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Biomelanin antioxidants in cosmetics: assessment based on inhibition of lipid peroxidation.

Acute adverse effects of ultraviolet (UV) radiation in humans include sunburn, photosensitivity reactions and immunological suppression. Chronic exposure to UV light, particularly the UVB (290-320 nm) component of the UV radiation, and certain environmental chemicals increase the risk of nonmelanoma skin cancer and play a major role in cutaneous aging. The lipid peroxidation (LPO) of biomembranes, mediated by reactive oxygen species and free radicals, is one of the major causes of cellular damage induced by UV radiation and toxins. Antioxidants, such as vitamin E, vitamin C and melanins, are reactive oxygen and radical scavengers, thereby minimizing the light- and toxin-induced tissue destruction. We examined the influence of 8 biotechnically produced polyphenolic melanins on the LPO of microsomal membranes in comparison with alpha-tocopherol, ascorbate and synthetic melanin. All biomelanins showed better inhibition of peroxidative damage than synthetic melanin. Three of the 8 tested drugs inhibited the LPO at least as effectively as vitamin C and vitamin E. The combination of the most effective biomelanin with both vitamin C and vitamin E resulted in greater LPO inhibition than caused by each agent alone. Our data show that biomelanins are potent inhibitors of the peroxidative destruction of biomembranes, indicating that these compounds may be useful antioxidative agents in cosmetic preparations.

Animals↗

Adjunctive procedures to maximize the result of cosmetic eyelid surgery.

The cosmetic blepharoplasty should be complemented by surgical procedures that augment the favorable aesthetics of the blepharoplasty. A blepharoplasty is frequently not fully satisfying to the patient or the surgeon. The plastic surgeon must recognize the need for adjunctive procedures such as eyebrow lift, blepharocanthoplasty, malar implants, dermal abrasion, chemosurgery, and temporoauricular lift to fulfill the more ideal expectations of both surgeon and patient. Evaluation of the aesthetic requirements for youthful restoration around the eye and the need for additional surgical techniques to enhance the beauty of the eye is discussed. Included in the discussion are the techniques used for the various procedures, the complications that can arise, and the reward of surgery performed in conjunction with the routine blepharoplasty or instead of it.

Dermabrasion↗

Cosmetic neurology: the controversy over enhancing movement, mentation, and mood.

Advances in cognitive neuroscience and neuropharmacology are yielding exciting treatments for neurologic diseases. Many of these treatments are also likely to have uses for people without disease. Here, I review the ways in which medicine might make bodies and brains function better by modulating motor, cognitive, and affective systems. These potential "quality of life" interventions raise ethical concerns, some related to the individual and others related to society. Despite these concerns, I argue that major restraints on the development of cosmetic neurology are not likely. Neurologists and other clinicians are likely to encounter patient-consumers who view physicians as gatekeepers in their own pursuit of happiness.

Affect↗

Lateral rhinotomy through nasal aesthetic subunits. Improved cosmetic outcome.

The traditional lateral rhinotomy incision described originally by Moure in 1902 has proved a versatile approach to the mid-facial skeleton. It is not, however, without its complications, particularly poor cosmesis due to depression of the nasofacial groove. In one series 10 per cent of patients developed wound complications. We present our modification of the lateral rhinotomy incision, that takes account of the nasal aesthetic subunits by placing the incision between the dorsal and side wall nasal subunits with extension inferiorly along the alar groove. From November 1994 to February 2001, a retrospective review of case notes showed that 20 patients underwent modified lateral rhinotomy incision for a variety of pathology. Ten cases were for transitional papilloma, nine for malignant disease and one for chronic osteitis of the maxilla and ethmoids post-trauma. Follow up ranged from two weeks to five years. In five cases we were able to preserve the bony piriform aperture without compromising the excision or exposure. We believe that preservation of the bony piriform aperture will further enhance the overall cosmesis and nasal function. No complaints related to the incision were recorded. Our experience with the modified lateral rhinotomy incision has been very satisfactory. It provides good exposure, a low complication rate and excellent cosmetic outcome without undue technical difficulty. It is our preferred incision for all surgery on the mid-facial skeleton and anterior skull base.

Cohort Studies↗

Simple, painless, cosmetic closure of endaural incisions.

Endaural incisions provide a cosmetic approach to the middle-ear cleft, tympanic membrane for myringoplasty, and attic and antrum for small cavity mastoidectomy. These wounds have traditionally been closed with sutures, but platelet or fibrin adhesives provide an alternative. However, discomfort at the time of suture removal, particularly in children, and the risk of transmission of blood-borne infections in gels are limitations to these wound closure techniques. This paper describes our experience with Histoacryl glue (butyl-2-cyanoacrylate) in closing endaural incisions.

Ear, External↗

Office photography for facial cosmetic surgery.

