AACS Survey Says Cosmetic Surgery Growing Among Minorities

cosmetic_surgery_minorityA new survey conducted by the American Academy of Cosmetic Surgery says that cosmetic surgery is growing among minority groups in the United States.  In a survey, more than half of the respondents said they think the popularity of cosmetic surgery has increased among members of their racial group.

“Feeling better about yourself and making improvements to your looks is thankfully not limited to a specific race or culture,” comments AACS President Mark Berman MD.

According to the survey, the top cosmetic surgical procedures among specific racial groups include facelift surgery for patients of Asian descent, liposuction for patients of African descent and abdominoplasty for Hispanic patients.  Interestingly, more than 30 percent of the respondents said they when seeking a procedure, they would seek out a cosmetic surgeon of the same racial group as themselves, although many believed this would be a difficult task.

Most cosmetic surgeons are cognizant of the special needs of patients of varying racial groups.  For most surgical procedures, ethnic characteristics are not a significant factor for the doctor to consider.  However, in procedures like rhinoplasty (nose reshaping) or eyelid surgery, the surgeon must take these characteristics into account.  Most patients want to improve their appearance but few want to erase the distinct markers or traits that signify membership within a certain group.

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NBC News Explores Strange Behavior of “Beauty Bandits”

What is a “beauty bandit?”  According to news from msnbc, it’s a person who skips out on their bill for cosmetic treatments.  Surgeons and dermatologists across the country have reported this type of theft, leading some to theorize about the economic reasons for it.

“Because the economy is bad, these women who are used to getting these treatments will now get them whatever way then can,” says Dr Shino Bay Aguilera to reporters for msnbc.  Other doctors quoted for the story agree and say they now collect payment before administering outpatient, non-surgical procedures.

How do these cosmetic criminals pull it off?  They either write a fraudulent check or simply waltz out the door.  The woman in south Florida featured in the story left her purse on the front desk as a diversion, making the staff believe she was walking to a nearby ATM and would return to get the purse.  Of course, she never did and now likely faces criminal charges for theft.

Dr. Samir Pancholi a facial plastic surgeon in Las Vegas, says this has happened in his office on 3 different occasions: “The first time, it was a woman in her 50s who came in and got treatment, then said, ‘My purse is in the car, I’ll go grab it and be right back.’ Then she was gone.”

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German Pharmaceutical Gets U.S. Approval for Botulinum Toxin Product

XEOMIN, a new product containing the botulinum toxin, has just received FDA approval for the treatment of cervical dystonia and blepharospasm.  Clearance of the drug makes it the 3rd product of this kind (with Botox and Dysport) to enter the U.S. market.

2 clinical trials conducted in the United States were cited during the approval process, along with comparator studies that evaluated XEOMIN in relation to Botox.

According to a study referenced in the Journal of Neurological Sciences, [XEOMIN] showed “non-inferiority” to Botox when used in equivalent doses for the treatment of blepharospasm.

So what’s the difference?  According to German manufacturer, Merz Pharmaceutical, “XEOMIN is the only botulinum toxin that does not require refrigeration prior to reconstitution. “  The company says this could “simplify product distribution and storage, and help ensure product integrity at the time of injection.”

In related news, Merz is acquiring Bioform Medical, maker of Radiesse dermal filler.

Read more on Merzusa.com

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Study Examines Prevalence of Body Dysmorphic Disorder

Body dysmorphic disorder (BDD) is something cosmetic surgeons routinely watch for in prospective patients.  Characterized by abnormal preoccupation with self-perceived appearance defects, BDD can be a distressing condition and contraindication for surgery.

A recent study published in Psychiatry Research provides the most recent update on the prevalence of BDD, examining the population demographics that are most affected and the tendency of those affected to seek cosmetic surgery.  2,510 German people were analyzed in the research study, and 45 of them were showed symptoms of BDD.  Symptoms (or inclusion criteria) included the following:

  • Preoccupation with an imagined defect in appearance
  • Concern is markedly excessive
  • Causes clinically significant distress / impairment in function

Of those 45 people experiencing the above symptoms, 7 of them had undergone cosmetic surgery.

As a general rule, cosmetic surgeons do not operate on patients who have this disorder — for many reasons, including the high chance for the patient to be dissatisfied with the results.  However, patients do not always report symptoms of BDD to their cosmetic surgeon.  They may be embarrassed about it or they may be unaware that such behavior (preoccupation with a perceived appearance defect) is abnormal.  Subjects in the study showed an intense, frequent preoccupation and dislike of body parts such as the ears, nose, stomach, hips, buttocks, skin and breasts.

