Prevalence and Determinants of Plastic Surgery Among Adults in Saudi Arabia.

BACKGROUND: Social and cultural factors have a significant impact on body image standards, and the media's messages play a crucial role in shaping beauty ideals. People's perceptions of beauty can be negatively affected by social media, which promotes unrealistic beauty standards and can lead to a desire for plastic surgery. Plastic surgery includes both reconstructive and aesthetic procedures and has become increasingly popular worldwide. In Saudi Arabia, there has been a significant increase in the number of women seeking cosmetic surgery, particularly breast augmentation, rhinoplasty, and liposuction, indicating that cosmetic surgery is becoming more accepted as a way to enhance beauty. AIMS: To investigate the frequency of performance of plastic and aesthetic surgical procedures among adults aged 18 to 60 years old in Saudi Arabia, as well as the determinants that may contribute to it. METHODOLOGY: A cross-sectional web survey with a representative sample (n = 3238) of individuals in Saudi Arabia was carried out from 10 April 2023 to 28 October 2023. RESULTS: The study included a cohort of 3238 participants, with 1328 individuals choosing to undergo plastic surgery. Among the surgical subgroups, the predominant procedure of choice was breast augmentation, representing 1009 cases (31.2%), while a minority opted for alternative plastic surgical interventions. Notably, the primary impetus behind plastic surgery, as indicated by the majority of participants (38.4% of the overall 41% who underwent the procedure), was appearance enhancement. Examination of the participants' demographic profile revealed a predominance of women between the ages of 18 and 30, married individuals, predominantly having a primary level of education, with a subset working in the public sector. Furthermore, a considerable segment of participants (32.6%) indicated low income, while 31.8% fell into the category of obesity. CONCLUSION: To address the multifaceted nature of plastic surgery decisions in Saudi Arabia, the key focus should be on promoting cultural acceptance, creating a supportive environment, and establishing ethical guidelines. This entails conducting awareness campaigns, promoting inclusive beauty standards, facilitating community discussions, fostering collaboration with support organizations, integrating mental health services, and ensuring rigorous monitoring of safety and professionalism in plastic surgery practices. By implementing these recommendations, individuals seeking plastic surgery can enhance their overall well-being and satisfaction.

Prevalence of Hypothyroidism Among Carpal Tunnel Syndrome Patients at a Hospital in Saudi Arabia.

Introduction Patients with carpal tunnel syndrome have a high prevalence of hypothyroidism, therefore, it is recommended to assess thyroid function routinely in patients with carpal tunnel syndrome. This study aims to determine the prevalence of hypothyroidism among carpal tunnel patients and to relate carpal tunnel in hypothyroidism to other socio-demographic factors. Methods This was a retrospective study carried out in King Fahad Medical City (KFMC) in Riyadh, Saudi Arabia. A total of 422 samples were collected conveniently from the files of patients who underwent carpal tunnel release surgery. The Statistical Package for the Social Sciences (SPSS) version 23 was used for data processing. The chi-square test was used to test the association between the categorical variables. A p-value of less than .05 was considered to be significant. Results Most of the respondents were females and most of them within the age group of 46 to 60 years. Thirteen point eight percent (13.8%) of the respondents are suffering from hypothyroidism and 5% from the sub-clinical form of the disease. More than two-thirds of those with hypothyroidism were asymptomatic. The duration of the disease was one to five years, and bilateral nerve concerns were mostly present in patients with carpal tunnel syndrome. The presence of thyroid abnormality doesn't affect the duration of carpal tunnel syndrome but body mass index (BMI) is significantly associated with hypothyroidism (p-value = .001). Conclusion Clinical symptoms of hypothyroidism are mostly absent in patients with carpal tunnel syndrome. Most patients with carpal tunnel syndrome have the disease for one to five years and this is not significantly associated with abnormal thyroid. Most patients have bilateral wrist involvement with no apparent symptoms and signs.

Functional Subunit Reconstruction of Giant Facial Congenital Melanocytic Nevi in Children With the Use of Matriderm and Skin Graft: Surgical Experience and Literature Review.

