Abdominoplasty Research Articles

An Overview of Abdominoplasty

The number of tummy tuck surgeries has recently increased significantly, largely due to the rise in bariatric surgery procedures. This surgical procedure is undertaken for both functional and aesthetic reasons. Several surgical techniques may be employed in the performance of an abdominoplasty. Most techniques are based on the excision of the skin in the lower abdomen and the stretching of the skin in the upper abdomen to cover the resulting defect. It is not feasible to utilize a singular technique for each patient. A meticulous assessment of the patient is imperative in determining the optimal technique. The advent of liposuction has provided a valuable adjunct to surgical intervention. This article outlines the evolution of abdominoplasty and the role of liposuction techniques in its development. Furthermore, the outcomes of the surgical method for reducing abdominal flap thickness by tangential excision of the abdominal flap before the advent of liposuction techniques are presented. Abdominal contouring procedures offer patients not only an enhancement in their appearance but also an improvement in their quality of life. Despite the numerous options, it is crucial to select a body contouring procedure that is safe and effective by evaluating the needs and expectations of each patient.

An Updated Analysis of Body Contouring Malpractice Cases.

Body contouring procedures are commonly performed in the United States for patients seeking to sculpt specific areas of their bodies. The aim of this study was to provide an updated analysis of the factors that influence medical malpractice litigation surrounding body contouring surgery. The following terms were used to search the Westlaw Campus Legal research Database for cases with earliest documentation after January 2013: ("contouring" OR "abdominoplasty" OR "liposuction" OR "tummy tuck" OR "body lift" OR "thigh lift" OR "arm lift" OR "brachioplasty" OR "thighplasty" OR "lipectomy" OR "panniculectomy") AND "surgery" AND "medical malpractice." Cases were only included if there was a complaint of medical malpractice subsequent to a body contouring procedure, and details of the cases were provided. Information was collected on the location of the lawsuit, the earliest year of available case documentation, patient demographics, procedure(s) performed, alleged injury, specialty involvement, and verdicts. A total of 32 cases were included in the study. Most of the patients involved in the cases were women (n = 30, 93.8%) and alive (n = 28, 87.5%). New York state had the most cases (n = 7, 21.9%). Abdominoplasty (56.3%), liposuction (53.1%), and buttock augmentations (15.6%) were the most common procedures. Plastic surgeons were involved in 93.8% (n = 30) of the cases, and anesthesia, emergency medicine, dermatology, and oncology were also involved. Claims of malpractice most often discussed negligent technique (71.9%) and poor postoperative management (62.5%). Common postoperative complications were infection/sepsis (40.6%), scarring (31.3%), and emotional distress/prolonged pain (31.3%). One available ruling was in favor of the plaintiff. Although many of the cases in this analysis cited negligent technique, none were founded in their argument. Because involvement in these cases can place a burden on attending physicians, clear expectations of postoperative infections, scarring, and prolonged pain should be addressed during the informed consent process.

Developing a Training Model for Local Flaps Using Fresh Human Skin Excised During Tummy Tuck Procedures

Introduction: The proficient execution of local flaps poses a challenge for surgical residents. This study aimed to assess a training model for local flaps using fresh human skin excised during tummy tuck procedures. Methods: A questionnaire and a surgical skills evaluation, examining theoretical and procedural knowledge of local flaps, were administered before and after the training. All surgical procedures were performed on a simulation model utilizing freshly excised human skin. Skills were evaluated using a modified version of the Objective Structured Assessment of Technical Skills Score. SPSS version 21 was employed for comparing pre- and post-training results. Results: In the pretraining assessment, residents faced difficulties in flap design accuracy and wound coverage adequacy, indicating a need for surgical training beyond the operating theater. Post-training, there was a significant improvement in procedural skills, as reflected in the modified Objective Structured Assessment of Technical Skills score. The mean cumulative pretraining score was 26.81 ± 5.41, while the posttraining score was 43.59 ± 5.72 (P = 0.008). Theoretical knowledge also significantly improved in the posttraining evaluation, except for the indication of a Z-plasty (P = 0.257). The training model received positive feedback and was deemed highly useful and recommendable. Discussion: The presented model demonstrated improved surgical handling and understanding of tissue rotation under realistic conditions. The simulation model, using fresh human skin, is cost-effective and versatile for a broad range of flap procedures, advocating for its further adoption. Conclusions: The training model significantly enhanced surgical handling and comprehension of tissue rotation, replicating realistic conditions. The cost-effective simulation model, based on fresh human skin, offers versatility for various flap procedures, emphasizing the need for its wider implementation.

