OCT 2018

MedEsthetics—business education for medical practitioners—provides the latest noninvasive cosmetic procedures, treatment trends, product and equipment reviews, legal issues and medical aesthetics industry news.

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16 OCTOBER 2018 | MedEsthetics © GETTY IMAGES Lasers and light sources are highly effective in reducing the redness and visible vessels of rosacea, but how long do these benefi ts last? In an effort to document both effi cacy and continuity of benefi ts of pulsed dye laser (PDL) treatment in rosacea, research- ers Emel Bulbul Baskan and Asli Akin Bell of Turkey treated 14 rosacea patients with one to four PDL sessions. They used physician clinical assessment (PCA), patient self-assessment (PSA), and erythema and telangiectasia grading scores to evaluate effi cacy. The patients were then followed for 21.64+/-14.25 months. Erythema and telangiectasia scores were signifi cantly improved in all subjects following treatment. Nine patients achieved 50 percent clinical improvement, according to PCA. According to PSA, 11 patients had good/excellent improvement. Twelve of the 14 patients reported mod- erate or signifi cant benefi t of treatment at the end of the follow-up period. The study was published in the Journal of Cosmetic and Laser Therapy (online July 24, 2018). PDL OFFERS LONG-TERM EFFICACY IN ROSACEA Key Drivers of Employee Engagement and Performance Practices struggling to get their employees on board with managements' visions and goals may benefi t from a new study, "What Employees Say Drives Engagement and Perfor- mance," from The Six Disciplines, a consultancy that helps business owners and managers engage their teams in a shared purpose to improve performance and drive growth. After reviewing responses from more than 600 respondents with different educational levels and various functional responsibilities who worked at companies with 100 to 2,500 employees, the fi rm found that improving engagement and organizational performance requires management to focus on both soft skills, such as attitudes and relationships, and hard skills, such as identifi able systems and processes, in the workplace. Respondents indicated that the top drivers for better employee engagement included: 1. The organization cares about me (88 percent) 2. Openness and honesty (84.1 percent) 3. I care about the organization (84.1 percent) 4. We live our core values (83.5 percent) 5. People around me are enthusiastic about their work (83.4 percent) The top drivers for better performance included: 1. Leadership sets long-term vision and aligns resources accordingly (77 percent) 2. Openness and honesty (76.5 percent) 3. There is a mindset of constant improvement (76.5 percent) 4. Workgroups are managed in an organized way (76.1 percent) 5. Plans are reviewed and revised by department on a regular quarterly basis (75.7 percent) Recent deaths and serious complications associated with the increasingly popular Brazilian Buttock Lift Pro- cedure (BBL) have prompted the American Society for Aesthetic Plastic Surgery (ASAPS) to form a task force to examine the causes behind these complications and help educate physicians on best practices. The ASAPS notes that to-date, autopsy reports reveal that all deceased BBL patients have had specifi c fi ndings in common, including: 1. Fat in the gluteal muscles 2. Fat beneath the muscles 3. Damage to the superior or inferior gluteal vein 4. Massive fat emboli in the heart and/or lungs Further, ASAPS identifi ed factors that added addi- tional risk to the procedure as well as those that proved to be protective and/or preventative. These fi ndings led to the adoption of the following recommendations: 1. Avoid injecting fat into the deep muscle. No deaths have occurred with fat found only in the subcutaneous plane (under skin but over muscle). 2. Avoid gluteal veins and the sciatic nerve. Fat should only be grafted into the superfi cial planes with the subcutaneous space considered safest. 3. Use a >4.1mm single hole injection cannula and instrumentation that offers control, avoiding bendable cannulas and mobile luer connections. Vibrating can- nulas may provide additional tactile feedback. 4. Avoid downward angulation of the cannula. 5. Position patient and place incisions to create a path that will avoid deep muscle injections. 6. Maintain constant three-dimensional awareness of the cannula tip. 7. Only inject when the cannula is in motion to avoid high-pressure bolus injections. 8. Consider pulmonary fat embolism in unstable intra- and post-operative patients. 9. Review gluteal vascular anatomy and draw landmarks to identify and avoid injection into the pedicle. 10. Include risk of fat embolism and surgical alternatives in the informed consent process. BEST PR ACTICES Rece with cedu Aest to ex help T rev fin 4 F tiona to be to the 1. Avo hav plan BEST PRACTICES IN BUTTOCK AUGMENTATION

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