Tip Asymmetry Leading Request for Rhinoplasty, Revision Rhinoplasty

There are many reasons why someone would undergo rhinoplasty: deviated septum, collapsed nostrils, crooked nose, etc. HealthDay News recently reported that the number one aesthetic reason for rhinoplasty and revision rhinoplasty in patients is tip asymmetry.

The study, which was published in the September/October issue of the Archives of Facial Plastic Surgery, was administer by Kathy Yu, M.D. of Columbia College and Cornell University in New York. Yu and her colleagues used a questionnaire to analyze the functional and aesthetic concerns of 104 patients considering revision rhinoplasty.

According to the investigators, tip asymmetry topped the list as the most common aesthetic concern for surgeons and patients alike. The second most popular was the crooked middle third of the nose, followed by upper third irregularity. An average of 79 percent of surgeons shared the same aesthetic concerns as their patients.

"In conclusion, this study sheds light on the major concerns of patients seeking revision rhinoplasty and compares them with the surgeon's objective findings. These findings emphasize the importance of physician awareness of patients' concerns, understanding the causes of post-surgical nasal obstruction, and clearly explaining nasal aesthetics to patients seeking revision rhinoplasty,” the authors wrote.

For patients considering rhinoplasty for the first time or revision rhinoplasty, it is important that your doctor understand your aesthetic concerns and objectives. Whether it is difficulty breathing, a crooked middle third or an asymmetrical tip, it is important that the patient’s concerns are adequately communicated to their plastic surgeon.

The Line Between Cosmetics and Cosmeceuticals is Getting Thinner

A recent article by Plastic Surgery Practice reports that the gray area between the skin care and cosmetics industry is growing. Global Industry Analysts, Inc., revealed that the color cosmetics market will reach $41.4 billion by 2015. This is due in part to the inclusion of UV protection, moisturizing components, and natural and organic ingredients in cosmetics.  Makeup is now available in a multitude of formats, textures and pigments.

Not only that, consumers are now benefiting from an array of different treatment options available in the cosmetics, including anti-aging effects. There is a cosmetic product made for virtually every skin type and condition.

Going green is another trend that has been affecting the cosmetics industry. Product manufacturers are now beginning to include ‘natural’ and ‘organic’ ingredients such as vitamin E and plant extracts to attract consumers.

Once upon a time, makeup contained heavy pigments that clogged pores and caused skin irritation. Now, mineral blends and light-capturing crystals, like topaz and mother-of-pearl, are being used to give skin a natural, flawless appearance. To produce an intense color and limit smudging, lipsticks are beginning to incorporate vitamins A, C and E.

Referred to as cosmeceuticals, products with skincare benefits were once only made by high-end makeup lines such as Jane Iredale. Nowadays, one can walk into a drug store and nearly every makeup brand offers SPF-enriched or mineral products. With this growing gray area, it will be interesting to see how the boundaries of the FDA will adjust.

A Way to Treat Those Aging Lobes

Just like any other area of skin, earlobes are prone to the signs of aging. From drooping earring holes wrinkled skin, your ears deserve to look just as beautiful as you do.

Dermal fillers—such as Juvederm or Radiesse—can now be used to treat aging earlobes. More commonly used for wrinkles in the face, these fillers can rejuvenate your maturing lobes. For earring holes that have drooped due to heavy jewelry, fillers can be injected to minimize the size of the whole and add support.

Plastic surgeons can also treat wrinkles on the earlobe with fillers as they would treat wrinkles around the eyes or mouth.

Avoiding sun exposure and heavy earrings are ways to prevent premature aging of the skin, however, collagen and elastin naturally breaks down over time.

While some patients prefer to undergo otoplasty for more permanent wrinkle reduction, dermal fillers both deliver permanent results and no downtime. If you are a Delaware resident considering fillers for your ears,  our friendly staff at Danyo Plastic Surgery would be happy to address any questions or concerns you may have.

The Future of the Body Contouring Market

Let’s face it, North America, particularly the U.S., is getting fatter. With rising obesity rates comes an increased demand in the body contouring market. Patients are seeking at latest ways to get their body in shape, and doctors are increasingly adapting to advancements in body contouring technology.

