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Hohenberger R, Endres P, Salzmann I, Plinkert PK, Wallner F, Baumann I, Alt J, Riedel F, Lippert BM, Bulut OC. Quality of Life and Screening on Body Dysmorphic Disorder, Depression, Anxiety in Septorhinoplasty. Laryngoscope 2024; 134:2187-2193. [PMID: 38050954 DOI: 10.1002/lary.31212] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 10/10/2023] [Accepted: 11/21/2023] [Indexed: 12/07/2023]
Abstract
OBJECTIVES Septorhinoplasty (SRPL) can improve quality of life (QoL) in functional and aesthetical aspects of the nose. A key factor compromising postoperative satisfaction is symptoms of body dysmorphic disorder (BDD), defined by excessive concerns and distress over slight or imagined physical defects. Although a high prevalence of BDD in SRPL patients is evident, the effect of positive screening on BDD and other psychiatric disorders is understudied. It was hypothesized that patients screening positive for BDD, depression or anxiety do not show increased postoperative QoL. METHODS A multicenter, prospective study including 259 patients. For psychiatric evaluation, the BDD concern questionnaire-aesthetic version and the Hospital Anxiety and Depression Scale were used; for disease-specific QoL the Rhinoplasty Outcomes Evaluation (ROE) and the Functional Rhinoplasty Outcome Inventory (FROI-17). RESULTS In preoperative evaluation, 32.5% had a positive screening for BDD, 42.2% for increased anxiety, and 32.9% for depression. Mean QoL improved in the whole cohort (FROI total score: 54.4 ± 21.8 to 32.8 ± 23.7 and ROE: 32.3 ± 15.6 to 69.8 ± 23.1, both p < 0.001). Patients screening positive for BDD, depression or anxiety did show an increased postoperative QoL, but to a significantly lower degree and with lower pre- and postoperative QoL levels. CONCLUSIONS SRPL patients show a high prevalence of BDD symptoms, elevated anxiety, and depression. These subgroups show lower QoL levels and an impaired QoL increase after surgery. Rhinoplasty surgeons must be aware of the disorders and their symptoms, discuss potential concerns with the patients, and potentially refer them to a specialist. LEVEL OF EVIDENCE 3 Laryngoscope, 134:2187-2193, 2024.
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Affiliation(s)
- Ralph Hohenberger
- Department of Otorhinolaryngology, Head and Neck Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Philipp Endres
- Department of Otorhinolaryngology, Head and Neck Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Irina Salzmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Peter K Plinkert
- Department of Otorhinolaryngology, Head and Neck Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Frank Wallner
- Department of Otorhinolaryngology, Head and Neck Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Ingo Baumann
- Department of Otorhinolaryngology, Head and Neck Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Janes Alt
- Department of Otorhinolaryngology, Head and Neck Surgery, SLK Kliniken, Heilbronn, Germany
| | | | - Burkard M Lippert
- Department of Otorhinolaryngology, Head and Neck Surgery, SLK Kliniken, Heilbronn, Germany
| | - Olcay Cem Bulut
- Department of Otorhinolaryngology, Head and Neck Surgery, Heidelberg University Hospital, Heidelberg, Germany
- Department of Otorhinolaryngology, Head and Neck Surgery, SLK Kliniken, Heilbronn, Germany
- HNO-Zentrum Rhein-Neckar, Mannheim, Germany
