Cosmetic Plastic Surgery Research Articles

Patient-Reported Outcomes after Subpectoral Breast Augmentation with Microtextured or Macrotextured Implants Using the BREAST-Q.

Background Breast augmentation with implants is the most commonly performed cosmetic plastic surgery in Brazil and worldwide. The aim of this study was to assess patient satisfaction and quality of life following subpectoral breast augmentation with either microtextured or macrotextured implants, using the BREAST-Q. Methods A prospective study was conducted with 40 women with hypomastia undergoing subpectoral breast augmentation. The patients were randomly allocated to two groups to receive either microtextured or macrotextured breast implants. All participants were assessed preoperatively (baseline) and after 2 and 4 months of surgery for quality of life and patient satisfaction with the surgical results, using the BREAST-Q augmentation module, a patient-reported outcome measure. Results The patients had a mean age of 28.9 ± 6.45 years. The microtextured ( n = 20) and macrotextured ( n = 20) groups were homogeneous for sex, age, education level, marital status, and number of children ( p > 0.05). Both groups showed significant improvement in satisfaction with breasts ( p < 0.001), psychosocial well-being ( p < 0.001), and sexual well-being ( p < 0.001) at the 2- and 4-month follow-up visits compared with baseline. The observed improvements were associated with high effect size values of 5.09, 3.44, and 3.90, respectively. In contrast, significant decreases from baseline in physical well-being scores ( p = 0.001) were found 2 and 4 weeks after surgery in both groups. Conclusion Subpectoral breast augmentation with either microtextured or macrotextured breast implants improved satisfaction with breasts and quality of life in patients with hypomastia.

A Study on the Establishment of Objective Standards Value for Physiognomy and Cosmetic Plastic Surgery: For Your Eyes and Eyebrows

Purpose: This study aims to reduce the failure rate due to excessive surgery (procedure) by consumers who want to satisfy their appearance through cosmetic plastic surgery. Most plastic surgery consumers want to know their face (especially their eyes and eyebrows) in advance to achieve results that look physiognomically good ahead of procedures or surgery. Until now, however, the characteristics of each part cannot be objectively converted into data. Therefore, we intend to develop a system so that the specific part of the face to be identified can be examined before surgery (procedure). The system allows you to immediately grasp the current physiognomic results and appearance status while automatically recording feature points in coordinates when you show your face on the screen of a mobile device. Again, the purpose of this study is to prevent wrong judgment and failure in performing surgery (procedure) through the development of such a system. Method: First, the name of each part of the feature points constituting the eyes and eyebrows was designated as a point on the coordinate plane. Second, the six types of eyes and eyebrows were first defined by equation. By substituting the input coordi-nates into this equation, a criterion for determining what shape the user s eyebrows fit was presented. In addition, it is possible to determine what shape the user s eyes are according to the coordinates of the eyes. Third, by substituting the coordinates of the eyes and eyebrows, the length and position of the eyes were com-pared with the position of the eyebrows to determine the image state of the physiognomy and cosmetic plastic surgery, and to what extent it is allowed in surgery (procedure) was suggested. Results: Since eyes and eyebrows are the most important parts of one s physiognomy (appearance), a method for setting standards that allow immediate judgment of each shape was suggested. The equation was defined according to the shape of the eyes and eyebrows, and when the coordinates were input, it was possible to deter-mine which shape they were, so that good results could be derived. Conclusion: In physiognomy, the color of the pupils and the degree of clarity of the eyes are important. Eyes can be said to be windows to the mind, and they are important parts of judging one s personality and character because they convey thoughts. Eyebrows, along with the eyes, are in an important position to determine large parts of physiognomy and beauty. There are times when you have to decide on surgery for better physiognomy and appearance, but it takes time and effort to learn the correlation between your eyes and eyebrows professionally. Therefore, if you have a tool to analyze it when you do not have knowledge on physiognomy (appearance), you can expect much more efficient results. Based on this paper, it is believed that it will be possible to establish a system that presents the direction or limitations of physiognomy (appearance) and surgery (procedure) because the user s appearance image status can be immediately known by reflecting eyes and eyebrows on the screen of devices.

