Impact of Minimally Invasive Aesthetic Procedures on the Psychological and Social Dimensions of Health.

BACKGROUND: The impact on psychosocial health of injectable facial treatments such as hyaluronic acid fillers and botulinum toxin type A remains poorly defined. The aim of this study was to measure changes in psychosocial health following aesthetic intervention with injectables in routine clinical practice using the validated FACE-Q patient-reported outcome measure. METHODS: This was a prospective assessment of patients presenting at a single center for the first time for aesthetic treatment of the face with injectables in February 2020. Participants completed 3 FACE-Q scales at the baseline and again 2 weeks posttreatment: Psychological Function; Social Function; and Appearance-related Psychosocial Distress. RESULTS: Complete data were available for 35 individuals (n = 32 women [91%]; mean age: 45.9 ± 13.8 years). Twenty-nine (83%) were treated with hyaluronic acid filler (mean: 2.3 ± 1.3 syringes), and 12 (34%) received onabotulinumtoxinA (mean: 2.0 ± 0.7 areas of the upper face). There were significant improvements on each FACE-Q scale posttreatment: mean change in Psychological Function score was +12.4 [95% CI: 7.9, 16.9; P < 0.001; standardized effect size by Cohen's d: 0.93]; mean change in Social Function score was +7.9 (95% CI: 3.3, 12.5; P = 0.001; effect size: 0.50); and mean change in Appearance-related Psychosocial Distress score was -20.9 (95% CI: -27.4, -14.3; P < 0.001; effect size: 1.27). CONCLUSIONS: Aesthetic treatment with injectables was associated with significant improvements in patient-reported psychological and social functioning and reductions in appearance-related distress. This change underlines the value of these therapies for improving psychosocial health in well-selected patients.

Significant improvement in body contour with multiple cycles of CoolSculpting: Results of a prospective study.

Cryolipolysis is a nonsurgical body sculpting technique that uses controlled cooling for localized fat reduction. The aim of the present study was to assess whether an intensive regimen of CoolSculpting based on multiple cycles/sessions on the same body area(s) could yield greater (more clinically significant) improvements in body contour. This was a prospective analysis of consecutive, healthy, adult patients undergoing CoolSculpting in routine practice across a variety of treatment areas. Patients underwent ≤4 cycles of CoolSculpting per body area during an initial treatment session, and ≤4 further cycles 4 weeks later (if required). They were followed up for ≥12 weeks. Twenty-eight patients were enrolled (n = 26 female; mean age: 51.6 ± 9.0 years; mean body weight: 69.4 ± 13.7 kg). They were treated across 58 body areas: 48 in a single session; 10 across two sessions. The mean number of cycles per area was 2.8 ± 1.5. Twenty-seven patients (54 body areas) were considered as treatment "responders." In these individuals, mean skinfold thickness decreased from 35.4 ± 9.9 mm pretreatment to 22.2 ± 7.6 mm at 12 weeks (mean change: -40%; P < .001). Mean change in skinfold thickness was greater with ≥3 vs 1 to 2 cycles of CoolSculpting (P = .01). Patient satisfaction was high (n = 51/58; 88%). No adverse events were recorded. The study shows that multiple cycles/sessions of CoolSculpting can safely improve overall treatment benefit in body contouring, with greater decreases in skinfold thickness than have typically been previously observed.

Improving aseptic injection standards in aesthetic clinical practice.

The rise in popularity and demand for nonsurgical injectable aesthetic procedures is inherently accompanied by an increase in reported complications, particularly those related to infection. Aseptic technique is under the control of aesthetic practitioners and can be modified to minimize the potential for cross-contamination and infection. This should be a key consideration during all clinical procedures, particularly those involving breach of the skin's natural defenses and the use of soft tissue filler. A consensus group of five UK expert aesthetic clinicians were convened to discuss current best practice for aseptic techniques in medical aesthetics. The aim of the consensus group was to recommend a step-by-step procedure to achieve optimal aseptic practice in private clinics, and define important considerations for reducing infection risk during the whole patient journey: pre-, during- and postaesthetic procedure. Recommendations were based on current evidence and extensive clinical experience. Various procedure recommendations were made to achieve and maintain a high standard of asepsis and infection control. Guidance was divided into three phases for patients and health care professionals, covering preprocedure (including patient selection), during-procedure, and postprocedure considerations. Although adherence to standard hospital guidance on handwashing and cleanliness measures is a cornerstone of controlling cross-contamination, aesthetic clinics carry a high potential risk of infection-particularly as popular treatments with dermal fillers primarily involve the face. This expert consensus guidance recommends procedures to mitigate the potential risks of asepsis.

Use of buccal myomucosal flap in secondary cleft palate repair.

BACKGROUND: The purpose of this study was to assess the effectiveness of the buccal myomucosal flap in secondary repairs of cleft palate. METHODS: Twenty-two patients who underwent secondary palatoplasty between 1989 and 2004 in which a buccal myomucosal flap was used were reviewed retrospectively. All patients had undergone at least one previous attempted repair at other institutions. Indications for the secondary repair included velopharyngeal incompetence and/or oronasal fistula. Patients were evaluated preoperatively for oronasal fistula status, velopharyngeal competence, nasal resonance, speech quality, and nasal escape. RESULTS: The buccal myomucosal flap was used in all patients. The patients' mean age was 8.5 years (range, 1 to 23 years). Correction was indicated in seven patients with velopharyngeal incompetence (32 percent), five patients with oronasal fistulas (23 percent), and 10 patients with both conditions (45 percent). Preoperative assessment revealed four patients (18 percent) with an associated syndrome, 17 of 20 patients with hyperresonance (85 percent), 16 of 20 patients with nasal escape (80 percent), and 12 of 20 patients with poor speech (60 percent). The buccal myomucosal flap technique was used alone in 50 percent of patients, six patients had a staged correction (27 percent) and five patients required multiple procedures (23 percent). All fistulas remained closed. Two patients showed mild velopharyngeal incompetence (p = 0.001) and two patients continued to display hyperresonance (p < 0.001). Speech quality improved to a good level in 17 patients (77 percent) (p < 0.001). CONCLUSION: Palate re-repair combined with a buccal myomucosal flap, occasionally in conjunction with other techniques, is an effective method for correcting failed cleft palate repairs.