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Moosaie F, Javankiani S, Mansournia MA, Rahavi S, Najeeb ZJ, Mohammadi S, Saedi B. Comparison of Aesthetic and Functional Rhinoplasty Outcomes Between Patients with Body Dysmorphic Disorder and Normal Individuals. Aesthetic Plast Surg 2024:10.1007/s00266-024-03961-y. [PMID: 38575764 DOI: 10.1007/s00266-024-03961-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: 01/11/2024] [Accepted: 02/16/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Rhinoplasty is among the top five most popular cosmetic surgical procedures worldwide. Among rhinoplasty candidates, the most common mental health disorder is body dysmorphic disorder. (BDD). The present study aimed to assess the prevalence of BDD among rhinoplasty candidates, its association with the patient's self-assessment of aesthetic outcome and nasal functional, post-rhinoplasty compared to applicants with negative screening for BDD. METHODS The following study is a cross-sectional, comparative study. Out of the 209 rhinoplasty candidates screened by the BDDQ questionnaire, 39 were positive for BDD. From the remaining 170 patients who screened negative for BDD, 39 participants were randomly selected as the control group for the comparative analysis. Rhinoplasty outcome evaluation (ROE) and standardized cosmesis and health nasal outcomes survey-cosmetic (SCHNOS-C) questionnaires were used for assessment of patient satisfaction with the cosmetic outcome of rhinoplasty. Nasal obstruction symptom evaluation (NOSE) and standardized cosmesis and health nasal outcomes survey-obstruction (SCHNOS-O) were used for the assessment of satisfaction with functional outcomes between groups of patients screened positive and negative for BDD. RESULTS The prevalence of BDD was 18.66% among rhinoplasty candidates. The average age of patients screened positive for BDD was 31.41. The mean ROE score was significantly lower (i.e. lower satisfaction) in patients screened positive for BDD (15.69 versus 19.08, P = 0.001), regardless of confounding variables, such as age, sex, and marital status. SCHNOS-C score was higher (i.e. less satisfaction) among patients with BDD (47.01 versus 34.96, P = 0.021) and was significantly associated with higher odds of severe aesthetic concern post-rhinoplasty (OR (95%CI) = 5.000 (1.135-22.022), P = 0.033). Patients screened positive for BDD had significantly higher NOSE scores (i.e. less satisfaction with functional outcome) compared to participants negative for BDD (49.74 versus 37.82, P = 0.012). SCHNOS-O score had no significant association with BDD (P = 0.053). Furthermore, there was no significant association between BDD and NOSE or SCHNOS-O score after adjustment for the confounders. CONCLUSION Patients screened positive for BDD were significantly less satisfied with the cosmetic outcome of the rhinoplasty compared to those screened negative for BDD. Assessment of BDD among rhinoplasty candidates before surgery, could potentially be beneficial for both patients and surgeons. 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)
- Fatemeh Moosaie
- Otolaryngology Department, Tehran University of Medical Sciences, Tehran, Iran
- International Surgical Research Association (ISRA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
- Psychosomatic medicine research center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Dr. Qarib St, Keshavarz Blvd, Tehran, 1419733141, Iran
| | - Sepide Javankiani
- Otolaryngology Department, Tehran University of Medical Sciences, Tehran, Iran
- International Surgical Research Association (ISRA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Rahavi
- Otolaryngology Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Zainab Julia Najeeb
- International Surgical Research Association (ISRA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Sara Mohammadi
- Otolaryngology Department, Tehran University of Medical Sciences, Tehran, Iran
- International Surgical Research Association (ISRA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Babak Saedi
- Otolaryngology Department, Tehran University of Medical Sciences, Tehran, Iran.
- Psychosomatic medicine research center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Dr. Qarib St, Keshavarz Blvd, Tehran, 1419733141, Iran.
