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American Journal of Cosmetic Surgery
Number of Followers: 7  Hybrid journal (It can contain Open Access articles)ISSN (Print) 0748-8068 - ISSN (Online) 2374-7722 Published by Sage Publications  [1176 journals]
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- “The Utility of Preoperative Acetaminophen in Reducing Postoperative
Pain and Narcotic Use in Patients Undergoing Cosmetic Breast
Augmentations, During a National Opiate Crisis”-
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Authors: Garrett Jones, Jacob Haiavy, Kaelen Kay
Abstract: The American Journal of Cosmetic Surgery, Ahead of Print.
Background:Preoperative use of acetaminophen has become widely adopted across the surgical subspecialties in attempt to maximize analgesia and minimize postoperative narcotic requirements. Whether or not acetaminophen use has an influence on these outcomes in cosmetic breast augmentation needs to be studied. Objectives: The aim of this study was to compare the differences in reported pain and narcotic use between patients undergoing breast augmentations who received preoperative oral acetaminophen and those who did not. Methods: This was a prospective, single-center study including 59 patients undergoing primary breast augmentation which were divided into 2 groups: control group (did not receive acetaminophen) and a study group (received 1000 g PO acetaminophen), all medications were administered prior to surgery. A self-reported survey was received from all patients which included pain scores as well as number of narcotics taken. Results: Data analysis indicated that the only statistically significant difference in pain was on postoperative day 2 (POD2), with patients who did not receive PO tylenol reporting more pain. There was no significant difference in the number of narcotics required between either group. Conclusions: It appears that preoperative PO acetaminophen did not significantly influence the amount of postoperative narcotic use. The only difference in reported pain was on POD2 and was higher in those who did not receive preoperative acetaminophen. It seems that PO acetaminophen is an inexpensive way of improving postoperative pain in patients undergoing cosmetic breast augmentation; however, it does not reduce narcotic use.
Citation: The American Journal of Cosmetic Surgery
PubDate: 2023-11-29T11:57:47Z
DOI: 10.1177/07488068231212596
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- Book Review: What Happened To You' Conversations on Trauma, Resilience,
and Healing by Bruce D. Perry and Oprah Winfrey-
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Authors: Eve Bluestein, Isaac Bluestein
Abstract: The American Journal of Cosmetic Surgery, Ahead of Print.
Citation: The American Journal of Cosmetic Surgery
PubDate: 2023-11-20T05:39:18Z
DOI: 10.1177/07488068231213323
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- A Safe and Simple Method of Augmentation Mastopexy
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Authors: Tong Le, Michael John Higgs
Abstract: The American Journal of Cosmetic Surgery, Ahead of Print.
Introduction:Combining breast augmentation with mastopexy has historically been considered challenging, with concerns about complications and suboptimal aesthetic outcomes. However, recent data suggest that the combined procedure can be performed safely and effectively.Materials and Method:This article presents a technique for augmentation mastopexy that aims to minimize complications and is safe to perform. The technique focuses on preserving a robust blood supply, minimizing lower breast contour bottoming out, maintaining upper pole fullness, reducing the risk of recurrent ptosis, minimizing scar burden, and avoiding periareolar scar widening. Precise preoperative and intraoperative markings are crucial for achieving long-lasting results. The use of tailor tacking and marking the vertical excess with the patient in an upright position provides a reliable method for determining the amount of soft tissue resection required.Results:The results are shown in the postoperative photographs at 10 days, 1 month, and 3 months, respectively. These are compared with the preoperative photographs of the patient’s features.Discussion:The technique incorporates the use of an implant placed in the dual-plane subpectoral pocket to address upper pole flatness and provide structural support in the lower pole. The article emphasizes the importance of preserving Cooper’s ligaments during skin resection to maintain the supportive role of the skin. Vertical wedge resection of the lower pole is employed to reconstruct the breast cone and create a strong vertical fibrous band, which contributes to the long-term shape and support of the breast. The article also discusses techniques to mitigate nipple-areolar complex widening and emphasizes the importance of patient selection based on specific criteria.Conclusion:Overall, the authors present a safe and simple technique for augmentation mastopexy that aims to achieve long-lasting results with minimal complications. The authors advocate for careful patient selection and adherence to their methodology, which incorporates principles of preserving blood supply, maintaining breast contours, and minimizing scar burden.
Citation: The American Journal of Cosmetic Surgery
PubDate: 2023-10-07T09:35:59Z
DOI: 10.1177/07488068231200092
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- Advancements in Facelift Surgery Instrumentation: Modifications to Trepsat
Spatula-Tipped Facelift Scissors—A Letter to the Editor-
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Authors: Hatem Elfieshawy
Abstract: The American Journal of Cosmetic Surgery, Ahead of Print.
