The Ethics and Responsibilities of Social Media Usage by Plastic Surgeons: A Literature Review.

BACKGROUND AND OBJECTIVES: Social media has revolutionised how plastic surgeons advertise their work and promote their services, but concerns have been raised regarding the ethics of these practices. This review aims to identify said concerns and develop measures to address them. METHODS: PubMed, Cochrane and Medline were searched for studies assessing the ethics of social media use by plastic surgeons. Five search terms were used and 23 studies identified. Results were catalogued according to which principle of medical ethics was infringed. RESULTS: Autonomy: Patients must not be coerced into allowing their operative media to be shared and content anonymised by removing identifiable features and scrubbing metadata. Beneficence: It is difficult to balance the benefit to patients of posting photographs for educational purposes with the risk of identifiable features being present, particularly within craniofacial surgery. Non-maleficence: Taking operative media could be a distraction from the patient and lengthen the procedure which could lead to harm. Any content posted on social media should be adapted to avoid trivialisation or sexualisation. Justice: Surgeons should not entertain their audience to increase their following at the expense of patients. CONCLUSIONS: Greater oversight of social media use by plastic surgeons is required to avoid patient harm and tarnishing of the specialty's professional standing. Professional bodies should be tasked with devising a course dedicated to the responsible use of these platforms. This should ensure the public's trust in the specialty does not become eroded and patients are not harmed by unethical social media use. This review highlights the relevant shortfalls of SoMe use by plastic surgery Several proposals are made to reduce the incidence of these shortfalls and to ensure SoMe is used in a professional and responsible manner It also lists areas of the specialty where SoMe is underused and could be of help, such as academia LEVEL OF EVIDENCE IV: 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 http://www.springer.com/00266 .

Face Structure, Beauty, and Race: A Study of Population Databases Using Computer Modeling.

Background: Understanding the differences in facial shapes in individuals from different races is relevant across several fields, from cosmetic and reconstructive medicine to anthropometric studies. Objectives: To determine whether there are features shared by the faces of an aesthetic female face database and if they correlate to their racial demographics using novel computer modeling. Methods: The database was formed using the "top 100 most beautiful women" lists released by "For Him Magazine" for the last 15 years. Principal component analysis (PCA) of 158 parameters was carried out to check for clustering or racial correlation with these clusters. PCA is a machine-learning tool used to reduce the number of variables in a large data set, allowing for easier analysis of the data while retaining as much information as possible from the original data set. A review of the literature on craniofacial anthropometric differences across ethnicities was also undertaken to complement the computer data. Results: Two thousand eight hundred and seventy aesthetic faces formed the database in the same racial proportion as 10,000 faces from the general population as a baseline. PCA clustering illustrated grouping by latent space parameters for facial dimensions but showed no correlation with racial demographics. There was a commonality of facial features within the aesthetic cohort, which differed from the general population. Fourteen papers were included in the review which contained 8142 individuals. Conclusions: Aesthetic female faces have commonalities in facial features regardless of racial demographic, and the dimensions of these features vary from the baseline population. There may even be a common human aesthetic proportion that transcends racial boundaries, but this is yet to be elucidated.

Comparing the safety profiles of implants and autologous fat grafting in gluteal augmentation: A systematic review.

Gluteal augmentation has become a popular esthetic procedure since its inception. The main methods are augmentation using implants or autologous fat grafting, which is the harvesting and grafting of patients' own fat tissue. The last review comparing the safety of these methods was written 7 years ago, which warrants the writing of a new one. PubMed, Cochrane, and Medline were searched for studies focusing on the methods of gluteal augmentation listed previously. Five search terms were used and 15 studies fulfilled the criteria. The data were cataloged according to the method described and outcomes compared. Seven articles focused on gluteal implants and another seven assessed autologous fat grafting, whereas one detailed both. The most common complications in 524 implant procedures were wound dehiscence (9.16%), excessive implant palpability (5.92%), and seroma (3.82%), with an overall complication rate of 25%. The most common complications in 1788 gluteal fat augmentation procedures were seroma (6.9%), infection (3.0%), and transient sciatic paresthesia (1.0%), with an overall complication rate of 13%. Several articles listed satisfaction figures, but these were not assessed because this article was not powered to assess this outcome. Overall, gluteal augmentation using autologous fat grafting leads to fewer postoperative complications than implants and allows greater contouring of the buttocks and the surrounding areas. However, it can also be a far more dangerous procedure if certain recommendations are not followed.