Plastic Surgery Hospital Research Articles

Evaluation of respiratory system anomalies associated with microtia in a Chinese specialty clinic population

BackgroundMicrotia is a congenital malformation of the external ear often with one or more associated congenital anomalies. The purpose of this study was to identify the characteristics and prevalence of respiratory anomalies in patients with microtia, and clarify the importance of this association in the perioperative period of patients’ external ear reconstruction surgery. MethodsData were collected from 923 microtia patients between August 2017 and December 2020 in the Department of Auricular Reconstruction at the Plastic Surgery Hospital of Peking Union Medical College. Co-occurring respiratory anomalies were detected using chest computed tomography plus three-dimensional reconstruction and Chest X-ray. Physical examination was performed to assess the severity and type of microtia by trained clinicians. Fisher's exact test was used to analyze the relation between laterality of pulmonary underdevelopment and microtia type. ResultsAmong the 923 participants enrolled in the study, we identified 21 cases (2.3%) having respiratory system anomalies, consisting of 6 cases with pulmonary underdevelopment (28.6% of all anomalies of respiratory system detected), 2 cases with tracheal bronchus (9.5%), 1 case with tracheal diverticula (4.8%), 11 cases with lung bullae(52.4%), and 1 case with pulmonary azygos lobe (4.8%). The laterality of pulmonary underdevelopment was related to the type of microtia (difference between types, p < 0.05), as patients with concha-type remnant ear had pulmonary underdevelopment ipsilaterally. ConclusionsThis study represents the first detailed and thematic study of a association featured by microtia and respiratory anomalies. Characteristics and prevalence of respiratory anomalies was observed in a Chinese clinical microtia population. Early diagnosis of associated respiratory malformations had practical clinical significance for microtia patients, plastic surgeons and anesthesiologists. Future studies are required to improve understanding of this association and its cause.

Early tangential excision with guidance of gentian violate application

Background: Uses of gentian violet as a marker to determine burn depth, to facilitate early tangential excision.Patient and Method: A prospective study conducted on eighteen burned patients, they were admitted to Burns and Plastic Surgery Hospital in Sulaimani, with deep second and third degree burn, and they underwent early tangential excision with the guidance of gentian violet and grafting. Incisional biopsy was taken from two patients and sent for histopathology, they resulted in staining of dead tissues and preservation of normal tissues.Results: The mean age of the patients was (23.25) years. (77.7%) were with flame burn and (22.3%) were with scald burn. With the use of our method (55.5%) of patients needed one session and (44.5%) of patients needed more than one session of excision and grafting. The mean of excised and grafted area was (9.97%) TBSA. (77.7%) of patients with good graft take (90-100%), (16.6%) of patients with moderate graft take (50-89%), (5.5%) of patients with poor graft take (

Application of the FACE-Q rhinoplasty module in a mixed reconstructive and corrective rhinoplasty population in Finland

The FACE-Q Rhinoplasty module is a patient-reported outcome instrument developed for the assessment of primarily aesthetic outcomes of rhinoplasty. The aim of our study was to produce a Finnish version of the instrument and validate it for use in patients undergoing nasal reconstruction as well as those treated with a rhinoplasty. Finnish versions of the FACE-Q scales Satisfaction with Nose, Satisfaction with Nostrils and Adverse Effects: Nose, were translated following established guidelines. Patients undergoing nasal resection, reconstruction or rhinoplasty in Helsinki University Hospital plastic surgery department in 2009–2019 were identified using theatre records. A total of 240 Finnish-speaking patients 18–85 years old were approached with a postal survey questionnaire. The questionnaire included the translated FACE-Q modules and those for Satisfaction with Facial Appearance, Appearance-Related Psychosocial Distress and Satisfaction with Outcome, as well as the general health-related quality of life instrument 15 D. The FACE-Q scales translated readily to Finnish. Eighty-three patients (35%) responded to the survey. Most FACE-Q scales performed well with high internal consistency (Cronbach’s alphas 0.87–0.92) and repeatability. Only the Adverse Effects: Nose scale displayed poor consistency and a floor effect with 18% of the patients reporting no adverse outcomes. Answers to the Appearance-Related Psychosocial Distress scale were skewed towards no experienced stress. Answers to the other scales were normally distributed with weak correlation with 15 D dimensions. The Finnish translations of the FACE-Q Rhinoplasty scales perform well at assessing a diverse group of patients including those undergoing nasal reconstruction as well as those undergoing rhinoplasty.