Introduction: Facial giant congenital melanocytic nevus represents a major cosmetic deformity for the child and parents and is a challenge for the plastic surgeons to achieve best cosmetic results. Herein, we present a case of single-stage surgical reconstruction using partial-thickness scalp skin graft aided with Matriderm dermal substitute for a facial giant congenital melanocytic nevus. Methods: An 8-year-old boy presented with a facial giant congenital melanocytic nevus without leptomeningeal involvement. A single-stage complete excision of the nevus was performed. A split-thickness skin graft, 12/1000-inch thick, was then harvested from the anterior scalp region for reconstruction. A 1-mm Matriderm dermal substitute was first applied, on which functional subunit skin graft was then secured to cover the defect. Eyelid reconstruction was reconstructed separately using full-thickness postauricular skin grafts. Results: Histopathology of the excised specimen confirmed the diagnosis of congenital melanocytic nevus, with no evidence of melanoma. The donor area healed with a favorable scar and no donor site morbidity or complications such as alopecia or hypertrophic scar. The postoperative result was satisfactory with minimal residual nevus around the eye, and the patient was fully satisfied with the cosmetic and functional results. Discussion and Conclusions: Resection of facial congenital melanocytic nevi, followed by single-stage reconstruction using Matriderm and skin graft from the scalp, is an excellent and fast reconstructive method with promising aesthetic outcomes and greater improvement in physiological outcome, especially in the pediatric population.

Reconstruction of Congenital Sternal Clefts: Surgical Experience and Literature Review.

BACKGROUND: Sternal cleft is a rare anomaly with a reported incidence of 1:100,000 cases per live births. Surgical intervention represents a crucial factor altering the overall patient prognosis, since they are at high risk of impaired oxygenation, as well as multiple chest infections. Herein, we are reporting our experience of surgical management of such rare cases, alerting plastic surgeons to their possibly crucial role in the reconstructive team. METHODS: A retrospective chart review of 2 cases presenting with chest wall defects. All perioperative data were collected and presented. RESULTS: Two patients with sternal clefts of variable degrees were managed. The first was an 18-month-old boy with partial inferior sternal cleft, who was otherwise asymptomatic. The patient underwent reconstruction at the same age using autologous rib graft and pectoralis major flaps due to ectopia cordis that was putting the patient at higher risk for cardiac trauma. The second patient was a 3-month-old girl having a V-shaped partial superior cleft with lung herniation. Surgical reconstruction was applied due to difficulty in weaning the patient off of ventilator support. Initially, reconstruction was applied with SurgiMend dermal matrix, but this was complicated by chest retraction and high oxygen requirement. Definitive reconstruction was later applied with allogeneic bone graft and pectoralis major flaps. CONCLUSIONS: Meticulous patient assessment and screening for associated anomalies are crucial. Surgical intervention is warranted at an early age. The use of acellular dermal matrix products in the reconstruction is of interest, but should be approached with caution.

Nasal Septal Agenesis and Attenuated Lower and Upper Lateral Cartilages in a 5-Year-Old Child: A Sporadic Finding.

Introduction: Cartilaginous nasal septal agenesis is a rare finding. In fact, just one case has been reported to have congenital agenesis of all nasal cartilages in a 6-year-old child by Bakhshaee et al. The literature review shows another case that was reported by Ozek et al in Turkey, where they reported a case of total nasal agenesis that was associated with Tessier no. 30. We could not find a similar case in the literature where only agenesis of the nasal cartilaginous septum was present. Methods/Case Report: This is a case report of a 5-year-old child presenting to our clinic with agenesis of his nasal septum and attenuation of the upper and lower lateral cartilages. His parents were seeking a corrective procedure to improve the shape of his nose. He was a male child with a right unilateral cleft lip and palate that were corrected surgically in 2009 (lip repair) and 2010 (palate repair), respectively. Results: On postoperative week 3, the patient's mother brought him to the emergency department with a history of falling on his face while playing at home. Examination revealed swelling of the nose but no breathing difficulties. He still had an acceptable augmented nose but with sings of deviation and collapse. Discussion: We report this case to find an answer to how such cases can be approached in the future in terms of the surgical intervention required and to study the options of redoing such cases.

Nasal bone length in Saudi rhinoplasty: a clinical-radiological study.

BACKGROUND AND OBJECTIVES: Hump reduction in the presence of short nasal bones can result in significant esthetic and/or functional problems in patients seeking rhinoplasty in the Middle East. The aims of this study were to determine the mean length of nasal bones, amount of nasal dorsum it forms in relation to the whole nose, and incidence of short nasal bones in the Middle Eastern population. DESIGN AND SETTINGS: A prospective study that has been carried out in a tertiary care hospital. PATIENTS AND METHODS: A total of 154 patients (80 females and 74 males) who were scheduled for computed tomography scan for the paranasal sinuses were included in the study. The inclusion criteria were adults with no history of facial/nasal trauma, sinus space occupying lesions, or surgery. RESULTS: In males, the mean clinical nasal bone length was 19.59 mm and the mean radiological nasal bone length was 24.96 mm. In females, the mean clinical nasal bone length was 18.17 mm and the mean radiological bone length was 22.82 mm. CONCLUSION: The bony vault represents 44.2% of the female nose and 44.3% of the male nose. In the present study, no patients displayed a short nasal bone that was less than one-third of the whole nasal length.