Citation: The American Journal of Cosmetic Surgery
PubDate: 2023-10-06T05:37:05Z
DOI: 10.1177/07488068231203242
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- WITHDRAWAL – Administrative Duplicate Publication: “Editorial: The
Struggle to Change: Consolidation as the Future of Cosmetic Surgery”-
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Abstract: The American Journal of Cosmetic Surgery, Ahead of Print.
Citation: The American Journal of Cosmetic Surgery
PubDate: 2023-09-02T10:18:36Z
DOI: 10.1177/07488068231200761
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- The Struggle to Change: Consolidation for Success and the Future of
Cosmetic Surgery-
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Authors: Erik J. Nuveen, Courtney J. Caplin
Abstract: The American Journal of Cosmetic Surgery, Ahead of Print.
Citation: The American Journal of Cosmetic Surgery
PubDate: 2023-07-18T11:54:50Z
DOI: 10.1177/07488068231183209
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- Autologous Lipo-Dermal Advancement Flap for Inframammary Fold
Reconstruction: A Technical Note for Prevention and Management of Caudal
Breast Implant Migration-
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Authors: Hatem Elfieshawy, Graham Smyth, Monika Jasinska
Abstract: The American Journal of Cosmetic Surgery, Ahead of Print.
Inferior breast implant displacement, also known as caudal migration, or bottoming-out, is a known complication of breast augmentation. This leads to a loss of upper pole fullness, a more superiorly located nipple-areolar complex, and an unnatural appearance. Avoiding these complaints has been a longstanding challenge in the field of aesthetics and this technical note suggests a novel solution. This technical note describes the process of preoperative assessment, careful markings, and the use of an autologous lipo-dermal advancement flap that has been designed, mobilized, and rotated to be internally fixated to costal margins and the relevant deep fascial structures at the proposed inframammary fold level. This technique creates a robust partitioning hammock-like structure that stabilizes the breast implant and prevents future caudal displacement. The described technique may be implemented as an independent solution, or as an adjunct to other modalities like biological meshes in revision breast surgery.
Citation: The American Journal of Cosmetic Surgery
PubDate: 2023-07-17T07:08:56Z
DOI: 10.1177/07488068231186742
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- High-Definition Abdominal Body Scale
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Authors: Arian Mowlavi, Hamid Mirzania, Zachary Sin, Chelsea Sahami
Abstract: The American Journal of Cosmetic Surgery, Ahead of Print.
Introduction: High-definition liposuction (HDL) has been coined to identify liposuction results that are superior to traditional liposuction. The HDL Body scale has been previously described to help objectify changes required to achieve HDL results (that range from 2 to 10 score) with the ultimate goal of achieving a near perfect 9 or 10 body score. Materials/Methods: We present the High-Definition (HD) Abdominal Body Scale that is intended to assist with attaining HD abdominal contouring outcomes. High-definition abdominal contouring outcomes require comprehensive correction of abdominal contour concerns as well as creation of abdominal muscle highlights and natural shadows. HD Abdominal Body Scale assigns scores ranging from 2 to 10 with the ultimate goal of achieving a near perfect 9 or 10 body score indicative of HD outcomes. Results: The HD Abdominal Body Scale and subsequent surgical algorithm for HD abdominal contouring and case studies are presented. Discussion: Considerations for achieving HD abdominal contouring outcomes include assessing degree of fat excess, integrity of abdominal muscles, amount of skin redundancy, as well as quality and extent of skin texture changes. Evaluation of these factors provides the premise for determining HD abdominal contouring scores. HD abdominal contouring scores are used to establish proper patient selection, appropriate surgical design, and objective assessment of outcomes. Conclusion: This article presents an abdominal HDL Body Scale that helps expand patient populations who are candidates for HD body contouring. Surgeons’ outcomes may be improved using the HDL body scale and surgical algorithm presented.
Citation: The American Journal of Cosmetic Surgery
PubDate: 2023-07-14T11:37:23Z
DOI: 10.1177/07488068231165900
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- The Struggle to Change: Consolidation as the Future of Cosmetic Surgery
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Authors: Erik J. Nuveen, Courtney J. Caplin
Abstract: The American Journal of Cosmetic Surgery, Ahead of Print.
