Cosmetic Impact Research Articles

Apple cider vinegar in folk and modern medicine: a historical review and current scientific evidence.

Introduction and Aim of the Study: Apple cider vinegar (ACV) has been used for centuries in various cultural and medical contexts globally. This study seeks to explore ACV's traditional and contemporary applications, evaluating scientific evidence for its efficacy and safety. Material and Methods: This review synthesizes information from PubMed, Google Scholar, and other scientific sources. Key search terms included "apple cider vinegar," "apple cider vinegar medical use," "apple cider vinegar antimicrobial effect," "apple cider vinegar lipid profile," "apple cider vinegar glucose level," "apple cider vinegar preparation," and "apple cider vinegar historical use." Results: Research supports ACV's traditional role as a disinfectant, demonstrating effectiveness against a range of bacteria and fungi. Both animal and human studies suggest ACV may help lower cholesterol and triglyceride levels while boosting HDL cholesterol. Evidence indicates ACV can enhance insulin sensitivity and reduce blood glucose levels, offering benefits for type 2 diabetes management. ACV shows antioxidant properties, potential for lowering blood pressure, and use in certain skin diseases, though further research is needed to confirm these effects. Conclusions: The historical use of ACV in traditional medicine finds partial support in modern scientific research. Its antimicrobial, lipid-modulating, and glucose-regulating properties are documented, suggesting potential benefits for cardiovascular health, weight management, and metabolic regulation. Nonetheless, the evidence for its cosmetic applications and impact on muscle cramps remains less definitive. Additional research involving larger, diverse populations is necessary to fully validate ACV's benefits and establish safe usage guidelines.

Evaluation of cosmetic outcomes in breast reconstruction patients undergoing radiotherapy using an anomaly generative adversarial network model

Considering the rising prevalence of breast reconstruction followed by radiotherapy (RT), evaluating the cosmetic impact of RT is crucial. Currently, there are limited tools for objectively assessing cosmetic outcomes in patients who have undergone reconstruction. Therefore, we validated the cosmetic outcome using a previously developed anomaly Generative Adversarial Network (GAN)-based model and evaluated its utility. Between January 2016 and December 2020, we collected computed tomography (CT) images from 82 breast cancer patients who underwent immediate reconstruction surgery followed by radiotherapy. Among these patients, 38 received immediate implant insertion, while 44 underwent autologous breast reconstruction. Anomaly scores (AS) were estimated using an anomaly GAN model at pre-RT, 1st follow-up, 1-year (Post-1Y) and 2-year (Post-2Y) after RT. Subsequently, the scores were analyzed in a time-series manner, considering reconstruction types (implant versus autologous), RT techniques, and the incidence of major complications. The median age of the patients was 46 years (range 29–62). The AS between Post-1Y and Post-2Y demonstrated a positive relationship (coefficient 0.515, P < 0.001). The AS was significantly associated with objective cosmetic indices, namely Breast Contour Difference (P = 0.009) and Breast Area Difference (P = 0.004), at both Post-1Y and Post-2Y. Subgroup analysis stratified by type of breast reconstruction revealed significantly higher AS values in patients who underwent prosthetic implant insertion compared to those with autologous reconstruction at all follow-up time points (1st follow-up, P = 0.001; Post-1Y, P < 0.001; and Post-2Y, P < 0.001). A threshold AS of ≥ 1.9 was associated with a 10% predicted risk of developing major complications. The feasibility of an AS generated by a GAN model for predicting both cosmetic outcomes and the likelihood of complications following RT has been successfully validated. Further investigation involving a larger patient cohort is warranted.