Treatment of Pathological Scars with Nanofat Lipograft at the Hermanos Ameijeiras Hospital

Introduction: The healing is the result of the natural restoration of the organism before a corporal aggression produced by a surgical wound or trauma. Poor wound and injury healing represents a functional and aesthetic problem, which is why it deserves special attention. Objective: To evaluate the aesthetic results of the treatment of pathological scars with lipotransfer by nanofat. Method: A prospective longitudinal and descriptive study was carried out with 8 patients from Plastic Surgery Hospital ‘‘Hermanos Ameijeiras” with pathological scars, who received lipotransfer treatment by Coleman method and processing of adipose tissue by nanofat from January to June 2020. Results: 8 patients with ages between 25 and 50 years with a mean age of 39 years were included. The female sex predominated with 75%. The predominant skin color was grades 3 and 5 of the Fitzpatrick classification, both with 50%. The most frequent etiologies were post acne, postoperative and injection scars of allogenic substances, all with 25%. The main anatomical locations were the facial region and in the breasts with 3 patients each, followed by 2 cases in the gluteal region. The postoperative aesthetic results at three months were 100% good, observing macroscopic and microscopic positive changes with the nanograft. No patient presented complications. Conclusions: The treatment of pathological scars with lipotransfer by nanofat is an available, simple and reproducible option that offers objective improvement of the scar with rapid recovery.

Retrospective analysis of off-label medication use at a plastic surgery hospital in China and evidence-based evaluation.

To retrospectively analyze the off-label prescriptions at a plastic surgery hospital in China and conduct a literature review. The prescriptions in outpatient department from January 1, 2018 to December 31, 2018 were collected and compared with the related drug instructions in indications, dosage, frequency and route of administration to identify the off-label prescriptions. According to related literatures, guidelines, and MICROMEDEX, the rationality of off-label drug uses was evaluated. A total of 39 836 prescriptions were screened and 3395 (8.52%) off-label prescriptions were identified. It involved 23 items off-label medication uses. 20 items were off-label used in indication and three items were in indication and administration route. These off-label prescriptions involved 19 medicines and 12 indications and the dermatology related drug usage accounted for the largest proportion (91.3%). Additionally, five items (21.7%) were Chinese patent medicine related. Of the 23 items, seven (30.4%) have been recommended by guidelines and two (8.7%) by Thomson Grading System of Micromedex. All of them have been proved by literature evidence of level 1 to 4, in which 19 (82.6%) by Level 1 evidence, 21 (91.3%) by Level 1 to 2 evidence and 2 (8.7%) only by level 3 to 4 evidence. This can provide a theoretical basis to clinicians in prescribing. Our next work is to perfect some details about evidence assessment to improve the reliability.

Reconstructive Options for Composite Maxillary Defects With Orbital Exenteration—The Royal Adelaide Experience

PURPOSE: Composite orbito-maxillary defects following maxillectomy and orbital exenteration remain one of the most sophisticated reconstructive challenges in head and neck surgery. We present the outcomes of a 15-year single-centre review of patients who underwent reconstruction of Cordeiro types IIIB and IV defects, and review the reconstructive options. METHODOLOGY: All patients who underwent maxillectomy with orbital exenteration between 2004 and 2019 were identified from the Royal Adelaide Hospital Plastic Surgery database. Patient’s medical records, operation notes, pre- and postoperative photographs were reviewed. The reconstructive methods were analysed based on defect components—skin, maxilla, orbit, palate, and skull base. RESULTS: A total of 22 patients underwent reconstruction for Cordeiro types IIIB and IV orbito-maxillary defects. The most common pathologies were SCC (59%) followed by melanoma (18%). Fourteen (64%) patients had type IIIB and 8 (36%) had type IV defects. The most commonly used free flaps were rectus abdominis with or without skin paddle (55%), ALT (22%), and ALT/vastus lateralis chimeric flap (14%). Reconstructive options for the skin, maxilla, orbit, palate, and skull base were analysed and described in detail. Flap survival rate was 95%. Other postoperative complications included hematoma (9%) and infection (9%). CONCLUSION: Reconstruction of Cordeiro types IIIB and IV defects should identify and address each defect component to achieve soft tissue coverage, contour, oronasal, and cranionasal separation. The most robust and versatile option is the rectus abdominis free flap. In our experience, bony reconstruction is not required for most Cordeiro IIIB and IV defects.

