Cosmetic Acceptability Research Articles

EXAMINATION OF NURSING STUDENTS' ACCEPTANCE LEVELS FOR AESTHETIC SURGERY AND AFFECTING FACTORS

As a result of the rise of socioeconomic levels and globalization in the 21st century, aesthetic appearance has become more prominent, and the aesthetic/cosmetic sector has made great progress. Nursing education and practice are constantly evolving to meet the needs of the current community. The aim of this research is to examine the acceptance level of nursing students for aesthetic/cosmetic surgery and the affecting factors. This research is of descriptive type. It was conducted in the nursing department of a university in western Turkey (n:179). Permission was obtained from authors who made the adaptation of the scale used in this research, ethics board, institution, and students. The research data were collected using the introductory information form and Cosmetic Surgery Acceptance Scale (CSAS). Number, percentage, mean, standard deviation, Pearson correlation analysis, t test, Mann Whitney u test, one-way Anova and Kruskal Wallis test were used to evaluate the data. 84.9% of nursing students were women, 58.1% had income equal to expenses, 23.5% had a father with undergraduate or higher degree, and 49.2% lived in the city center before enrolling in university. 2.8% of students had previous experience of aesthetic surgery, 29.1% had a friend/family member undergoing aesthetic surgery earlier, 44.7% stated that those who underwent aesthetic surgery were stigmatized by the community, 48.6% stated that aesthetic surgery was not risky compared to other surgical procedures, 55.3% stated that they wanted awareness training about aesthetic surgery, and 47.5% stated that individuals underwent aesthetic surgery to become more beautiful. The mean CSAS score of nursing students was 56.11±21.80 (16.00-105.00). When looking at the characteristics that may affect acceptance levels of the students for aesthetic surgery, there was a statistically significant difference in terms of having a father with undergraduate degree or higher education, living in the city center before enrollment at university, having a friend/family member with previous aesthetic surgery, not seeing aesthetic surgery procedures as more risky compared to surgical procedures and seeking awareness training related to aesthetic surgery. Aesthetic surgery acceptance level of nursing students was found to be moderate. The interaction of demographic and socio-cultural factors plays a role in accepting aesthetic surgery.

Investigation of the Relationship Between University Students Social Appearance Anxiety and Their Attitudes Towards Aesthetic Surgery

Introduction and Purpose: The aim of this study is to investigate the factors affecting University students' attitudes toward aesthetic surgery. Materials and Methods: This descriptive study was carried out in the spring semester of the 2018-2019 academic year with the students of the nursing Karabuk University. A form determining the sociodemographic characteristics of the students, the Cosmetic Surgery Acceptance Scale, and the Social Appearance Anxiety Scale were used to collect the study data. Results: The mean age of the students participating in the study was 21 ± 1.9 years, the mean body mass index was 22.54 ± 3.8, 72.5% were female, and 97.2% were single. The mean scores of the students obtained from the Cosmetic Surgery Acceptance Scale and Social Appearance Anxiety Scale were 45.73 ± 17.68, 34.85 ± 10.05, respectively. A significant relationship was determined between the mean of the Cosmetic Surgery Acceptance Scale and the ages of the students (P < 0.0001). In addition, there was a positive and strong relationship between the mean scores of the sub-dimensions of the Cosmetic Surgery Acceptance Scale (personal, social, and intellectual levels) and the mean score of the Social Appearance Anxiety Scale (P < 0.0001). Conclusion: In this study, it was determined that age and social appearance anxiety among university students are the factors that increase the possibility of opting for aesthetic surgery. Before aesthetic surgery interventions, determining psychological factors such as aging anxiety and social appearance anxiety that affect attitude toward aesthetic surgery in psychosocial evaluations and integrating the necessary interventions into nursing care will be beneficial in evaluating the suitability of patients for surgical intervention more accurately, applying more qualified nursing care, and increasing patient satisfaction.

Efficacy and safety of fixed-dose combination calcipotriol/betamethasone dipropionate foam for the treatment of psoriasis.

The fixed-dose combination calcipotriol (Cal; 50µg/g) plus betamethasone dipropionate (BD; 0.5mg/g) ointment and gel formulations have well-established efficacy profiles in the treatment of psoriasis vulgaris (chronic plaque psoriasis); this combination has been shown to produce favourable outcomes versus either monotherapy. To improve upon the efficacy and cosmetic acceptability of these treatments Cal/BD foam was developed, demonstrating superior efficacy in Phase II/III studies compared with either of its monocomponents, Cal/BD ointment, Cal/BD gel and various other therapies for the treatment of psoriasis. Multiple outcome measures were evaluated in the clinical studies, including physician's global assessment of disease severity and modified psoriasis area and severity index. Of note, 38-55% of patients across studies achieved a physician's global assessment of 'clear' or 'almost clear' after 4weeks of Cal/BD treatment. This superior efficacy was not associated with an increased frequency or severity of adverse events, and there was no evidence for dysregulation of the hypothalamic-pituitary-adrenal axis or calcium homeostasis. Overall, Cal/BD foam was efficacious, with a good tolerability profile consistent with established Cal/BD formulations.

