It is here that we must consider, possibly the strongest argument for the proponents of cosmetic facialsurgery; autonomy. This pivotal point stipulates a patient with capacity has a right, with the aid of informed decision-making, to determine what happens to their body. Literature suggests that facialplasticsurgery increases patient self-esteem and confidence. However it is difficult to measure comparable groups, since distress created through the perception of disfigurement or inadequacy is not always in proportion to the physical presence of deformity [10,11]. Opponents would argue that the basis of autonomy is informed consent, with cosmetic surgery outcomes limited to cross-sectional and cohort studies. These studies attract particular sub-sets of patients, potentially producing data that is difficult to generalise to the wider population. Researchers attempted to overcome this by highlighting that body image dissatisfaction surveys within the study cohort were comparable to a normative sample. However, a systematic review demonstrated narcissistic and histrionic personality disorders, as well as body dysmorphic disorder as the three most common psychiatric conditions encountered in patients seeking cosmetic surgery [15,16]. There is even some data indicating despite improvement in body image post-operatively, psychological problems remained, inhibiting the positive effects of cosmetic surgery . Despite small studies, and minimal literature regarding psychosocial effects of cosmetic surgery, the potential risks of operating are well documented and medical device use stringently monitored . This results in appropriate levels of information potentially provided to a patient with capacity. In consideration of informed decision making and autonomy, cosmetic surgery would be favourable for patients who meet the psychological standards to achieve best results. However, whilst autonomy is a principle pillar, surgeons have a responsibility not only to the patient but also society, and while they may be presented with autonomous, capable patients who would like to look non-human, a surgeon is governed by personal ethical principles and societies understanding as a whole.
These are the Basic Standards for Residency Training in Otolaryngology / FacialPlasticSurgery as established by the American Osteopathic Colleges of Ophthalmology and Otolaryngology Head and Neck Surgery (AOCOO-HNS) and approved by the American Osteopathic Association (AOA). These standards are designed to provide the osteopathic resident with advanced and concentrated training in otolaryngology / facialplasticsurgery and to prepare the resident for examination for certification in Otolaryngology / FacialPlasticSurgery by American Osteopathic Boards of Ophthalmology and Otolaryngology-Head and Neck Surgery (AOBOO-HNS).
Side effects of the most frequently performed double eyelid surgery included a clearly visible surgical scar, lagophthalmos, xeroma, asymmetry, and paresthesia. It was the wish of the participants to enhance their appearance naturally, as if no surgery had been performed, but instead, they were left with permanent, conspicuous scars at the surgical site. After undergoing an FPS, the participants suffered from fear, shame, distress, depression, being upset, anger, and a victim mentality. The participants experienced conflicts with the family members who recommended surgery to them, as well as conflicts between other family members. Furthermore, they were faced with ridicule and misunderstanding by their friends and teachers at school and developed mistrust and frustration toward medical staff and medical facilities. They were emotionally hurt by callus jokes and passing comments. They also stated that the information that they had received plasticsurgery, which they wished to keep hidden, was dis- closed by the inconsiderate comments of others. They were embarrassed and baffled by strangers on the streets asking them about their plasticsurgery, and even plastic surgeons, with whom they met privately, asking about where they have received the surgery.
The practical application of near set theory on the pre and post plasticsurgeryfacial images to extract resemblance between them was introduced in this article. Facialplasticsurgery can be reconstructive to correct facial feature anomalies or cosmetic to improve the appearance. Both corrective as well as cosmetic surgeries alter the original facial information to a great extent thereby posing a great challenge for face recognition algorithms. The main aim of this article is to measure the degree of resemblance of facial images before and after plasticsurgery. Blepharoplasty (Eyelid surgery) and Rhinoplasty (Nose surgery) is being considered for this purpose due to the availability of maximum number of individuals and it is easy to differentiate faces before and after plasticsurgery. tHd ,tNM and tHM is being used to measure the degree of resemblances between plasticsurgery images. tHD measure shows around 100% nearness as compared to tNM and tHM for all features . More features can be considered like Pal’s Entropy, Zernike Moments etc to analyze the resemblances between images, similarly we can use other metrics also to measure the distances . These measure can also be used in increasing the efficiency of any face recognition system containing normal facial images and plasticsurgery images.
