Medesthetics

MAY-JUN 2016

MedEsthetics magazines offers business education and in-depth coverage of the latest noninvasive cosmetic procedures for physicians and practice managers working in the medical aesthetics industry.

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56 MAY/JUNE 2016 | Surgical Aesthetics Nine-year follow-up data on Sientra's high strength cohesive silicone gel implants has been published in the Aesthetic Surgery Journal (April 2016). W. Grant Stevens, MD, et al, enrolled 1,788 patients with 3,506 Sientra implants across four indications (primary augmentation, revision-augmentation, primary reconstruction and revision-reconstruction) as part of a 10-year Core study for safety analysis. They used Kaplan-Meier risk rates to evaluate postoperative complications, including all breast implant-related adverse effects, for the safety analysis as well as patient satisfaction scores for the effectiveness analysis. The overall risk of capsular contracture was 12.6%—smooth devices had a statistically signifi cantly higher rate of capsular contracture compared to textured devices. Of the 610 re-operations in 477 patients, over half of all re-operations were due to cosmetic reasons, and patient satisfaction was high with 90% of primary augmentation patients indicating their breast implants look natural and feel soft. High Safety Profi le Shown in Sientra Follow-Up Data © GETTY IMAGES CUTTING EDGE SURGICAL AESTHETICS A study investigating the effi cacy of topically applied arnica and mucopolysac- charide polysulfate (MPS) on postoperative edema and ecchymosis in patients who have undergone open-technique rhinoplasty–—published in Plastic and Reconstructive Surgery (March 2016)—revealed less bruising and swelling when compared to control. Gokce Simsek, MD, et al, performed a placebo-con- trolled study of 108 patients, who were randomized into three groups, all of whom had undergone rhinoplasty. Group 1 (n = 36) received postoperative arnica cream treatment; group 2 (n = 36) received postoperative MPS cream treatment; group 3 (n = 36, control group) received no postoperative local treatments. Postoperative edema and ecchymosis were evaluated on days 2, 5, 7 and 10 after the operation using a scale ranging from zero to four. Postoperative ecchymosis was signifi cantly lower in groups 1 and 2 compared to the control group on post-op days 1, 5 and 7. The regression of the edema was more rapid in groups 1 and 2 than in the control group on post-op days 1, 5 and 7. Neither edema nor ecchymosis was signifi cantly different between groups 1 and 2. The researchers concluded "that a rapid regression of edema and ecchymosis may be achieved by local treatments of arnica and mucopolysaccharide poly- sulfate cream. In addition, there are no signifi cant differences between these two treatment regimens." Topical Arnica and MPS Reduce Postsurgical Edema and Ecchymosis in Rhinoplasty Facelift Improves Self- Esteem in Some Patients In an effort to evaluate the effect of facelift surgery on patients' self esteem, New York City-based facial plastic surgeons Andrew Jacono, MD, Ryan P. Chas- tant, MD, and Greg Dibelius, MD, performed a prospective study of 59 consecutive patients under- going rhytidectomy. All of the procedures were performed between July 1, 2013, and October 31, 2013, by the same surgeon. Self-esteem was mea- sured at baseline and at six months postprocedure with the Rosenberg Self-Esteem Scale (RSES). Of the 59 patients, 50 completed the six-month postoperative questionnaire; the mean age was 58 years (range: 37-73 years) and 48 were women. There was no statistically signifi cant change in self-esteem overall, but when separated into subgroups, the researchers found a wide range in experiences. The group that reported low self- esteem at baseline showed a statistically signifi cant improvement in self-esteem after surgery with a mean difference of 3.7 in the RSES score, while the group with high self-esteem at baseline revealed a 3.1-point decrease in the RSES score. The group with average self-esteem before surgery showed a nonsignifi cant increase of 0.5 in the RSES score. The perceived change in youthful appearance (mean 8.9 years) did not correlate with self-esteem changes. The authors note that, "These fi ndings underscore the complex nature of the human psyche as it relates to aesthetic surgery and demonstrates that patients exhibit a wide spectrum of psychological reactions after facelift surgery." The study was published in JAMA Facial Plastic Surgery (January/February 2016).

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