Clinical Efficacy, Cosmetic Acceptability, and Local Tolerability of a New Formulation of Topical 5% Minoxidil without Propylene glycol: A 6-month, Multicentre, Real-life, Prospective, Assessor-Blinded Study in 196 Subjects with Hair Loss. The andldquo;NOMINALandrdquo; Trial

Background and trial objectives: A new propylene glycol (PG)-free 5% minoxidil (PG-Free-Mnx) lotion has been recently commercialized. Clinical efficacy and local tolerability have been, so far, documented in a limited number of patients. The aim of this study was to evaluate the clinical efficacy, cosmetic acceptability, and local tolerability of 6-month application of this new PG-Free Mnx lotion in a real-life situation. Materials and methods: The NOMINAL (NO-PG MINoxidil reAL life study) trial was performed in 22 out-patients Italian dermatology clinics. A total of 196 subjects of both sexes with a diagnosis of AGA/FAGA were enrolled in the trial, after their written informed consent. PG-Free-Mnx lotion was applied 1 ml twice daily for 6 months. Clinical efficacy was evaluated in an open fashion in all the enrolled subjects with a 5-grade scale score (from-2: severe worsening, to +2: very good improvement in comparison with baseline condition). In a subgroup of subjects (n=60) an assessor-blinded clinical efficacy evaluation has been also performed using high definition standardized and coded scalp global pictures at baseline, and after 6 months by an assessor unaware of the temporal sequence using a 3-grade score (from 0: no improvement to 3: very high improvement). Cosmetic acceptability evaluation was assessed using a 7-item questionnaire using a 10-point scale score, with score 1meaning not at all and score 10 meaning the worst possible condition. Cosmetic acceptability and clinical efficacy were evaluated after 12 and 24 weeks of treatment. Global tolerability, assessed at week 24, was evaluated with a 4-grade scale score (from -1: very low tolerability to +2: very good tolerability). Results: All but seven (3.6%) subjects concluded the study. Clinical efficacy scores (open evaluation) were 0.8 ± 0.7 and 1.0 ± 0.7 at week 12 and 24, respectively. Good or very good clinical response (score +1 or +2) at week 12 and week 24 was observed in 64% and 74% respectively of the subjects with a similar response in women (75%) and men (73%). Baseline severity of AGA/FAGA was inversely correlated with the clinical response with a better outcome in subjects with AGA type II in comparison with subjects with types III/ IV AGA. The clinical efficacy was confirmed by the assessor-blinded evaluation of the subgroup of 60 subjects’ pictures at baseline (clinical score at baseline: 0.2 ± 0.4 vs. 1.8 ± 0.7 after 6 months; p=0.0001; absolute mean difference: 1.6; 95% CI: 1.1 to 2.0). Cosmetic acceptability score mean values were always 7) burning, itching or redness sensations. Conclusion: This new PG-free lotion shows, in real-life conditions, a very good cosmetic acceptability and tolerability profile. Clinical efficacy, evaluated both in open and assessor-blinded fashions, was also documented, and it was in line with the available data of traditional Mnx formulations with propylene glycol.

The “NOMINAL” trial: Clinical efficacy, cosmetic acceptability, and local tolerability of topical 5% minoxidil lotion without propylene glycol: A 6-month, multicentre, real-life, prospective, assessor-blinded study in 196 subjects with hair loss.