Dog bites are increasing in frequency and severity – a sustained effect following the COVID-19 pandemic

The COVID-19 pandemic and subsequent lockdown measures have changed various aspects of society, including patterns of human-animal interactions. This audit investigates the incidence and severity of dog bites admitted under the plastic surgery department at a major trauma centre before and after COVID-19 lockdowns. We assessed trends in dog bite cases over the course of one year (2018) prior to the COVID-19 lockdown and one year after (2022). A time period during COVID-19 lockdown itself was not included to avoid confounding factors due to changes in healthcare provision during the pandemic. Our analysis reveals a 47 % increase in dog bites after lockdowns ended compared to before. We also demonstrate statistically significant increases in the need for operative management (90 % of patients compared to 78 %) and length of inpatient hospital stay (average 63 h compared to 51). Moreover we show that dog bites have increased in severity, with a clear increase in patients presenting with deeper tissue injuries, tissue loss and muscle, nerve, vascular or bone involvement. This represents a significant functional, cosmetic and psychological impact for patients as well as financial impact on the NHS and increased workload for plastic surgery departments. This is the first paper to examine the severity of dog bite injuries and to demonstrate a sustained effect even after the easing of lockdown measures. Our findings shed light on the potential impact of lockdown measures on human-dog interactions and highlight the importance of public awareness and prevention strategies in mitigating dog bites. Lay summaryOur study demonstrates that dog bite injuries increased in frequency by 47 % following COVID-19 lockdowns. Patients with dog bites are also being admitted for longer than before, requiring more operations and have more severe injuries, with some requiring skin grafting, nerve repair or more complex plastic surgery reconstruction.

Abstract PO2-07-04: Applying the Alliance Trial Guidelines in Multi-focal Breast Disease Using an Artificial Intelligence Computational Platform: Economic Analysis and Cosmetic Sensitivity

Abstract Background: Traditionally, multi-focal breast cancer results in mastectomy. The Alliance Trial offers a paradigm shift in surgical options available for multi-focal breast cancer patients in the context of adjuvant chemotherapy. In the trial, patients with multi-focal disease (&amp;lt; 3 tumors) who underwent breast conservation surgery (BCS) were found to have similar outcomes to patients undergoing mastectomy. BCS for large volume tumors ( &amp;gt;30%) has been cited as having a high potential for cosmetic defect, and hence represents a typical upper limit for potential tissue removal in BCS. Here, we evaluated a patient cohort to better understand the economic impact of the Alliance trial and further categorize patients that would most benefit without suffering cosmetic impact. We employed a novel computational technology to quantify the ratio of tumor size to breast tissue volume. Methods: Using a publicly available, single site cohort (n=243, DUMC) of breast cancer patients that underwent mastectomy, we segmented the tumors using our TumorSight Viz software platform. This platform uses artificial intelligence to segment the tumor and surrounding tissues and allows for a volumetric and morphologic assessment in 3D space. We then applied relevant inclusion/exclusion criteria from the Alliance Trial to the cohort (Saha et al, 2018). In trial eligible patients, we used TumorSight Viz to create a convex hull (CH) around the multi-focal disease using dilations of 1 cm and 2 cm. The volume of the CH, corresponding to proposed surgical extirpation, and the overall breast volume (BV) were then computationally assessed in 3D. The ratio of CH to BV (CH:BV) was calculated and a cutoff of 30% (high potential for cosmetic deformity) was applied. A cost analysis was then carried out. We determined the aggregate per annum savings that could potentially be realized by transforming a subset of mastectomies to BCS by tabulating total costs of mastectomy+reconstruction vs. BCS+WBI (whole-breast irradiation), as well as adjusted for relative rates of adjuvant therapy (~80%) across the nationwide patient population. Results: We found that 19.3% of adjuvant mastectomy patients were eligible for BCS based on Alliance Trial criteria. Of those, 68% had tumor CH:BV &amp;lt; 30% when using a 1 cm dilation around the tumor. When using a 2 cm dilation, 56% had tumor CH:BV &amp;lt; 30%. Together, these results indicate that of all adjuvant mastectomy patients, an estimated 10.8-13.1% are eligible for BCS based on volumetric measures of cosmetically acceptable breast tissue removal. Our economic analysis of BCS vs. mastectomy revealed an estimated $28,500 cost savings for patients with private insurance, suggesting that both decreased costs and improved quality-of-life (QOL) can be mutually aligned. By assessing the nationwide number of patients receiving adjuvant therapy for breast cancer, alongside the percentage potentially eligible for BCS using the above cosmetic defect analysis, we estimate that BCS conversion from mastectomy offers to provide a net savings of $300-350 million annually. Conclusion: The Alliance Trial guidelines unveiled the potential option of BCS in ~20% of patients with multi-focal disease in our cohort, demonstrating considerable cost-savings. Computational tools can further differentiate individuals who may not be best candidates for BCS in this setting, ensuring high QOL and informed decision-making. Citation Format: John Pfeiffer, Matthew Biancalana, Dorys Lopez-Ramos, Bradley Feiger, Anuja Antony. Applying the Alliance Trial Guidelines in Multi-focal Breast Disease Using an Artificial Intelligence Computational Platform: Economic Analysis and Cosmetic Sensitivity [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO2-07-04.