Citation: The American Journal of Cosmetic Surgery
PubDate: 2023-07-12T06:44:01Z
DOI: 10.1177/07488068231182784
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- Self-Reported Height and Weight for BMI Calculation Compared With Measured
Height, Weight, and BMI in Patients Undergoing Liposuction of the Upper
and Lower Abdomen: A Single-Center Retrospective Review-
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Authors: Nicolas Hayes, Alexander Sobel
Abstract: The American Journal of Cosmetic Surgery, Ahead of Print.
Self-reported height and weight is commonly used in medical practice for the determination of body mass index (BMI). Self-reported height and weight can be underestimated or overestimated resulting in inaccurate BMI calculations. In our practice the self-reported height and weight are obtained at the time of cosmetic surgery consultation. The purpose of this study is to determine the accuracy of preoperative height, weight, and BMI calculations in patients undergoing liposuction of the abdomen in comparison to measurements obtained by nursing staff the day of surgery. Clinically, these data may affect perioperative risk stratification and preoperative planning with respect to deep venous thrombosis prophylaxis. Using Nextech electronic medical records (EMR) system, charts were reviewed from July 2019 to July 2022. Patients identified as having underwent liposuction of the upper and lower abdomen were reviewed. All patients had been consented for the prescribed procedure. Data extracted included the self-reported height/weight and calculated BMIs obtained at the time of consultation as well as measured height/weight and BMIs from the day of surgery. The study sample included 50 patients (31 women and 19 men), with an average age of 44 ± 11 years (range, 20-71 years). Time from consult to surgery ranged from 2 to 270 days with an average of 58 days. Time of consult (TOC) height average was 169.1 cm (range, 152.4-190.5 cm) versus day of surgery (DOS) height average of 169.5 cm (range, 149-190 cm). Time of consult weight average was 82.4 kg/181.66 lbs (range, 54.5-115.9 kg/120.15-264.89 lbs) versus DOS average of 84 kg/185.19 lbs (range, 53.8-116 kg/118.61-255.74 lbs). Time of consult BMI average was 28.5 kg/m2 (range, 21.1-43.9 kg/m2) with a DOS average of 29 kg/m2 (range, 20.9-47 kg/m2). Height was on average underestimated by 0.03 cm. Weight was on average underestimated by 1.6 kg at the TOC compared with DOS. BMI difference between TOC and DOS had an average underestimate of 0.5 kg/m2. A total of 8 patients upstaged to a higher obesity classification based on DOS BMI calculation. Subgroup analysis of male and female height and weight estimations versus measured data are also reviewed. When averaged the time of consultation height, weight, and BMI correlated with height, weight, and BMIs measured and calculated the day of surgery in patients undergoing liposuction of the abdomen. Sixteen percent of our study population were reclassified to a higher obesity class based on DOS height and weight. For the purposes of accurate perioperative risk management and deep venous thrombosis prophylaxis planning, height and weight should be obtained accurately at the time of consultation or at a preoperative visit within 1 month of surgery.
Citation: The American Journal of Cosmetic Surgery
PubDate: 2023-05-23T09:28:07Z
DOI: 10.1177/07488068231169247
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- Frontotemporal Brow lift With Suspension to Frontal Bone
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Authors: Lessandro Martins, Juan Martin Zarate, Ibrahim Fakih-Gomez, Nabil Fakih-Gomez
Abstract: The American Journal of Cosmetic Surgery, Ahead of Print.
Brow position is a key feature to define a fresh and youthful appearance of the periorbital region. Frontotemporal brow lift implies the elevation of both the medial brow and lateral brow and can be performed through an open (coronal), endoscopic, or combined approach. While endoscopic brow lift has the advantage of minimal incisions compared with the open coronal approach, it requires specific equipment, a longer learning curve, and has been associated with high recurrence rates. Herein, the authors’ technique for frontotemporal brow lift is presented, an approach that includes complete access under direct vision to the lateral brow and glabellar area, through 2 limited frontotemporal incisions and a novel method of 3-vectoring suspension to the frontal bone. It has proved to be predictable with long-lasting results.
Citation: The American Journal of Cosmetic Surgery
PubDate: 2023-05-16T12:44:01Z
DOI: 10.1177/07488068231175582
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- Gangrenous Bowel Obstruction Managed With Local Tumescent Anesthesia and
MAC-
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Authors: Ehab Akkary, Brett Tomlin, Mohamed Almoukadem, Barry Friedberg
Abstract: The American Journal of Cosmetic Surgery, Ahead of Print.