Background and Trial Objectives: A new propylene glycol (PG)-free 5% minoxidil (Mnx) (PG-Free-Mnx) lotion has been recently commercialized. Clinical efficacy and local tolerability have been, so far, documented in a limited number of patients. The aim of this study was to evaluate the clinical efficacy, cosmetic acceptability, and local tolerability of 6-month application of this new PG-Free Mnx lotion in a real-life situation. Materials and Methods: The NOMINAL (NO-PG MINoxidil reAL life study) trial was performed in 22 out-patients Italian dermatology clinics. A total of 196 subjects of both sexes with a diagnosis of androgenic alopecia (AGA) and female androgenic alopecia (FAGA) were enrolled in the trial, after their written informed consent. PG-Free-Mnx lotion was applied 1 ml twice daily for 6 months. Clinical efficacy was evaluated in an open fashion in all the enrolled subjects with a 5-grade scale score (from-2: severe worsening, to +2: very good improvement in comparison with baseline condition). In a subgroup of subjects (n=60) an assessor-blinded clinical efficacy evaluation has been also performed using high definition standardized and coded scalp global pictures at baseline, and after 6 months by an assessor unaware of the temporal sequence using a 3-grade score (from 0: no improvement to 3: very high improvement). Cosmetic acceptability evaluation was assessed using a 7-item questionnaire using a 10-point scale score, with score 1 meaning not at all and score 10 meaning the worst possible condition. Cosmetic acceptability and clinical efficacy were evaluated after 12 and 24 weeks of treatment. Global tolerability, assessed at week 24, was evaluated with a 4-grade scale score (from -1: very low tolerability to +2: very good tolerability). Results: All but seven (3.6%) subjects concluded the study. Clinical efficacy scores (open evaluation) were 0.8±0.7 and 1.0±0.7 at week 12 and 24, respectively. Good or very good clinical response (score +1 or +2) at week 12 and week 24 was observed in 64% and 74% respectively of the subjects with a similar response in women (75%) and men (73%). Baseline severity of AGA/FAGA was inversely correlated with the clinical response with a better outcome in subjects with AGA type II in comparison with subjects with types III/IV AGA. The clinical efficacy was confirmed by the assessor-blinded evaluation of the subgroup of 60 subjects’ pictures at baseline (clinical score at baseline: 0.2±0.4 vs. 1.8±0.7 after 6 months; p=0.0001; absolute mean difference: 1.6; 95% CI: 1.1 to 2.0). Cosmetic acceptability score mean values were always <2 at each time-point evaluation, demonstrating good or very good acceptability. Global Tolerability score mean±SD value was 1.7±0.4 with 94% of the subjects reporting good or very good tolerability with no differences between men and women. No subjects reported severe or very severe (Tolerability score >7) burning, itching or redness sensations. Conclusions: This new PG-free lotion shows, in real-life conditions, a very good cosmetic acceptability and tolerability profile. Clinical efficacy, evaluated both in open and assessor-blinded fashions, was also documented, and it was in line with the available data of traditional Mnx formulations with propylene glycol.

Nose Reconstruction Using Local and Regional Flaps: The Challenges and Advantages.

Background:Nose is a central structure in midface. It has an important function in maintaining the aesthesis of the face. The three-dimensional (3D) structure of the nose is challenging to reconstruct. However, the availability of abundant vascularity and surrounding tissue is advantageous for the reconstruction of the soft tissue. Hence, this study was carried out to assess the cosmetic outcome and acceptability of patients undergoing nasal soft tissue reconstruction using local and regional flaps.Materials and Methods:Patients undergoing nasal soft tissue reconstruction using local or regional flaps, between January 2017 and December 2018, were studied. Patients requiring free flaps or skin grafts for reconstruction were excluded from the study. All the patients during follow-up at 3–6 months were asked to rate cosmetic acceptability and donor site cosmesis as bad, good, and very good.Results:In this study, 15 cases of nasal soft tissue reconstruction were studied. Among the 15 cases, 9 (60%) were male and 6 (40%) were female; the age range of patients was 7–65 years. Majority of the patients (5, 33.3%) had trauma as major cause of deformity. Post malignancy excision defect was the next major cause. All patients were happy with the results, only patient with composite graft complained regarding hyperpigmentation.Conclusion:Nose is an important structure in the midface. Apart from olfaction and respiration, maintaining adequate cosmesis is also an important function of the nose. Any deformity of the nose can be devastating to the patient. But, the 3D structure with varied structures makes reconstruction challenging to recreate. However, the availability of adequate donor tissue in local and surrounding region makes it advantageous. If principles of reconstruction are followed strictly, the outcome is good. Tissue expansion can be used whenever soft tissue requirement is more.

Sunscreens: UV filters to protect us: Part 1: Changing regulations and choices for optimal sun protection.

Sunscreens are topical preparations containing any number of ultraviolet filters (UVFs). The first part of the review will focus on the recent Food and Drug Administration (FDA) regulations of 2019 and general use of these agents. While sunscreen products are becoming more regulated in the United States, we still lag behind other countries in our options for UVFs. Sun protection to prevent skin cancer and aging changes should be a combination of sun avoidance, protective structures, and clothing as well as use of sunscreen products. Newer and safer products are needed to help supplement and replace older agents as well as improve their cosmetic acceptability. This will be a review of ingredients, local toxicities (i.e. contact dermatitis, photocontact dermatitis), special considerations for children, and cosmesis of sunscreen preparations. Part 2 will focus on the environmental, ecological and human toxicities that have been increasingly related to UVFs.

General practice recommendations for the topical treatment of psoriasis: a modified-Delphi approach.

