Management of hyperplastic tissue response following connective tissue grafting.

OBJECTIVE: While connective tissue graft shrinkage is a well-documented post-transplantation reaction, there is a literature gap concerning hyperplastic tissue response. Despite its infrequent occurrence, investigation is warranted due to its capacity to compromise esthetics, disrupt lip dynamics, and promote food retention. Moreover, efforts to mitigate hyperplastic tissue response often prove challenging, and there is a potential risk of exacerbating gingival tissue rebound. CLINICAL CONSIDERATIONS: This report presents a potential solution to managing tissue overgrowth after connective tissue grafting in five clinical cases. The patients underwent corrective surgery involving internal excision of excessive tissue while preserving the overlying mucosa. The surgical approach was tailored to excise hyperplastic tissue with minimal trauma, aiming to optimize esthetic outcomes. Subsequent follow-up assessments spanning 1-5 years demonstrated stable results, with no indications of relapse or recurrence of tissue overgrowth. CONCLUSIONS: Within the limitations of this case series, surgical internal excision holds promise as a viable treatment modality for addressing post-transplantation hyperplastic tissue response. CLINICAL SIGNIFICANCE: This case series addresses the challenge of uncontrolled tissue overgrowth following connective tissue grafting, a concern for which previous attempts have proven unsuccessful. Internal in-toto excision emerges as a promising approach for effectively eliminating overgrown tissue, offering potential advancements in the clinical management of this complication.

Artificial Intelligence in Plastic Surgery: Analysis of Applications, Perspectives, and Psychological Impact.

Artificial intelligence (AI) is emerging as a promising tool in the field of plastic surgery, offering a wide array of applications that enhance surgical outcomes, patient satisfaction, and overall efficiency. This paper explores the utilization of AI, highlighting its various advantages and potential drawbacks. AI-driven technologies such as computer vision, machine learning algorithms, and robotic assistance facilitate preoperative planning, intraoperative guidance, and postoperative monitoring. These advancements enable precise anatomical measurements, personalized treatment plans, and real-time feedback during surgery, leading to improved accuracy and safety. Furthermore, AI-powered image analysis aids in facial recognition, skin texture assessment, and simulation of surgical outcomes, enabling enhanced patient consultations and predictive modeling. However, the integration of AI in plastic surgery also presents challenges, including ethical concerns, data privacy, algorithm biases, and the need for comprehensive training among healthcare professionals. Additionally, the reliance on AI systems may potentially lead to over-reliance or reduced surgeon autonomy, necessitating careful validation and continuous refinement of these technologies. Despite these challenges, the synergistic collaboration between AI and plastic surgery holds great promise in advancing clinical practice, fostering innovation, and ultimately benefiting patients through optimized esthetic and reconstructive outcomes.Level of Evidence V 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 https://www.springer.com/00266 .

Enhancing root coverage and esthetic outcomes in isolated gingival recession using orthodontic intervention and lateral closed tunnel technique: An interdisciplinary prospective case series.

