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Laryngoscope Investigative... Jun 2024During the COVID-19 pandemic, elective surgeries faced cancelations due to quarantine measures. The objective of this study was to assess facial plastic and...
OBJECTIVE
During the COVID-19 pandemic, elective surgeries faced cancelations due to quarantine measures. The objective of this study was to assess facial plastic and reconstructive surgery (FPRS) volume before, during, and after the height of the pandemic on a national scale.
METHODS
The TriNetX Research Network identified 68,101,098 individuals aged 18+ with healthcare interactions from 2017 to 2022. Rates of common FPRS surgeries and procedures were compared during March-August of each year, aligning with the pandemic lockdown.
RESULTS
Compared to immediately before the pandemic in 2019, the 2020 pandemic peak saw an overall surgical volume reduction of -36.8%, with specific surgeries decreasing significantly: rhinoplasty (-28.6%), septoplasty (-34.0%), rhytidectomy (-54.9%), blepharoplasty (-40.7%), brow lift (-43.8%), ectropion/entropion repair (-35.6%), repair of blepharoptosis (-45.6%), correction of lagophthalmos (-29.9%), correction of lid retraction (-36.8%), and lipectomy (-41.8%) ( < .001). The procedural volume also decreased by 28.6%, encompassing reductions in various procedures: botulinum toxin A (-18.7%), facial filler (-40.7%), dermabrasion (-62.3%), chemical peel (-36.6%), and intralesional injection (-33.3%) ( < .001). In contrast to 2020, 2021 witnessed an increase of +75.0% in total surgical and +61.3% procedural volume: rhinoplasty (+81.0%), septoplasty (+74.7%), rhytidectomy (+143.4%), blepharoplasty (+81.7%), brow lift (+64.5%), ectropion/entropion repair (+55.2%), repair of blepharoptosis (+62.7%), correction of lagophthalmos (+39.0%), correction of lid retraction (+73.0%), lipectomy (+121.2%), botulinum toxin A (+52.4%), filler (+59.6%), dermabrasion (+91.8%), chemical peel (+78.8%), and intralesional injection (+67.3%) ( < .001). In 2022, rates of total surgeries (+8.5%) and procedures (+12.8%) surpassed pre-pandemic levels from 2019 ( < .001).
CONCLUSIONS
FPRS experienced significant pandemic-induced decreases, followed by a notable recovery in subsequent years, with certain surgeries and procedures surpassing pre-pandemic levels.
LEVEL OF EVIDENCE
4.
PubMed: 38864000
DOI: 10.1002/lio2.1292 -
Aesthetic Surgery Journal. Open Forum 2023The facelift remains the gold standard for rejuvenating the aging face. Many surgical techniques exist in the surgeon's armamentarium that vary based on scar burden,... (Review)
Review
The facelift remains the gold standard for rejuvenating the aging face. Many surgical techniques exist in the surgeon's armamentarium that vary based on scar burden, extent of skin undermining, and manipulation of the superficial musculoaponeurotic system. Yet, existing strategies predominantly address the mobile face and have limited effect on fixed zones such as perioral, periorbita, and forehead. Multiple ancillary techniques have therefore been developed to address this therapeutic gap in facial rejuvenation. The most popular techniques today include dermabrasion, lasers, chemical peels, and radiofrequency devices. All have demonstrable safety and efficacy and are chosen based on the patient's unique anatomical presentation, comfort level, and tolerability of recovery time. Surgeons are ideally equipped with the tools and skills to offer all modalities and then tailor their treatment to the specific patient's anatomy. Herein, we review the most effective ancillary procedures of the facelift and describe an evolution of their use in our practice.
PubMed: 38828090
DOI: 10.1093/asjof/ojad063 -
Annals of Burns and Fire Disasters Jun 2023Post-burn leucoderma patients remain the most challenging to treat because they have two distinct issues: textural changes and hypopigmentation that must be managed...
Post-burn leucoderma patients remain the most challenging to treat because they have two distinct issues: textural changes and hypopigmentation that must be managed simultaneously. A variety of surgical techniques have been used with variable outcome. This prospective study evaluated the efficacy of superficial dermabrasion followed by suction blister epidermal grafting (SBEG) in post-burn leucoderma treatment. Twenty patients, 15 females and 5 males, ages ranging from 18 to 52 years, all having post-burn leucoderma ranging from 10 to 36 months, were included. The recipient sites were prepared by superficial dermabrasion. The Chinese cupping device was used for blister induction. Blister formation times, as well as the number of blisters, were noted. Complications, extent of the repigmentation, treatment efficacy and color matching were recorded. The mean time taken for blister formation was 91.75±10.29 min. The number of blisters harvested for each case ranged from 2 to 9. Regarding complications, 1 had partial graft loss, 3 developed perigraft halo at the recipient site, and all patients had temporary hyperpigmented circular macules at the donor sites. After a mean follow up period of 8.5±1.73 months, repigmentation percentage ranged from 40 to 100% with good color matching. Treatment efficacy was excellent in 3 cases (15%), good in 12 cases (60%), fair in 4 cases (20%), and poor in 1 case (5%). As regards patient satisfaction, 15 patients (75%) were satisfied, while 5 patients (25%) weren't. Combined superficial dermabrasion and SBEG appears to be a simple and cost-effective surgical treatment modality for localized post-burn leucoderma.