BackgroundAlthough GPs are usually the first port of call for patients with psoriasis, there is a lack of consistent and up-to-date clinical recommendations for interventions for patients with mild-to-moderate disease.AimTo provide practical recommendations for GPs to optimise psoriasis treatment with topical therapies in four key areas: patient identification; treatment decision making with topical theory; topical treatment outcomes; and optimising patient adherence.Design & settingA consensus-seeking programme (modified-Delphi approach) was undertaken to assess the literature and develop recommendations for GPs, based on evidence and expert opinion.MethodThree dermatologists compiled 47 questions that were subsequently ranked and refined according to clinical relevance or importance using an online survey. Thereafter, 19 dermatologists from different European countries developed statements and clinical recommendations for the top seven ranked topical treatment and GP-relevant questions based on literature research and clinical experience. The final recommendations were based on 100% agreement among a final panel of seven experts.ResultsThe clinical effectiveness, fast onset of action, tolerability, cosmetic acceptability, and practicability of topical therapy, in addition to good physician—patient communication, are important for optimising patient adherence and maximising efficacy. Topical treatments combining corticosteroids and vitamin D analogues (administered as fixed combination) are well-established first-line treatments in mild-to-moderate psoriasis.ConclusionSimple but detailed practical guidance is provided, which is formed from evidence and expert clinical recommendations, to assist GPs with the optimal use of topical agents based on efficacy, tolerability, disease severity, site of psoriasis, patient lifestyle and preferences, and intended duration of treatment.

Measurements meet perceptions: rheology-texture-sensory relations when using green, bio-derived emollients in cosmetic emulsions.

Product aesthetics and sensory performance can strongly influence a cosmetic product's acceptance by consumers. However, classic sensory analysis is time-consuming, expensive and does not provide information on the target group's preference. In the previous phase of this project, we had untrained consumers evaluate six cosmetic emulsions based on their aesthetics using a check-all-that-apply (CATA) survey. In this project, our goals were to quantitatively characterize the rheology and textural properties of the six cosmetic emulsions containing green, bio-derived emollients and identify statistical relationships between the consumers' description of products and the instrumental measurements. Six emulsions were prepared-three with olive oil and three with heptyl undecylenate as an emollient. Four sensory-like attributes, namely firmness, work of shear, stickiness and adhesiveness, were tested using a texture analyser. Rheological characterization included continuous flow testing and oscillatory measurements. Droplet size and stability were also evaluated. Statistical relationships were quantified between measurements in this study and sensory survey results published previously. The textural and rheological results indicated that the emulsions were different-as designed. The texture and rheology measurements had analogous grouping outcomes to the consumers' discrimination. Emulsions 1 and 2 were the firmest, hardest to spread, stickiest and had the highest viscosity, while Emulsions 5 and 6 were the least firm, easiest to spread, less sticky than Emulsions 1 and 2, and had the lowest viscosity. Emulsions 3 and 4 fell in between the other two groups. Using olive oil instead of heptyl undecylenate as an emollient increased firmness, spreading, stickiness, viscosity and droplet size of the emulsions in every case-when comparing emulsions within each pair. All six emulsions had a shear-thinning behaviour. Viscosity and firmness directly correlated for the emulsions. Emulsions were visually stable at room temperature over the course of 6months and viscosity remained relatively constant over this period also. Certain sensory attributes can be reliably predicted with instrumental measurements. Identifying and quantifying sensory-texture-rheology relationships can contribute to achieving appropriate product characteristics tailored to suit market needs.

Laparoscopic Treatment of Slipping Rib Syndrome in Pediatric Patients.

Background: Slipping rib syndrome (SRS) is an often unrecognized cause of lower chest and upper abdominal pain in children and adolescents. Surgical resection of the cartilaginous portions of the slipping rib often provides permanent pain relief, with the standard surgical approach being an open resection. A minimally invasive approach has not been reported previously; we report a novel laparoscopic technique for the treatment of SRS with satisfactory results. Materials and Methods: A retrospective review of all consecutive pediatric patients who underwent laparoscopic cartilage resection during the year 2019 and open cartilage resection during the year 2018 was included. Following data were recorded: age of patients, length of symptoms, length of procedure, length of cartilage resection, length of stay, resolution of pain, cosmetic acceptability, and postoperative complications. Results: Four patients underwent laparoscopic slipping rib resection without complication during the year 2019. The mean age of symptom onset was 15 (range 14-16) years old, mean length of symptoms was 1.4 (0.5-2.0) years, and mean age at operation was 16.5 (16-18) years old. The average length of the procedure was 72.8 (55-102) minutes, and mean length of cartilage removed was 2.3 (1.9-3.0) cm. Three patients underwent standard open operation during the year 2018. All patients reported complete resolution of their chronic pain at their 6-month follow-up visit. Conclusions: Laparoscopic technique can be used to treat SRS. All patients reported high satisfaction from resolution of chronic pain and the cosmetic appearance of their surgical scars.

Tolerance and efficacy of a new celastrol-containing balm as adjunct care in psoriasis.