Beauty Plastic Surgery Coordinate Protection System using Face Recognition Program

Purpose: The purpose of this study is to increase the satisfaction of customers who want good physiognomy and appearance by creating a system that allows cosmetic plastic surgery professionals to automatically see the faces on screens such as those of mobile devices. Method: First, the name of each part of the face as a point on the coordinate plane. Second, the beauty plastic elements were first defined as math formulas, and criteria for determining beauty plastic images were prepared according to the calculation results of inputting information-protected coordinate values into the math formulas. Third, a method of outputting beauty plastic judgments when the math formulas in which the coordinates of feature points are input satisfies a given condition was presented. Results: Since philtrum is an important part of physiognomy and plastic surgery, a method of determining cri-teria related to philtrum was suggested. In addition, since the jawline shows a person s ability in terms of physi-ognomy, the ratio of the jawline was defined to present the criteria for an angled jawline. Conclusion: Experts in the service industry, such as physiognomy and cosmetic surgery, are habitually considering ways to analyze facial shapes and create better images according to customer needs. Since it takes time and effort to learn physiognomy professionally, if you have a tool to analyze physiognomy when you do not have knowledge of physiognomy, you can expect much more efficient results. Based on the effect of this paper, when the face appears on the screen, the customer s personality and image will react immediately, enabling the establishment of a system that suggests the direction of procedures for makeup, plastic surgery, and tattoos.

미용성형 의료기관의 고객만족이 재이용에 미치는 영향: 대안매력도의 조절효과를 중심으로-의료관광을 위한 기초적 연구

Amid changes and competition in the medical market, medical institutions have also pursued diversity and specificity. Through these changes, it was recognized that customer satisfaction is a very important factor in the development of medical institutions. Recognizing the importance of customer satisfaction, this study identifies the relationship between customer satisfaction and re-visit and reveals the moderating effect of alternative attractiveness on these relationships. The results of these studies were presented as follows: First, customer satisfaction had an effect on re-visit. Second, the alternative attractiveness had a moderating effect in the relationship between customer satisfaction and re-visit. As in previous studies, it can be seen that customer satisfaction is a very important factor for re-visit. The results of this study can provide practical implications for future service improvement and re-visit of cosmetic plastic surgery hospitals.

Plastic Surgery: Review on Screening of Psychiatric Disorder

Recently the popularity of plastic surgical procedure has been increased. Many people surgically alter their physical appearance with the intent of boosting their social and psychological well-being; however, the long-term effectiveness of aesthetic surgery on improving well-being is unconfirmed. To have successful cosmetic plastic surgery result, it is imperative to assess candidates for predictors of poor outcomes. These include the following factor: psychiatric disorder, demographic factors (male and younger age), relationship issues, unrealistic expectations, previous dissatisfied surgery, and minimal deformity. For psychiatric patients, despite having technically satisfactory cosmetic surgery, poor emotional adjustment and social functioning were seen post procedure. Proper screening and evaluation of these patients could save money and resources. In this brief review we discuss about psychiatric disorder screen on plastic surgery to prevent unwanted outcome. A literature review was conducted in the electronic database PubMed using keyword “Psychiatric Disorder”, “Plastic surgery”, “Prevention” and “Screening”. All type of studies were included for this study, such as controlled trials, systematic reviews, literature reviews, and pilot studies published between 2011 and 2021. Articles which not written in English were excluded from the study. This search resulted in 18 papers. Some patient who undergo cosmetic surgery suffer from underdiagnosed or untreated psychiatric disorder. To avoid unnecessary expense and resource it is advisable that all patient who seek cosmetic procedure undergo psychiatric screen such as PHQ-9, GAD-7, BDDQ and other test to avoid un-necessary expense and resource.