PubMed: 38681944
DOI: No ID Found -
Skin Research and Technology : Official... Apr 2024Hydradermabrasion, also known as "HydraFacial," is an exfoliative cosmetic procedure for skin rejuvenation that has gained popularity. Despite its increasing popularity,...
BACKGROUND
Hydradermabrasion, also known as "HydraFacial," is an exfoliative cosmetic procedure for skin rejuvenation that has gained popularity. Despite its increasing popularity, clinical studies validating its efficacy with non-invasive assessment of histological changes to the skin, are scarce. In this study, we used Line-Field Confocal Optical Coherence Tomography (LC-OCT), an optical imaging device, to non-invasively visualize microscopic changes to skin anatomy after hydradermabrasion treatment.
MATERIALS/METHODS
Eight volunteers (Fitzpatrick skin types II-V) were recruited for this study. Images, using LC-OCT (DeepLive, DAMAE medical) were obtained before and after hydradermabrasion and at 2 weeks post-treatment. A commercially available hydradermabrasion device was utilized to perform the dermabrasion.
RESULTS
In the epidermis, initially, a decrease in the average thickness of the stratum corneum, from 9.42 to 6.67 µm was visualized in LC-OCT images after hydradermabrasion. However, at 2 weeks of follow-up, the average stratum corneum thickness was 9.75 µm, resulting in an overall increase in the average thickness after treatment. Improved homogenization of the stratum corneum and decreased number of undulations in the epidermis post-treatment were also visualized. In all the subjects, the superficial dermis appeared stretched, which returned to baseline by the 2-week follow-up. At the 2-week follow-up, there were no visible differences in the quality and quantity of collagen fibers in the dermis.
CONCLUSION
In our study, LC-OCT images of the epidermis and dermis demonstrated microscopic features of skin rejuvenation when treated with hydradermabrasion. Thus, not only highlighting the efficacy of hydradermabrasion but also the potential of LC-OCT to serve as a tool for visualizing the microscopic effects of cosmetic procedures on skin anatomy.
Topics: Humans; Tomography, Optical Coherence; Skin; Epidermis
PubMed: 38558475
DOI: 10.1111/srt.13684 -
Indian Dermatology Online Journal 2024Bowen's disease (BD) is a precancerous squamous cell carcinoma and has a high recurrence rate with any single treatment modality, necessitating combination therapy for...
BACKGROUND
Bowen's disease (BD) is a precancerous squamous cell carcinoma and has a high recurrence rate with any single treatment modality, necessitating combination therapy for a successful outcome.
AIM
This study aimed to the efficacy and safety of carbon dioxide (CO) laser ablation followed by manual dermabrasion and intralesional 5-fluorouracil (IL 5-FU) injection as combination therapy for BD.
MATERIALS AND METHODS
This was a retrospective, observational study comprising 29 clinically and histopathologically diagnosed BD patients with no history of prior treatment. Demographic characteristics and clinical examination of the lesions and regional lymph nodes were retrieved. All patients were subjected to CO laser ablation followed by manual dermabrasion and IL 5-FU injection.
RESULTS
Mean age was 61.93 ± 9.31 years with male preponderance (62.1%). Trunk (48.3%) was the most frequently involved site. Mean tumor size was 40.8 ± 16.4 mm (range: 15-86 mm). All lesions healed with a cure rate of 96.6%. Complications seen in patients included atrophic scarring with persistent post-inflammatory hyperpigmentation in three patients (10.3%), secondary infection in two cases (6.9%), and hypertrophic scar with early keloid in one patient (3.4%). Recurrence was reported in one patient (3.4%).
LIMITATION
The study was limited by retrospective study design, small sample size, and no comparison with standard therapy.
CONCLUSION
Combination approach using carbon dioxide laser ablation followed by manual dermabrasion and IL 5-FU injection has been proved to be effective, efficient and safe with good functional, oncological and aesthetic outcomes in treating BD.
PubMed: 38550815
DOI: 10.4103/idoj.idoj_339_23 -
Plastic and Reconstructive Surgery.... Mar 2024Traumatic tattoos can occur when foreign pigment particles are embedded within the dermis, sometimes resulting as traumatic events. Traditional treatment modalities,...
