Plastic Surgery Outpatient Clinic Research Articles

Prevalence of body dysmorphic disorder, its clinical characteristics and psychiatric comorbidities in patients admitted to a plastic surgery outpatient clinic

Purpose The present study aimed to determine the prevalence of body dysmorphic disorder (BDD), its clinical features, and comorbidities in patients applying for plastic and reconstructive surgery. Method Five-hundred and seventy nine participants who applied to the plastic and reconstructive surgery outpatient clinic completed a sociodemographic data form, and were subjected to the Body Perception Scale (seventy-nineBPS), Social Appearance Anxiety Scale (SAAS), TEMPS-A Temperament Scale, and Beck Depression Inventory (BDI). Participants who scored 135 or more on the BPS were included in a psychiatric interview. Next, the participants diagnosed with BDD were compared with participants with a high BPS scores but without a BDD diagnosis, along with a control group. Results The prevalence of BDD among all patients attending the plastic surgery outpatient clinic was found to be 4.7%, whereas the prevalence was 8.6% among those specifically seeking cosmetic procedures. The mean SAAS, BDI, TEMPS-A depressive, and anxious scores were higher in the BDD group compared to the controls (p < 0.001). The difference in the mean SAAS, BDI, TEMPS-A depressive, and anxious scores of the patients with a high BPS scores and the control group was comparable to the difference observed between the BDD and control groups. A regression analysis revealed that the SAAS and depressive temperament scores have an effect on the BPS score. Conclusion The significantly high comorbidity of BDD in patients seeking plastic and reconstructive surgery underscores the importance of identifying these patients to prevent unnecessary surgical procedures.

Prevalence of body dysmorphic disorder, its clinical characteristics and psychiatric comorbidities in patients admitted to a plastic surgery outpatient clinic

Purpose The present study aimed to determine the prevalence of body dysmorphic disorder (BDD), its clinical features, and comorbidities in patients applying for plastic and reconstructive surgery. Method Five-hundred and seventy nine participants who applied to the plastic and reconstructive surgery outpatient clinic completed a sociodemographic data form, and were subjected to the Body Perception Scale (seventy-nineBPS), Social Appearance Anxiety Scale (SAAS), TEMPS-A Temperament Scale, and Beck Depression Inventory (BDI). Participants who scored 135 or more on the BPS were included in a psychiatric interview. Next, the participants diagnosed with BDD were compared with participants with a high BPS scores but without a BDD diagnosis, along with a control group. Results The prevalence of BDD among all patients attending the plastic surgery outpatient clinic was found to be 4.7%, whereas the prevalence was 8.6% among those specifically seeking cosmetic procedures. The mean SAAS, BDI, TEMPS-A depressive, and anxious scores were higher in the BDD group compared to the controls (p < 0.001). The difference in the mean SAAS, BDI, TEMPS-A depressive, and anxious scores of the patients with a high BPS scores and the control group was comparable to the difference observed between the BDD and control groups. A regression analysis revealed that the SAAS and depressive temperament scores have an effect on the BPS score. Conclusion The significantly high comorbidity of BDD in patients seeking plastic and reconstructive surgery underscores the importance of identifying these patients to prevent unnecessary surgical procedures.

397 The Effects of a Virtual Specialist Nurse-Led Clinic on Plastics Outpatient Services at a Major Trauma Centre: A Closed Loop Audit

Abstract Aim To reduce the number of plastic surgery clinics working over capacity due to the effects of both increasing caseload and the COVID-19 pandemic by implementing a virtual specialist nurse-led clinic. Method Outpatient activity was audited due to the number of patients being overbooked into the plastic surgery outpatient clinics. A virtual specialist nurse-led clinic was implemented to bridge gaps between appointments, maintain early triaging of complications, and reduce clinics working over-capacity. Suitable patients were identified and offered virtual follow-up in place of face-to-face appointments. Outpatient activity was re-audited after implementation, to assess effects on force bookings and number of new/follow-ups seen in consultant clinics. Results Following virtual clinic implementation, there was a significant reduction in consultant clinics working over-capacity (95% to 71.8%, p = 0.002) and forced bookings (54 to 10, p = 0.006) in the audited period. The average number of new patients seen in consultant clinics each month increased by 15.3% (p = 0.019). Conclusions Introduction of a virtual clinic reduced forced bookings and clinics working over-capacity. This increased capacity for new patients to be seen face-to-face, created a manageable clinic while maintaining early identification of complications, and reduced delays between clinic appointments. Early virtual assessment of wounds and identification of complications enabled patients to be booked into urgent face-to-face plastic appointments, triaging them away from A&amp;E and GP services. The virtual clinic also allowed the team to reassure patients with ongoing concerns between appointments, further reducing A&amp;E and GP burden.

