Internet and Social Media as a Source of Information About Plastic Surgery: Comparison Between Public and Private Sector, A 2-center Study.

BACKGROUND: The popularity of social media among plastic surgeons and patients has increased in the last years. We conducted this study to explore the differences in patients' social media habits between public and private aesthetic plastic surgery practice. METHODS: A 2-cohort study was conducted in aesthetic plastic surgery clinic and public department of plastic and surgery by surveying consecutive first-time patients. RESULTS: Two hundred patients completed a 18-question survey at a private aesthetic plastic surgery clinic. The questionnaire was also filled by 113 patients at a public plastic surgery department. Facebook was the most popular social media platform in both groups. Word of mouth from other patients and the clinic's website were the most-valued source of information about the surgeon and surgical procedure for patients of both studied groups. Patients from the aesthetic group were mainly women from small towns; they were significantly younger and better educated and used Instagram more frequently than patients from public group. The aesthetic group patients focused significantly more often on the surgeon's credentials and on before and after photographs. They appreciated social media as a source of information for patients significantly more than public group patients who stated that social media were the worst source of information. CONCLUSIONS: Word of mouth from other patients remains the most-valued source of information about plastic surgery. However, proper use of social media and building online image in a professional manner can provide attract more patients to the aesthetic plastic surgery practice.

Female Sexual Function and Sexual Well-being Before and After Breast Reduction: A Pilot Cross-sectional Study and Review of Literature.

BACKGROUND: Breast reduction is one of the most frequently performed procedures in plastic surgery practice. Patients often undergo this procedure for not only aesthetic but also functional reasons because breast hypertrophy may hinder daily activities because of chronic spinal pain. Breast reduction has a documented impact on quality of life. However, there are only a few reports on the influence of breast reduction on sexuality. OBJECTIVE: The aim of the study was to analyze the impact of breast reduction on female sexual dysfunction and on sexual well-being. METHODS: Ours was a pilot cross-sectional 2-cohort study, including 75 females who had undergone breast reduction (post-BRG) and a preoperative group of 27 females with breast hypertrophy awaiting surgery (pre-BRG). Female Sexual Function Index (FSFI), Sexual Quality of Life-Female, and BREAST-Q Reduction/Mastopexy module were assessed within 12 to 36 months postoperatively via e-mail. A review of literature was performed. RESULTS: The mean total Sexual Quality of Life-Female score was significantly higher in the post-BRG than in the pre-BRG (76.7 ± 11.6 vs 64.4 ± 13.7; P < 0.01). The mean total FSFI score in the pre-BRG was 21 ± 11.4. It was below the FSFI cutoff score for female sexual dysfunction (≤26). In the post-BRG, the total FSFI score was significantly higher (27.4 ± 9.1; P < 0.01). The outcome of the sexual well-being domain of BREAST-Q was significantly higher in the post-BRG (72 ± 14 vs 39.3 ± 14.5; P < 0.01). CONCLUSIONS: Breast reduction procedure has a positive impact on female sexual function, sexual quality of life, and sexual well-being.

Landscape of oncoplastic breast surgery across Poland.

Oncoplastic and reconstructive techniques are essential tools in the armamentarium of contemporary breast surgeons. The aim of the study was to identify oncoplastic reconstructive patterns in breast cancer centers across Poland. A questionnaire of 18 questions was sent by email to the members of the Polish Society of Surgical Oncology and the Polish Society of Plastic, Reconstructive and Esthetic Surgery via their dedicated websites. The numbers of breast cancer patients operated on in each center ranged from 120 to 904 per year. Breast-conserving surgery (BCS) predominated in all but one center (range 50-70%). Immediate breast reconstructions (IBR) accounted for 6-42% of procedures, The most frequent type of IBR was either a two-stage expander followed by a permanent implant or one-stage implant- based with or without synthetic mesh. The most frequent type of delayed breast reconstruction (DBR) was a two-stage expander followed by implant-based reconstruction. None of the surveyed cancer centers performed free flap reconstruction. Deep inferior epigastric perforator (DIEP) flaps were performed in the plastic surgery department. Reconstructions based on pedicled flaps were performed in cancer centers. Acellular dermal matrices (ADM) and fat transfer were used in selected centers. In the clinical scenario of adjuvant radiotherapy, delayed breast reconstruction was favored. The full range of oncoplastic BCS was performed. Patient-reported outcome measures (PROM) and complications were assessed. Our findings can act as a platform for further improvement in skills, certification, data collection and audit, including patient reported expectation measures. There is also an urgent need to address pan-European inconsistencies in procedural reimbursement.

Incomplete excision of basal cell carcinoma (BCC) in the head and neck region: to wait, or not to wait?

INTRODUCTION: Recurrence rates for incompletely excised basal cell carcinoma (BCC) vary widely in the literature. Clinical observation is a commonly accepted method of follow up, however such management of these lesions still remains controversial. AIM: To evaluate the rate and factors associated with the recurrence of BCC of the head and neck region after incomplete excision. MATERIAL AND METHODS: Medical records of 135 patients with 156 incompletely excised BCCs of the head and neck region were analyzed retrospectively. The primary outcome was the rate of recurrence. Additionally, a correlation of recurrence to clinical and morphological factors was analyzed. RESULTS: Recurrence occurred in 72 (46%) lesions. The mean interval to recurrence was 20 months. In each category of factors, the highest relative risk of recurrence was correlated to: location on the scalp - 2.27, diameter over 2 cm - 1.21, nodular clinical form - 1.29, morpheaform histopathological type - 1.67, recurrent lesion - 1.88, irradicality of excision in the lateral margin - 1.24 and closure of the skin defect with the split-thickness skin graft - 1.42 relative risk. CONCLUSIONS: Observation is an acceptable management option as less than a half of incompletely excised BCCs recurred and needed further treatment. As 85% of recurrences occur within 3 years after operation, clinical observation should be particularly careful during this period, however long-term recurrence should not be underestimated.