Novas disputas e intervenções no corpo feminino: fronteiras entre ginecologia e cirurgia plástica / New disputes and interventions in the female body: divisions between gynecology and plastic surgery

Resumo Este artigo analisa tensões e disputas entre o campo da ginecologia e da cirurgia plástica estética, especialidades autorizadas a realizar a cirurgia estética genital feminina no Brasil. Utiliza material documental, incluindo artigos científicos desde a década de 1990, e sites institucionais. Enquanto ginecologistas têm se mantido mais cautelosos com a prática, defendendo sua realização apenas quando há indicações funcionais, cirurgiões/ãs plásticos/as têm sido mais influentes na disseminação do procedimento, privilegiando a dimensão estética. Argumenta-se que, para além de disputas entre campos profissionais, esse fenômeno precisa ser entendido à luz da crescente ênfase no aprimoramento de si, via recursos biomédicos, e dos imperativos de gênero.

Abstract This article analyzes the tensions and disputes between the fields of gynecology and esthetic plastic surgery, the specialties which are authorized to perform aesthetic female genital surgeries in Brazil. Documentary materials are used, including scientific articles from the 1990s onward and institutional websites. While gynecologists have remained more cautious, recommending the surgery only for functional reasons, plastic surgeons have been more influential in publicizing these procedures and emphasizing the aesthetic dimension. Beyond professional disputes, we debate whether this phenomenon needs to be understood in light of the growing emphasis on self-improvement via biomedical resources and gender imperatives.

Awareness about vulvovaginal aesthetics procedures among medical students and health professionals in saudi arabia

Abstract Objective The present study aimed to explore the opinion and ethical consideration of vulvovaginal aesthetics procedures (VVAPs) among health professionals and medical students in Saudi Arabia. Methods This is a cross-sectional study performed between January 2020 and April 2020. Data was collected through electronic media, WhatsApp, and emails. The results were analyzed by applying the Students t-test, and correlations were considered significant if they presented a p-value<0.05. Results There is significant demand to educate doctors, health professionals, medical students, and gynecologists for the VVAPs to have a solid foundation, justified indications, and knowledge about various aesthetic options. Although female doctors, medical students, young doctors, and gynecologists have more knowledge about VVAPs, all health professionals ought to be aware of recent trends in vulvovaginal aesthetics (VVA). The present analysis determined that VVA should be under the domain of gynecologists, rather than under that of plastic surgeons, general surgeons, and cosmetologists. Themajority of the participants considered that vaginal rejuvenation, "G-spot" augmentation, clitoral surgery, and hymenoplasty are not justifiable on medical grounds. Conclusion The decision to opt for different techniques for vaginal tightening and revitalization should be taken very carefully, utilizing the shared decision-making approach. Ethical aspects and moral considerations are important key factors before embarking in the VVAPs purely for cosmetic reasons. Further research is required to determine the sexual, psychological, and body image outcomes for women who underwent elective VVAPs. Moreover, medical educators must consider VVAPs as part of the undergraduate and postgraduate medical curriculum.

Research progress on shared decision making in maxillofacial plastic surgery and aesthetic surgery / 口腔疾病防治

@#Shared decision making (SDM) refers to two-way communication between doctors and patients. SDM helps surgeons decide the most suitable treatment plan for patients based on the medical evidence and the preferences of patients. A standardized clinical process and decision assistant tools, such as verbal tools, graphic tools, and patient decision aids, can help the shared decision-making work effectively. Since the sense of facial aesthetics is individual and there are multiple treatment options in plastic surgery, facial aesthetic surgery is suitable for the application of SDM. In addition, medical service centers can also meet the personalized needs of patients, provide high-quality medical services for patients and achieve better treatment results with SDM. SDM has not been introduced into the clinical practice of maxillofacial plastic surgery in China, and its development is facing many difficulties, such as the lack of decision aid tools, the limited time of diagnosis, and the lack of doctor-patient communication. Research and development of standard SDM clinical implementation path guides and decision aid tools will be beneficial to the application and development of SDM in the field of maxillofacial plastic surgery in China.

Precision management of traumatic injury and scars: an indication that plastic surgery steps into the era of aesthetic reconstruction / 中华整形外科杂志

Reconstructive treatment of traumatic injury and scars is the essence of plastic surgery. Technological development plays a vital role in treating traumatic injury and scars and realizing functional restoration and mental recovery. The techniques developed for the treatment of traumatic injury and scars were reviewed in this paper, which could hopefully provide some clues and experiences for future innovation and advances in this field and showcase the possible direction for technological progress with high standard.