A photographic record of the appearance of the patient's face and neck preoperatively, and of the changes resulting from surgery is a most important aspect of facial cosmetic surgery. This report describes a practical, efficient system of photography performed in the surgeon's own office. The photographic equipment can be placed in a relatively small area at a total cost of well under $1000. The procedure described, when smoothly running can provide almost 99% efficacy in obtaining consistently good photographs with a minimum of effort and time spent by the surgeon and his office staff. The photographs are a precise, valuable record (medically and legally) of the patient's preoperative and postoperative appearances, and are important for the patient to see and for the surgeon to study. The patient is provided with a striking reminder of preoperative reality; the surgeon with insight into the progress of his surgical expertness.

Face↗

The effect of cosmetic rhinoplasty on nasal patency.

Fifty patients who primarily desired cosmetic improvement underwent nasal airflow studies using posterior rhinomanometry before and after reduction rhinoplasty. There was no significant difference in nasal resistance before and after surgery. This study demonstrates that neither subjective nor objective nasal obstruction follows reduction rhinoplasty, despite the potential for a decreased cross-sectional area of the valve region.

Adult↗

Women, the body and brand extension in medicine: cosmetic surgery and the paradox of choice.

This paper explores the relationship between Western medicine, female body image and gender inequalities. It evaluates the extent to which the medicalisation of appearance through cosmetic surgery may serve to reinforce limited and restrictive models of femininity. Collusion with these processes, it is suggested, may be rational for some women at the individual level as they seek to increase their social power in a society where women are judged by their appearance more than men. At the social level, however, such action can be seen to go against women's collective interests and perpetuate wider social inequalities.

Body Image↗

Toxicity of Food Drug and Cosmetic Blue No. 1 dye in critically ill patients.

Food Drug and Cosmetic Blue No. 1 dye (FD&C Blue No. 1) is commonly added to enteral nutrition formulations in order to facilitate the detection of gastric aspirate in tracheal secretions of critically ill patients. However, reports of systemic blue dye absorption and associated adverse outcomes are emerging. We report two cases of abnormal systemic absorption of FD&C Blue No. 1 in critically ill patients who subsequently died of refractory shock and metabolic acidosis. Risk factors and mechanisms of FD&C Blue No. 1 toxicity are discussed, and alternate approaches to gastric aspiration detection in critically ill patients are considered.

Aged↗

Blindness after cosmetic blepharoplasty: case report.

Blepharoplasty is one of the most commonly performed surgeries for rejuvenation of the periorbital region. We present a case of unilateral permanent visual loss following a bilateral lower lid cosmetic blepharoplasty with fat removal. The etiology of retrobulbar hemorrhage following blepharoplasty, treatment, and recommendations to reduce the chance of this rare but serious complication are discussed.

Aged↗

Cosmetic outcome of three sutures levator aponeurosis tuck procedure in congenital ptosis.

OBJECTIVE: To determine the results of three sutures aponeurosis tuck procedure in patients with congenital ptosis. DESIGN: A quasi-experimental study. PLACE AND DURATION OF STUDY: Department of Ophthalmology, Khyber Teaching Hospital, Peshawar from January 2004 to January 2005. PATIENTS AND METHODS: Twenty-four eyes of 20 patients (13 males and 7 females) with congenital ptosis were included in the study. All these lids had either good or fair levator function. Amount of ptosis in all lids were measured before surgery and their mean calculated. Single surgeon performed the three sutures levator aponeurosis tuck procedure on all these lids. Degree of ptosis, after surgery was measured on multiple occasions and mean of measures of last follow-up was calculated. At this stage, the patients' satisfaction level was also documented. RESULTS: Mean amount of ptosis was 3.25 +/-0.99 mm before surgery and 0.33 +/- 0.56 mm after surgery (p < 0.0001). Satisfaction level of 18 (90%) patients was 70-90%, while in 2 (10%) patients it was 50-60%. CONCLUSION: Levator aponeurosis tuck procedure had good cosmetic outcome in patients with congenital ptosis having good and fair levator function in this series.

Adolescent↗

Compression arthrodesis of the ankle. Evaluation of a cosmetic modification.

Between 1955 and 1979, a modification of the compression arthrodesis of the ankle was performed in twenty-eight patients at The Campbell Clinic. The ages of the patients ranged from twenty-one to seventy-seven years, with an average of 48.4 years. The modification narrows both the medial and lateral sides of the ankle, resulting in a much better cosmetic appearance as the fused ankle is essentially the same width as the normal ankle. The distal end of the tibia and the talus are easily approached through anteromedial and anterolateral incisions, and all articular cartilage can be removed without difficulty. A solid arthrodesis was achieved in 92.8 per cent of the ankles, a higher percentage than in most reported series. Not only is the final appearance of the ankle more pleasing to the patient, but the modification also eliminates the complication of irritation and abrasion of the soft tissue beneath the malleoli by the top of the shoe.