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Hohenberger R, Baumann I, Riedel F, Plinkert PK, Bulut OC. Impact of Psychiatric Symptoms on Nasal Perception in Septorhinoplasty Patients. Facial Plast Surg 2024. [PMID: 38196074 DOI: 10.1055/a-2240-8943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024] Open
Abstract
Psychological assessment plays a crucial role in the preoperative phase of septorhinoplasty (SRPL), exerting potential influence on both pre- and postoperative aspects of quality of life (QoL). In this prospective study, SRPL patients were systematically screened using two validated questionnaires for body dysmorphic disorder (BDD) and one each for anxiety, depression, and somatic symptom disorder (SSD). Nasal perception was evaluated utilizing two disease-specific, self-report instruments: The Rhinoplasty Outcomes Evaluation (ROE) and the Functional Rhinoplasty Outcome Inventory-17 (FROI-17). A total of 95 patients were enrolled. Positive screening rates were 40.4 and 28.3% for BDD, 37.3% for elevated anxiety, 16.4% for depression, and 22.4% for SSD. Mean scores on the ROE and FROI indicated lower QoL in all positive screening groups. Statistically significant differences were observed for anxiety (FROI total score: 47.1 ± 14.6 to 37.8 ± 16.2; p = 0.021) and BDD (ROE: 43.7 ± 15.7 to 32.5 ± 15.5; p = 0.003 and FROI total score: 47.4 ± 15.3 to 37.8 ± 17.1; p = 0.014). The Hospital Anxiety and Depression Scale exhibited a significant correlation with the preoperative FROI score (r = 0.34, p = 0.005). Patients with positive screenings for depression, anxiety, BDD, and SSD demonstrated compromised QoL during preoperative assessments compared with their negative counterparts, reflecting diminished nasal perception in both esthetic and functional dimensions. Surgeons must be cognizant of these psychological aspects during preoperative evaluations.
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Affiliation(s)
- Ralph Hohenberger
- Department of Otorhinolaryngology, Head and Neck Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Ingo Baumann
- Department of Otorhinolaryngology, Head and Neck Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Peter K Plinkert
- Department of Otorhinolaryngology, Head and Neck Surgery, Heidelberg University Hospital, Heidelberg, Germany
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Mandavia R, Parmar D, Ahmed MN, Berber V, Sanz D, Paulucci B, D'Souza AR. An Overview of Rhinoplasty Practices: European Academy of Facial Plastic Surgery, Collaborative Cross-Sectional Study. Facial Plast Surg 2024; 40:31-35. [PMID: 36787791 DOI: 10.1055/a-2034-8397] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
This collaborative European Academy of Plastic Surgery (EAFPS) study aimed to provide an overview of rhinoplasty practices, informing clinician and patient decision making. It is a multicenter cross-sectional study, reported as per Strengthening the Reporting of Observational Studies in Epidemiology guidelines. All EAFPS members were contacted via email, inviting them to participate. Members expressing an interest to participate were asked to anonymously complete a questionnaire, related to rhinoplasties that they performed as first/supervising surgeon over a period from January 1, 2019 to January 1, 2022. A descriptive analysis was performed. One hundred and fifteen surgeons submitted data on 41,259 rhinoplasties from 33 countries. Eighty percent of rhinoplasties were primary, and 20% were secondary. Thirty five percent of primary rhinoplasties were closed and 65% were open. Thirty one percent of primary rhinoplasties were for cosmetic indications, 11% functional and 58% were for both. Of the 8147 secondary rhinoplasties, 44% were closed and 56% were open. Thirty percent were for cosmetic indications, 11% functional, and 59% for both cosmetic and functional. Ninety-one percent of rhinoplasties were performed by ENT surgeons, 3% by plastic surgeons, 5% by maxillofacial surgeons, and 1% were dual (maxillofacial and ENT) trained. One-thousand seven-hundred thirty primary rhinoplasties underwent revision surgery (5%) and 102 secondary rhinoplasties underwent revision surgery (1%). The most commonly reported indications for revision surgery were dorsal asymmetry, nasal blockage, and dissatisfaction with nasal tip. Three percent of rhinoplasties underwent preoperative psychological assessment. To the authors knowledge, this is the largest published rhinoplasty dataset. This study provides an overview of rhinoplasty practices that can be used for benchmarking and to guide clinician and patient decision making. Psychological assessment of prerhinoplasty appears insufficient with higher levels recommended to minimize unsuccessful outcomes. This study showcases the power of collaborative research and may serve as a catalyst for future collaborative facial plastic surgery research.