BACKGROUND: Gingival recession (GR) in malposed tooth in association with bone dehiscence and/or fenestration poses a challenge for successful root coverage treatment. Lateral closed tunnel (LCT) technique is particularly useful in isolated GR in mandibular anterior region, where the shallow vestibular depth prevents tension-free coronal mobilization of tissues. METHODS: Twenty patients with GR associated with tooth malposition were treated using a combined orthodontic-periodontic approach with a torquing auxiliary spring followed by LCT technique. RESULTS: The two techniques resulted in a combined recession depth reduction from 3.75 ± 1.14 mm to 0.40 ± 0.50 mm at the end of 6-month study period. The orthodontic intervention led to an increase in labial marginal bone levels, as assessed through cone beam computed tomography (CBCT), while the LCT achieved closure of residual recession defect. Also, an increase of keratinized tissue width from 0.81 ± 0.88 mm at baseline to 3.30 ± 0.67 mm at 6 months was achieved. Mean root coverage percentage (MRC%) of 91.40% + 10.25% was seen, with 11 out of 20 sites (55%) showing complete root coverage (CRC). CONCLUSIONS: Single tooth orthodontic repositioning followed by LCT technique proved effective in successfully managing isolated recession defects in the mandibular anterior gingival region, which often presents challenging mucogingival conditions. The precise single tooth repositioning resulted in labial marginal bone augmentation, while the LCT surgical approach allowed residual defect closure. KEY FINDINGS: Why are these cases new information? Correction of single tooth malposition is achieved before recession coverage treatment to achieve a favorable environment for graft uptake. The reduction in denuded root surface along with the bone remodeling results in increasing the ratio of vascular to avascular region, thus improving the overall prognosis of the treatment. What are the keys to successful management of these cases? The lateral closed tunnel technique involves creating a mucoperiosteal tunnel to close the recession site. Precision is crucial to avoid damage to surrounding tissues. The recipient site should be wider than the width of recession to improve graft vascularity. What are the primary limitations to success in these cases? Limitations may arise when dealing with complex cases, such as multiple teeth involvement or teeth with significant vertical or horizontal bone loss.

Demographic review of aesthetic surgery for patients with facial palsy.

BACKGROUND: This study analyzed the demographic characteristics of patients with facial palsy who were treated using either dynamic or static procedures. This study aimed to compare the frequency of procedure implementation and age distribution between the two groups. METHODS: This study retrospectively analyzed the medical records of patients treated for facial palsy at a single institution from 2014 to 2022. Among cases included in our study, dynamic procedures involved cross-facial nerve graft and latissimus dorsi or gracilis muscle flap transfer. Static procedures included gold weight insertion, canthopexy, browlift, and thread lift/static slings. RESULTS: Among the 31 patients included in our study, eight (25.8%) incorporated dynamic techniques, and the average age of patients was 44.75 years (range, 24-68 years) with a male to female ratio of 1:4. The remaining 23 patients (74.2%) underwent a static procedure, of which the average age was 59.17 years (range, 23-81 years) which was statistically significantly higher than the average age of 44.75 of dynamic patients (p= 0.013). Regarding the timing of treatment after diagnosis, no patient underwent dynamic procedures more than 20 years after initial diagnosis. A greater diversity in the timing of treatment was observed in the static group. All patients who underwent dynamic procedures were treated using static procedures during the study period. CONCLUSION: Because aesthetics-based static techniques are typically quick outpatient procedures that can be performed under local anesthesia, our study shows that these are often preferred treatments for all age groups, especially for debilitated or older patients. Further research is required to investigate the long-term functional outcomes of these surgical techniques in a wider population of patients.

Deciphering the "David Sign": Intersections in esthetic surgery and renaissance sculpture.

Spotlighting a 500-year-old detail in Michelangelo's "David," this paper delves into the intricate connection between technique and art in the medical field, especially in esthetic surgery. With rapid technological advancement, medical specialties are becoming increasingly segmented, leading to potential oversights in holistic human examination. Drawing from ancient Greek concepts, "Techne," "Ars," and "Episteme" are explored as symbolic representations of the convergence of skill and knowledge. Art, defined as a reflection of human creativity and emotion, was historically intertwined with science, as symbolized by the nine Muses. The Renaissance period, exemplified by works like "David," underlines the profound relationship between art and anatomy. Dr. Gelfman's observations on the "David sign" serve as a testament to the continuous dance between medical science and artistic representation. This paper underscores the timeless value of a comprehensive approach in medical practice, urging professionals to amalgamate technical precision with an artistic understanding of the human form. LEVEL OF EVIDENCE: Level V, opinion expert.

The Reconstruction of Plastic Surgery: A Historical Perspective on the Etymology of Plastic and Reconstructive Surgery.