Delivering high quality documentation on operative consent forms: a UK major trauma center Quality Improvement Project

Background: Royal College of Surgeons guidelines exist on the importance of full, accurate and legible completion of consent forms as a key part of the process of gaining informed consent. In addition to this, consent forms serve as an important medico-legal document to protect clinicians and patients should problems arise. It is therefore in all parties’ interests that they are correctly completed. It was noted that consent forms within the Royal London Hospital Plastic Surgery department were often not correctly completed. A Quality Improvement Project was undertaken to improve the completion of consent forms within the department. Materials and methods: Common problem areas on consent forms were identified and Quality Improvement (QI) methodology was used to design the study including selection of appropriate outcome, process and balancing measures. Baseline information on completion of: (1) patient details, (2) consultant details, (3) legibility, (4) use of abbreviations in description of operation/complications, and (5) patient signatures was collected. Four weekly interventions were made which were accompanied by 4 further data collection cycles. A further reaudit took place 4 months following the completion of the project to establish whether improvements had been sustained. Results: Over the 5 QI data collection cycles the average completion of the 3 outcome measures rose from 59% to 93% and 4 months later was sustained at 91%. Outcome measure 1 (legibility of documentation) rose from 62% to 100%. Outcome measure 2 (omission of abbreviations) rose from 33% to 79%. Outcome measure 3 (patient signature) rose from 81% to 100%. Conclusion: This Quality Improvement Project led to a significant and sustained improvement in quality of completion of consent forms within the department with the most marked improvement in omission of abbreviations. This quality improvement methodology could easily be adapted for other surgical specialities.

Epidemiological Analysis and the Nomogram for Possible Risk Factors for Severe Microtia.

Microtia is a severe congenital malformation of the external ear. This study aimed to explore the epidemiologic characteristics and the possible risk factors in patients with severe microtia in China, and integrate significant variables into a predictive nomogram. A total of 965 patients with microtia were included. This retrospective case study was conducted from July 2014 to July 2019 at Plastic Surgery Hospital in China. The detailed questionnaires concerning potential risk factors were completed and data were gathered. Chi-Square and Fisher tests were used to analyze the variables, and a multivariate logistic regression model was used to select variables related to severe microtia, and then construct a nomogram. The nomogram model was evaluated by the concordance index (C-index), calibration plot, and receiver operating characteristics (ROCs) curve. Bootstraps with 1000 resamples were applied to these analyses. Of the 965 microtia patients, 629 (65.2%) were male and 867 (89.8%) were sporadic. The cases were observed more commonly in unilateral (83.1%) and right-sided (52.0%). And multiple malformations were observed in 392 (40.6%) cases. Multivariate logistic regression analysis showed that maternal age, miscarriage frequency, virus infection, anemia, using progesterone, paternal alcohol intake, and topography of living areas were associated with a higher risk of severe microtia. All the significant variables were combined into a predictive nomogram (C-index = 0.755,95% CI = 0.703-0.807). Higher prediction accuracy (adjusted C-index = 0.749) was further verified via bootstrap validation. The calibration plot showed good performance, and the ROCs curve analysis demonstrated high sensitivity and specificity. Most microtia patients are male, sporadic, and accompanied by other malformations, which are similar to the phenotypic analysis results of other studies. A nomogram predicting severe microtia was constructed to provide scientific guidance for individualized prevention in clinical practice.

Staged Buccal Mucosa Graft Urethroplasty for Proximal Hypospadias in Children: A Short- to Mid-Term Follow-Up Retrospective Study.

The aim of this study is to report our experience with modified staged buccal mucosa graft urethroplasty for the repair of proximal hypospadias in children and adolescents. A total of 183 patients were treated at the Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College between 2010 and 2019. The patients were grouped according to age: (1) within 1.5-year-old group, (2) prepuberty group (Tanner stage 1), and (3) puberty group. In total, 153 patients were included in this study. Thirty-six patients had complications: seven after stage one; 29 after stage two; one patient had two complications. Maximum flow rates were 11.80 ± 1.46 mL/s in the 1.5-year-old group, 13.24 ± 2.61 mL/s in the prepuberty group, and 13.60 ± 2.20 mL/s in the puberty group (p = 0.199). Average flow rates were 6.86 ± 1.37, 7.94 ± 1.74, and 7.88 ± 1.22 mL/s, respectively (p = 0.203). The optimal hypospadias objective scoring evaluation score of 16 was seen in 117 patients (76%), the score of 15 in 23 patients (15%), 14 in 10 (7%), and 13 in 3 patients (2%). Patients with an uncomplicated treatment (no complication) had a higher clinical outcome than patients with a complication (15.8 ± 0.53 vs. 15.3 ± 0.97, with or without complication, p = 0.000). Multivariable analyses showed that previous treatment was closely related to the complication rate (p = 0.016). The modified procedure allows for two-stage repair of proximal hypospadias with good results with a low complication rate and good functional results. Delaying operation did not increase complication rates in our research.