Impact of breast augmentation on female sexuality.

The breasts are symbols of femininity, sexuality, and maternity. Breast augmentation is among the most sought-after procedures for women and has a positive impact on quality of life. Sexuality is one of the items that contribute to increased quality of life. Surgical outcomes can be evaluated from the patients' perspective using developed and validated questionnaires. For the assessment of sexuality, the most commonly used instruments are the Female Sexual Quotient and the Female Sexual Function Index, which estimate several domains of sexuality and can be used to evaluate the impact of surgery on it. The objective of this study was to evaluate the impact of breast augmentation on female sexuality. We selected 87 patients from the Plastic Surgery Outpatient Clinic of Hospital São Paulo (Federal University of São Paulo) who wished to undergo breast augmentation. The patients were classified into two groups: the Female Sexual Quotient questionnaire was applied to one group, and the Female Sexual Function Index questionnaire was applied to the other group to evaluate sexuality preoperatively as well as at 2 and 4 months postoperatively. In both groups, there was a significant increase in the total score of the Female Sexual Quotient and Female Sexual Function Index questionnaires, and an individual increase in each domain assessed, with a significant increase in the domains of orgasm and sexual satisfaction, as well as foreplay and arousal, indicating an improvement in the patients' sexuality postoperatively. Breast augmentation has a positive impact on female sexuality; furthermore, the Female Sexual Quotient and Female Sexual Function Index are sensitive in detecting this impact.

The Influence of Personality on Health Complaints and Quality of Life in Women With Breast Implants.

A causal relation between systemic symptoms and breast implants has not been established. Psychological factors, such as personality and psychological distress, are strongly associated with the development of medically unexplained symptoms. It can be hypothesized that psychological factors may be related to the development of breast implant illness (BII). This study was conducted to evaluate the correlation between self-reported health complaints, health- and breast-related quality of life (QoL), and personality, in women with cosmetic breast implants. Women who attended the plastic surgery outpatient clinic of Maastricht University Medical Center between October 2020 and October 2021 for reasons related to their implants and women recruited for a BII study at the Center during this period were invited to participate in this study. Only women who underwent cosmetic breast augmentation were eligible. Participants completed a physical complaints score form and the BREAST-Q, SF-36, and EPQ-RSS questionnaires via an online survey. In total, 201 women completed the questionnaires. Extroversion and social desirability were predominant personality traits in women with breast implants, followed by neuroticism. Relatively high levels of neuroticism were found compared with normative data. Neuroticism correlated significantly with health status and breast-related QoL. Physical and mental health-related QoL had the strongest correlations with neuroticism (β = -3.94, β = -4.86, P < 0.001). Personality can play a role in the development of complaints. High levels of neuroticism are seen in cosmetic surgery patients and are negatively correlated with subjective health and patient-reported outcomes in women with breast implants. Therefore, neuroticism may be a factor in the development of BII.

Non-suicidal self-injurious Behaviour: Insights into a littleknown Patient Population in Plastic Surgery

Despite its high prevalence in adolescents and young adults, non-suicidal self-injury (NSSI) is poorly known and understood in areas other than psychiatry. Due to this lack of knowledge, affected patients often face a lack of understanding as well as rejection and discrimination when seeking help from medical professionals. This not only hampers a lasting improvement of NSSI and the development of a trustful physician-patient relationship but may also lead to traumatisation of affected patients. Based on our patients' data, this article aims to inform interested plastic surgeons about NSSI and thus to support the treatment of affected patients. 600 patients with scars from NSSI presenting to our outpatient clinic for the first time during the past five years were enrolled in this study. Extensive data collected during the first contact was analysed and compared with the current literature. 95 % of the patients were female; 5 % were male. On average, patients presented 8.4 years after the last NSSI event and with a mean age of 26 years. NSSI scars were most often located on the left forearm (48 %), followed by both forearms (40 %), the left upper arm (20 %), both upper arms (15 %) and both thighs (14 %). In 57 % of patients, scars were only present on one side. A mean of 380 cm2 of the body surface was affected by NSSI scars. 47 % of patients reported having at least one additional diagnosis, with thyroid dysfunction and depression being the most common. 21 % of patients had ongoing psychiatric or psychological therapy at the time of their first consultation in our clinic. Our data provides first insight into a large population of NSSI patients seeking treatment options for their NSSI-associated scars in a plastic surgery outpatient clinic. Most patients were female with scars located on their forearms. A mean of more than 8 years had passed between their last NSSI and their first presentation to our clinic. Our findings offer a data-based approach to a group of patients with a disease pattern that is largely misunderstood in surgical disciplines and needs more attention, especially in the light of its high prevalence and life-long consequences.