In patients with psoriasis, the non-lesional skin also presents abnormalities, requiring emollient application on the whole body. To evaluate the tolerance of a new emollient balm containing celastrol, an active ingredient with anti-Th17 immunomodulatory properties used alone or in association with topical or systemic drug treatments or phototherapy, and its efficacy when used alone. Adults with body plaque psoriasis applied the product over the whole body once a day for 4weeks (balm used alone in 41 patients and with ongoing treatment in 50 patients). At D1, D8 ('balm alone' study) or D15 ('balm in association' study) and D29, the dermatologist rated physical and functional signs and assessed pruritus and body global lesion score (evaluating erythema, induration/thickness, scaling and dryness) in the 'balm alone' study. No reaction related to the product was reported, and the tolerance was deemed excellent. In the 'balm alone' study, mean pruritus intensity score significantly decreased at D8 (-39%, P<0.001) and D29 (-60%, P<0.001) compared with D1, together with the body global lesion score (-24% at D8 and -26% at D29, P<0.001). In parallel, quality of life improved, as evidenced by a patient-reported outcome questionnaire. Cosmetic acceptability was good. This new emollient balm was very well tolerated by patients with body plaque psoriasis either alone or in association with drug treatment or phototherapy, which is important to ensure long-term compliance. Daily application during one month improved pruritus, physical signs and quality of life.

A spray containing extracts of oat plantlets and Uncaria tomentosa relieves pain associated with chronic inflammatory skin diseases and dermatological procedures

Inflammation from skin conditions such as psoriasis, eczema-like atopic dermatitis (AD) and hand eczema (HE) and following dermatological procedures (post-acts) can result in intense itching and cutaneous pain. Dermo-cosmetics containing plant extracts have been shown to reduce or alleviate these symptoms. Assessment of the tolerability and efficacy of a spray containing Rhealba® Oat plantlets and Uncaria tomentosa extracts in adults and children with inflammatory skin diseases and after dermatological procedures. Data from five open label studies were analysed (Study 1: adults with AD; Study 2: children with AD; Study 3: adults with psoriasis; Study 4: adults with HE; Study 5: adults who had undergone a dermatological procedure: laser, intense pulsed light, glycolic acid peeling, photodynamic therapy or cryotherapy procedure). In all studies, subjects could use the test product up to six times per day for symptom relief. Physical and functional signs of inflammation, treatment-emergent adverse events (TEAEs), soothing effect, changes in quality of life, cutaneous pain and cosmetic acceptability were compared pre- and postapplication. A total of 176 subjects were enrolled across the five studies. Overall, investigators judged the dermatological tolerance of the test product containing Rhealba® Oat plantlets extract and Uncaria tomentosa as good to excellent. All studies showed significant improvements in physical signs, reduction in itching and feeling of pain (P<0.05). The soothing effect was evident after the first application. TEAEs were mostly mild, transient and occurred within the first few days of treatment. The majority of subjects reported improved QoL across the studies. The dermo-cosmetic spray containing Rhealba® Oat plantlets extract and U. tomentosa was well tolerated and efficacious in providing relief of symptoms associated with cutaneous pain from inflammatory skin diseases and following dermatological procedures; however, further studies are needed to rule out alternative explanations of symptom reduction such as natural history and response biases.

A Randomized Controlled Trial with a Medical Device Containing Sodium Hyaluronate and Nicotinic Acid to Increase the Efficacy of Ultraviolet Phototherapy in Psoriasis.

IntroductionThe dry and scaly skin of psoriatic patients decreases the efficacy of ultraviolet B (UVB) phototherapy. Different agents are used to facilitate the transmission of light, but most of these preparations are cosmetically unfavorable. We have tested a novel preparation containing sodium hyaluronate and nicotinic acid (UV Fotogel®; Pernix Ltd.) with the double aim to improve the efficacy of UVB phototherapy and assess the cosmetic acceptability of the preparation.MethodsNinety patients with plaque psoriasis were enrolled in the study, of whom 44 received narrow-band UVB (NB-UVB) phototherapy. Prior to phototherapy, one side of the patient’s body was treated with UV Fotogel while the other side served as a control. The other 46 patients used the preparation at their homes before regular sunbathing. The Local Psoriasis Severity Index (L-PSI), cosmetic acceptability and tolerability were recorded. The median values with the 25th and 75th percentiles (25p and 75p, respectively) were determined for the UV Fotogel-treated and control sites and then compared.ResultsThe sides of the body to which UV Fotogel was applied prior to NB-UVB phototherapy had a significantly lower median L-PSI score than the non-treated control sides at the end of the treatment (1.0 [25p–75p: 0.0–2.0] vs. 2.0 [1.0–3.0], respectively). The application of UV Fotogel prior to sunbathing also led to a significant decrease in L-PSI score. There was a significant reduction in the median L-PSI score of patients at the final visit compared to baseline (2.5 [25p–75p: 1.5–3.5] vs. 6.0 [6.0–7.0], respectively). Use of the preparation was not accompanied by considerable adverse effects, and the patients found it cosmetically acceptable. Application of UV Fotogel prior to sunbathing was well tolerated by the patients, and the cosmetic acceptability was also good.ConclusionUV Fotogel is potentially a useful device for enhancement of the efficacy of phototherapy in patients with psoriasis.