Efficacy of Bee Honey on Wound Healing: Split Skin Graft with Hyper-granulation Tissue

The present prospective study was aimed to evaluate the effectiveness of topical application of bee honey on wound healing with hyper granulation tissue of infected split skin graft. Methods: A 27 years old female was admitted to Khartoum North Teaching Hospital plastic surgery unit with painful swelling of the right buttock with localized heat, which was proved as a pyogenic abscess. Swabs were taken from the wound for isolation, identification and viable bacterial count. The abscess was drained under general anesthesia and dressed with saline and MEBO ointment (combination of honey and herbs). Skin graft was performed. After 2 weeks of MEBO dressing, the wound was infected and hyper granulation tissue was observed. Daily application of honey was used instead of MEBO ointment. Results: Isolated organism was identified as Staphylococcus aureus. In vitro antibacterial test of honey against the isolated organism exhibited strong antibacterial activity. After one week of honey dressing, bacterial growth was inhibited and finally the wound was free from S. aureus. After 2 weeks of honey dressing, wound healing with reduced, hyper- granulation tissue was found. Conclusion: Topical application of honey dressing on wound with hyper granulation tissue for 3 weeks resulted in clean sterile wound with healthy granulation tissue and prompt graft was observed. Complete wound healing was achieved and hyper granulation tissue was reduced without surgical interference.

Transbrow Excision Blepharoplasty for Upper Eyelid Dermatochalasis: A Modified Approach.

Many aging women with upper lid dermatochalasis pluck their lower lateral eyebrows to combat lateral drooping. The authors present and evaluate outcomes of a modified excision blepharoplasty method performed using a transbrow excision approach instead of infra/suprabrow access to more efficiently correct upper eyelid dermatochalasis. The authors conducted a retrospective review of 192 patients who underwent transbrow excision blepharoplasty (TBEB) between 2014 and 2019 at the Plastic Surgery Hospital of Beijing in China. The clinical features, complications, and outcomes of patients were reviewed. The Strasser grading system was used to evaluate surgical results postoperatively. Aesthetic improvement was subjectively judged by the patients. All 192 patients (aged 25-72 years old, mean 46 years old) were reviewed and followed up for 6 months to 2 years. Patients were evaluated after 1 week and after at least 6 months. All patients reported an improved aesthetic appearance of the lateral periorbital area, and 174 patients (90.6%) rated their results as satisfactory. No serious complications were related to the procedure. TBEB is used to correct problems that are not adequately managed by conventional excision blepharoplasty. Among 192 patients evaluated over 5 years, excision of the transbrow skin pad sufficiently reduced the redundancy of the upper eyelid and achieved an acceptable appearance of the periorbital area, where the postoperative location of a subtle scar defined a desired youthful brow position. In selected patients, this is an effective and safe method that uses patient-observed features to provide an alternate cosmetic approach.

Madelung Disease Type Ia: Lipectomy or Liposuction?

Plastic Surgery Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing, China. Plastic Surgery Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing, China [email protected] Conflicts of interest and sources of funding: none declared.

Platelet-rich fibrin membrane nerve guidance conduit: a potentially promising method for peripheral nerve injuries.

Platelet-rich fibrin membrane nerve guidance conduit: a potentially promising method for peripheral nerve injuries.

Mild to moderate blepharoptosis correction: Outcomes of levator aponeurosis posterior layer plication.