Under the knife: Unfavorable perceptions of women who seek plastic surgery.

Plastic surgery is growing in popularity. Despite this, there has been little exploration to date regarding the psychosocial consequences of seeking plastic surgery. Our study investigated how women seeking plastic surgery are perceived by others. We presented a random sample of 985 adults (men = 54%, Mage = 35.84 years, SDage = 10.59) recruited via Amazon's Mechanical Turk with a series of experimental stimuli consisting of a photographed woman (attractive versus unattractive) and a vignette describing an activity she plans to engage in (plastic surgery versus control activity). Participants rated stimuli on perceived warmth, competence, morality, and humanness. We ran linear mixed-effect models to assess all study hypotheses. There was a negative plastic surgery effect; that is, women seeking plastic surgery were perceived less favorably than those planning to complete control activities across all outcome variables (warmth, competence, morality, and humanness). These relationships were moderated by physical attractiveness; while attractive women planning to undergo plastic surgery were perceived less favorably than attractive women planning to engage in control activities, perceptions of unattractive individuals remained unchanged by plastic surgery status. We theorized that empathy toward unattractive women seeking plastic surgery mitigated the negative plastic surgery effect for these women. In sum, our results suggest that perceptions of attractive women are worsened when these women decide to seek cosmetic surgery. Perceptions of warmth and competence have implications for an individual's self-esteem and interpersonal relationships, while perceptions of morality and humanness can impact an individual's ability to fulfil their psychological needs. As such, we concluded that attractive women seeking plastic surgery are potentially subject to experience negative psychosocial outcomes. Future research ought to examine whether perceptions and outcomes differ for women seeking reconstructive plastic surgery (versus cosmetic plastic surgery) and whether they differ across different types of surgeries (i.e. face versus body).

The Social Comparison Theory in the Context of Cosmetic Plastic Surgery Advertising: Predictors and Consequences of their Impact on Women

The Social Comparison Theory in the Context of Cosmetic Plastic Surgery Advertising: Predictors and Consequences of their Impact on Women

Plastic Surgery: Review on Screening of Psychiatric Disorder

Recently the popularity of plastic surgical procedure has been increased. Many people surgically alter their physical appearance with the intent of boosting their social and psychological well-being; however, the long-term effectiveness of aesthetic surgery on improving well-being is unconfirmed. To have successful cosmetic plastic surgery result, it is imperative to assess candidates for predictors of poor outcomes. These include the following factor : psychiatric disorder, demographic factors (male and younger age), relationship issues, unrealistic expectations, previous dissatisfied surgery, and minimal deformity. For psychiatric patients, despite having technically satisfactory cosmetic surgery, poor emotional adjustment and social functioning were seen post procedure. Proper screening and evaluation of these patients could save money and resources. In this brief review we discuss about psychiatric disorder screen on plastic surgery to prevent unwanted outcome. A literature review was conducted in the electronic database PubMed using keyword “Psychiatric Disorder”, “Plastic surgery”, “Prevention” and “Screening”. All type of studies were included for this study, such as controlled trials, systematic reviews, literature reviews, and pilot studies published between 2011 and 2021. Articles which not written in English were excluded from the study. This search resulted in 18 papers. Some patient who undergo cosmetic surgery suffer from underdiagnosed or untreated psychiatric disorder. To avoid unnecessary expense and resource it is advisable that all patient who seek cosmetic procedure undergo psychiatric screen such as PHQ-9, GAD-7, BDDQ and other test to avoid un-necessary expense and resource.