Punch biopsies in tattooed skin: Complications and patient‐reported outcomes

AbstractBackgroundDespite the popularity and usage of tattoos in modern society, various complications can occur such as allergic tattoo reactions, infections, tattoo removal complications and chronic granulomatous inflammatory tattoo reactions such as sarcoidosis. Histopathology of skin biopsies in tattoos is crucial in the diagnostic process of complications. As tattoos are frequently obtained for cosmetic reasons, cosmetic consequences of a skin biopsy in a tattoo are important. Remarkably, no studies have been performed regarding the consequences and expected outcome of taking a punch biopsy of tattooed skin.ObjectivesThe objective of this study is to report on the possible complications and patient‐reported cosmetic outcomes after punch biopsies in tattooed skin. Specifically, this study aims to assess the impact on appearance, symptoms and psychosocial burden of biopsies in tattooed skin, using the SCAR‐Q.MethodsPatients who underwent a punch biopsy of tattooed skin at the Tattoo Clinic in the Alrijne Hospital between 2021 and 2023 were included. To evaluate patient satisfaction of the biopsy scar the SCAR‐Q and a questionnaire regarding the recovery of the punch biopsy was used.ResultsThe final cohort consisted of 50 patients. Across all scales, the median scores on the SCAR‐Q questionnaire were consistent with the maximum score. Patients scored significantly better on the appearance scale when the biopsy was taken longer than 8 months ago. Two‐third of the patients reported no postbiopsy symptoms, with the remainder experiencing itch, pain or redness, which typically resolved within 10 days (88%). Remarkably, 42% of the patients reported the biopsy scar was not visible on the skin anymore. Scars on the lower extremities and trunk were significantly more frequently visible, as well as scars among patients aged 40 and above.ConclusionsThis study demonstrates that the cosmetic and psychological impact of punch biopsies in tattooed skin is minimal and the recovery is fast with minimal symptoms. For this reason, biopsies of tattooed skin should not be avoided in the diagnostic process.

Periorbital Rejuvenation: Artificial Intelligence Highlights the Importance of Brow Lift