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Affiliation(s)
- R Mandavia
- Department of ENT, Head and Neck Surgery, University College London Hospitals, NHS Trust, London, United Kingdom
| | - D Parmar
- Bedfordshire Hospitals NHS Foundation Trust, Luton, United Kingdom
| | - M N Ahmed
- Queen Elizabeth Hospital, Birmingham, United Kingdom
| | - V Berber
- Department of Otolaryngology, Ege University, Izmir, Turkey
| | - D Sanz
- Miguel Servet University Hospital, Zaragoza, Spain
| | - B Paulucci
- Royal Free NHS Trust, London, United Kingdom
| | - A R D'Souza
- Department of Otolaryngology, Lewisham and Greenwich NHS Trust UK, London, United Kingdom
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Blough CL, Kuschner SH, Berihun H, Tseng CC, Kulber DA. Carpal Tunnel Syndrome: As Seen from the Perspective of the Patient. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e5146. [PMID: 37483890 PMCID: PMC10358804 DOI: 10.1097/gox.0000000000005146] [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: 04/04/2023] [Accepted: 06/12/2023] [Indexed: 07/25/2023]
Abstract
Carpal tunnel syndrome (CTS) is the most common nerve compression syndrome in the upper extremity and is one of the most common problems treated by hand surgeons. Despite its ubiquity-or perhaps because of it-there is a lack of unanimity regarding how best to treat CTS and what the options for treatment are. This study aimed to explore what patients find important when deciding on treatment of CTS in an effort to improve the physician-patient shared decision-making process. Methods An online crowdsourcing platform was used to recruit participants for this study. Study participants were first led through a clinical scenario in which the symptoms of CTS were explained. They were then asked a series of questions regarding what was important to them when deciding upon treatment. A Likert scale was used for responses. Results In total, 268 participant responses were included in the study. A majority of patients responded that all surveyed factors were either very important or important when considering treatment. The risk of surgery was most important, whereas postoperative pain was least important. The risk of surgery was significantly more important to patients than postoperative pain and time out of work. The cost of surgery was significantly more important to patients than postoperative pain. Conclusions Given the lack of consensus regarding an algorithm for the treatment of CTS, the patient's preference is increasingly important when formulating a treatment plan. The results of this study may better help physicians frame the discussion of treatment options for CTS with their patients.
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Affiliation(s)
- Christian L. Blough
- From the Department of Orthopaedic Surgery, Cedars-Sinai Medical Center, Los Angeles, Calif
| | - Stuart H. Kuschner
- From the Department of Orthopaedic Surgery, Cedars-Sinai Medical Center, Los Angeles, Calif
| | - Haben Berihun
- From the Department of Orthopaedic Surgery, Cedars-Sinai Medical Center, Los Angeles, Calif
| | - Cassie C. Tseng
- The Department of Outpatient Rehabilitation, Cedars-Sinai Medical Center, Los Angeles, Calif
| | - David A. Kulber
- From the Department of Orthopaedic Surgery, Cedars-Sinai Medical Center, Los Angeles, Calif
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Dattilo LW, Workman AD, Xiao R, Shaye DA, Lee LN, Lindsay RW, Bhattacharyya N. Rhinoplasty Patients Do Not Have Higher Rates of Antidepressant, Anxiolytic, and ADHD Medication Use. Laryngoscope 2022; 132:2368-2369. [PMID: 35218561 DOI: 10.1002/lary.30075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/04/2022] [Accepted: 02/13/2022] [Indexed: 12/16/2022]
Affiliation(s)
- Lillian W Dattilo
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Otolaryngology, Massachusetts Eye & Ear, Boston, Massachusetts, USA
| | - Alan D Workman
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Otolaryngology, Massachusetts Eye & Ear, Boston, Massachusetts, USA
| | - Roy Xiao
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Otolaryngology, Massachusetts Eye & Ear, Boston, Massachusetts, USA
| | - David A Shaye
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Otolaryngology, Massachusetts Eye & Ear, Boston, Massachusetts, USA
| | - Linda N Lee
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Otolaryngology, Massachusetts Eye & Ear, Boston, Massachusetts, USA
| | - Robin W Lindsay
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Otolaryngology, Massachusetts Eye & Ear, Boston, Massachusetts, USA
