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The merits of septorhinoplasty, performed as a one-stage procedure of alleviate obstruction and improve the cosmetic appearance of a deformed nose, are described. The 2492 patients treated in an 8-year period attest to the frequency with which this defect presents in the community. An 80% improvement rate was achieved with the acquisition of skill, and no major defect was caused by the conservative methods employed.
Everyone is marketing their dental practice whether they know it or not. It is far better to design the desired effect than to send mixed messages to your clients. All marketing must be carried out with a plan or mission that is internalized by the doctor and by each member of the staff. The mission coupled with creative talent becomes the proprietary personality of your office and the focus of your marketing efforts. Internal marketing is perhaps the most economical and effective--and most used--method of creating positive results for the practice. External marketing takes your office out to the public most often in print via newsletters, direct mailings, and the yellow pages. Getting the message out through newspapers, radio, and television has and will become increasingly important. This article takes you through the steps we used to identify and market to our cosmetic clients. The results of our demographic and psychographic studies afford unique insight into the type of person attracted by our services. Marketing to this group has to do with diversity in appeal, "the boomers," and experiential motivation.
The Franklin Applied Physics (FAP) Cosmetic Cover is the result of research and development directed by Dr. Robert Erb at the Franklin Research Center, Norristown, PA. The FAP Cover is a silicone rubber cosmesis designed to improve the appearance of lower limb prostheses and provide wider social integration for the wearer. The Technology Transfer Section, Rehabilitation Research and Development Service, Department of Veterans Affairs, coordinated a pilot study of four pre-commercial covers at selected sites. Participating prosthetists and subjects evaluated fit, relevant physical criteria, and overall potential value of the cover. The following statements summarize responses of the participants: 1) well accepted with regard to overall fit, appearance, and ease of donning/doffing; 2) lightweight, highly elastic, and easy to maintain; and 3) split toe and closed toe versions are needed for above-knee and below-knee models. Data gleaned from the pilot study were used to define dimensions for standardized off-the-shelf sizing and to make recommended modifications, resulting in pre-market models that are ready for a national field evaluation.
A case of surgical reconstruction after penoscrotal skin avulsion is described. Penile coverage was gained by two full thickness grafts helicoidally placed to avoid retractions. Scrotal reconstruction was carried out in two steps, after testis subcutaneous implantation, with axial flaps expanded in abdominal region. The procedure has the advantage of flaps sure vitality, avoids patient discomfort produced by a perineal expansion with satisfactory cosmetic appearance and restore of a normal sexual function.
The donor-site defect poses a special problem in free and pedicled forearm flaps. A multi-center-study of seven departments for Hand and Plastic Surgery in Germany and Switzerland studied the problem and showed the functional and cosmetic results. 342 questionnaires were checked. 267 patients came for a follow-up examination. 83.9% of them were satisfied with the result of the operation. Restrictions of movement in the wrist, forearm, and elbow appeared to be very rare. Half of the patients considered the donor-site defect to be ugly. Nearly the same number objected to preoperative information about the appearance of the donor-site defect. Based on the results of this study, we can still recommend the radial forearm flap for small and medium size soft-tissue defects, delicate technique of closure of the donor site defect provided.
INTRODUCTION: Cosmetic dermopigmentation designates tattooing of the superficial derma with pigments in order to obtain an aesthetic effect. We observed two cases illustrating the inconveniences of this technique. CASE REPORTS: Two women underwent dermopigmentation on the face in a beauty institution to create pseudo-freckles. Definite macular hyperpigmentation occurred with dyschromia in both subjects. COMMENTS: There is a major risk in subjects who undertake dermopigmentation of freckles and/or naevus, a practice which should be discouraged by dermatologists.
With increasing consumer awareness of the innovative procedures available for cosmetic dentistry, this area of practice is growing rapidly and has become an excellent source for patient referrals. Unfortunately, it can also be a large source of stress for the practitioner. Esthetics has been described by The Pocket Oxford Dictionary as "the philosophy of beautiful"; its perception varies from individual to individual. In the field of dentistry, there are criteria which define one tooth as being more esthetic than another and one individual's smile as more pleasing than another. However, that which is esthetically pleasing to the clinician may not be esthetically pleasing to the patient.