Abstract Goals/Purpose Well described facial changes occur over time, which collectively result in an increased perceived age of an individual. These changes affect everything including the bony framework, facial fat pads, soft tissue, skin quality, and facial muscles. Aesthetic surgery provides an opportunity to reverse the appearance of facial aging. With the recent increase in mask utilization following the COVID-19 pandemic, an increased focus on the upper face and the impact of age-related changes in the periorbital region has been observed. Blepharoplasty and brow lifts aim to restore a youthful, rested, and attractive appearance by addressing the periorbital region. Blepharoplasty is a commonly performed procedure and has consistently ranked the third most common aesthetic procedure performed by plastic surgeons since 2018. However, following the pandemic we saw a 28% increase in blepharoplasties performed, now totaling 1.4 million in 2022. Over the same time period, the number of brow lifts performed has increased by 60%, now accounting for 352,324 surgeries performed in 2022. Despite this increase, recent surveys demonstrate that nearly 30% of plastic surgeons feel that neuromodulators have completely replaced operative brow lifting procedures. Additionally, a recently published study demonstrated that 62% of patients presenting for blepharoplasty have unfavorable preoperative brow aesthetics. However, only 36% of patients underwent brow lifts.Those with preoperative unfavorable brows who underwent a brow lift procedure were found to have significantly higher postoperative aesthetic scores than those who did not. Despite the increase in popularity of periorbital procedures, the literature continues to lack objective evaluation and outcome measurements related to perceived facial aging and the impact of individual procedures. The goal of this study is to quantify the impact of different periorbital rejuvenation surgeries on perceived age through the utilization of artificial intelligence (AI) in the form of convolutional neural network algorithms. Methods/Technique A retrospective review of patients who underwent periorbital rejuvenation surgery (upper blepharoplasty, lower blepharoplasty, and brow lift) at a single cosmetic practice between 2018-2023 was performed. Charts were reviewed for demographic information, periocular history, prior surgeries, surgical technique utilized, and complications/revisions. Exclusion criteria included: simultaneous procedures, incomplete patient records, poor quality or missing photographs, periocular medical conditions with cosmetic impact, and facial aesthetic procedures performed in the postoperative period. Pre and post operative frontal photographs of each patient were analyzed using four facial analysis AI platforms (Face++, Betaface, Facelytics, and Everypixel). Each platform generated an age estimate. A collective pre-op and post-op age estimation was then calculated for each patient by averaging the 4 platforms responses. To evaluate accuracy of the AI age estimation, a percent error was calculated by dividing the difference between the true age and estimated preoperative age by the true preoperative age. To account for natural aging between surgery and post-op photographs due to follow-up time, a corrective difference was calculated and subtracted from the mean postoperative estimated age. Statistical analysis included student’s t-test for univariate analysis and linear regression for multivariate analysis. All statistical analyses were performed on Stata version 14.0 (Stata Corporation, College Station, Texas, USA). Results/Complications A total of 153 patients were included for analysis, of which 120 underwent upper blepharoplasty, 66 underwent lower blepharoplasty, and 35 underwent a brow lift procedure. The study population consisted of 130 females and 23 males, 95% were Caucasian, and the average preoperative age was 58.1 (± 9.2 years). Post-operative photographs were taken at 3.8 months (± 5.4 months). Across all AI platforms, the mean age estimation percent error was 10%, with the tendency for AI to underestimate compared to true age. Univariate analysis revealed an overall age reduction following periorbital rejuvenation surgery of 1.03 years (p&amp;lt;0.001), with a standard error of 0.257. When controlling for all other procedures via linear regression, patients who underwent brow lifts demonstrated a statistically significant age reduction, with the mean AI perceived age reduction of 1.72 years (p=0.007). No significant age reduction was identified for patients undergoing lower blepharoplasty (regardless of technique), ptosis repair, or fat pad resection. Conclusion The results of this study highlight the rejuvenation power of a brow lift, with an average age reduction of nearly 2 years. In our patient population, brow lifting procedures conveyed the most age reduction of periorbital surgery. Recently published literature indicates that brow lifts are under performed and can serve as a potential avenue for further facial rejuvenation. Therefore, when planning periorbital rejuvenation, a thorough preoperative evaluation of brow position and shape should be performed and additional consideration should be given to operative brow lifting procedures.

Cosmetic and functional impact of fascia lata harvest for use in surgery for stress urinary incontinence.

There has been increased interest in using autologous tissues since the Food and Drug Administration banned transvaginal mesh for pelvic organ prolapse in 2019. Our study aims to assess patients' perspective of functional and cosmetic impact on the fascia lata harvest site in patients undergoing fascia lata harvest for the treatment of stress urinary incontinence (SUI). This is a prospective survey study of a retrospective cohort of patients who underwent a fascia lata pubovaginal sling between 2017 and 2022. Participants completed a survey regarding the functional and cosmetic outcomes of the harvest site. Seventy-two patients met the inclusion criteria. Twenty-nine patients completed the survey for a completion rate of 40.3%. For functional symptoms, 24.1% (7/29) of patients reported leg discomfort, 10.3% (3/29) reported leg weakness, 10.3% (3/29) reported a bulge, 17.2% (5/29) reported scar pain, 14.8% (4/27) reported scar numbness, and 17.2% (5/29) reported paresthesia at the scar. For cosmetic outcomes, 72.4% (21/29) reported an excellent or good scar appearance. On the PGI-I, 75.9% (22/29) reported their condition as very much better (48.3%, 14/29) or much better (27.6%, 8/29). The majority of patients reported being satisfied with the functional and cosmetic outcomes of their harvest site as well as satisfied with the improvement in their SUI. Less than 25% of patients report harvest site symptoms, including leg weakness, scar bulging, scar pain, scar numbness, or paresthesia in the scar. This is important in the context of appropriate preoperative discussion and counseling regarding fascia lata harvest.

