ABSTRACT
BACKGROUND: In past decades, several invasive and noninvasive aesthetic procedures have been sought as a way to improve body contouring, and one may resort to uncertified and potentially dangerous procedures to achieve that goal. An example of this practice would be the resection of ribs to reduce the waist for aesthetic reasons. The objective was to check scientific evidence on the effectiveness and safety of removal of floating ribs for aesthetic purposes. METHODS: A systematic review of the literature was carried out in EMBASE/Elsevier, Cochrane, Scopus, Medline, PubMed, BVS, SciELO, OneFile, and Lilacs, throughout the period until June 2020, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS: Fifty-six articles were found in all databases. After applying the inclusion criteria, by reading the title and abstract of the studies found, only two articles were definitively included. One addressed the possibility of removing the 7th and 8th ribs for improving body contouring in patients with an exaggerated anterior projection of the chest wall, without showing cases or surgical techniques. The other demonstrated procedures of body contouring in transgender by the removal of the 11th and 12th ribs in five of the 22 patients studied, just providing a brief description of the surgical technique used, without details. CONCLUSIONS: Despite the relevance of the theme and its popularity, there is not enough scientific evidence to support the practice, effectiveness and safety of the resection of ribs for aesthetic purposes. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Subject(s)
Body Contouring , Thoracic Wall , Esthetics , Humans , Ribs/surgery , Thoracic Wall/surgery , Treatment OutcomeABSTRACT
Introdução: O uso de gel de silicone em cicatrizes data do começo da década de 1980. Desde então, um grande número de trabalhos científicos, e dezenas de diferentes fórmulas do produto, vêm sendo publicados e experimentados, atestando os benefícios do gel de silicone na prevenção de cicatrizes hipertróficas e quelóides. Apesar do mecanismo exato de ação do silicone ainda ser desconhecido, a hipótese mais aceita é que o curativo oclusivo estimula os queratinócitos à maior secreção de fatores de crescimento localmente, influenciando consequentemente a regulação dos fibroblastos. Método: Com o objetivo de comprovar os benefícios do silicone gel na melhora clínica das cicatrizes de etiologia cirúrgica eletiva,foi realizado um estudo prospectivo, numa população miscigenada, no Serviço de Cirurgia Plástica na 38ª Enfermaria da Santa Casa da Misericórdia do Rio de Janeiro. Resultados: O gel de silicone demonstrou ação favorável em cicatrizes pós-cirurgia plástica. Conclusão: O uso de silicone gel mostrou-se útil na melhora de cicatrizes recentes, melhorando parâmetros subjetivos e objetivos, como eritema, prurido e endurecimento.
Background: The use of silicone gel on surgical wounds began in the 1980s. Since then, a large number of scientific papers and dozens of different formulas have been published and experimented, attesting the benefits of this product in the prevention of hypertrophic scars and keloids. Although the exact mechanism of action of silicone gel has not yet been elucidated, the most widely accepted theory explains that the occlusive film stimulates the keratinocytes to increase the local secretion of growth factors, subsequently influencing the regulation of fibroblasts. Methods: A prospective study was undertaken at the 38th Ward of the Santa Casa General Hospital, Rio de Janeiro, to evaluate the positive effects of silicone gel on surgical wounds, in a mixed race population. Results: Silicone gel demonstrated apositive effect on surgical wounds following plastic surgery. Conclusion: Silicone gel is useful to enhance the quality of recent scars, in both subjective and objective parameters, such as erythema, pruritus and firmness.