Cosmetic facial surgery can improve appearance but it cannot make everyone beautiful (or handsome) or solve all problems. The patient must be well motivated and must comprehend the limitations of the procedures. Procedures useful in providing a more youthful appearance include blepharoplasty, browlift and face-lift. Sometimes all three are indicated. Chemical face peeling is used for correction of fine skin lines.
The aims of this study were to determine the opinions of a group of adolescents about the cosmetic acceptability of a range of fluorosis, investigate the prevalence and severity of fluorosis in the sample and consider the extent to which fluorosis levels were related to their dental caries experience. A random sample of 534 14-year-old pupils from the non-fluoridated industrial city of Manchester were examined for caries and fluorosis. Each subject then examined six photographs of upper anterior teeth showing a range of TF scores 0-4 and were asked to rate the appearance of each as either very poor, poor, acceptable, good or very good and to indicate whether they would request treatment if their teeth were so affected. Four hundred and seventy-six subjects (89 per cent) had TF scores of 0. Of the 58 subjects (11 per cent) with fluorosis, 27 (5 per cent) scored TF = 1; 22 (4 per cent) TF = 2; 7 (1 per cent) TF = 3 and one subject scored TF = 4. The subjects who had no fluorosis had a mean DMFT of 3.0 which was significantly higher than the mean of 2.2 among those with any fluorosis. The proportion of subjects who rated the photographs as poor or very poor fell from 29 per cent for TF score 0 to 15 per cent for TF score 2 and then increased to 92 per cent for TF score 3. The responses of the subjects regarding their desire for treatment matched closely with their opinions on appearance; the majority of subjects expressed concern over the appearance of teeth with TF scores of 3 and higher. It is concluded that the prevalence of aesthetically objectionable dental fluorosis was low and that mild fluorosis was associated with a lower risk of dental caries and a more acceptable appearance. It is essential that a balanced view of the relative benefits and risks of the use of fluorides is maintained and proven benefits are not overwhelmed by largely unfounded aesthetic concerns.
A modified labioplasty to improve the cosmetic appearance after feminizing genitoplasty is described. Good results were obtained in all five patients in whom the technique was utilized.
A modified labioplasty to improve the cosmetic appearance after feminizing genitoplasty is described. Good results were obtained in all five patients in whom the technique was utilized.
OBJECTIVES: To determine the prevalence of fluorosis and other developmental defects of enamel (DDE) in the United Kingdom over the last 40 years. To examine the risk factors that may have influenced the prevalence of fluorosis. DESIGN: All relevant publications between 1956-1995 on the prevalences of DDE and fluorosis in the UK were critically reviewed in addition to publications from other countries where these added substantial information about the risk factors involved in the latter. RESULTS: The likely overall prevalence of DDE in the UK is approximately 40 per cent of which diffuse opacities account for about half. In areas benefiting from water fluoridation the overall prevalence of DDE is around 70 per cent with diffuse opacities accounting for two thirds. No substantial evidence of increases in either DDE or fluorosis could be identified. Risk factors for fluorosis include inappropriate use of fluoride supplements and fluoride toothpaste during early childhood and life-time residence in an optimally fluoridated area. CONCLUSIONS: Fluorosis does not appear to be of public health concern in the UK at present. However, the inadequacies of the data and paucity of in-depth studies highlight the need for further co-ordinated research using agreed methods of monitoring prevalence, multivariate analysis to identify risk factors and a societal norm to discover its cosmetic impact.
The authors described two cases of airborne contact dermatitis caused by 2-amino-2-methyl-1-propanol (AMP 100) in two subjects with periorbital erythema and itching skin. The AMP 100 has been used to replace ammonia as a hair dye component in the cosmetic industry with the purpose to eliminate its smell. Patch tests proved positive only to dilutions of 10% and 20% in the two described patients, as well as in other six asymptomatic subjects operating in the same working environment. The authors have diagnosed an irritative airborne contact dermatitis by AMP 100.
A sensory control system based on the force-sensing resistor (FSR) for an upper limb prosthesis has been designed for application to a commercial prosthetic hand of proven reliability. In particular, FSR sensors have been used to control the strength of the grip on objects. Moreover, the problem of the object possibly slipping from the grip has been addressed by a system based on an optical sensor for detecting movement. Tests on different everyday objects have shown the feasibility of the above approach, given the constraints of the limited dimensions of the prosthesis and the presence of a cosmetic glove.