A Corrective Cosmetic Improves the Quality of Life and Skin Quality of Subjects with Facial Blemishes Caused by Skin Disorders.

BackgroundFacial blemishes resulting from skin disorders have a significant effect on the patient’s self-esteem and impact quality of life (QOL).AimTo assess the impact of a corrective cosmetic (CC) on QOL on top of skin quality parameters.MethodsAn international observational study was conducted on subjects with visible facial flaws that would benefit from a corrective cosmetic. Investigators collected data regarding demographics, QOL using the Skindex-16 scale, skin dryness and tautness, subject and investigator satisfaction, cosmetic acceptability and tolerance at baseline and after 4 to 6 weeks of daily use.ResultsA total of 1840 subjects participated; the mean age was 31.5±11.1 and 95% were women. Acne accounted for 48.9% of skin conditions, followed by melasma (16.7%) and rosacea (15.3%). Of the subjects 81.2% had at least 10% of the face affected and the condition was rated as disfiguring by 45.3% of the subjects; 45.0% and 44.4%, respectively, had neither taut nor dry skin at baseline. Baseline Skindex-16 scores for symptoms, emotions, functioning and overall were 1.4±1.3, 3.5±1.6, 2.4±1.8 and 2.4±1.3, respectively, on a scale from 0 to 6. Compliance was 96.0±10.6%. At the end of the study, Skindex-16 scores had significantly (p<0.0001) improved for all parameters, as did skin dryness and tautness. Subject and investigator satisfaction were high or very high; cosmetic acceptability was high or very high and local tolerance good or very good.ConclusionThe tested corrective cosmetic significantly improved the QOL of subjects with significant facial flaws, skin tautness and dryness, and was well tolerated.

Association Between the Use of Social Media and Photograph Editing Applications, Self-esteem, and Cosmetic Surgery Acceptance.

Social media platforms and photograph (photo) editing applications are increasingly popular sources of inspiration for individuals interested in cosmetic surgery. However, the specific associations between social media and photo editing application use and perceptions of cosmetic surgery remain unknown. To assess whether self-esteem and the use of social media and photo editing applications are associated with cosmetic surgery attitudes. A population-based survey study was conducted from July 1 to September 19, 2018. The web-based survey was administered through online platforms to 252 participants. Each participant's self-esteem was measured using the Rosenberg Self-esteem Scale (scores range from 0-30; higher scores indicate higher self-esteem) and the Contingencies of Self-worth Scale (scores range from 1-7; higher scores indicate higher self-worth). Cosmetic surgery attitude was measured using the Acceptance of Cosmetic Surgery Scale (scores range from 1-7; higher scores indicate higher acceptance of cosmetic surgery). Unpaired, 2-tailed t tests were used to assess the significance of self-esteem and cosmetic surgery attitude score differences among users of various social media and photo editing applications. Structural equation modeling was used to assess the association between social media investment and cosmetic surgery attitudes. Of the 252 participants, 184 (73.0%) were women, 134 (53.2%) reported themselves to be white, and the mean age was 24.7 (range, 18-55) years. Scores on the Rosenberg Self-esteem Scale from users and nonusers across applications were compared, with lower self-esteem scores noted in participants who reported using YouTube (difference in scores, -1.56; 95% CI, -3.01 to -0.10), WhatsApp (difference in scores, -1.47; 95% CI, -2.78 to -0.17), VSCO (difference in scores, -3.20; 95% CI, -4.98 to -1.42), and Photoshop (difference in scores, -2.92; 95% CI, -5.65 to -0.19). Comparison of self-esteem scores for participants who reported using other social media and photo editing applications yielded no significant differences. Social media investment had a positive association with consideration of cosmetic surgery (R, 0.35; 95% CI, 0.04-0.66). A higher overall score on the Acceptance of Cosmetic Surgery Scale was noted in users of Tinder (difference in means, 0.79; 95% CI, 0.34-1.23), Snapchat (difference in means, 0.39; 95% CI, 0.07 to 0.71), and/or Snapchat photo filters (difference in means, 0.44; 95% CI, 0.16-0.72). Increased consideration of cosmetic surgery but not overall acceptance of surgery was noted in users of VSCO (difference in means, 0.84; 95% CI, 0.32-1.35) and Instagram photo filters (difference in means, 0.38; 95% CI, 0.01-0.76) compared with nonusers. This study's findings suggest that the use of certain social media and photo editing applications may be associated with increased acceptance of cosmetic surgery. These findings can help guide future patient-physician discussions regarding cosmetic surgery perceptions, which vary by social media or photo editing application use. NA.