Methods: Non-syndromic infants, aged six months, with isolated cleft of the secondary palate without associated lip deformity, were included in this prospective randomised controlled trial to one of four options: Veau-Wardill-Kilner palatoplasty at six months of age (VWK06) or 12 months of age (VWK12), or two-flap palatoplasty with intra-velar veloplasty at six months of age (2F-IVV06) or 12 months of age (2F-IVV12). Outcome measures are early and late postoperative complications, velopharyngeal inadequacy symptoms, nasality, articulation and presence of otitis media at three years of age. Results: Of the 76 infants included in the trial, 90.8 per cent received surgery: VWK06 (n=18), VWK12 (n=16), 2F-IVV06 (n=18) and 2F-IVV12 (n=17). Early postoperative complications occurred in two VWK infants (6.1%) and three 2F-IVV infants (8.8%)—a difference of -2.8 per cent. With surgery planned at six months of age (T06) and 12 months of age (T12) respectively, there were three VWK infants (8.6%) and two 2F-IVV infants (6.3%)—a difference of +2.3 per cent. At age three, speech assessments were conducted for 62 (84%) children. Velopharyngeal inadequacy symptoms were detected in 4/30 VWK children (13.3%) and 3/30 2F-IVV children (10.0%)—a difference of 3.3. With T06 and T12, there were three VWK infants (9.4%) and four 2F-IVV infants (14.3%)—a difference -4.9%. Otitis media was documented in 40/61 of children (65.6%), hyper- and/or hyponasality in 27/61 of children (44%) and articulation errors in 53/60 of children (88%).
claims creating unreasonable expectations, or failed to clearly indicate out-of-pocket expenses. There were no recorded cases of inaccurate use of titles or claims of having the lowest fees or prices. Rates of discrepancy were higher for offers of gifts or discounts, inappropriate phraseology to encourage surgery, website photos that create
Result: In plastic and reconstructive surgery, the most commonly used, free software platforms are 3D Slicer (Surgical Planning Laboratory, Boston, MA, USA) and OsiriX (Pixmeo, Geneva, Switzerland). Perforator mapping using 3D-reconstructed images from computed tomography angiography (CTA) and magnetic resonance angiography (MRA) is commonly used for preoperative planning. Three- dimensional volumetric analysis using current software techniques remains labour-intensive and reliant on operator experience. Three-dimensional printing has been investigated extensively since its introduction. As more free open-source software suites and affordable 3D printers become available, 3D printing is becoming more accessible for clinicians.
We identified 38 patients who underwent single- digit fasciectomy during the review period. The actual total cost per patient was calculated and compared to CCH treatment (Table 1). The mean cost of surgery for single-digit fasciectomy was AU$4609.61 (AU$2761.44–AU$10,928.67) . In terms of fasciectomy component cost, the highest was theatre, followed by medical and surgical staff and then anaesthetic staff. The cheapest variables were imaging, pathology and pharmacy.
Background: Postoperative suction drainage has historically been a routine part of care following reduction mammaplasty surgery. Purported benefits are a reduction in complications such as haematoma, seroma, delayed wound healing and loss of nipple or areola. The aim of this study is to compare the complication profile of breast reduction surgery patients who had received postoperative drains and those who had not.