The Effect of Extended SMAS Face-lift on Earlobe Ptosis and Pseudoptosis

In this study, we explore the changes in the earlobe segments following an extended superficial musculoaponeurotic system (SMAS) face-lift and neck lift. We proposed to delineate the effect of the cheek and neck skin tension vectors on the earlobe based on the amount of excised skin length. A retrospective study identified patients who underwent extended SMAS rhytidectomy performed by the senior author (A.M.) at the Cosmetic Plastic Surgery Institute (CPSI) from 2017 to 2020. A total of 34 North American Caucasians, who had preoperative and postoperative photographs available for comparison, were evaluated. Preoperative and postoperative cephalic (the distance from the intertragal notch to the otobasion inferius, abbreviated as I to O) and caudal earlobe segment (the distance from the otobasion inferius to the subaurale, abbreviated as O to S) heights were collected. The change from the postoperative to preoperative measurements was calculated. The effects of the degree of cheek skin (superior ear [SE]) and neck skin (mastoid peak [MP]) excision lengths were then determined by comparing the change in I to O and O to S. The postoperative attached cephalic segment (15.94 ± 1.02 mm) increased significantly compared with the preoperative attached cephalic segment (12.99 ± 1.03 mm). The postoperative free caudal segment (3.62 ± 0.81 mm) decreased significantly compared with the preoperative free caudal segment (5.44 ± 0.95 mm). The SE median was found to be 3.0 cm and the MP median was found to be 3.5 cm. I to O increased by 3.85 mm for SE ≤3.0 cm compared with only 1.57 mm for SE &gt;3.0 cm. O to S decreased by 2.79 mm for SE ≤3.0 cm compared with only decrease of 0.14 mm for SE &gt;3.0 cm. I to O increased by only 1.67 mm for MP &lt; 3.5 cm. O to S decreased less dramatically by 0.55 mm for MP ≤3.5 cm compared with decrease of 2.39 mm for MP &gt;3.5 cm. These data demonstrate that more aggressive SE &gt;3.0 cm cheek excision lengths resulted in a protective effect on decreasing the free caudal segment of the earlobe. More aggressive excisions of the cheek demonstrate a protective effect on preserving the free earlobe caudal segment, whereas more aggressive neck skin excisions result in higher propensity for loss of the free earlobe caudal segment. In our study, we demonstrate findings observed with clinical observations that a face-lift and neck lift will result in increase in the attached cephalic earlobe segment height (I to O) and a decrease in caudal free earlobe segment height (O to S). These findings may assist plastic surgeons when trying to fine-tune the earlobe aesthetics during face-lift and neck lift. If the patient has a small free hanging earlobe, the more aggressive pull on the cheek flap will result in less reduction in the earlobe hang.

Contemporary Fiqh Study: South Korea as a Country of Appearance-Oriented Views (외모 지상 주의) on Trend of Cosmetic Plastic Surgery

This research attempted to find out the view of Islamic law in modern fiqh studies on plastic surgery and Appearance oriented views (Lookism) in South Korea. The use of juridical empirical method, or also known as sociological research, aimed to provide an overview of the implementation of plastic surgery in society based on applicable law by analyzing problems in society through secondary data.According to the data from the International Society of Aesthetic Plastic Surgery (ISAPS) in 2019, South Korea was in fifth position as a country that is estimated to carry out the most plastic surgery procedures in the world, 2,571 times (5.1%). This shows that this country has an Appearance-oriented view (Lookism) which is part of the Lookism culture. According to Bio Med Central 2017 data, there was a high ratio of recurrent discrimination rates (OR: 3.70; 95% CI: 2.19-6.27) and ‘incident’ (OR: 3.10; 95% CI: 2.99-4.83) from 2005 to 2013 against individuals in the age group of 15-24 years.