Low-Profile Dual Small Plate Fixation Is Biomechanically Similar to Larger Superior or Anteroinferior Single Plate Fixation of Midshaft Clavicle Fractures

Background: Limited biomechanical data exist for dual small plate fixation of midshaft clavicle fractures, and no prior study has concurrently compared dual small plating to larger superior or anteroinferior single plate and screw constructs. Purpose: To biomechanically compare dual small orthogonal plating, superior plating, and anteroinferior plating of midshaft clavicle fractures by use of a cadaveric model. Study Design: Descriptive laboratory study. Methods: The study used 18 cadaveric clavicle specimens (9 pairs total), and 3 plating techniques were studied: anteroinferior, superior, and dual. The dual plating technique used smaller diameter plates and screws (1.6-mm thickness) than the other, single plate techniques (3.3-mm thickness). Each of the 9 clavicle pairs was randomly assigned a combination of 2 plating techniques, and randomization was used to determine which techniques were used for the right and left specimens. Clavicles were plated and then osteotomized to create an inferior butterfly fracture model, which was then fixed with a single interfragmentary screw. Clavicle specimens were then potted for mechanical testing. Initial bending, axial, and torsional stiffness of each construct was determined through use of a randomized nondestructive cyclic testing protocol followed by load to failure. Results: No significant differences were found in cyclical axial (P = .667) or torsional (P = .526) stiffness between plating groups. Anteroinferior plating demonstrated significantly higher cyclical bending stiffness than superior plating (P = .005). No significant difference was found in bending stiffness between dual plating and either anteroinferior (P = .129) or superior plating (P = .067). No significant difference was noted in load to failure among plating methods (P = .353). Conclusion: Dual plating with a smaller plate-screw construct is biomechanically similar to superior and anteroinferior single plate fixation that uses larger plate-screw constructs. No significant differences were found between dual plating and either superior or anteroinferior single plating in axial, bending, or torsional stiffness or in bending load to failure. Dual small plating is a viable option for fixing midshaft clavicle fractures and may be a useful low-profile technique that avoids a larger and more prominent plate-screw construct. Clinical Relevance: Plate prominence and hardware irritation are commonly reported complaints and reasons for revision surgery after plate fixation of midshaft clavicle fractures. Dual small plate fixation has been used to improve cosmetic acceptability, minimize hardware irritation, and decrease reoperation rate. Biomechanically, dual small plate fixation performed similarly to larger single plate fixation in this cadaveric model of butterfly fracture.

Ultrasound assessment of the keratolytic effect of a 50% urea anhydrous paste on psoriasis plaques: a prospective study.

The keratolytic effect of urea is well-known, although the majority of the available studies rely on clinical observation only. The aim of this open trial was to evaluate, through clinical and ultrasound assessment, the efficacy and tolerability of a 50% urea anhydrous paste on hyperkeratotic psoriatic plaques. Twenty-five patients (12 male, 13 female; age: 35-75 years) with plaque psoriasis characterized by an evident hyperkeratotic component were enrolled. One target lesion was selected in each patient that was instructed to apply the 50% urea anhydrous paste twice a day for up to 3-week study duration. Clinical clearance of hyperkeratosis at day 21 was observed in 23 out of 25 plaques (92%), with nine (36%) and ten (40%) patients already reaching clear status respectively at day 7 and 14. Ultrasound significant reduction of the mean epidermal thickness score was also observed at the same time-points. No side effects were reported and all patients rated the product as excellent in terms of cosmetic acceptability. The tested product resulted to be an effective keratolytic agent in plaque psoriasis. Strength of our study was the ultrasound assessment, allowing to objectively confirm and correlate the epidermal changes seen at clinical evaluation.

Liposomes, Formulation and Pharmacotechnical Assessment of Anti-Acne Preparations

The present study aims at obtaining an efficient local formulation able to ensure both stability and increased penetration of the active ingredients in effective optimal concentrations without side-effects. The novelty of this study is the association in an encapsulated form (liposomes) of tretinoin to benzoyl peroxide as an innovative alternative capable of minimizing side-effects, but preserving at the same time their efficiency. The pharmaceutical forms using liposomes ensure the controlled release of medicine, as a result of the encapsulation of the active substances in the amphiphile structure�liposomes, with the possibility to diminish irritating secondary reactions in various forms of acne, and to provide efficiency, tollerability, conformity and cosmetic acceptability, to be proved in a future study.