Although the origins of procedures now falling under the scope of modern plastic surgery date back thousands of years, it was only fairly recently that these were grouped under the umbrella term "plastic" surgery. However, mainly due to the industrialization period, the popular understanding of the term "plastic" would soon change-making way for the addition of the term "reconstructive" to the specialty's name. Through a careful look at historical trends, the authors illustrate how this unintentionally led to an ideological divide between the aesthetic and reconstructive portions of our work, prompting a recent push to unify the field under the one, original, lexical choice: "plastic" surgery.

Même si les origines des interventions qui font désormais partie du champ de la chirurgie plastique moderne remontent à des millénaires, ces interventions n'ont été regroupées que récemment sous le vocable de chirurgie "plastique". Cependant, en grande partie à cause de l'industrialisation, la compréhension populaire du terme "plastique" allait bientôt changer, laissant place à l'ajout du terme "reconstructive" au nom de la spécialité. Par un examen attentif des tendances historiques, les auteurs démontrent que cet ajout a involontairement entraîné un fossé idéologique entre la partie esthétique et reconstructive du travail, ce qui a suscité une récente impulsion en vue d'unifier le domaine sous un choix lexical unique et original : chirurgie "plastique".

How to stratify the risk of thrombosis for esthetic plastic surgery? The proposal of a new scale.

Scales to qualify the risk of thrombosis do not include all thrombogenic factors that are generated in esthetic plastic surgery. Methods: We performed a systematic review to assess the risk of thrombosis in plastic surgery. Thrombogenic factors in esthetic surgery were analyzed by a panel of experts. We proposed a scale with 2 versions. In the first version, factors were stratified according to their impact on the possible risk of thrombosis. The second version includes the same factors but in a simplified form. We evaluated the efficacy of the proposed scale by comparing it with the Caprini score; we scored the risk in 124 cases and controls. Results: Using the Caprini score, we found that 81.45% of the patients studied and 62.5% of the cases of thrombosis were observed in the low-risk group. Only 1 case of thrombosis was reported in the high-risk group. Using the stratified version of the scale, we found that the low-risk group comprised 25% of the patients, and there were no cases of thrombosis. The high-risk group included 14.51% of patients; 10 presented thrombosis (62.5%). The proposed scale was very effective in detecting both low-risk and high-risk patients undergoing esthetic surgery procedures.

Autologous fat transfer for orbital volume augmentation in sockets with small nonseeing eyes.

OBJECTIVE: End-stage ocular diseases usually end up with atrophic bulbi or phthisis bulbi leading to orbital volume loss which needs to be addressed. We studied the use of autologous fat for volume augmentation of the orbit because it is minimally invasive and allows early rehabilitation with the use of an artificial eye. DESIGN: It was a prospective, interventional study. METHODS: A total of 14 eyes of 14 patients with atrophic bulbi with shrinkage or phthisis bulbi with no perception of light (PL) and aged older than 18 years were included for the study purpose. Painful or inflamed eyes or suspected intraocular tumors were excluded. An autologous fat graft was obtained from the lower abdomen or buttocks and injected into the retrobulbar space using a 20-gauge cannula after adequate peribulbar anesthesia. Outcomes measures were patient satisfaction, change in Hertel's exophthalmometry, vertical and horizontal palpebral aperture, and socket volume. RESULTS: Hertel exophthalmometry showed a significant improvement both with and without an artificial eye from 14.92 ± 2.3 mm to 16.71 ± 1.94 mm (p-value 0.003 without an artificial eye). The vertical palpebral aperture also showed a significant improvement from 5 ± 1.70 mm to 6.71 ± 1.58 mm (p-value < 0.001). There was a significant reduction in the socket volume from 1.22 ml to 0.39 ml (p-value < 0.001). No local or donor site complications were seen. CONCLUSIONS: Autologous fat transfer is a minimally invasive, safe, and effective procedure for orbital volume augmentation in small, nonseeing eyes. The short-term outcome of our study was good in most patients and can be considered for such patients.

Clinical evaluation of periosteal pedicle flap in the treatment of gingival recessions for esthetic root coverage: A randomized controlled clinical trial.

