NOV-DEC 2016

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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CUTTING EDGE SURGICAL AESTHETICS 56 NOVEMBER/DECEMBER 2016 | Surgical Aesthetics ADSCs Inhibit Infl ammation To Aid in Fat Graft Survival Researchers at Fujian Medical University Union Hospital in China have uncovered a potential mechanism of action by which adipose-derived stem cells (ADSCs) increase the survival rate of fat grafts. Xiaosong Chen, MD, et al, compared the outcomes of fat grafts in mice and posit that ADSCs reduce oxidative stress and infl am- mation in the area of fat grafting. The mice that received fat grafts enriched with ADSCs exhibited lower infl am- matory cytokine production, enhanced growth factors, down-regulated NADPH oxidase expression, increased vascularization and increased fat graft survival compared to mice that received non-ADSC-enriched grafts. Western blot analyses showed that crosstalk be tween Nrf2 antioxidant responses and NF- KB- and TLR4- mediated infl ammatory responses regulated the effects of hypoxia on ADSCs. "Taken together, our results indicate that ADSCs can increase the survival of fat transplants through the modulation of infl ammatory and oxidative responses via Nrf2 and TLR4, suggesting potential strategies to improve the use of ADSCs for cell therapy," the authors wrote. The study is published in Cell Death and Disease (September 2016). In recognition of the growing popularity of genital plastic and aesthetic surgery procedures, Wiley Publications has released Female Genital Plastic and Cosmetic Surgery, a comprehensive textbook written by gynecologists and plastic surgeons and edited by Michael P. Goodman, MD. The book covers: • The anatomy of the area • Specifi c surgical procedures and their variations • Patients' rationales for surgery • Training guidelines and ethical issues • Outcome statistics • Sexual and psychosexual issues • Patient selection • Potential risks and complications • Revisions Available at New Text Focuses On Genital Plastic Surgery Procedures ALLERGAN 410 ANATOMICAL IMPLANTS SHOW GOOD FOLLOW-UP SAFETY PROFILE Two recent studies published in Plastic and Reconstructive Surgery investigate the long-term safety of Allergan's Natrelle 410 anatomical shaped, cohesive silicone gel implants. Jacob G. Unger, MD, et al, enrolled 212 consecutive patients who re ceived the implants for breast reconstruction over a 12-year period. Minimum follow-up was 3.3 years. The overall complication rate was 19.8%, the majority of adverse events were minor and included rippling (9.4%) and asymmetry (4.2%). Major complications included infection (2.4%), malposition (1.4%), capsular contracture (0.9%), seroma (0.5%), extrusion (0.5%) and implant rupture (0.5%). The rate of implant-related reoperation, excluding cancer recur- rence, was 9%. Average patient satisfaction was 4.83 out of 5; surgeon satisfaction averaged 4.9 out of 5. The study was published in the September 2016 issue. A second study, "Risk Factor Analysis for Capsular Contracture, Malpo- sition, and Late Seroma in Subjects Receiving Natrelle 410 Form-Stable Silicone Breast Implants," by Patricia McGuire, MD, et al, was published online September 10, 2016. It included the results of two ongoing, prospec- tive, multicenter studies with 17,656 subjects who received Natrelle 410 implants for augmentation (n = 5,059), revision-augmentation (n = 2,632), reconstruction (n = 7,502) or revision-reconstruction (n = 2,463). Median follow-up was 4.1, 2.6, 2.1 and 2.3 years in the four cohorts, respectively. Capsular contracture rates across cohorts ranged from 2.3% to 4.1%; malposition from 1.5% to 2.7%; and late seroma from 0.1% to 0.2%. Signifi cant risk factors for capsular contracture included: • Subglandular implant placement • Periareolar incision site and older device age in the augmentation cohort • Older subject age in the revision-augmentation cohort • Higher body mass index in the reconstruction cohort • No Betadine pocket irrigation in the reconstruction cohort Signifi cant risk factors for malposition included: • Longer incision size in the augmentation cohort • Capsulectomy at time of implantation in the reconstruction cohort • Implantations performed in the physician's offi ce versus a hospital or stand-alone surgical facility in both revision cohorts a 3.3 19.8% and includ A A

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