A recent article from BusinessWire.com predicts how the introduction of new devices, as well as the recession, will have an effect on the body contouring market over the next few years. There have been numerous devices approved since 2008 in the way of laser-assisted liposuction(LAL) and cryolipolysis that have recently become more available to consumers.

Despite the rising frequency of body contouring devices, the price of treatment may deter patients during the recession. Doctors have to earn back their investment on said devices, which cost upwards of $100,000, and do so through the cost of the treatment to patients. The cosmetic surgery industry is currently facing many obstacles; however, as patients postpone or even forego these elective procedures in order to conserve funds.

Despite the decline in device sales from 2008 to 2009, Millennium Research Group predicts an economic revival of the body contouring market to be reported for 2010.

SmartLipo MPX, the first dual-wavelength LAL device available in the market, was launched in Canada and the U.S. in 2008. Other big launches to take place in 2009 included CoolLipo by CoolTouch, SlimLipo by Palomar Medical Technologies, Syneron’s LipoLite, Sciton’s ProLipo PLUS and SmoothLipo by Elem Medical.

The first transdermal ultrasound device to be available in Canada was UltraShape’s Contour 1. In 2009, Medicis’ LipoSonix, which has had difficulty getting FDA approval, received Health Canada approval. To date, there are no transdermal ultrasound devices available in the U.S. In the way of cryolipolysis, Coolsculpting by Zeltiq has been available for off-label fat removal since last summer.

Even with the threats of the recession affecting the body contouring market, the obesity problem in North America guarantees a growing number of prospective patients available.  Furthermore, as body contouring technology advances there will be a growing consumer demand and market growth.

Cosmetic Surgery is No Cure for Body Dysmorphic Disorder

Body dysmorphic disorder (BDD) has been getting a lot of attention in the media recently.  The condition, which drives people to constantly alter their appearance in a desire to be perfect, is oftentimes linked to plastic surgery. But do BDD sufferers actually benefit emotionally by undergoing plastic surgery? A new study’s says ‘no’. Despite these findings, there are surgeons who still provide requested surgeries to BDD sufferers.

The study, which was recently published in the Annals of Plastic Surgery, was spearheaded by Katharine A. Phillips, MD, is the director of the body image program at Rhode Island Hospital. Phillips defines BDD as “a psychiatric disorder characterized by preoccupation with an imagined or slight defect in appearance which causes clinically significant distress or functional impairment. A majority of these individuals believe they have an actual deformity that can be corrected by cosmetic treatments to fix these perceived defects rather than seeking psychiatric intervention."

Phillips co-authored the study with Canice Crerand, PhD, of the Children’s Hospital of Philadelphia. The researchers reported that previous studies showed BDD to be relatively common among individuals who underwent plastic surgery, accounting for roughly 7-8% American plastic surgery patients. The duo retrospectively studied 200 individuals with BDD. Of the group, 31% sought and 21% received surgical or minimally invasive treatments to remedy their BDD symptoms.

The study found that almost all of the individuals still experienced BDD symptoms, while some even developed new appearance fixations. The researchers also surveyed 265 cosmetic surgeons, of which 65% reported treating patients with BDD symptoms. Only one percent of the reported cases that were treated resulted in symptom improvement.

The most common surgical procedures among the patients were rhinoplasty and breast augmentation, while the most popular non-invasive treatments were dermal fillers and microdermabrasion. Three-quarters of all the desired procedures involved the face, and more than a third of the patients studied underwent numerous different treatments.

In the long-term, only 25% of patients with BDD showed a more positive appraisal of their treated body parts. Not only that, only two percent of treated patients saw a lasting improvement of their overall BDD symptoms.   

Of the patients who sough treatment, 20% did not receive a procedure. Surprisingly, patients with BDD were turned down more often due inability to pay for a procedure than they were for their symptoms. Thirty percent of patients could not undergo their procedure due to financing, while 26% were refused treatment by a doctor. The researchers also found that surgeons were significantly less likely to refuse a cosmetic treatment than other procedures, such as dermatological, dental or otherwise.