A preliminary study on measurements of 512 normal female genital appearance of Han and Uygur nationality in Xinjiang / 中华整形外科杂志

Objective@#To collect preliminary data of normal Chinese female genital appearance, to compare the parameters of Han and Uygur nationality, and to present the preliminary data for normal female external genitalia database.@*Methods@#This study design recruited healthy females referred to the out-patient clinic for physical examination from October 2014 to March 2015 in Xinjiang Petroleum Geological Survey Department Staff Hospital. The recruitment was based on rigid inclusion and exclusion criteria. Demographic data consists of nationality, age, height, weight, marital status, gravidity, parity, vaginal delivery, and intercourse frequency. Anthropometric measurements were taken in 234 females of Han group whereas 278 females of Uygur group. For each individual 16 parameters were measured. The external genitalia appearance in Han and Uygur nationality was compared. The significance of variations in age, height, weight, BMI, gravidity, parity, vaginal delivery and intercourse frequency were analyzed.@*Results@#Primary measurements of Han and Uygur nationality are presented as mean (95% confidence interval). There are many differences in female genital appearance between Han and Uygur nationality. Several parameters were statistically associated with age, BMI, gravidity, parity, vaginal delivery and intercourse frequency. The females with complete labial asymmetry account for 5.6%(13/234) and 5.8%(16/278) in Han and Uygur normal adults, respectively.@*Conclusions@#This study presented the external genitalia measurements of normal Chinese female adults in Xinjiang, thus providing the preliminary data for normal female external genitalia database. Females of Han and Uygur nationality have multiple differences in external genitalia appearances. The parameters are associated with age, BMI, gravidity, parity, vaginal delivery, and intercourse frequency. The labial asymmetry is a universal phenomenon.

Artificial intelligence and machine learning in plastic and aesthetic surgery / 中华整形外科杂志

With the emergence of artificial intelligence and application of Watson Health (International Business Machines Corp, Armonk, N. Y.), more and more medical physicians and researchers attempt to contact with this technology. The purpose of this article is to introduce the modern plastic surgeon to machine learning, a subfield of artificial intelligence. This article provides a brief introduction to background of machine learning and current research and potential projects in the field of plastic and aesthetic surgery.

Labioplastia de labios menores con la técnica de Trim / Labiaplasty of the labia minors with a Trim technique

Introducción: la labioplastia, en contraste con los procedimientos que incluyen el rejuvenecimiento vaginal, se enfoca en la vulva y labios, en esta técnica se remueve una porción de los labios menores hipertróficos y, ocasionalmente, se realiza un aumento en labios mayores. Estos problemas, pueden surgir, debido al parto, tratamientos con hormonas, sobre-esfuerzos, o un componente genético, haciendo a la mujer sentirse con menos confianza, lo que puede provocar daños en la autoestima y en definitiva, malestar general. Objetivo: identificar las principales causas de solicitud de labioplastia en las pacientes y su evolución. Método: se reporta un estudio de diez pacientes atendidas en el Hospital Vladimir Ilich Lenin, Holguín, desde enero de 2015 a enero del 2016 con hipertrofia y/o asimetría de los labios menores y que fueron operadas con la técnica de Trim. Se identificó edad, causas de consulta (físicas, psicológicas y estéticas), tipo de deformidad, aparición de complicaciones y satisfacción de las pacientes en estudio. Resultados: los resultados fueron muy buenos. El rango de edad predominó en pacientes jóvenes entre 20 y 39 años, la causa por la que todas las pacientes se sometieron a la cirugía fue primordialmente estética aunque un total de 6 pacientes también refirió trastornos funcionales. Fue la hipertrofia central del labio el tipo de deformidad más frecuente. No hubo complicaciones intraoperatorias y las complicaciones postoperatorias fueron menores dadas por la hipersensibilidad que desapareció al paso de los meses Conclusiones: después de la cirugía las pacientes lograron labios menores simétricos, con buena apariencia estética y se reducen los síntomas.

