Cosmetic Effect Research Articles

Scope of Ayurvedic Nasal Instillation Therapy (Nasya Karma) in Cosmetology: A Review

Cosmetics has become an important & influential part of human’s daily life in today’s world due to one’s tendency for self-care & regard as it boost their confidence and self-esteem. The increase in daily use of these various cosmetics has also garnered a lot of increased demand in pharmaceutical industry; resulting into various harmful & chemical drug practices for monetary gain also leading to lots of side effects of such cosmetics on human skin. The beauty ailments that commonly affect people are hair fall, greying of hairs, dandruff, acne, melasma, minor skin and oral disorders. These problems are not only difficult to treat but also requires a lot of expenses too. Ayurveda has mentioned various methods to tackle these problems as Ayurvedic scholars has put heavy weightage on importance of beauty; external as well as internal in both male and female and has described treatments for these ailments in ancient texts such as Nasya Karma [Ayurvedic Nasal Instillation Therapy]. Nasya is one of famous Panchakarma procedure used for management of above mention cosmetic ailments. It is a procedure in which herbal drug [oil/decoction/extract/powder] is instilled through nasal route and is highly appreciated for its therapeutic value in diseases related to Urdhava-Jatrugata [above clavicle region]. In this article, we have discussed various types and probable action of Nasya Karma [Ayurvedic Nasal Instillation Therapy] in these disorders and how this single Ayurvedic procedure can be a one stop solution for multiple beauty ailment and can be helpful in reaching the goal of enhancement of beauty with assurance of safety and prevention from any harmful effect.

Comparative Study of Complications and Incision Esthetic Satisfaction Between Single-Port Laparoscopy and Traditional Laparoscopy in Benign Gynecological Surgery

Objective Single-port laparoscopic surgery (SPLS) is an effective, minimally invasive, feasible, and promising surgical technique for the treatment of various benign and malignant gynecological diseases. This study aimed to evaluate the differences in surgical conditions, complications, and esthetic incisions between SPLS and traditional laparoscopic surgery (TLS) in benign gynecological surgeries. Methods Fifty-one eligible patients were included, and their general information (age, surgical approach), surgical conditions (surgical time, blood loss, postoperative first flatus), postoperative pain, and incision healing were collected. Results There was a significant difference in the results of hysterectomy between the two groups. The surgical time in the SPLS group was significantly shorter than that in the TLS group (p = 0.026). Furthermore, the SPLS group had less blood loss (p < 0.05) and earlier postoperative first flatus (p < 0.05) than the control group. There was no significant difference in postoperative conditions between the two groups. During the follow-up, it was found that the Vancouver Scar Scale score was 8.37 ± 2.30 in the control group and 6.81 ± 2.14 in the study group. The cosmetic effect and satisfaction were better in the SPLS group (p = 0.018). Subgroup analysis showed that in other benign gynecological diseases without uterine lesions, SPLS significantly improved surgical time, intraoperative blood loss, and postoperative first flatus (p < 0.05). Conclusion SPLS demonstrated good clinical efficacy in benign gynecological surgery, with shorter surgical time, less blood loss, earlier postoperative first flatus, fewer complications, and better cosmetic effects of scars.

Tips and tricks for transluminal specimen extraction and extra-abdominal sigmoid colon resection.

The purpose of this video is to demonstrate how to achieve adequate length and blood supply of the proximal colon for a perineal pull-through procedure, without splenic flexure mobilization during natural orifice specimen extraction. Key steps of the procedure include lateral mobilization of the colon, D3 lymph node dissection, preservation of the left colic artery, low ligation of the inferior mesenteric vein, ligation and washout of the distal bowel lumen, extra-abdominally proximal resection of sigmoid colon, purse-string sutures on the distal sigmoid colon, and an air leak test. Transluminal specimen extraction with extra-abdominal resection was found to be a cost-effective procedure with good cosmetic effects. Tension-free anastomosis was achieved by preservation of the left colic artery and low ligation of the inferior mesenteric vein. The purse-string sutures were placed on the proximal and distal bowel to avoid crossing the staples line. Transluminal specimen extraction with extra-abdominal resection required minimal manipulation intra-abdominally in comparison with other natural orifice specimen extraction techniques.

СОВРЕМЕННОЕ ЛЕЧЕНИЕ РУБЦОВОЙ ДЕФОРМАЦИИ ТКАНЕЙ

The problem of scar treatment is one of the most widespread in modern medicine. Treatment of scar formations is one of the most difficult tasks, as there is no single standard that is favorable in terms of efficacy and safety despite the active development in this area of research. Currently, conservative methods of treatment of scar tissue deformities such as corticosteroid administration, botulinum therapy, cryotherapy, microneedling, as well as surgical excision in combination with therapeutic methods are widely used, due to which the most favorable result is achieved. This study is devoted to the study of various modern methods of correction of hypertrophic and keloid scars that are becoming widespread in medicine, their comparison and identification of important advantages and disadvantages in order to choose the most effective treatment technique. Currently used conservative methods of treatment allow to cope with the problem of scar formations, but due to the high incidence of side effects, there is a tendency to search for the combined use of each of them, including with surgical excision to prevent the development of recurrences and to achieve a pronounced cosmetic effect and satisfaction among patients. Thanks to the constant development of medicine and the improvement of various methods, each patient can receive a personalized treatment approach that is guaranteed to reduce aesthetic discomfort due to the existing pathology, which is the main and important aspect of scar correction.

A large long standing keratinous cyst on the cheek: a case report

Epidermal inclusion cysts or keratinous cysts can be congenital or acquired. These slow-growing, chronic cysts can sometimes be neglected, unless they affect cosmesis or present the fear of turning malignant. We present a case of a keratinous cyst on a patient’s cheek, overlooked for many years, which slowly and steadily kept on growing and finally presenting as a disfiguring ovoid swelling over the patient’s cheek. Epithelial inclusion cysts have a tendency of slow but steady growth, with a rare of real risk of malignant change. Secondary infection, abscess formation, pressure effect and cosmetic effect are a few complications seen in such cases. Improper excision of these cysts leads to recurrence due to left over residual cyst tissue. This unearths the importance of timely investigation and treatment of swellings that we might at first assume to be insignificant.

Use of facial cosmetics and their effects on skin among female students of Bayero University Kano, Nigeria

Cosmetics are used for cleansing, beautifying, enhancing attractiveness, or altering appearance and commonly applied by young women. This study examined the use and effects of cosmetics on the skin of female students at Bayero University Kano, Nigeria. A sample of 360 students from five faculties were randomly selected. Data on age, purpose, type, frequency of use, and effects of cosmetic products were collected. The age groups were divided into younger (18-25 years) and older (25+ years). Pearson’s Chi-square test assessed associations between age, ethnicity, and cosmetic use. The study found that facial creams (83.1%), lipstick (52.2%), eyeliners (54.7%), mascara (33.1%), eyelashes (12.5%), eyeshadow (16.1%), and foundation (15.6%) were the most commonly used cosmetics. Usage was mostly occasional (63%) or daily (37%), with 88% preferring daytime application. Significant associations were found between age and usage purpose (p=0.043), and between ethnicity and choice of cosmetics (p=0.030). Reported side effects included acne (23.3%), bleaching (25.7%), pigmentation (12.2%), rashes/itching (13.9%), irritation (5.2%), skin hardening (4.5%), and other complications (15.3%). Eye-related issues included redness (52.2%), itching (20.2%), soreness (15.4%), puffiness (3.5%), and miscellaneous problems (8.8%). Lip problems were primarily cracking (70.8%), swelling (16.9%), and bumps (12.3%). In conclusion, the use of facial cosmetics is prevalent among students, mainly for occasional use and primarily during the day. The purpose of cosmetic use varies with age and ethnicity. The most common side effects are skin pigmentation, eye redness, and swollen lips.

A review of environmental and health effects of synthetic cosmetics

The use of cosmetic products is expanding globally, and with it, so is the range of chemical substances employed in their production. As a result, there is also a higher risk of intoxication, allergic reactions, prolonged chemical exposure, adverse effects, and indiscriminate use. Cosmetic products can contain more than 10,000 ingredients. Most users of synthetic cosmetics are unaware of the harmful effects if they even are. However, it is linked to many diseases like cancer, congenital disabilities, reproductive impairments, developmental systems, contact dermatitis, hair loss, lung damage, old age, skin diseases and reactions, allergies, and harm to human nails. Many beauty products also create a high demand for natural oils, leading to extensive and intensive cultivation, harming natural habitats through deforestation, and contaminating soil and water through pesticides and fertilizers. The adverse effects of hazardous substances in synthetic cosmetics extend beyond human health and influence ecosystems, air quality, and oceans. Thus, this review aims to assess the environmental and health impacts of cosmetics using published scientific articles. The study used a systematic review based on Scopus, Science Direct, Web databases, Scholar Google, and PubMed. The results of this review showed that the formulation of cosmetics until the disposal of their containers could adversely affect environmental and human health.

Total Stripping of the Great Saphenous Vein in Varicose Vein Patients with Thrombophlebitis

Introduction. Patients with varicose disease of the lower extremities may suffer from subcutaneous vein thrombophlebitis with an incidence of more than 50%. However, saphenous vein thrombophlebitis occurs against the background of varicose veins in 80% of patients. Aim. To improve the efficacy of phlebectomy in patients with varicose veins complicated by saphenous vein thrombophlebitis. A modified method of total stripping of the great saphenous vein was developed and introduced into clinical practice in City Clinical Hospital No. 21 (Ufa, Russia). The modified surgical technique is aimed at reducing the severity of postoperative hematomas, increasing the cosmetic effect and reducing the incidence of damage to the cutaneous nerve located near the large saphenous vein. The surgery technique was patented (Patent No. RU2812293C1). Materials and methods. From 2022 to 2023, total stripping of the great saphenous vein was performed in 26 patients with varicose veins of the lower extremities and thrombophlebitis of the great saphenous vein in Cardiac Surgery Department of City Clinical Hospital No. 21. The examined patients were divided into a control group (18 patients) and a comparison group (8 patients). The quality of life of all patients was assessed before and after surgical intervention using the Visual Analog Scale (VAS). Results and discussion. All patients underwent total stripping of the great saphenous vein. Prior to surgery, no statistically significant difference was reported in the assessment of quality of life between the groups. The group of the modified stripping technique demonstrated positive clinical and aesthetic results after surgery. Performing total stripping of the great saphenous vein using the modified technique statistically significantly improved the quality of life in the postoperative period. Control points of examinations were on days 1, 7, 30, 90 after surgery. Conclusion. The comparative analysis of the treatment results proved the efficacy of the modified technique of total stripping in varicose vein patients with thrombophlebitis, including a higher level of quality of life, better clinical and aesthetic result of surgical treatment.

Comparison of Laparoendoscopic Single-Site Adrenalectomy with the Aid of Intracavitary Retractors and Multiport Laparoendoscopic Adrenalectomy.

Objective: To evaluate the operative outcome of the use of intracavitary retractors in transumbilical laparoendoscopic single-site (LESS) adrenalectomy in comparison with the conventional multiport laparoendoscopic procedure. Methods: Between July 2021 and December 2023, 34 patients underwent transumbilical LESS adrenalectomy with intracavitary retractors, while 47 patients underwent conventional multiport laparoscopic adrenalectomy. Comprehensive data were compared, including demographics, intraoperative outcomes, perioperative complications, postoperative visual analog pain scale score, analgesic requirement, and short-term measures of convalescence. Results: Baseline characteristics were similar between the groups. All procedures were successfully completed without additional access or open conversion. The mean operative time and estimated blood loss for LESS adrenalectomy were comparable with multiport adrenalectomy. The LESS group had significantly shorter incision length (3.07 cm versus 5.16 cm, P < .01), lower postoperative pain scores (3.29 versus 4.91, P < .01), less analgesic drug use (29% versus 53%, P = .03), and better cosmetic scores (9.29 versus 7.28, P < .01). No significant differences were observed in time to resume oral intake, time to ambulation, or postoperative hospital stay. Complication rates were similar between the groups. Conclusion: The utilization of intracavitary retractors in transumbilical LESS adrenalectomy has demonstrated feasibility, effectiveness, and the potential to reduce technical complexities with satisfactory cosmetic effects. This technique enhances visualization of the surgical field without the need for extra ports.

Comparison of the safety and efficacy of three superficial skin closure methods for multi-layer wound closure in total knee arthroplasty: a multicenter, prospective, randomized controlled trial

BackgroundGood wound healing is critical to infection prophylaxis and satisfactory rehabilitation in Total Knee Arthroplasty (TKA). Currently, two techniques, i.e., barbed continuous subcuticular suture without skin adhesive or combined use skin adhesive (n-butyl-2) are being used for superficial wound closure of TKA. While a new skin adhesive (2-octyl) with self-adhesive mesh has been employed as an alternative to conventional surgical skin closure in TKA, its superiority, especially in reducing wound complications and improving wound cosmetic outcomes has not been investigated. This study aimed to compare 2-octyl, n-butyl-2, and no skin adhesive in terms of safety and efficacy in TKA superficial wound closure.MethodsWe conducted a multicenter, prospective, randomized controlled study in 105 patients undergoing primary TKA between May 2022 and October 2023. Each patient’s knee was randomized to receive 2-octyl, n-butyl-2, or no skin adhesive skin closure with all using barbed continuous sutures in deep tissue. Wounds were followed 1, 3, 5 days, 2, 6 weeks, and 3 months after surgery. Wound discharge, complications, cosmetic outcomes, patient satisfaction, and wound-related costs were compared among these three methods.ResultsWound discharge was less in 2-octyl group and n-butyl-2 group than in non-adhesive group at 1 day, with the discharge only being less in 2-octyl group than in the non-adhesive group at day 3 and day 5 days (P < 0.05). There was no statistical difference in the incidence of other wound complications among the groups (P > 0.05). The 2-octyl group achieved better cosmetic effects than the other two groups in 6 weeks and 3 months (P < 0.05). Compared to the non-adhesive group, 2-octyl group scored higher in overall patient satisfaction score in 2 weeks and incurred lower costs (P < 0.05).ConclusionsSkin closure in TKA using 2-octyl adhesive material showed superiority when compared to no skin adhesive or n-butyl-2, in reducing wound discharge, improving the cosmetic outcomes, without increasing wound complications. In addition, the use of 2-octyl yielded better patient satisfaction and also was less costly compared to no skin adhesive. Our study exhibited that 2-octyl was a safe and effective wound closure technique for patients undergoing TKA.Trial registrationThis study has been registered at Clinical Trials. Gov (No. ChiCTR210046442).

Clinical application of retroauricular hairline approach in submandibular gland resection assisted by endoscope

Objective:To investigate the clinical effect of retroauricular hairline approach in submandibular gland resection assisted by endoscope. Methods:A total of 18 patients with submandibular gland benign tumors treated in our hospital from September 2022 to September 2023 were selected. A 5 cm incision was designed in the retroauricular hairline, and the flap was turned over directly to the anterior edge of sternocleidomastoid muscle, then the flap was turned over to build the cavity through endoscopic surgery, and submandibular gland resection was completed with the assistance of endoscope. After operation, a negative pressure drainage was placed into the hairline, and the wound was closed by continuous intracutaneous suture. The clinical effect was evaluated after 3-6 months follow-up. Results:All patients underwent submandibular gland resection with endoscopic assistance as planned, and none of them converted to submaxillary incision during operation. The operation time was 65-97 min, with an average of 75 min. Intraoperative bleeding was 10-20 mL, with an average of 14 mL.No tongue numbness, wound infection, or tumor recurrence occurred after operation. However, there were 10 patients with ear numbness and discomfort of auricle after surgery, which gradually recovered after 6-9 months of follow-up. Two patients had crooked mouth after surgery, and the symptoms were gradually relieved after follow-up. All incisions healed in stage I and were concealed. Conclusion:Endoscopic retroauricular hairline approach is a choice for submandibular gland resection with good cosmetic effect, less trauma and fewer complications.

Endoscopic resection of benign breast tumors via a single axillary incision using the insufflation method: a preliminary summary report.

Clinicopathological data from 62 patients who underwent this procedure from June 2022 to July 2023 were retrospectively collected. The surgical success rate, number of tumors excised, operative time, intraoperative conditions, postoperative complications, and clinical outcomes were analyzed. A total of 144 benign tumors were resected, and the surgical success rate was 100% (62/62). The time required to resect tumors located in the inner quadrant with larger diameters was shorter than the time to resect tumors located in the outer quadrant with smaller tumors. Sixty-two patients experienced reduced intraoperative bleeding and did not experience skin burns, incision infections, or poor healing. However, all patients experienced varying degrees of subcutaneous emphysema during the postoperative period. Fourteen patients experienced minor local effusions, and 3 patients experienced mild upper limb dysfunction, which resolved within one month. During the six-month follow-up period, there were no cases of tumor recurrence or new tumors. The ABNSW score was above 14 points, and patient satisfaction was high. Endoscopic resection of benign breast tumors through a single incision in the axilla via the inflatable method could quickly remove lesions larger than 3.0cm. This method also results in hidden scars and good cosmetic effects on the shape of the breast. This is a new and effective treatment for benign breast tumors. This retrospective study was registered in the National Medical Research Registry filing system ( https://www.medicalresearch.org.cn ) (No. MR-44-22-007981) and recorded in the Medical Research Division of our hospital (No. NYXJS-22-021).

Modification of proximal row carpectomy (PRC) technique for adaptive wrist collapse (pilot study)

Introduction Proximal carpal row resection has been used for many decades as a “salvage procedure” for progressive wrist collapse. Improving the technique of its implementation, as well as introducing various modifications of the technique into practice are an important area for achieving better results of surgical treatment.The purpose of this work was to demonstrate aspects of the modified proximal row carpectomy (PRC) technique and the immediate results of its use.Materials and methods Eight patients aged from 24 to 57 years (seven men and one woman) were treated with the modified PRC technique. Treatment results were assessed using an adapted QuickDASH questionnaire, a visual analogue scale (VAS), based on patient satisfaction and radiographic results.Results The average duration of surgical intervention was (149.0 ± 35.5) minutes. In the postoperative period, six patients (75 %) underwent fixation with an Ilizarov apparatus, the rest with a plaster splint. The average range of motion of flexion and extension was (67.5 ± 18.3)°, range: 40–95°. The patients had an average of (35.6 ± 16.13)° extension, range: 10–65° and (31.87 ± 10.9)° flexion, range: 10–45°. Patients reported decreased grip strength after surgery. Pain syndrome according to VAS at rest was equal to 0–1 points and 3–4 points when the affected limb was loaded. Six patients completed the QuickDASH survey, with a mean score of (14.83 ± 4.25) points. All patients are satisfied with the result of treatment and the absence of pain at rest. Patients returned to their usual work.Discussion Unlike the conventional dorsal approach through the III–IV tendon canals, the use of two mini-approaches provides a better cosmetic effect and makes it easier to restore the integrity of the tendon canals, which are important for the prevention of desmogenic contractures. The use of the Ilizarov apparatus has proven to be the method of choice, providing absolute stability and reduction of pain in the postoperative period. For patients under 45 years of age with increased functional demands, a balanced approach is required when choosing PRC or intercarpal arthrodesis, depending on which functional parameters are more important to the patient.Conclusion The analysis of short-term results of using the modified PRC technique shows that it reduces the invasiveness of the operation, improves its esthetic result, provides pain relief and a satisfactory range of motion and grip strength.

Refractory pruritus in cholestatic drug-induced liver injury secondary to androgenic anabolic steroids: Plasmapheresis to the rescue

Abstract: Anabolic androgenic steroids (AASs) have long been misused by professional athletes. Easy online and over-the-counter availability of AASs makes it an alluring option even among amateurs for their desired cosmetic and performance-enhancing effects. AASs have been associated with distinct forms of liver injury including transient transaminitis, peliosis hepatis, and hepatic tumors. An acute cholestatic syndrome with bland histology is another characteristic form of liver injury rarely reported with AASs. Plasmapheresis may provide a long-lasting relief of symptoms when conventional pharmacotherapeutic measures fail. Herein, we report a challenging case of a young male with refractory pruritus secondary to AASs, managed effectively with plasmapheresis.

Tongue squamous cell carcinoma treated by 5-aminolevulinic acid administrated through Microdrop method

BackgroundPostoperative recurrence of tongue squamous cell carcinoma (TSCC) has always been a clinical problem for patients and doctors. Surgery and radiotherapy are the main treatment methods for TSCC, but reoperation often leads to functional impairment. Side effects of radiotherapy include mucosal gland damage, dry mouth, weakened or lost taste. Improved treatment is needed. ObjectiveTo evaluate the clinical outcome of a patient with TSCC treated with Microdrop aminolevulinic acid (ALA) photodynamic treatment (PDT) twice. MethodsALA was dissolved in 5 % lidocaine and the concentration of ALA was 20 % by Microdrop method. Then, the tumor tissue was expanded 1 cm outward, and the injection points were evenly distributed with an upper and lower left and right interval of 2–3 mm. The 1 ml syringe was used to perform the injection in the skin of the tumor area, and there was a small cuticle at each injection point. A pathologically confirmed patient with TSCC received twice Microdrop ALA-PDT treatments, which were evaluated at 1 month and 4 months later. ResultsAfter 3 h of Microdrop ALA injection, the wavelength of semiconductor laser was set to 630 nm, and the energy of 300 mW /cm2 was irradiated for 30 min. After two treatments, the lesions were not visible, and no recurrence occurred after 4 months of follow-up. The patient's tongue function was well preserved and the cosmetic effect was good. ConclusionMicrodrop ALA-PDT may be effective in the salvage treatment of select tongue squamous cell carcinoma.

Improvement of Single-port Laparoscopic Cholecystectomy

The desire of both surgeons and patients to reduce the trauma of the operation and shorten the length of hospital stay, on the one hand, and on the other hand, the development of new technologies and the emergence of special devices led to the development and implementation of video endoscopic minimally invasive methods of surgical intervention. The results of single-port laparoscopic cholecystectomy and the possibility of choosing instrumental support when performing these operations should be analyzed. Our study included 116 patients hospitalized for planned surgical treatment with chronic calculous cholecystitis from 2019 to 2023. The patients were divided into two groups: the first main group consisted of 52 (44.8%) patients with chronic calculous cholecystitis who underwent single-port laparoscopic cholecystectomy (SLP) using the single access technique (SAL). The second group (TLCE) consisted of 64 (55.2%) patients with CCC who underwent laparoscopic four-port cholecystectomy. A comparative analysis of the results of the intraoperative and early postoperative periods in patients after TLCE using the single access method, the number of complications was minimal than with TLCE using a four-port approach. Long-term results of surgical treatment of patients with cholelithiasis after OLCE using the single access method are characterized by the least complications, high cosmetic effect, and low morbidity.

Endoscopic assisted parathyroid surgery via a subclavian approach

Objective:To explore the safety and efficacy of airless endoscopic surgery in the treatment of parathyroid diseases. Methods:By retrospective comparison, clinical treatment of 26 patients with primary hyperparathyroidism admitted to the Department of Otolaryngology and Head and Neck Surgery of the Hospital, Sun Yat-sen University from January 2018 to January 2023 were collected. They were divided into traditional group（13 cases） and endoscopic group（13 cases） according to the surgical method. The traditional group underwent traditional open parathyroid surgery, and the endoscopic group underwent airless endoscopic surgery through the subclavian approach. The efficacy, postoperative incision pain, incidence of adverse events, and aesthetic effects of the two groups were evaluated. Results:A total of 26 patients were included, including 13 patients in the traditional group and 13 patients in the endoscopic group. There was no significant difference in the incidence of hypocalcemia and transient hypoparathyroidism on the first day after surgery between the two groups（P>0.05）. No patients with incision pain（>3 points） or swallowing pain were found in both groups after the operation, and they were afraid or unwilling to cough and expel phlegm. There were no significant differences in the amount of blood loss, duration of operation, incidence of temporary recurrent laryngeal nerve palsy and transient hypocalcemia, and postoperative pain score between the two groups. The endoscopic group's scar evaluation score and aesthetic effect satisfaction score at 6 months after surgery were higher than those of the traditional group（P<0.01）. Conclusion:Airless Endoscopic parathyroid surgery via the subclavian approach has good effectiveness and safety, which did not significantly increase the risk of surgery. It can safely remove the lesion and leave no surgical scar on the anterior neck, which has the advantage of a good cosmetic effect. It is a safe and feasible endoscopic parathyroid surgery and can be used as a new choice for patients undergoing parathyroid surgery.

Liposuction Through an Axillary Fold Incision Combined with a Small Areola Incision to Treat Gynecomastia.

Gynecomastia is a progressive disease characterized by enlarged breasts, affecting a significant proportion of men. Persistent gynecomastia negatively affects the psychological and emotional development of patients; therefore, surgical intervention is required. In this article, we describe a surgical technique, where liposuction through an axillary incision is used in combination with a single small periareolar incision, to obtain the most minimal scars in the treatment of gynecomastia. Between June 2021 and June 2023, 125 patients with different Simon grades of gynecomastia were enrolled. The patients' basic conditions and operation processes were recorded. Following surgery, a score was assigned according to the five main aesthetic aspects of the surgical procedure. In total, 125 patients with gynecomastia were treated with a pre-axillary fold incision combined with a small areolar incision. There were 17 cases of Simon grade I, 46 grade IIA, 42 grade IIB, and 20 grade III. The average operation time was 45.8min, the average liposuction volume was 250.5mL, the average glandular tissue volume was 50.5g, intraoperative blood loss ranged from 15 to 60mL, and the average hospital stay was 3.2days. Regarding the postoperative aesthetic effect, doctors scored > 4 points, and the patient satisfaction score was > 7.5, which fully affirmed the aesthetic effect of this method. Treatment of gynecomastia through an anterior axillary fold incision combined with a small areolar incision is safe and feasible, involving a simple procedure, short operation time, and few complications. Its efficacy and cosmetic effects could lead to its use as a primary surgical method to treat gynecomastia. 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 Table of Contents or online Instructions to Authors www.springer.com/00266 .

Incidence of alopecia in brain tumour patients treated with pencil scanning proton therapy and validation of existing NTCP models

Background and purposeRadiation-induced alopecia (RIA) is one of the most frequent and upsetting cosmetic side effects after radiotherapy (RT) for brain cancer. We report the incidence of RIA in a cohort of brain tumours patients treated with Proton Therapy (PT) and externally validate published NTCP models of grade 2 (G2) RIA for their implementation in clinical practice. MethodsData for patients treated for brain tumours with scanning beam PT between 2018 and 2022 were extracted. Acute, late and permanent RIA events were evaluated according to CTCAE 5.0. Lyman-Kutcher-Burman (LKB) and multivariable logistic regression (MLR) published models were computed from the relative dose-surface histogram of the scalp. External validity of models was assessed in terms of discrimination and calibration. ResultsIn the 264 patients analysed, rates of any grade acute (≤90 days after PT completion), late (>90 days) and permanent RIA (persisting for> 12 months) were 61.8 %, 24.7 % and 14.4 %, respectively. In our independent cohort, LKB- and MLR-NTCP showed a good discrimination for G2 RIA (0.71≤ROC-AUC≤0.83) while model calibration was unsatisfactory possibly due to a different outcome evaluation between training and validation cohorts, as well as differences in clinical and treatment related variables between the two groups. ConclusionsDespite the reasonable sensitivity and specificity of the NTCP models for RIA in the validation cohort, our study emphasizes the significance of differences between the cohorts utilized for model development and validation. Specifically, variations in the reporting of clinical outcomes inevitably jeopardize the validation of NTCP models. A standardize and objective RIA scoring system is essential.

Complications after liposuction: current state of the problem (literature review)

The variety of body shape correction techniques based on liposuction and currently used in plastic surgery is largely due to the desire to achieve the greatest possible cosmetic effect and, at the same time, minimize the possible negative consequences of invasive intervention. The choice of a specific method depends on a number of factors, among which are the treatment plan agreed with the patient, the individual characteristics of the patient being operated on, the presence or absence of medical contraindications to the use of certain techniques, the qualifications of the personnel, the level of material equipment of the operating unit. Liposuction is the aspiration of fat from subcutaneous tissue. It can be used for aesthetic lipoplasty or combined with body contouring surgery. The article is of a review nature and contains modern data on the medical effects of liposuction, VASER (Vibration Amplification of Sound Energy at Resonance) and PAL (Power Assisted Liposuction) techniques, and possible complications after liposuction.