Analyzing AI-Generated Packaging's Impact on Consumer Satisfaction With Three Types of Datasets

The study quantitatively examines how AI-generated cosmetic packaging design impact consumer satisfaction, offering strategies for database-driven development and design based on this evaluation. A comprehensive evaluation system consisting of 18 indicators in five dimensions was constructed by combining literature review and user interviews with expert opinions. On this basis, a questionnaire survey on AI-generated packaging design was conducted based on three types of datasets. In addition, importance-performance analysis was used to analyze the satisfaction of AI-generated packaging design indicators. The study found that while consumers are highly satisfied with the information transmission and creative attraction of AI-generated packaging design, the design's functional availability and user experience still have to be improved. It is suggested that the public model be combined into the data warehouse to build an AI packaging service platform. Focusing on the interpretability and controllability of the design process will also help increase consumer satisfaction and trust.

846 Bone Grafting as an Alternative Approach to Treating Severe Hypodontia in a Child

Abstract Background Severe hypodontia (developmental absence of teeth) can have significant functional and cosmetic impact, causing dietary restrictions, speech delay and bullying. Management in childhood is usually with removable dental prostheses, but retention and stability are often compromised by hypoplastic dento-alveolar bone ridges in the edentulous areas. Presenting problems A 3-year-old child was referred to Paediatric Dentistry with no erupted primary teeth. Radiographs revealed developmental absence of the entire primary dentition. Genetic investigation was negative for changes in genes known to be associated with hypodontia. In the permanent dentition only first molars were radiographically present. The child was struggling with bullying and self-confidence related to his dental appearance and speech. Investigations Plain films and cone beam computed tomography (CBCT) revealed agenesis of all canines and incisors in both jaws, an atrophic edentulous anterior maxilla, and soft tissue communication with the nasal fossa floor. Clinical management Despite provision of a retentive upper removable prosthesis was made impossible by a fleshy anterior maxillary ridge with severe atrophy of the dento-alveolar bone and inadequate sulcus depth. Multiple removable prostheses were fabricated, but retention and stability were poor. He was referred to maxillofacial surgery for excision of redundant fleshy tissue in the anterior maxilla and placement of corticocancellous block graft from the hip with Sonic Weld (KLS Martin) to augment and consolidate the ridge. A successfully retentive prosthesis was subsequently fabricated. Discussion This case presents an unusually invasive, but effective alternative approach to treating severe hypodontia in childhood, where hypoplastic dental ridge and sulcus depth can restrict treatment options.

Impact of Orthodontic Appliances on Hiring Prospects in Saudi Arabia: A Cross-Sectional Study.

This study provides valuable insights into the cosmetic impact of orthodontic appliances on job-hiring prospects in Saudi Arabia. Both ceramic braces and clear aligners are considered cosmetic corrective devices compared to traditional metallic braces. This survey-based, cross-sectional study used two models, one male, and one female. Four standardized smiling frontal photographs were taken for each model: one without any appliance and three with different orthodontic appliances (i.e., metal braces, ceramic braces, and clear aligners). The photographs of each model were shown to potential employers, followed by three questions for each photo to assess the employers' views on the applicants' professionalism, communication skills, and the likelihood of being hired. The survey was distributed via an electronic questionnaire to employers in Saudi Arabia, collecting feedback from 189 participants. The sample was collected from October 2022 to February 2023. The models' scores while wearing metal and ceramic bracket appliances were significantly lower than when the models were wearing clear aligners or were not wearing any appliance in each domain. In conclusion, orthodontic appliances have cosmetic implications that affect job-hiring prospects, with a higher chance of being hired if the candidate does not have an orthodontic appliance.

