augmented breast. We linked a cohort of 2955 women, who received cosmetic breast implants in Denmark during the period 1973-1997 with the Danish Cancer Registry and the Danish Breast Cancer Cooperative Group register. We identified 23 incident cases of invasive breast cancer diagnosed subsequent to breast implantation. We randomly selected 11 controls for each case from the Danish Breast Cancer Cooperative Group's register, and obtained detailed information on all study subjects about surgery, histopathology and stage of breast cancer at diagnosis, intended adjuvant treatment according to trial protocols and overall survival. We found that women with breast implants on average were diagnosed with breast cancer at the same stage as controls. Significantly more women with breast implants had tumour cells in the surgical margins according to the Danish Breast Cancer Cooperative Group's data. There was no significant difference in overall survival between the two groups after an average of 6.4 years of follow-up. Based on this limited number of women with breast cancer subsequent to breast augmentation, breast implants do not appear to delay the diagnosis of breast cancer, and no evidence of impaired survival after breast cancer diagnosis in augmented women was found.

Adult↗

Liposuction in cosmetic dermatology.

Liposuction is one of the most frequently performed cosmetic procedures in the world today. The central role of dermatologists in evolving many of the procedural methods now used is discussed. Tumescent anaesthesia and the associated tumescent technique proper allow liposuction to be performed safely and effectively in an outpatient setting. An overview of the technique and applications is presented.

Anesthesia, Local↗

Long-term patient satisfaction with cosmetic outcome of minor cutaneous surgery.

We evaluated our patients' own assessment of the cosmetic outcome of minor dermatological surgery procedures. A postal questionnaire was sent to patients who had undergone surgery between 12 and 18 months previously. Patient satisfaction was correlated with variables, including age, sex, lesion size and site, indication for excision, histological diagnosis and operator. Two hundred and seven excisional procedures were identified in 193 patients. Seventy-nine per cent of the questionnaires (163/207) were returned. Seventy per cent of patients reported that the scar was invisible or better than expected and 9% rated it to be worse than expected. Ninety per cent of patients said they would undergo the procedure again. Patient dissatisfaction was associated significantly and independently with excisions from the back, younger age and benign histology.

Adult↗

Influence of the luminance level on visual performance with a disposable soft cosmetic tinted contact lens.

The purpose of the present work was to study the effect on visual performance of wearing disposable soft tinted contact lenses for cosmetic purposes. Parameters such as contrast sensitivity (Vistech 6000), colour vision (Farnsworth-Munsell 100-Hue colour test), visual fields (static Goldmann perimetry) and subjective vision (what the wearer feels while wearing the lenses) were studied under different illumination levels in order to check for possible vision losses while wearing these contact lenses at low illumination levels. Sixteen emmetropic subjects were fitted consecutively with seven pairs of different colour lenses (Optima Colors lenses by Bausch & Lomb), and the experimental parameters were measured under four different illumination levels (60, 6, 1, and 0.1 cd/m2; but 15 and 0.3 cd/m2 for the static perimetry) The results obtained showed no statistically significant differences in visual performance between wearing the lenses and not wearing them (p > 0.01), except for the static perimetry, in which statistically significant differences (p < 0.01) occur at eccentricities greater than 30 degrees.

Adolescent↗

A screening questionnaire for body dysmorphic disorder in a cosmetic dermatologic surgery practice.

BACKGROUND: Dermatologic surgeons frequently see patients with body dysmorphic disorder, a distressing or impairing preoccupation with a nonexistent or slight defect in appearance. Recognition of this disorder is essential to avoid unnecessary and generally unsatisfying surgical outcomes, but no screening tools are available for use in a dermatology setting. OBJECTIVE: To develop and validate a brief self-report questionnaire to screen for body dysmorphic disorder in dermatology settings. METHODS: A questionnaire was developed and its sensitivity and specificity determined in 46 subjects, using a reliable clinician-administered diagnostic interview for body dysmorphic disorder. The interrater reliability of a defect severity scale was also determined (n = 50). RESULTS: The self-report questionnaire had a sensitivity of 100% and a specificity of 93%. The interrater reliability (ICC) of the defect rating scale was.88. CONCLUSIONS: This brief questionnaire was a highly effective screening tool for body dysmorphic disorder in a cosmetic dermatology setting. Use of this questionnaire may help identify patients with this syndrome.

Adolescent↗

Areolar cosmetic tattoo ink darkening: a complication of Q-switched alexandrite laser treatment.

BACKGROUND AND OBJECTIVE: Medical tattooing of the areola is widely performed in Korea. However, cosmetic tattoos containing flesh-tone, purple-red, and yellow dyes are sometimes resistant to Q-switched laser and may even become darker. METHOD: Two Korean women in their 30s who had a mastectomy got light brown to red areolar medical tattoos but they were not satisfied with the shape and size of the tattoos. They underwent Q-switched alexandrite laser treatment with a 3 mm collimated beam at fluences of 7.5-8 J/cm2 in order to trim the irregular contour and reduce the diameter of the tattoos. RESULTS: Within 5 minutes a dark gray to black discoloration of the treated area was evident and remained dark for 6 weeks. Improvement was not noted after two further Q-switched Nd:YAG laser treatments. CONCLUSION: Medical areolar tattoos should be approached with extra caution when attempting their removal with high-energy pulsed lasers such as Q-switched alexandrite laser and a small test site should be performed prior to treatment.

Adult↗

Techniques for improving the cosmetic outcome of breast conservation surgery.

This paper presents techniques to enhance the aesthetic results of conservative breast surgery. A number of methods are described to improve results of conservative surgery by limiting deformity, reducing scars and by immediate replacement of tissue. By application of the appropriate technique breast tumours may be excised from any quadrant in a large or small breast with a good cosmetic outcome. Attention to detail with pre-operative planning of the estimated tissue loss, placement of incisions, fish-tailing of quadrantectomy scars, utilization of reduction mammoplasty incisions and immediate replacement of defects after wide excision are useful in obtaining good aesthetic results.

Breast Neoplasms↗

The normal position of the umbilicus in the newborn: an aid to improving the cosmetic result in exomphalos major.

BACKGROUND/PURPOSE: The aim of this study was to determine the normal position of the umbilicus and hence improve the cosmetic result of exomphalos major repair. METHODS: The position of the umbilicus was determined in 50 neonates with respect to the xiphisternum and pubis. RESULTS: The normal umbilical position is 60% of the way from the inferior border of the xiphisternum to the superior border of the pubis in the midline. CONCLUSION: In the repair of exomphalos major, the most aesthetically pleasing result is obtained if the umbilicus is placed 60% of the way from the xiphisternum to the pubis.

Esthetics↗

Topical photodynamic therapy: a new tool in cosmetic dermatology.

Topical photodynamic therapy is an evolving relatively new modality in dermatology. While widely used in Europe for treatment of actinic keratoses and skin cancer, topical photodynamic therapy is still relatively unfamiliar in the United States. Approved by the US Food and Drug Administration in 1999, photodynamic therapy is now being evaluated for superficial epidermal tumors, acne, and cosmetic applications. This article reviews recent advances in this field, with emphasis on skin rejuvenation, acne, and hair removal.

Acne Vulgaris↗