Introduction: the labiaplasty, in contrast to the procedures that include vaginal rejuvenation, focuses on the vulva and labia, in this technique a portion of the hypertrophic labia is removed and, occasionally, an increase is made in the labia majora. These problems may arise, due to childbirth, hormone treatments, over-efforts, or a genetic component, making women feel less confident, which can cause damage to self-esteem and ultimately, discomfort Objective: to identify the main causes of demand for labiaplasty for patients and their evolution. Methods: a study of ten patients treated at the Vladimir Ilich Lenin Hospital from January 2015 to January 2016 with hypertrophy and / or asymmetry of the labia minora and who were operated using the Trim technique was reported. Age, causes of consultation (physical, psychological and aesthetic), type of deformity, appearance of complications and satisfaction of the patients under study were identified. Results: the results were very good. The age range prevailed in young patients between 20 and 39 years of age, the reason why all the patients underwent the surgery was primarily aesthetic, although a total of 6 patients also reported functional disorders. The central hypertrophy of the lip was the most frequent type of deformity. There were no intraoperative complications and the postoperative complications were minor due to the hypersensitivity that disappeared over the months Conclusions: after surgery, patients achieved symmetrical labia minora with good aesthetic appearance and reduced symptoms.

Survey on Aesthetic Vulvovaginal Procedures: What do Portuguese Doctors and Medical Students Think? / Inquérito sobre procedimentos estéticos vulvovaginais: qual a opinião dos médicos e estudantes de medicina portugueses?

Abstract Objective To assess themedical doctors andmedical students' opinion regarding the evidence and ethical background of the performance of vulvovaginal aesthetic procedures (VVAPs). Methods Cross-sectional online survey among 664 Portuguese medical doctors and students. Results Most participants considered that there is never or there rarely is amedical reason to perform: vulvar whitening (85.9% [502/584]); hymenoplasty (72.0% [437/607]); mons pubis liposuction (71.6% [426/595]); "G-spot" augmentation (71.0% [409/576]); labia majora augmentation (66.3% [390/588]); labia minora augmentation (58.3% [326/559]); or laser vaginal tightening (52.3%[313/599]).Gynecologists and specialistsweremore likely to consider that there are no medical reasons to performVVAPs; the opposite was true for plastic surgeons and students/residents. Hymenoplasty raised ethical doubts in 51.1% (283/554) of the participants. Plastic surgeons and students/residents were less likely to raise ethical objections, while the opposite was true for gynecologists and specialists. Most considered that VVAPs could contribute to an improvement in self-esteem(92.3% [613/664]); sexual function (78.5% [521/664]); vaginal atrophy (69.9% [464/664]); quality of life (66.3% [440/664]); and sexual pain (61.4% [408/664]). Conclusions While medical doctors and students acknowledge the lack of evidence and scientific support for the performance of VVAPs, most do not raise ethical objections about them, especially if they are students or plastic surgeons, or if they have had or have considered having plastic surgery.

Resumo Objetivos Avaliar a opinião de médicos e estudantes de medicina relativamente à evidência e contexto ético para a realização de procedimentos estéticos vulvovaginais (PEVVs). Métodos Estudo transversal, consistindo de inquérito online a 664 médicos e estudantes de medicina portugueses. Resultados A maioria dos participantes considerou que nunca ou raramente há uma razão médica para a realização de: branqueamento vulvar (85,9% [502/584]); himenoplastia (72,0% [437/607]); lipoaspiração do mons pubis (71,6% [426/595]); aumento do "ponto G" (71,0% [409/576]); aumento dos grandes lábios (66,3% [390/588]); aumento dos pequenos lábios (58,3% [326/559]) ou aperto vaginal com laser (52,3% [313/599]). Ser ginecologista e especialista associou-se a maior probabilidade de considerar não haver razões médicas para a realização de PEVV; o oposto foi verdade para os cirurgiões plásticos e estudantes/internos. A himenoplastia levantou dúvidas em termos éticos em 51,1% (283/554) dos participantes. Cirurgiões plásticos e estudantes/internos relatarammenos dúvidas emtermos éticos; o oposto foi verdade para os ginecologistas ou especialistas. Amaioria considerou que os PEVVs podemcontribuir para uma melhoria na autoestima (92,3% [613/664]); função sexual (78,5% [521/664]); atrofia vaginal (69,9% [464/664]); qualidade de vida (66,3% [440/664]); e dor sexual (61,4% [408/664]). Conclusões Ainda que os médicos e estudantes de medicina reconheçam a falta de evidência e bases científicas para a realização de PEVVs, a maioria não levanta objecções em termos éticos, especialmente se forem estudantes, cirurgiões plásticos, ou se eles próprios tiverem sido submetidos a cirurgia plástica ou considerem vir a sê-lo.