| | - Neil Bhattacharyya
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Otolaryngology, Massachusetts Eye & Ear, Boston, Massachusetts, USA
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Kelly JD, Comstock B, Shauly O, Smartt JM, Gould DJ. Validation of Ideal Breast Characteristics With Breast Augmentation Patients. Aesthet Surg J Open Forum 2022; 4:ojac010. [PMID: 35274097 PMCID: PMC8905333 DOI: 10.1093/asjof/ojac010] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background Breast augmentation procedures are one of the most commonly performed aesthetic procedures in the United States. Little work has focused on the general public's overall perception of the ideal breast or has validated them with patient photographs. Objectives To validate crowdsourced perceptions of breasts with their alignment to the aesthetics of breast augmentation patients. Methods A prospective cross-sectional study was performed using participants enrolled through the AmazonMechanical Turk crowdsourcing platform (Amazon Web Services, Amazon, Seattle, WA) to obtain participant opinions ofhow closely patient breasts aligned with previously obtained results of 4 ideal breast characteristics. Outcomes were reported based on the correlation between breast attractiveness and alignment to ideal breast characteristics, both before and after breast implant procedures. Results 2306 responses from 737 participants reported patient photograph alignment with ideal breast projection proportion (1.0) as having the highest correlation to opinions of heightened aesthetic beauty (R = 0.98, P < 0.001), and ideal nipple direction (front) as having the lowest correlation to aesthetic beauty (R = 0.90, P < 0.001). Younger age groups (18-24) and participants with a high school diploma or less rated patients as less attractive, while married and wealthy individuals reported higher attraction levels. Conclusions Crowdsourcing can be a useful tool for aesthetic surgery preferences and has helped reveal key takeaways. The importance of the 4 breast characteristics has been validated, with alignment to all 4 characteristics tested having a high correlation to preferences. Differences in preference across demographic groups are a topic to further investigate.
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Affiliation(s)
- Jason D Kelly
- Corresponding Author: Dr Jason D. Kelly, 16 Hull Street Apt 3, Boston, MA 02113, USA. E-mail:
| | | | - Orr Shauly
- Division of Plastic and Reconstructive Surgery, Emory University School of Medicine, Emory University, Atlanta, GA, USA
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Kelly JD, Comstock B, Shauly O, Smartt JM, Gould DJ. Public Perception of Ideal Breast Shape. Aesthet Surg J Open Forum 2021; 4:ojab049. [PMID: 35072071 PMCID: PMC8781772 DOI: 10.1093/asjof/ojab049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND In the past decade, there has been a dramatic increase in trends related to body-shaping procedures. According to the American Society of Plastic Surgeons, nearly 300,000 breast augmentation procedures were conducted in 2019. Learning the ideal shape of a breast and which esthetics lead to public perception of the most attractive breast is beneficial to properly performing these procedures. OBJECTIVES The authors aimed to quantify the public's perception of attraction to breast shape by measuring public opinion for various esthetic elements of breast anatomy and linking this to various demographic factors. METHODS Survey responses were collected from 1000 users of Amazon Mechanical Turk to collect demographic data and ask users to rank preferences for randomized image panels of breast proportions. RESULTS 960 responses were used for analysis. A majority of respondents were male (60%), with a plurality being 25 to 34 years old (49.3%). The most notable preferences between all groups were breast projection proportion and nipple direction, with preferences of 1.0 and frontal nipple direction, respectively. Breast width to shoulder width ratio also had a clear preference among the crowd, with 105% being the preferred percentage, and the 25 to 34 age group having a very strong preference for this. CONCLUSIONS The authors used a crowdsourcing survey technique with randomized image panels to analyze ideal breast preference using images of various anatomical traits of the female breast. It was concluded that crowdsourcing can be a favorable technique for learning ideal overall preferences for specific anatomy.