Clinical and Radiological Evaluation of Onlay Mesh Abdominoplasty in Obese Multiparous Patients with Moderate-to-Severe Rectus Diastasis.

Women with multiple pregnancies often experience abdominal protrusion and/or a lax abdominal wall. Various open surgical techniques have been developed to address rectus diastasis in abdominoplasty, ranging from suture plication to mesh reinforcement. This study aims to compare the clinical and radiological changes between traditional abdominal plication and the addition of non-absorbable mesh for rectus muscle (RM) diastasis repair in terms of function, postoperative outcome, and recurrence. This prospective retrospective study involved 63 women who underwent cosmetic tummy tuck surgery and met certain eligibility criteria. Patients with only mild diastasis recti, midline hernia, contraindications for major surgery, recent smoking history, or refusal of mesh augmentation were excluded. Clinical examination for abdominal protrusion or bulging and CT imaging was performed to check for recurrence of diastasis recti. The study included 33 patients who underwent mesh repair and 30 who underwent traditional abdominal plication. Follow-up was conducted after 1year using CT and a questionnaire to assess various factors compared to preoperative measurements, with overall satisfaction rated on a 10-point Likert scale. There was no significant difference in demographic data between the two groups. Patients who underwent mesh repair had a slightly longer hospital stay and drain duration. The average waist circumference decreased in both groups without any statistically significant difference. Objective CT showed significant reductions in both groups in inter-rectus distance, RM width and circumference, and intra-abdominal circumference compared to preoperative values. All patients expressed satisfaction with scar quality and umbilicus aesthetics, and no recurrence was detected either clinically or radiologically during the follow-up period. Comprehensive preoperative assessment and imaging techniques like ultrasound and CT scans allow surgeons to detect postpartum changes in the abdominal wall. Mesh reinforcement may be indicated for diastasis above 4 cm in obese multiparous females. Thorough preoperative evaluation permits customized surgical plans to optimally restore abdominal wall anatomy and function. 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 at www.springer.com/00266 .

Recent Fluctuations in Public Searches for Cosmetic Procedures as Shown by Google Trends.

The goal of this study is to understand the dynamic trends of 20 cosmetic procedures in the United States using Google Trends. This was a descriptive cross-sectional study using Google Trends to measure changes in search volumes for 20 cosmetic procedures from a 5-year period (2018 to 2023) in the United States. Outcome measures included total and weekly changes in relative search volumes and variance levels for the following 20 search terms related to cosmetic surgeries: blepharoplasty, botox, breast augmentation, breast lift, brow lift, buccal fat removal, chemical peel, dermal filler, face lift, hair removal, hair transplant, lip filler, liposuction, masseter botox, microneedling, otoplasty, photofacial, rhinoplasty, tear trough filler, and tummy tuck. Search terms were divided into 3 categories, a) those with a change of public interest over a single week of 25% or less, b) 26%-50%, and c) greater than 50%. There was an overall 5-year increase of public interest in all but 5 search terms: breast augmentation, breast lift, liposuction, photofacial, and tummy tuck. Within a single week, lip filler, masseter botox, buccal fat removal, and tear trough filler exhibited greater than 50% change in public interest, while public interest in microneedling, hair removal, rhinoplasty, tummy tuck, liposuction, breast lift, and augmentation were more stable with less than 26% change. While certain procedures may experience rapid accelerations in public interest, not all procedures will consistently increase in popularity. Physicians must recognize the shifting popularity of cosmetic procedures to provide informed cosmetic care to patients.

Interdisciplinary aspects of abdominal and plastic surgery- what does the (abdominal) surgeon need to know?