A grey case.

We present an unusual case of a 67-year-old woman who gradually noted blue–grey pigmentation developing in a photodistributed pattern. She felt well in herself and there were no systemic features. She had a history of hypertension, hypercholesterolaemia and absence seizures for which she took ramipril, atorvastatin, levetiracetam as well as alternative therapies for recurrent urinary tract infections.

Factors affecting hand cosmesis and the aesthetic impact of surgery on congenital hand differences in Finland.

We assessed the appearance and cosmetic impact of surgery in congenitally different hands in Finland. A questionnaire was sent to 1165 respondents (786 female) with a mean age of 33 years (range 3-84). Participants were shown nine image pairs and seven pairs of pre- and postoperative images twice in a random order and asked to choose the more cosmetically pleasing one. We found that the appearance and number of fingers had an important aesthetic role, with higher number and more normal appearing digits consistently scoring higher than its counterpart (range 59-99%). Postoperative appearances were perceived as better than preoperative ones in syndactyly (98%), thumb duplication (92%), cleft hand (93%) and radial dysplasia (99%). Toe transfer and pollicization had little impact on cosmesis. This study demonstrated that surgery could improve cosmesis in congenitally different hands and overall, most respondents prefer an appearance that is as close as possible to normality. Level of evidence: IV.

Human monkeypox outbreak: Epidemiological data and therapeutic potential of topical cidofovir in a prospective cohort study

Human monkeypox has become increasingly frequent worldwide since the outbreak was first reported in May 2022. As cidofovir is effective against vaccinia and other Orthopoxvirus diseases, we hypothesize that its topical use could be an effective treatment for monkeypox skin lesions, avoiding the adverse effects of systemic administration. We conducted a prospective study to collect data on the clinical and virologic course of patients with monkeypox. All patients were offered symptomatic treatment. They were also offered treatment with topical cidofovir on a compassionate use basis. Twelve patients received treatment with topical cidofovir 1%, while the others received only symptomatic treatment. Prospective visits were scheduled for the collection of clinical and virological data. Lesions cleared quicker in the cidofovir-treated group (hazard ratio, 4.572; P=.0039). The median time to resolution was 12 (11.5-15) and 18 (16-21) days, respectively. On day 14, polymerase chain reaction-positive skin lesions were detected in 10% of the cidofovir sample, compared with 62.5% of the non-treated group (P= .019). Local adverse effects were frequent (50%), especially in the anogenital region. No systemic adverse effects were reported. The study is not a clinical trial and lacks a placebo-controlled arm. Topical cidofovir is a potentially relevant therapy in patients with skin lesions but mild systemic involvement. Reducing time to resolution could shorten isolation time and improve the cosmetic impact in areas such as the face.

SH2 domain-containing protein tyrosine phosphatase-2 isenriched in eyelid specimens of rosacea.

Rosacea is a cutaneous disease that may secondarily affect the ocular surface. Due to the vision threatening, cosmetic, psychological, and work productivity impact, the identification of cellular targets that govern rosacea would enhance our understanding of the biology of the disease and delineate targets for therapeutic manipulation. To characterize the involvement of SH2 domain-containing protein tyrosine phosphatase-2 (SHP2) in the pathogenesis of rosacea. Specimens from elective ectropion surgery (n=20) were processed from patients with rosacea (n=10) and control patients (n=10). Immunohistochemistry (IHC) and quantitative western blotting (WB) were performed to identify and quantify the presence of SHP2 and 4G10 (a phosphotyrosine antibody) in rosacea compared to normal tissue. IHC samples were graded according to an intensity scale (0-4). Mann-Whitney statistical analyses were performed via a dedicated computerized software package. On WB, SHP2 was expressed in higher concentrations in rosacea specimens (p<0.05). On IHC, SHP2 was enriched in the epidermis in rosacea (p<0.05), although 4G10 levels were not statistically significantly different between the two groups (p>0.05). SHP2 is enriched in cutaneous specimens of rosacea, suggesting a critical role for this protein in the disease and indicating a modifiable therapeutic moiety.

