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Lim B, Seth I, Cuomo R, Kenney PS, Ross RJ, Sofiadellis F, Pentangelo P, Ceccaroni A, Alfano C, Rozen WM. Can AI Answer My Questions? Utilizing Artificial Intelligence in the Perioperative Assessment for Abdominoplasty Patients. Aesthetic Plast Surg 2024:10.1007/s00266-024-04157-0. [PMID: 38898239 DOI: 10.1007/s00266-024-04157-0] [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: 03/23/2024] [Accepted: 05/21/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND Abdominoplasty is a common operation, used for a range of cosmetic and functional issues, often in the context of divarication of recti, significant weight loss, and after pregnancy. Despite this, patient-surgeon communication gaps can hinder informed decision-making. The integration of large language models (LLMs) in healthcare offers potential for enhancing patient information. This study evaluated the feasibility of using LLMs for answering perioperative queries. METHODS This study assessed the efficacy of four leading LLMs-OpenAI's ChatGPT-3.5, Anthropic's Claude, Google's Gemini, and Bing's CoPilot-using fifteen unique prompts. All outputs were evaluated using the Flesch-Kincaid, Flesch Reading Ease score, and Coleman-Liau index for readability assessment. The DISCERN score and a Likert scale were utilized to evaluate quality. Scores were assigned by two plastic surgical residents and then reviewed and discussed until a consensus was reached by five plastic surgeon specialists. RESULTS ChatGPT-3.5 required the highest level for comprehension, followed by Gemini, Claude, then CoPilot. Claude provided the most appropriate and actionable advice. In terms of patient-friendliness, CoPilot outperformed the rest, enhancing engagement and information comprehensiveness. ChatGPT-3.5 and Gemini offered adequate, though unremarkable, advice, employing more professional language. CoPilot uniquely included visual aids and was the only model to use hyperlinks, although they were not very helpful and acceptable, and it faced limitations in responding to certain queries. CONCLUSION ChatGPT-3.5, Gemini, Claude, and Bing's CoPilot showcased differences in readability and reliability. LLMs offer unique advantages for patient care but require careful selection. Future research should integrate LLM strengths and address weaknesses for optimal patient education. 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)
- Bryan Lim
- Department of Plastic Surgery, Peninsula Health, Melbourne, Victoria, 3199, Australia
| | - Ishith Seth
- Department of Plastic Surgery, Peninsula Health, Melbourne, Victoria, 3199, Australia
| | - Roberto Cuomo
- Plastic Surgery Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy.
| | - Peter Sinkjær Kenney
- Department of Plastic Surgery, Velje Hospital, Beriderbakken 4, 7100, Vejle, Denmark
- Department of Plastic and Breast Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Richard J Ross
- Department of Plastic Surgery, Peninsula Health, Melbourne, Victoria, 3199, Australia
| | - Foti Sofiadellis
- Department of Plastic Surgery, Peninsula Health, Melbourne, Victoria, 3199, Australia
| | | | | | | | - Warren Matthew Rozen
- Department of Plastic Surgery, Peninsula Health, Melbourne, Victoria, 3199, Australia
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Berkane Y, Saget F, Lupon E, Mocquard C, Pluvy I, Watier E, Lellouch AG, Duisit J, Chaput B, Bertheuil N. Abdominoplasty and Lower Body Lift Surgery Improves the Quality of Life after Massive Weight Loss: A Prospective Multicenter Study. Plast Reconstr Surg 2024; 153:1101e-1110e. [PMID: 37189244 DOI: 10.1097/prs.0000000000010683] [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: 05/17/2023]
Abstract
BACKGROUND This study was conducted to assess the impact of abdominoplasty and lower body lift surgery following massive weight loss on both the general quality of life and the sexual life of patients. METHODS The authors performed a multicenter prospective study on the quality of life after massive weight loss using three scoring questionnaires: The Short-Form 36 questionnaire, the Female Sexual Function Index questionnaire, and the Moorehead-Ardelt Quality of Life Questionnaire. Seventy-two patients who underwent lower body lift and 57 patients who underwent abdominoplasty in three centers with preoperative and postoperative evaluation were included. RESULTS The mean age of the patients was 43.2 ± 13.2 years. All categories of the Medical Outcomes Study Short-Form 36 Health Status Survey questionnaire were statistically significant at 6 months, and all categories except health change were significantly improved at 12 months postoperatively. Overall, the Moorehead-Ardelt questionnaire showed a higher quality of life in general (1.78 ± 0.92 and 1.64 ± 1.03 at 6 and 12 months, respectively) and in all domains (ie, self-esteem, physical activity, social relationships, work performance, and sexual activity). Interestingly, global sexual activity improved at 6 months but not at 12 months. Some domains of sexual life improved at 6 months (ie, desire, arousal, lubrication, satisfaction), but only desire remained improved at 12 months. CONCLUSIONS Abdominoplasty and lower body lift improve the quality of life of patients after massive weight loss and the sexual quality of life. This should be an additional valid reason for promoting reconstructive surgery for massive weight loss patients. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, IV.
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Affiliation(s)
- Yanis Berkane
- From the Department of Plastic, Reconstructive, and Aesthetic Surgery, Hôpital Sud
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, and Shriners Children Boston
- Harvard Medical School
| | - François Saget
- From the Department of Plastic, Reconstructive, and Aesthetic Surgery, Hôpital Sud
| | - Elise Lupon
- Department of Plastic, Reconstructive, and Aesthetic Surgery, CHU de Nice, Côte d'Azur University
| | - Camille Mocquard
- From the Department of Plastic, Reconstructive, and Aesthetic Surgery, Hôpital Sud
- INSERM U1236, University of Rennes 1
- SITI Laboratory, Rennes University Hospital
| | - Isabelle Pluvy
- Department of Plastic, Reconstructive, and Aesthetic Surgery, CHU de Besancon, Franche-Comté University
| | - Eric Watier
- From the Department of Plastic, Reconstructive, and Aesthetic Surgery, Hôpital Sud
| | - Alexandre G Lellouch
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, and Shriners Children Boston
- Harvard Medical School
| | - Jérôme Duisit
- From the Department of Plastic, Reconstructive, and Aesthetic Surgery, Hôpital Sud
| | - Benoit Chaput
- Department of Plastic, Reconstructive, and Aesthetic Surgery, Rangueil Hospital, Paul Sabatier University
| | - Nicolas Bertheuil
- From the Department of Plastic, Reconstructive, and Aesthetic Surgery, Hôpital Sud
- INSERM U1236, University of Rennes 1
- SITI Laboratory, Rennes University Hospital
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Monteiro IA, de Sousa Barros A, Costa-Ferreira A. Postbariatric Abdominoplasty: A Comparative Study on Scarpa Fascia Preservation Versus Classical Technique. Aesthetic Plast Surg 2023; 47:2511-2524. [PMID: 37365309 DOI: 10.1007/s00266-023-03455-3] [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: 04/21/2023] [Accepted: 05/27/2023] [Indexed: 06/28/2023]
Abstract
BACKGROUND Abdominoplasties performed with Scarpa Fascia preservation, improve recovery and reduce complications, particularly seroma. Bariatric patients who experience massive weight loss frequently seek body contouring procedures and represent a high-risk group. This study aimed to evaluate the effects of abdominoplasty with Scarpa Fascia preservation versus the classical technique in a bariatric population. METHODS A retrospective observational cohort study was performed between March 2015 and March 2021 in 65 postbariatric patients who underwent a classic full abdominoplasty (group A, N = 25) or a similar procedure except for the preservation of Scarpa fascia (group B, N = 40). Total and daily drain output, time until drain removal, long drainers (≥ 6 days), length of hospital stay, emergency department visit, readmission to the hospital, reoperation, local and systemic complications were the outcomes evaluated. RESULTS Group B had a 3-day reduction in time until drain removal (p < 0.001), a 62.6% reduction of total drain output (p < 0.001) and a 3-day reduction in the length of the hospital stay (p < 0.001). Long drainers (≥ 6 days) were highly reduced (from 56.0% in group A to 7.5% in group B) (p < 0.001). There was a lower incidence of liquid collections in group B, with a 66.7% reduction in seroma incidence. CONCLUSIONS Abdominoplasty with Scarpa Fascia preservation improves recovery by reducing drain output, allowing earlier drain removal and reducing long periods with suction drains. It also reduces hospital stay and seroma incidence. This technique modifies the high-risk postbariatric patient in such a major way that he behaves like a nonbariatric. 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 www.springer.com/00266 .
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Affiliation(s)
- Inês Araújo Monteiro
- Department of Surgery and Physiology, Faculty of Medicine, Porto University, Porto, Portugal.
| | - António de Sousa Barros
- Department of Surgery and Physiology, Faculty of Medicine, Porto University, Porto, Portugal
- Cardiovascular Research and Development Center (UnIC@RISE), Porto, Portugal
| | - António Costa-Ferreira
- Department of Surgery and Physiology, Faculty of Medicine, Porto University, Porto, Portugal
- Cardiovascular Research and Development Center (UnIC@RISE), Porto, Portugal
- Department of Plastic, Reconstructive and Aesthetic Surgery, São João University Hospital, Porto, Portugal
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Peng C, Yang F, Yu J, Peng L, Zhang C, Chen C, Lin Z, Li Y, He J, Jin Z. Machine Learning Prediction Algorithm for In-Hospital Mortality following Body Contouring. Plast Reconstr Surg 2023; 152:1103e-1113e. [PMID: 36940163 DOI: 10.1097/prs.0000000000010436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2023]
Abstract
BACKGROUND Body contouring is a common procedure, but it is worth attention because of concern for a variety of complications, and even the potential for death. As a result, the purpose of this study was to determine the key predictors following body contouring and create models for the risk of mortality using diverse machine learning (ML) models. METHODS The National Inpatient Sample database from 2015 to 2017 was queried to identify patients undergoing body contouring. Candidate predictors, such as demographics, comorbidities, personal history, postoperative complications, and operative features, were included. The outcome was in-hospital mortality. Models were compared by area under the curve, accuracy, sensitivity, specificity, positive and negative predictive values, and decision curve analysis. RESULTS Overall, 8214 patients undergoing body contouring were identified, among whom 141 (1.72%) died in the hospital. Variable importance plot demonstrated that sepsis was the variable with greatest importance across all ML algorithms, followed by Elixhauser Comorbidity Index, cardiac arrest, and so forth. The naive Bayes model had a higher predictive performance (area under the curve, 0.898; 95% CI, 0.884 to 0.911) among these eight ML models. Similarly, in the decision curve analysis, the naive Bayes model also demonstrated a higher net benefit (ie, the correct classification of in-hospital deaths considering a tradeoff between false-negatives and false-positives) compared with the other seven models across a range of threshold probability values. CONCLUSION The ML models, as indicated by this study, can be used to predict in-hospital death for patients at risk who undergo body contouring.