BREAST RECONSTRUCTION AFTER MASTECTOMY FOR BREAST TUMOR : ABOUT 24 CASES

The mutilating surgery for breast cancer causes deep somatic and psychological sequelae. Breast reconstruction can mitigate these effects and permit the patient to help rebuild their lives. Our work is a retrospective study over 7 years, from 1st January 2012 to 31st December 2019, covering 24 cases of reconstruction breast collected in the department of cosmetic and reconstructive plastic surgery of ERRAZI hospital in Marrakech.This work presents through these first operated cases, the results obtained as well as an illustrated panorama of the different surgical methods used in the service during the different surgical times.It also Conducts a review of the literature, discussing our findings and reviewing the techniques currently used in the various centers for breast reconstruction. Breast reconstruction is today one of the most successful plastic surgery, however a few women use it, often because of lack of information. Every day, the surgical teams demonstrate an increasingly technical skill, in their constant search for perfection. It is clear that it is at the level of information that efforts should be intensified.

“Mirror, mirror on the wall … ”: A person-centred approach to appearance distress

ABSTRACT Overemphasis on appearance and strong appearance stereotypes to date are expected to contribute to the challenges and distress of people who live with skin conditions and those with appearance distress. Skin conditions are highly prevalent and are often associated with high levels of distress and disruption in the life and well-being of patients. On the other hand, demand for cosmetic procedures and elective plastic surgery has been increasing. Psychological interventions in the field of skin and appearance rarely feature person centred approaches. We intend to fill this gap by: Juxtaposing symptom-based and person centred conceptualisations; Presenting person centred ways of working therapeutically of skin and appearance related concerns and Discussing potential challenges in application of the approach in this field.

Does Surgeon Gender Matter for Aesthetic Patients?

Plastic surgery patients have expectations for an ideal practice to visit. However, patients' preferences regarding their plastic surgeon are still being described. The aim of this study was to investigate if elective cosmetic plastic surgery patients exhibit gender preference in their plastic surgeon when making online inquiries. A retrospective, single-practice review of all online inquiries for elective plastic surgery and nonsurgical injectable treatment from June 2019 to June 2020 was performed. The study was based on a private practice located in Houston, TX. The practice surgeons were a married couple, 1 female and 1 male, with identical training, age, and post-residency experience. Patients submitted an online inquiry for their procedure of interest and surgeon preference via the practice website. The private practice received 873 online inquiries during the year-long study period. The majority of patients were female, 855 (97.9%), and the remaining 18 (2.1%) were male. Of the female patients, 476 (55.7%) preferred a female surgeon and 138 (16.1%) preferred a male surgeon; 241 (28.2%) female patients expressed no surgeon preference. Regardless of surgeon preference, the majority of procedures inquired about were breast and body contouring. This cohort of female patients prefers the female surgeon for breast procedures or multiple procedures involving the breast, and the male surgeon for injectable procedures and facial procedures. There is no preference for the male or female surgeon for body procedures. Female plastic surgery patients may be influenced by surgeon gender in choosing their surgeon, depending on their surgery of interest.

Women in Cosmetic Plastic Surgery: An Analysis of Female Authorship in Cosmetic Plastic Surgery Over the Last 10 Years

There is a significant gender gap in research conducted by women in plastic surgery. Previous work has not explored female authorship trends in cosmetic plastic surgery. We asked how authorship trends in cosmetic plastic surgery compare with those in plastic surgery overall, over the last 10 years. All the articles published in Journal of Plastic Reconstructive and Aesthetic Surgery (JPRAS), Facial Plastic Surgery and Aesthetic Medicine (JAMA facial plastics), and Aesthetic Surgery Journal. (ASJ) in 2009, 2014, and 2019 were retrieved. The gender of the first and last author was determined. In addition, article type and total number of authors were extracted. Chi-square or Fisher exact test were performed to determine differences between groups Linear regression models were used to investigate whether total number of authors, or female last authorship predicted female first authorship. A total of 4358 articles were reviewed. Of these, 16.6% (n = 723) were published by a female first and/or last author. Percent of female first and/or last author increased with time, from only 12.2% in 2008, to 15.9% in 2014, reaching 21.7% in 2019. A total of 25% (n = 181) of randomized controlled trials were published by a female first and/or last author compared with only 14% (n = 440) of case studies. Female first and last authorship both increased across the 10-year study period, but there were consistently more female first authors than female last authors in all 3 surveyed years ( P &lt; .001). There was an 86% increased chance of female first authorship if the last author was also female ( P &lt; .001), and a 7% increased likelihood of female first authorship ( P = .002). Women have a lower representation in the cosmetic plastic surgery literature than men. This gender disparity gap, however, is decreasing. While encouraging, opportunities for improvement remain.