Background: Root coverage using subepithelial connective tissue graft (SCTG) is gold standard with few drawbacks such as requirement of second surgical site, reduced donor tissue availability, and increased surgical complications and pain. Periosteal pedicle graft (PPG) due to its rich source of pluripotent stem cells and nonrequirement of second surgical site could be a successful alternative for invasive SCTG. Therefore, current research aims to compare the amount of root coverage obtained with PPG to SCTG. Materials and Methods: Fifty-two single gingival recessions were included in the sample, with 26 patients allocated to the SCTG (control) and PPG (test) groups at random. At baseline, 3, and 6 months after surgery, clinical measurements of probing depth, clinical attachment level (CAL), recession depth (RD), recession width (RW), and width of keratinized tissue were taken. Results: Both procedures, i.e., SCTG and PPG, resulted in root coverage to a variable extent and a significant decrease in RD (1.69, 1.38 mm in SCTG and PPG groups, respectively) and RW, CAL gain is found in both the groups without any intergroup statistical variance. Complete root coverage (CRC) was obtained in 14 out of 26, i.e., 53.8% defects in both SCTG and PPG groups. A better comfort level is found in the group treated with PPG. Conclusion: Gingival recessions can be successfully treated with PPG, which has predictability comparable to SCTG and does not require a second surgical site.

Assessment of clinical and ultrasonographic parameters as indicators for buccal fat pad excision by esthetic reasons.

PURPOSE: The selection of candidates for buccal fat pad (BFP) removal depends on the patient's requirements, the subjective surgeons' evaluation, and objective clinical factors. This cross-sectional observational study aimed to identify objective clinical and ultrasonographic parameters as indicators of cheek contouring with BFP excision. METHODS: Sixty-six patients with cheek fullness complaints were examined by two experienced surgeons to determine if they were good candidates for the procedure. Thereafter, participants underwent clinical and ultrasonographic assessments in a separate session to aid in the surgical decision-making. The association between the clinical judgment for BFP excision and the study variables was analyzed individually and adjusted for confounders using binary logistic regression and grouping analyses. RESULTS: Forty-nine participants were regarded as suitable and 17 as non-suitable for the procedure. After regression analysis, cheek skin-fold thickness > 6.00 mm, midfacial contour > 2.20 mm, ovoid/triangular facial form, and ultrasonographic BFP volume > 2.05 mL remained as robust individual indicators for the suitability for the procedure. However, the grouping analysis showed that patients having three-to-four significant criteria synchronously had significantly higher odds for eligibility with excellent discrimination capability. CONCLUSION: Although high values of cheek skin-fold thickness, midfacial contour, and ultrasonographic BFP volume, as well as an ovoid/triangular facial form, might be robust indicators for the suitability for BFP excision, the surgical decision-making should not be based on isolated parameters. Instead, those patients possessing a combination of at least three of these specific eligibility criteria above the threshold value might be considered the best candidates for the procedure.

The Safety of Large-Amount Liposuction: A Retrospective Analysis of 28 Cases.

Aim: Our study aims to assess the safety of large amounts of liposuction in a new light. Materials and Methods: This is a retrospective review of patients who underwent large-volume liposuction from August 2020 to April 2021. Patient demographics, liposuction areas, the amount of infiltrate and aspirate, the surface area of liposuction areas, anesthesia duration, pain score after surgery, preoperative and 4-h postoperative hemoglobin, and basic metabolic panel (sodium, potassium, creatinine, urea) were measured. Results: Out of the 28 patients, 26 (92.85%) were females. The mean age was 37.1 years old. The mean preoperative hemoglobin was 13.73 g/dL. The average anesthesia time was 220.39 min. The average amount of liposuction infiltrated was 7.55 L, and the average amount of liposuction aspirate was 6.83 L. The mean hemoglobin 4 h postoperatively was 13.7 g/dL. Conclusions: With proper patient selection and a comprehensive physical exam with preoperative blood workup performed in an accredited facility with a highly experienced plastic surgeon and anesthesiologist, mega liposuction can be safely performed as a day surgery procedure.