was AU$4676 per patient in favour of collagenase. To moderate this cost difference by the effect of complications using the ICER, this gross cost difference must be divided by the difference in the risk of complications (aggregated complication risk of surgery minus aggregated complication risk of collagenase = 6.85 – 2.74 = 4.11). When this is done, the cost saving is AU$1137.71 per unit decrease in complications with collagenase treatment. If the risk of recurrence for surgical fasciectomy is 20.9 per cent and the risk of recurrence for collagenase use is 47 per cent, then 8 and 19 patients, respectively, would recur in our surgical and matched hypothetical cohorts (n=48). In other words, we can infer that 13 patients in our cohort treated with collagenase would not have recurred if they were treated with surgery. The ICER can be recalculated using recurrence as a measure of effect by dividing the gross cost difference by the gross difference in the number of patients who we predict would have recurred (AU$4676/13 = AU$359.69). Therefore, the cost to the healthcare system for each patient who does not recur within five years of surgical fasciectomy is AU$359.69. If collagenase use is limited to pre-tendinous cords and MCP joint contracture, giving a recurrence rate of 39 per cent, the additional cost would be AU $519.55 per patient who does not recur (AUD$4676/9).
A 57-year-old woman presented with facial cellulitis with one week of increasing erythema and swelling of the nose, forehead and cheeks with a background of cosmetic nasal dorsum augmentation with PAAG filler in China eight years earlier. Ultrasound and MRI of the face showed two pockets of displaced filler material on the lateral aspect of the nose and left zygomatic arch. She was taken to theatre the following day to drain two abscesses on bilateral nasal side walls and to remove the PAAG filler (Figure 4). Swab for microscopy and culture did not isolate a dominant organism. Nasendoscopy showed no sinusitis or nasal discharge and healthy
included in this study had Doppler ultrasonography prior to surgery for diagnosis of PMA thrombosis and BMN. It appears that only some of previous case studies reporting PMA thrombosis in CTS used ultrasonography for diagnosis prior to treatment, and in others the pathology was found at surgical exploration. 1,23,25,30,36,37 Kele et al used preoperative
The process of having cosmetic breast augmentation surgery in Australia involves a completely private arrangement (and transactions) between a surgeon, anaesthetist, hospital and patient, with no funding or rebates available through the Medicare- based public health system. The procedure is not limited to Royal Australasian College of Surgeons (RACS) accredited surgeons and, in many instances, the doctor performing the surgery is a cosmetic proceduralist. Further, the Australian Society of Plastic Surgeons’ Breast Implant Registry does not capture data related to non-specialist surgeons who perform the procedures.
Background: The accurate determination of intact breast volume facilitates preoperative planning for a range of plastic surgical breast procedures. In women with breast hypertrophy, volumetric assessment assists in planning the amount of tissue to be removed during breast reduction surgery to achieve breast symmetry. Further, in jurisdictions where restrictive surgical guidelines exist, measurement of intact breast volume is essential in order to justify breast reduction surgery. Not all practitioners have access to magnetic resonance imaging (MRI) or three dimensional (3D) laser scanning facilities, so the purpose of this study was to determine whether water displacement of the intact breast is an effective substitute method of measurement in women with breast hypertrophy.
Those of us with two X chromosomes in a surgical occupation are increasingly asked to speak on the topic of ‘women in surgery’ or ‘women in plasticsurgery’. Although the promotion of women in our profession is important, the broader principle that people and groups who have experienced disadvantage in the past should now be more welcomed is one that perhaps has a more fundamental basis and is, in some ways, less developed. The problem of categorising people as ‘women surgeons’ or ‘ethnic minority surgeons’ is that it puts emphasis on one particular attribute and pigeonholes people in a simplistic way.
Results: Image-guided navigation systems using fiducial markers have demonstrated utility in numerous surgical disciplines, including perforator- based flap surgery. However, these systems have largely been superseded by augmented reality (AR) and virtual reality (VR) technologies with superior convenience and speed. With the added benefit of tactile feedback, holograms also appear promising but have yet to be developed beyond the prototypic stage. Aided by a growing volume of digitalised clinical data, machine learning (ML) poses significant benefits for future image-based decision-making processes.
the surveyed centres routinely used 3D cameras in the preoperative assessment of both single-suture and multi-suture/syndromic craniosynostoses. Of the remaining four centres, three stated they wished to offer 3D photography to patients in the future. Sharing of data obtained from 3D cameras would allow for objectively comparing outcomes following synostosis surgery while avoiding the long-term detriments of repeat CT scanning.