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Affiliation(s)
- Chi Peng
- From the Department of Health Statistics, Second Military Medical University
| | - Fan Yang
- Departments of Plastic Surgery and Burns
| | - Jian Yu
- From the Department of Health Statistics, Second Military Medical University
| | - Liwei Peng
- Neurosurgery, Tangdu Hospital, Fourth Military Medical University
| | - Chenxu Zhang
- From the Department of Health Statistics, Second Military Medical University
| | - Chenxin Chen
- From the Department of Health Statistics, Second Military Medical University
| | - Zhen Lin
- From the Department of Health Statistics, Second Military Medical University
| | - Yuejun Li
- Departments of Plastic Surgery and Burns
| | - Jia He
- From the Department of Health Statistics, Second Military Medical University
| | - Zhichao Jin
- From the Department of Health Statistics, Second Military Medical University
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Firriolo JM, Truong AK, Charvet HJ. Abdominoplasty in the Presence of a Stoma for Functional and Aesthetic Indications. Aesthet Surg J Open Forum 2023; 5:ojad009. [PMID: 36860683 PMCID: PMC9969733 DOI: 10.1093/asjof/ojad009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Background Abdominoplasty is widely available; however, patients with abdominal stomas appear to be relatively undertreated. Apprehension to offer abdominoplasty in the presence of a stoma may be secondary to the fear of surgical site infection and stoma compromise. Objectives To demonstrate the feasibility and safety of abdominoplasty in the presence of an abdominal stoma for both functional and aesthetic indications and to define perioperative protocols to reduce the risk of surgical site infection in this patient population. Methods The authors present 2 patients with stomas who underwent abdominoplasty. Patient 1 was a 62-year-old female with a history of urostomy formation and weight loss. She had a fold of skin overhanging her ostomy site, making it difficult to maintain a seal on her urostomy bag. She underwent fleur-de-lis abdominoplasty and urostomy revision. Patient 2 was a 43-year-old female with a history of end ileostomy formation, who requested cosmetic abdominoplasty to address postpartum abdominal changes; she had no functional stoma-related complaints. Abdominoplasty, flank liposuction, and ileostomy revision were performed. Results Both patients were satisfied with their aesthetic and functional outcomes. There were no complications and no instances of stoma compromise. At follow-up, Patient 1 reported a complete amelioration of her urosotomy appliance issues. Conclusions Abdominoplasty may confer both functional and aesthetic benefits to patients with abdominal stomas. The authors present peri- and intraoperative protocols, both to prevent stoma compromise and to reduce the risk of surgical site infection. The presence of a stoma does not appear to be an absolute contraindication to cosmetic abdominoplasty. Level of Evidence 5
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Affiliation(s)
- Joseph M Firriolo
- Division of Plastic and Reconstructive Surgery, University of California Davis, Sacramento, CA, USA
| | - Ashley K Truong
- Division of Plastic and Reconstructive Surgery, University of California Davis, Sacramento, CA, USA
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Quality of Life Improvement Following Blepharoplasty: A Prospective Study. J Craniofac Surg 2022; 34:888-892. [PMID: 36397205 DOI: 10.1097/scs.0000000000009119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 08/08/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Our previous retrospective study indicates that esthetic surgery in general results in a significant improvement in Quality of life (QoL). This is the first indication-specific prospective evaluation of QoL after blepharoplasty using standardized and validated questionnaires. OBJECTIVES To report changes in QoL after blepharoplasty prospectively with a 6-month follow-up. METHODS The same surgical team performed an esthetic blepharoplasty on 50 patients. Participants answered 1 set of questionnaires preoperatively and 6 months postoperatively. The instrument consisted of a self-developed indication-specific part specially designed for blepharoplasty and 4 validated and standardized testing instruments (FLZ, FPI-R, RSES, and PHQ-4) with norm data for German-speaking countries available. RESULTS This study reveals a high rate of satisfaction after blepharoplasty. 96% felt better about themselves and 94% would undergo the procedure again. Statistically significant increased values were found postoperatively in the items "income" ( P =0.016), "family life" ( P =0.028), "partner relationship" ( P =0.039), "ability to relax" ( P <0.001), "energy" ( P <0.001), "hobbies" ( P <0.001), and with their outer appearance in general ( P =0.018). Blepharoplasty showed a statistically significant improvement in emotional stability ( P =0.017) and a reduction in depressive symptoms ( P <0.001). Our patients had statistically significantly higher self-esteem before ( P <0.001) and after ( P <0.001) the intervention. CONCLUSION Our prospective study shows that blepharoplasty increases most aspects of QoL significantly, has a positive effect on emotional and physical well-being, and reduces the incidence of depressive symptoms and anxiety.
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Kazeminia M, Salari N, Heydari M, Akbari H, Mohammadi M. The effect of cosmetic surgery on self-esteem and body image: a systematic review and meta-analysis of clinical trial studies. EUROPEAN JOURNAL OF PLASTIC SURGERY 2022. [DOI: 10.1007/s00238-022-01987-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Comparison of Frequency of Body Deformity Disorder in Women Applicants of Abdominoplasty with Applications of Other Plastic Surgery Clinic. World J Plast Surg 2022; 11:101-195. [PMID: 36117888 PMCID: PMC9446113 DOI: 10.52547/wjps.11.2.95] [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: 03/14/2021] [Accepted: 09/02/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Body Dysmorphic Disorder (BDD) is a psychic disorder in which a person is dissatisfied with their normal appearance. Identifying these people among the applicants for cosmetic surgery leads to the proper decision about the cosmetic procedure of these patients and their postoperative consequences. METHODS This cross-sectional study was performed on 250 women referred to a private Plastic Surgery Clinic in Mashhad, Iran from 2016 to 2017. Applicants were divided into two groups as abdominoplasty and other cosmetic surgeries. BDD was assessed using the modified form of the Bill Brown Questionnaire. Applicants’ information including age, marital status, number of children, education level, and history of cosmetic surgeries were recorded. RESULTS The mean BDD score in the abdominoplasty group and another group was 93.6 ± 23.5 and 75.5 ± 25.8, respectively. There was a significant difference between the two groups in terms of the BDD score (P-value < 0.001). Although there was a notable relation between BDD score and marital status, no significant association between BDD score, age, and education level was found. CONCLUSION Considering the exact criteria of BDD, we noticed a significant increase in the frequency of BDD in abdominoplasty applicants. It was erroneous and could be explained by not applying the accurate diagnostic criteria of BDD.
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Wu Y, Mulkens S, Alleva JM. Body image and acceptance of cosmetic surgery in China and the Netherlands: A qualitative study on cultural differences and similarities. Body Image 2022; 40:30-49. [PMID: 34801810 DOI: 10.1016/j.bodyim.2021.10.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 08/19/2021] [Accepted: 10/19/2021] [Indexed: 10/19/2022]
Abstract
There is an established relationship between acceptance of cosmetic surgery and psychological factors, including body image. However, qualitative research among diverse cultural groups is needed to provide a more fine-grained understanding of the influences on women's attitudes towards cosmetic surgery. In this study, 20 Chinese and 20 Dutch women aged 18-50 years (MChinese = 34.20; MDutch = 34.70) participated in one-on-one semi-structured interviews. Data were analyzed using reflexive thematic analysis. We identified three themes that captured the factors that women perceived to foster favorable attitudes towards cosmetic surgery: (a) sociocultural pressures (e.g., normalization of cosmetic surgery, appearance-focused peers); (b) intrapersonal characteristics (e.g., beauty-ideal internalization, social comparison); and (c) benefits of beauty (e.g., attracting men, socioeconomic benefits). Conversely, two themes captured the factors perceived to reduce favorable attitudes towards cosmetic surgery: (a) intrapersonal characteristics (e.g., unconditional body acceptance, self-confidence); and (b) external considerations (e.g., health risks, financial costs). Overall, Chinese and Dutch participants shared many similarities in their opinions about what might affect cosmetic surgery consideration. The most striking cross-cultural differences concerned perceived socioeconomic benefits of beauty (mainly Chinese women) and women's conceptualization of body appreciation. This study may enable a more comprehensive understanding about the factors influencing Chinese and Dutch women's attitudes towards cosmetic surgery, and the nuances in these relationships across these cultures.