The disorder poses a significant threat to one’s health.  Aside from being a general hindrance, BDD is linked to increased thoughts about suicide and suicide attempts.  Therefore, as authors of the study suggest, awareness of body dysmorphic disorder should continue to increase and careful screening by healthcare providers should be initiated to help people suffering from it.  A disorder like BDD also reinforces the need for cosmetic surgery patients to be completely open and honest about their reasons for seeking surgery and their medical history.

You can access this study, “Updates on the prevalence of body dysmorphic disorder: A population-based survey” through Elsevier Journals or Science Direct.

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Model With Largest Breasts Experiences Complications After Surgery

A Brazilian model who underwent breast augmentation to have the largest breasts in the world, is now experiencing complications after her 32nd surgical procedure, which was performed in Brazil.  According to news reports, Sheyla Hershey has a staph infection in both breasts, which could be life threatening if it reaches the bloodstream.

Is this a common complication? Dr. Angelo Cuzalina, Tulsa cosmetic surgeon and President Elect of the American Academy of Cosmetic Surgery, gave a brief statement about the topic:

Any infection in a breast implant is unwanted by both patient and surgeon.  They are fortunately very rare (just less than 3 in 1000 patients), but a breast implant infection is difficult to deal with when they do occur and almost always require implant removal.  Having massive implants just complicates the problem further due to the excess skin after removal.

Certain infections such as methocillin resistant staph (MRSA) are becoming more common in today’s society and require more aggressive treatment.  Patients should let their surgeon know if redness or unusual pain occurs along with fever combined with a general feeling of extreme malaise during the first few weeks following breast augmentation.

“Sheyla takes her craft seriously,” says the model’s official website.  After undergoing multiple surgical procedures on her breasts, lips and buttocks, she seems very comfortable going under the knife and talking about it publicly.

But in an interview with Fox News, she expresses regret for choosing extremely large breast implants and suggests that if she could start over again, she would.  As she demonstrates her daily routine on video, it’s clear that she’s a very dedicated and strong-willed woman.

Fox News Houston has a series of video interviews with Sheyla Hershey and you can read regular updates about her status on her website, sheylahershey.net

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From Collagen to Fibroblasts: the Changing Face of Dermal Fillers

The last two years have been rough for collagen-based dermal fillers—and it shows in the announcements by two leading manufacturers, Allergan and Johnson & Johnson, that they will no longer produce their respective collagen products (the human-derived CosmoDerm and CosmoPlast, the bovine Zyderm and Zyplast for Allergan; the porcine Evolence for Johnson & Johnson). For more than two decades, collagen has been the filler of choice for many dermatologists. Considering donor tissue origins, it’s natural that questions could arise. Plus, collagen-based fillers require skin allergy testing and are relatively short-lived.

As in many markets, money drives the evolution of new products, and facial fillers are no exception. The popularity of non-animal hyaluronic acid (HA) dermal fillers (known as replacement fillers because they replace lost volume) and PLLA and PMMA fillers (known as stimulatory fillers because they stimulate collagen and fibroblast production) has been strong in the recent past. Juvéderm, Perlane, Restylane, Radiesse, and Sculptra currently dominate the US market. Dermatologists report HA, PLLA and PMMA fillers as bring more versatile, longer-lasting, bulkier, and better for deep-volume filling than collagen.

But what about fine and thin line use, such as for foreheads or smokers lines around the mouth? Collagen was usually considered better in those instances. But Restylane Fine Lines is one HA product that makers hope to cover this application.

What will the world of fillers look like in the future? Who can say? But certainly change is afoot. Although fillers that indirectly stimulate fibroblast production are holding sway, direct injection of fibroblasts with Human Dermal Fibroblasts (HDFs) may be a trend. UK dermatologists are currently testing Valveta, a filler derived from the foreskins of male babies that is reputed to repopulate skin with healthy young cells and be long-lasting, if not permanent.

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Latisse Wishes Challenge Donates to Make-A-Wish Foundation

On June 15th, Allergan Inc announced a brand new Latisse promotion planned to benefit the Make-A-Wish Foundation.  In the Latisse Wishes Challenge, they’re asking people to donate $20 or more to the Make-A-Wish foundation in exchange for a Latisse free trial certificate.  However, only the first 10,000 people who donate will receive a certificate.

