Cosmetic Facial Plastic Surgery Research Articles

The Effect and Implication of Social Media Platforms on Cosmetic Facial Plastic Surgery Among Females in Saudi Arabia.

Introduction Facial plastic surgery addresses various facial imperfections, offering a range of procedures like rhinoplasty and facelifts. Social media promotes unrealistic beauty standards, leading to increased demand for such surgeries. Studies highlight its influence, emphasizing the need for research in this area. Our study aimed to evaluate the effect of social media advertisements and selfies on facial cosmetic surgery decisions and plans among females in Saudi Arabia. Methodology This is a cross-sectional study conducted in the Kingdom of Saudi Arabia that targeted females aged 18-80 years old. An electronic questionnaire in Arabic was used for data collection. Data was analyzed in IBM SPSS Statistics for Windows, Version 29 (Released 2023; IBM Corp., Armonk, New York, United States). Results Our study assessed 568 Saudi females regarding social media's impact on facial cosmetic surgery. Most of them were aged 21-30 years (39.4%) and Saudi nationals (94.2%). The majority, 87.9% (n=499), had not undergone cosmetic surgeries, and 12.1% (n=69) had; 68.1% (n=387) did not plan future surgeries. Notably, 42.6% (n=242) cited surgeon self-advertising and 38.0% (n=216) better selfies as an influencing factor in their cosmetic surgery decision. Logistic regression revealed several significant predictors of cosmetic surgery decisions including surgeon's advertisement (Exp(B) = 2.812, p < 0.001), cosmetic show viewing (Exp(B) = 2.327, p = 0.004), and social media photos (Exp(B) = 2.762, p = 0.001). Education (Exp(B) = 1.533, p = 0.035) and previous surgery (Exp(B) = 4.523, p < 0.001) correlated positively with considering surgery. Conclusion Our study highlights social media's influence on facial cosmetic surgery decisions among Saudi females. Surgeon advertisements, social media exposure, education, and previous surgery history emerged as significant predictors, warranting further research and targeted interventions.

Prevalence and Characteristics Associated with Positive Body Dysmorphic Disorder Screening Among Patients Presenting for Cosmetic Facial Plastic Surgery.

Background: Many patients with body dysmorphic disorder (BDD) seek out cosmetic surgery to alleviate their symptoms of distress related to a perceived defect in their appearance; however, the prevalence and risk factors for BDD among patients with cosmetic concerns have not been well characterized. Methods: We screened adult patients presenting to the clinic from June 2021 through September 2022 for BDD using the BDD Questionnaire-Aesthetic Surgery (BDDQ-AS) who were seen in consultation for rhinoplasty, aging face, and injectables. Results: Among 488 patients, the prevalence of screening positive for BDD was 41.0%. The prevalence of a positive BDD screen was highest among patients who were younger (p = 0.02), and those who had a positive self-reported psychiatric history (p = 0.02). Among rhinoplasty patients, those with aesthetic/cosmetic motivations, and those seeking revision rhinoplasty had higher rates of positive BDD screen. Higher scores on the Standardized Cosmesis and Health Nasal Outcomes Survey-Nasal Obstruction Score (SCHNOS-O) (p = 0.01) and Standardized Cosmesis and Health Nasal Outcomes Survey-Nasal Obstruction Score-Nasal Cosmesis Score (SCHNOS-C) (p < 0.0001) were predictive of a positive BDD screen, while question 5 of the SCHNOS was highly predictive of positive BDD screening (p < 0.0001). Conclusions: Our study characterizes relationships between positive BDD screening and age, gender, self-reported psychiatric history, and motivations for consultation, among patients seen for cosmetic surgery evaluation in a facial plastic and reconstructive surgery setting.

Has the COVID-19 Pandemic Impacted Interest in Cosmetic Facial Plastic Surgery? A Google Trends Analysis.