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Affiliation(s)
- Yi Wu
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands.
| | - Sandra Mulkens
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands; Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine, and Life Sciences; School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Jessica M Alleva
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands
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Slater K, Ajjikuttira AA. Is simultaneous panniculectomy an ideal approach to repair a ventral hernia: a general surgeon's experience. Hernia 2021; 26:139-147. [PMID: 34392437 DOI: 10.1007/s10029-021-02483-9] [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: 03/19/2021] [Accepted: 07/20/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND The number of Australian patients undergoing ventral hernia repair has seen a significant increase in the last twenty years. With the obesity epidemic, the general surgeon is frequently seeing patients with hernias and significant abdominal aprons and is being asked to address this at the time of the hernia repair. This can be performed utilising a general surgery and plastic surgery team, but there may be some advantages to general surgeon being able incorporate this into their practice. We present our approach to patients undergoing ventral hernia repair and simultaneous panniculectomy (VHR + PAN) by a single general surgeon. METHODS Data were analysed from a single surgeon's experience performing VHR + PAN at the same operation. Data were collected prospectively from 2009 to 2020. 146 cases of patients undergoing VHR + PAN were identified and included in this study. RESULTS The mean age of patients undergoing VHR + PAN was 58 years. The mean BMI was 35, with 59% of patients losing weight loss prior to surgery. 66% of patients had a hernia repair with biosynthetic mesh and 91% of patients had retro-rectus or pre-peritoneal mesh approach to the repair. 42% of patients had a post-operative complication with 80.6% of these being related to surgical-site occurrences. Other complications included gastrointestinal (14%), respiratory (13%) and venous thromboembolism, such as a deep vein thrombus or pulmonary embolism (6%). There were 2 deaths in the series (1.3%). The hernia recurrence rate was 6%. CONCLUSION Simultaneous PAN is possible in patients with an abdominal apron who are undergoing VHR, with an acceptable risk of SSOs and other complications. This technique provides excellent exposure and with appropriate training is well within the remit of the general surgeon. This may save further operative management in the future and can offer patients improved self-esteem, mobility, and independence. Patient optimisation is key, paying careful attention to pre-operative weight loss, diabetic control, smoking cessation and respiratory function. VHR + PAN is an important technique that should be in the repertoire of all abdominal wall reconstruction units.
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Affiliation(s)
- K Slater
- Department of Hepato-Pancreato-Biliary Surgery, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, Brisbane, QLD, 4102, Australia.
- Department of Hepatic and Biliary Surgery, Greenslopes Private Hospital, Brisbane, QLD, Australia.
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Edmondson SJ, Ross DA. The postpartum abdomen: psychology, surgery and quality of life. Hernia 2021; 25:939-950. [PMID: 34309770 DOI: 10.1007/s10029-021-02470-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 07/16/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE The postpartum abdomen presents significant challenges to the surgeon. It is anatomically complex, with often substantial symptomatic divarication of the rectus abdominis, affecting all anterior abdominal wall layers. This may lead to profound functional sequelae, and often, of more importance to patients, a significant physical deformity. The complex interplay of functional/physical symptoms can result in reduced quality of life (QoL) as well as negative body image/self-esteem. Postpartum women may seek abdominoplasty to address the whole scope of these concerns. Whilst techniques have evolved achieving such goals operatively, the impact of such surgery on QoL/mental health has yet to be established. METHODS We perform a comprehensive review of potential options of validated patient-reported outcome measures (PROMs) for consideration of use in postpartum women seeking abdominoplasty; in addition to discussing current driving factors for seeking surgery and associated ethics. RESULTS Pressure on postpartum women to return their abdominal wall contour to a pre-pregnant state is high. This poses important ethical considerations for surgeons. There are several well-established/validated PROMs used in body contouring in massive weight loss/bariatric population groups, including Body-Q and Body-QoL scales, but none yet specific to postpartum women. CONCLUSION PROMs use to enable establishment of the true value of abdominoplasty in postpartum women, not just in terms of functional/physical restoration, but also in terms of delivering a positive impact on patients' mental health and QoL, are important. Further research is needed to determine if those already developed are appropriate or whether a postpartum-specific PROM would be beneficial.
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Affiliation(s)
- S-J Edmondson
- Plastic and Reconstructive Surgery Department, The London Clinic, 20 Devonshire Place, London, W1G 6BW, England.
| | - D A Ross
- Plastic and Reconstructive Surgery Department, The London Clinic, 20 Devonshire Place, London, W1G 6BW, England
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Papadopulos NA, Ehrenberger B, Zavlin D, Lellé JD, Henrich G, Kovacs L, Herschbach P, Machens HG, Schaff J. Quality of Life and Satisfaction in Transgender Men After Phalloplasty in a Retrospective Study. Ann Plast Surg 2021; 87:91-97. [PMID: 33661220 DOI: 10.1097/sap.0000000000002693] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Partly as a result of the increasing attention directed toward transgender individuals and despite much research work on the topic of quality of life (QOL) of transgender, there is still a lack of studies using standardized questionnaires in their evaluation. AIMS We designed a survey to evaluate the influence of surgery after phalloplasty (osteofasciocutaneous fibula free flap or osteofasciocutaneous radial free forearm flap) on QOL, emotional stability, self-esteem, and psyche of postoperated transgender men. METHODS The present study included 32 transgender men who had undergone gender-affirming surgery (GAS) exclusively in our department between 2000 and 2012. Apart from our self-developed, indication-specific questionnaire with questions on socioeconomic and demographic data as well as postoperative satisfaction, the testing instrument included 4 frequently used, standardized testing instruments, which we compared with normative data. These included (a) a self-assessment test Fragebogen zur Lebenszufriedenheit with questions on QOL consisting of 3 modules (general satisfaction, satisfaction with health, and satisfaction with body image/outer appearance), (b) the Freiburg Personality Inventory, (c) the Rosenberg Self-Esteem Questionnaire, and (d) the Patient Health Questionnaire 4. FINDINGS Our self-developed, indication-specific questionnaire showed that 88% of our patients were very satisfied with the aesthetic result, 75% have had sex after surgery, and 72% were very satisfied with sexual function after GAS. Eighty-one percent had a strong improvement of QOL, and 91% would undergo the same treatment again. Eighty-four percent would recommend GAS to others. All patients lived as men fulltime. DISCUSSION Our study reveals that GAS plays an important part in the interdisciplinary treatment of transgender individuals as it improves the QOL in transgender men in most aspects of everyday life and has a positive influence on the patients' psyche and self-esteem in a retrospective study.
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Affiliation(s)
| | | | | | | | - Gerhard Henrich
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Rechts der Isar, Munich Technical University
| | - Laszlo Kovacs
- From the Department of Plastic Surgery and Hand Surgery, University Hospital Rechts der Isar, Munich Technical University, Munich, Germany
| | - Peter Herschbach
- Roman-Herzog-Krebszentrum Comprehensive Cancer Center, Munich, Germany
| | - Hans-Günther Machens
- From the Department of Plastic Surgery and Hand Surgery, University Hospital Rechts der Isar, Munich Technical University, Munich, Germany
| | - Jürgen Schaff
- Department of Plastic Surgery, University Teaching Hospital Rotkreuz-Klinikum München, Munich Technical University, Munich, Germany
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Elhage SA, Marturano MN, Deerenberg EB, Shao JM, Prasad T, Colavita PD, Kercher KW, Heniford BT, Augenstein VA. Impact of panniculectomy in complex abdominal wall reconstruction: a propensity matched analysis in 624 patients. Surg Endosc 2020; 35:5287-5294. [DOI: 10.1007/s00464-020-08011-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 09/16/2020] [Indexed: 01/20/2023]
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Body Contouring Surgery Improves Physical Activity in Patients After Massive Weight Loss-a Retrospective Study. Obes Surg 2020; 30:146-153. [PMID: 31444775 DOI: 10.1007/s11695-019-04145-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND The aim of the study was to compare physical activity (PA) in patients who had undergone massive weight loss (MWL), before and after body contouring procedures. METHODS All patients undergoing body contouring surgery after MWL between 2007 and 2017 with a minimum follow-up of 6 months after the last procedure were included in this retrospective study. Excluded were those with a body mass index > 35 kg/m2 and those with comorbidities leading to impaired PA. Quality of life (QOL) was assessed using the Moorehead-Ardelt QOL Questionnaire II. Evaluation of PA was obtained with the International Physical Activity Questionnaire (IPAQ) short form and the Freiburg PA Questionnaire. Functional impairment during exercise was analyzed using a self-designed functional impairment score (FIS). RESULTS In the 45 patients completing the survey (37 female, 8 male), an improvement in QOL (p < 0.001) and PA scored by the IPAQ (p = 0.017) was found. The Freiburg PA Questionnaire showed no difference in PA before and after body contouring surgery (p = 0,274). Furthermore, scores of the FIS indicated a decrease of functional impairment during physical activity after body contouring surgery (p < 0.001). CONCLUSION Body contouring improves QOL and PA in patients after massive weight loss. The results of our study confirm the important role of plastic surgery in the treatment and maintenance of health of patients with former obesity.
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de Vries CE, Klassen AF, Hoogbergen MM, Alderman AK, Pusic AL. Measuring Outcomes in Cosmetic Abdominoplasty. Clin Plast Surg 2020; 47:429-436. [DOI: 10.1016/j.cps.2020.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Hernio-abdominoplasty with or without Scarpa's Fascia Preservation for Ventral Hernia and Abdominal Wall Deformity. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2020; 7:e2302. [PMID: 31942338 PMCID: PMC6952146 DOI: 10.1097/gox.0000000000002302] [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: 04/05/2019] [Accepted: 04/26/2019] [Indexed: 11/29/2022]
Abstract
Scarpa’s fascia preservation plays a great role in decreasing the volume of wound drainage and reducing seroma after abdominoplasty. This study aimed to assess the role of Scarpa’s fascia preservation in patients with ventral hernias associated with abdominal wall deformity who underwent concomitant hernio-abdominoplasty in terms of early and late postoperative outcome and quality of life.
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Zhitny VP, Iftekhar N, Moreno S, Stile F. Abdominoplasty for treatment of abdominal gun-shot wound sequalae – A case report. Int J Surg Case Rep 2020; 72:365-368. [PMID: 32563822 PMCID: PMC7306522 DOI: 10.1016/j.ijscr.2020.06.056] [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: 03/30/2020] [Revised: 06/09/2020] [Accepted: 06/09/2020] [Indexed: 11/24/2022] Open
Abstract
Limited literature exists on abdominoplasty for therapeutic purposes. Patient arrived with emotional distress related to lasting gunshot injury scar. Abdominoplasty was completed for revision of the gunshot injury. Plastic surgeons should be creative in their techniques for revision.