Conventional levator aponeurosis plication is a widely accepted technique for correction of mild to moderate ptosis. However, this method is associated with a high recurrence rate. The objective of this study was to investigate the clinical efficacy of levator aponeurosis posterior layer plication technique for correction of mild to moderate ptosis.A convenience sampling approach was used to recruit 450 patients with mild to moderate blepharoptosis at the Guangzhou Eye-Nose-Face Aesthetic Plastic Surgery Hospital between August, 2015 and December, 2017. All participants were treated with levator aponeurosis posterior layer plication technique. The primary outcome was the postoperative change in marginal reflex distance 1 (MRD1). The paired t test was used to determine the clinical efficacy. Outcomes were assessed at 1 week, 1 month, 3 months, and 6 months after surgery.The mean preoperative MRD1 was 1.7 ± 0.5 mm, and the mean postoperative MRD1 at 6-month follow-up was 3.7 ± 0.4 mm (P < .0001). According to the postoperative survey, 427 (94.9%) patients were satisfied with surgical outcomes.This modified levator aponeurosis plication technique is a simple and effective procedure for correction of mild to moderate blepharoptosis. It results in good MRD1 and high patient satisfaction.

The influence of cognitive schemas on the mixed anxiety-depressive symptoms of breast cancer patients

BackgroundThe surgical treatment of breast cancer involves various psychological consequences, which differ according to individual characteristics. Our study aimed to identify the role that cognitive schemas had in triggering anxiety and depressive symptoms in patients diagnosed with breast cancer that underwent oncological and plastic surgery treatment.Methods64 female patients, diagnosed with breast cancer from an Oncology and Plastic Surgery Hospital, were selected to participate in this study between March–June 2018. They were divided into two groups: I. 28 patients who underwent mastectomy surgery; II. 36 patients, who required mastectomy and, subsequently, also chose to undergo breast reconstruction surgery. For the purposes of evaluating a possible change in mental health status, we employed two assessment scales: the Young Cognitive Schema Questionnaire - Short Form 3 (YSQ-S3) and the Romanian version of the Depression Anxiety Stress Scale – 21 (DASS-21R).ResultsParticipants who underwent mastectomy and subsequent breast reconstruction surgery employed cognitive schemas that did not generate symptoms of depression or anxiety. In contrast, the cognitive schemas found in women who refused reconstructive breast surgery were significantly correlated with the presence of anxiety-depressive symptoms. The cognitive schema domain of ‘disconnection and rejection’ correlated uncertainly with the presence of anxiety-depressive symptoms for the group with breast reconstruction (Spearman’s ρ = 0.091, p = 0.644), while for the other group the correlation was moderate-strong (Spearman’s ρ = 0.647, p < 0.01). Negative emotional schemas were significantly correlated with the presence of anxiety-depressive symptoms (Spearman’s ρ = 0.598, p < 0.01) in the group of participants without reconstructive surgery.ConclusionA correct identification of dysfunctional cognitive schemas and coping mechanisms at the commencement of the combined treatment in breast cancer patients could serve as an indicator for the evolution of their mental health, therefore assisting professionals in establishing the most suitable psychological, psychotherapeutic and psychiatric intervention plan.

Mobilizing Volume: Trauma, Surgical Skill, and Clinical Tourism in South India

This article considers the ways in which the concept of volume is deployed to create and sustain surgical expertise. Drawing on research at a large plastic and orthopedic surgery hospital in Tamil Nadu, India, I explore the ways in which a steady supply of trauma is converted into medical expertise, reputation, and care. Volume functions as a key metric by which this conversion takes place. This hospital is particularly well known for its cutting-edge treatment of severe trauma, and, while some Indian hospitals have used their combination of low cost and high expertise to attract foreign patients for medical tourism, this hospital has converted its supply of trauma patients into surgical expertise that brings foreign surgeons there to learn. This article therefore also considers the role of visiting foreign doctors in this form of clinical tourism.

A Smartphone Application for Burn Self-care.

Burn treatment and management is largely patient-dependent and self-care education helps reducing tangible and intangible costs as well as improving quality of care. Thus, this study aimed to develop a smartphone application for burn self-care. This research, conducted in 2018, consisted of two phases. Initially, the educational content required for the application was determined based on the literature review and clinicians' and patients' perspectives. The setting of the study was the largest burn and plastic surgery hospital in the country. Based on the results derived from the first phase of the study, the application prototype was designed in the Persian language to be used on smartphones. The usability of the application was evaluated by using a standard questionnaire and the data were analyzed by using descriptive statistics. The educational content of the application included eight different areas of self-care; namely, wound care, scar management, care and control of hypertrophic burn scars, nutrition, in-home pain management, mental health, follow-up, and rehabilitation. A specialist was consulted and related texts and images were selected to be included in the application. The application was used by burn patients for a week and users evaluated its usability at a good level. It seems that the application designed in the present study can help to increase patients' knowledge about burn conditions and improve their self-care skills. Further studies are needed to present the efficiency and effectiveness of the application in practice.