Since the mid-1980s, Klein’s tumescent anesthesia has been used routinely in different surgical specialties such as cosmetic surgery, dermatology, vascular surgery, reconstructive plastic surgery, and breast surgery. The tumescent anesthesia technique was developed by Dr Jeffrey Klein, a board-certified dermatologist. The technique was first published in 1987. Tumescent means “swelling.” This technique involves injection of an ultra-dilute lidocaine and epinephrine solution into the surgical planes offering multiple advantages including, but not limited to, postoperative analgesia, reduced blood loss, and avoidance of general anesthesia. The standard liter of Klein’s solution contains lidocaine 1 g, epinephrine 1 mg, and sodium bicarbonate 12.5 mg. Multiple modifications and variations have been implemented and used over the years, an evolution from Klein’s original description. While tumescent anesthesia started in liposuction procedures, its application has now extended into a wider variety of procedures and specialties. In this article, we present a case of tumescent anesthesia in a critically ill general surgery patient who presented with an acute life-threatening surgical emergency. The patient was assessed to be a very high risk for general anesthesia, and after collaborative discussion between the surgical and anesthesia teams and taking informed consent from the patient, the decision was made to proceed with surgery under monitored intravenous sedation with tumescent anesthesia. The patient had an uneventful recovery and survived a very high mortality surgical emergency. He was subsequently discharged back to his nursing home in stable condition. Tumescent anesthesia has become tremendously popular in cosmetic surgery. Tumescent anesthesia allows patients to have surgical procedures in an ambulatory setting, avoid general anesthesia, and allow for better pain control postoperatively. While tumescent anesthesia is used in other specialties, the field of general surgery has not widely adopted tumescent anesthesia. Many general surgeons and anesthesiologists are not familiar with the technique and how to implement it in their practice. It is of utmost importance to understand the pharmacokinetics of tumescent solution and safe implementation. Tumescent anesthesia with monitored anesthesia care is here reported as an alternative to general anesthesia in the care of a moribund patient with multiple comorbidities requiring open abdominal surgery. Close cooperation between the surgeon and the anesthesiologist made the successful conduct of this case possible.
Citation: The American Journal of Cosmetic Surgery
PubDate: 2023-05-16T12:37:02Z
DOI: 10.1177/07488068231166916
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- Contemporary Upper Blepharoplasty: Volumetric Contouring Concept
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Authors: Nabil Fakih-Gomez, Juan Martin Zarate, Lessandro Martins, Luis Miguel Lindo Delgadillo, Ibrahim Fakih-Gomez
Abstract: The American Journal of Cosmetic Surgery, Ahead of Print.
Upper blepharoplasty has traditionally involved subtractive approaches with excision of different amounts of skin, muscle, and fat. However, this approach often results in iatrogenic acceleration of the normal volume depletion and bone resorption associated with aging, which leads to deepening of the superior sulcus, A-shape deformity and generalized hollowness. In recent years, the concept of periorbital volume restoration and augmentation has shifted the paradigm toward fat preservation and gland repositioning procedures. Herein, we describe the volumetric contouring concept, a contemporary approach for upper blepharoplasty that includes gland repositioning, suspension of the levator aponeurosis, fat transposition or reposition, and adjunctive filling procedures. This concept seeks for long-term restoration of the eyelid-brow complex by addressing every involutional aspect of the aging process, while treating and preventing hollow eyes and A-shaped deformity. In our experience, this approach has enabled us to attain optimal and long-lasting aesthetic results.
Citation: The American Journal of Cosmetic Surgery
PubDate: 2023-04-29T01:22:28Z
DOI: 10.1177/07488068231171313
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- A Minimally Invasive, Outpatient, Office Procedure for Severe Stress
Urinary Incontinence in Women: Luksenburg Systems LSG3-
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Authors: Ariel Luksenburg, Juan J. Barcia, Jorge Gaviria, Roberto Sergio, Santiago Palacios, Marco A. Pelosi, Marco A. Pelosi
Abstract: The American Journal of Cosmetic Surgery, Ahead of Print.
The worldwide prevalence of female urinary incontinence (UI) is reported at 55%, and about 27% of UIs are severe. The complications in cases of severe UI treated surgically and the ineffective or incomplete results of prolonged treatments with thermal energies motivated us to develop an innovative treatment. Our hypothesis was based on correcting the descent and/or urethral hypermotility and repositioning the descended bladder urethral junction. We have designed a system for the development of a dense and resistant fibrosis that supports the urethra and can correct the alterations of severe UI, Luksenburg systems procedure, LSG3. A group of 652 women between the age of 46 and 74 years, post-menopausal, with more than 2 vaginal births and severe UI, documented by the clinical presentation and the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) score index, were enrolled. Originally developed polycaprolactone threads were placed in suburethral space using specific designed tools (LSG3). Immediate results—24 hours (P < .05): 469 patients without clinical UI (72% efficacy), 122 patients with grade 1 UI (drops) (18% improvement), and 59 patients with grade 3 UI (unchanged 9%). Thirty-day results (P < .05): 560 patients without UI (86% efficacy), 58 patients with grade 1 UI (drops) (9% improvement), and 34 patients with grade 3 UI (unchanged 5%). Fifteen-month results (P < .05): 542 patients without UI (83%), 74 patients with grade 1 UI (drops) (11%), and 36 patients with grade 3 UI (6%). No complications or secondary effects were found after the procedure in the 15 months of follow-up. We have developed an innovative system called “suburethral spider web” to treat and cure severe (grade 3) UI in office, as outpatient, that is effective, safe, and cheap.
Citation: The American Journal of Cosmetic Surgery
PubDate: 2023-04-24T06:26:15Z
DOI: 10.1177/07488068231166912
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- Objections on Using the Fasanella-Servat Operation to Repair Eyelid Ptosis
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Authors: Jorge Schwember, Luisa Madrid
Abstract: The American Journal of Cosmetic Surgery, Ahead of Print.
Citation: The American Journal of Cosmetic Surgery
PubDate: 2023-04-07T06:15:41Z
DOI: 10.1177/07488068231166998
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- Familial Multiple Lipomatosis: A Case Report
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Authors: Tatevik Malisetyan, Skylar Harmon, Neng Zhong, Gevork Tatarian
Abstract: The American Journal of Cosmetic Surgery, Ahead of Print.
A 32-year-old man presents to the clinic with multiple subcutaneous masses. Further history and a review of the literature are discussed. This is a case study of a patient with familial multiple lipomatosis and our management. Liposuction was performed after informed consent was obtained to manage familial multiple lipomatosis in an aesthetically pleasing manner without recurrence. Liposuction is an excellent technique for an aesthetically pleasing outcome to manage familial multiple lipomatosis. Additional therapy modalities including laser, chemicals, high-pressure tumescent injection, and Vibration Amplification of Sound Energy at Resonance (VASER) are reviewed. To avoid multiple incisions and scars, liposuction for familial multiple lipomatosis is an aesthetically pleasing, definitive treatment modality with no recurrence of lipomas.
Citation: The American Journal of Cosmetic Surgery
PubDate: 2023-03-31T09:11:47Z
DOI: 10.1177/07488068231161043
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- Tip Plasty: A New Modified Vertical Dome Division. “How I Do
It'”-
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Authors: Elie Akl, Michel El Hajj
Abstract: The American Journal of Cosmetic Surgery, Ahead of Print.
This manuscript aimed to report a new vertical dome division technique for the correction of different common nasal tip deformities. This technique is a novel approach and was never reported in the literature to the best of our knowledge. The technique was performed using an open approach on 337 patients presenting with a combination of different nasal tip deformities: overprojected nasal tips, drooping tips, asymmetical tips and wide domal arches. The included patients were operated on between 2012 and 2018, with a follow-up period of at least 1 year. A detailed description of the surgical steps used is provided. Surgery outcomes were predominately positive, with unsatisfactory results obtained only in 11 of the 212 included patients (125 patients were excluded from the study due to inadequate or no follow-up). Satisfactory results and minor complications were detected following this procedure. In conclusion the presented technique is an easy and effective method for the narrowing, uprotation, and deprojection of nasal tips as well as the correction of tip asymmetries mainly in thick-skin patients, with a low complication rate.
Citation: The American Journal of Cosmetic Surgery
PubDate: 2023-01-23T09:29:02Z
DOI: 10.1177/07488068221145086
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- Durable Suture Technique: A Simple and Versatile Nonsurgical Technique to
Create/Reshape Double Eyelid in Asians-
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Authors: Peter Sang-Hui Kim, Joon Tae Ahn
Abstract: The American Journal of Cosmetic Surgery, Ahead of Print.
Nonincisional double-eyelid plasty, the Durable Suture Technique, is a popular nonsurgical procedure for creating double eyelids on monolids. We report cases where the Durable Suture Technique was successfully applied to other Asian cosmetic eyelid indications. A series of before-and-after photos of patients who underwent the Durable Suture Technique were shown to demonstrate that it is effective in reshaping and rejuvenating the double eyelids, as well as treating post-blepharoplasty complications. The rationale for applying the Durable Suture Technique in the above nonstandard indications was discussed. The Durable Suture Technique is a versatile, nonsurgical cosmetic eyelid enhancement procedure in Asians.
Citation: The American Journal of Cosmetic Surgery
PubDate: 2023-01-06T10:52:14Z
DOI: 10.1177/07488068221148315
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