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Rahman E, Philipp-Dormston WG, Webb WR, Rao P, Sayed K, Sharif AQMO, Yu N, Ioannidis S, Tam E, Rahman Z, Mosahebi A, Goodman GJ. "Filler-Associated Acute Stroke Syndrome": Classification, Predictive Modelling of Hyaluronidase Efficacy, and Updated Case Review on Neurological and Visual Complications. Aesthetic Plast Surg 2024:10.1007/s00266-024-04202-y. [PMID: 38971925 DOI: 10.1007/s00266-024-04202-y] [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: 04/01/2024] [Accepted: 06/09/2024] [Indexed: 07/08/2024]
Abstract
INTRODUCTION The rising use of soft tissue fillers for aesthetic procedures has seen an increase in complications, including vascular occlusions and neurological symptoms that resemble stroke. This study synthesizes information on central nervous system (CNS) complications post-filler injections and evaluates the effectiveness of hyaluronidase (HYAL) treatment. METHODS A thorough search of multiple databases, including PubMed, EMBASE, Scopus, Web of Science, Google Scholar, and Cochrane, focused on publications from January 2014 to January 2024. Criteria for inclusion covered reviews and case reports that documented CNS complications related to soft tissue fillers. Advanced statistical and computational techniques, including logistic regression, machine learning, and Bayesian analysis, were utilized to dissect the factors influencing therapeutic outcomes. RESULTS The analysis integrated findings from 20 reviews and systematic analyses, with 379 cases reported since 2018. Hyaluronic acid (HA) was the most commonly used filler, particularly in nasal region injections. The average age of patients was 38, with a notable increase in case reports in 2020. Initial presentation data revealed that 60.9% of patients experienced no light perception, while ptosis and ophthalmoplegia were present in 54.3 and 42.7% of cases, respectively. The statistical and machine learning analyses did not establish a significant linkage between the HYAL dosage and patient recovery; however, the injection site emerged as a critical determinant. CONCLUSION The study concludes that HYAL treatment, while vital for managing complications, varies in effectiveness based on the injection site and the timing of administration. The non-Newtonian characteristics of HA fillers may also affect the incidence of complications. The findings advocate for tailored treatment strategies incorporating individual patient variables, emphasizing prompt and precise intervention to mitigate the adverse effects of soft tissue fillers. LEVEL OF EVIDENCE III 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)
- Eqram Rahman
- Research and Innovation Hub, Innovation Aesthetics, London, WC2H9JQ, UK.
| | | | | | - Parinitha Rao
- The Skin Address, Aesthetic Dermatology Practice, Bengaluru, India
| | - Karim Sayed
- Nomi Oslo, Oslo, Norway
- University of South-Eastern Norway, Drammen, Norway
| | - A Q M Omar Sharif
- Shaheed Suhrawardy Medical College, Sher e Bangla Nagar, Dhaka, Bangladesh
| | - Nanze Yu
- Peking Union Medical College Hospital, Beijing, China
| | | | | | - Zakia Rahman
- Stanford Dermatology, Stanford University School of Medicine, Redwood City, CA, USA
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Park JH, Jeong JW, Park JU. Advanced Facial Rejuvenation: Synergistic Effects of Lower Blepharoplasty and Ultrasound Guided Mid-Face Lift Using Polydioxanone (PDO) Threads. Aesthetic Plast Surg 2024; 48:1706-1714. [PMID: 38519570 PMCID: PMC11093801 DOI: 10.1007/s00266-024-03975-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 02/27/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND Traditional facial aging surgeries have risks and extended recovery times, leading to a demand for minimally invasive alternatives. PDO (polydioxanone) threads, which are absorbable sutures that stimulate collagen production and tissue contraction, offer improved aesthetic outcomes. This paper evaluates the combined use of PDO thread mid-cheek lift and lower blepharoplasty for facial rejuvenation. METHODS This retrospective study compared outcomes in patients undergoing lower blepharoplasty combined with a mid-face lift using PDO threads versus those undergoing only lower blepharoplasty. Focused on individuals with baggy lower eyelids and pronounced nasolabial folds, outcome measures included the Modified Fitzpatrick wrinkle scale, Allergan® midface volume deficit scale, Width of inter zygomatic distance, Patient and Observer Scar Assessment Scale, and patient satisfaction questionnaires, assessed at baseline, 3 months, and 1 year postoperatively. RESULTS The combined procedure demonstrated superior aesthetic outcomes and higher patient satisfaction compared to lower blepharoplasty alone. Improvements were more significant in wrinkle reduction, midface volume, and inter-zygomatic distance in the combined procedure group. Although the combined procedure had a longer mean operation time, scar assessment scores were similar between both groups, with no complications reported. CONCLUSION The combination of lower blepharoplasty and mid-face lift using PDO threads is a comprehensive and effective approach for facial rejuvenation. It significantly enhances wrinkle reduction, mid-face lifting, and patient satisfaction. Ultrasound-guided thread lifting, a method of assessing and performing mid-face lifting, proves to be safe and efficient. This approach holds promise as a future option in cosmetic anti-aging surgery, presenting a minimally invasive alternative with natural-looking results and reduced downtime. LEVEL OF EVIDENCE II 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 https://link.springer.com/journal/00266 .
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Affiliation(s)
- Jun Ho Park
- Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, SMG-SNU Boramae Medical Center, 20 Boramae-ro 5-gil, Dongjak-gu, 07061, Republic of Korea
| | - Ji Won Jeong
- Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, SMG-SNU Boramae Medical Center, 20 Boramae-ro 5-gil, Dongjak-gu, 07061, Republic of Korea
| | - Ji-Ung Park
- Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, SMG-SNU Boramae Medical Center, 20 Boramae-ro 5-gil, Dongjak-gu, 07061, Republic of Korea.
