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Cosmetic camouflaging techniques can be used to minimize the appearance of facial scarring due to trauma and/or surgery. Facial pigmentation defects are minimized through the application of facial foundations of complimentary colors. Principles of high-lighting and shadowing are used to conceal surface contour defects by combining opaque facial foundations with colored cosmetics.
Longitudinal scars perpendicular to the abductor skin creases of the wrist that result from basal joint arthroplasties can produce scarring that is distracting to both the patient and others. The author presents his technique for performing basal joint arthroplasty through a single transverse incision over the trapezium that blends with the normal creases of the wrist, producing a cosmetically acceptable scar.
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The effects of surgical treatment techniques, radiation doses and fraction sizes on cosmetic outcome were analysed in a population of 161 patients with stage I and II breast cancer treated with breast conserving surgery and a wide range of radiotherapy doses. In 142 patients also quantitative measurements of nipple position asymmetries and breast contour retraction were carried out. The scoring and measurement results were analysed using a multivariate model to assess the relative importance of the various factors involved. In this material radiation dose to the breast was the most significant parameter correlated with cosmetic outcome (p = 0.0001). Radiation doses higher than 75 Gy in 37 fractions led to very poor results in more than 30% of patients. For the quantitative measurements of radiation fibrosis, a dose-response curve could be demonstrated over a dose range of 40 to 86 Gy in fraction sizes of 2 Gy. Above 50 Gy, increases in dose of 1 Gy correlated with an average displacement of nipple and breast contour of 1 mm, in upward direction and of 0.75 mm to the median. An increased amount of fibrosis was observed when part of the treatment was given in larger fraction sizes (4-6 Gy). Plotting the data against dose equivalent TE values, an alpha/beta value of 2.5 Gy could be estimated for the development of late fibrosis. Other treatment factors whose influence on cosmetic outcome could be identified and quantified were the differences in surgical techniques for the removal of the primary tumor (tumorectomy vs. segmentectomy, p = 0.05) and for the axillary clearance ("en bloc" dissection vs. separate incisions, p = 0.018). Also technical aspects of the radiotherapy on the regional lymph nodes, sometimes leading to matchline fibrosis, proved to be important (p = 0.0075). Finally, a number of tumor-related factors were assessed in order to take their relative importance into account, if necessary, when studying therapy factors. While tumor stage had only a limited impact in the range of tumors included in this study, the localisation of the tumor significantly influenced cosmetic outcome with worse results for inferior and medial localisations. While quantitative measurements were not correlated with all the factors identified for poor cosmesis, their great value is to quantify the radiation-induced fibrosis as well as the effects of different surgical techniques on nipple retraction.
The author describes a variant of a cosmetic operation of varicosities of the lower extremities which proved successful in the course of 17 years. The operation was performed in a total of 1823 patients. Minimalization of the size and number of surgical incisions is made possible by the use of very simple instruments comprising an elevator of the saphena magna, strippers for subsidiary varicosities (4 sizes), an applicator of temporary tamponade and two types of chisels for suprafascial and subfascial severing of perforating veins. The number of operations on account of relapses is 9.04% during a representative period in 1990 and 1991. The period of work incapacity is by one week shorter. The cosmetic results are excellent. The instruments and the described technique are at present used in 35 institutes.
A method of blepharoplasty for cosmetic purposes to eliminate superfluous skin and fat from aging eyelids is described in detail. A technique for correct placement of incisions, a method of locating and excising orbital fat, control of bleeding and a safe method of approximating skin flaps are discussed and illustrated.
PURPOSE: Complications of the recent cosmetic technique of penile lengthening and girth enhancement are reviewed. MATERIALS AND METHODS: During a 16-month period 12 men presented with complications of penile augmentation performed elsewhere. All 12 patients had undergone release of the suspensory ligament and 10 had received autologous fat injection. RESULTS: The chief complaint was poor cosmetic appearance (irregular residual fat nodules in 7 men, skin deformity and scarring in 4 and scrotalization in 4). Reoperation was necessary in 6 patients, wound complications occurred in 6 and sexual dysfunction was reported by 4. Only 1 patient reported a subjective increase in penile length. CONCLUSIONS: Although a verifiable complication rate may never be available, the morbidity of elective penile lengthening and girth enhancement is noteworthy. These cosmetic techniques should be regarded as experimental.