"This suggests that many surgeons were not aware of the patient's BDD or do not consider BDD a contraindication to treatment,” says Phillips.  “In a survey of 265 cosmetic surgeons, only 30 percent believed that BDD was always a contraindication to surgery."

While some cases of body dysmorphic disorder are easy to recognize, other cases are not so clear-cut. This study is an indicator that there should be more training and sensitivity in the aesthetic plastic surgery industry to the symptoms of BDD.  While most patients have a healthy desire to simply enhance their features, the crippling symptoms of BDD could be the motive for patients to undergo cosmetic surgery.

2009 International Aesthetic Trends Now Available

For the first time ever, accurate aesthetic plastic surgery statistics are available to the public. The International Society of Aesthetic Plastic Surgery (ISAPS) issued the "ISAPS Biennial Global Survey™" to surgeons in order to gauge aesthetic trends in the top 25 countries and regions for plastic surgery. The Survey represented 75% of all procedures performed in 2009.

Although the ISAPS Biennial Global Survey™ confirmed that the United States remains the country with the most procedures performed annually, there are some countries that are emerging as major centers that may be surprising. Making the top ten list are a few other countries that are not always associated with plastic surgery:
1.    United States
2.    China
3.    Brazil
4.    India
5.    Mexico
6.    Japan
7.    South Korea
8.    Germany
9.    Turkey
10.    Spain

The Survey also revealed that, contrary to popular belief, breast augmentation is not the most popular invasive procedure performed internationally. The top 5 invasive aesthetic procedures are as follows:
1.    Liposuction-18.8%
2.    Breast Augmentation-17%
3.    Blepharoplasty-13.5%
4.    Rhinoplasty-9.4%
5.    Abdominoplasty or Tummy Tuck-7.3%

As for as non-surgical procedures go, neuromodulators like Botox® top the list in popularity. Not only that, the overall number of non-surgical cosmetic treatments performed surpassed the number of surgical procedures. The top 5 non-invasive aesthetic treatments for 2009 were:
1.    Neuromodulators such as Botox® and Dysport®-32.7%
2.    Hyaluronic acid injections such as Juvederm and Radiesse-20.1%
3.    Laser hair removal-13.1%
4.    Fat grafting-5.9%
5.    IPL treatments-4.4%

Amongst other things, the Survey established that there are approximately 30,817 board certified (or national equivalent) plastic surgeons currently practicing. The number of surgical procedures performed globally in 2009 was 8,536,379, while the number of non-invasive treatments was 8,759,187.

The ISAPS Biennial Global Survey™ was created and proctored by Industry Insights, Inc., an independent research firm from Columbus, OH.  Scott Hackworth, a CPA who, along with the firm, has 15 years of experience in researching trends in aesthetic plastic surgery, led the Survey. The two-page, English-based questionnaire was administered to different international plastic surgery societies and focused on the aesthetic procedures performed in 2009.

Study: Less Frequent Botox Injections Achieve Same Results

A study recently found that patients require less frequent Botox® injections after two years of treatment to maintain the same wrinkle-reducing effect.

“After two years of treatment at recommended intervals, patients can potentially cut the frequency, and thus, the cost of their Botox® treatments by half,” says Roger A. Daily, leader of the study and professor of oculofacial plastic surgery at the Oregon Health & Science University (OHSU). The research also showed that Botox® injections are capable of preventing wrinkles in patients who begin treatment during their 30s.

During the study, 50 females aged 30 to 50-years-old were analyzed over two years while they underwent regular Botox® injections. Dailey and his colleagues found that, after undergoing injections every four months for two years, patients can slow the frequency to once every six months and still see desired results.

Physicians previously advised patients—based on earlier research—that they should undergo Botox® injections every three months to see maximum wrinkle-smoothing benefits. According to Dailey, the cost and frequency of Botox® deterred some patients from starting or even continuing their treatment.

Botox® was approved by the FDA for cosmetic purposed eight years ago. In 2009 alone, more than 2.5 million Americans underwent the popular injection (source: ASPAS). Botox® in Delaware should be injected by, or under the supervision of, a board certified plastic surgeon.