[interest of scaphal cartilage grafting or ulnar proximal bone graft, under the olecranium, in secondary nose repair]. / Intérêt des Greffons de scapha ou du greffon de facette cubitale(ulna)sous olécrânien dans les rhinoplasties secondaires.

The proper use of scaphal ear cartilaginous autograft or ulnar bone lateral side under the olecranium, on the postero-médial flat wall covered by muscle, may be an innovative way for secondary nasal repair or reconstruction.These techniques are not well popularised, but they may represent a good solution in complicated cases when straighter cartilage than the concha, or a planar bone graft easy to take out, are considered; this may be the case mostly in secondary noses surgery;These techniques are also easy to perform because the position to take the grafts is very easy, the donor site is under the operative field; the observed complications have been few and the results were rewarding.

Complications following thread rhinoplasty.

BACKGROUND: The debate on thread rhinoplasty (TR) has never stopped owing to its complications. However, few studies have reported the clinical characteristics of TR complications, as well as their treatment. AIMS: We aim to summarize the clinical, ultrasonographic, and histopathologic characteristics of TR complications. PATIENTS/METHODS: This retrospective case series study included consecutive patients presenting with TR complications. Patients' demographics, medical history, complications, ultrasonography, treatment, histopathology, and follow-up outcome were collected through the electronic medical record. RESULTS: A total of 30 patients (28 females) with an average age of 28.7±6.8 years were included. The most common complication leading to consultation was infection (46.7%), followed by thread extrusion (30%), chronic inflammation (16.7%), and dimpling (6.7%). Most patients who developed complications received TRs at illegal nonmedical places (70%). Ultrasonography of infection showed multiple dotted heterogeneous hyperecho signals surrounded by a hypoecho area. Twenty patients (66.7%) received debridement, thread removal, or release of dimpling. Threads could be completely removed within one month of TR. Histopathological examination showed multifocal crystal-like material surrounded by excessive inflammatory cells in hyperplastic granulation tissues. All patients were satisfied with the clinical outcomes over a follow-up of 25.6 ± 14 months. CONCLUSIONS: Infection is the most common complication that always warrants thread removal. Ultrasonography is helpful in detecting the remaining threads and delineating the infection area. We do not recommend threading as a regular method for rhinoplasty owing to its complications for an expedience with short-lasting effect.

Perforation of Abdominal Viscera Following Liposuction: A Systemic Literature Review.

BACKGROUND: Liposuction is among the most popular esthetic procedures worldwide. With growing demand and popularity, reports of serious complications accumulate. Despite being a rare complication of the procedure, visceral perforation is associated with morbidity and severe debilitation. METHODS: The authors conducted a literature search for reported cases of perforation of abdominal viscera following liposuction procedures in the electronic databases of PubMed, Scopus and Cochrane Library databases. RESULTS: The authors found 22 publications; 19 cases case reports and three studies, reporting a total of 49 cases of visceral perforation following abdominal liposuction procedures. Average age of patients was 50 years (range 24-72). Twenty-seven patients (73%) were female, and 10 were male (27%). Forty (81%) patients underwent isolated liposuction, and nine (19%) had multiple procedures carried out in a single surgery. Twenty patients (42%) had undergone previous abdominal surgery, 13 (27%) suffered abdominal wall weakness or deformities, and 7 (14%) suffered from obesity. 25 (52%) ileal perforations occurred, 6 jejunal (12.5%), 5 colic (10%) and 2 (4%) each of splenic and hepatic. Seven patients (14%) died during their hospitalization, 20 (41%) were discharged with no sequelae complications, and 22 (45%) developed complications after discharge. CONCLUSIONS: Liposuction is a popular esthetic procedure that underwent numerous changes over the past century since its introduction. Despite its widely accepted reputation of a safe procedure with minimal complications, a growing number of reports on visceral perforation following liposuction have emerged. Scrupulous pre-operative evaluation and high index of suspicion are crucial for avoiding complications and unfavorable outcomes. 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 .