Correção estética em paciente portador de exostose frontal: relato de caso / Aesthetic correction in patients with frontal exostose: case report

Introdução: Exostoses são protuberâncias ósseas benignas e calcificadas, geralmente surgindo na região cortical dos ossos, cuja etiologia ainda não é bem definida. Clinicamente, são lesões fixas, indolores que apresentam crescimento lento. Em geral, nenhum tratamento para exostose frontal é sugerido, à exceção de acometimento funcional, estético, com repercussão social do paciente, em função da fisionomia desarmônica. Nesses casos, é indicada a exérese da lesão. Objetivo: Relatar um caso clínico de exostose em região frontal. Relato do caso: Paciente do sexo feminino, 30 anos, com queixa estética em terço superior da face. Ao exame físico, foi constatado um crescimento ósseo assintomático, em região frontal. Na tomografia computadorizada, ficou evidente aumento da espessura da tábua óssea externa do osso frontal. Foram realizadas osteotomias e osteoplastias da região. Estudo histopatológico dos fragmentos removidos confirmou a hipótese diagnóstica de exostose do osso frontal. Resultados: A paciente teve uma evolução satisfatória, e no 30º dia foi detectada a correção da assimetria facial. O acompanhamento segue há 6 meses, sem sinal de recidiva. Conclusão: Exostose do osso frontal, muitas vezes, não requer tratamento cirúrgico, porém pode causar agravos estéticos e comprometimento emocional. Sendo assim, normalmente recomenda se a correção da assimetria presente e melhores resultados estéticos... (AU)

Introduction: Exostosis are benign and calcified bony protuberances, usually arising in the cortical region of bones, whose etiology is not well defined. Clinically, these lesions are fixed, painless and slow growing. In general, no treatment for frontal exostosis is suggested, except for functional, aesthetic involvement, with social repercussion of the patient, due to the disharmonious physiognomy. In such cases, surgical excision is indicated. Objective: Report a clinical case of exostosis in frontal region. Case report: Womenkid patient, 30 years old, with aesthetic complaint in the upper third of the face. Upon physical examination, asymptomatic bone growth was observed in the frontal region. Computed tomography revealed an increase in the thickness of the external bone of the frontal bone. Performing osteotomies and osteoplasties of the region. A histopathological study of the fragments removed confirmed the diagnostic hypothesis of frontal bone exostosis. Results: The patient had a satisfactory evolution and on the 30th day the facial asymmetry correction was detected. Follow-up has been ongoing for 6 months, with no sign of relapse. Conclusion: Exostosis of the frontal bone often does not require surgical treatment, however it can cause aesthetic damage and emotional impairment. Therefore, it is usually recommended to correct the asymmetry present and better aesthetic results... (AU)

O pensamento social de universitários sobre beleza e cirurgia estética / The social thinking of college students about beauty and aesthetics surgery / El pensamiento social de universitarios sobre belleza y cirugía estética

O estudo objetivou identificar as representações sociais de homens e mulheres com diferentes formações acadêmicas, a respeito de beleza e da cirurgia estética. Pesquisa de natureza descritiva e comparativa, com delineamento transversal, com a participação de 120 universitários; plano de investigação multimétodo desenhado por A.S. de Rosa através de questionário semiestruturado, autoaplicável, dividido em cinco partes; envolvendo análise estatística descritiva, relacional e análise textual de redes associativas. Os resultados destacam diferenças significativas nas representações sociais dos grupos em relação aos objetos sociais, beleza e cirurgia estética, em termos de conteúdo, avaliações e dimensões sociopsicológicas. A proximidade dos indivíduos e grupos com o corpo confirma parcialmente as evidências das variáveis influentes em termos de gênero e formação acadêmica dos participantes nas representações dos objetos pesquisados