COMPARING QUALITY OF LIFE IN BREAST CANCER PATIENTS AFTER MODIFIED RADICAL MASTECTOMY VERSUS BREAST-CONSERVING SURGERY AT GOVERNMENT CANCER HOSPITAL, AURANGABAD

Background: Breast Cancer is the most frequently seen cancer among women. Different types of surgeries for Breast cancer have a different impact on the quality of life of the patients. The aim of the study is to evaluate the cosmetic effect and impact of surgery type on quality of life in Breast cancer patients. Methods: 30 patients of Breast Conservative Surgery (BCS) and 30 patients of Modified Radical Mastectomy (MRM) aged between 25 to 85 years were included in this study. The complete demographic data, tumor characteristics and treatment modalities used were recorded. Validated Turkish version of EORTC QLQ 30 (Version 3) and EORTC QLQ BR45 questionnaires were used for all patients to assess the quality of life and Harvards scale was used for Breast cosmesis grading. Statistical analysis was done to compare BCS and MRM data which was collected Results: When identical parameters were compared in both arms of BCS and MRM taking into consideration the factors like general wellbeing, physical role, cognitive, sexual, psychological, social functions BCS has a favorable outcome on the quality of life of the Breast Cancer patients. The results are statistically significant as well. Conclusions:Quality of life of Breast cancer patients depends on type of surgery done. So in the decision making process, active patient participation is sought as per quality of life should be taken into consideration and treatment planning should be done accordingly.

OPTIMISING FUNCTIONAL OUTCOME IN SURGICAL RESECTION OF TONGUE BASE MALIGNANCIES USING LABIO-MANDIBULO-GLOSSOTOMY

AIM To highlight the advantages of median labiomandibulo glossotomy as a surgical approach for excision of tongue base malignancy. MATERIAL &amp; METHODS It is a case review of 5 cases with tongue base malignant tumours treated in a tertiary care centre. There were 3 female and 2 male patients in the age group of 18-50 years. Histopathology included muco-epidermoid carcinoma in 3 cases, squamous cell carcinoma in1 case and clear cell sarcoma in 1 case. Pre-operative assessment included endoscopic examination and MRI. Surgical excision was done via medianlabio-mandibuloglossotomy. Outcome was assessed in terms of oncologic adequacy and the functional impact. RESULTS Disease free resection margin could be achieved in all the 5 cases. Near normal functional recovery could be achieved within 2 weeks. 2 cases required speech therapy for few months. None of the patients developed recurrence during the follow up period. CONLUSION In selected cases of base of tongue malignant tumours, this approach provides complete disease clearance without any significant functional and cosmetic impact. KEYWORDS Labio-mandibuloglossotomy, oropharyngeal carcinoma, base of tongue malignancy, Chemoradiotherapy.

Intradermal Botulinum Toxin A Injection Versus Topical 2% Glycopyrrolate for the Treatment of Primary Facial Hyperhidrosis: A Pilot Study and Review of Literature.

Facial hyperhidrosis (HH), a common problem with both cosmetic and psychological impact, interferes with quality of life. Wide range of treatment options is available for HH. Finding the most effective and yet a safe, tolerable option is the main target. To evaluate and compare clinical efficacy, safety, and tolerability of topical 2% glycopyrrolate versus intradermal Botulinum toxin A injection in facial HH treatment. Twenty-four patients with primary facial HH were randomly divided into 2 equal groups: Group A included patients treated by intradermal Botulinum toxin A injection and Group B included patients treated by topical glycopyrrolate gel 2%. Starch iodine test was performed before and after treatment to assess response, along with Hyperhidrosis Disease Severity Scale, Dermatology Life Quality Index (DLQI), and patient satisfaction. Both modalities showed complete response in 75% of cases with a longer duration of action in botulinum toxin group up to 6 months. Side effects were minor and temporary. Both Hyperhidrosis Disease Severity Scale and DLQI showed statistically significant improvement after treatment. Topical glycopyrrolate 2% showed comparable results to Botulinum toxin A in facial HH treatment with faster onset but shorter duration of action.