The minimal access cranial suspension (MACS) lift: A systematic review of literature 18 years after its introduction.

BACKGROUND: One of the most popular short-scar rhytidectomy techniques used nowadays is the minimal access cranial suspension (MACS) lift developed by Tonnard and Vaerpele. The technique uses purse-string sutures in combination with limited skin undermining to obtain a clear vertical tissue repositioning. Since its introduction, the technique has extensively been described and used around the world by facial plastic surgeons. Now, 18 years after its introduction, a systematic review concerning the results and complications of the MACS lift is presented to establish its current position in facial rejuvenation. METHODS: The MEDLINE, Embase, Cochrane Central, and Google Scholar databases were searched for studies evaluating the MACS lift (June 10, 2020). Outcomes of interest were long-term effect, satisfaction, and complications of the MACS lifting as determined by the patient and/or surgeon. RESULTS: Six studies were included, with 739 patients treated with the MACS lift in total. No major complications were reported, four studies did report on the occurrence of minor complications. All of the six studies reported relatively high levels of satisfaction. Three studies reported a shorter procedural duration for the MACS lift compared with the conventional facelift. In three of the six included studies, the level of evidence was low. The effect on neck rejuvenation is limited. CONCLUSION: The MACS lift can be considered a minimally invasive facelift procedure with a relatively low complication rate. The procedure, often combined with additional procedures, results in evident patient and/or surgeon satisfaction. To obtain a better desired result on an aged neck area, additional procedures are warranted.

Treatment of gingival recessions using coronally advanced flap and connective tissue graft: a long-term retrospective analysis.

OBJECTIVES: The aim of this retrospective study was to evaluate the long-term effectiveness of coronally advanced flap (CAF) in combination with connective tissue graft (CTG) in the treatment of gingival recessions. METHOD AND MATERIALS: Periodontal charts of 13 patients with single and multiple gingival recessions treated by means of CAF and CTG with a follow-up of 7 years were selected for the study. Full-mouth plaque score (FMPS), full-mouth bleeding score (FMBS), gingival recession depth (GRD), gingival recession width (GRW), height of keratin-ized gingiva (KG), probing depth (PD), and clinical attachment level (CAL) were assessed at baseline, and after 1 and 7 years of follow-up. Complete root coverage (CRC) was evaluated at 1 year and after 7 years of follow-up. A comparison of gingival recessions with or without non-carious cervical lesions (NCCL) was also performed. RESULTS: All clinical variables showed a significant improvement (P < .05) between baseline and after 7 years of follow-up. CRC was achieved in 69.2% and 53.8% of sites after 1 and 7 years of follow-up, respectively. The comparison between gingival recessions with and without NCCL did not show statistically significant differences (P > .05) in terms of all parameters. CONCLUSIONS: Within limits of the present study, the combination of CAF and CTG for the treatment of single and multiple recessions yielded positive outcomes in terms of GRD reduction and CRC after 7 years. These findings were independent of the presence of NCCLs.

Determinación de Valores de Armonía del Perfil Facial en la Población Chilena

RESUMEN: El realizar un tratamiento ortodóntico sólo en base a referencias de tejidos duros, puede llevar a resultados estéticos desfavorables, debido a la gran variabilidad que existe en los tejidos blandos que los recubren. Arnett et al. (1999) presentaron un análisis basado en los tejidos blandos y determinó normas que definen un rostro armónico. Sin embargo, éstas normas se obtuvieron de pacientes norteamericanos y puede que no reflejen los conceptos estéticos de nuestra población. El objetivo del presente trabajo fue determinar valores de armonía facial para la población chilena, utilizando el análisis cefalométrico de tejidos blandos presentado por Arnett et al., y compararlos con los valores previamente establecidos para la población caucásica. Se analizaron 200 fotografías y se clasificaron los perfiles en balanceados y no balanceados según el criterio de un grupo de especialistas. Posteriormente se analizaron las telerradiografías correspondientes a los perfiles clasificados, con el análisis cefalométrico de tejidos blandos. Los valores de las diferentes variables fueron analiza dos separadamente por sexo, clase esqueletal y biotipo facial, y se determinaron las diferencias entre las variables presentadas por Arnett et al. y las obtenidas en el presente estudio. Para ello se utilizaron pruebas de significancia estadística como el test t y otros no paramétricos. Sólo se encontró diferencias significativas en dos variables respecto de las normas sugeridas por Arnett et al., correspondientes a un menor espesor del labio inferior en ambos sexos, y una mayor prominencia del pómulo en mujeres chilenas, por lo que consideramos que los valores de armonía de Arnett et al., pueden ser también aplicados como parámetro estético para la población chilena.