The use of an episiotomy for vaginal delivery is a controversial topic in modern obstetrics. If one is done, however, correct technique of perineal trauma repair is important. The usual episiotomy has traditionally been closed with interrupted suture. The use of a less reactive material, e.g. polyglycolic acid (Dexon), seem to be suitable for subcutaneous skin closure and beneficial in terms of acute postpartum discomfort and healing. The comparison of healing and patient comfort parameters between interrupted and subcutis polyglycolic acid suture used for episiotomy repair after delivery was done. Patients had follow-up during hospital stay, and two months after delivery a self administered questionnaire was sent to all women who participated, enquiring about perineal pain, resumption of sexual intercourse and cosmetics of suture line. Of 52 patients who had repair with interrupted suture, 21 were lost to follow-up. Of 65 gravidas who had repair with subcutis suture, 23 were lost to follow-up. At the 3rd day postpartum examination, patients with subcutis sutures had significantly better healing. An inflammatory process was present in 2 of 52 patients with interrupted sutures comparable with 1 of 65 in the subcutis group, and a gaping wound in 0 of 52 and 1 of 65, respectively. Recovery of function, measured by resumption of sexual activity by 8 weeks, was demonstrated in 5 of 31 patients with interrupted sutures versus 24 of 42 patients who had subcutis sutures. Episiotomy repair with subcutis polyglycolic acid (Dexon) offers significant advantages over traditional interrupted suture, both in terms of wound healing and resumption of sexual activity.
Primarily because of the lack of highly accurate preoperative localizing studies, the standard operation for primary hyperparathyroidism (HPTH) has consisted of bilateral neck exploration with examination of all four parathyroid glands. Recent experience with the technetium-99m-Sestamibi scan at our hospital has suggested that this single test was now accurate enough to allow unilateral neck exploration. This study was designed to examine the efficacy and safety of minimally invasive parathyroid-ectomy in select patients with a single adenoma demonstrated on a preoperative sestamibi. Eighteen consecutive patients with primary HPTH in whom a sestamibi scan suggested a single adenoma underwent unilateral neck exploration through a 2.5-cm incision, which was extended as necessary. Results were compared to the preceding 25 parathyroid explorations for primary HPTH due to a single adenoma, which were nondirected and included bilateral neck exploration. All patients undergoing minimal exploration were found to have a single adenoma and demonstrated a normal serum calcium within 24 hours of surgery. Standard bilateral exploration failed to locate the adenoma in one patient requiring subsequent re-exploration. Operative time, incision length, and length of hospital stay were all significantly less for those undergoing minimal exploration (all P < 0.01). There were no complications in either group. Minimally invasive neck exploration is a safe and effective treatment for primary HPTH, is easily accomplished under local anesthesia, and is associated with significant reductions in operative time and hospital stay. Limited exploration provides a better cosmetic result while decreasing the potential complications of bilateral exploration, but is dependent upon a high-quality sestamibi scan.
Two patients, a woman aged 21 and a man aged 29, with asymmetrical swellings of both mandibular angles and a painful, heavy sensation in the masticatory muscles (and in the woman also round the maxillary joint), were diagnosed as having hypertrophy of the masseter muscles. Both had the habit of jaw clenching and tooth grinding. Treatment consisted not of the traditional surgical debulking which also allows correction of overdeveloped osseous mandibular angles, but of injections with botulinum toxin type A. Injection of 40-60 IU (product: Botox) per muscle was followed by some atrophy; cosmetically satisfactory results were achieved after repetition of the treatment a few months later. Reduction of muscle volume was confirmed by a quantitative volumetric assessment of MRI scans. In the female patient, the pain also abated.
The presentation of proposed dental treatment has been hampered by the absence of visual communication technologies. New high tech dentistry-related tools permit efficient production of case presentations for cosmetic dentistry and restorative dentistry. This review describes how to create computer-based case presentations using Microsoft PowerPoint (Microsoft Corp., Redmond, WA) and visual treatment proposals using Microsoft Word for Windows.