Background Gun violence is a public health epidemic in the United States with 15,315 non-suicide related deaths reported in 2019 by the Gun Violence Archive. To date, abdominoplasty is primarily a cosmetic procedure, which involves low-lying incision, removal of excess skin, fat, and tissue, and strengthening of the abdominal wall musculature. There currently are limited reports in regard to abdominoplasty as a procedure for scar revision and abdominal deformity repair associated with gunshot related injuries. Methods An African American female patient, 38 years of age, presented for correction of a wide healed surgical incision and incisional hernia in the midline abdomen. This resulted from a trauma laparotomy in treatment of multiple gunshot wounds. Results Patient presented post-operatively with no complications. She had successful reduction of her incisional hernia using an anatomic repair. Her wide hypertrophic abdominal scar was excised and primarily closed. Conclusion In the cases of abdominal hernia and scarring secondary to trauma laparotomies performed for gunshot wounds, abdominoplasty is an option for revision and repair.
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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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Psychological Pathologies and Sexual Orientation in Transgender Women Undergoing Gender Confirming Treatment. Ann Plast Surg 2019; 84:312-316. [DOI: 10.1097/sap.0000000000002035] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Papadopulos NA, Kolassa MJ, Henrich G, Herschbach P, Kovacs L, Machens HG, Klöppel M. Quality of life following aesthetic liposuction: A prospective outcome study. J Plast Reconstr Aesthet Surg 2019; 72:1363-1372. [DOI: 10.1016/j.bjps.2019.04.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 03/01/2019] [Accepted: 04/06/2019] [Indexed: 10/27/2022]
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Arafa A, Mahmoud O, Abu Salem E. Excessive Internet use and self-esteem among Internet users in Egypt. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2019. [DOI: 10.1080/00207411.2019.1611167] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Ahmed Arafa
- Department of Public Health, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Omaima Mahmoud
- Department of Psychiatric Nursing, Faculty of Nursing, Beni-Suef University, Beni-Suef, Egypt
| | - Entisar Abu Salem
- Department of Psychiatric Nursing, Faculty of Nursing, Beni-Suef University, Beni-Suef, Egypt
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Abstract
BACKGROUND Asymmetry of the hips and its implication in body contouring procedures has not yet been reported. Hip asymmetry is common in the general population and may account for uneven abdominoplasty scar and the apparent discrepancies in volume following liposuction of the hips and flanks. The goal of this study was to determine the presence of hip asymmetry in women presenting for abdominal contouring surgery. METHODS Analysis of preoperative photographs of 100 female patients was performed by three independent plastic surgeons. They were asked to evaluate for hip asymmetry and, when present, determine which side was higher. Adobe Photoshop was also used to objectively measure hip asymmetry. Patients were women with no known history of hip abnormalities; age ranged from 17 to 64 years and the body mass index ranged from 16 to 47 kg/m(2). RESULTS All three plastic surgeon reviewers found that the majority of patients had hip asymmetry, with raters 1, 2, and 3 documenting discrepancies in hip height in 88, 60, and 76 percent of patients, respectively. The interrater reliability was 0.713. Chi-square statistical analysis suggested that the raters were not statistically different from one another (p = 0.086). The objective analysis found asymmetry in 82 percent of patients. CONCLUSIONS The results showed that the majority of patients who present for abdominal contouring surgery have asymmetric hips. Patients are usually unaware of the unevenness of their own hips; however, they often notice postoperative discrepancies in scar height after abdominoplasty or volume differences after liposuction.
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Johnson SP, Swiatek PR, Wang L, Liu M, Chung TT, Chung KC. Risk Factors for Undergoing Elective Abdominal Contouring Surgery Shortly After Hospitalization. J Surg Res 2019; 236:51-59. [PMID: 30694779 DOI: 10.1016/j.jss.2018.11.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 09/26/2018] [Accepted: 11/09/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Having posthospital syndrome (PHS) at the time of an elective surgery increases the risk of postoperative adverse outcomes. The purpose of this article was to identify incidence and risk factors for having PHS at the time of abdominal contouring surgeries. METHODS Insurance claims from the Truven MarketScan Databases were used to identify patients who underwent outpatient abdominoplasty, liposuction, or panniculectomy between April 2010 and August 2015. Patients were presumed to have PHS if they were hospitalized within 90 d before surgery. Incidence rates of having PHS were calculated for patient groups defined by demographic data and comorbidities. Statistical inference based on adjusted odds ratios was used to evaluate the association of potential risk factors with PHS. A nonparametric regression method was used to demonstrate nonlinear effects of patient covariates on the risk of PHS. RESULTS This study included 18,947 patients who underwent abdominal contouring; 77% were female, and the mean age was 48.7 y (SD = 14.7). Six percent (n = 1045) of patients had PHS at the time of surgery. A significantly stronger association with PHS (P < 0.001) was observed in patients with deep venous thrombosis (adjusted odds ratio = 3.56), Elixhauser score > 8 (3.28), and smokers (2.16). Age was found to have a piecewise linear effect on PHS, with odds increasing by 2.1% per year over the age of 45 y. CONCLUSIONS Older patients have an increased risk of undergoing abdominal contouring surgery in a deconditioned state. Screening at-risk populations for PHS would help identify patients who need rehabilitation before operative intervention.
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Affiliation(s)
- Shepard P Johnson
- Plastic and Reconstructive Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | | | - Lu Wang
- Department of Biostatistics, University of Michigan, Ann Arbor, Michigan
| | - Mochuan Liu
- Department of Statistics, University of Michigan, Ann Arbor, Michigan
| | - Ting-Ting Chung
- Center for Big Data Analytics and Statistics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Kevin C Chung
- Department of Surgery, Section of Plastic Surgery, Assistant Dean for Faculty Affairs, University of Michigan Medical School, Ann Arbor, Michigan.
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The Effect of Blepharoplasty on Our Patient's Quality of Life, Emotional Stability, and Self-Esteem. J Craniofac Surg 2019; 30:377-383. [PMID: 30608369 DOI: 10.1097/scs.0000000000005057] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Several studies have been conducted evaluating psychological effects following aesthetic surgery, however few of them following blepharoplasty! PURPOSE To determine whether blepharoplasty affects quality of life and satisfaction as well as, emotional stability and self-esteem in patients who underwent only blepharoplasty. DESIGN A retrospective study including transdermal blepharoplasty operations between the years 1995 and 2008. METHODS A self-developed and indication-specific questionnaire especially for blepharoplasty, as well as the standardized testing instruments FLZM, FPI-R, and RSES, concerning quality of life, body image, personality, and self-esteem was utilized. PARTICIPANTS A total of 123 patients were included in the study. Forty-six patients participated in the study. MAIN OUTCOMES AND MEASURES Results were compared with the existing representative norm data from the German speaking countries. RESULTS In the indication-specific questionnaire, 44 patients reported a positive influence on their personal wellbeing, and 33 were more satisfied with their appearance (follow-up 3-95 months; average 48.5 months); 20 felt more self-confident, and 25 felt more attractive.Statistically significant increased values in quality of life (FLZM) were found in the aspects work (P = 0.02), mobility (P < 0.001) and independence from assistance or help (P < 0.001).Higher scores concerning personality and self-esteem compared with the respective random sample were found in the questionnaires FPI-R (P = 0.02) and RSES (P < 0.001). CONCLUSION AND RELEVANCE Among plastic surgical interventions, blepharoplasty is a minimal invasive operation, which is very well tolerated by patients. Patients take advantage in personal wellbeing, self-esteem, and different aspects of their daily life.
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Papadopulos NA, Meier AC, Henrich G, Herschbach P, Kovacs L, Machens HG, Klöppel M. Aesthetic abdominoplasty has a positive impact on quality of life prospectively. J Plast Reconstr Aesthet Surg 2018; 72:813-820. [PMID: 30638894 DOI: 10.1016/j.bjps.2018.12.020] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 12/02/2018] [Accepted: 12/09/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND In our previous retrospective study, we detected an increased quality of life after aesthetic abdominoplasty. In this survey, we analyzed quality of life, self-esteem, emotional stability, and mental health before and after aesthetic abdominoplasty prospectively. METHODS Twenty-two female patients were surveyed before and six months after their surgeries. The testing instrument consisted of a self-developed indication-specific questionnaire and four standardized tests (Questions on Life Satisfaction plus a specified part body image, Rosenberg Self-Esteem Scale, Freiburg Personality Inventory, and Patient Health Questionnaire-4). RESULTS Significantly increased values were found concerning feeling comfortable in swimwear in front of the mirror or the sexual partner and at social or professional activities (each p=0.000). Women had less problems doing sports (p=0.029) and felt more feminine (p=0.012). Sum scores of general life satisfaction (p=0.016) and scores of the items leisure activity (p=0.003), relaxing abilities (p=0.002), and sexuality (p=0.046) showed significant improvements. The body image improved in general (p=0.010) and in particular in the items abdomen, hips, and waist (each p=0.000). Emotional stability increased significantly (p=0.029). We detected a mild mental depression in 27% and a moderate depression in 32% of our patients before surgery. Depressive disorders were significantly reduced (p=0.004) down to mild depression in 18% and moderate depression in 9% of the patients. CONCLUSION Positive results for quality of life shown in the retrospective study were confirmed. Abdominoplasty improves general life satisfaction and satisfaction with health and outer appearance and increases emotional stability. Depressive patients showed a significant improvement after aesthetic abdominoplasty.