Skeletal muscle-derived cells repair peripheral nerve defects in mice.

Skeletal muscle-derived cells have strong secretory function, while skeletal muscle-derived stem cells, which are included in muscle-derived cells, can differentiate into Schwann cell-like cells and other cell types. However, the effect of muscle-derived cells on peripheral nerve defects has not been reported. In this study, 5-mm-long nerve defects were created in the right sciatic nerves of mice to construct a peripheral nerve defect model. Adult female C57BL/6 mice were randomly divided into four groups. For the muscle-derived cell group, muscle-derived cells were injected into the catheter after the cut nerve ends were bridged with a polyurethane catheter. For external oblique muscle-fabricated nerve conduit and polyurethane groups, an external oblique muscle-fabricated nerve conduit or polyurethane catheter was used to bridge the cut nerve ends, respectively. For the sham group, the sciatic nerves on the right side were separated but not excised. At 8 and 12 weeks post-surgery, distributions of axons and myelin sheaths were observed, and the nerve diameter was calculated using immunofluorescence staining. The number, diameter, and thickness of myelinated nerve fibers were detected by toluidine blue staining and transmission electron microscopy. Muscle fiber area ratios were calculated by Masson's trichrome staining of gastrocnemius muscle sections. Sciatic functional index was recorded using walking footprint analysis at 4, 8, and 12 weeks after operation. The results showed that, at 8 and 12 weeks after surgery, myelin sheaths and axons of regenerating nerves were evenly distributed in the muscle-derived cell group. The number, diameter, and myelin sheath thickness of myelinated nerve fibers, as well as gastrocnemius muscle wet weight and muscle area ratio, were significantly higher in the muscle-derived cell group compared with the polyurethane group. At 4, 8, and 12 weeks post-surgery, sciatic functional index was notably increased in the muscle-derived cell group compared with the polyurethane group. These criteria of the muscle-derived cell group were not significantly different from the external oblique muscle-fabricated nerve conduit group. Collectively, these data suggest that muscle-derived cells effectively accelerated peripheral nerve regeneration. This study was approved by the Animal Ethics Committee of Plastic Surgery Hospital, Chinese Academy of Medical Sciences (approval No. 040) on September 28, 2016.

A History of the Frenchay Hospital Plastic Surgery Unit, Bristol, United Kingdom.

Frenchay Hospital has long since been established as the center for plastic surgery in Bristol, providing care to the city and its surrounding catchment area. From humble origins in the Second World War when the site took on the role of a large military hospital providing reconstructive surgery for the victims of war to a busy modern-day National Health Service establishment, the plastic surgery unit at Frenchay Hospital has grown and developed through in parallel with the genesis and development of the specialty. Recent centralization of care in Bristol has seen a massive reorganization of services, and with it the closure of Frenchay Hospital. Because the plastic surgery unit establishes a new home at Southmead Hospital, this review documents the foundations of reconstructive surgery in Bristol and the South West United Kingdom.

The relationship between body image, self-concept and happiness among women seeking cosmetic surgery in Tehran

Introdution: In today's societies, a high percentage of people are dissatisfied with the physical appearance that such physical dissatisfaction provides tendencies for many psychological problems.The purpose of this study was to investigate the relationship between body image and self-concept with happiness among women seeking cosmetic surgery in Tehran. Methods The research method was descriptive-correlational. The statistical population consisted of all female applicants for cosmetic surgery referred to the medical centers (15 khordad plastic surgery hospital, and Fatima plastic surgery hospital) in Tehran in 2016. 100 of them were selected through purposive sampling. For collecting the data,, the self-body multidimensional relationship questionnaire (Cache, Winstead and Janda, 1987), self-concept questionnaire (SCQ) (Rogers, 1961) and the Oxford Happiness Questionnaire (Argyle, 1989) were used. Data were analyzed by Pearson correlation coefficient and multivariate regression analysis using SPSS (ver. 16) software. Results: The findings showed that there was a positive and significant relationship between physical image and happiness. Therefore, there was a positive and significant relationship between happiness and physical image components such as appearance assessment, fit assessment, tendency to fit and body satisfaction, But there was not a significant relationship between happiness, subjective weight and apparent tendency .There was also a negative and significant relationship between self-concept and happiness. Body image and self-concept significantly predicted happiness. Conclusion: Therefore, it can be concluded that body image and self-concept play a significant role in the happiness of women who apply for cosmetic surgery