Gluteal Augmentation in Men.

The shape and definition of the male buttock have been emphasized throughout time, as it represents masculinity, strength, health, and beauty across various cultures. Aesthetic Plastic Surgery in general has become more acceptable for men; thus, the demand for gluteal enhancement parallels this shift in social norms. Surgeons interested in such cases must first understand the aesthetic ideals and principles of gluteal shaping as it pertains to men. By using gluteal implants, fat transfer techniques, local tissue rearrangement principles, or a combination thereof, one can sculpt an aesthetically pleasing male buttock with a high degree of patient satisfaction.

An Assessment of Gender Differences in Plastic Surgery Patient Education and Information in the United States: Are We Neglecting Our Male Patients?

BACKGROUND: The number of total cosmetic procedures performed yearly has increased by more than 274% between 1997 and 2014, according to the American Society for Aesthetic Plastic Surgery. However, the vast majority of plastic surgery procedures are still targeted toward women, with little attention toward men. OBJECTIVES: This study sought to quantify the extent of gender discrepancies observed in online plastic surgery marketing in this country. METHODS: For the 48 contiguous United States, a systematic Google (Mountain View, CA) search was performed for "[state] plastic surgeon." The first 10 solo or group practice websites in each state were analyzed for the gender of the first 10 images featured, presence of a male services section, and which procedures were offered to men. The results were statistically analyzed using SPSS Software (IBM Corporation, Armonk, NY). RESULTS: A total of 453 websites were analyzed, as 5 states did not have 10 unique solo or group practice websites. Of the 4239 images reviewed, 94.1% were of females, 5.0% were of males, and 0.9% were of a male and female together. A male services page was present in 22% of websites. The most common procedures marketed toward men were gynecomastia reduction (58%), liposuction (17%), blepharoplasty (13%), and facelift (10%). Less than 10% of all websites offered other procedures to males, with a total of 15 other aesthetic procedures identified. CONCLUSIONS: Many plastic surgeons choose to ignore or minimize male patients in their online marketing efforts. However, as the number of men seeking cosmetic procedures continues to grow, plastic surgeons will benefit from incorporating male patients into their practice model.

A Retrospective Review of Patients Undergoing Lateral Canthoplasty Techniques to Manage Existing or Potential Lower Eyelid Malposition: Identification of Seven Key Preoperative Findings.

BACKGROUND: Lateral canthal procedures are often indicated to correct or prevent lower eyelid malposition. When determining an appropriate lateral canthal procedure, planning is essential and includes proper analysis and identification of any contributory anatomical factors. METHODS: A 12-month retrospective review was performed on patients undergoing lateral canthal procedures. Important components of the preoperative examination were studied to relate patient anatomy and results. Outcomes were followed for a minimum of 5 years. RESULTS: Of 288 consecutive lower eyelid canthal procedures, a total of 146 met the inclusion criteria. Common designated abnormal preoperative findings included a negative vector (62 percent), lid margin eversion (12 percent), scleral show (21 percent), neutral or negative canthal tilt (49 percent and 18 percent, respectively), and lateral canthus -to -orbital rim distance of more than 1 cm (11 percent). The distribution of lateral canthal procedures performed in our study population included inferior retinacular lateral canthopexy (n = 36), inferior retinacular lateral canthoplasty (n = 88), tarsal strip lateral canthoplasty (n = 15), and dermal-orbicular pennant lateral canthoplasty (n = 7). Successful outcomes were noted to be 86 percent and 91 percent according to surgeons and patients, respectively. CONCLUSIONS: Specific findings on the preoperative physical examination identify when simple or more complex lateral canthal procedures should be performed. The authors report seven key physical findings that should be documented to effectively determine a lateral canthal procedure that is appropriate for prevention and management of lower eyelid malposition. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

Factors in the fracture microenvironment induce primary osteoblast angiogenic cytokine production.

Neoangiogenesis is essential for successful wound repair. Platelets are among the earliest cells recruited to a site of skeletal injury and are thought to provide numerous factors critical to successful repair. The release of platelet-derived growth factor (PDGF) after skeletal injury increases osteoblast proliferation, chemotaxis, and collagen synthesis; however, its angiogenic effect on osteoblast biology remains unknown. The purpose of this study was to investigate the effect of recombinant human (rh)PDGF-BB on the synthesis of vascular endothelial growth factor (VEGF) by primary neonatal rat calvarial osteoblasts. Furthermore, the authors investigated whether PDGF works in concert with hypoxia, another component of the fracture microenvironment, to additively or synergistically induce VEGF production. Osteoblast cultures were stimulated with varying concentrations of rhPDGF-BB (1, 10, 50, and 100 ng/ml) in normoxic and hypoxic (<1% oxygen) conditions for 0, 3, 6, 12, and 24 hours, and VEGF gene expression was analyzed by Northern blot analysis. To determine whether rhPDGF-BB-induced VEGF messenger RNA (mRNA) expression was transcriptionally mediated or required de novo protein synthesis, transcription, and translation, studies were performed using actinomycin D and cycloheximide, respectively. Treatment with 50 ng/ml rhPDGF-BB resulted in a 2.4-fold increase in VEGF mRNA expression after 3 hours. Interestingly, rhPDGF-BB and hypoxia seemed to have an additive effect, resulting in a 3.7-fold increase in VEGF mRNA expression after 6 hours in primary neonatal rat calvarial osteoblasts. Furthermore, by using actinomycin D and cycloheximide, the authors demonstrated that the rhPDGF-BB-induced VEGF mRNA expression was transcriptionally mediate and not dependent on de novo protein synthesis. These data demonstrate that rhPDGF-BB transcriptionally increases osteoblasts VEGF mRNA expression in vitro. Furthermore, the semiquantitative results suggest that rhPDGF-BB and hypoxia act additively to increase VEGF mRNA expression. It is postulated that similar mechanisms may occur in vivo, at a site of skeletal injury, to induce neoangiogenesis and promote fracture repair.