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Affiliation(s)
- Nikolaos A Papadopulos
- Department of Plastic Surgery & Hand Surgery University Hospital Rechts der Isar, Munich Technical University, Munich, Germany; Department of Plastic Surgery, Alexandroupoli University Hospital, Democritus University of Thrace, Alexandroupoli, Greece.
| | - Anna C Meier
- Department of Plastic Surgery & Hand Surgery University Hospital Rechts der Isar, Munich Technical University, Munich, Germany
| | - Gerhard Henrich
- Department of Psychosomatic Medicine and Psychotherapy, Munich Technical University, Munich, Germany
| | - Peter Herschbach
- Roman Herzog Comprehensive Cancer Center, Department of Psychosomatic Medicine and Psychotherapy, Munich Technical University, Munich, Germany
| | - Laszlo Kovacs
- Department of Plastic Surgery & Hand Surgery University Hospital Rechts der Isar, Munich Technical University, Munich, Germany
| | - Hans-Günther Machens
- Department of Plastic Surgery & Hand Surgery University Hospital Rechts der Isar, Munich Technical University, Munich, Germany
| | - Markus Klöppel
- Aesthetic Surgery & Medicine, MediCenter Munich Solln, Munich, Germany
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DIEAP Flap Patients Equally as Satisfied with the Abdomen as Abdominoplasty Patients. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2018; 6:e1876. [PMID: 30324061 PMCID: PMC6181487 DOI: 10.1097/gox.0000000000001876] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 05/30/2018] [Indexed: 11/30/2022]
Abstract
Background: The dermolipectomy of the deep inferior epigastric artery perforator (DIEAP) flap procedure is designed to give an end result as seen with abdominoplasty (AP). Several steps of an AP are, however, not routinely performed. This study compared the patient-reported outcomes between these 2 procedures with an emphasis on the abdomen. Methods: Thirty-four patients reconstructed with a DIEAP flap (DIEAP group), and 30 patients with an AP (AP group) were asked to complete 2 study-specific questionnaires. The first questionnaire covered abdominal outcomes, whereas the second was concerned with general outcomes. Results: The DIEAP group was significantly older compared with the AP group. Eighty-five percentage of the DIEAP group and 66 % of the AP group answered the questionnaires. Postoperatively, the DIEAP group was significantly more satisfied with their bodies when dressed (P = 0.009), and there was a trend of DIEAP patients being more satisfied with the appearance of the abdomen (P = 0.085). No significant difference was found comparing outcomes concerning umbilicus, muscle function, pain, scarring, and contour. The DIEAP group was more worried about their health than the AP group postoperatively (P = 0.044). AP patients had a significantly more altered body image (P = 0.016) and increased sexual desire (P = 0.003) than DIEAP patients. There was no significant difference regarding changes in self-image, social relationships, being naked with partner, and overall satisfaction. Conclusion: DIEAP flap patients were equally as satisfied with the abdomen as AP patients.
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Assari S, Moghani Lankarani M. Depressive Symptoms and Self-Esteem in White and Black Older Adults in the United States. Brain Sci 2018; 8:E105. [PMID: 29891800 PMCID: PMC6024986 DOI: 10.3390/brainsci8060105] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Revised: 05/24/2018] [Accepted: 06/09/2018] [Indexed: 01/03/2023] Open
Abstract
Background. Poor self-esteem is a core element of depression. According to recent research, some racial groups may vary in the magnitude of the link between depression and poor self-esteem. Using a national sample, we compared Black and White older Americans for the effect of baseline depressive symptoms on decline in self-esteem over time. Methods. This longitudinal study used data from the Religion, Aging, and Health Survey, 2001⁻2004. The study followed 1493 older adults (734 Black and 759 White) 65 years or older for three years. Baseline depressive symptoms (CES-D), measured in 2001, was the independent variable. Self-esteem, measured at the end of the follow up, was the dependent variable. Covariates included baseline demographic characteristics (age and gender), socioeconomic factors (education, income, and marital status), health (self-rated health), and baseline self-esteem. Race/ethnicity was the moderator. Linear multi-variable regression models were used for data analyses. Results. In the pooled sample, higher depressive symptoms at baseline were predictive of a larger decline in self-esteem over time, net of covariates. We found a significant interaction between race/ethnicity and baseline depressive symptoms on self-esteem decline, suggesting a weaker effect for Blacks compared to Whites. In race/ethnicity-specific models, high depressive symptoms at baseline was predictive of a decline in self-esteem for Whites but not Blacks. Conclusion. Depressive symptoms may be a more salient contributor to self-esteem decline for White than Black older adults. This finding has implications for psychotherapy and cognitive behavioral therapy of depression of racially diverse populations.
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Affiliation(s)
- Shervin Assari
- Department of Psychology, University of California Los Angeles (UCLA), Los Angeles, CA 90095, USA.
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48104, USA.
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI 48109-2700, USA.
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Zavlin D, Schaff J, Lellé JD, Jubbal KT, Herschbach P, Henrich G, Ehrenberger B, Kovacs L, Machens HG, Papadopulos NA. Male-to-Female Sex Reassignment Surgery using the Combined Vaginoplasty Technique: Satisfaction of Transgender Patients with Aesthetic, Functional, and Sexual Outcomes. Aesthetic Plast Surg 2018; 42:178-187. [PMID: 29101439 DOI: 10.1007/s00266-017-1003-z] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Accepted: 10/07/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND Currently available patient-reported outcome measures are limited in the field of sex reassignment surgery (SRS). Standardized questionnaires deliver high evidence data on satisfaction of male-to-female (MTF) transgender patients but do not allow any modification in their clinical application. We therefore designed a prospective study using self-developed indication-specific questionnaires to evaluate the aesthetic, functional, and sexual outcomes of MTF patients undergoing SRS. METHODS Forty-nine adult MTF transgender patients who underwent two-stage SRS were eligible for study inclusion between September 2012 and January 2014. Forty patients (= N) ultimately filled out both parts of the questionnaire sets: 1 day before the first stage (T0) and 6 months after the second stage of SRS (T1). These questionnaires focused on demographic characteristics, the satisfaction with aesthetic and functional results, and sexuality. RESULTS Patients rated their surgical satisfaction of most items with mean scores above 7 on a 0-10-point scale. Many items evaluating everyday life activities improved significantly after SRS compared to T0 (p < 0.01). All but one patient (97.5%) reported no regrets about having undergone surgery, and the majority recommended it to other patients with gender dysphoria. Femininity and sexual activity increased significantly postoperatively (p < 0.01). Satisfaction with intercourse and orgasm was high: 6.70 and 8.21, respectively, on a 0-10 scale. CONCLUSION Satisfaction with the cosmetic outcome, as well as the functional and sexual outcomes, reveal positive effects of SRS using the combined technique on transgender patient lives. Nevertheless, standardized and validated SRS-specific questionnaires are lacking. LEVEL OF EVIDENCE IV 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)
- Dmitry Zavlin
- Department of Plastic and Hand Surgery, University Hospital Rechts der Isar, Munich Technical University, Ismaninger Strasse 22, 81675, Munich, Germany
- Institute for Reconstructive Surgery, Houston Methodist Hospital, Weill Cornell Medicine, Houston, TX, USA
| | - Jürgen Schaff
- Department of Plastic Surgery, University Teaching Hospital Rotkreuzklinikum München, Munich Technical University, Munich, Germany
| | - Jean-Daniel Lellé
- Department of Plastic and Hand Surgery, University Hospital Rechts der Isar, Munich Technical University, Ismaninger Strasse 22, 81675, Munich, Germany
| | - Kevin T Jubbal
- Department of Plastic Surgery, Loma Linda University Medical Center, Loma Linda, CA, USA
| | - Peter Herschbach
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Rechts der Isar, Munich Technical University, Munich, Germany
| | - Gerhard Henrich
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Rechts der Isar, Munich Technical University, Munich, Germany
| | - Benjamin Ehrenberger
- Department of Plastic and Hand Surgery, University Hospital Rechts der Isar, Munich Technical University, Ismaninger Strasse 22, 81675, Munich, Germany
| | - Laszlo Kovacs
- Department of Plastic and Hand Surgery, University Hospital Rechts der Isar, Munich Technical University, Ismaninger Strasse 22, 81675, Munich, Germany
| | - Hans-Günther Machens
- Department of Plastic and Hand Surgery, University Hospital Rechts der Isar, Munich Technical University, Ismaninger Strasse 22, 81675, Munich, Germany
| | - Nikolaos A Papadopulos
- Department of Plastic and Hand Surgery, University Hospital Rechts der Isar, Munich Technical University, Ismaninger Strasse 22, 81675, Munich, Germany.
- Department of Plastic Surgery and Burns, Alexandroupoli University Hospital, Democritus University of Thrace, 68100, Alexandroupoli, Greece.
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Tremp M, Wang W, Oranges CM, Schaefer DJ, Wang W, Kalbermatten DF. Evaluation of the Neo-umbilicus Cutaneous Sensitivity Following Abdominoplasty. Aesthetic Plast Surg 2017; 41:1382-1388. [PMID: 28791469 DOI: 10.1007/s00266-017-0951-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2017] [Accepted: 07/20/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Abdominal cutaneous sensitivity loss after abdominoplasty is an undesirable outcome. However, little is known in the literature about sensitivity changes of the neo-umbilicus after abdominoplasty. The aim of this study was to evaluate post-abdominoplasty cutaneous sensitivity of the neo-umbilicus using clinical, quantitative, and reproducible methods. METHODS Patients who underwent abdominoplasty were included, whereas the control group consisted of healthy volunteers with similar demographic characteristics but who did not undergo abdominoplasty. The umbilicus was divided into five zones, and superficial tactile sensitivity and spatial orientation were assessed subjectively (score 1-4) and objectively (Semmes-Weinstein monofilament examination). RESULTS Twenty patients (45 ± 12 years) operated on consecutively between April 2012 and May 2016 and 14 healthy volunteers in the control group (39 ± 9 years) could be included. Although there were statistically significant differences (p = 0.0005) in the average cutaneous pressure thresholds between the control group (0.4 g/mm2, range 0.07-2 g/mm2) and the study group (0.4 g/mm2, range 0.07-4 g/mm2), patient satisfaction after a mean follow-up of 33 ± 16 months (range 10-62 months) was acceptable (mean satisfaction score 1.8 ± 0.7). Furthermore, spatial perceptions were precise in all patients and similar to the control group. CONCLUSION Our long-term results indicate that spontaneous reinnervation of the neo-umbilicus after abdominoplasty together with accurate spatial orientation can occur. LEVEL OF EVIDENCE IV 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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Impact of Patient Subtype and Surgical Variables on Abdominoplasty Outcomes. Plast Reconstr Surg 2017; 140:899-908. [DOI: 10.1097/prs.0000000000003816] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Papadopulos NA, Zavlin D, Lellé JD, Herschbach P, Henrich G, Kovacs L, Ehrenberger B, Machens HG, Schaff J. Male-to-Female Sex Reassignment Surgery Using the Combined Technique Leads to Increased Quality of Life in a Prospective Study. Plast Reconstr Surg 2017; 140:286-294. [PMID: 28746274 DOI: 10.1097/prs.0000000000003529] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The authors' previous research showed that various plastic surgical procedures can increase a patient's quality of life in its different aspects. In a prospective setting, they evaluated whether sex reassignment surgery has similar effects for male-to-female transgender patients compared to baseline data before sex reassignment surgery. METHODS All 39 patients who underwent their first-stage male-to-female sex reassignment surgery between October of 2012 and January of 2014 received one set of questionnaires preoperatively (time 0) and approximately 6 months after their final operation (time 1). Each set contained self-developed, indication-specific questions combined with the standardized validated Questions on Life Satisfaction, Modules (German version) questionnaire, the Freiburg Personality Inventory, the Rosenberg Self-Esteem Scale, and the Patient Health Questionnaire, which were compared to available norm data. RESULTS The mean patient age was 38.6 years. The majority of the patients were highly educated, childless, and single. Significant improvements were found in the Questions on Life Satisfaction, Modules (German version), especially for the items "partnership," "ability to relax," "energy," "freedom from anxiety," "hair," "breast," and "penis/vagina" (p < 0.01). Furthermore, the patients appeared more emotionally stable (p = 0.03), showed higher self-esteem (p = 0.01), and showed much lower depression/anxiety (p < 0.01). CONCLUSIONS The positive study findings were confirmed with the results from prior retrospective studies. However, medical literature focuses largely on surgical and functional satisfaction and not overall quality of life. In addition, standardized questionnaires are used rarely and solely retrospectively, with the risk of recall bias. The increased quality of life of transgender women postoperatively endorses sex reassignment surgery as a valuable option for these patients. CLINICAL QUESTON/LEVEL OF EVIDENCE Therapeutic, IV.