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Tepavcevic B. Satisfaction of Patients and Surgeons with Combined Aptos Thread Lifting Treatment, Fat Grafting and Laser Treatment. Aesthetic Plast Surg 2024; 48:116-121. [PMID: 35882646 DOI: 10.1007/s00266-022-03019-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 07/04/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Measuring satisfaction with aesthetic treatment and health related quality of life of patients has become one of the indicators of the success of aesthetic interventions. Therefore, the aim of our study was to examine and compare the satisfaction of patients and surgeons with combined Aptos thread lifting treatment, fat grafting and laser treatment. METHODS In total, 48 patients underwent a combination Aptos thread lifting, fat grafting and laser treatment from August 2020 to august 2021. The outcome of treatment was assessed using the Global Scale of Aesthetic Improvement, both subjectively (patient satisfaction assessments) and objectively (blind surgeons assessments). RESULTS The study included 48 respondents, with an average age of 51.8 years, of whom 90% were women. The average intervention time was 66 min. Patient satisfaction was highest in the first month after treatment (mean, 4.7/5.0), and consequently tends to decline up to 1 year after treatment (3.8/5.0). The trend of the results on the objective assessment was stable during the entire follow-up period (4.5/5.0 after first month; 4.1/5.0 after one year). CONCLUSION Our results show what is the key period when the patient has a subjective need to request reintervention. The duty of the aesthetic physician is to help the patient understand and choose the most appropriate evidence-based rejuvenation treatment. LEVEL OF EVIDENCE IV Level of evidence IV Opinions of respected authorities, based on clinical experience, descriptive studies, or reports of expert committees. 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 Table of Contents or online Instructions to Authors www.springer.com/00266.
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Gallo L, Kim P, Yuan M, Gallo M, Thoma A, Voineskos SH, Cano SJ, Pusic AL, Klassen AF. Best Practices for FACE-Q Aesthetics Research: A Systematic Review of Study Methodology. Aesthet Surg J 2023; 43:NP674-NP686. [PMID: 37162009 DOI: 10.1093/asj/sjad141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/02/2023] [Accepted: 05/03/2023] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND The FACE-Q Aesthetics module is a validated patient-reported outcome measure (PROM) that evaluates perspectives on facial aesthetic treatments. Improper administration and poor study methodology can compromise the validity and interpretation of this PROM. OBJECTIVES This systematic review sought to evaluate the administration and scoring of the FACE-Q Aesthetics scales within the literature. METHODS A search of Ovid Medline, Embase, Cochrane, and Web of Science was performed on December 20, 2022, with the assistance of a health-research librarian (CRD42022383676). Studies that examined facial aesthetic interventions using the FACE-Q Aesthetics module as a primary or secondary outcome measure were included for analysis. RESULTS There were 114 studies included. The Face Overall (n = 52, 45.6%), Psychological (n = 45, 39.4%), and Social (n = 43, 37.7%) scales were most frequently reported. Errors in FACE-Q administration were identified in 30 (26.3%) studies. The most common error was the presentation of raw ordinal scores rather than the converted Q score (n = 23). Most studies reported a time horizon for their primary analysis (n = 76, 66.7%); however, only 4 studies provided a rationale for this selection. Sample size calculations for the primary outcome were rarely performed (n = 9, 7.9%). CONCLUSIONS There continues to be limitations in PROM administration and the quality of articles that report FACE-Q Aesthetic scale data. The authors suggest that future investigators using the FACE-Q refer to the User's Guide regarding administration and scoring of this scale, report a rationale for the study time horizon, and provide an a priori sample size calculation for the primary outcome of interest.
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Evaluation of a Plastic and Reconstructive Surgery Resident Non-surgical Cosmetic Clinic Experience. J Surg Res 2023; 287:33-39. [PMID: 36868121 DOI: 10.1016/j.jss.2022.12.006] [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: 03/01/2022] [Revised: 11/18/2022] [Accepted: 12/14/2022] [Indexed: 03/05/2023]
Abstract
INTRODUCTION An important component of plastic surgery residency training is independent cosmetic patient management. A resident cosmetic clinic was created at Oregon Health & Science University in 2007 to expand this experience. The cosmetic clinic has traditionally been most successful in offering nonsurgical facial rejuvenation with neuromodulators and soft tissue fillers. This study focuses on the demographics of the patient population and the treatments provided over a 5-year period and compares this experience to those of the same program's attending cosmetic clinics. METHODS A retrospective chart review of all patients seen at Oregon Health & Science University's Plastic and Reconstructive Surgery Resident Cosmetic Clinic between January 1, 2017, and December 31, 2021 was performed. Patient demographics, type of injectable received (neuromodulator versus soft tissue filler), location of injection, and additional cosmetic procedures were evaluated. RESULTS Two hundred patients met the study criteria, which included 114 seen in the resident clinic (RC), 31 seen in attending clinic (AC), and 55 patients seen in both. A primary analysis compared the two groups seen in the resident and attending only clinics. The average age of patients seen in the RC was younger, 45 versus 51.5 (P ≤ 0.05). There was a trend toward more patients in the RC being involved in healthcare as compared to those patients seen in the AC, but this difference was not found to be statistically significant. The median number of neuromodulator visits in the RC was 2 (1, 4) versus 1 (1, 2) in the AC (P ≤ 0.05) The most common location for neuromodulator injections in both clinics was the corrugators. CONCLUSIONS Patients in the resident cosmetic clinic were younger females, most receiving neuromodulator injections. No statistically significant differences were identified in patient population, injections received, and location of injections between the two clinics, indicating a similar trainee skill set and patient care plan between the two clinics.