Traumatic tattoos can occur when foreign pigment particles are embedded within the dermis, sometimes resulting as traumatic events. Traditional treatment modalities, including surgical excision, cryosurgery, electrosurgery, dermabrasion, CO lasers, and argon lasers, have limitations such as nonselectivity for pigment and risks of scarring and discoloration. We present the case of a patient who developed a postoperative tattoo after a minimal access cranial suspension facelift procedure that subsequently completely resolved after treatment with the high-powered 1064-nm picosecond laser. The patient achieved complete resolution of the postoperative tattoo after five laser treatments without adverse events or recurrence of pigmentation on follow-up. High-powered 1064-nm picosecond laser can serve as a fast, safe, and effective modality that in our clinic has become the first-line treatment for traumatic tattoos, and in our patient led to high satisfaction.
PubMed: 38515554
DOI: 10.1097/GOX.0000000000005680 -
Case Reports in Dermatology 2024Pachydermoperiostosis (PDP), or primary hypertrophic osteoarthropathy, is a rare autosomal dominant disease with primary clinical features of pachydermia (thickening of...
INTRODUCTION
Pachydermoperiostosis (PDP), or primary hypertrophic osteoarthropathy, is a rare autosomal dominant disease with primary clinical features of pachydermia (thickening of skin) and periostosis (new bone formation). Keloid scar formation is also rather obscure, and some scientists have claimed that keloid scars contain an excessive amount of fibroblasts compared with normal skin as well as a dense mass of irregularly deposited connective tissues.
CASE PRESENTATION
A 25-year-old man exhibited extensive skin folding on his face, a gyrus-like scalp, depressed nasolabial folds, and keloids. Symptoms began at 18 years of age, progressing insidiously. Additionally, he experienced clubbing of fingers and toes, joint pain, muscle soreness, and hyperhidrosis. Radiographic examinations revealed thickened bone and cystic regions. Diagnosed with complete primary PDP and facial keloid scars, he underwent skin dermabrasion, biopsies, and a comprehensive treatment involving, botulinum toxin injections, 5-fluorouracil, and a carbon dioxide lattice laser.
CONCLUSION
PDP presents challenges due to its unclear etiology but stabilizes over time in most cases. Comprehensive treatment strategies, including dermabrasion and a combination of intralesional therapies, are effective in managing keloids in PDP patients. This case contributes to the understanding of managing rare diseases and underscores the importance of personalized approaches to improve therapeutic outcomes in patients with complete primary PDP and concurrent keloids.
PubMed: 38440721
DOI: 10.1159/000536550 -
JMIR Dermatology Feb 2024Acne scarring is a frequent complication of acne. Scars negatively impact psychosocial and physical well-being. Optimal treatments significantly improve the appearance,...
Acne scarring is a frequent complication of acne. Scars negatively impact psychosocial and physical well-being. Optimal treatments significantly improve the appearance, quality of life, and self-esteem of people with scarring. A wide range of interventions have been proposed for acne scars. This narrative review aimed to focus on facial atrophic scarring interventions. The management of acne scarring includes various types of resurfacing (chemical peels, lasers, and dermabrasion); the use of injectable fillers; and surgical methods, such as needling, punch excision, punch elevation, or subcision. Since the scarred tissue has impaired regeneration abilities, the future implementation of stem or progenitor regenerative medical techniques is likely to add considerable value. There are limited randomized controlled trials that aimed to determine which treatment options should be considered the gold standard. Combining interventions would likely produce more benefit compared to the implementation of a single method.
PubMed: 38381492
DOI: 10.2196/49954 -
JPRAS Open Mar 2024Facial burns constitute a severe medical and psychological challenge, dramatically affecting patients' quality of life. We present an innovative approach involving the...
INTRODUCTION
Facial burns constitute a severe medical and psychological challenge, dramatically affecting patients' quality of life. We present an innovative approach involving the use of a monolayer acellular matrix-specifically the INTEGRA® Dermal Regeneration Template Single Layer-to optimize skin grafting outcomes in a facial burn patient.
CASE REPORT
The case revolves around a 45-year-old woman suffering a facial burn due to a clothes iron accident. Following escharectomy, dermabrasion, and homologous tissue graft placement, a monolayer acellular dermal matrix was strategically applied to the right malar area. Subsequently, we conducted a reconstruction with partial-thickness grafts. The integration of grafts with the acellular dermal matrix was seamless, absent of complications. The patient's healing process was marked by significant improvement, devoid of infections, bleeding, or any need for graft resection.
DISCUSSION
This case underscores the profound benefits of using a monolayer dermal matrix in facial burn reconstruction. Despite necessitating surgical expertise and meticulous wound preparation, this approach substantially reduced operating room time and improved clinical outcomes. This study illuminates the potential of acellular dermal matrix application in facial burn reconstruction, paving the way for further research and clinical advancements in this area.
PubMed: 38380185
DOI: 10.1016/j.jpra.2024.01.017