Pulmonary thromboembolism due to superficial venous thrombophlebitis in upper limbs after cosmetic breast plastic surgery: report of 3 cases

Pulmonary thromboembolism due to superficial venous thrombophlebitis in upper limbs after cosmetic breast plastic surgery: report of 3 cases

What is the role of COVID-19 IgM/IgG rapid diagnostic tests in the preoperative cosmetic plastic surgery period?

What is the role of COVID-19 IgM/IgG rapid diagnostic tests in the preoperative cosmetic plastic surgery period?

Ultrasound-guided regional anesthesia in cosmetic plastic surgeries of the breasts

Ultrasound-guided regional anesthesia in cosmetic plastic surgeries of the breasts

What is the role of rapid diagnostic tests for COVID-19 IgM/IgG in the pre-operative period of cosmetic plastic surgery?

A Revista Brasileira de Cirurgia Plástica é o órgão oficial de divulgação da Sociedade Brasileira de Cirurgia Plástica (SBCP), tem como objetivo registrar a produção científica em Cirurgia Plástica, fomentar o estudo, aperfeiçoamento e atualização dos profissionais da especialidade.

Research on Understanding and Actual Situation of Chinese Adult Women age of 20-40 on Cosmetic Plastic Surgery

ëª©ì  ë¯¸ìš©ì„±í˜•ìˆ˜ìˆ ì´ 보편화 되어 ê°€ê³ ìžˆì§€ë§Œ 부작용이 심각한 것으로 나타났다. 본 연구는 외모 ê´€ë ¨ 요인, 성형 ìˆ˜ìˆ ì— 대한 관심이 많은 성인 여성대상으로 외모의 만족도를 ì•Œì•„ë³´ê³ ë¯¸ìš©ì„±í˜•ì— 대한 인식과 경험실태를 조사하여 그에 따른 만족도와 부작용을 íŒŒì• í•˜ê³ ìž 한다. 방법 중국 20-40세 성인여성 대상으로 설문조사를 실시 하였다. 조사기간은 2019ë „ 10월16일부터 2019ë „ 10월 31일 까지 í•˜ì˜€ê³ ìžë£Œ 분석은 카이 ì œê³± ê²€ì •ê³¼ SPSS 프로그램을 이용하여 빈도 및 백분율 분석을 진행하였다. ê²°ê³¼ 첫째, 외모 만족도와 ì™¸ëª¨ê´€ë ¨ 특성에 따른 외모 ìŠ¤íŠ¸ë ˆìŠ¤ 해결 방법에서는 ìœ ì˜í•œ 차이가 없지만 화장을 통해서 해결한다가 가장 ë§Žì•˜ê³ ê·¸ 다음 성형을 ì„ íƒ 했다. 둘째, 미용성형 ìˆ˜ìˆ ì‹œ 코 ì„±í˜•ìˆ˜ìˆ ì´ 외모변화에 가장 큰 영향을 ë¯¸ì¹œë‹¤ê³ ì¸ì‹í•˜ëŠ” 여성이 21.3%로 가장 많았으며, 다음으로 눈 ì„±í˜•ìˆ˜ìˆ 19%, ìž ìˆ ìˆ˜ìˆ 15.7%, 체형 13.5 %, 얼굴윤곽 ìˆ˜ìˆ 11.9%, 피부 관리 9.6%, 두피, 모발이식 9% 순으로 나타났다. ì—°ë ¹ë³„ë¡œëŠ” 20대 여성이 다른 여성보다 미용성형 ìˆ˜ìˆ ì‹œ 눈 성형 ìˆ˜ìˆ ê³¼ 얼굴윤곽 ìˆ˜ìˆ ì´ 외모변화에 많은 영향을 ë¯¸ì¹œë‹¤ê³ ì¸ì‹í•˜ì˜€ê³ , 30대 여성은 체형관리는 외모변화에 많은 영향을 ë¯¸ì¹œë‹¤ê³ ì¸ì‹í•˜ì˜€ìœ¼ë©°, 40대 여성은 ìž ìˆ ìˆ˜ìˆ ì´ 외모변화에 많은 영향을 ë¯¸ì¹œë‹¤ê³ ì¸ì‹í•˜ì˜€ë‹¤. ì ‹ì§¸, ì—°ë ¹ë³„ë¡œëŠ” 20대 여성이 다른 여성보다 미용성형 ìˆ˜ìˆ ë” 많이 ë°›ì•˜ê³ , ì—°ë ¹ì´ 많은 여성일수록 2회 이상 받았으며, ì—°ë ¹ì— 따라 ìœ ì˜ë¯¸í•œ 차이를 보였다. ê²°ë¡ ì¤‘êµ­ì—ì„œ 외모 ìŠ¤íŠ¸ë ˆìŠ¤ 해결 방법을 화장을 한다는 사람이 가장 ë§Žê³ ê·¸ 다음에 병원에서 미용성형을 이며, ì—°ë ¹ë³„ë¡œ 미용성형 요구도가 다르게 나타났다. 가장 중요한 요소는 ' 의료진의 ì „ë¬¸ì„±ê³¼ ì‹ ë¢°ì„±'ìž ë‹ˆë‹¤. 대부분의 여성들이 미용성형 후에 부작용을 경험한 ì ì´ 있었으며, ì—°ë ¹ì´ 많은 여성일수록, 미용성형을 많이 한 여성일수록 미용성형 ìˆ˜ìˆ í›„ 부작용 경험한 ì ì´ 많았다. 핵심용어: 중국 여성, 미용성형, 외모만족, 외모변화, 외모관심도