Facial cosmetic surgery trends are evolving in the current climate of the coronavirus disease 2019 (COVID-19) pandemic. The aim of this study was to evaluate public interest in elective facial plastic surgery during the COVID-19 pandemic including the period of the COVID-19 vaccine distribution using Google Trends. A Google Trends analysis was completed using popular terms related to facial cosmetic surgery and procedures from March 2017 to August 2021. Three stages were identified (baseline, pre-COVID-19 vaccine distribution, and post-COVID-19 vaccine distribution). Descriptive statistics were calculated and two-tailed t-tests were performed between the pre-vaccine and the post-vaccine phases. Linear regression analysis was also performed to determine percent deflection of search terms. There was significantly greater interest in facial aesthetic procedure search terms, except for tear trough filler, during the post-COVID-19 vaccine phase compared with the pre-COVID-19 vaccine phase. There was greater interest in lower facial procedure interest during this phase compared with upper facial procedures (p-value = 0.0011). The search terms with the greatest deflection percentage during the post-vaccine phase were lip filler, brow lift, and lip flip. There continues to be high demands of facial plastic surgery and procedures despite COVID-19 pandemic.

Preoperative Imaging and Online Photo Galleries: The #Key to Surgical Commitment.

Importance Preoperative imaging provides an advantageous balance by helping patients to effectively communicate their aesthetic desires while allowing surgeons to establish realistic expectations of surgical outcomes. Objective To determine the role of preoperative imaging and the importance of online-based photo galleries in influencing a patient's decision to pursue cosmetic facial plastic surgery. Design, Setting, and Participants A retrospective study was conducted on 100 patients who underwent preoperative imaging prior to undergoing aesthetic facial plastic surgery from July 2019 to May 2020. An in-office physician-led clinical consultation followed by a preoperative imaging session was performed on each patient prior to surgical intervention. A 6-question survey was provided once to all patients between their 3- and 12-month postoperative time periods. Main Outcomes and Measures The importance of preoperative imaging and the influence of physician website and social media photo galleries regarding surgical decision-making was evaluated. Results A total of 100 participants (female [90; 90%]) and mean age 52.6 (range, 18–77) years were included. Nearly 60% of patients underwent facial rejuvenation procedures. All reported that preoperative in-office physician consultation in combination with the use of preoperative imaging were helpful in facilitating a commitment to surgical intervention. Sixty-nine (69%) patients endorsed the use of both the frontal and lateral imaging views, while 30 (30%) deemed a single angle to be superior. Seventy (70%) participants utilized online-based “before & after” photo galleries in the form of physician websites and/or social media platforms to assist in their decision to undergo surgical intervention. Conclusions and Relevance The combination of in-office physician consultation, preoperative imaging, and availability of website and/or social media photo galleries plays a key role in a patient's decision to pursue cosmetic surgery. Thus, implementation of all facets should become an integral part of any facial plastic surgeon's aesthetic practice.

The Valuation of Rhytidectomy in Different Economic Markets.

This study demonstrates that the trend of how rhytidectomy is valued can be used to determine not only the pricing of this good but also how receptive developing economic markets are to the export of cosmetic facial plastic surgery. This study seeks to analyze and compare the value of rhytidectomy in an established market and an emerging market. A cross-sectional survey was administered through public online forums to 162 casual observers in the United States and 74 casual observers in India. Participants were shown pre- and postoperative photos of 10 patients who underwent cosmetic rhinoplasty and 2 patients who did not undergo surgery. Observers were asked to quantify the perceived change in attractiveness, change in age, and willingness to pay (WTP). There is a similar nonlinear trend between WTP and change in attractiveness in both the United States and India. Baseline values of rhytidectomy in the United States and India have a similar ratio of 2.122 compared with the ratio between both countries in the 2018 Big Mac index. The comparison of the trend in WTP in the United States and India shows that facial cosmetic surgery functions as a luxury good in both an established market and an emerging market. Our model successfully approximates the relationship between each country's purchasing power parity. Since the market behavior of rhytidectomy can be predicted based on purchasing power parity, there may be an untapped market for facial cosmetic surgery among populations with growing economies.

Evaluation of the Quality of Printed Online Education Materials in Cosmetic Facial Plastic Surgery.