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Affiliation(s)
- Nikolaos A Papadopulos
- Munich, Germany; Alexandroupoli, Greece; and Houston, Texas.,From the Departments of Plastic and Hand Surgery, and the Department of Psychosomatic Medicine and Psychotherapy, University Hospital Rechts der Isar, Munich Technical University; the Department of Plastic Surgery and Burns, Alexandroupoli University Hospital, Democritus University of Thrace, Greece; the Department of Plastic Surgery, University Teaching Hospital Rotkreuzklinikum München; the Roman-Herzog-Krebszentrum Comprehensive Cancer Center, University Hospital Rechts der Isar, Munich Technical University; and the Institute for Reconstructive Surgery, Houston Methodist Hospital, Weill Cornell Medicine
| | - Dmitry Zavlin
- Munich, Germany; Alexandroupoli, Greece; and Houston, Texas.,From the Departments of Plastic and Hand Surgery, and the Department of Psychosomatic Medicine and Psychotherapy, University Hospital Rechts der Isar, Munich Technical University; the Department of Plastic Surgery and Burns, Alexandroupoli University Hospital, Democritus University of Thrace, Greece; the Department of Plastic Surgery, University Teaching Hospital Rotkreuzklinikum München; the Roman-Herzog-Krebszentrum Comprehensive Cancer Center, University Hospital Rechts der Isar, Munich Technical University; and the Institute for Reconstructive Surgery, Houston Methodist Hospital, Weill Cornell Medicine
| | - Jean-Daniel Lellé
- Munich, Germany; Alexandroupoli, Greece; and Houston, Texas.,From the Departments of Plastic and Hand Surgery, and the Department of Psychosomatic Medicine and Psychotherapy, University Hospital Rechts der Isar, Munich Technical University; the Department of Plastic Surgery and Burns, Alexandroupoli University Hospital, Democritus University of Thrace, Greece; the Department of Plastic Surgery, University Teaching Hospital Rotkreuzklinikum München; the Roman-Herzog-Krebszentrum Comprehensive Cancer Center, University Hospital Rechts der Isar, Munich Technical University; and the Institute for Reconstructive Surgery, Houston Methodist Hospital, Weill Cornell Medicine
| | - Peter Herschbach
- Munich, Germany; Alexandroupoli, Greece; and Houston, Texas.,From the Departments of Plastic and Hand Surgery, and the Department of Psychosomatic Medicine and Psychotherapy, University Hospital Rechts der Isar, Munich Technical University; the Department of Plastic Surgery and Burns, Alexandroupoli University Hospital, Democritus University of Thrace, Greece; the Department of Plastic Surgery, University Teaching Hospital Rotkreuzklinikum München; the Roman-Herzog-Krebszentrum Comprehensive Cancer Center, University Hospital Rechts der Isar, Munich Technical University; and the Institute for Reconstructive Surgery, Houston Methodist Hospital, Weill Cornell Medicine
| | - Gerhard Henrich
- Munich, Germany; Alexandroupoli, Greece; and Houston, Texas.,From the Departments of Plastic and Hand Surgery, and the Department of Psychosomatic Medicine and Psychotherapy, University Hospital Rechts der Isar, Munich Technical University; the Department of Plastic Surgery and Burns, Alexandroupoli University Hospital, Democritus University of Thrace, Greece; the Department of Plastic Surgery, University Teaching Hospital Rotkreuzklinikum München; the Roman-Herzog-Krebszentrum Comprehensive Cancer Center, University Hospital Rechts der Isar, Munich Technical University; and the Institute for Reconstructive Surgery, Houston Methodist Hospital, Weill Cornell Medicine
| | - Laszlo Kovacs
- Munich, Germany; Alexandroupoli, Greece; and Houston, Texas.,From the Departments of Plastic and Hand Surgery, and the Department of Psychosomatic Medicine and Psychotherapy, University Hospital Rechts der Isar, Munich Technical University; the Department of Plastic Surgery and Burns, Alexandroupoli University Hospital, Democritus University of Thrace, Greece; the Department of Plastic Surgery, University Teaching Hospital Rotkreuzklinikum München; the Roman-Herzog-Krebszentrum Comprehensive Cancer Center, University Hospital Rechts der Isar, Munich Technical University; and the Institute for Reconstructive Surgery, Houston Methodist Hospital, Weill Cornell Medicine
| | - Benjamin Ehrenberger
- Munich, Germany; Alexandroupoli, Greece; and Houston, Texas.,From the Departments of Plastic and Hand Surgery, and the Department of Psychosomatic Medicine and Psychotherapy, University Hospital Rechts der Isar, Munich Technical University; the Department of Plastic Surgery and Burns, Alexandroupoli University Hospital, Democritus University of Thrace, Greece; the Department of Plastic Surgery, University Teaching Hospital Rotkreuzklinikum München; the Roman-Herzog-Krebszentrum Comprehensive Cancer Center, University Hospital Rechts der Isar, Munich Technical University; and the Institute for Reconstructive Surgery, Houston Methodist Hospital, Weill Cornell Medicine
| | - Hans-Günther Machens
- Munich, Germany; Alexandroupoli, Greece; and Houston, Texas.,From the Departments of Plastic and Hand Surgery, and the Department of Psychosomatic Medicine and Psychotherapy, University Hospital Rechts der Isar, Munich Technical University; the Department of Plastic Surgery and Burns, Alexandroupoli University Hospital, Democritus University of Thrace, Greece; the Department of Plastic Surgery, University Teaching Hospital Rotkreuzklinikum München; the Roman-Herzog-Krebszentrum Comprehensive Cancer Center, University Hospital Rechts der Isar, Munich Technical University; and the Institute for Reconstructive Surgery, Houston Methodist Hospital, Weill Cornell Medicine
| | - Jürgen Schaff
- Munich, Germany; Alexandroupoli, Greece; and Houston, Texas.,From the Departments of Plastic and Hand Surgery, and the Department of Psychosomatic Medicine and Psychotherapy, University Hospital Rechts der Isar, Munich Technical University; the Department of Plastic Surgery and Burns, Alexandroupoli University Hospital, Democritus University of Thrace, Greece; the Department of Plastic Surgery, University Teaching Hospital Rotkreuzklinikum München; the Roman-Herzog-Krebszentrum Comprehensive Cancer Center, University Hospital Rechts der Isar, Munich Technical University; and the Institute for Reconstructive Surgery, Houston Methodist Hospital, Weill Cornell Medicine
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Quality of Life and Patient Satisfaction Following Male-to-Female Sex Reassignment Surgery. J Sex Med 2017; 14:721-730. [DOI: 10.1016/j.jsxm.2017.01.022] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2016] [Revised: 12/12/2016] [Accepted: 01/24/2017] [Indexed: 01/09/2023]
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Correia-Gonçalves I, Valença-Filipe R, Carvalho J, Rebelo M, Peres H, Amarante J, Costa-Ferreira A. Abdominoplasty with Scarpa fascia preservation – comparative study in a bariatric population. Surg Obes Relat Dis 2017; 13:423-428. [DOI: 10.1016/j.soard.2016.09.024] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 09/09/2016] [Accepted: 09/23/2016] [Indexed: 11/16/2022]
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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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Wilhelmsson S, Fagevik Olsén M, Staalesen T, Elander A, Nygren-Bonnier M. Abdominal plasty with and without plication-effects on trunk muscles, lung function, and self-rated physical function. J Plast Surg Hand Surg 2016; 51:199-204. [DOI: 10.1080/2000656x.2016.1222293] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Sofia Wilhelmsson
- Functional Area Occupational Therapy & Physiotherapy, Allied Health Professionals Function, Karolinska University Hospital, Stockholm, Sweden
| | - Monika Fagevik Olsén
- Department of Surgery, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Trude Staalesen
- Department of Plastic Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Anna Elander
- Department of Plastic Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Malin Nygren-Bonnier
- Functional Area Occupational Therapy & Physiotherapy, Allied Health Professionals Function, Karolinska University Hospital, Stockholm, Sweden
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden
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Yin Z, Wang D, Ma Y, Hao S, Ren H, Zhang T, Chen W, Fan J. Self-esteem, Self-efficacy, and Appearance Assessment of Young Female Patients Undergoing Facial Cosmetic Surgery: A Comparative Study of the Chinese Population. JAMA FACIAL PLAST SU 2016; 18:20-6. [PMID: 26469879 DOI: 10.1001/jamafacial.2015.1381] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE The psychological traits of cosmetic surgery patients (CSP) are important for selecting patients and postoperative patient satisfaction. A patient's self-esteem, self-efficacy, and self-assessment affect his or her motivation for cosmetic surgery, but the association among these traits remains unclear, especially in the Asian population. OBJECTIVE To clarify the association of a patient's psychological traits, decision to undergo cosmetic surgery, and the effectiveness of facial cosmetic surgery on the psychological conditions of young, female Chinese patients. DESIGN, SETTING, AND PARTICIPANTS Three different groups of young women (aged 18-30 years) from the Plastic Surgery Hospital, Chinese Academy of Medical Sciences, and 7 universities were enrolled from January 1, 2012, through December 31, 2014: CSPs (n = 161), general population controls (GPCs) (n = 355), and facial appearance raters (FARs) (n = 268). The last date of follow-up was January 20, 2015. Patient data from questionnaires were obtained preoperatively and 6 months postoperatively, and the data from the control groups were obtained immediately after enrollment. Front-view facial images of the study participants