You may remember last year’s campaign led by Brooke Shields.  This year, the campaign is led by lifestyle designer Kathy Ireland, professional ballroom dancer Chelsie Hightower and style guide Bobbie Thomas.

“With approximately 1.5 million bottles sold since launching the product a little more than a year ago, LATISSE is giving back by helping the Make-A-Wish Foundation grant the wishes of children. Through the campaign, we will double each individual’s donation, with a maximum donation of $250,000, through October 31,” said Robert Grant, President of Allergan Medical, a division of Allergan, Inc.

Read more about purchasing Latisse in Cincinnati

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Breast Ptosis: Definition, Cause and Cure

Ptosis (pronounced “toe-sis”) is a condition characterized by breast droop and loose, stretched skin on the breasts.  The skin on a woman’s breasts is primarily responsible for maintaining their position.  When the skin becomes stretched, loose or less elastic, the breasts will droop.

Measuring Breast Ptosis

A common way to measure breast ptosis is the Regnault classification, which is as follows in simplified form:

1. Pseudoptosis – the nipple falls above the fold, but the breast is hypoplastic and hangs below the breast crease.

2. Glandular Ptosis – the nipple is above the fold, but the breast hangs below the crease.

3. Minor Ptosis – the nipple is level with the breast crease.

4. Moderate Ptosis – the nipple is below the breast crease, but above the lower breast contour.

5. Severe Ptosis: the nipple is below the breast crease and below the lower breast contour.

Causes of Breast Ptosis

In general, the cause of breast droop is a combination of factors including breast size, aging, and gravity.  Large breasts are gradually pulled downward by gravity.  As your skin becomes thinner and less elastic with age, it stretches and becomes less able to maintain a youthful breast position.

A recent study sheds light on the lifestyle factors that contribute to breast ptosis.  Plastic surgeons at the University of Kentucky found that age, significant weight loss, higher BMI, larger bra cup size, number of pregnancies, and smoking were found to be significant risk factors for breast ptosis, while “breast-feeding, weight gain during pregnancy, and lack of participation in regular upper body exercise were not found to be significant risk factors.”

Correcting Breast Ptosis

Using the classification system above, a surgeon can recommend the right procedure to correct breast ptosis.  Surgery to correct minor ptosis may be quite different from the procedure to correct a severe case of ptosis.  The usual procedure of choice is breast lift surgery / mastopexy.

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Preserving Ethnic Characteristics in Rhinoplasty

As rhinoplasty continues to grow in popularity, one question seems to arise repeatedly: Can I do the operation without sacrificing my ethnic identity?  In a recent article for Modern Medicine, several cosmetic surgeons comment on how they handle this situation and communicate with their patients.

“There are subtle things that we can do to make a change in the profile, in the definition of the nose, without changing their ethnicity, without intrinsically changing their appearance,” said Charles M. Boyd M.D.

For the cosmetic surgeon, managing the patient’s expectations is important.  Likewise for the rhinoplasty patient, communicating desires and aesthetic goals is critical.  Each surgeon-patient relationship will go through this process in a different way.  One emerging trend facilitating this communication process is the use of 3-dimensional imaging to visually approximate the results that can be achieved.

“I use computer imaging and this is very helpful in pinpointing what patients are trying to achieve, and it enables them to see what’s in my mind as well,” said Steven B. Hopping M.D.

When it comes down to operating, there are also anatomical considerations for the ethnic patient.  View the article on modernmedicine.com to read how these surgeons approach rhinoplasty in patients of Asian, African American, and Middle Eastern descent.

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Surgeons Study Suture Success in Otoplasty

Ear surgery, commonly known as Otoplasty, is a cosmetic procedure that brings the ears closer to the patient’s head.  While it’s commonly performed for children, adults will often choose to undergo the procedure as well.  There are several established techniques that your cosmetic surgeon may use, but each will typically involve an incision behind the ear and reshaping of the ear cartilage.

Plastic surgeons in Lithuania recently studied the success rate of different suture types used in Otoplasty.  A 3-year study was conducted with 100 patients.  They were divided into these groups based on the suture materials chosen:

  • PDS
  • Monocryl
  • Mersilene

Patients (48 men and 52 women) had a median age of 20 years.  After analyzing the data for each group, the doctors found that 3 patients in the PDS group and 3 patients in the Monocryl group had unsatisfactory aesthetic outcomes requiring revision surgery.  Patients in the Mersilene suture group had the lowest rate of recurrence.

Read more about this study online on PubMed: “Comparison of otoplasty outcomes using different types of suture materials”

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