Importance: In the modern-day health care environment, it is expected that a large proportion of patients will utilize the Internet to gather health care-related information. However, online sources are often not subjected to adequate quality control measures. Objective: To evaluate the quality of printed online education materials (POEMs) pertaining to elective facial cosmetic surgery. Design, Setting, and Participants: This is a descriptive correlational study. Independent Internet searches for the terms "rhinoplasty," "rhytidectomy," "blepharoplasty," and "browlift" were carried out using the Google search engine. The top 20 web resources for each term were analyzed. Main Outcomes and Measures: All web resources were analyzed for HONcode certification. The DISCERN instrument was then used to determine reliability and specificity of information, whereas readability was assessed using the Flesch Reading Ease (FRE) score and the Flesch-Kincaid Grade Level (FKGL). Results: Of the resulting 80 web resources, 30% (n = 24) were HONcode certified. None of the surgical society web resources (n = 12) were HONcode certified, and only 42% (n = 8) of web resources associated with academic institutions were HONcode certified. Out of a maximum DISCERN score of 80, the mean (standard deviation [SD]) scores were 48 (11) for rhinoplasty, 50 (11) for rhytidectomy, 47 (11) for blepharoplasty, and 45 (10) for browlift. The mean DISCERN scores of the HONcode-certified web resources did not differ significantly from scores of uncertified web resources (p = 0.069). There was no significant difference in overall mean DISCERN scores for the different web resource categories. The mean (SD) FRE score was 45.7 (11.9), whereas the mean FKGL score was 10.7 (1.9). HONcode-certified web resources had significantly higher FRE scores (p = 0.028) and significantly lower FKGL scores (p = 0.0003). Conclusions and Relevance: A significant proportion of POEMs regarding elective cosmetic facial plastic surgery remains uncertified and of inadequate quality. This can negatively impact the informed decision-making process and increase the risk of poor outcomes and lower satisfaction rates.

Importance of Facial Plastic Surgery Education in Residency: A Resident Survey.

Introduction Facial plastic and reconstructive surgery (FPRS) is a key part of the curriculum for otolaryngology residents. It is important to gain an understanding of the breadth of exposure and level of competence residents feel with these concepts during their residency. Objective To determine the level of FPRS exposure and training otolaryngology residents receive during their residency. Methods A survey was emailed to all Accreditation Council for Graduate Medical Education (ACGME) accredited otolaryngology residents. The survey aimed to find the level of exposure to FPRS procedures otolaryngology residents get and how confident they feel with their training in cosmetic FPRS. Results A total of 213 residents responded to the survey for an overall response rate of 13.4%. There was an even mixture of residents from all postgraduate year (PGY) levels, with 58% of respondents being male. Almost all (98%) of the residents felt FPRS was important to otolaryngology residency training. Exposure to procedures varied with 57% performing or assisting with cosmetic minor procedures, 81% performing or assisting with cosmetic major procedures, and 93% performing or assisting with reconstructive procedures. Only 49% of residents felt their programs either very or somewhat adequately prepared them in cosmetic facial plastic surgery. Conclusion There was a wide variability in the FPRS procedure exposure. Most residents felt procedures were a vital part of otolaryngology residency training, but not all were able to participate in them. Only half of the residents felt well-prepared in cosmetic procedures.

The Prevalence of Cosmetic Facial Plastic Procedures among Facial Plastic Surgeons

This is the first study to report on the prevalence of cosmetic facial plastic surgery use among facial plastic surgeons. The aim of this study is to determine the frequency with which facial plastic surgeons have cosmetic procedures themselves. A secondary aim is to determine whether trends in usage of cosmetic facial procedures among facial plastic surgeons are similar to that of nonsurgeons. The study design was an anonymous, five-question, Internet survey distributed via email set in a single academic institution. Board-certified members of the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) were included in this study. Self-reported history of cosmetic facial plastic surgery or minimally invasive procedures were recorded. The survey also queried participants for demographic data. A total of 216 members of the AAFPRS responded to the questionnaire. Ninety percent of respondents were male (n = 192) and 10.3% were female (n = 22). Thirty-three percent of respondents were aged 31 to 40 years (n = 70), 25% were aged 41 to 50 years (n = 53), 21.4% were aged 51 to 60 years (n = 46), and 20.5% were older than 60 years (n = 44). Thirty-six percent of respondents had a surgical cosmetic facial procedure and 75% has at least one minimally invasive cosmetic facial procedure. Facial plastic surgeons are frequent users of cosmetic facial plastic surgery. This finding may be due to access, knowledge base, values, or attitudes. By better understanding surgeon attitudes toward facial plastic surgery, we can improve communication with patients and delivery of care. This study is a first step in understanding use of facial plastic procedures among facial plastic surgeons.

Validation of a Method for Estimation of Facial Age by Plastic Surgeons

Within cosmetic facial plastic surgery, there is considerable difficulty in producing high-quality scientific publications because of the lack of scientific tools that serve to transform sensations, such as more beautiful or rejuvenated, into numbers capable of being used in statistical analysis. To validate an objective evaluation method that can be used to define the perception of facial age in scientific studies. This is a cross-sectional, observational study of evaluation by plastic surgeons of 70 photographs of patients from a private care hospital performed from March 1, 2015, through April 30, 2016. When evaluating the photographs, 7 plastic surgeons wrote down the perceived age of each patient. The photographs of each patient were randomly presented twice to each evaluator (photograph 1 and photograph 2) and analyzed singly using a trimmed mean. Three evaluators were randomly chosen for further statistical analysis in an attempt to make the assessment technique more practical. Usual aging process. Estimated mean age and chronological age. Photographs of 70 patients were evaluated (mean [SD] age, 41.5 [13.8] years; 48 women [68.6%]; and mean [SD] body mass index, 22.5 [2.7]). No significant differences were observed between photographs 1 and 2 for any of the evaluators. A significant difference in the mean ages was not observed when comparing evaluators. For photograph 1 (evaluated by only 3 evaluators), the difference was 0.16 years (P = .52). For photograph 2, the difference was 0.05 years (P = .86). The difference between the mean perceived age for the 3 evaluators and the chronological age was only 0.8 years (<10 months). The intraevaluator and interevaluator agreement suggests that 3 plastic surgeons can estimate the age of a person with a margin of error of 10 months by analyzing a photograph. This article is important to facial plastic surgeons because it reveals how the results of rejuvenation procedures can be assessed. NA.

The deep plane facelift.

The goal of any cosmetic facial plastic surgery procedure is to obtain a natural-appearing result that is not overdone or obviously operated upon. This is the case whether the background of the operating surgeon is in facial plastic and reconstructive surgery, general plastic surgery, dermatology, or oculoplastic surgery. To satisfy this goal, the surgeon must apply those techniques that consistently achieve effective but understated results rather than experimenting with every new innovation or fad. More and more surgeons are moving away from some of the so-called advances of the last decade, including the use of lasers for skin resurfacing and the application of endoscopic approaches to the face, in the search for the best results possible. Sometimes this means utilizing older techniques that have proven the test of time, such as the coronal browlift and chemical peels, whereas other times this means embracing those newer techniques that clearly represent major advances in our specialty, such as the transconjunctival approach to lower lid blepharoplasty. The deep plane facelift is one such advance. In contrast to traditional, skin or short-SMAS flap techniques, the deep plane facelift allows the surgeon to consistently obtain a natural-appearing result that not only addresses the key areas of concern in the aging face but also proves to be longer lasting as well. The deep plane technique also results in fewer complications, an improved ability to address the melolabial region and jowls, and increased anatomic appeal for the operating surgeon.

Cosmetic surgery procedures as luxury goods: measuring price and demand in facial plastic surgery.

To evaluate the relationship between cosmetic facial plastic surgery procedure price and demand, and to test the hypothesis that these procedures function as luxury goods in the marketplace, with an upward-sloping demand curve. Data were derived from a survey that was sent to every (N = 1727) active fellow, member, or associate of the American Academy of Facial Plastic and Reconstructive Surgery, assessing the costs and frequency of 4 common cosmetic facial plastic surgery procedures (face-lift, brow-lift, blepharoplasty, and rhinoplasty) for 1999 and 1989. An economic analysis was performed to assess the relationship of price and demand for these procedures. A significant association was found between increasing surgeons' fees and total charges for cosmetic facial plastic surgery procedures and increasing demand for these procedures, as measured by their annual frequency (P</=.003). After a multiple regression analysis correcting for confounding variables, this association of increased price with increased demand holds for each of the 4 procedures studied, across all US regions, and for both periods surveyed. Cosmetic facial plastic surgery procedures do appear to function as luxury goods in the marketplace, with an upward-sloping demand curve. This stands in contrast to other, traditional, goods for which demand typically declines as price increases. It appears that economic methods can be used to evaluate cosmetic procedure trends; however, these methods must be founded on the appropriate economic theory.

Measuring Cosmetic Facial Plastic Surgery Outcomes

To test 4 previously published outcomes instruments (the Facelift Outcomes Evaluation, the Rhinoplasty Outcomes Evaluation, the Blepharoplasty Outcomes Evaluation, and the Skin Rejuvenation Outcomes Evaluation) in terms of their reliability and validity in assessing patient-related outcomes of surgical intervention. A prospective pilot study of 78 patients in 3 similar private cosmetic surgery centers undergoing a total of 100 face-lift, rhinoplasty, blepharoplasty, and skin rejuvenation procedures. Patients were evaluated at 2 preoperative and 1 postoperative time points and the instruments were analyzed with regard to their test-retest reliability, internal consistency, and responsiveness to change. All 4 outcomes instruments had excellent reliability, consistency, and validity scores. Test-retest reliability was 0.74 to 0.83 (Pearson correlation coefficients), internal consistency scores were.83 to.88 (Cronbach alpha), and responsiveness to change was statistically significant for each instrument tested (P< or =.001). In addition, patients experienced significant quality of life improvement, with overall satisfaction increasing on average from 37% to more than 84% after these procedures. These 4 instruments are reliable and valid and can be used to accurately assess patient-related satisfaction in studies of face-lift, rhinoplasty, blepharoplasty, and skin resurfacing outcomes. These brief questionnaires provide the cosmetic surgeon with quantitative tools to evaluate otherwise subjective and purely qualitative outcomes and are recommended for use in future prospective studies.

Cost Outcomes of Facial Plastic Surgery

To describe the geographic and temporal trends in cosmetic facial plastic surgery procedure costs and frequency during the last decade and to evaluate factors that may influence changes in the demand for cosmetic procedures.A survey sent to every (N = 1727) active fellow, member, or associate of the American Academy of Facial Plastic and Reconstructive Surgery assessing the costs and frequency of 4 common cosmetic facial plastic surgery procedures (ie, face-lift, brow lift, blepharoplasty, and rhinoplasty) for 1999 and 1989.The annual frequency of the aging-face procedures (ie, face-lift, brow lift, and blepharoplasty) have increased 41% over the last decade while rhinoplasties have declined slightly (18%). Each of the procedures studied have increased in cost since 1989; however, only face-lifts have increased at a rate greater than inflation during this period (average surgeon's fees, $3154-$4582). Although the average cost of each of these procedures is stable across US geographic areas, there seem to be fewer aging-face procedures being performed in the East (represented largely by New England and the northeastern states) compared with the Midwest, South, and West (P< or = .03), while rhinoplasty frequency across these regions is essentially unchanged. In addition to variables such as age, years in practice, and degree of marketing, the strongest correlates with increased cosmetic procedure frequency were the costs of these procedures (P< or = .008).Although the cost and frequency of cosmetic facial plastic surgery procedures continues to rise across the United States, there are interesting differences in these trends between different regions and procedure type during the last decade. There also seems to be an association between increased cost and increased frequency of these cosmetic procedures.

Toxicity of Local Anesthetics in Hair Transplantation and Facial Plastic Surgery

The tendency toward the use of local anesthetics for longer outpatient procedures such as hair transplantation micrograft megasessions and cosmetic facial plastic surgery calls for special consideration of potential toxicity and adverse reactions. As longer procedures on larger, highly vascular surface areas are attempted, the potential for adverse reactions becomes more likely. Understanding the pharmacological properties that govern the clinical effects of local anesthetics, such as onset of action, duration of action, and adverse effects, will prompt the clinician to carefully consider the technique of administration and the dosing limits of these potentially toxic anesthetic drugs.

Foreheads and Brows Revisited

The treatment of the ptotic brow and forehead and glabellar rhytids continues its evolution as an extremely important aspect of the aging-face syndrome. There is controversy concerning the best incision placement to obtain scar camouflage with the most natural hairline and brow. Brow lifting is important in functional as well as in cosmetic facial plastic surgery. Excessive upper eyelid skin resection in the patient with brow ptosis may even make the patient's visual-field defect worse. To obtain the best cosmetic and functional improvement, the brow should be repositioned prior to the upper eyelid blepharoplasty. Direct brow lifting (Fig 1) provides the most direct effect but gives the least camouflaged scar. The incision results in distortion of normal forehead furrows and some loss of fine upper brow hairs, giving a sharply demarcated upper eyelid margin. Dr Ike Matta, Sayre, Pa, at the recent 1988 AAFPRS spring meeting, reviewed his experience with