The study aimed to identify the social representations of men and women with different academic backgrounds, regarding beauty and aesthetic surgery. This study is a descriptive and comparative research, with cross-sectional design, based on the participation of 120 university students; Multi-method research plan designed by A.S. de Rosa through a semi-structured, self-administered questionnaire, divided into five parts; involving descriptive and relational statistical analysis, and textual analysis of associative networks. The results highlight significant differences in the social representations of the groups in relation to social objects, beauty and aesthetic surgery, in terms of contents, assessments and socio-psychological dimensions. The proximity of individuals and groups to the body partially confirms the evidence of influential variables in terms of gender and academic training of the participants in the representations of the objects surveyed

El estudio tuvo como objetivo identificar las representaciones sociales de hombres y mujeres con diferentes antecedentes académicos, en cuanto a belleza y cirugía estética. Este estudio es una investigación descriptiva y comparativa, con trazabilidad transversal, con la participación de 120 estudiantes universitarios; Plan de investigación múltiple método diseñado por A.S. de Rosa a través de un cuestionario semi-estructurado, auto-aplicable, dividido en cinco partes; que envuelve análisis estadístico descriptivo, relacional y análisis textual de redes asociativas. Los resultados ponen de manifiesto diferencias significativas en las representaciones sociales de los grupos en relación con los objetos sociales, belleza y cirugía estética, en términos de contenidos, evaluaciones y dimensiones socio-psicológicas. La proximidad de individuos y grupos con el cuerpo confirma parcialmente las evidencias de variables influyentes en términos de género y formación académica de los participantes en las representaciones de los objetos encuestados

Transtornos depressivos em pacientes que buscam cirurgia plástica estética: uma visão ampla e atualizada / Depressive disorders in patients who seek cosmetic surgery: a broad and updated view

INTRODUÇÃO: A cirurgia estética pode melhorar a qualidade de vida de pacientes, porém alguns que se apresentam para o procedimento são portadores de transtornos depressivos (TD) e podem evoluir, no pós-operatório, de forma desastrosa do ponto de vista psicológico e até mesmo evoluir para o suicídio. A prevalência de TD em pacientes de cirurgia plásticaestética é em média de 20%, podendo chegar até 70%. Este artigo tem por objetivo fazer uma revisão sobre depressão e cirurgia estética bem como alertar e conscientizar os cirurgiões plásticos sobre o crescente aumento destes pacientes nos consultórios. Objetiva, ainda, orientar os cirurgiões quanto a abordagem adequada e condutas específicas perante estes. MÉTODOS: Realizou-se busca nos bancos de dados MEDLINE/PubMed e Embase e cruzamento de palavras chaves, incluindo "cirurgia plástica estética", "depressão"; "transtornos de humor", "transtorno depressivo", "sintomas depressivos", "suicídio e cirurgia plástica". RESULTADOS: O sucesso de uma cirurgia plástica depende em muito da seleção dos pacientes para o procedimento. Pacientes suspeitos, pacientes com sintomas depressivos elevados nos questionários (como o BDI) e pacientes com "marcadores" de psicopatologia deverão ser encaminhados ao psiquiatra para avaliação adequada. CONCLUSÃO: Pela elevada prevalência de TD em cirurgia plástica estética, todo paciente de cirurgia plástica deverá ser avaliado adequadamente para identificação daqueles com possíveis TD no pré-operatório e encaminhado ao psiquiatra, para assim tentar se evitar evolução psicológica desfavorável pós-operatória.

INTRODUCTION: Aesthetic surgery can improve the quality of life of patients, but some candidates for the procedure have depressive disorders (DDs) that may develop, in the postoperative period, in a disastrous manner from a psychological point of view and even progress to suicide. The prevalence of DDs in cosmetic surgery patients is 20% on average and reaches 70%. This article aims to review depression and aesthetic surgery as well as to alert and educate plastic surgeons on the growing number of these patients in clinical settings. It also aims to guide surgeons to the appropriate approach and specific behaviors with these patients. METHODS: A search was performed in MEDLINE/PubMed and Embase, and key words were entered, including "cosmetic surgery," "depression," "mood disorders," "depressive disorder," "depressive symptoms," and "suicide and plastic surgery." RESULTS: The success of plastic surgery depends a great deal on the selection of patients for the procedure. Suspect patients, patients with elevated depressive symptoms in questionnaires (such as the BDI), and patients with psychopathology "markers" should be forwarded to a psychiatrist for proper evaluation. CONCLUSION: Due to the high prevalence of DDs in aesthetic plastic surgery patients, every plastic surgery patient should be evaluated properly to identify those with possible DDs in the preoperative period, and those should be forwarded to a psychiatrist, thus avoiding an unfavorable postoperative psychological evolution.