ABSTRACT: Performing an orthodontic treatment based only on hard tissue references can lead to unfavorable aesthetic results due to the great variability that exists in soft tissues that cover them. In 1999, W.Arnett, presented an analysis based on soft tissues and determined norms that define a harmonious face. However, these standards that were obtained from North Americans and Chilean aesthetic concepts could be different. The aim of the study was to determine the values of facial harmony for the Chilean population, using the cephalometric analysis of soft tissues presented by Arnett, and compare them with the values previously established for the Caucasian population. In this study 200 photographs were analyzed, and the profiles were classified in balanced and unbalanced according to the criteria of a group of specialists. Subsequently, teleradiographs corresponding to the classified profiles were analyzed, with the cephalometric analysis of soft tissues. The values of the different variables were analyzed separately by sex, skeletal class and facial biotype, and the differences between the variables presented by Arnett et al., and those obtained in the present study. For this purpose, statistical significance tests such as the t test and other non- parametric tests were used. There were only significant differences in two variables: inferior lip variables in both sexes, and a greater prominence of the cheekbone in Chilean women, therefore we consider that the values of harmony of Arnett, can also be applied as an aesthetic parameter for the Chilean population.

Consideraciones acerca de la cirugía plástica en Santiago de Cuba / Considerations on plastic surgery in Santiago de Cuba

El problema de la conformidad del ser humano con las características específicas de su cuerpo puede tener su origen en un problema estético o en un aspecto de carácter puramente físico que limita de manera marcada el desarrollo de sus actividades diarias. Ambos pueden tener solución mediante una cirugía, especialmente la estética. El objetivo de este trabajo es reafirmar que la cirugía plástica estética resuelve verdaderos problemas de salud tanto física como mental al reconocer la labor de los especialistas de cirugía plástica como evaluadores y consejeros de pacientes que acuden a consulta en busca de ayuda en nuestra provincia. Se revisó la literatura nacional e internacional sobre el tema y se concluyó que la cirugía plástica con fines estéticos constituye una solución, al satisfacer las expectativas tanto de las personas que reciben el tratamiento, como de los especialistas que realizan el trabajo.

The problem of dissagrement of the human being with the specific characteristics of his body may have its origin in an esthetical problem or in a purely physical character affair which limits, in a marked way, the development of his daily activities. Both may be solved through a surgery, specially, a esthetic surgery. The objective of this work is to reaffirm that the plastic esthetic surgery solves real physical or mental health problems, so as to recognize the work of plastic surgery specialists as evaluators and advisers of patients visiting the provincial department who look for help. National and international literature on the topic was reviewed and it was concluded that plastic surgery with esthetic aims is a solution, as it satisfies the expectatives either from people searching treatment, as from the specialists who give the service.

Complications in Facial Esthetic Surgery.

Esthetic surgery continues to become increasingly popular both in the United States and globally. Facial esthetic procedures in particular account for a large proportion of procedures performed. This increase in popularity will inevitably result in the number of potential complications associated with these procedures. In this review, the authors describe common complications encountered with frequently performed cosmetic facial procedures and their associated management. This article is meant as a general overview and introduction to potential complications surgeons may encounter, interested readers are encouraged to further review comprehensive subspecialty literature for more detailed discussion.