The aim was to reflect the established interdisciplinary aspects of general/abdominal and plastic surgery by means of a narrative review. Methods: (i) With specific references out of the medical literature and (ii) own clinical and perioperative as well as operating technical and tactical management experiences obtained in surgical daily practice, we present a choice of options for interdisciplinary cooperation that could be food of thought for other surgeons. - Decubital ulcers require pressure relieve, debridement and plastic surgery coverage, e.g., by a rotation flap plasty, V-Y flap or"tensor-fascia-lata"(TFL) flap depending on localization (sacral/gluteal defects, ischiadic tuber).-Coverage of soft tissue defects, e.g., after lymph node dissection, tumor lesions or disturbance of wound healing can be managed with fasciocutaneous or muscle flaps.-Bariatric surgery: Surgical interventions such as butt lift, tummy tuck should be explained and demonstrated in advance and performed commonly after reduction of the body weight.-Abdominoperineal rectum extirpation (APE): Holm's procedure with greater circumferential extent of resection at the mesorectum and the insertion site of the levator muscle at the anal sphicter muscle resulting in a substantial defect is covered by myocutaneous flap plasty.-Hernia surgery: Complicated/recurrent hernias or abdominal wall defect can be covered by flap plasty to achieve functional reconstruction, e.g., using innervated muscle. Thus, abdominal wall can respond better onto changes of pressure and tension.-Necrotising fasciitis: Even in case of suspicious fasciitis, an immediate radical debridement must be performed, followed by intensive care with calculated antibiotic treatment; after appropriate stabilization tissue defects can be covered by mesh graft of flap plasty.-Soft tissue tumor lesions cannot be resected with primary closure to achieve appropriate as intended R0 resection status by means of local radical resection all the time-plastic surgery expertise has to be included into interdisciplinary tumor concepts.-Liposuction/-filling: Liposuction can be used with aesthetic intention after bariatric surgery or for lipedema. Lipofilling is possible for reconstruction and for aesthetic purpose.-Reconstruction of lymphatic vessels: Lymphedema after tumor operations interrupting or blocking lymphatic drainage can be treated with microsurgical reconstructions (such as lympho-venous anastomoses, lympho-lymphatic anastomoses or free microvascular lymph node transfer).-Microsurgery: It is substantial part of modern reconstructive plastic surgery, i.e.,surgery of peripheral nerves belongs to this field. For visceral surgery, it can become important for reconstruction of the recurrent laryngeal nerve.-Sternum osteomyelitis: Radical debridement (eventually, complete sternal resection) with conditioning of the wound by vacuum-assisted closure followed byplastic surgery coveragecan prevent chronification, threatening mediastinitis, persisting infectious risk, long-term suffering or limited quality of life. The presented selection of single topics can only be an excerpt of all the options for surgical cooperation in daily clinical and surgical practice. An interdisciplinary approach of abdominal and plastic surgery is characterized bya highly developed cooperationin common surgical interventions including various techniques and tactics highlighting the specifics of the two fields.

Cosmetic surgery procedures accessed by Nigerian women at a single private cosmetic surgery practice: A retrospective review.

Little is known about the cosmetic surgery procedures sought by Nigerian women. Aim: We sought to report the proportion of cosmetic surgery procedures accessed by Nigerian women and determine any associations between the demographics and cosmetic procedures accessed. A retrospective review was conducted between January 2020 and July 2021 of all cosmetic surgery procedures at a single private cosmetic surgery practice. Data were analyzed using means, Mann-Whitney U-test, chi square test, and Fisher's exact test as appropriate. The statistical significance was set at P ≤ 0.05. Of the 392 consultations for cosmetic procedures, 245 (62.5%) patients accessed cosmetic surgery. Most were women (239 (97.6%)) and single (178 (72.7%)). The median age of the patients at surgery was 29.0 years (IQR 26-33), the median weight was 78.8 kg (IQR 71.4-88.8), and the median body mass index (BMI) was 28.1 (IQR 25.7-32.3). Liposuction was the procedure accessed by nearly all the patients (224 (91.4%)). Next to this was bilateral buttock augmentation (199 (81.2%)). Other cosmetic procedures such as tummy tuck, facial cosmetic surgery, umbilicoplasty, and labiaplasty each constituted less than three percent of the patients. The abdomen (224 (91.4%)), back (219 (89.4%)), and arms (79 (32.2%)) were the most common regions of the body sought for liposuction, while the calves (2 (0.8%)) were the least. Liposuction of the arms was associated with the BMI (p < 0.003). Liposuction and bilateral buttock augmentation are the most common cosmetic surgery procedures accessed by this cohort of Nigerian women.

Assessing the Impact of COVID-19 on Facial Aesthetic Surgery Search Interest.

The global COVID-19 pandemic reshaped many components of modern health care practice. Before the pandemic, research was beginning to demonstrate the impact of self-facing cameras, selfie images, and webcams on patient interest in head and neck (H&N) aesthetic surgery. We sought to determine temporal changes in patient interest in aesthetic surgery of the H&N as compared with the rest of the body because of COVID-19, and the subsequent surge in Web-conferencing and telecommunication. The 2020 Plastic Surgery Trends Report produced by the American Society of Plastic Surgeons was used to identify the 5 most common aesthetic surgical procedures performed on the H&N and the rest of the body for 2019: blepharoplasty, face lift, rhinoplasty, neck lift, cheek implant, and breast lift, liposuction, tummy tuck, breast augmentation, and breast reduction, respectively. Google Trends filters, which provide relative search interest for greater than 85% of Internet searches, were applied to gauge interest from January 2019 to April 2022. Relative search interest and mean interest were plotted as a function of time for each term. Our findings demonstrate a sharp decline in online aesthetic surgery interest in March 2020, coinciding with the beginning of the COVID-19 pandemic for both the H&N and the rest of the body. Search interest increased shortly after March 2020 and reached values greater than those of the prepandemic year (2019) in 2021 for rest of the body procedures. After March 2020, there was a brief, sharp increase in search interest for rhinoplasty, neck lift, and facelift, whereas patient interest in blepharoplasty increased more gradually. There was no increase in search interest for H&N procedures as a result of COVID-19 when using the mean values of the included procedures, although current interest has returned to prepandemic levels. The COVID-19 pandemic caused a disruption of normal trends in aesthetic surgery interest, with a sharp decline in search interest in March 2020. Afterward, there was a sharp increase in rhinoplasty, face lift, neck lift, and blepharoplasty interest. Patient interest in blepharoplasty and neck lift has remained elevated compared with 2019. Interest in rest of the body procedures has returned to and even surpassed prepandemic levels.

Differences in postoperative satisfaction between orthopedic and cosmetic patients

Undergoing any surgery can be impactful on a patient’s emotional state and satisfaction. Surgeries can range from elective to emergency with the goal to improve functional or aesthetic outcomes. Specific types of surgeries may differentially affect a patient’s contentment with outcomes. Given this significant and variable impact, it is valuable to investigate how different types of surgeries can impact a patient in different ways in hopes to improve individualized patient support. The current study aims to investigate differences in psychological outcomes from patients who have undergone either cosmetic surgery (e.g., liposuction, breast augmentation, breast reduction, tummy tuck) or orthopedic surgery (e.g., hip replacement, knee replacement, rotator cuff surgery). Data was retrospectively collected through self-report surveys completed by adult patients (aged 18 to 50) who underwent first-time surgery. Survey items requested participants to rank their level of satisfaction at different time points before and after surgery. We hypothesized that patients who had cosmetic surgery would be more satisfied after surgery than patients who had orthopedic surgery. Results of this study revealed cosmetic patients temporarily had more satisfaction than orthopedic patients 1-2 weeks after surgery. These findings may demonstrate a better understanding of patients’ satisfaction with outcomes in varying types of surgeries. In this specific study, we might draw the inference that orthopedic patients were less satisfied because their mobility was compromised immediately post-operatively and they required time to recover. We may also infer that cosmetic patients were more satisfied shortly after surgery with higher expectations for their altered appearance.

H-Wing Neoumbilicoplasty: A New Technique for Advanced Abdominoplasty and Umbilical Zones by Gender.

Multiple umbilicoplasty techniques have been described, even more after the advent of full tummy tuck procedures and the neoumbilicoplasty (X-shaped incision) described by the authors in a previous report. The authors decided to upgrade the technique (H-wing incision) because the former procedure is associated with relatively common complications. The authors report a case series of an upgraded technique for neoumbilicoplasty (H-wing technique), comparing its outcomes with their previous standard procedure (X-shaped incision). The authors reviewed their records for neoumbilicoplasties performed between January of 2014 and December of 2019. The authors divided the procedures according to the surgical technique and performed a detailed analysis regarding timing, complications, uses, and quality standards according to patients' opinion through a nonstandardized survey. A total of 407 procedures were distributed between two techniques: X-shaped incision, 179 procedures; and H-wing technique, 228 procedures. The former was performed from January of 2014 to October of 2016 and the latter from September of 2016 to December of 2019. High satisfaction indexes were found for both procedures; however, fewer complications were seen in the H-wing group. The X-shaped incision is thought to generate a greater force of tension over the flaps compared to that from the H-wing technique, which consequently increased the risk of flap necrosis and flattening. The H-wing technique for neoumbilicoplasty decreases the risk of postoperative complications such as dehiscence, skin necrosis, and navel flattening, and maintains high aesthetic standards and satisfaction indexes among patients. The technique can be used after either lipoabdominoplasty or secondary procedures.

Modified Abdominal Skin Resection: A Novel Approach to High-Definition Body Contouring of the Abdomen

Introduction: We present a novel abdominal contouring procedure, called the modified abdominal skin resection, designed to maximize elimination of skin redundancy while allowing for simultaneous high-definition liposuction of the entire abdominal skin flap. Technical details of the modified abdominal skin resection will be presented including inclusion and exclusion criteria, complications, and outcomes. Materials and Methods: Strategic limiting of abdominal skin undermining, preserving of any visible perforators, using ultrasound liposuction, and if necessary, administering Renuvion J plasma skin contraction are components of the presented high-definition abdominal contouring procedure. Limited undermining allows for high-definition liposuction of the abdomen to create muscle highlights and smooth contour junctions. Results: We present case studies demonstrating superior contour results when compared to traditional tummy tucks without muscle plication or liposuction alone. We present technical details of the modified abdominal skin resection, inclusion and exclusion criteria, complications, and outcomes. Discussion: The modified abdominal skin resection allows for high definition abdominoplasty outcomes. These results are superior to traditional abdominoplasties that are performed without muscle plication. This novel abdominoplasty procedure allows for aggressive removal of fat, as well as maximal elimination of skin redundancy and laxity. Inclusion and exclusion criteria established in this paper dicatate whether a patient is a good candidate for the modified abdominal skin resection. Conclusion: We present technical details required to complete the high definition abdominoplasty without muscle plication which allows for waistline snatching and creation of abdominal muscle highlights. High definition body contouring principles are applied to the modified abdominal skin resection to achieve superior body contouring results.

Ex Vivo Versus In Vivo Liposuction Hemolysis Index in High-Definition Liposuction and Body Contouring

Background: Ex vivo liposuction is a novel technique wherein tissues that are preoperatively planned for excision can be liposuctioned in a sterile manner after removal from the patient. Excised tissues are routinely obtained during a tummy tuck or variant, lateral thigh tuck, buttock tuck, brachioplasty, upper body tuck, and medial thigh tuck. These tucking procedures are performed when moderate to severe skin redundancy is present in patients undergoing body contouring. Traditionally, these tissues were first liposuctioned prior to being excised, termed in vivo liposuction. However, we have developed ex vivo liposuction protocols wherein the tissues are liposuctioned after they have been excised off the patient. Routine processing of harvested fat focuses on minimizing blood products in the aspirate prior to injection. This is because blood products are felt to contain pro-inflammatory products that negatively affect fat graft take. We hypothesized that fat collected by ex vivo technique provides a less bloody harvest than fat collected by in vivo technique. Materials and Methods: We quantitated blood concentrate of ex vivo versus in vivo fat aspirate by comparing the hemolysis index in 14 consecutive patients undergoing high-definition liposuction and body contouring. Results: Comparison of hemolysis index demonstrated significant reduction in blood concentrate in ex vivo versus in vivo fat aspirate. In vivo hemolysis index demonstrated a larger median than ex vivo hemolysis index. These results confirm our clinical observation that fat harvested by ex vivo liposuction is cleaner and less blood-tinged than fat harvested by in vivo liposuction. Conclusion: No patients experienced complications related to fat graft infection nor fat emboli. Ex vivo liposuction has proven a safe and less blood-tinged technique for harvesting fat in patients who require excisional procedures.

Awareness about Advantages and Disadvantages of Abdominoplasty in the Kingdom of Saudi Arabia

Background: Abdominoplasty (AP) is a pervasive procedure in cosmetic clinics with spectrum cosmetic reasons used globally under the giant umbrella of enhancing the quality of life. In Saudi Arabia (KSA), AP is the most common requested body-contouring surgery. It is associated with a significant number of complications, thus, there is a need to increase the clinical knowledge of physicians about AP to increase their clinical management ability of these patients as well raise the awareness of potential patients. Aim of study: The study aims to increase the awareness about advantages and disadvantages of AP among Saudi physicians and patients going to have an AP surgery. Methodology: The study adopts a quantitative descriptive approach among public and private cosmetic clinics practicing AP surgery. An online questionnaire form was distributed to patients who had AP surgery. Results: total of 229 patients participated in this study, 172 (75.1%) males and 57 (24.9%) females. One third of participants with BMI &gt;30. The main reasons of performing AP surgery were cosmetics (96.9%), weight loss (86.9%), sagging skin (67.2%) and stretch marks (42.8%). only 12.2% need to re-correct their primary operations and majority (89.9 %%) reported a positive response of AP satisfaction, weight loss (67.9%) and emotional and social benefits (66.4%). Conclusion: We conclude that most of the study participants were satisfied with their results. Unfortunately, there is a lack of data in Saudi Arabia, and this study somewhat fulfill the current gap about the advantages and disadvantages of AP surgery. Keywords: Cosmetic Surgery, Risks post Abdominoplasty, Advantages &amp; Disadvantages, Obesity, KSA.

My Mother's Facelift

My Mother's Facelift

Knowledge, Attitudes, and Practice of Cosmetic Procedures among Population of Majmaah, Saudi Arabia, 2019-2020

Introduction: Cosmetic procedures have been growing recently among men and women. Cosmetics procedures refer to both surgical and non-surgical procedures. For example, rhinoplasty (nose surgery), surgical face-lifts, abdominoplasty (tummy tuck), and liposuction, etc. referred to surgical procedures. In contrast, procedures such as chemical peels, filler, and botulinum toxin injections, laser skin resurfacing, vein removal, and laser hair removal are collectively referred to as non-surgical procedures. In recent years cosmetics surgeries have decreased while people have moved towards non-invasive cosmetic procedures. Objective: Knowledge, Attitude, and Practice of Cosmetic procedure among the population of Al-Majmaah, Saudi Arabia, 2019-2020. Methodology: This is an observational cross-sectional study targeted Al- Majma’ah population. Half of the participants were asked to complete an electronic questionnaire and the remaining completed a paper-based questionnaire. The questionnaire was divided into four parts: Socio-Demographic Data, Knowledge, Attitude, and Practice of cosmetic procedures. Data were analyzed by using SPSS v.25. In addition, Pearson Chi-square tests applied to determine associations between qualitative variables. Results: Most of the participants were aged between 18-25 years. The majority were female. All of them have heard about cosmetic procedures. Social media was the most common source of information. More than half of the participants recognized different types of cosmetic procedures. More than two-thirds of them believed low self-esteem affects decisions about cosmetic procedures. Only 146 reported undergoing cosmetic procedures, where most of them underwent liposuction and hair removal. Personal desire was the primary source of motivation.,Whereas self satisfaction was the commonest cause for not considering such procedures. 244 of the participants reported their relatives had undergone cosmetic procedures Conclusion: Most of the participants had poor to moderate levels of knowledge regarding Cosmetic procedures. Most of the participants had a positive attitude regarding such a procedure. The prevalence of cosmetic procedures is somewhat uncommon as about one-third of the participants underwent surgical and non-surgical procedures. Keywords: Cosmetic Procedures, Knowledge, Attitudes, Practice, Majmaah, Saudi Arabia

Knowledge, Attitudes, and Practice of Cosmetic Procedures among Population of Majmaah, Saudi Arabia, 2019-2020

Introduction: Cosmetic procedures have been growing recently among men and women. Cosmetics procedures refer to both surgical and non-surgical procedures. For example, rhinoplasty (nose surgery), surgical face-lifts, abdominoplasty (tummy tuck), and liposuction, etc. referred to surgical procedures. In contrast, procedures such as chemical peels, filler, and botulinum toxin injections, laser skin resurfacing, vein removal, and laser hair removal are collectively referred to as non-surgical procedures. In recent years cosmetics surgeries have decreased while people have moved towards non-invasive cosmetic procedures. Objective: Knowledge, Attitude, and Practice of Cosmetic procedure among the population of Al-Majmaah, Saudi Arabia, 2019-2020. Methodology: This is an observational cross-sectional study targeted Al- Majma’ah population. Half of the participants were asked to complete an electronic questionnaire and the remaining completed a paper-based questionnaire. The questionnaire was divided into four parts: Socio-Demographic Data, Knowledge, Attitude, and Practice of cosmetic procedures. Data were analyzed by using SPSS v.25. In addition, Pearson Chi-square tests applied to determine associations between qualitative variables. Results: Most of the participants were aged between 18-25 years. The majority were female. All of them have heard about cosmetic procedures. Social media was the most common source of information. More than half of the participants recognized different types of cosmetic procedures. More than two-thirds of them believed low self-esteem affects decisions about cosmetic procedures. Only 146 reported undergoing cosmetic procedures, where most of them underwent liposuction and hair removal. Personal desire was the primary source of motivation.,Whereas self satisfaction was the commonest cause for not considering such procedures. 244 of the participants reported their relatives had undergone cosmetic procedures Conclusion: Most of the participants had poor to moderate levels of knowledge regarding Cosmetic procedures. Most of the participants had a positive attitude regarding such a procedure. The prevalence of cosmetic procedures is somewhat uncommon as about one-third of the participants underwent surgical and non-surgical procedures. Keywords: Cosmetic Procedures, Knowledge, Attitudes, Practice, Majmaah, Saudi Arabia

Classic versus High Lateral Tension Abdominoplasty in Post-bariatric Patients

Abstract Background: Obesity is a chronic condition with a high prevalence and multifaceted etiologies; it is accompanied by an increased risk of morbidity and mortality. Bariatric surgeries (weight loss surgeries) include a variety of procedures performed on people who have obesity. Skin redundancy is a common post-bariatric complication. Abdominoplasty or "tummy tuck" is a cosmetic surgery procedure used to make the abdomen thinner and more firm. The surgery involves the removal of excess skin and fat from the middle and lower abdomen in order to tighten the muscle and fascia of the abdominal wall. This type of surgery is usually sought by patients with loose or sagging tissues after pregnancy or major weight loss. This study is a comparison between Classic and High lateral tension abdominoplasty techniques in treatment of abdominal skin redundancy in post bariatric patients. In our research, we compared between two techniques of abdominoplasty in treatment of post bariatric abdominal skin redundancy, the classic technique and High Lateral Tension technique, the comparison was in patient satisfaction and in post operative complications The study showed that patient satisfaction was higher in classic technique than the High lateral tension technique due to smaller and less apparent scar, while post operative complications were almost the same in both techniques According to our study, we advise plastic surgeons to perform classic abdominoplasty technique in treatment of post bariatric abdominal skin redundancy.