were taken and then shown to independent raters to assess the participants' facial appearances on a rating scale. MAIN OUTCOMES AND MEASURES Evaluation of self-esteem and self-efficacy, subjective and objective assessment of facial appearance, and structural equation models. RESULTS A total of 163 CSPs and 387 GPCs were recruited for the study, and complete and valid data were obtained from 161 CSPs and 355 GPCs. All responses from the 268 FARs met the criteria for subsequent analysis. Of the questionnaires issued to the CSPs 6 months postoperatively, 126 valid responses were returned (response rate, 78.3%). Self-esteem and self-efficacy decreased significantly in preoperative patients compared with controls (P < .001) (mean [SD] scores, 22.60 [1.80] for CSPs and 27.39 [2.11] for GPCs for self-esteem and 21.50 [2.40] for CSPs and 28.59 [4.23] for GPCs for self-efficacy) and were found to be at nearly normal levels 6 months postoperatively (mean [SD] scores, 25.88 [3.65] and 26.38 [2.45] for self-esteem and self-efficacy, respectively). The patients' objective assessments of facial appearance did not differ significantly from those of the control group participants (mean [SD] scores, 4.51 [0.77] and 4.55 [0.74] for CSPs and GPCs, respectively; P = .86); however, a significant decrease in patient self-assessment was noted (mean [SD scores], 6.45 [1.15] and 7.31 [1.42] for CSPs and GPCs, respectively; P = .01). Moreover, the structural equation models revealed a path from low self-esteem and self-efficacy after decreased self-assessment to decision for cosmetic surgery. CONCLUSIONS AND RELEVANCE Self-esteem and self-efficacy mediate the negative effects of self-assessment on the decision of young women to undergo facial cosmetic surgery. The impairment of self-esteem and self-efficacy may indicate the need for preoperative psychological intervention. Facial cosmetic surgery can have positive effects on self-esteem and self-efficacy. LEVEL OF EVIDENCE 2.
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Affiliation(s)
- Zhuming Yin
- Ninth Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Dafang Wang
- Ninth Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yan Ma
- Department of Medical Psychology, Institute of Medical Humanities, Peking University Health Science Center, Beijing, China
| | - Shuwei Hao
- Department of Medical Psychology, Institute of Medical Humanities, Peking University Health Science Center, Beijing, China
| | - Huiwen Ren
- Department of Pharmacology, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China
| | - Tingting Zhang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, National Clinical Research Center for Mental Disorders , Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - Wenlin Chen
- Ninth Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jincai Fan
- Ninth Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Moreno-Egea A, Campillo-Soto Á, Morales-Cuenca G. Does Abdominoplasty Add Morbidity to Incisional Hernia Repair? A Randomized Controlled Trial. Surg Innov 2016; 23:474-80. [PMID: 27130646 DOI: 10.1177/1553350616646480] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Abdominoplasty is considered an operation linked to a considerable rate of morbidity. The convenience of simultaneously performing an incisional hernia repair and an abdominoplasty remains controversial. Methods A total of 111 patients were randomized prospectively to compare isolated incisional hernia repair and hernia repair when combined with abdominoplasty. Primary end points were in-hospital stay and early morbidity. Secondary end points were late morbidity, recurrences, and quality of life. Patients were followed-up for 24 months. Results Duration of the surgical procedure differed significantly between both groups (39 vs 85 minutes, P < .001) and postoperative hospital stay (2.5 vs 3.5 days; P < .001). No statistically significant differences in early or late morbidity between both groups were detected. The perceived quality of life for patients was higher in the combined surgery group (P < .001) that in the isolated hernia repair group. Conclusions Postoperative in-hospital stay and early and late morbidity do not differ significantly between isolated incisional hernia repair and simultaneous hernia repair with abdominoplasty, but associated abdominoplasty provides a higher quality of life when indicated.
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The Impact of Personality Traits on the Outcome of Total Knee Arthroplasty. BIOMED RESEARCH INTERNATIONAL 2016; 2016:5282160. [PMID: 26989686 PMCID: PMC4775792 DOI: 10.1155/2016/5282160] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 02/02/2016] [Indexed: 01/13/2023]
Abstract
Ten to twenty percent of patients with total knee arthroplasty (TKA) are dissatisfied with their clinical outcome. Aim of this study was to investigate the impact of personality traits on the subjective outcome of TKA. We investigated 80 patients with 86 computer navigated TKAs. We asked for patients satisfaction and divided patients into two groups (satisfied or dissatisfied). 12 personality traits were tested by the Freiburg Personality Inventory (FPI-R). Postoperative examination included Knee Society Score (KSS), Western Ontario and McMaster University Osteoarthritis Index (WOMAC), and the Visual Analogue Scale (VAS). Radiologic investigation was done in all patients. 84% of our patients were satisfied, while 16% were not satisfied. The FPI-R showed statistical significant influence of four personality traits on patient satisfaction: life satisfaction (p = 0.006), performance orientation (p = 0.015), somatic distress (p = 0.001), and emotional stability (p = 0.002). All clinical scores (VAS, WOMAC, and KSS) showed significantly better results in the satisfied patient. Radiological examination showed optimal alignment of all TKAs. There were no complications requiring revision surgery. The results of our study show that personality traits may influence patients satisfaction and clinical outcome after TKA. Therefore patients personality traits may be a useful predictive factor for postoperative satisfaction after TKA.
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40
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Dreifuss SE, Rubin JP. Insurance coverage for massive weight loss panniculectomy: a national survey and implications for policy. Surg Obes Relat Dis 2016; 12:412-6. [DOI: 10.1016/j.soard.2015.08.509] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 08/11/2015] [Accepted: 08/19/2015] [Indexed: 11/28/2022]
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Aboudib JH, Serra-Guimarães F, Sampaio FJB. Profile of Patients Undergoing Gluteoplasty. Aesthetic Plast Surg 2016; 40:30-7. [PMID: 26578193 DOI: 10.1007/s00266-015-0587-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 10/14/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Gluteal augmentation surgery has grown by 42 % per year; however, the epidemiological profile of patients who seek this treatment has never been studied. OBJECTIVE To establish the epidemiological profile of patients who have undergone gluteoplasty surgery, evaluating their level of satisfaction and the social impact caused by the surgery. METHODS Fifty patients, with ages ranging from 23 to 57 years replied to a specific questionnaire and the esthetic result of the surgery was evaluated. Thirty-seven patients were analyzed prospectively, using CT scans and gluteal reconstruction. The esthetic result was evaluated by eight plastic surgeon specialists from SBCP. RESULTS About satisfaction and quality of life, 98 % of the patients demonstrated improvement in some aspect of life. Analysis of the marital status of patients showed that 24 % of them have changed it. Therefore, all cases showed positive correlations between implant size and monthly income, age and satisfaction of patients. There has also been a positive correlation between implant size and recovery time. There was no statistically significant correlation between the esthetic result and the implant volume or the anthropometric measurements. CONCLUSIONS The epidemiological profile of patients undergoing gluteoplasty augmentation with implants is predominantly white skin, 36 years old, unrelated to the occupation or socioeconomic status. Augmentation gluteoplasty with implants is a surgery with a high level of satisfaction to patients, improving life in many aspects but, mainly, affectively. Its outcome produces a natural look and is hardly noticed by others. 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)
- Jose Horacio Aboudib
- Pedro Ernesto University Hospital, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Fernando Serra-Guimarães
- Pedro Ernesto University Hospital, Rio de Janeiro State University, Rua Visconde de Pirajá 550/1413, Ipanema, Rio de Janeiro, RJ, 22410-901, Brazil.
| | - Francisco J B Sampaio
- Urogenital Research Unit, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
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Moreno-Egea A. Abdominoplastia y reparación de hernia incisional: lo que un cirujano general debe saber. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.rehah.2015.03.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Sucupira E, Matta R, Zuker P, Matta J, Uebel CO. Inguinal Fold as a Closed-Suction Drain Exit Site in Abdominoplasty. Aesthetic Plast Surg 2015; 39:1022-4. [PMID: 26487656 DOI: 10.1007/s00266-015-0572-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Accepted: 10/01/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Eduardo Sucupira
- General and Plastic Surgery Department, Santa Casa da Misericórdia Hospital of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Renato Matta
- Plastic Surgery Department, São Lucas Hospital of PUC-RS, Porto Alegre, Brazil.