The importance of preoperative imaging methods in reduction mammoplasty

Breast reduction surgery is a common procedure in plastic surgery clinics, and there are varying practices regarding preoperative mammography and breast ultrasound in patients who have no history of cancer and no symptoms other than those caused by macromastia.In this study, we retrospectively analyzed the imaging findings of patients who presented to the plastic surgery outpatient clinic due to macromastia between January 1, 2006 and June 1, 2020 and underwent mammography and/or breast ultrasound for preoperative screening and breast magnetic resonance imaging for further examination. Patients with a history of breast cancer diagnosed prior to preoperative screening or any other breast disease were excluded. Radiologically suspicious findings were significantly more common in patients over 40 years of age and significantly less frequent in the group under 50 years of age. When the patients were grouped by the decade of life, the frequency of radiologically suspicious findings was significantly lower in the 20–29 group and significantly higher in the 40–49 and 50–59 groups. Malignancy was not detected by histopathological examination in any patient. Proliferative lesions were detected in 10 reduction mammoplasty specimens (2.4%) of 7 patients (3.1%).The correlation between radiological and histopathological findings may be weak in macromastia patients. Most suspicious radiological findings appear to be the population between 40 and 59 years of age .

Topical ALA-Photodynamic Therapy Combined with Acne Debridement and Meticulous Nursing for the Treatment of Moderate-Severe Acne in Adolescent Patients.

ObjectiveThe present study aims to explore the effect of acne debridement + meticulous nursing on 5-aminolevulinic acid photodynamic therapy (ALA-PDT) in adolescent patients with moderate–severe acne.MethodsA total of 60 adolescent patients with moderate–severe acne who were admitted to our plastic surgery outpatient clinic between January 2018 and January 2020 were selected as the subjects of the present retrospective study. The patients were divided into two groups: the observation group and the control group (n = 30, each). Patients in the control group were treated with standardized ALA-PDT and conventional nursing, while patients in the observation group were treated with ALA-PDT and acne debridement + meticulous nursing intervention. The treatment’s therapeutic effect, adverse reaction incidence, and patient satisfaction 6 months after treatment were compared between the two groups.ResultsThe acne debridement + meticulous nursing effectiveness was 86.7% in the observation group and 60% in the control group, and the adverse reaction incidence was 20% in the observation group and 46.7% in the control group. There existed statistically significant differences in the above-stated indicators between the two groups (p < 0.05). The difference in the visual analogue scores (VASs) for pain, which were measured immediately after the operations, between the two groups was not statistically significant (p > 0.05); however, the respective VAS differences between the two groups at 30 min and 60 min after the operation were statistically significant (p < 0.05). There was a statistically significant difference in patient satisfaction between the two groups (p < 0.05).ConclusionIn adolescent patients with ALA-PDT-treated moderate–severe acne, the application of acne debridement + meticulous nursing could improve the clinical treatment efficacy and patient comfort as well as reduce the adverse reaction incidence. For these reasons, the treatment method could be worth promoting in clinical practice.

The musculoskeletal injury patterns in homeless patients: poor compliance with outpatient follow-up

ABSTRACT Injuries are a leading cause of hospital presentation in the street homeless population. We aimed to determine attendance patterns at outpatient surgical clinics and the seeking of alternative care at a homeless medicine practice by street homeless patients with musculoskeletal injuries. This study investigates the number of street homeless patients over a two-year period with injuries requiring follow-up who did not attend outpatient clinic (OPC) appointments and their subsequent presentations to emergency departments (ED), readmission rates and presentation to alternative care. We found 206 street homeless patients were identified of which 57 (27%) required follow-up care in an orthopedic or plastic surgery OPC. 31 (55%) did not attend their scheduled follow-up outpatient appointments but were seen in ED for their primary injury within a 3-month period after discharge. Ten patients (18%) required readmission for their primary injury. Of the 31 patients who did not attend surgical OPCs, 15 presented to ED and seven individuals sought follow-up care at the Homeless Healthcare GP practice. Eight patients had no known follow up. This study provides further evidence that people who are homeless are poor attenders at scheduled OPC and instead they often attend ED and homeless clinics.