Recent Knowledge of Facial Plastic and Reconstructive Surgery / 대한이비인후과학회지

Performance of facial aesthetic surgeries except rhinoplasty in otorlarygoloic department is not usual in South Korea. However, otolaryngologic doctors have been performing facial surgeries, thus, their knowledge of facial surgical anatomy is better than that of other doctors. For this reason, otolaryngologic doctors should study hard in order to learn about performance of facial aesthetic surgeries. Recently, in South Korea, because many facial aesthetic surgeries have been performed, many complications have been reported and facial aesthetic surgery techniques have been developed rapidly. Herein, I would like to introduce some facial aesthetic and reconstructive techniques that are not usually performed in the otolaryngologic department in South Korea.

The Ethics of Facial Plastic Surgery.

In a modern world of aesthesis, the role of surgery is ever broadening and with this healthcare professionals must be in constant vigilance of ethical values. We discuss the role of facial plastic surgery in modern society and the ethical standpoint of the field in the context of aesthetics.

Two-step procedure for root coverage using a free gingival graft and a subepthelial connective tissue graft.

Gingival recession is a multifaceted problem, for which several treatment options are available. Both epithelized and subepithelial connective tissue grafts offer predictable solutions for the treatment of gingival recession.The case report involved a 30-year-old man with gingival recession of 8 mm on 41 (Miller's class II recession). Before surgery, full mouth scaling and polishing were performed. Recession height, width, probing depth, clinical attachment level (CAL), and width of the attached gingiva (WAG) were measured at the baseline, two months postoperatively, and six months postoperatively. Four weeks after scaling, the first step of increasing the width of the attached gingiva was carried out, using a free gingival graft. Two months after this step, the subepithelial connective tissue was harvested from the palate and placed in relation to 41, to cover the residual defect.Two months postoperatively, there was a 3 mm gain in WAG and 35% root coverage. Six months postoperatively there was a significant increase in WAG, CAL; and reduction in height and width of recession (root coverage achieved was 75%). These results suggested that this two-stage surgical procedure could be successful for root coverage in case of deep recession and lack of attached gingiva in the mandibular anterior region.

Cirurgias estéticas, discurso médico e saúde / Aesthetic surgery, medical discourse and health

O crescimento do número de cirurgias plásticas no Brasil e a expansão da indústria da beleza, dos cuidados com o corpo e da metamorfose corporal fazem parte de um processo mais amplo de medicalização e estetização da saúde. Segundo dados da Associação Brasileira de Cirurgia Plástica, nos últimos anos houve um número substancial de cirurgias plásticas realizadas no Brasil. A cada ano, em média, são realizadas cerca de 350.000 cirurgias estéticas no país. Nosso trabalho investigou a construção de sentidos e valores, a utilização de parâmetros estéticos nessa construção e a forma como tais sentidos são apropriados e tratados pelos representantes do saber médico que atuam nesse processo de transformação dos corpos, os cirurgiões plásticos. Para tal, foi realizada uma análise dos enunciados e dos discursos disponíveis no endereço eletrônico da Sociedade Brasileira de Cirurgia Plástica, que é a instância reguladora do campo e tem o papel de formar profissionais e fiscalizar o setor. A análise foi realizada a partir do conteúdo oficial do site na página exibida em 26/09/2005.

The increase in plastic surgery interventions in Brazil and the growth of the beauty industry, as well as care of the body and corporal enhancement, are part of a broader process of medical and aesthetic preoccupation with health. According to the Brazilian Plastic Surgery Association there has been a substantial increase in the number of plastic surgery procedures in Brazil. Every year, approximately 350,000 aesthetic surgical interventions are performed in the country. Our work investigated the construction of meaning and value, the use of aesthetic parameters in this construction and how those meanings are appropriated and treated by those representatives of the medical profession who work in the body transformation process, namely plastic surgeons. In this respect, an analysis of the pronouncements and discourse posted on the Brazilian Plastic Surgery Association website was conducted, as it is the regulatory body of the field and is responsible for training professionals and supervising the sector. Analysis of the official content of the website page posted on September 26, 2005 was the basis for this research.

Nodular Fasciitis of the Zygomatic Area: A Case Report and Its Aesthetic Considerations

Nodular fasciitis is the most common benign mesenchymal tumor that can be mistaken both clinically and pathologically for soft tissue sarcoma due to its infiltrative growth pattern. It most commonly appears in the extremities and trunk. However, occurrence in the zygomatic area is extremely rare. We present a case of 28-year-old man, who was characterized with a firm, tender, clearly visible mass in his left zygomatic area. We performed a local excision, together with microscopic and immunohistochemical analysis. The mass was eventually diagnosed as nodular fasciitis in the zygomatic area. No postoperative oncological treatment was done and the postoperative follow-up was maintained up to the present time without any tumor recurrence. Nodular fasciitis should be considered in the differential diagnosis when a rapid growing subcutaneous mass is detected in this area. Accurate diagnosis, appropriate treatment and follow-up are mandatory to avoid overly aggressive treatment and limit treatment-related morbidities. Moreover, the disease itself and its surgical treatment may cause aesthetic compromise and the aesthetic implications have been discussed.

Present and future of aesthetic plastic surgery in Korea

Due to Confucian ethics and socioeconomic factors, aesthetic plastic surgery came late to Korea. However, the field of aesthetic plastic surgery developed rapidly after the establishment of the Korean Society of Aesthetic Plastic Surgeons in 1985. At present, Korean aesthetic plastic surgeons have achieved world leading surgical skills and research abilities. This article review the history and current state of Korean aesthetic plastic surgery with the follow-up study of statics and numerical data. Over the period of 10 years (2001-2010), the Korean plastic surgeons contributed 607 papers to SCI & SCI(E) journals. Among them, the number of pure cosmetic surgical papers was 133 (21.9%). According to biannual survey data from the International Society of Aesthetic Plastic Surgery in 2009, the number of plastic surgeons and aesthetic procedures in Korea became the highest contrast to percentage of the population in the world. As dynamic forces of development for Korean aesthetic plastic surgery, this advocate the medical tourism, non-surgical cosmetic procedures, and adipose-derived stem cells. With developing these items, Korean plastic surgeons will create the brilliant future of the aesthetic plastic surgery in Korea.

Incidência de dor no pós-operatório de cirurgia plástica estética / Incidence of postoperative pain after aesthetic plastic surgery

JUSTIFICATIVA E OBJETIVOS: A cirurgia plástica estética tem como escopo melhorar algum aspecto físico que não agrada o paciente, sendo bastante realizadas a lipoaspiração e o implante de prótese de silicone nas mamas. Os objetivos deste estudo foram verificar a incidência da dor em cirurgia estética e identificar os analgésicos prescritos.MÉTODO: Pesquisa descritivo-exploratória, quantitativa, baseada em pesquisa documental de fonte primária, com análise quantitativa dos dados. Após os procedimentos ético-legais, foram analisados 408 prontuários de pacientes submetidas à cirurgia estética lipoaspiração, abdominoplastia, rinoplastia e prótese de mama, sendo analisado o conteúdo das anotações da equipe multiprofissional durante o período de internação hospitalar dos pacientes, a intensidade da dor e os analgésicos prescritos e usados pelos pacientes.RESULTADOS: A média de idade dos pacientes foi de 36 anos, sendo a maioria do sexo feminino. A maioria dos pacientes não relatou dor, e apenas 34% referiu ter sentido um ou mais episódios de dor, de leve ou moderada intensidade e apenas 16% relatou dor intensa. Apenas 0,5% pacientes não tinham nenhum analgésico prescrito pelo médico, para os demais 99,5% havia prescrição de um ou mais analgésicos, sendo que para 70% a prescrição era em regime de horário e de demanda, para 24% a prescrição dos analgésicos era exclusivamente em regime de horário e em apenas 6% a prescrição de analgésicos era unicamente, em regime de demanda. Foram identificados 11 analgésicos prescritos de horário, sendo a dipirona o mais frequente, seguida de cetorolaco e paracetamol e 11 analgésicos em regime de demanda, sendo a meperidina o mais frequente, seguida do tramadol e da morfina. CONCLUSÃO: A maioria dos pacientes não referiu dor no período pós-operatório imediato, porém 34% relataram dor de moderada intensidade, uma ou mais vezes no período de internação. Os analgésicos anti-inflamatórios não esteroides mais prescritos foram a dipirona e o cetorolaco, enquanto que os analgésicos opioides mais prescritos foram a meperidina e o tramadol.

BACKGROUND AND OBJECTIVES: Aesthetic plastic surgeries are intended to improve some physical aspect which is unpleasant for the patient being the most popular liposuction and silicone breast prosthesis implant. This study aimed at evaluating the incidence of pain after aesthetic surgeries and identifying prescribed analgesics.METHOD: Descriptive-exploratory and quantitative study based on primary source documents research, with quantitative data analysis. After ethical-legal procedures, 408 records of patients submitted to aesthetic liposuction, tummy tuck, rhinoplasty and breast prosthesis were analyzed by checking the content of notes of the multiprofessional team during patients' hospital stay, the intensity of pain and analgesics prescribed and used by patients. RESULTS: Mean age of patients was 36 years being most female patients. Most patients have not referred pain and only 34% have referred one or more mild or moderate pain episodes and only 16% have reported severe pain. Only 0.5% of patients had no analgesics prescribed by the physician. For the remaining 99.5% there was prescription of one or more analgesics, being that for 70% the prescription was by time and demand, for 24% analgesics prescription was exclusively by time and for just 6% analgesics prescription was only by demand. We have identified 11 analgesics prescribed by time, being dipirone the most frequent followed by ketorolak and paracetamol; 11 analgesics were prescribed by demand, being meperidine the most frequent, followed by tramadol and morphine. CONCLUSION: Most patients have not referred immediate postoperative pain, however 34% have referred one or more moderate pain episodes during hospital stay. Most widely prescribed non-steroid anti-inflammatory drugs were dipirone and ketorolak, while most widely prescribed opioid analgesics were meperidine and tramadol

O corpo, a cirurgia estética e a Saúde Coletiva: um estudo de caso / Body, aesthetic surgery and public health: a case study

O corpo, na cultura ocidental, foi por muitos séculos rechaçado, temido e desvalorizado; hoje, diferentemente, é supervalorizado e tornou-se um bem precioso. Por este motivo, é cuidado e modelado, pois a ele são atribuídos os sucessos e as virtudes do indivíduo contemporâneo. Na busca de um corpo ideal, muitos procuram cirurgias estéticas como solução de insatisfações e melhoria da auto-estima. Este artigo procurou compreender a relação da cirurgia estética com a Saúde Coletiva e a promoção da saúde. Realizamos um estudo qualitativo, usando o método do estudo de caso, com o objetivo de compreender as crenças, as atitudes, as percepções e os processos culturais subjacentes às narrativas das universitárias submetidas à cirurgia estética e dos cirurgiões plásticos. Os resultados demonstram que o corpo deve ser entendido como algo mais complexo do que o corpo físico e visível, pois muitos que buscam a cirurgia estética continuam insatisfeitos, visto que suas insatisfações atribuídas ao físico são também da alma. Concluímos que existe uma medicalização da beleza estética e que a cirurgia é uma questão de Saúde Coletiva, pois os resultados dependem das motivações e expectativas de quem procura este procedimento.

The body, in the occidental culture, was for many centuries rejected, feared and devaluated; today, differently, it is super valued and became a precious good, for this reason it is well-taken care of and shaped, due to successes and virtues of the individual contemporary being attributed to it. In the search for an ideal body, many people look for aesthetic surgeries as solution for their problems and improvement of their self-esteem. This article aims to understand the relation of the aesthetic surgery with the Public Health and the promotion of health. We carried out a qualitative study, using the case study method, with the objective of understanding the underlying beliefs, attitudes, perceptions and cultural processes to the narratives of the college's students submitted to aesthetic surgery and of the plastic surgeons. The results demonstrate that the body must be understood as something more complex than the physical and visible body, because many of those who look for aesthetic surgery continue unsatisfied, seeing that their dissatisfactions attributed to their body are also a matter of them being attributed to their soul. We conclude that aesthetic beauty is becoming a medical subject and that aesthetic surgery is a question of public health, as the results depend on the motivations and expectations of who searches for this procedure.

Como obter melhor cicatrização nas incisões das cirurgias estéticas corporais / How to get better healing of incisions in corporal aesthetic surgeries

A cicatriz pós-operatória resultante dos procedimentos estéticos é uma grande preocupação para o cirurgião. Existem vários fatores que podem influenciar no resultado final dessas cicatrizes. Este artigo tem por finalidade mostrar os principais fatores responsáveis por uma boa cicatrização.