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Affiliation(s)
- Jason D Kelly
- Corresponding Author: Dr Jason D. Kelly, 16 Hull Street Apt 3, Boston, MA 02113, USA. E-mail:
| | | | - Orr Shauly
- Division of Plastic and Reconstructive Surgery, Emory University School of Medicine, Emory University, Atlanta, GA, USA
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Hemal K, Cignetti NE, Newsom MR, David LR. Consumer Awareness and Comfort with Resident-run Cosmetic Clinics: A Crowdsourcing Study. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2021; 9:e3681. [PMID: 34262841 PMCID: PMC8274800 DOI: 10.1097/gox.0000000000003681] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 05/13/2021] [Indexed: 11/25/2022]
Abstract
Background: Resident cosmetic clinics (RCCs) are the training modality of choice among both residents and faculty and are a mainstay at most residency programs.1–4 Despite this, knowledge of RCCs among plastic surgery consumers remains untested. We hypothesize that the public would be aware of and receptive to RCCs. Methods: Participants with prior cosmetic procedures or interest in future cosmetic procedures were recruited using Amazon Mechanical Turk and asked to complete a survey in September 2020. First, prior awareness of RCCs was assessed. After a brief description of RCCs, perceptions of safety and preferences for care were assessed. Results: After screening for quality, 815 responses were included. Forty-five percent of consumers were aware of RCCs. Seventy-six percent of consumers believed that RCCs were just as safe as attending clinics and 65% were comfortable receiving care from fourth-year residents or higher. Belief in RCC safety was associated with 4.8 times higher odds of feeling comfortable receiving care at an RCC [95% confidence interval (3.3–7.1), P < 0.001]. When given a hypothetical choice between residents and attendings in two scenarios, 46% of consumers chose residents for abdominoplasty and 60% chose residents for Botox injections. Belief in RCC safety was associated with choosing a resident or being indifferent in both scenarios. Conclusions: Consumer preference regarding RCCs has largely been untested. This study shows that belief in RCC safety influences consumers’ perceived comfort with receiving care at an RCC. This knowledge can help guide RCC practice and maximize learning opportunities for surgeons-in-training.
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Affiliation(s)
| | | | | | - Lisa R David
- Department of Plastic and Reconstructive Surgery, Wake Forest Baptist Medical Center, Winston Salem, N.C
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Factors Involved in the Decision of Iranian Men to Undergo Rhinoplasty: A Grounded Theory Study. Plast Surg Nurs 2021; 41:86-94. [PMID: 34033632 DOI: 10.1097/psn.0000000000000366] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Undergoing a rhinoplasty can affect an individual's mental health either positively or negatively, depending upon how he or she perceives the results. Because of the impact that rhinoplasty may have on an individual's mental health and the cost of this surgery, it is important to understand the reasons that men decide to undergo rhinoplasty and the challenges they face when making the decision to have a rhinoplasty. Using a grounded theory method, we collected data by conducting interviews with 20 participants. We analyzed the data and initially obtained 684 initial codes. After we removed duplicate codes and carefully analyzed participants' interviews, a total of 497 codes remained. We developed these codes into 10 main categories and 32 subcategories. We found that the causal factors affecting the decision of Iranian men to undergo rhinoplasty included the following 5 categories: a lack of confidence; a desire to improve their appearance; a desire for attention from others; a need to keep up with the Joneses (i.e., a desire to show that one is as good as other people by getting what others have and doing what others do); and persuasion by others. Intervening factors affecting the decision of Iranian men to undergo rhinoplasty included the following 4 categories: family challenge; social atmosphere; financial problems; and unwanted consequences. Iranian men make the decision to undergo rhinoplasty by overcoming and ignoring these intervening factors. The primary variable in participants' decision to undergo rhinoplasty was the desire to improve their appearance.
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