20 Safety of abdominoplasty with concomitant hysterectomy: Do routes matter?

To compare postoperative complication rates in patients undergoing abdominoplasty (ABP) with or without concomitant hysterectomy, specifically comparing abdominal (TAH) and minimally invasive hysterectomy (MIH). Using the National Surgical Quality Improvement Program (NSQIP) database, patients who underwent abdominoplasty from 2014 to 2018 were identified by CPT codes. Patient characteristics and perioperative data were abstracted. Patients were stratified into 3 groups: ABP only, ABP + TAH, and ABP with ABP + MIH. Differences between these groups were calculated using bivariate analyses. Multivariable logistic regression was used to identify factors associated with postoperative complications. A total of 9,064 women underwent ABP during the study period. Of these, 216 patients had ABP + TAH and 53 had ABP + MIH (41 laparoscopically and 12 vaginally). Table 1 describes patient and surgical characteristics for each group. All 3 groups had similar postoperative complication rates (ABP 11.5%, ABP + TAH 15.3%, ABP + MIH 9.4%, P = 0.207). Of all the complications in this cohort, superficial incisional surgical site infection (SSI) was the most common (3.9%) and followed by transfusion (2.6%), deep incision SSI (1.3%), and organ/space SSI (0.7%). Women with ABP + TAH had the longest lengths of hospital stay (days) when compared to those with ABP and ABP+MIH (3.1 ± 3.3 vs 1.6 ± 4.2 and 1.6 ± 1.1, P < 0.001). Operating time (minutes) differed significantly across approaches, with ABP + MIH demonstrating the longest operative time (ABP + MIH 275 [219-351], ABP + TAH 237 [171-311], ABP 168 [120-237], P < 0.001). In the regression model with variables being controlled as shown in Table 2, neither concomitant TAH nor MIH were associated with increased odds of postoperative complications when compared to those without hysterectomy (aOR = 1.37, 95% CI = 0.91-2.01 and aOR = 0.90, 95% CI = 0.31-2.11). ASA classes 2 and 3 (aOR = 1.96, 95% CI = 1.47-2.64 and aOR = 3.55, 95% CI = 2.60-4.93) along with current smoking status (aOR = 1.33, 95% CI = 1.07-1.63) were associated with increased odds of postoperative complications. Black race was associated with a decreased odds of complications (aOR = 0.81, 95% CI = 0.67-0.97). Abdominoplasty can be safely performed at the time of any route of hysterectomy without increased risk of complications. While concomitant minimally invasive hysterectomy at the time of abdominoplasty results in longer operative time, this approach leads to considerably shorter hospital stay when compared to concomitant abdominal hysterectomy.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Public Interest in Cosmetic Surgical and Minimally Invasive Plastic Procedures During the COVID-19 Pandemic: Infodemiology Study of Twitter Data.

BackgroundThe unprecedented COVID-19 pandemic has brought drastic changes to the field of plastic surgery. It is critical for stakeholders in this field to identify the changes in public interest in plastic procedures to be adequately prepared to meet the challenges of the pandemic.ObjectiveThe aim of this study is to examine tweets related to the public interest in plastic procedures during the COVID-19 pandemic and to help stakeholders in the field of plastic surgery adjust their practices and sustain their operations during the current difficult situation of the pandemic.MethodsUsing a web crawler, 73,963 publicly accessible tweets about the most common cosmetic surgical and minimally invasive plastic procedures were collected. The tweets were grouped into three phases, and the tweeting frequencies and Google Trends indices were examined. Tweeting frequency, sentiment, and word frequency analyses were performed with Python modules.ResultsTweeting frequency increased by 24.0% in phase 2 and decreased by 9.1% in phase 3. Tweets about breast augmentation, liposuction, and abdominoplasty (“tummy tuck”) procedures consecutively increased over the three phases of the pandemic. Interest in Botox and chemical peel procedures revived first when the lockdown was lifted. The COVID-19 pandemic was associated with a negative impact on public sentiment about plastic procedures. The word frequency pattern significantly changed after phase 1 and then remained relatively stable.ConclusionsAccording to Twitter data, the public maintained their interest in plastic procedures during the COVID-19 pandemic. Stakeholders should consider refocusing on breast augmentation, liposuction, and abdominoplasty procedures during the current phase of the pandemic. In the case of a second wave of COVID-19, stakeholders should prepare for a temporary surge of Botox and chemical peel procedures.

Structural injustice and the Requirements of Beauty

Structural injustice and the Requirements of Beauty