Adult↗

Botulinum toxin A (Botox Cosmetic): a review of its use in the treatment of glabellar frown lines.

Botox Cosmetic (Botox) is a formulation of the neuromuscular blocking agent botulinum toxin type A (BTX-A). When injected into hyperactive corrugator superciliaris and/or procerus muscles of the face that predominantly control frowning, Botox produces a transient (3- to 6-month), dose-dependent localized muscle weakness, resulting in a temporary improvement in glabellar frown lines ('brow furrows'). After a decade of successful 'off-label' use, the efficacy and tolerability of Botox (total dose 20 biological units) in the treatment of glabellar frown lines have been demonstrated in two identical, large, multicenter, randomized, double-blind, placebo-controlled pivotal trials in a total of 537 subjects, mostly women, with moderate or severe glabellar lines during facial animation. Based both on subjects' and physicians' assessments, the improvement in glabellar lines with Botox was superior to that with placebo at each visit during the 120-day post-injection follow-up period, beginning on day 7 post-injection. The peak effect was seen on day 30 post-injection when 80% of subjects in the two studies combined had the severity of their lines at maximum frown reduced to mild or none, as assessed by their physician, and 89% had at least a moderate (> or =50%) improvement in the appearance of their glabellar lines, as rated by themselves. In a noncomparative extension of these trials, there was a tendency for a higher proportion of subjects to respond to Botox injections after a second and third treatment session. Botox injections for glabellar lines are well tolerated. Headache, the most common adverse event, occurred with a similar frequency to placebo in the two pivotal studies (13% vs 18%). Temporary blepharoptosis occurred in 3.2% of Botox recipients; however, the incidence of this adverse event tended to decrease with repeated treatment sessions. In summary, Botox injections offer a convenient, effective, and well tolerated treatment for improving glabellar frown lines. Repeated injections are necessary to maintain a long-term effect; however, this technique clearly represents an attractive option for individuals who wish to avoid a more major procedure.

Botulinum Toxins, Type A↗

A case of malignant hypertension and scleroderma after cosmetic surgery.

A 44-year-old woman with scleroderma-like skin lesions and malignant hypertension following mammoplasty is reported. Sclerotic change is an unusual finding for ordinary finding progressive systemic sclerosis. On admission, she had severe high-renin hypertension and progressive renal failure, suggesting scleroderma renal crisis. With intensive treatment for hypertension including angiotensin-converting enzyme inhibitor, the blood pressure was well controlled. It was then suggested that she had malignant hypertension due to scleroderma after silicone injection, or the so-called human adjuvant disease after cosmetic surgery.

Adjuvants, Immunologic↗

Modified petrosal approach using cosmetic osteoplastic craniotomy with NEURO-SAT guidance.

The petrosal approach has become a routine procedure for petroclival lesions, but there are some disadvantages such as the time-consuming craniotomy during surgery and depressed deformity of the mastoid area after surgery. To solve these disadvantages, we modified the petrosal approach. Before surgery, the three-dimensional points of the sigmoid sinus and semicircular canals are calculated on computed tomography scan and are input to a computer. A single temporooccipital bone flap is made, and the outer table of bone overlying the mastoid is preserved by forming a narrow groove with a small air drill and cutting the outer table with a chisel. After removing these two free bone flaps, mastoidectomy is performed guided by NEURO-SAT (neuronavigation by computer-assisted frameless stereotaxy). The mastoid bone can be drilled out safely and quickly. The two bone flaps are connected and replaced at the end of the procedure. Osteoplastic petrosal craniotomy guided by NEURO-SAT can achieve a quick craniotomy and satisfactory cosmetic result.

Abducens Nerve↗

The cosmetic outcome of the scar formation after cesarean section: percutaneous or intracutaneous suture?

Three methods of skin closure after cesarean section were tested and compared in a prospective trial. Eighty-nine (82.5%) appeared for follow-up investigation 4-5 months after delivery. The mean scar width was significantly narrower after phannenstiel incision compared with percutaneous nylon sutures after lower midline incision, 3.1 mm versus 11.3 mm. Intracutaneous continuous PDS-suture after lower midline incision produced scars 40% narrower than with percutaneous sutures, 6.8 versus 11.3 mm. 37.5% of the women sutured intracutaneously complained over persistent secretion after discharge from the hospital. Some of these complaints were probably due to the introduction of new materials and skin closure technique. None consulted a physician with their complaints, i.e. the complications were sub-clinical. Exclusion of the women with persistent secretions from the material led to significantly narrower scars compared with percutaneous closure, 4.5 versus 11.1. Thus, even better results can be expected as experience with the technique increases. Observer and patient satisfaction with the cosmetic outcome were measured independently on a 'Lasa-line'. Their opinions coincided; the order of acceptability was worst with percutaneous wound closure after lower midline incision, next best with intracutaneous closure after lower midline incision, and best after phannenstiel incision with intracutaneous closure.

Adult↗