| | - Patrícia Zuker
- General and Plastic Surgery Department, Santa Casa da Misericórdia Hospital of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Jorge Matta
- Plastic Surgery Resident, Materno Infantil Perinatal Institute, Recife, Brazil
| | - Carlos O Uebel
- Plastic Surgery Department, São Lucas Hospital of PUC-RS, Porto Alegre, Brazil
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Massenburg BB, Sanati-Mehrizy P, Ingargiola MJ, Rosa JH, Taub PJ. Outcomes and Safety of the Combined Abdominoplasty-Hysterectomy: A Preliminary Study. Aesthetic Plast Surg 2015; 39:667-73. [PMID: 26174140 DOI: 10.1007/s00266-015-0531-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Accepted: 06/26/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Abdominoplasty (ABP) at the time of hysterectomy (HYS) has been described in the literature since 1986 and is being increasingly requested by patients. However, outcomes of the combined procedure have not been thoroughly explored. METHODS The authors reviewed the American College of Surgeons National Surgical Quality Improvement Program database and identified each ABP, HYS, and combined ABP-HYS performed between 2005 and 2012. The incidence of complications in each of the three procedures was calculated, and a multiplicative-risk model was used to calculate the probability of a complication for a patient undergoing distinct HYS and ABP on different dates. One-sample binomial hypothesis tests were performed to determine statistical significance. RESULTS There were 1325 ABP cases, 12,173 HYS cases, and 143 ABP-HYS cases identified. Surgical complications occurred in 7.7 % of patients undergoing an ABP-HYS, while the calculated risk of a surgical complication was 12.5 % (p = 0.0407) for patients undergoing separate ABP and HYS procedures. The mean operative time was significantly lower for an ABP-HYS at 238 vs. 270 min for separate ABP and HYS procedures (p < 0.0001), and the mean time under anesthesia was significantly lower at 295 vs. 364 min (p < 0.0001). CONCLUSIONS A combined ABP-HYS has a lower incidence of surgical complications than separate ABP and HYS procedures performed on different dates. These data should not encourage all patients to elect a combined ABP-HYS, if only undergoing a HYS, as the combined procedure is associated with increased risks when compared to either isolated individual procedure. However, in patients who are planning on undergoing both procedures on separate dates, a combined ABP-HYS is a safe option that will result in fewer surgical complications, less operative time, less time under anesthesia, and a trend towards fewer days in the hospital. LEVEL OF EVIDENCE IV 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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Does Liposuction Improve Body Image and Symptoms of Eating Disorders? PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2015; 3:e461. [PMID: 26301150 PMCID: PMC4527635 DOI: 10.1097/gox.0000000000000440] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 06/03/2015] [Indexed: 11/26/2022]
Abstract
Background: Unpleasant attention to unfavorable fat may have harmful psychological effects in terms of body dissatisfaction. As a consequence, this may cause abnormal eating regulation. It has been noted that women interested in liposuction self-report more eating problems. As far as we know, there are no prospective studies with standardized instruments providing sufficient data regarding the effects of aesthetic liposuction on various aspects of quality of life. Nevertheless, publications on the effects of eating habits are lacking. Methods: Sixty-one consecutive women underwent aesthetic liposuction. Three outcome measures were applied at baseline and at follow-up: the eating disorder inventory, Raitasalo's modification of the Beck depression inventory, and the 15-dimensional general quality of life questionnaire. Results: The mean age at baseline was 44 years, and the mean body mass index was 26.0. Thirty-six (59%) women completed all outcome measures with a mean follow-up time of 7 months. A significant improvement from baseline to follow-up was noted in women's body satisfaction, and their overall risk for developing an eating disorder decreased significantly. Conclusion: Aesthetic liposuction results in a significantly reduced overall risk for an eating disorder in combination with improved body satisfaction.
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Cognitive investigation study of patients admitted for cosmetic surgery: information, expectations, and consent for treatment. Arch Plast Surg 2015; 42:46-51. [PMID: 25606489 PMCID: PMC4297806 DOI: 10.5999/aps.2015.42.1.46] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Revised: 10/12/2014] [Accepted: 10/31/2014] [Indexed: 11/17/2022] Open
Abstract
Background In all branches of medicine, it is the surgeon's responsibility to provide the patient with accurate information before surgery. This is especially important in cosmetic surgery because the surgeon must focus on the aesthetic results desired by the patient. Methods An experimental protocol was developed based on an original questionnaire given to 72 patients. The nature of the responses, the patients' motivation and expectations, the degree of patient awareness regarding the planned operation, and the patients' perceptions of the purpose of the required consent for cosmetic surgery were all analyzed using Fisher's exact test. Results Candidates for abdominal wall surgery had significantly more preoperative psychological problems than their counterparts did (P=0.035). A significantly different percentage of patients under 40 years of age compared to those over 40 years of age searched for additional sources of information prior to the operation (P=0.046). Only 30% of patients with a lower educational background stated that the preoperative information had been adequate, whereas 92% of subjects with secondary schooling or a postsecondary degree felt that the information was sufficient (P=0.001). A statistically significant difference was also present between patients according to their educational background regarding expected improvements in their quality of life postoperatively (P=0.008). Conclusions This study suggests that patients require more attention in presurgical consultations and that clear communication should be prioritized to ensure that the surgeon understands the patient's expectations.
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Carruthers KH, Kocak E, Hulsen JH, McMahan JD. Improvement in stress urinary incontinence after abdominoplasty. Aesthet Surg J 2014; 34:1091-8. [PMID: 25073582 DOI: 10.1177/1090820x14544023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Abdominoplasty is indicated in cosmetic surgery to improve body contour. Results from several studies suggest that abdominoplasty also could be therapeutic for certain individuals with urinary incontinence. OBJECTIVES The authors sought to determine the potential therapeutic effect of abdominoplasty on urinary incontinence in a large population to confirm the findings of smaller studies and to identify common characteristics of patients who experience the greatest improvement in these symptoms postoperatively. METHODS Through a retrospective chart review, the authors identified 250 patients who underwent cosmetic abdominoplasty. These patients were invited to participate in a survey to ascertain changes in stress urinary incontinence (SUI) symptoms after abdominoplasty. Patients were subgrouped according to postoperative changes in their urinary incontinence symptoms, and the subgroups were evaluated for common within-group characteristics. RESULTS Of the 250 patients who underwent abdominoplasty during the period of interest, 100 (40%) completed the survey, half of whom (n=50) reported incontinence preoperatively. After abdominoplasty, 30 (60%) of these 50 patients noted improvement in their symptoms, and the other 20 (40%) reported no improvement. Lack of previous cesarean section was a predictor of improvement in SUI symptoms after abdominoplasty. CONCLUSIONS Abdominoplasty to improve body contour also may alleviate symptoms of SUI, especially among patients who have not undergone previous cesarean section. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- Katherine H Carruthers
- Ms Carruthers is a medical student at The University of Toledo College of Medicine in Toledo, OhioDr Kocak is a plastic surgeon in private practice in Dublin, OhioDr Hulsen is a clinical house staff member in the Department of Plastic Surgery at The Ohio State University in Columbus, OhioDr McMahan is a plastic surgeon in private practice in Columbus, Ohio
| | - Ergun Kocak
- Ms Carruthers is a medical student at The University of Toledo College of Medicine in Toledo, OhioDr Kocak is a plastic surgeon in private practice in Dublin, OhioDr Hulsen is a clinical house staff member in the Department of Plastic Surgery at The Ohio State University in Columbus, OhioDr McMahan is a plastic surgeon in private practice in Columbus, Ohio
| | - John H Hulsen
- Ms Carruthers is a medical student at The University of Toledo College of Medicine in Toledo, OhioDr Kocak is a plastic surgeon in private practice in Dublin, OhioDr Hulsen is a clinical house staff member in the Department of Plastic Surgery at The Ohio State University in Columbus, OhioDr McMahan is a plastic surgeon in private practice in Columbus, Ohio
| | - James D McMahan
- Ms Carruthers is a medical student at The University of Toledo College of Medicine in Toledo, OhioDr Kocak is a plastic surgeon in private practice in Dublin, OhioDr Hulsen is a clinical house staff member in the Department of Plastic Surgery at The Ohio State University in Columbus, OhioDr McMahan is a plastic surgeon in private practice in Columbus, Ohio
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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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49
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Analysis of the abdominal musculo-aponeurotic anatomy in rectus diastasis: comparison of CT scanning and preoperative clinical assessment with direct measurement intraoperatively. Hernia 2014; 18:465-71. [DOI: 10.1007/s10029-014-1221-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Accepted: 01/18/2014] [Indexed: 10/25/2022]
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50
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Giordano S, Victorzon M, Stormi T, Suominen E. Desire for body contouring surgery after bariatric surgery: do body mass index and weight loss matter? Aesthet Surg J 2014; 34:96-105. [PMID: 24334498 DOI: 10.1177/1090820x13515701] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND There is disparity between the number of postbariatric surgery subjects who desire body contouring and those who receive it due to lack of resources or insurance criteria. OBJECTIVES The authors evaluate the desire for body contouring after bariatric surgery and its relationship with demographic patient characteristics. METHODS Three hundred sixty patients who had undergone bariatric surgery procedures >1 year previously completed a questionnaire designed by the surgical team to analyze each patient's desire for body contouring by area (face, upper arm, upper back, chin/neck, chest/breast, waist/abdomen, lower back, rear/buttock), scored from 0 to 3 (do not want, want somewhat, want, want a great deal). Data were compared with patient characteristics, postoperative body mass index (BMI), amount of weight loss, and BMI difference (ΔBMI). RESULTS Most patients desired body contouring surgery, with high or very high desire for waist/abdomen (62.2%), upper arm (37.6%), chest/breast (28.3%), and rear/buttock (35.6%) contouring. Many patients (36.4%) cited "very high" expectations for how body contouring might change their appearance. Patients >50 years old and >3 years postsurgery had a significantly lower desire. Patients with a ΔBMI >10 and with a weight loss >20 kg showed a significantly stronger overall desire for body contouring compared with other groups. CONCLUSIONS Most patients desire body contouring surgery after bariatric surgery, and our multivariate analysis showed a significant positive association between female sex, younger age, amount of weight loss, and ΔBMI with desire for body contouring.
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Affiliation(s)
- Salvatore Giordano
- Dr Giordano is a Resident in Plastic Surgery and Dr Suominen is an Assistant Professor of Plastic Surgery in the Department of Plastic and General Surgery, Turku University Hospital, Turku, Finland
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