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The demand for non-surgical cosmetic treatments has grown considerably in recent years. It appears German dermatology departments now also increasingly seem to offer many of these methods. In 2001 we evaluated the use of different non-surgical cosmetic techniques in German dermatology departments through means of a national questionnaire. Information was requested from 85 departments, of which 63.5% responded. The outcome revealed that 96.3% of the participating departments have lasers at their disposal to treat cosmetic skin lesions, 79.6% carry out injections with botulinum toxin, 59.3% perform chemical peels and 37% perform tissue augmentation with injectable fillers. Overall, the ratio between desired and adverse effects as well as the economic benefit of all evaluated methods was judged as positive by the interviewees. In a comparison of all evaluated modalities, the therapeutic index was considered most favourable with botulinum toxin and most unfavourable with injectable filling agents. With regard to cost-effectiveness, soft tissue augmentation was judged best, while chemical peels alongside lasers were regarded as least advantageous in this respect. Further evaluated topics were indications, substances, organisation and other issues. In summary the survey confirmed that a large number of German dermatology departments employ non-surgical cosmetic procedures matching the international upward trend of cosmetic dermatology.
BACKGROUND: Lip tattooing is a common cosmetic technique not exempt from certain risks and which may lead an unsatisfied customer to seek tattoo elimination. OBJECTIVE: To assess the clinical outcome of a patient with a brownish-colored cosmetic lip tattoo after treatment with the Q-switched alexandrite laser (QSAL). METHODS: Two sites were tested using the pigment lesion dye laser (PLDL) and QSAL. The patient received 10 monthly sessions with QSAL, with an average fluence of 6.925 J/cm2. The double and triple shot technique was applied. RESULTS: The brownish pigmentation turned black after the PLDL and QSAL tests. Epidermal splattering and bleeding made a fluence increase with QSAL inadvisable. Treatment was unsuccessful. CONCLUSIONS: PLDL and QSAL may induce a photochemical alteration in brownish pigment. Factors that may contribute to the poor response of a cosmetic lip tattoo to QSAL treatment are related to pigment characteristics and laser parameters.
Appearance is one of the most powerful factors influencing social interactions with others. What patients with disfigurements experience from society on a daily basis is a very real stigma. Cosmetic rehabilitation is a system of cosmetic techniques devised for patients to use to assist themselves to cope constructively with the psychological and physical trauma of their disfigurements.
In the past, the primary focus of dentistry has been on the alleviation of pain and stopping the progression of disease. The reduction in the prevalence of dental caries, along with advances in adhesive technology, have combined to revolutionize the practice of dentistry today. The modern dentist, using the latest available cosmetic techniques, is now able to satisfy the emotional wants and needs of patients. The public, well informed about the possibilities for anterior esthetics, now desire tooth-colored restorations in the posterior. A new heat- and pressure-curing resin inlay/onlay material and the clinical and laboratory technique for its use are discussed.
Camouflage therapy is a system of cosmetic techniques designed for patients to use to assist themselves in coping constructively with the psychological and physical trauma of their disfigurements. It is described as a "system" because these techniques are interrelated. A camouflage therapist may teach the patient to use one, two, or all of the techniques at the same time in order to normalize their appearance. Four basic techniques have been described in this article. They are as follows: (1) the use of opaque, waterproof cover creams to conceal scarring; (2) the application of pancake makeup for patients with oily or acne-prone skin; (3) color correctors to obliterate discoloration from postoperative trauma; and (4) recreating imperfections on the skin. For more information about the use of cosmetics to normalize the appearance of physical disfigurements, the following books are recommended.