Efficacy of autologous platelet-rich plasma in the treatment of vitiligo: A 10-patient prospective study.

Vitiligo is an autoimmune disorder characterized by loss of epidermal melanocytes. It has cosmetic and psychosocial impact. The objective of this paper is to evaluate the interest of platelet-rich-plasma in the treatment of vitiligo. We conducted a prospective study between January 2019 and September 2021. Our descriptive study included 10 patients followed-up for vitiligo refractory to conventional therapies. The mean age was 36.2 years. Sex ratio was 0.25. Prior to platelet-rich-plasma treatment, vitiligo was stable in all cases. The mean number of platelet-rich-plasma sessions received by our patients was 2.6 (1-6). A visible improvement of lesions was obtained after a mean of 1.5 sessions. 40% of patients had obtained repigmentation of more than 50% for at least one lesion. An improvement of more than 75% (grade 4) was noted in 2 cases after a mean duration of 5.5 sessions. 40% of patients had obtained repigmentation of more than 50% for at least one lesion. A percentage of improvement between 50 and 74% (grade 3) was obtained for 2 patients. Four patients had an improvement of less than 25% (grade 1) after a mean of 1.75 sessions. There was no recurrence of depigmentation after a mean follow-up of 6 months (1 to 24 months). Our series proves the benefit of platelet-rich-plasma in the treatment of vitiligo. It is a safe and promising option for stable lesions in different body sites with few side effects.

Follow-up for a Preterm Infant with Beckwith-Wiedemann Syndrome.

Follow-up for a Preterm Infant with Beckwith-Wiedemann Syndrome.

Improving Nasal Symmetry with Alar Composite Graft: Technique and Outcome Assessments in Cleft Patient

PurposeResidual cleft nasal deformities after initial cleft repair can have long-term cosmetic and psychological impact on patients. The authors describe a novel technique of an alar composite graft for patients with cleft lip and/or palate and assess the surgical outcomes with respect to symmetry of individual anatomical components. Materials and methodsThis was a retrospective study of patients with a history of cleft lip/palate who underwent rhinoplasty with alar composite graft placement by the senior author from March 2014 to January 2021. Patients who had high-quality pre-operative and postoperative 3D imaging were included. Patient age, sex, surgical history, cleft side, cleft details, and operative details were recorded. The primary operative technique includes the following: 1) Weir and sill excision at the donor side, 2) composite graft harvest, 3) Weir and sill incision at the recipient side, 4) graft placement, 5) closure of the incision sites. Three-dimensional imaging was obtained pre-operatively and postoperatively using Vectra M3 3D Imaging (Canfield Imaging System, Fairfield, NJ). Linear and surface area measurements were made on donor and recipient sides. The difference in measurements was calculated to analyze the degree of similarity across sides, and this difference was compared pre-operatively to postoperatively.1,2 Symmetry of the patient's nostrils and overall nasal symmetry was compared pre-operatively and postoperatively using root-mean-square deviation (RMSD), with smaller values indicating more symmetry. Differences between preoperative and postoperative measurements were calculated with a paired T-test. ResultsOut of 10 patients undergoing the surgery, 8 were able to be included in this study. On lateral view, the donor and recipient sides were more similar postoperatively compared to pre-operatively with respect to lateral alar-columellar disproportion (1.040 versus 3.324, P = .005) and nostril area (0.466 versus 1.065, P = .001) . On basal view, postoperative results showed more similar measurements comparing the donor and recipient sides in nostril height (1.461 versus 3.542, P = .012), nostril width (0.956 versus 2.222, P = .033), nasal dome height (1.597 versus 3.822, P = .024), and nostril surface area (0.188 versus 0.531, P = .015). On symmetry analysis, the overall external nose was more symmetrical after placement of the alar composite graft (1.094 vs 1.772, P = .015). ConclusionCleft lip and palate can cause significant asymmetry related to the nostrils, ala, and overall appearance of the nose. The alar composite graft is a useful technique to improve symmetry over a wide range of dimensions on lateral, basal, and frontal views.