Abstract P2-14-16: Comparison of robotic nipple sparing mastectomy (R-NSM) to endoscopic assisted nipple sparing mastectomy (E-NSM) in the management of breast cancer

Abstract Background: Endoscopic assisted nipple sparing mastectomy (E-NSM) alone or followed by immediate breast reconstruction (IBR) with implants or autologous flaps were reported to be associated with small inconspicuous incision and good cosmetic outcome. Robotic nipple sparing mastectomy (R-NSM), which introduce da Vinci surgical platform through a small axillary wound to perform NSM with (or without) IBR, was reported to have potential to overcome the technique difficulty of E-NSM and showed promising cosmetic outcome. However, few evidence was available compared the effectiveness and safety of R-NSM compared with E-NSM in the management of breast cancer. Methods: Patients with breast cancer received E-NSM or R-NSM performed from July 2010 to June 2018 were searched from breast surgery database at Changhua Christian Hospital (CCH), Taiwan. Data on clinicopathologic characteristics, type of surgery, complications and recurrence were analyzed to determine the effectiveness and oncologic safety of R-NSM and E-NSM. Patient-reported cosmetic outcome result was also obtained and compared. Results: A total of 127 E-NSM and 36 R-NSM procedures were found and data collected for analysis. About 77.8% of R-NSM group received breast reconstruction, and 78% of E-NSM group received breast reconstruction (P=0.982). The surgical margin involved rate was 2.8%(1/36) in R-NSM versus 3.4%(5/127) in E-NSM (P=1). The overall operation time was 281.5 ± 77.0 mins in R-NSM group versus 210.8 ± 55.5 mins in E-NSM group (P &amp;lt;0.001). Blood loss was mean 36.5 ± 33.7 ml in R-NSM group versus 88.0 ± 61.0 ml in E-NSM group (P &amp;lt;0.001). The hospital stay was 6.8 ± 1.3 days in R-NSM group versus 5.1 ± 1.3 in E-NSM group (&amp;lt;0.001). -From learning curve analysis, about 15-17 cases needed to significantly decrease operation time in E-NSM group, and in R-NSM group around 10-12 cases needed. -About 50 E-NSM and 25 R-NSM patients received post-operative questionnaire survey for cosmetic outcome evaluation and acceptance of operations. Patient-reported outcome survey showed that the satisfaction rate of R-NSM 96.4% group versus 94.8 in E-NSM group (p=0.96). The will to receive the same operation again if they could chose again: 100% in E-NSM group versus 96.4% in R-NSM group. -Cost analysis- The breast cancer operation cost was reimbursed by national insurance in Taiwan. The additional cost of E-NSM and IBR with Gel implant was 4,000-6,000 USD (according to different type of implants used). The cost of R-NSM and IBR with Gel implant was 10,000-12,000 USD (according to different type of implants used). The cost difference was about 2,500-3,300 USD higher in R-NSM group than in E-NSM group. Conclusion: Both E-NSM and R-NSM were equally effectively in the management of breast cancer with no different surgical margin involved rate, however, longer follow-up remained mandatory for oncologic safety evaluation. Shorter learning curve indicated more friendly operation plateform of robotic surgery in performing NSM. Relative longer operation time, and higher cost of R-NSM compared with E-NSM was observed. Longer hospitalization is biased from personal insurance consideration due to higher cost of R-NSM. Citation Format: Lai H-W, Chen S-T, Chen D-R, Kuo S-J. Comparison of robotic nipple sparing mastectomy (R-NSM) to endoscopic assisted nipple sparing mastectomy (E-NSM) in the management of breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-14-16.

Direct-to-Consumer Hearing Devices: Capabilities, Costs, and Cosmetics.

Direct-to-consumer (DTC) hearing devices can be purchased without consulting a hearing health professional. This project aims to compare 28 DTC devices with the most popular hearing aid supplied by the U.K. National Health Service (NHS). The comparison was based on technical performance, cosmetic acceptability, and the ability to match commonly used gain and slope targets. Electroacoustic performance was evaluated in a 2-cc coupler. Match to prescription target for both gain and slope was measured on a Knowles Electronic Manikin for Acoustic Research using a mild and also a moderate sloping hearing loss. Using an online blinded paired comparison of each DTC and the NHS reference device, 126 participants (50 were hearing aid users and 76 were nonhearing aid users) assessed the cosmetic appearance and rated their willingness-to-wear the DTC devices. The results revealed that higher purchase prices were generally associated with a better match to prescribed gain–frequency response shapes, lower distortion, wider bandwidth, better cosmetic acceptability, and higher willingness-to-wear. On every parameter measured, there were devices that performed worse than the NHS device. Most of the devices were rated lower in terms of aesthetic design than the NHS device and provided gain–frequency responses and maximum output levels that were markedly different from those prescribed for commonly encountered audiograms. Because of the absence or inflexibility of most of the devices, they have the potential to deliver poor sound quality and uncomfortably loud sounds. The challenge for manufacturers is to develop low-cost products with cosmetic appeal and appropriate electroacoustic characteristics.