Efficacy of Topical Tranexamic Acid (Cyclokapron) in "Wet" Field Infiltration with Dilute Local Anaesthetic Solutions in Plastic Surgery.

Surgical bleeding may lead to the need for blood transfusion and minimizing blood loss has been a basic principle followed by surgeons for generations. Antifibrinolytic agents are widely used to reduce perioperative haemorrhage. The present study sought to assess the efficacy of directly infiltrated tranexamic acid in ameliorating bruising in participants undergoing cosmetic plastic surgery (liposuction). The study employed a blinded, prospective, randomized, case control design. Thirty-three patients were studied. Tranexamic acid free infiltration tumescent solution (saline, bupivacaine lignocaine and adrenalin) was infiltrated to one flank of patients undergoing liposuction of flanks. The other flank was infiltrated with the same tumescent solution (saline, bupivacaine lignocaine and adrenalin) mixed with tranexamic acid (0.1%). Bruises were photographed one and seven days after surgery and measured for size. The surface area of the bruises was calculated using ImageJ software. We compared the bruised surface are between the tranexamic acid infiltrated flank and non-tranexamic acid infiltrated flank in the same patient. The model employed involved measuring the bruises on each flank of the same patient, with surgery by a single surgeon using the same infiltration and surgical techniques for both sides. The only variable was the difference in tranexamic acid concentration between study and control flanks. We found that use of tranexamic acid consistently resulted in a smaller bruise area on days one and seven after liposuction of flanks. Results were statistically significant. This is the first study examining addition of tranexamic acid to a tumescent infiltration solution-to produce a predictable local concentration of tranexamic acid-in order to maximize surgical site effect and minimize systemic effect. The authors recommend incorporation of tranexamic acid as a routine component along with adrenaline and local anaesthetics in tumescent field infiltration solution 10-15min before commencement of the cosmetic surgery. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .