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Govrin-Yehudain Y, Hadad E, Heller L. Updated trends of breast implant surgeries: An Israeli analysis. J Plast Reconstr Aesthet Surg 2024; 88:517-523. [PMID: 38103534 DOI: 10.1016/j.bjps.2023.11.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 11/09/2023] [Accepted: 11/15/2023] [Indexed: 12/19/2023]
Abstract
INTRODUCTION Breast augmentation remains one of the most prevalent procedures in plastic surgery. While most patients experience high satisfaction with the outcomes, a subset may encounter various complications or dissatisfaction with achieved results necessitating subsequent surgical intervention including implant removal or exchange. MATERIALS AND METHODS We collected information from three pivotal private medical centers in Israel where a considerable number of breast surgeries are performed. We examined the number of breast augmentations, implant exchange and implant removal surgeries with or without breast lift that were performed on a biannual basis for each center for the period 2018-2022. Trends in surgery types were analyzed and compared to registries in other countries. RESULTS Between the years 2018 and 2022, 20,075 surgeries were done in three main private medical centers in Israel. Data show a gradual increase in implant removal surgeries from 2018 (n = 80, 2.9%) to 2019 (n = 269, 9.9%), followed by a significant increase in 2020 (n = 1436, 27.3%), and a gradual decline between 2021 (n = 1019, 22.8%) and 2022 (n = 916, 18.5%). The overall number of breast implant insertion procedures (breast augmentation procedures and exchange procedures) was 2659 in 2018 (97%), 2424 in 2019 (90.0%), 3816 in 2020 (72.6%), 3437 in 2021 (77.1%), and 4019 in 2022 (81.4%). SUMMARY We present updated trends in breast implant surgeries in Israel. 2020 was a key year in which the rate of explantations was the highest, and the percentage rate of implantations was the lowest and a year in which the trend changed. These patterns partly align with trends seen in other countries worldwide.
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Affiliation(s)
- Yoad Govrin-Yehudain
- Department of Plastic Surgery, Shamir Medical Center, Tel Aviv University, Zerifin, Israel.
| | - Eran Hadad
- Department of Plastic Surgery, Shamir Medical Center, Tel Aviv University, Zerifin, Israel.
| | - Lior Heller
- Department of Plastic Surgery, Shamir Medical Center, Tel Aviv University, Zerifin, Israel.
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Wright MA, Miller AJ, Dong X, Karinja SJ, Samadi A, Lara DO, Mukherjee S, Veiseh O, Spector JA. Reducing Peri-implant Capsule Thickness in Submuscular Rodent Model of Breast Reconstruction With Delayed Radiotherapy. J Surg Res 2023; 291:158-166. [PMID: 37421826 DOI: 10.1016/j.jss.2023.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 04/05/2023] [Accepted: 04/29/2023] [Indexed: 07/10/2023]
Abstract
INTRODUCTION Capsular contracture remains the most common complication following device-based breast reconstruction, occurring in up to 50% of women who also undergo adjuvant radiotherapy either before or after device-based reconstruction. While certain risk factors for capsular contracture have been identified, there remains no clinically effective method of prevention. The purpose of the present study is to determine the effect of coating the implant with the novel small molecule Met-Z2-Y12, with and without delayed, targeted radiotherapy, on capsule thickness and morphologic change around smooth silicone implants placed under the latissimus dorsi in a rodent model. METHODS Twenty-four female Sprague Dawley rats each had 2 mL smooth round silicone breast implants implanted bilaterally under the latissimus dorsi muscle. Twelve received uncoated implants and twelve received implants coated with Met-Z2-Y12. Half of the animals from each group received targeted radiotherapy (20 Gray) on postoperative day ten. At three and 6 months after implantation, the tissue surrounding the implants was harvested for analysis of capsular histology including capsule thickness. Additionally, microCT scans were qualitatively analyzed for morphologic change. RESULTS Capsules surrounding Met-Z2-Y12-coated implants were significantly thinner (P = 0.006). The greatest difference in capsule thickness was seen in the irradiated 6-month groups, where mean capsule thickness was 79.1 ± 27.3 μm for uncoated versus 50.9 ± 9.6 μm for Met-Z2-Y12-coated implants (P = 0.038). At the time of explant, there were no capsular morphologic differences between the groups either grossly or per microCT. CONCLUSIONS Met-Z2-Y12 coating of smooth silicone breast implants significantly reduces capsule thickness in a rodent model of submuscular breast reconstruction with delayed radiotherapy.
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Affiliation(s)
- Matthew A Wright
- Laboratory of Bioregenerative Medicine and Surgery, Division of Plastic Surgery, Department of Surgery, Weill Cornell Medicine, New York, New York
| | - Andrew J Miller
- Laboratory of Bioregenerative Medicine and Surgery, Division of Plastic Surgery, Department of Surgery, Weill Cornell Medicine, New York, New York
| | - Xue Dong
- Laboratory of Bioregenerative Medicine and Surgery, Division of Plastic Surgery, Department of Surgery, Weill Cornell Medicine, New York, New York
| | - Sarah J Karinja
- Laboratory of Bioregenerative Medicine and Surgery, Division of Plastic Surgery, Department of Surgery, Weill Cornell Medicine, New York, New York
| | - Arash Samadi
- Laboratory of Bioregenerative Medicine and Surgery, Division of Plastic Surgery, Department of Surgery, Weill Cornell Medicine, New York, New York
| | - Daniel O Lara
- Laboratory of Bioregenerative Medicine and Surgery, Division of Plastic Surgery, Department of Surgery, Weill Cornell Medicine, New York, New York
| | - Sudip Mukherjee
- Veiseh Lab, Department of Bioengineering, Rice University, Houston, Texas
| | - Omid Veiseh
- Veiseh Lab, Department of Bioengineering, Rice University, Houston, Texas
| | - Jason A Spector
- Laboratory of Bioregenerative Medicine and Surgery, Division of Plastic Surgery, Department of Surgery, Weill Cornell Medicine, New York, New York; Nancy E. and Peter C. Meinig School of Biomedical Engineering, Cornell University, Ithaca, New York.
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Karinja SJ, Bernstein JL, Mukherjee S, Jin J, Lin A, Abadeer A, Kaymakcalan O, Veiseh O, Spector JA. An Antifibrotic Breast Implant Surface Coating Significantly Reduces Periprosthetic Capsule Formation. Plast Reconstr Surg 2023; 152:775-785. [PMID: 36847657 DOI: 10.1097/prs.0000000000010323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
BACKGROUND The body responds to prosthetic materials with an inflammatory foreign body response and deposition of a fibrous capsule, which may be deleterious to the function of the device and cause significant discomfort for the patient. Capsular contracture (CC) is the most common complication of aesthetic and reconstructive breast surgery. The source of significant patient morbidity, it can result in pain, suboptimal aesthetic outcomes, implant failure, and increased costs. The underlying mechanism remains unknown. Treatment is limited to reoperation and capsule excision, but recurrence rates remain high. In this study, the authors altered the surface chemistry of silicone implants with a proprietary anti-inflammatory coating to reduce capsule formation. METHODS Silicone implants were coated with Met-Z2-Y12, a biocompatible, anti-inflammatory surface modification. Uncoated and Met-Z2-Y12-coated implants were implanted in C57BL/6 mice. After 21, 90, or 180 days, periprosthetic tissue was removed for histologic analysis. RESULTS The authors compared mean capsule thickness at three time points. At 21, 90, and 180 days, there was a statistically significant reduction in capsule thickness of Met-Z2-Y12-coated implants compared with uncoated implants ( P < 0.05). CONCLUSIONS Coating the surface of silicone implants with Met-Z2-Y12 significantly reduced acute and chronic capsule formation in a mouse model for implant-based breast augmentation and reconstruction. As capsule formation obligatorily precedes CC, these results suggest contracture itself may be significantly attenuated. Furthermore, as periprosthetic capsule formation is a complication without anatomical boundaries, this chemistry may have additional applications beyond breast implants, to a myriad of other implantable medical devices. CLINICAL RELEVANCE STATEMENT Coating of the silicone implant surface with Met-Z2-Y12 alters the periprosthetic capsule architecture and significantly reduces capsule thickness for at least 6 months postoperatively in a murine model. This is a promising step forward in the development of a therapy to prevent capsular contracture.
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Affiliation(s)
- Sarah J Karinja
- From the Laboratory of Bioregenerative Medicine & Surgery, Weill Cornell Medical College
- Department of Surgery, Division of Plastic Surgery
| | - Jaime L Bernstein
- From the Laboratory of Bioregenerative Medicine & Surgery, Weill Cornell Medical College
- Department of Surgery, Division of Plastic Surgery
| | | | - Julia Jin
- From the Laboratory of Bioregenerative Medicine & Surgery, Weill Cornell Medical College
- Department of Surgery, Division of Plastic Surgery
| | - Alexandra Lin
- From the Laboratory of Bioregenerative Medicine & Surgery, Weill Cornell Medical College
- Department of Surgery, Division of Plastic Surgery
| | - Andrew Abadeer
- From the Laboratory of Bioregenerative Medicine & Surgery, Weill Cornell Medical College
- Department of Surgery, Division of Plastic Surgery
| | - Omer Kaymakcalan
- From the Laboratory of Bioregenerative Medicine & Surgery, Weill Cornell Medical College
- Department of Surgery, Division of Plastic Surgery
| | - Omid Veiseh
- Department of Bioengineering, Rice University
- Sigilon Therapeutics
| | - Jason A Spector
- From the Laboratory of Bioregenerative Medicine & Surgery, Weill Cornell Medical College
- Department of Surgery, Division of Plastic Surgery
- Meinig School of Biomedical Engineering, Cornell University
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Kim YH, Park DW, Song KY, Lim HG, Jeong JP, Kim JH. Use of High-Resolution Ultrasound in Characterizing the Surface Topography of a Breast Implant. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1092. [PMID: 37374297 DOI: 10.3390/medicina59061092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 05/19/2023] [Accepted: 05/31/2023] [Indexed: 06/29/2023]
Abstract
Background and Objectives: With the emergence of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), it has become necessary to identify the implant shell type patients have received. Therefore, an immediate, reliable method for identifying a breast implant shell type is essential. Evidence-based research and applying a real-world technique that identifies the surface topographic information of the inserted breast implants, without surgery, has become of paramount importance for breast implant physicians. Methods and Materials: A review of the medical records of 1901 patients who received 3802 breast implants and subsequently received an ultrasound-assisted examination was performed. All patients received not only a breast cancer examination but also a high-resolution ultrasonography (HRUS) assisted examination of the device at a single center between 31 August 2017 and 31 December 2022. Results: Most patients had breast implants within 10 years (77.7%) of the examination. Of the 3802 implants screened, 2034 (53.5%) were identified with macro-textured shell topography in ultrasonography. A macrotextured shell type implant was used in 53.5% of cases and a smooth type in 42.7% of cases. Seventy-three (1.9%) breast implant shell types could not be identified due to ruptures. However, 250 breast implant shell types could be identified despite rupture cases (6.5%). Conclusions: HRUS was found to be a useful and reliable image modality for identifying various surface shell types of breast implants. The shell type information would be helpful to patients who lack information about their breast implants and are concerned about BIA-ALCL.
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Affiliation(s)
- Yang-Hee Kim
- Department of Surgery, Kangwon National University, Chuncheon 24289, Republic of Korea
| | | | - Keun-Yeong Song
- Department of Breast Surgery, Gwangju Suwan Hospital, Gwangju 62247, Republic of Korea
| | - Hyung-Guhn Lim
- Department of Radiology, Gwangju Suwan Hospital, Gwangju 62247, Republic of Korea
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5
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Lee JH, Jang JH, Min KH. A Comparison of Smooth and Microtextured Breast Implants in Breast Augmentation: A Retrospective Study. Arch Plast Surg 2023; 50:160-165. [PMID: 36999152 PMCID: PMC10049833 DOI: 10.1055/s-0042-1760405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 11/30/2022] [Indexed: 03/30/2023] Open
Abstract
Background
The number of cosmetic and reconstructive surgeries that use breast implants is increasing in Korea. Recently, it has been reported that breast implant-associated anaplastic large-cell lymphoma is related to textured breast implants, and interest in classification according to the texture of breast implants is increasing. However, there is currently no clear and unified classification. In particular, the definition of “microtextured” is highly varied. In this study, we retrospectively investigated and analyzed the clinical outcomes of smooth and microtextured breast implants.
Methods
A retrospective chart review of all patients who underwent breast augmentation surgery with smooth and microtextured silicone gel implants between January 2016 and July 2020 was performed. We retrospectively analyzed implant manufacturer, age, body mass index (BMI), smoking status, incision location, implant size, follow-up period, complications, and reoperation rate.
Results
A total of 266 patients underwent breast augmentation surgery, of which 181 used smooth silicone gel implants and 85 used microtextured silicone gel implants. Age, BMI, smoking status, implant size, and follow-up period were not significantly different between the two groups. Similarly, complications and reoperation rates were not significantly different between the two groups.
Conclusion
It is important to provide information regarding the clinical risks and benefits of breast implants to surgeons and patients through a clear and unified classification according to the texture of the breast implant.
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Affiliation(s)
- Joo Hyuck Lee
- KIES-U Plastic Surgery Clinic, Seoul, Republic of Korea
| | - Jae Hyuk Jang
- Department of Plastic and Reconstructive Surgery, Nowon Eulji Medical Center, School of Medicine, Eulji University, Seoul, Republic of Korea
| | - Kyung Hee Min
- Department of Plastic and Reconstructive Surgery, Nowon Eulji Medical Center, School of Medicine, Eulji University, Seoul, Republic of Korea
- Address for correspondence Kyung Hee Min, MD, PhD Department of Plastic and Reconstructive SurgeryNowon Eulji Medical Center, School of Medicine, Eulji University, 68, Hangeulbiseok-ro, Nowon-gu, Seoul 01830Republic of Korea
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6
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Nilforoushzadeh MA, Golparvaran M, Yekaninejad MS. Assessment of quality of life and self-esteem in male patients with androgenetic alopecia before and after hair transplantation. J Cosmet Dermatol 2023. [PMID: 36912697 DOI: 10.1111/jocd.15716] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 02/07/2023] [Accepted: 02/28/2023] [Indexed: 03/14/2023]
Abstract
BACKGROUND Patients with androgenetic alopecia experience a significant decrease in self-esteem and quality of life. There are several methods by which these factors may be improved. AIMS Determining whether patients feel better about themselves with a better quality of life after undergoing hair transplant procedure. PATIENTS/METHODS 35 people were chosen from Jordan Skin and Hair Clinic in Tehran, Iran. Following hair transplant, follow-up subjects had their quality of life and level of self-esteem assessed using the Rosenberg Self-Esteem Scale (RSES) and Dermatology Life Quality Index (DLQI), respectively. The means of quantitative results were compared using paired T-test. The chi-square test was done to compare preoperative and postoperative characteristics qualitatively. Differences were regarded significant if p < 0.05. Analysis of covariance was applied to evaluate the effect of marital status and educational level on outcome variables (ANCOVA). RESULTS Our findings showed a statistically significant difference (p < 0.001) between pre- and post-operative hair transplantation for quality of life, and mean score increased to 2.17. There was a statistically significant difference between the two groups, with an average self-esteem score on RSES rising to 5.35 (p < 0.001). A statistically significant link between educational achievement and quality of life was found (p < 0.001). CONCLUSION This study found postoperative psychological aspects of AGA patients significantly improve than preoperative. Our results show that there is a statistically significant difference between the self-esteem and quality of life of AGA patients before and after hair restoration surgery.
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Affiliation(s)
- Mohammad Ali Nilforoushzadeh
- Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Jordan Dermatology and Hair Transplantation Center, Tehran, Iran
| | - Maryam Golparvaran
- Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Jordan Dermatology and Hair Transplantation Center, Tehran, Iran
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7
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Schoffer AK, Bittner AK, Hess J, Kimmig R, Hoffmann O. Complications and satisfaction in transwomen receiving breast augmentation: short- and long-term outcomes. Arch Gynecol Obstet 2022; 305:1517-1524. [PMID: 35597817 PMCID: PMC9166844 DOI: 10.1007/s00404-022-06603-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 04/27/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND To achieve long-term improvement in health care of transgender women, it is necessary to analyze all aspects of gender-confirming surgery, especially the relation of risks and benefits occurring in these procedures. While there are many studies presenting data on the urologic part of the surgery, there are just few data about complications and satisfaction with breast augmentation. METHODS This is a retrospective study using parts of the BREAST-Q Augmentation Questionnaire and additional questions for symptoms of capsular contracture and re-operations and analyzing archived patient records of all transwomen which were operated at University Hospital Essen from 2007 to 2020. RESULTS 99 of these 159 patients (62%) completed the questionnaire after a median time of 4 years after surgery. Breast augmentation led to re-operations due to complications in 5%. The rate of capsular contracture (Baker Grad III-IV) in this population was 3%. Most patients (75%) rated high scores of satisfaction with outcome (more than 70 points) and denied to have restrictions due to their implants in their everyday life. All patients reported an improvement in their quality of life owing to breast augmentation. CONCLUSION Breast augmentation by inserting silicon implants is a safe surgical procedure which takes an important part in reducing gender dysphoria.
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Affiliation(s)
- A K Schoffer
- Department of Gynecology and Obstetrics, University Hospital Essen, Hufelandstraße 55, 45147, Essen, Germany.
| | - A K Bittner
- Department of Gynecology and Obstetrics, University Hospital Essen, Hufelandstraße 55, 45147, Essen, Germany
| | - J Hess
- Department of Urology, University Hospital Essen, Essen, Germany
| | - R Kimmig
- Department of Gynecology and Obstetrics, University Hospital Essen, Hufelandstraße 55, 45147, Essen, Germany
| | - O Hoffmann
- Department of Gynecology and Obstetrics, University Hospital Essen, Hufelandstraße 55, 45147, Essen, Germany
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Huang SQ, Chen Y, Zhu Q, Zhang YM, Lei ZY, Zhou X, Fan DL. In Vivo and In Vitro Fibroblasts' Behavior and Capsular Formation in Correlation with Smooth and Textured Silicone Surfaces. Aesthetic Plast Surg 2022; 46:1164-1177. [PMID: 35237878 DOI: 10.1007/s00266-022-02769-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 01/04/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND As the most principal complication following breast augmentation with silicone breast implants, capsular contracture is greatly influenced by surface texture. However, there have long been widespread debates on the function of smooth or textured surface implants in reducing capsular contracture. MATERIALS AND METHODS Three commercially available silicone breast implants with smooth and textured surfaces were subjected to surface characterization, and in vitro and in vivo assessments were then implemented to investigate the effect of these different surfaces on the biological behaviors of fibroblasts and capsular formation in rat models. RESULTS Surface characterization demonstrated that all three samples were hydrophobic with distinct roughness values. Comparing the interactions of fibroblasts or tissues with different surfaces, we observed that as surface roughness increased, the adhesion and cell spreading of fibroblasts, the level of echogenicity, the density of collagen and α-SMA-positive immunoreactivity decreased, while the proliferation of fibroblasts and capsule thickness increased. CONCLUSIONS Our findings elucidated that the effect of silicone implant surface texture on fibroblasts' behaviors and capsular formation was associated with variations in surface roughness, and the number of myofibroblasts may have a more significant influence on the process of contracture than capsule thickness in the early stage of capsular formation. These results highlight that targeting myofibroblasts may be wielded in the prevention and treatment strategies of capsular contracture clinically. LEVEL OF EVIDENCE V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Shu-Qing Huang
- Department of Plastic and Cosmetic Surgery, Xinqiao Hospital, Army Medical University, Xinqiao Road, Sha Ping Ba District, Chongqing, 400037, People's Republic of China
| | - Yao Chen
- Department of Plastic and Cosmetic Surgery, Xinqiao Hospital, Army Medical University, Xinqiao Road, Sha Ping Ba District, Chongqing, 400037, People's Republic of China
| | - Qiong Zhu
- Department of Ultrasound, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Yi-Ming Zhang
- Department of Plastic and Cosmetic Surgery, Xinqiao Hospital, Army Medical University, Xinqiao Road, Sha Ping Ba District, Chongqing, 400037, People's Republic of China
| | - Ze-Yuan Lei
- Department of Plastic and Cosmetic Surgery, Xinqiao Hospital, Army Medical University, Xinqiao Road, Sha Ping Ba District, Chongqing, 400037, People's Republic of China
| | - Xin Zhou
- Department of Plastic and Cosmetic Surgery, Xinqiao Hospital, Army Medical University, Xinqiao Road, Sha Ping Ba District, Chongqing, 400037, People's Republic of China.
| | - Dong-Li Fan
- Department of Plastic and Cosmetic Surgery, Xinqiao Hospital, Army Medical University, Xinqiao Road, Sha Ping Ba District, Chongqing, 400037, People's Republic of China.
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9
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Moon DJ, Deva AK. Adverse Events Associated with Breast Implants: The Role of Bacterial Infection and Biofilm. Clin Plast Surg 2021; 48:101-108. [PMID: 33220897 DOI: 10.1016/j.cps.2020.09.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- David J Moon
- Department of Plastic and Reconstructive Surgery, Macquarie University, Suite 301, Level 3, 2 Technology place, New South Wales 2109, Australia
| | - Anand K Deva
- Department of Plastic and Reconstructive Surgery, Macquarie University, Suite 301, Level 3, 2 Technology place, New South Wales 2109, Australia; Integrated Specialist Healthcare Education and Research Foundation, Miranda, New South Wales, 2228, Australia.
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10
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Two-person screening of mental well-being before primary breast augmentation: Can we do more? J Plast Reconstr Aesthet Surg 2020; 74:152-159. [PMID: 33082077 DOI: 10.1016/j.bjps.2020.08.125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 05/03/2020] [Accepted: 08/01/2020] [Indexed: 11/24/2022]
Abstract
Patients choosing aesthetic surgery are asymptomatic individuals opting for surgery. Psychologists and surgeons have been interested in identifying characteristics of these individuals' preoperative as well as postoperative psychological changes. It was identified that a small number of patients have a primary issue with self-body image, which resulted in altered perceptions and attitudes such that the preoccupation with perceived deficiencies continued even after surgery. The recommended course is to attempt to screen for the patients' mental well-being, as surgery alone does not improve the patients' symptoms. In the first author's practice, each prospective patient is reviewed by two individuals on separate occasions in order to discuss surgery and assure their mental and physical suitability. However, we encountered four patients who exhibited a strong negative reaction to their new shape, to the point that it necessitated explanation in the immediate postoperative phase in two of them. To our knowledge, this situation has not been described in the literature. We discuss the available literature as well as our consent process for breast augmentation. The first author has since introduced BREAST-Q to assess general patient well-being in the pre- and post-operative phases as a result of this experience. We also discuss the results for each of its domains and offer our thoughts about the management of such a situation.
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11
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Sharp G, Maynard P, Hudaib AR, Hamori CA, Oates J, Kulkarni J, Sarwer DB. Do Genital Cosmetic Procedures Improve Women's Self-Esteem? A Systematic Review and Meta-Analysis. Aesthet Surg J 2020; 40:1143-1151. [PMID: 32020160 DOI: 10.1093/asj/sjaa038] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND The popularity of genital cosmetic procedures in women is increasing. These procedures are often assumed and promoted as having a positive effect on women's psychological well-being, particularly their self-esteem. Empirical support for these claims is lacking. OBJECTIVES The aim of this study was to conduct a systematic review and meta-analysis of the impact of genital cosmetic procedures on self-esteem in women. METHODS The authors performed a systematic literature review of MEDLINE, PreMEDLINE, Ebase, EMBASE, OVID, CINAHL, Cochrane, PsycINFO, and PubMed to identify articles that measured self-esteem in women after a genital cosmetic procedure. A meta-analysis was conducted to assess the pooled effect of these procedures on self-esteem. RESULTS The authors identified 5 eligible studies for the meta-analysis, comprising 2 prospective and 3 retrospective studies. Labia minora reduction was the most commonly studied procedure. All 5 studies used different measures of self-esteem, with only 1 study employing a validated psychometric measure at both preoperative and postoperative time points. The meta-analysis results showed a pooled logit rate estimate of 1.230, indicating a positive effect of surgery on self-esteem. However, there was substantial heterogeneity across studies. CONCLUSIONS Female genital cosmetic procedures, particularly labiaplasty, appear to have a positive effect on women's self-esteem. However, inconsistencies in study measures and methods limit our conclusions. Future research should involve the development of standardized outcome measures to more accurately assess the impact of these procedures on self-esteem, and on psychological well-being more generally. LEVEL OF EVIDENCE: 3
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Affiliation(s)
- Gemma Sharp
- Monash Alfred Psychiatry Research Centre at Monash University, Melbourne, Victoria, Australia
| | - Pascale Maynard
- Monash Alfred Psychiatry Research Centre at Monash University, Melbourne, Victoria, Australia
| | - Abdul-Rahman Hudaib
- Monash Alfred Psychiatry Research Centre at Monash University, Melbourne, Victoria, Australia
| | | | | | - Jayashri Kulkarni
- Monash Alfred Psychiatry Research Centre at Monash University, Melbourne, Victoria, Australia
| | - David B Sarwer
- Research and Director of the Center for Obesity Research and Education in the College of Public Health, Temple University, Philadelphia, PA
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12
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Pikoos TD, Rossell SL, Tzimas N, Buzwell S. Assessing Unrealistic Expectations in Clients Undertaking Minor Cosmetic Procedures: The Development of the Aesthetic Procedure Expectations Scale. Facial Plast Surg Aesthet Med 2020; 23:263-269. [PMID: 32881596 DOI: 10.1089/fpsam.2020.0247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objective: To develop and validate a novel patient-reported measure to assess internally and externally driven expectations for change after a cosmetic procedure, termed the aesthetic procedure expectations (ASPECT) scale. Method: In total, 186 adults recruited from nonsurgical cosmetic clinics in Melbourne, Australia, accessed an online survey (150 completed; 81% response rate) including the novel ASPECT questionnaire, demographics, and measures of psychological distress. Results: The final sample included 141 women and 5 men with a mean age of 44.78 years (standard deviation = 11.68) with <10% missing data. Results supported a two-factor ASPECT scale measuring intrinsic and extrinsic expectations, with high internal consistency and convergent validity. Heightened extrinsic and intrinsic expectations were both associated with individuals who were emotionally distressed, younger, and had previously undertaken more cosmetic procedures. Cutoff scores for the ASPECT subscales are proposed to aid cosmetic practitioners in identifying clients requiring further assessment. Conclusions: The ASPECT scale may provide a reliable and useful clinical tool for cosmetic practitioners to assess unrealistic expectations and determine which clients may require more in-depth consultation before undergoing surgical or nonsurgical cosmetic treatment.
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Affiliation(s)
- Toni D Pikoos
- Faculty of Health, Arts and Design, Centre for Mental Health, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Susan L Rossell
- Faculty of Health, Arts and Design, Centre for Mental Health, Swinburne University of Technology, Melbourne, Victoria, Australia.,Psychiatry, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - Nicky Tzimas
- Cosmetic Professional Development Institute of Australia, Melbourne, Victoria, Australia
| | - Simone Buzwell
- Faculty of Health, Arts and Design, Centre for Mental Health, Swinburne University of Technology, Melbourne, Victoria, Australia
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Sarwer DB. Body image, cosmetic surgery, and minimally invasive treatments. Body Image 2019; 31:302-308. [PMID: 30704847 DOI: 10.1016/j.bodyim.2019.01.009] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 01/21/2019] [Accepted: 01/21/2019] [Indexed: 12/20/2022]
Abstract
Over the past 60 years, a growing body of research has investigated the psychological aspects of cosmetic surgery and related minimally-invasive treatments. While the earliest studies were influenced by psychoanalytic thinking, much of the work over the past several decades has been influenced by Thomas Cash's cognitive-behavioral theory of body image and has focused on the appearance concerns of patients who seek these procedures. The majority of individuals interested in the procedures report heightened dissatisfaction typically focused on the feature being considered for treatment. Studies from around the world also have suggested that between 5-15% of patients who present for cosmetic procedures meet diagnostic criteria for body dysmorphic disorder (BDD). While individuals with BDD typically do not report a reduction in their BDD symptoms following a cosmetic procedure, the great majority of patients without the disorder do report improvement in body image. The paper reviews this literature and also discusses the role of body image in three newer areas of plastic surgery-body contouring after massive weight loss, genital procedures (either for cosmetic purposes or as part of gender reassignment), and vascularized composite allotransplantation, including face and hand transplantation.
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Affiliation(s)
- David B Sarwer
- College of Public Health, Temple University, United States.
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Liu F, Miao Y, Li X, Qu Q, Liu Y, Li K, Feng C, Hu Z. The relationship between self-esteem and hair transplantation satisfaction in male androgenetic alopecia patients. J Cosmet Dermatol 2019; 18:1441-1447. [PMID: 30582267 DOI: 10.1111/jocd.12839] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Revised: 10/02/2018] [Accepted: 11/13/2018] [Indexed: 01/24/2023]
Abstract
BACKGROUND Frustrated with the embarrassing appearance, patients with androgenetic alopecia (AGA) suffer from poor quality of life and low self-esteem. Moreover, several researches indicate that self-esteem is an important factor affecting outcomes of cosmetic surgery. OBJECTIVE This retrospective study aims to investigate the impact of hair transplantation on patients' self-esteem and satisfaction with appearance, as well as relationship between self-esteem and patient satisfaction which includes preoperative and postoperative satisfaction. METHODS The preoperative and 9-month postoperative self-esteem were evaluated by Rosenberg Self-Esteem Scale (RSES), and preoperative satisfaction indicators (satisfaction with appearance, visual age and expected visual age) were assessed by Face-Q scale. At the same time, postoperative satisfaction indicators (satisfaction with appearance, visual age, satisfaction with decision, psychological well-being, and social function) were reevaluated as well. RESULTS Of the 1106 male AGA patients, 875 completed a 9-month postoperative questionnaire. Compared with preoperative scores, postoperative scores of self-esteem and satisfaction with appearance showed an increase of 1.56 and 30.25 respectively (P < 0.05). Subgroup analysis showed that patients with high self-esteem level trended to have higher scores of postoperative satisfaction with appearance (P = 0.129), psychological well-being (P = 0.168), social function (P = 0.027), and satisfaction with decision (P = 0.043) compared with patients with low and average self-esteem level. CONCLUSION Hair transplantation significantly elevated self-esteem level and increased satisfaction with appearance of AGA patients. Meanwhile, patients with low self-esteem level trended to have worse postoperative satisfaction. Thus, apart from ensuring the quality of operation, plastic surgeons should offer guidance based on patients' psychological state to improve postoperative satisfaction.
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Affiliation(s)
- Fang Liu
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital of Southern Medical University, Guangzhou, China
| | - Yong Miao
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital of Southern Medical University, Guangzhou, China
| | - Xingdong Li
- Kafuring Hair Transplant Hospital, Beijing, China
| | - Qian Qu
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital of Southern Medical University, Guangzhou, China
| | - Yang Liu
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital of Southern Medical University, Guangzhou, China
| | - Kaitao Li
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital of Southern Medical University, Guangzhou, China
| | - Chuanbo Feng
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital of Southern Medical University, Guangzhou, China
| | - Zhiqi Hu
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital of Southern Medical University, Guangzhou, China
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Gurok MG, Kılıç F, Sağlam S, Göçer Gürok N, Kuloğlu MM, Yıldırım AM. Patients without psychopathology applying for aesthetic rhinoplasty may display elevated harm avoidance and reduced self-directedness: a cross-sectional, case–control study. PSYCHIAT CLIN PSYCH 2019. [DOI: 10.1080/24750573.2019.1605666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- Mehmet Gurkan Gurok
- Department of Psychiatry, School of Medicine, Fırat University, Elazig, Turkey
| | - Faruk Kılıç
- Department of Psychiatry, School of Medicine, Suleyman Demirel University, Isparta, Turkey
| | - Sema Sağlam
- Psychiatry, Adiyaman University Training and Research Hospital, Adiyaman, Turkey
| | - Neşe Göçer Gürok
- Department of Dermatology, Elazığ Training and Research Hospital, Elazig, Turkey
| | - M. Murat Kuloğlu
- Department of Psychiatry, Akdeniz University, School of Medicine, Antalya, Turkey
| | - Alpagan M. Yıldırım
- Department of Plastic, Reconstructive & Esthetic Surgery, School of Medicine, Afyon Kocatepe University, Afyon, Turkey
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Periprosthetic Capsule Formation and Contracture in a Rodent Model of Implant-Based Breast Reconstruction With Delayed Radiotherapy. Ann Plast Surg 2019; 82:S264-S270. [PMID: 30855398 DOI: 10.1097/sap.0000000000001892] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Capsular contracture (CC) is the most common complication of breast implantation, with an incidence of nearly 50% in patients undergoing breast reconstruction with subsequent radiotherapy. Although the move toward submuscular (SM) device placement led to a decreased incidence of CC, subcutaneous (SQ) implantation has seen a resurgence. The purpose of this study was to use a rodent model of breast reconstruction with smooth silicone implants and delayed radiotherapy to assess the occurrence of CC in SQ versus SM implantation. METHODS Custom 2 mL smooth round silicone implants were placed bilaterally into 12 female Sprague Dawley rats that were randomized into 4 groups of 3, with each group differing by implantation plane (SQ vs SM) and irradiation status (irradiated vs nonirradiated). Rats from the SQ group received implants bilaterally underlying the skin on the flank. Rats in the SM groups received implants bilaterally under the latissimus dorsi muscle. Irradiated rats received 20 Gy localized to each implant on postoperative day 10. One rat from each group was imaged with a micro-computed tomography scanner at baseline and at explant 3 months later, whereupon capsules from all rats were examined histologically. RESULTS Rats in the SQ group showed evidence of contracture on gross examination and greater evidence of morphologic disruption per micro-computed tomography scan. There was no evidence of contracture or morphologic disruption in either SM group. Mean ± SD capsule thickness was 39.0 ± 9.0 μm in the SQ versus 37.6 ± 9.8 μm in the SM nonirradiated groups and 43.9 ± 14.9 μm in the SQ versus 34.3 ± 8.3 μm in the SM irradiated groups (all P > 0.05). CONCLUSIONS In a rodent model of smooth silicone breast implantation and delayed radiotherapy, although there did not appear to be differences in capsule thickness regardless of device placement plane, SQ implants demonstrated gross evidence of CC. These data indicate that capsule thickness is only part of a larger pathogenetic picture, which should take into consideration the contribution from all peri-implant tissue.
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Nam SY, Lee M, Shin BH, Elfeky B, U. Lee Y, Moon DH, Seo D, Heo CY. Characterization of BellaGel SmoothFine<sup>®</sup> Implant Surfaces and Correlation with Capsular Contracture. ACTA ACUST UNITED AC 2019. [DOI: 10.4236/jbnb.2019.104012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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18
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Broers DLM, van der Heijden GJMG, Rozema FR, de Jongh A. Do patients benefit from orthognathic surgery? A systematic review on the effects of elective orthognathic surgery on psychosocial functioning and patient satisfaction. Eur J Oral Sci 2017; 125:411-418. [DOI: 10.1111/eos.12371] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Dyonne L. M. Broers
- Centre for Special Care Dentistry; Amsterdam the Netherlands
- Department of Social Dentistry; University of Amsterdam and Vrije Universiteit; Amsterdam the Netherlands
| | | | - Frederik R. Rozema
- Department of Oral Medicine; Academic Centre for Dentistry Amsterdam; University of Amsterdam and Vrije Universiteit; Amsterdam the Netherlands
- Department of Oral and Maxillofacial Surgery; Academic Medical Centre; University of Amsterdam; Amsterdam the Netherlands
| | - Ad de Jongh
- Centre for Special Care Dentistry; Amsterdam the Netherlands
- Department of Social Dentistry; University of Amsterdam and Vrije Universiteit; Amsterdam the Netherlands
- School of Health Sciences; Salford University; Manchester UK
- Institute of Health and Society; University of Worcester; Worcester UK
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Barr S, Hill EW, Bayat A. Functional biocompatibility testing of silicone breast implants and a novel classification system based on surface roughness. J Mech Behav Biomed Mater 2017; 75:75-81. [PMID: 28697402 DOI: 10.1016/j.jmbbm.2017.06.030] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 06/21/2017] [Accepted: 06/24/2017] [Indexed: 11/28/2022]
Abstract
PURPOSE Increasing numbers of women undergo breast implantation for cosmetic and reconstructive purposes. Contracture of the fibrous capsule, which encases the implant leads to significant pain and reoperation. Texture, wettability and the cellular reaction to implant surfaces are poorly understood determinants of implant biocompatibility. The aim of this study was to evaluate the in-vitro characteristics of a range of commercial available implants using a macrophage based assay of implant biocompatibility and a quantitative assessment of wettability and texture. METHODS Thirteen commercially available surfaces were subjected to wettability and texture characterisation using scanning and laser confocal microscopy. THP-1 macrophages were cultured on their surfaces and assessed using Integrin αV immunocytochemistry, SEM and RT-PCR for the expression of TNF-Alpha, IL-6, IL-10 and a cytokine array for the production of TNF-alpha, IL-10, IL-1RA and IL1β; important indicators of inflammation and macrophage polarization. RESULTS Textured surfaces can be accurately sub-categorized dependent upon roughness and re-entrant features into four main types (macro, micro, meso and nano-textured surfaces). Significant (P < 0.0001) differences in implant hydrophobicity and texture exist. Certain surfaces promoted poor macrophage polarization and an innate potential to foster a proinflammatory response. A subgroup analysis showed that texture had a variable effect on markers of inflammation in these surfaces. CONCLUSIONS We propose a classification of implant surfaces based on roughness and present a macrophage based assay of breast implant biocompatibility with a quantitative assessment of implant wettability and texture. The breast implant surface-cell interaction is variable and sufficient to alter healing response and capsular contracture fate in-vivo.
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Affiliation(s)
- S Barr
- Plastic and Reconstructive Surgery Research, University of Manchester, Stopford Building, Oxford Road, Manchester M13 9PT, United Kingdom; Department of Computer Sciences, University of Manchester, Manchester M13 9PL, United Kingdom
| | - E W Hill
- Department of Computer Sciences, University of Manchester, Manchester M13 9PL, United Kingdom
| | - A Bayat
- Plastic and Reconstructive Surgery Research, University of Manchester, Stopford Building, Oxford Road, Manchester M13 9PT, United Kingdom; Bioengineering Research Group, School of Materials, Faculty of Engineering & Physical Sciences, The University of Manchester, Manchester, United Kingdom.
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Prospective Analysis of Primary Breast Augmentation on Body Image Using the BREAST-Q: Results from a Nationwide Study. Plast Reconstr Surg 2017; 137:954e-960e. [PMID: 27219264 PMCID: PMC4879787 DOI: 10.1097/prs.0000000000002183] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The Breast Implant Follow-up Study is a large, ongoing observational study of women who received Natrelle round silicone-filled or saline-filled breast implants. This analysis describes patient-reported outcomes in the cohort who underwent breast augmentation. METHODS Subjects prospectively completed two validated scales of the BREAST-Q (satisfaction with breasts and psychosocial well-being) preoperatively and at 1 and 4 years postoperatively. Effect size and z tests were used to compare differences between preoperative versus postoperative scores; multivariate mixed models were used to compare differences in scores between silicone-filled and saline-filled implants. RESULTS Of 17,899 subjects completing the BREAST-Q preoperatively, 14,514 (81.1 percent) completed the postoperative questionnaire (12,726 received silicone-filled implants and 1788 received saline-filled implants). Overall, satisfaction with breasts and psychosocial well-being increased significantly at postoperative year 1 (p < 0.0001 for both), and the improvement was sustained at year 4 (p < 0.0001 for both). Large effect sizes were observed for satisfaction with breasts (2.0 at year 1; 1.8 at year 4) and psychosocial well-being (1.2 at year 1; 1.0 at year 4). In the multivariate model, silicone-filled implants were associated with significantly greater improvement compared with saline-filled implants for satisfaction with breasts and psychosocial well-being at year 1 (p < 0.0001 for both) and year 4 (p < 0.0001 and p < 0.0019, respectively). CONCLUSIONS Breast implants are effective in improving women's quality of life. The authors found significant and sustained improvements in satisfaction and psychosocial well-being in women undergoing breast augmentation with Natrelle silicone-filled or saline-filled implants. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, IV.
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21
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Correia-Sá I, Cordeiro MNDS, Amarante J, Marques M. Predictors of satisfaction in patient with silicone breast implants and its association with drug intake habits. Acta Chir Belg 2017; 117:89-98. [PMID: 27884086 DOI: 10.1080/00015458.2016.1258784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Satisfaction is an important outcome variable in surgical success. The purpose of this study is to evaluate predictors of satisfaction in women submitted to silicone textured breast implant surgery. METHODS A retrospective evaluation of women receiving textured silicone breast implants was performed. Patients were divided in four groups: cosmetic cohort (n = 104), reconstructive cohort (n = 120), general population control cohort (n = 120) and aesthetic control cohort (n = 54). Data were collected based on information retrieved from patient records, a planned consultation and a self-administered structured questionnaire. RESULTS Patient satisfaction was influenced by preoperative information (p = .007), cohort (p < .001), and occurrence of postoperative complications (p < .001). The degree of satisfaction was also related with drug intake habits: women using psychotropic drugs were 3-fold more likely to report poor satisfaction than those that never used these drugs (p < .001). CONCLUSION The purpose of the surgery, preoperative information and the occurrence of postoperative complications have an impact on the degree of satisfaction of women submitted to silicone breast implant surgery. Women using psychotropic drugs are more likely to report poor satisfaction.
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Affiliation(s)
- Inês Correia-Sá
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine, University of Porto and Hospital de São João, Porto, Portugal
| | | | - José Amarante
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine, University of Porto and Hospital de São João, Porto, Portugal
| | - Marisa Marques
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine, University of Porto and Hospital de São João, Porto, Portugal
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22
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Barr S, Hill E, Bayat A. Development, fabrication and evaluation of a novel biomimetic human breast tissue derived breast implant surface. Acta Biomater 2017; 49:260-271. [PMID: 27919840 DOI: 10.1016/j.actbio.2016.11.052] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Revised: 11/18/2016] [Accepted: 11/22/2016] [Indexed: 12/17/2022]
Abstract
Breast implant use has tripled in the last decade with over 320,000 breast implant based reconstructions and augmentations performed in the US per annum. Unfortunately a considerable number of women will experience capsular contracture, the irrepressible and disfiguring, tightening and hardening of the fibrous capsule that envelops the implant. Functionalising implant surfaces with biocompatible tissue-specific textures may improve in vivo performance. A novel biomimetic breast implant is presented here with anti-inflammatory in vitro abilities. Topographical assessment of native breast tissue facilitated the development of a statistical model of adipose tissue. 3D grayscale photolithography and ion etching were combined to successfully replicate a surface modelled upon the statistics of breast tissue. Pro-inflammatory genes ILβ1, TNFα, and IL6 were downregulated (p<0.001) and anti-inflammatory gene IL-10 were upregulated on the novel surface. Pro-inflammatory cytokines Gro-Alpha, TNFα and neutrophil chemoattractant IL8 were produced in lower quantities and anti-inflammatory IL-10 in higher quantities in culture with the novel surface (p<0.01). Immunocytochemistry and SEM demonstrated favourable fibroblast and macrophage responses to these novel surfaces. This study describes the first biomimetic breast tissue derived breast implant surface. Our findings attest to its potential translational ability to reduce the inflammatory phase of the implant driven foreign body reaction. STATEMENT OF SIGNIFICANCE Breast implants are still manufactured using outdated techniques and have changed little since their inception in the 1960's. Breast implants can cause a medical condition, capsular contracture which often results in disfigurement, pain, implant removal and further surgery. This condition is due to the body's reaction to these breast implants. This article describes the successful development and testing of a novel breast implant surface inspired by the native shapes present in breast tissue. Results show that this novel implant surface is capable of reducing the negative reaction of human cells to these surfaces which may help reduce capsular contracture formation. This work represents the first steps in producing a biocompatible breast implant.
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Oranges CM, Schaefer KM, Haug M, Schaefer DJ. The Impact of Aesthetic Surgery on Body Image and its Implications for Mental and Physical Health. Aesthet Surg J 2016; 36:NP256-8. [PMID: 27402786 DOI: 10.1093/asj/sjw066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2016] [Indexed: 11/14/2022] Open
Affiliation(s)
- Carlo M Oranges
- From the Department of Plastic, Reconstructive, Aesthetic, and Hand Surgery, Basel University Hospital, Basel, Switzerland
| | - Kristin M Schaefer
- From the Department of Plastic, Reconstructive, Aesthetic, and Hand Surgery, Basel University Hospital, Basel, Switzerland
| | - Martin Haug
- From the Department of Plastic, Reconstructive, Aesthetic, and Hand Surgery, Basel University Hospital, Basel, Switzerland
| | - Dirk J Schaefer
- From the Department of Plastic, Reconstructive, Aesthetic, and Hand Surgery, Basel University Hospital, Basel, Switzerland
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24
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Understanding the Etiology and Prevention of Capsular Contracture: Translating Science into Practice. Clin Plast Surg 2015; 42:427-36. [PMID: 26408434 DOI: 10.1016/j.cps.2015.06.007] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Capsular contracture remains a common and preventable complication of implanted breast prostheses. As our understanding of the pathophysiology continues to develop, it is prudent to reexamine existing beliefs in a contemporary context. This article presents a current summary of clinical and laboratory evidence, expressed as an interaction between potentiating and suppressing factors, and how this understanding can be applied to practice.
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Abstract
BACKGROUND This study verifies selected opinions on breast cosmetic surgery in the population of Polish women. MATERIALS AND METHODS A total of 78 women aged 20 to 48 years were surveyed between 2008 and 2010 before and after breast augmentation surgery using a questionnaire. The χ and Wilcoxon signed rank tests were used for statistical analysis. Most were married and single women aged approximately 30 years and residents of large cities. RESULTS The significance of professional success in the hierarchy of values and the level of self-assessment increased after surgery (P = 0.0000 and 0.0213, respectively). The distribution of responses concerning the expectations of surgery and the evaluation of their fulfillment changed significantly (P = 0.0031). In general, the satisfaction with one's life after surgery also increased (P = 0.0000). CONCLUSIONS A well-thought-out decision on breast cosmetic surgery positively affects at least several spheres of psychosocial functioning and fulfills most women's expectations.
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Characteristics of Women Who Have Had Cosmetic Breast Implants That Could Be Associated with Increased Suicide Risk: A Systematic Review, Proposing a Suicide Prevention Model. Arch Plast Surg 2015; 42:131-42. [PMID: 25798383 PMCID: PMC4366693 DOI: 10.5999/aps.2015.42.2.131] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 07/21/2014] [Accepted: 07/26/2014] [Indexed: 11/08/2022] Open
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Yagil Y, Geller S, Sidi Y, Tirosh Y, Katz P, Nakache R. The implications of body-image dissatisfaction among kidney-transplant recipients. PSYCHOL HEALTH MED 2014; 20:955-62. [PMID: 25343489 DOI: 10.1080/13548506.2014.972417] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The role that body image plays in the psychological adjustment of kidney-transplant recipients is an understudied issue. In the current study, the association between three variables - (a) body-image dissatisfaction, (b) quality of life (QOL), and (c) psychological distress - was investigated. The research participants were 45 kidney-transplant recipients who were under follow-up care at the Transplant Unit of the Tel-Aviv Medical Center (Israel). Body image, psychological distress, and QOL were measured using self-report questionnaires [Body-Image Ideals Questionnaire (BIIQ), Brief Symptoms Inventory (BSI), and SF-12]. Medical and background data were collected from medical and administrative records. The findings indicated an association between higher level of body-image dissatisfaction and a decrease in several quality-of-life dimensions (role emotional, physical pain, general health, and social functioning), and with an increase in psychological distress. These findings highlight the importance of body-image dissatisfaction as a factor that is associated with QOL and psychological distress among kidney-transplant recipients. Body image warrants further attention and should be screened and treated among those who demonstrate high levels of dissatisfaction.
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Affiliation(s)
- Yaron Yagil
- a Department of Social Work and Department of Education , Tel-Hai College , Upper Galilee , Israel
| | - Shulamit Geller
- b School of Behavioral Sciences , Tel Aviv-Yaffo Academic College , Tel-Aviv , Israel
| | - Yael Sidi
- b School of Behavioral Sciences , Tel Aviv-Yaffo Academic College , Tel-Aviv , Israel
| | - Yael Tirosh
- c Organ Transplantation Unit, Tel-Aviv Sourasky Medical Center-Affiliated with the Sackler Faculty of Medicine , Tel-Aviv University , Tel-Aviv , Israel
| | - Paulina Katz
- c Organ Transplantation Unit, Tel-Aviv Sourasky Medical Center-Affiliated with the Sackler Faculty of Medicine , Tel-Aviv University , Tel-Aviv , Israel
| | - Richard Nakache
- c Organ Transplantation Unit, Tel-Aviv Sourasky Medical Center-Affiliated with the Sackler Faculty of Medicine , Tel-Aviv University , Tel-Aviv , Israel
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28
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Crerand CE, Magee L. Cosmetic and reconstructive breast surgery in adolescents: psychological, ethical, and legal considerations. Semin Plast Surg 2014; 27:72-8. [PMID: 24872744 DOI: 10.1055/s-0033-1343999] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Cosmetic and reconstructive breast surgery has increased in popularity among adolescents in the United States. As more adolescents pursue these procedures, an understanding of the psychological aspects of these surgeries becomes increasingly important for the benefit of both patients and providers. The authors review the psychological aspects of cosmetic and reconstructive surgical breast procedures as they pertain to adolescents, including augmentation mammoplasty, gynecomastia correction, breast reduction, and asymmetry correction. They include a discussion of the medicolegal and ethical implications of these procedures and recommendations for clinical management.
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Affiliation(s)
- Canice E Crerand
- Division of Plastic and Reconstructive Surgery, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania ; Division of Plastic Surgery, Department of Surgery, The Edwin and Fannie Gray Hall Center for Human Appearance, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Leanne Magee
- Division of Plastic and Reconstructive Surgery, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
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29
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Papadopulos N, Totis A, Kiriakidis D, Mavroudis M, Henrich G, Papadopoulos O, Kovacs L, Herschbach P, Machens HG, Biemer E. Quality of life, personality changes, self esteem, and emotional stability after breast augmentation. EUROPEAN JOURNAL OF PLASTIC SURGERY 2014. [DOI: 10.1007/s00238-014-0963-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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30
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Veale D, Eshkevari E, Ellison N, Costa A, Robinson D, Kavouni A, Cardozo L. A comparison of risk factors for women seeking labiaplasty compared to those not seeking labiaplasty. Body Image 2014; 11:57-62. [PMID: 24239491 DOI: 10.1016/j.bodyim.2013.10.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Revised: 09/30/2013] [Accepted: 10/01/2013] [Indexed: 12/23/2022]
Abstract
Little is known about the factors associated with the desire for labiaplasty. We compared 55 women seeking labiaplasty with 70 women in a comparison group who were not seeking labiaplasty. Measures administered included the Perception of Appearance and Competency Related Teasing Scale, Childhood Trauma Questionnaire, Disgust Scale Revised, and the Genital Appearance Satisfaction scale with open-ended questions about their genitalia. Approximately a third of the labiaplasty group recalled specific negative comments in the past towards their labia, a proportion significantly greater than the three per cent in the comparison group. Participants reporting genital teasing also showed higher Genital Appearance Satisfaction scores than those who were not teased. However, women seeking labiaplasty were, compared to the comparison group, no more likely to have a history of neglect or abuse during childhood. There was no difference between the groups on disgust sensitivity or the perception of being teased in the past about their competence or appearance in general.
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Affiliation(s)
- David Veale
- The Institute of Psychiatry, King's College London and the South London and Maudsley NHS Foundation Trust, London, UK.
| | - Ertimiss Eshkevari
- The Institute of Psychiatry, King's College London and the South London and Maudsley NHS Foundation Trust, London, UK
| | - Nell Ellison
- The Institute of Psychiatry, King's College London and the South London and Maudsley NHS Foundation Trust, London, UK
| | - Ana Costa
- The Institute of Psychiatry, King's College London and the South London and Maudsley NHS Foundation Trust, London, UK
| | - Dudley Robinson
- Urogynaecology Unit, King's College London and King's College Hospital NHS Foundation Trust, UK
| | | | - Linda Cardozo
- Urogynaecology Unit, King's College London and King's College Hospital NHS Foundation Trust, UK
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31
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França DCC, de Castro AL, Soubhia AMP, de Aguiar SMHCÁ, Goiato MC. Evaluation of the biocompatibility of silicone gel implants - histomorphometric study. Acta Inform Med 2013; 21:93-7. [PMID: 24039333 PMCID: PMC3766542 DOI: 10.5455/aim.2013.21.93-97] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Accepted: 04/05/2013] [Indexed: 11/03/2022] Open
Abstract
CONFLICT OF INTEREST NONE DECLARED Breast implants are medical devices that are used to augment breast size or to reconstruct the breast following mastectomy or to correct a congenital abnormality. Breast implants consist of a silicone outer shell and a filler (most commonly silicone gel or saline). Approximately 5 to 10 million women worldwide have breast implants. Histomorphometric study to evaluate the biological tissue compatibility of silicone implants suitable for plastic surgery and the adverse effects and risks of this material. Thirty Wistar white rats received subcutaneous implants and the revestiment of silicone gel Silimed ®®, and randomized into six groups of five animals each, according to the type of implanted material and the time of sacrifice. Eight areas of 60.11mm2 corresponding to the obtained surgical pieces were analyzed, counting mesenchymal cells, eosinophils, and foreign body giant cells, observing an acceptable biocompatibility in all implants, for subsequent statistical analysis by Tukey test. Silicone gel showed inflammation slightly greater than for other groups, with tissue reactions varying from light to moderate, whose result was the formation of a fibrous capsule around the material, recognized by the organism as a foreign body. Despite frequent local complications and adverse outcomes, this research showed that the silicone and top layer presented an acceptable chronic inflammatory reaction, which did not significantly differ from the control group. In general, it is possible to affirm that silicone gel had acceptable levels of biocompatibility, confirmed the rare presence of foreign body giant cells, and when of the rupture, formed a fibrous capsule around the material, separating the material of the organism.
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Affiliation(s)
- Diurianne Caroline Campos França
- Pediatric Dentistry, Araçatuba School of Dentistry , Unesp, Stomatologist of CEOPE - State Center of Dentistry for Patients with Special Needs, Department of Univag- Academic Center/Várzea Grande/MT/Brazil
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Tam KP. Existential motive underlying cosmetic surgery: A terror management analysis. JOURNAL OF APPLIED SOCIAL PSYCHOLOGY 2013. [DOI: 10.1111/jasp.12059] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Kim-Pong Tam
- Division of Social Science; Hong Kong University of Science and Technology
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Tam KP, Ng HKS, Kim YH, Yeung VWL, Cheung FYL. Attitudes toward cosmetic surgery patients: the role of culture and social contact. The Journal of Social Psychology 2012; 152:458-79. [PMID: 22822685 DOI: 10.1080/00224545.2011.637997] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Cosmetic surgery is increasingly popular globally, but how cosmetic surgery patients are socially evaluated is largely unknown. The present research documents attitudes toward these patients in multiple cultures (Hong Kong, Japan, and the United States). Across these cultures, attitudes toward cosmetic surgery patients were predominantly negative: Participants ascribed more negative attributes to cosmetic surgery patients and found cosmetic surgery not acceptable. Also, participants in Hong Kong and Japan were not willing to form social relationships, particularly intimate ones, with these patients. These attitudes were less negative in the United States than in Hong Kong and Japan, partly because social contact, which reduced negativity in attitudes toward cosmetic surgery patients, was more prevalent in the United States. These findings bear important implications for the subjective well-being of cosmetic surgery patients, who very often expect improvement in their social relationships through the surgery.
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Affiliation(s)
- Kim-Pong Tam
- The Hong Kong University of Science and Technology, Division of Social Science, Room 3383, Academic Building, HKUST, Clear Water Bay, Hong Kong.
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Lyubomirsky S, Martin-Krumm C, Nelson S. Psychologie positive et modèle de l’adaptation hédonique. PRAT PSYCHOL 2012. [DOI: 10.1016/j.prps.2012.02.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Mazzocchi M, Dessy LA, Iodice P, Saggini R, Scuderi N. A study of postural changes after breast augmentation. Aesthetic Plast Surg 2012; 36:570-7. [PMID: 22083412 DOI: 10.1007/s00266-011-9841-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2011] [Accepted: 10/10/2011] [Indexed: 12/26/2022]
Abstract
BACKGROUND A number of factors, including body mass and one's mood, may influence posture. Breast augmentation results not only in a significant improvement in body image-related feelings and self-esteem but also in a sudden change in body mass. The aim of this study was to assess postural changes following breast augmentation by studying body position, orientation through space, and center of pressure. METHODS Patients with breast hypoplasia who underwent breast augmentation were enrolled. Posture evaluation was performed before and 1, 4, and 12 months after surgery by quantifying the center of mass using the Fastrak™ system and the center of pressure using stabilometry. The Wilcoxon signed-rank sum test was used to compare value modifications. RESULTS Forty-eight patients were enrolled in the study. A retropositioning of the upper part of the body, confirmed by baropodometric analysis, was evident in the early postoperative period. We subsequently observed a reprogramming of the biomechanical system, which reached a state of equilibrium 1 year after surgery, with a slight retropositioning of the head and a compensatory anterior positioning of the pelvis. CONCLUSION We believe that with respect to posture, the role played by psychological aspects is even more important than that played by changes in body mass. Indeed, hypomastia is often associated with kyphosis because patients try to hide what they consider a deficiency. Following breast augmentation, the discovery of new breasts overcomes the dissatisfaction with the patient's own body image, increases self-esteem, and modifies posture regardless of the changes in body mass due to the insertion of the implants.
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Affiliation(s)
- Marco Mazzocchi
- Department of Plastic Surgery, University of Perugia, Perugia, Italy.
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Sezgin B, Findikcioglu K, Kaya B, Sibar S, Yavuzer R. Mirror on the wall: a study of women's perception of facial features as they age. Aesthet Surg J 2012; 32:421-5. [PMID: 22436235 DOI: 10.1177/1090820x12442083] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Facial aesthetic treatments are among the most popular cosmetic procedures worldwide, but the factors that motivate women to change their facial appearance are not fully understood. OBJECTIVES The authors examine the relationships among the facial areas on which women focus most as they age, women's general self-perception, and the effect of their personal focus on "beauty points" on their perception of other women's faces. METHODS In this prospective study, 200 women who presented to a cosmetic surgery outpatient clinic for consultation between December 2009 and February 2010 completed a questionnaire. The 200 participants were grouped by age: 20-29 years, 30-39, 40-49, and 50 or older (50 women in each group). They were asked which part of their face they focus on most when looking in the mirror, which part they notice most in other women (of different age groups), what they like/dislike most about their own face, and whether they wished to change any facial feature. RESULTS A positive correlation was found between women's focal points and the areas they dislike or desire to change. Younger women focused mainly on their nose and skin, while older women focused on their periorbital area and jawline. Women focus on their personal focal points when looking at other women in their 20s and 30s, but not when looking at older women. CONCLUSIONS Women presenting for cosmetic surgery consultation focus on the areas that they dislike most, which leads to a desire to change those features. The plastic surgeon must fully understand patients' expectations to select appropriate candidates and maximize satisfaction with the outcomes.
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Affiliation(s)
- Billur Sezgin
- Department of Plastic, Reconstructive, and Aesthetic Surgery, Gazi University, Ankara, Turkey.
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Martin Salzmann-Erikson RN, Henrik Eriksson RNT. Torrenting values, feelings, and thoughts-Cyber nursing and virtual self-care in a breast augmentation forum. Int J Qual Stud Health Well-being 2011; 6:QHW-6-7378. [PMID: 22053162 PMCID: PMC3207633 DOI: 10.3402/qhw.v6i4.7378] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/30/2011] [Indexed: 11/29/2022] Open
Abstract
Earlier research shows that breast augmentation is positively correlated with positive psychological states. The aim of this study was to explore the shared values, feelings, and thoughts within the culture of breast enlargement among women visiting Internet-based forums when considering and/or undergoing esthetic plastic surgery. The study used a netnographic method for gathering and analyzing data. The findings show that the women used the Internet forum to provide emotional support to other women. Through electronic postings, they cared for and nursed each others’ anxiety and feelings throughout the whole process. Apart from the process, another central issue was that the women's relationships were frequently discussed; specifically their relationship to themselves, their environment, and with the surgeons. The findings suggest that Internet forums represent a channel through which posters can share values, feelings, and thoughts from the position of an agent of action as well as from a position as the object of action. These dual positions and the medium endow the women with a virtual nursing competence that would otherwise be unavailable. By introducing the concept of torrenting as a means of sharing important self-care information, the authors provide a concept that can be further explored in relation to post modern self-care strategies within contemporary nursing theories and practice.
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Affiliation(s)
- R N Martin Salzmann-Erikson
- Oslo University Hospital, Ullevål, Division of Mental Health and Addiction, Department of Acute Psychiatry, Oslo, Norway
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Callaghan GM, Lopez A, Wong L, Northcross J, Anderson KR. Predicting consideration of cosmetic surgery in a college population: a continuum of body image disturbance and the importance of coping strategies. Body Image 2011; 8:267-74. [PMID: 21641892 DOI: 10.1016/j.bodyim.2011.04.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2010] [Revised: 04/08/2011] [Accepted: 04/10/2011] [Indexed: 11/19/2022]
Abstract
Elective cosmetic surgeries are increasing in the American population with reasons linked to body image disturbance and body dysmorphic disorder (BDD). Little research exists documenting the continuum of body image disturbance and its relationship to seeking surgery. The present research examined data from 544 participants, 55 of whom were diagnosable with BDD. Using assessments for body image disturbance, problematic coping strategies, and BDD symptomatology, results provided evidence for a continuum of body image distress. Logistic regression analysis supported the hypothesis that increased levels of body image disturbance and one type of problematic coping strategy (Appearance Fixing) predicted consideration of cosmetic surgery. Of participants diagnosable with BDD, those who considered cosmetic surgery showed more severe body image disturbance and problematic coping than those who did not consider surgery. These results have implications for pre-surgical assessment as well as psychological interventions rather than invasive medical interventions.
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Affiliation(s)
- Glenn M Callaghan
- Department of Psychology, San Jose State University, San Jose, CA 95192-1020, USA.
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Sarwer DB, Crerand CE, Magee L. Body dysmorphic disorder in patients who seek appearance-enhancing medical treatments. Oral Maxillofac Surg Clin North Am 2011; 22:445-53. [PMID: 20970710 DOI: 10.1016/j.coms.2010.07.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Most patients who seek appearance-enhancing medical treatments report some degree of body image dissatisfaction, which is believed to motivate the pursuit of these treatments. However, patients with extreme body image dissatisfaction may be suffering from a psychiatric disorder known as body dysmorphic disorder (BDD). This article reviews BDD, including its clinical features and prevalence in medical settings. Although patients with BDD frequently seek cosmetic treatments to address their appearance-related distress, such treatments are rarely beneficial. The article concludes with recommendations for patient and provider safety.
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Affiliation(s)
- David B Sarwer
- Division of Plastic Surgery, Department of Surgery, The Edwin and Fannie Gray Hall Center for Human Appearance, The University of Pennsylvania School of Medicine, 10 Penn Tower, 3400 Spruce Street, Philadelphia, PA 19104, USA.
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Barr S, Bayat A. Breast implant surface development: perspectives on development and manufacture. Aesthet Surg J 2011; 31:56-67. [PMID: 21239673 DOI: 10.1177/1090820x10390921] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Capsular contracture poses a significant clinical and scientific research challenge for breast surgeons. Some researchers have pointed to the surface features of implant devices as being responsible for the potential tightening and hardening of the surrounding capsule. In this article, the authors review the history and development of breast implant design, specifically the data supporting improvements that have potential to mitigate the incidence of capsular contracture. The literature suggests that development of new implant surfaces designed to reduce a patient's foreign body response will improve the safety profile of implant devices and increase patient satisfaction in the long-term.
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Affiliation(s)
- Simon Barr
- Manchester Interdisciplinary Biocentre, School of Translational Medicine, University of Manchester, 131 Princess Street, Manchester, UK
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Berry M, Davies D. Breast augmentation: Part I – a review of the silicone prosthesis. J Plast Reconstr Aesthet Surg 2010; 63:1761-8. [DOI: 10.1016/j.bjps.2009.07.047] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2009] [Revised: 07/27/2009] [Accepted: 07/31/2009] [Indexed: 10/20/2022]
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Solvi AS, Foss K, von Soest T, Roald HE, Skolleborg KC, Holte A. Motivational factors and psychological processes in cosmetic breast augmentation surgery. J Plast Reconstr Aesthet Surg 2010; 63:673-80. [DOI: 10.1016/j.bjps.2009.01.024] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2008] [Accepted: 01/07/2009] [Indexed: 10/21/2022]
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Moser SE, Aiken LS. Cognitive and emotional factors associated with elective breast augmentation among young women. Psychol Health 2010. [DOI: 10.1080/08870440903207635] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Stephanie E. Moser
- a Department of Psychology , Arizona State University , P.O. Box 871104, Tempe, AZ 85287-1104, USA
| | - Leona S. Aiken
- a Department of Psychology , Arizona State University , P.O. Box 871104, Tempe, AZ 85287-1104, USA
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von Soest T, Kvalem I, Roald H, Skolleborg K. The effects of cosmetic surgery on body image, self-esteem, and psychological problems. J Plast Reconstr Aesthet Surg 2009; 62:1238-44. [DOI: 10.1016/j.bjps.2007.12.093] [Citation(s) in RCA: 108] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2007] [Revised: 10/05/2007] [Accepted: 12/22/2007] [Indexed: 11/17/2022]
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Pereira LH, Sterodimas A. Transaxillary breast augmentation: a prospective comparison of subglandular, subfascial, and submuscular implant insertion. Aesthetic Plast Surg 2009; 33:752-9. [PMID: 19597863 DOI: 10.1007/s00266-009-9389-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2009] [Accepted: 06/12/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND During the last decades transaxillary breast augmentation (TBA) has gained worldwide acceptance. Breast augmentation via transaxillary access endoscopically assisted in the subglandular, subfascial, and submuscular planes has been previously described. Although TBA is a well-studied procedure, few reports exist concerning the subfascial plane of implant insertion and none exist comparing the three different planes of insertion by TBA. METHODS A perspective study to evaluate the outcomes, complications, and patient satisfaction of TBA using the three different planes of implant insertion was performed during 2004-2005. Fifty-three patients fulfilled the inclusion criteria. They were randomly divided into three groups corresponding to the three planes of silicone insertion. All patients had a silicone texturized implant that ranged from 190 to 300 cc. Overall satisfaction with the breast appearance after TBA was rated on a scale of 1-5, where 1 is poor, 2 is fair, 3 is good, 4 is very good, and 5 is excellent. The evaluation was made at the follow-up times of 6 months and 3 years. RESULTS There were 18 patients enrolled for the subcutaneous TBA (Group A), 18 for the subfascial TBA (Group B), and 17 for the submuscular TBA (Group C). Axillary incision-related complications occurred in 9% of the patients and included formation of a hypertrophic scar and small-wound dehiscence. There was no hematoma formation and no case of infection. There was one patient from Group A who developed seroma and was treated conservatively. Twenty-seven months postoperatively the same patient developed Baker III capsule contracture, which required silicone implant replacement in the subfascial plane. One case of stretch marks in a young nulliparous woman from Group B did not need treatment. One patient from Group A underwent implant exchange because of implant size dissatisfaction. Three patients in Group C had mild distortion of the implant during pectoral contracture. A meta-analysis of patient satisfaction 6 months and 3 years after TBA is presented. CONCLUSION Transaxillary breast augmentation provides consistent, satisfactory results with ease of dissection, when properly indicated. Although the subfascial augmentation mammaplasty has all the advantages of the subpectoral and subglandular augmentation mammaplasties and eliminates the disadvantages of increased postoperative discomfort, implant visibility, and distortion, patients of all three groups had similar rates of satisfaction. Further follow-up is needed in order to compare the long-term effects of the three different planes of insertion.
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Abstract
Within the past decade, the popularity of cosmetic breast augmentation has surged and, with it, the interest in the psychological aspects of the procedure. Investigations of women who seek cosmetic breast augmentation have examined both their psychosocial characteristics and their motivations for surgery. Dissatisfaction both with body image and with breast size and/or shape are thought to be primary motivators for surgery. It is common for women seeking cosmetic breast augmentation to have some body image dissatisfaction. However, a considerable minority may suffer from excessive dissatisfaction consistent with the psychiatric diagnosis of body dysmorphic disorder, which is believed to contraindicate cosmetic surgery. Following breast augmentation, most women report satisfaction with the aesthetic result and improvements in body image. The impact of the procedure on other areas of functioning, such as self-esteem and quality of life, is less clear. These positive outcomes have been tempered by recent epidemiological studies that have identified a relationship between cosmetic breast implants and suicide. This article reviews this literature and provides recommendations to plastic surgical nurses regarding the psychological assessment and management of patients seeking breast augmentation.
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Abstract
The American Society of Plastic Surgeons (ASPS) reported that 329,396 women have undergone breast augmentation in the United States, an increase of 55% between 2000 and 2006, making it the most frequent US surgical cosmetic procedure for 2006 (ASPS, 2007). Although many studies have explored psychological aspects of this type of surgery, the consistently dramatic increase in numbers of breast augmentations, some that result in adverse psychological outcomes, remains a serious concern for health care providers. Surprisingly, very little is known about either the psychological characteristics of cosmetic surgery patients or the psychological impact of the surgical procedures. This literature review focuses on psychological issues in relation to breast augmentation procedures, including recent suicide findings related to this procedure. Conclusion of this review supports the necessity by health care providers to consistently screen patients for psychological disorders, such as Body Dysmorphic Disorder (BDD), prior to conducting cosmetic surgical procedures, specifically breast augmentation.
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Affiliation(s)
- Cynthia Figueroa-Haas
- Department of Adult and Elderly Nursing, University of Florida, P. O. Box 100187, Gainesville, FL 32610-0187, USA.
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Rastmanesh R, Gluck ME, Shadman Z. Comparison of body dissatisfaction and cosmetic rhinoplasty with levels of veil practicing in Islamic women. Int J Eat Disord 2009; 42:339-45. [PMID: 19115373 PMCID: PMC2804919 DOI: 10.1002/eat.20613] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The relationship between Islamic veiling, body dissatisfaction, and desire for cosmetic rhinoplasty (CR) has not been studied. We therefore compared body dissatisfaction (BD), depression, self-esteem, and prevalence and desire to have CR in 1,771 Iranian females. METHOD A battery of questionnaires was administered and participants were categorized into three groups of Islamic veil practicing: voluntarily and ideologically (IVP), non-complete (NCIVP), and Inconsiderate (IIVP). RESULTS Despite a similar BMI, the IVP group scored significantly lower on BD, prevalence of dieting and exercising in order to be sexually appealing, and depression, higher on self-esteem, and had a lower desire for a CR than the two other groups. Prevalence of CR was significantly higher in the IIVP group than the other groups. DISCUSSION Women who practiced more strict Islamic veiling techniques had increased body satisfaction and self esteem, and decreased depression scores and desire for CR. Consistent with other studies, our findings show that observance of a strict religious practice has a protective effect on psychological health.
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Affiliation(s)
- Reza Rastmanesh
- Faculty of Nutrition, Department of Human Nutrition, Shaheed Beheshti University of Medical Sciences (SBMU), Tehran, IRI.
| | - Marci E Gluck
- Obesity and Diabetes Clinical Research Section, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health, Phoenix, AZ
| | - Zhaleh Shadman
- Department of Human Nutrition, Shaheed Beheshti University of Medical Sciences (SBMU), Tehran, IRI
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