Anterior Temporal Eminectomy for Internal Derangement Of The Temporomandibular Joint with Local Anesthesia

background: Temporomandibular joint (TMJ) problems frequently characterized via pain and impairment of joint function and clicking sounds. TMJ internal derangement (ID) is the main widespread kind of temporomandibular disorders (TMDs), as 41.1% of suffers from TMD. Almost twenty-five percent of the population has an ID. TMJ ID's treatment regimens can be categorized into two subgroups: conservative and surgical. Early degrees of ID may be treated with medical or minimally invasive techniques according to Wilkes classification; however, the more advanced degrees (IV or V) may need open joint surgery. Aim of the work: assess the effectiveness of anterior temporal eminectomy in management of the manifestation of the ID of the TMJ disorder. Method: From Nov 2019 to Nov 2020. includes 10 patients with ID of the TMJ, presented to Plastic Surgery outpatient clinic, Damietta Al-Azhar University Hospital. Results: We include 10 patients 3 males, 7 females with a mean age of 32.70 ± 8.69 years. pain was presented in 5 patients, improved in 4 patients postoperatively. Clicking was present pre-operatively in 7 cases,which resolved in 5 patients after surgery. Conclusion: Anterior eminectomy, is a technique recommended for the management of ID. It enables the non-reducible disk to be a reducible disk, prevents pain inside of the TMJ, and promotes the flexible movement of TMJ. It's a safe, successful surgical technique that playing a role in the treatment as a 2nd-line surgical option in the treatment of ID of TMJ after other conservative medical options have fail

The BODY-Q Chest Module: Further Validation in a Canadian Chest Masculinization Surgery Sample.

The BODY-Q Chest module is a patient-reported outcome (PRO) instrument that measures satisfaction with how the chest (10 items) and nipples (5 items) look. This PRO instrument was previously field tested in an international sample of people seeking treatment for gynecomastia (n = 174), weight loss (n = 224), and chest masculinization (n = 341). The aim of this study was to examine the psychometric performance of the BODY-Q Chest module in a new chest masculinization surgery sample. Data were collected from patients attending a private plastic surgery outpatient clinic in Canada between January 2018 and June 2019. Rasch measurement theory analysis was used to examine how the scales performed psychometrically. The sample provided 266 assessments (115 preoperative, 151 postoperative). All items had ordered thresholds, providing evidence that the 4 response options for each scale worked as expected. Item fit was within ±2.5 for all items, with all Bonferroni adjusted chi-square values nonsignificant. The data for the chest (χ2(20) = 18.72, P = 0.54) and nipples (χ 2(10) = 12.28, P = 0.27) scales fit the requirements of the Rasch model. Reliability was high with person separation index and Cronbach's α values of ≥0.95 for the chest and ≥0.87 for the nipple scales, respectively. More depressive symptoms on the Patient Health Questionnaire-9 and lower health-related quality of life scales were weakly correlated with worse scores on the chest and nipple scales (P < 0.001). The BODY-Q Chest module was shown to be scientifically sound in an independent sample of patients seeking chest masculinization surgery.

Congenital synkinesis between orbicularis oculi and nasal musculature: is it rare indeed or just underreported?

In this study, demographic data, the incidence among rhinoplasty cases, and treatment approaches of cases diagnosed with congenital ONS in our clinic were discussed. Facial nerve examinations of 728 patients who applied to our plastic surgery outpatient clinic seeking primary rhinoplasty for cosmetic reasons between January 2015 and January 2019 and nine cases with ONS were included in the study. Family history, sex, age, unilateral or bilateral involvement, accompanying muscles, movement amplitude, accompanying anomalies, and treatment modalities of the subjects were documented. Among 728 primary rhinoplasty cases who admitted to our clinic, nine patients were diagnosed with ONS. Of these rhinoplasty patients, 76% were female (n 553) and 24% were male (n 175). In the study, the rate of ONS was found to be 0.12% among the patients seeking rhinoplasty. The mean age of the cases was 28.12 years (range 19–47). All patients were female. Eight patients had right-sided ONS, and in one patient, it was located on the left side. No family histories or coexisting anomalies accompanied ONS in any of the patients. The CNMm accompanying the contraction of the OOm muscle was observed during the eye blink in seven cases, dilator naris anterior muscle (DNAm) in one case, and transverse part of nasalis muscle (TNm) in another case. In the light of the data obtained from this study, we conclude that ONS is fairly common among rhinoplasty cases, and in order to prevent misunderstandings and medico-legal problems, it is essential to recognize this condition before undertaking rhinoplasty, blepharoplasty, or any other surgical procedure. Level of evidence: Level V, diagnostic study.

Sex Differences in Keloidogenesis: An Analysis of 1659 Keloid Patients in Japan.

IntroductionKeloids are a cutaneous fibroproliferative disorder. Despite the fact that keloids are relatively common lesions, the statistics of patient with keloids especially sex difference remain unknown. To better understand it, we conducted an extensive cross-sectional analysis of a large cohort of patients with keloids (n = 1659). The study showed for the first time that female sex may be an inherent keloid risk factor.MethodsThis cross-sectional study of 1659 consecutive patients with keloids who attended a plastic surgery outpatient clinic in Japan in 2014 analyzed age at keloid onset, age at the first medical examination for keloid, and the influence of sex on these variables.ResultsIn both male and female patients, the keloids were most likely to start in puberty and there was no significant difference in the mode value for age of onset (16 vs. 20 years). Though female patients were twice as prevalent as male patients at nearly all onset ages, female patients predominated over male patients with a gender ratio of 2.7:1 in cases of onset before the age of 15 years. Moreover male and female patients did not differ in terms of the mean ± SD duration between keloid onset and the first medical examination. This finding shows that female patients do not get their keloids examined earlier than male patients. These observations together suggest that female sex may promote early keloid development due to physiological, not social, reasons.ConclusionThis is the first report to suggest that female sex may drive keloidogenesis because of physiological reasons. Individuals were most likely to seek a medical examination almost 10 years after onset, regardless of sex. These findings provide new insight into the importance of sex in the development and progression of keloids. Future studies should address the influence of sex hormones on the keloid.

Chaperone Use in Plastic and Reconstructive Surgery Outpatient Clinics: The Patient Perspective.

Patient perspectives on chaperone use during examinations, especially in surgical subspecialties, are understudied. We aimed to identify specific patient cohorts that desire the presence of chaperones and compare patient and surgeon perspectives, all in an effort to improve quality of care. We prospectively administered a 15-question survey to all patients visiting 2 plastic surgery outpatient clinics between January 2015 and April 2016. Data on demographics, types of procedures (cosmetic or reconstructive), area of examination (sensitive or nonsensitive), views on chaperone use, type of chaperone, and instances of inappropriate behavior by surgeons were collected. Univariate analysis was performed after stratifying patients on their individual desire to have a chaperone. Subsequently, multivariate regression models were constructed to identify individual patient cohorts independently more likely to require a chaperone. A total of 398 participants were surveyed. There were 58.3% female and 41.7% male respondents; of whom 41.8% were 55 years or older and 8.1% were younger than 24 years. Ninety percent of all patients were receiving care for a reconstructive procedure. Most (77%) were being examined over a nonsensitive area. Overall, 82.1% preferred not to have a chaperone present during examinations. Most (72.6%) felt the sex of the examining physician was inconsequential to their need for a chaperone. Most (54.8%) preferred either a family member or a friend to be the chaperone. Only 1.8% (n = 7) experienced inappropriate behavior, of whom 77% (n = 5) noted the absence of a chaperone while being examined. On multivariate analysis, younger patients and examination over a sensitive area were independently associated with a higher odd of requiring a chaperone (odds ratios, 3.4 [95% confidence interval, 1.3-8.9; P = 0.016] and 3.9 [95% confidence interval, 1.9-6.7; P < 0.001], respectively). Most patients did not want a chaperone during examinations. Younger patients and those having a sensitive area examined were independently more likely to desire a chaperone. Patients preferred having their family member or friend as their chaperone. Given the major differences in perceptions, plastic surgeons should consider selectively using chaperones rather than the carte blanche use of chaperones with every patient.

What Do Plastic Surgery Patients Think of Financial Conflicts of Interest and the Sunshine Act?

The purpose of this study was to evaluate patients' views of conflicts of interest (COI) and their comprehension of recent legislation known as the Physician Payments Sunshine Act. This report constitutes the first evaluation of plastic surgery patients' views on COI and the government-mandated Sunshine Act. This cross-sectional study invited patients at an academic, general plastic surgery outpatient clinic to complete an anonymous survey. The survey contained 25 questions that assessed respondents' perceptions of physician COI and awareness of the Sunshine Act. Analyses were performed to examine whether perspectives on COI and the Sunshine Act varied by level of education or age. A total of 361 individuals completed the survey (90% response rate). More than half of respondents with an opinion believed that COI would affect their physician's clinical decision-making (n = 152, 52.9%). Although almost three fourths (n = 196, 71.2%) believed that COI should be regulated and COI information reported to a government agency, the majority were not aware of the Sunshine Act before this survey (n = 277, 81.2%) and had never accessed the database (n = 327, 95.9%). More than half of patients (n = 161, 59.2%) stated that they would access a publicly available database with physicians' COI information. A larger proportion of older and educated patients believed that regulation of physicians' COI was important (P < 0.001). Awareness of and access to plastic surgeon COI information is low among plastic surgery patients. Older and more educated patients believed that transparency regarding COI is important with regard to their clinical care.

High Prevalence of Body Dysmorphic Disorder and Moderate to Severe Appearance-Related Obsessive-Compulsive Symptoms Among Rhinoplasty Candidates.

Rhinoplasty is one of the most sought-after procedures in plastic surgery by individuals with body dysmorphic disorder (BDD). The identification of BDD symptoms is a challenge for plastic surgeons. The purpose of this study was to use a specific instrument for detection of BDD symptoms as a screening tool in rhinoplasty candidates and estimate the prevalence and severity of BDD symptoms in this population. Eighty patients of both sexes seeking rhinoplasty were consecutively recruited at a plastic surgery outpatient clinic of a university hospital from February 2014 to March 2015. In a clinical interview, 50 of them showed an excessive preoccupation with physical appearance associated with clinically significant subjective distress and were, therefore, selected to participate in the study. All participants were assessed using the Brazilian-Portuguese versions of the Yale-Brown Obsessive Compulsive Scale modified for BDD (BDD-YBOCS) and the Body Dysmorphic Symptoms Scale (BDSS), which can be applied by plastic surgeons, who are laypersons in psychology/psychiatry. Twenty-four (48%, 24/50) candidates had BDD symptoms, and 27 (54%, 27/50) showed moderate to severe appearance-related obsessive-compulsive symptoms. A strong correlation was found between the BDSS and BDD-YBOCS scores (r = 0.841, P < 0.001), and a strong agreement was observed between the BDSS cutoff point and body dysmorphic disorder symptom status (kappa = 0.822). A high prevalence of BDD and moderate to severe appearance-related obsessive-compulsive symptoms was found among aesthetic rhinoplasty candidates. The BDSS may be used as a screening tool for BDD symptoms in plastic surgery patients. 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 .

A review of pre-operative Anticoagulant (AC) and Antiplatelet (AP) prescribing in a plastic surgery Outpatient Local Anaesthetic Clinic (OPLA)

A review of pre-operative Anticoagulant (AC) and Antiplatelet (AP) prescribing in a plastic surgery Outpatient Local Anaesthetic Clinic (OPLA)

The Association Between Psychopathology Ans Quality Of Life In Burn Patients At Dr. Cipto Mangunkusumo Hospital, Jakarta

Background : Burns result in severe injuries that cause damage or loss of tissue due to contact with sources of heat resulting in injuries to all body systems. Injuries of the skin, which functions as a barrier to protect internal organs, may cause patients to experience damage to one's physical appearance and body image causing negative feelings that may lead to other problems such as psychopathology and symptoms of mental illness.&#x0D; Method : A cross sectional study with consecutive sampling method of burn patients who were treated at the Plastic Surgery Outpatient Clinic and Burn Unit of RSCM was conducted between April-May 2017. Subjects were asked to fill in self-report questionnaires including patient identity form, SRQ-20 (cutoff point ≥6) for presence of psychopathology, and WHOQoL-BREF to obtain mean scores of quality of life that include four domains of physical, psychological, social, and environment assessment. Data collected was analyzed using correlation analysis.&#x0D; Result : 56 burn patients were included in the study. 30.4% did not work and 48.2% had very low income per month. 67.9% patients experienced burns due to fire and 44.6% had burns 10-30% of the TBSA with a majority of patients (80.4%) experiencing a combination of second &amp; third degree burns. Based on the analysis, 57.1% of patients had a form of psychopathology and low mean scores of quality life (physical domain 48.1, psychological domain 51.5). Significant negative correlations (p ≤ 0.05) were obtained between the psychological domain and symptoms of depression, anxiety, low energy; physical domain and low energy; and social domain with anxiety.&#x0D; Conclusion: This study obtained significant results to identify the correlation between psychopathology and various domains of quality of life affected.

Short Mood and Feelings Questionnaire for screening children and adolescents for plastic surgery: cross-cultural validation study.

Patient-reported outcome measurements assessing the emotional state of children and adolescents who seek plastic surgery are important for determining whether the intervention is indicated or not. The aim of this study was to cross-culturally adapt and validate the Short Mood and Feelings Questionnaire (child/adolescent and parent versions) for Brazilian Portuguese, test its psychometric properties and assess the emotional state of children and adolescents who seek plastic surgery. DESIGN AND SETTING: Cross-cultural validation study conducted in a plastic surgery outpatient clinic at a public university hospital. A total of 124 consecutive patients of both sexes were selected between September 2013 and February 2014. Forty-seven patients participated in the cultural adaptation of the questionnaire. The final version was tested for reliability on 20 patients. Construct validity was tested on 57 patients by correlating the Short Mood and Feelings Questionnaire (child/adolescent and parent versions) with the Strengths and Difficulties Questionnaire and the Rosenberg Self-Esteem scale. The child/adolescent and parent versions of the Short Mood and Feelings Questionnaire showed Cronbach's alpha of 0.768 and 0.874, respectively, and had good inter-rater reliability (intraclass correlation coefficient, ICC = 0.757 and ICC = 0.853, respectively) and intra-rater reliability (ICC = 0.738 and ICC = 0.796, respectively). The Brazilian-Portuguese version of the Short Mood and Feelings Questionnaire is a reproducible instrument with face, content and construct validity.The mood state and feelings among children and adolescents seeking cosmetic surgery were healthy.

Surgical Correction of Alar Collapse with Alar Batten Graft : Technique and Results

Background: nasal valve collapse has great perception of nasal obstruction. The alar batten graft technique has proven to be a valid method for treatment of external and internal valve collapse. Aim: the aim of the present study was to evaluate a two year experience and follow up for external nasal valve collapse treatment using alar batten graft technique regarding results and complications. Patients and Methods: this prospective study was carried out on 18 patients attended the ENT and Plastic Surgery outpatient clinics of Al-Azhar University hospitals from January, 2014 to January 2016. Written consent was taken from every patient. All patients were complaining of nasal obstruction of gradual onset and progressive course with 7 years average. All patients were subjected to detailed history taking and questionnaire including the NOSE scale. Surgical correction was performed to all patients using the alar batten graft harvested from the septa cartilage or conchal cartilage. Postoperative results recorded in relation to subjective sensation of nasal obstruction and aesthetic appearance of the nose. Results: eleven patients (61.1%) were males and seven (38.9%) were females. Their age ranged from 18 to 45 years with a mean of 32±2. Bilateral obstruction was found in 33.3% of cases and unilateral obstruction in 66.7% of cases. There were 22.2%, 27.8%, and 50.0% of the cases had moderate, fair, and severe obstruction, respectively. Postoperatively, these figures were changed to no obstruction77.8% (P=0.0), mild 0.0%, moderate 11.1%, fair 11.1%, and sever 0.0%(P=0.0005). The technique significantly abolishes the severe nasal obstruction. Postoperative complications include 1 case with graft resorption (4.2%) and 1 case of graft displacement (4.2%). Both were improved on subsequent surgery. Regarding postoperative findings there was tenderness and hypertrophic postauricular scar in 5.5% of patient and nasal tip edema in 22.2%, all resolved. In the early postoperative period, 33.3% of patients complained of fullness in the supraalar region. Conclusion: Successful surgical correction of nasal obstruction requires the precise diagnosis of the anatomic point of collapse. Alar batten graft improves the rigidity of lower lateral cartilage preventing collapse of the lateral nasal wall preventing collapse during moderate and deep inspiration. The graft varies according to the severity of the obstruction and size of the collapsible area of the lateral nasal wall. The septal cartilage is usually sufficient. The technique significantly improves nasal breathing.