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Clinical Use of Non-Suture Silk-Containing Products: A Systematic Review. Biomimetics (Basel) 2023; 8:biomimetics8010045. [PMID: 36810376 PMCID: PMC9944446 DOI: 10.3390/biomimetics8010045] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/09/2023] [Accepted: 01/11/2023] [Indexed: 01/20/2023] Open
Abstract
AIMS The purpose of this systematic review is to determine how various innovative non-suture silk and silk-containing products are being used in clinical practice, and compare patient outcomes following their use. METHODS A systematic review of PubMed, Web of Science, and Cochrane was completed. A qualitative synthesis of all included studies was then performed. RESULTS Our electronic search identified 868 silk-related publications, which yielded 32 studies for full-text review. After exclusion, nine studies from 2011 to 2018 were included for qualitative analysis. A total of 346 patients were included which consisted of 37 males and 309 females. The mean age range was between 18-79 years old. The follow-up among studies ranged between one to twenty-nine months. Three studies addressed the application of silk in wound dressings, one on the topical application of silk-derived products, one on silk-derived scaffold in breast reconstruction, and three on silk underwear as adjunct for the treatment of gynecological conditions. All studies showed good outcomes alone or in comparison to controls. CONCLUSION This systematic review concludes that silk products' structural, immune, and wound-healing modulating properties are advantageous clinical assets. Nevertheless, more studies are needed to strengthen and establish the benefit of those products.
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Pereira IN, Hassan H. Impact of botulinum toxin for facial aesthetics on psychological well-being and quality of life: Evidence-based review. J Plast Reconstr Aesthet Surg 2022; 75:4450-4463. [PMID: 36274011 DOI: 10.1016/j.bjps.2022.08.063] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 08/10/2022] [Accepted: 08/18/2022] [Indexed: 10/15/2022]
Abstract
BACKGROUND There has been a steady growth of non-surgical minimally invasive procedures. In parallel, an ever-broadening range of clinicians has been engaging with botulinum toxin (BoNT) for aesthetic procedures, with reportedly compound positive impact on social health and psychological well-being. OBJECTIVE To identify and critically appraise current literature on the impact of BoNT injections into the upper face, as a sole treatment/combination with other modalities on facial aesthetics, psychological well-being, and quality-of-life. METHODS An evidence-based review was performed using advanced search from PubMed, Cochrane Library of Systematic Reviews, and Central Register of Controlled Trials databases . Only literature from inception to August, 2021 were considered. Eligibility criteria included human studies, FDA-approved BoNT applications, formulations, and dosages as a sole/multimodal approach; studies including patient-reported outcome tools psychometrically validated and facial lines-specific. Observer-reported outcome instruments were also considered for a thorough evaluation of outcomes. RESULTS Based on data investigations and participant assessments, all studies showed statistically significant improvement in psychosocial well-being and quality-of-life domains with a trend for highest impact when multiple upper facial areas are treated in a multimodal approach. CONCLUSION Aesthetic BoNT showed links to true health benefits for well-selected patients in addition to physical amelioration. However, the biological rational remains ambiguous. Well-designed controlled trials are needed, without pharmaceutical laboratories bias, in real clinical scenarios of patients paying for the interventions, often involving multiple areas with/without combined treatments. The persistence of positive outcomes following repetitive treatments provided by less experienced practitioners, potentially involving suboptimal patient selection and/or aesthetic results, warrants further investigation.
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Affiliation(s)
- Ines Novo Pereira
- University of Porto, Faculty of Dental Medicine, R. Dr. Manuel Pereira da Silva, 4200-393, Portugal.
| | - Haidar Hassan
- Barts & The London School of Medicine & Dentistry, Queen Mary University, Centre for Cutaneous Research, Blizard Institute of Cell and Molecular Science, 4 Newark Street, Whitechapel, London E1 2AT, United Kingdom
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Ottenhof MJ, Veldhuizen IJ, Hensbergen LJV, Blankensteijn LL, Bramer W, Lei BV, Hoogbergen MM, Hulst RRWJ, Sidey-Gibbons CJ. The Use of the FACE-Q Aesthetic: A Narrative Review. Aesthetic Plast Surg 2022; 46:2769-2780. [PMID: 35764813 PMCID: PMC9729314 DOI: 10.1007/s00266-022-02974-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 05/25/2022] [Indexed: 01/01/2023]
Abstract
INTRODUCTION In the past decade there has been an increasing interest in the field of patient-reported outcome measures (PROMs) which are now commonly used alongside traditional outcome measures, such as morbidity and mortality. Since the FACE-Q Aesthetic development in 2010, it has been widely used in clinical practice and research, measuring the quality of life and patient satisfaction. It quantifies the impact and change across different aspects of cosmetic facial surgery and minimally invasive treatments. We review how researchers have utilized the FACE-Q Aesthetic module to date, and aim to understand better whether and how it has enhanced our understanding and practice of aesthetic facial procedures. METHODS We performed a systematic search of the literature. Publications that used the FACE-Q Aesthetic module to evaluate patient outcomes were included. Publications about the development of PROMs or modifications of the FACE-Q Aesthetic, translation or validation studies of the FACE-Q Aesthetic scales, papers not published in English, reviews, comments/discussions, or letters to the editor were excluded. RESULTS Our search produced 1189 different articles; 70 remained after applying in- and exclusion criteria. Significant findings and associations were further explored. The need for evidence-based patient-reported outcome caused a growing uptake of the FACE-Q Aesthetic in cosmetic surgery and dermatology an increasing amount of evidence concerning facelift surgery, botulinum toxin, rhinoplasty, soft tissue fillers, scar treatments, and experimental areas. DISCUSSION The FACE-Q Aesthetic has been used to contribute substantial evidence about the outcome from the patient perspective in cosmetic facial surgery and minimally invasive treatments. The FACE-Q Aesthetic holds great potential to improve quality of care and may fundamentally change the way we measure success in plastic surgery and dermatology. LEVEL OF EVIDENCE III 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)
- Maarten J Ottenhof
- Division of Plastic and Reconstructive Surgery, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA, 02115, USA.
- Department of Plastic and Reconstructive Surgery, Catharina Ziekenhuis, Eindhoven, The Netherlands.
- Department of Plastic and Reconstructive Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.
- Patient-Reported Outcomes, Value & Experience (PROVE) Center, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.
| | - Inge J Veldhuizen
- Department of Plastic and Reconstructive Surgery, Catharina Ziekenhuis, Eindhoven, The Netherlands
| | - Lusanne J V Hensbergen
- Department of Plastic and Reconstructive Surgery, Catharina Ziekenhuis, Eindhoven, The Netherlands
| | - Louise L Blankensteijn
- Department of Plastic and Reconstructive Surgery, Catharina Ziekenhuis, Eindhoven, The Netherlands
| | - Wichor Bramer
- Medical Library, Erasmus MC, Erasmus University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Berend Vd Lei
- Department of Plastic Surgery, University and University Medical School of Groningen and Bey Bergman Clinics, Groningen, The Netherlands
| | - Maarten M Hoogbergen
- Department of Plastic and Reconstructive Surgery, Catharina Ziekenhuis, Eindhoven, The Netherlands
| | - René R W J Hulst
- Department of Plastic and Reconstructive Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Chris J Sidey-Gibbons
- Patient-Reported Outcomes, Value & Experience (PROVE) Center, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA
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Hoffman L, Fabi S. Look Better, Feel Better, Live Better? The Impact of Minimally Invasive Aesthetic Procedures on Satisfaction with Appearance and Psychosocial Wellbeing. THE JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY 2022; 15:47-58. [PMID: 35642226 PMCID: PMC9122280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Patients pursue cosmetic procedures to improve physical appearance as well as self-esteem and confidence, which translates into better quality of life. As aesthetic providers, it is important to understand the improvement in quality of life that can be achieved from various aesthetic procedures, best measured by patient reported outcomes (PROs), such as the validated FACE-Q. OBJECTIVE This review summarizes FACE-Q outcomes after nonsurgical dermatological facial cosmetic procedures. METHODS A review of relevant clinical terms was performed on the PUBMED database. All abstracts were reviewed; articles were included based on relevancy; bibliographies of selected articles were reviewed; and supplemental articles were added accordingly. RESULTS The current literature has 31 articles using the FACE-Q to measure quality of life, focusing on satisfaction with appearance, psychological wellbeing, social wellbeing, age appraisal, and recovery early life impact (i.e. disruption of the procedure on daily life activities) after minimally invasive aesthetic facial procedures. Clinical studies focused on treatment with dermal fillers for mid-face rejuvenation, chin/lower-face enhancement, lip enhancement, botulinum toxin-A for glabellar lines, combined filler and botulinum toxin-A, and other. Nearly all FACE-Q domains improved following minimally invasive cosmetic procedures. Absolute changes in FACE-Q psychological wellbeing and age appraisal were greatest with combined treatments compared to single treatments. LIMITATIONS Limitations included varying follow-up times, lack of control groups, and publication bias for positive findings. CONCLUSION To maximize patient satisfaction and retention, providers should consider a combined treatment approach, to improve patient psychological wellbeing and age appraisal, and ultimately quality of life.
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Affiliation(s)
- Lauren Hoffman
- Dr. Hoffman is with the Albert Einstein College of Medicine and Montefiore Medical Center, Department of Medicine and the Division of Dermatology in Bronx, New York
| | - Sabrina Fabi
- Dr. Fabi is with the University of California, San Diego and Cosmetic Laser Dermatology in San Diego, California
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Kumar N, Parsa AD, Rahman E. A Systematic Review on the Current Trend In Nonsurgical Aesthetic Training for Knowledge, Skill, and Professional Identity Formation. Aesthet Surg J 2022; 42:1056-1063. [PMID: 35156685 DOI: 10.1093/asj/sjac020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Non-surgical aesthetics is a rapidly growing healthcare domain and lacks pedagogically sound education and training programs. The trainee physicians often participate in short courses which are outside of the scope of an existing postgraduate training program to acquire the necessary knowledge and procedural skills. However, such training programs lack values and interests that shape critical thinking and holistic decision-making, often referred to as professional identity. OBJECTIVES This systematic review aims to analyse current trends in non-surgical aesthetic clinical education to form knowledge, skills, and professional identity. METHODS A detailed literature search was conducted in nine databases; PubMed [United States National Library of Medicine (NLM), Bethesda, MD], Cochrane (Wiley, Hoboken, NJ), Centre for Reviews and Dissemination [(CRD) University of York, York, United Kingdom], and Google Scholar (Google, Mountain View, CA) for relevant studies published between January 2010 and December 2020, with an update in September 2021. RESULTS Fifty-five articles were identified through electronic searches, amongst which forty were selected following a review of the abstracts. Sixteen articles were identified as the best evidence for the detailed and iterative review based on their relevance and fit to the inclusion criteria. Unfortunately, none of the included studies designed their questionnaire based on the Kirkpatrick Model, which is best known for analysing and evaluating the results of training and educational programs. CONCLUSIONS This systematic review provides valuable insight into graduate professional identity formation and graduates' readiness for independent clinical practice. Therefore, particular consideration should be given to incorporating these triggers when developing evidence-based postgraduate curricula for non-surgical aesthetics.
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Affiliation(s)
- Narendra Kumar
- Division of Biosciences, Department of Cell and Developmental Biology, University College London, London, UK
| | - Ali Davod Parsa
- Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Cambridge, UK
| | - Eqram Rahman
- Department of Plastic and Reconstructive Surgery, Royal Free Hospital, Hampstead, London, UK
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Morris MP, Toyoda Y, Christopher AN, Broach RB, Percec I. A Systematic Review of Aesthetic Surgery Training Within Plastic Surgery Training Programs in the USA: An In-Depth Analysis and Practical Reference. Aesthetic Plast Surg 2022; 46:513-523. [PMID: 34467421 DOI: 10.1007/s00266-021-02557-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 08/22/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND The importance of aesthetic surgery exposure for plastic and reconstructive trainees has been recently validated by the expansion of case requirements for aesthetic procedures from 50 to 150, as well as resident-driven desire for increased cosmetic exposure throughout training. We aim to systematically review the literature at a national level to report on overall trends in aesthetic surgery training within PRS residencies. METHODS A literature search of PubMed, Embase, and Scopus identified all English articles published in the USA between 2000 and 2020, using a combination of "aesthetic surgery", "cosmetic surgery", "plastic surgery", "residency and internship", "education", and "training." RESULTS Our initial search resulted in 415 articles. After review of inclusion and exclusion criteria, in addition to cross-referencing, 41 studies remained, including 15 studies discussing resident and/or program director surveys, eight studies discussing teaching methods, sixteen studies discussing dedicated resident clinics, four studies discussing cosmetic/aesthetic fellowships, three studies discussing cosmetic practice patterns, and eleven studies discussing patient outcomes. CONCLUSION Current literature demonstrates that there are gaps in aesthetic surgery training for PRS residents in the USA, including facial and neck surgeries and non-surgical interventions. Resident clinics have clear benefits for resident education, without sacrificing patient outcomes. Residency programs should consider the development of a resident cosmetic clinic and/or dedicated cosmetic center to increase surgical exposure and increase trainee comfort in providing this subset of procedures. Published literature is limited in consistency of methods of evaluation, and further in-depth analysis of case volume and diversity at training programs within the USA and internationally is indicated. LEVEL OF EVIDENCE III 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)
- Martin P Morris
- Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, 3400 Civic Center Boulevard, South Pavilion, 14th Floor, Philadelphia, PA, 19104, USA
| | - Yoshiko Toyoda
- Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, 3400 Civic Center Boulevard, South Pavilion, 14th Floor, Philadelphia, PA, 19104, USA
| | - Adrienne N Christopher
- Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, 3400 Civic Center Boulevard, South Pavilion, 14th Floor, Philadelphia, PA, 19104, USA
- Department of Surgery, Thomas Jefferson University, Philadelphia, PA, USA
| | - Robyn B Broach
- Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, 3400 Civic Center Boulevard, South Pavilion, 14th Floor, Philadelphia, PA, 19104, USA
| | - Ivona Percec
- Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, 3400 Civic Center Boulevard, South Pavilion, 14th Floor, Philadelphia, PA, 19104, USA.
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Abstract
The demand for minimally invasive cosmetic procedures is rising, and the public and other physicians deem dermatologists as top providers of these services. Given these expectations, dermatologic residency training must equip resident physician trainees to care for the growing population of patients with aesthetic concerns. As stands, formal hands-on cosmetic dermatology training in residency is lacking specific structure. Educational, cultural, time, and monetary barriers exist, among others, which restrict residents from attaining proficiency in cosmetic dermatology procedures prior to graduation. This may adversely impact patient safety and deter graduates from offering aesthetic procedures. The standardization of core residency competencies in minimally invasive cosmetic procedures is fundamental to guarantee patient safety and satisfaction while ensuring practitioner competence. The balance between these elements is essential for optimal patient care. We review and debate for modifying and strengthening the current curriculum requirements while presenting means to overcome barriers.
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Affiliation(s)
- Elizabeth J Kream
- Department of Dermatology, University of Illinois at Chicago, College of Medicine, Chicago, Illinois, USA
| | - Virginia A Jones
- Department of Dermatology, University of Illinois at Chicago, College of Medicine, Chicago, Illinois, USA
| | - Maria M Tsoukas
- Department of Dermatology, University of Illinois at Chicago, College of Medicine, Chicago, Illinois, USA.
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Impact of Minimally Invasive Aesthetic Procedures on the Psychological and Social Dimensions of Health. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2021; 9:e3578. [PMID: 33936919 PMCID: PMC8081460 DOI: 10.1097/gox.0000000000003578] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 02/05/2021] [Indexed: 11/26/2022]
Abstract
Background: The impact on psychosocial health of injectable facial treatments such as hyaluronic acid fillers and botulinum toxin type A remains poorly defined. The aim of this study was to measure changes in psychosocial health following aesthetic intervention with injectables in routine clinical practice using the validated FACE-Q patient-reported outcome measure. Methods: This was a prospective assessment of patients presenting at a single center for the first time for aesthetic treatment of the face with injectables in February 2020. Participants completed 3 FACE-Q scales at the baseline and again 2 weeks posttreatment: Psychological Function; Social Function; and Appearance-related Psychosocial Distress. Results: Complete data were available for 35 individuals (n = 32 women [91%]; mean age: 45.9 ± 13.8 years). Twenty-nine (83%) were treated with hyaluronic acid filler (mean: 2.3 ± 1.3 syringes), and 12 (34%) received onabotulinumtoxinA (mean: 2.0 ± 0.7 areas of the upper face). There were significant improvements on each FACE-Q scale posttreatment: mean change in Psychological Function score was +12.4 [95% CI: 7.9, 16.9; P < 0.001; standardized effect size by Cohen’s d: 0.93]; mean change in Social Function score was +7.9 (95% CI: 3.3, 12.5; P = 0.001; effect size: 0.50); and mean change in Appearance-related Psychosocial Distress score was –20.9 (95% CI: –27.4, –14.3; P < 0.001; effect size: 1.27). Conclusions: Aesthetic treatment with injectables was associated with significant improvements in patient-reported psychological and social functioning and reductions in appearance-related distress. This change underlines the value of these therapies for improving psychosocial health in well-selected patients.
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Kumar N, Rahman E. Global Needs-Assessment for a Postgraduate Program on Nonsurgical Facial Aesthetics. Aesthet Surg J 2021; 41:501-510. [PMID: 32090239 DOI: 10.1093/asj/sjaa054] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Standardizing training and education in nonsurgical facial aesthetic procedures during residency training has long been challenging because majority of the procedures are performed outside the usual teaching hospital settings. Several areas of refinement have been suggested and an increased need for more hands-on training identified in the available literature. Despite the growing demand for nonsurgical facial aesthetics (NSFA), it is yet to be fully integrated into standard postgraduate medical or surgical curriculum. OBJECTIVES The objective of this study was to explore the current state and the need for medical education and training of aesthetic clinicians across specialties in a formal postgraduate curriculum. METHODS A mixed-method, cross-sectional, online research was conducted among physicians involved in training and practicing NSFA between July 2018 and December 2018. Focus group discussion was conducted to ensure the face and content validity of the survey items. RESULTS The total responses collected in the trainer's group was 179 and 496 in the trainee's group. The majority of trainers (95%) and trainees (93.8%) across specialties expressed their opinion for the need of a standard postgraduate course in NSFA. Moreover, more than 55% of them felt that 12 months, with a work-based, blended learning approach, would be most suitable for training and education. CONCLUSIONS The survey results have underlined the need for specialized training in NSFA to enable clinicians to pursue independent practice with confidence. The authors recommend the inclusion of evidence-based postgraduate programs on NSFA in higher academic institutions as per their educational curriculum.
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Affiliation(s)
- Narendra Kumar
- Faculty of Health, Education, Medicine, and Social Care, Anglia Ruskin University, Chelmsford, United Kingdom
| | - Eqram Rahman
- Division of Surgical and Interventional Science, University College London, London, United Kingdom
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15
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Xie Y, Brenner MJ, Sand JP, Desai SC, Drumheller CM, Roberson DW, Nussenbaum B, Kienstra MA. Adverse events in facial plastic surgery: Data-driven insights into systems, standards, and self-assessment. Am J Otolaryngol 2021; 42:102792. [PMID: 33160176 DOI: 10.1016/j.amjoto.2020.102792] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 10/17/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE Complications in facial plastic surgery can lead to pain, suffering, and permanent harm. Yet, the etiology and outcomes of adverse events are understudied. This study aims to determine the etiology and outcomes of adverse events reported in aesthetic facial plastic surgery and identify quality improvement opportunities. MATERIAL AND METHODS A cross-sectional survey analysis was conducted using an anonymous 22-item questionnaire distributed to members of the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) and American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS). Participants were queried on demographics, practice type, and adverse events related to aesthetic facial surgeries. RESULTS Two hundred fifty-three individuals participated; nearly half of respondents (49.0%) held membership in both AAO-HNS and AAFPRS. Of these, 40.8% of respondents reported at least one adverse event within the past 12 months of practice. A total of 194 adverse events were reported, most commonly related to facelift (n = 59/194, 30.4%), rhinoplasty (n = 55/194, 28.4%), and injection procedures (n = 38/194, 19.6%), with hematoma or seroma being the most commonly described. Most adverse events were self-limited, but approximately 68% resulted in further procedures. Surgeon error or poor judgement (n = 42) and patient non-adherence (n = 18) were the most commonly ascribed reasons for adverse events; 37.1% of participants reported a change in clinical practice after the incident. CONCLUSIONS Adverse events were not infrequent in facial plastic surgery. Understanding these adverse events can provide impetus for tracking outcomes, standardization, and engagement with lifelong learning, self-assessment, and evaluation of practice performance.
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Harrison LM, Shapiro R, Johnson RM. Tissue Modification in Nonsurgical Facelift Options. Facial Plast Surg 2020; 36:688-695. [PMID: 33368123 DOI: 10.1055/s-0040-1721115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Nonsurgical facelifts are a term for a heterogeneous group of procedures used by physicians to improve facial rejuvenation without the use of operative techniques. Patients demand these services due to the reduced recovery time and generally lower risk. However, nonsurgical techniques, to be effective, must induce conformational change in the cells and tissues of the face. Therefore, these techniques are significant procedures that have associated risks. Understanding the tissue modifications and mechanisms of action of these techniques is vital to their safe and effective use. The purpose of this article is to provide a background of tissue modification in nonsurgical facelift options.
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Affiliation(s)
- Lucas M Harrison
- Department of Plastic Surgery, Wright State University, Dayton, Ohio
| | - Ryan Shapiro
- Department of Plastic Surgery, Wright State University, Dayton, Ohio
| | - R Michael Johnson
- Department of Plastic Surgery, Wright State University, Dayton, Ohio
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17
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Al-halabi B, Hazan J, Safran T, Gilardino MS. The Role of Resident-Run Clinics for Aesthetic Surgery Training in the Context of Competency-based Plastic Surgery Education. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2020; 8:e2766. [PMID: 32440433 PMCID: PMC7209860 DOI: 10.1097/gox.0000000000002766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 02/12/2020] [Indexed: 11/25/2022]
Abstract
Resident-run clinics (RRCs) have been suggested as a clinical teaching tool to improve resident exposure in aesthetic plastic surgery education. In exchange for reduced cost aesthetic services, RRCs offer trainees the opportunity to assess, plan, execute, and follow surgical procedures in an independent yet supervised manner. With the transition into a competency-based medical education model involving a switch away from a time-based into a milestones-based model, the role of RRCs, within the context of the evolving plastic surgery curriculum has yet to be determined. To that end, the present study summarizes current models of aesthetic surgery training and assesses RRCs as an adjunct to aesthetics education within the framework of competency-based medical education. Explored themes include advantages and issues of RRCs including surgical autonomy, feasibility, exposure, learners' perception, ethics, and quality improvement. In addition, attention is focused on their role in cognitive competency acquisition and exposure to non-surgical techniques. RRCs are considered an effective educational model that provides an autonomous learning platform with reasonable patient satisfaction and safety profiles.
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Affiliation(s)
- Becher Al-halabi
- Division of Plastic and Reconstructive Surgery, McGill University Health Centre, Montreal, Canada
| | - Jessica Hazan
- Division of Plastic and Reconstructive Surgery, McGill University Health Centre, Montreal, Canada
| | - Tyler Safran
- Division of Plastic and Reconstructive Surgery, McGill University Health Centre, Montreal, Canada
| | - Mirko S. Gilardino
- Division of Plastic and Reconstructive Surgery, McGill University Health Centre, Montreal, Canada
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Bustillo AMB, Lobato RC, Luitgards BF, Camargo CP, Gemperli R, Ishida LC. Translation, Cross-Cultural Adaptation and Linguistic Validation of the FACE-Q Questionnaire for Brazilian Portuguese. Aesthetic Plast Surg 2019; 43:930-937. [PMID: 31089752 DOI: 10.1007/s00266-019-01399-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 05/06/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Patient-reported outcomes measurement instruments (PRO) are a good way to measure results after aesthetic procedures. FACE-Q is a systematized and standardized PRO tool and was not available in Portuguese. METHODS This cross-sectional study included four stages: translation of FACE-Q, backtranslation, testing in patients who underwent facial aesthetic procedures and review of the questionnaires between September and December, 2018. Guidelines merging WHO and ISPOR's rules were followed. RESULTS Translation was conducted by two translators, resulting in two versions, translation A and translation B, which were reconciled to generate the first Portuguese version. Reconciliation showed inconsistencies between TA and TB in 63% (n = 222) of the 353 questions, which were solved by maintaining TA in 25% of cases (n = 87), TB in 27% and a new version in 11% (n = 40) of the questions. Backtranslation showed written differences with the original FACE-Q in 64 (22.7%) of the 353 question, but only one case of semantic difference, which was corrected resulting in production of the second Portuguese version. Seven patients with a mean age of 35.8 years were interviewed to assess the difficulty in understanding the questionnaires. Four patients had no or minor difficulties understanding the questionnaire, and the other three had difficulties and suggested changes that led to a third Portuguese version. The third version was reviewed for grammar and spelling resulting in the final Portuguese version. CONCLUSION A Brazilian Portuguese version of the FACE-Q questionnaire was obtained maintaining equivalency with the source instrument. This will allow cross-cultural research and comparison of results between different studies. 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)
| | - Rodolfo Costa Lobato
- Plastic Surgery Division, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
- , São Paulo, Brazil.
| | - Bruno Ferreira Luitgards
- Plastic Surgery Division, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Cristina Pires Camargo
- Plastic Surgery Division, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Rolf Gemperli
- Plastic Surgery Division, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Luiz Carlos Ishida
- Plastic Surgery Division, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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A Systematic Review of Patient-Reported Outcomes for Cosmetic Indications of Botulinum Toxin Treatment. Dermatol Surg 2019; 45:668-688. [DOI: 10.1097/dss.0000000000001878] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Kalantar-Hormozi A, Shahrokh S, Abbaszadeh-Kasbi A, Rita Davai N. Prefabricated Skin Excision in Face Lift: A Simplified Technique. World J Plast Surg 2019; 8:62-68. [PMID: 30873364 PMCID: PMC6409139 DOI: 10.29252/wjps.8.1.62] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The demand for facial plastic surgery has dramatically been increased in recent years. Over the last decade, numerous methods have been improved for facelift surgery. Despite these modifications, skin excision technique has not changed significantly. In this study, authors have tried to introduce a new technique regarding skin excision at the initial step of facelift surgery. METHODS A prospective study from 2012 to 2017 on 52 patients was carried out to apply a new technique for facelift ‘’Prefabricated skin excision method’’ for all eligible patients undergoing facelift surgery. The skin calling for excision was marked by the surgeon, and then, an analgesic drug was administered. Then, excision of the marked part of the skin was performed and afterward the dissection of the superficial musculoaponeurotic system (SMAS) was performed with the direct exposure. RESULTS All patients were female, and 50 (96.1%) cases were primary face lift and 2 (3.9%) cases were secondary. There were no complications among the patients. CONCLUSION Facilitating the manipulation of deep layer, using this technique led to the further exposure of the surgical site, and more preferable hemostasis was achieved as well.
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Affiliation(s)
- Abdoljalil Kalantar-Hormozi
- Department of Plastic and Craniofacial Surgery, 15 Khordad Hospital, Medical College, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soraya Shahrokh
- Department of Plastic and Craniofacial Surgery, Modarres Hospital, Medical College, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Mori S, Lee E. Beyond the physician's perspective: A review of patient-reported outcomes in dermatologic surgery and cosmetic dermatology. Int J Womens Dermatol 2019; 5:21-26. [PMID: 30809575 PMCID: PMC6374698 DOI: 10.1016/j.ijwd.2018.08.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 08/01/2018] [Accepted: 08/01/2018] [Indexed: 12/26/2022] Open
Abstract
Patient-reported outcome measures (PROMs) are utilized in health care to quantify the patient's perspective of a health condition or treatment on outcomes, such as health-related quality of life (HRQoL) and patient satisfaction. In dermatology, this is particularly relevant because the patient's perspective is critical in evaluating the outcome of cosmetic procedures as well as skin cancer treatment. We review seven validated PROMs that have been reported in the dermatologic surgery and cosmetic dermatology literature. For patients undergoing cosmetic procedures, the use of PROMs provides additional valuable outcome data beyond physician assessment. For patients with skin cancer, women experience a unique and often greater impact on HRQoL during treatment, which has been captured through PROMs. The recent development of multi-module instruments, such as the FACE-Q and FACE-Q Skin Cancer, have facilitated comprehensive assessments of treatment that impact multiple domains of HRQoL. The use of PROMs allows for dermatologists to reliably capture important disease- and treatment-related concerns, thus improving the patient experience.
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Affiliation(s)
| | - E.H. Lee
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, New York
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22
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David JA, Rifkin WJ, Saadeh PB, Sinno S. Assessing the Value of a Multimedia-Based Aesthetic Curriculum in Plastic Surgery Residency: A Single-Center Pilot Study. Aesthet Surg J 2018; 38:NP216-NP224. [PMID: 29733345 DOI: 10.1093/asj/sjy110] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Although global demand for cosmetic surgery continues to rise, plastic surgery residents feel that current models of aesthetic training are inadequate in preparing them for future practice. Digital learning resources offer promising educational possibilities, yet there are no formal studies investigating the integration of these technologies into the aesthetic curriculum. OBJECTIVES Here, we review the current state of aesthetic training for plastic surgery residents and present a pilot study investigating the value of a dedicated multimedia-based aesthetic curriculum at a single, large academic program. METHODS Twenty plastic surgery residents participated in an 8-week curriculum consisting of weekly multimedia-based modules covering a specific aesthetic topic. Participants completed pre- and post-intervention surveys at 0 and 10 weeks, respectively. Surveys evaluated resident perspectives of the current state of aesthetic training, confidence in performing surgical and non-surgical aesthetic procedures, perceived efficacy of multimedia interventions for learning, and preferences for inclusion of such approaches in future curricula. RESULTS 16.7% of participants planned on entering an aesthetic fellowship following residency. The mean number of months of dedicated cosmetic surgery rotations was 1.65 months. Resident confidence level in performing a particular aesthetic procedure significantly increased in 6/14 modules. More than 90% of residents were interested in incorporating the modules into residency. CONCLUSIONS Technology-based aesthetic training is critical for producing the finest future practitioners and leaders of this specialty. Here, we show that plastic surgery residents can benefit from a multimedia-based aesthetic curriculum, even if they do not plan on pursuing a career devoted to cosmetic surgery.
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Affiliation(s)
- Joshua A David
- Chief of Plastic Surgery Service, Bellevue Hospital Center New York University Langone Health, New York, NY
- Director of the Plastic Surgery Residency Program, New York University Langone Health, New York, NY Hansjörg Wyss Department of Plastic and Reconstructive Surgery, New York University Langone Health, New York, NY
| | - William J Rifkin
- Chief of Plastic Surgery Service, Bellevue Hospital Center New York University Langone Health, New York, NY
- Director of the Plastic Surgery Residency Program, New York University Langone Health, New York, NY Hansjörg Wyss Department of Plastic and Reconstructive Surgery, New York University Langone Health, New York, NY
| | - Pierre B Saadeh
- Chief of Plastic Surgery Service, Bellevue Hospital Center New York University Langone Health, New York, NY
- Director of the Plastic Surgery Residency Program, New York University Langone Health, New York, NY Hansjörg Wyss Department of Plastic and Reconstructive Surgery, New York University Langone Health, New York, NY
| | - Sammy Sinno
- Plastic surgeon in private practice in Chicago, IL
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23
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Mitkov MV, Thomas CS, Cochuyt JJ, Forte AJ, Perdikis G. Simulation: An Effective Method of Teaching Cosmetic Botulinum Toxin Injection Technique. Aesthet Surg J 2018; 38:NP207-NP212. [PMID: 29982282 DOI: 10.1093/asj/sjy159] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Learning to inject botulinum toxin for cosmetic purposes is difficult for beginners, given the nature of the procedure and patient population. Simulation training is an effective modality for medical professionals to acquire skills in an environment that provides low stress and ample opportunity for questions and correction of mistakes. OBJECTIVES Compare posttraining comfort, knowledge, and practical botulinum toxin injection scores among trainees who underwent simulation vs video training only. METHODS A total of 20 nurse practitioners, physician assistants, and resident physicians underwent cosmetic botulinum toxin injection training either through lecture and video, or lecture and hands-on simulation training. Comfort, knowledge, and practical test scores were recorded and compared between the groups. RESULTS There was no evidence of a statistically significant difference in comfort or knowledge scores between simulation and video groups. The median (range) practical score was significantly higher in the simulation group compared to the video group (59.0 [31-60] vs 44.5 [27-57]; P < 0.01). CONCLUSIONS Despite feeling similarly comfortable and having similar written knowledge test scores, the trainees who underwent simulation training had significantly higher hands-on practical test scores compared to trainees who underwent video training only for cosmetic botulinum toxin injections.
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Affiliation(s)
- Mario V Mitkov
- Department of Dermatology, Mayo Clinic, Jacksonville, FL
| | - Colleen S Thomas
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Jacksonville, FL
| | - Jordan J Cochuyt
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Jacksonville, FL
| | | | - Galen Perdikis
- Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, TN
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24
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Ingargiola MJ, Molina Burbano F, Yao A, Motakef S, Sanati-Mehrizy P, Burish NM, David LR, Taub PJ. Plastic Surgery Resident-Run Cosmetic Clinics: A Survey of Current Practices. Aesthet Surg J 2018; 38:793-799. [PMID: 29548007 DOI: 10.1093/asj/sjy065] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The recently increased minimum aesthetic surgery requirements set by the Plastic Surgery Residency Review Committee of the Accreditation Council for Graduate Medical Education highlight the importance of aesthetic surgery training for plastic surgery residents. Participation in resident aesthetic surgery clinics has become an important tool to achieve this goal. Yet, there is little literature on the current structure of these clinics. OBJECTIVES The authors sought to evaluate current practices of aesthetic resident-run clinics in the United States. METHODS A survey examining specific aspects of chief resident clinics was distributed to 70 plastic surgery resident program directors in the United States. Thirty-five questions sought to delineate clinic structure, procedures and services offered, financial cost to the patient, and satisfaction and educational benefit derived from the experience. RESULTS Fifty-two questionnaires were returned, representing 74.2% of programs surveyed. Thirty-two (63%) reported having a dedicated resident aesthetic surgery clinic at their institution. The most common procedures performed were abdominoplasty (n = 20), breast augmentation (n = 19), and liposuction (n = 16). Most clinics offered neuromodulators (n = 29) and injectable fillers (n = 29). The most common billing method used was a 50% discount on surgeon fee, with the patient being responsible for the entirety of hospital and anesthesia fees. Twenty-six respondents reported feeling satisfied or very satisfied with their resident aesthetic clinic. CONCLUSIONS The authors found aesthetic chief resident clinics to differ greatly in their structure. Yet the variety of procedures and services offered makes participation in these clinics an effective training method for the development of both aesthetic surgical technique and resident autonomy.
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Affiliation(s)
- Michael J Ingargiola
- Division of Plastic and Reconstructive Surgery, Mount Sinai Hospital, New York, NY
| | | | - Amy Yao
- Icahn School of Medicine, Mount Sinai Hospital, New York, NY
| | - Saba Motakef
- Department of Plastic Surgery, Loma Linda University, Loma Linda, CA
| | | | - Nikki M Burish
- Division of Plastic and Reconstructive Surgery, Mount Sinai Hospital, New York, NY
| | | | - Peter J Taub
- Division of Plastic and Reconstructive Surgery, Mount Sinai Hospital, New York, NY
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