As body weight is lost, bariatric surgery patients become prone to nutrient deficiencies.  In this study of 100 patients (98 gastric bypass and 2 lap band), nearly 18 percent of the subjects showed protein intake levels that were lower than the recommended intake.  Additionally, 39.7 percent showed low iron intake and 11 percent had low intake of vitamin b12.

The Importance of Protein

Protein intake is important for the post-bariatric patient, for general health reasons as well as surgical reasons.  Protein aids the healing process during recovery from body contouring and its deficiency has been linked to problems such as “decreased wound tensile strength and increased rates of skin and fascial wound breakdown.”

The authors found certain predictors of low protein intake in their subjects. Those with increasing age and those who underwent a greater change in BMI after bariatric surgery were more likely to have a low daily protein intake.  Because food intolerance is relatively common in post-bariatric patients, a higher daily protein allowance may be recommended, the authors suggest.

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Nutritional Assessment of Bariatric Surgery, Patients Presenting for Plastic Surgery: A Prospective Analysis Naghshineh, Nima; O’Brien Coon, Devin; McTigue, Kathleen; Courcoulas, Anita P.; Fernstrom, Madelyn; Rubin, J. Peter.  Plastic & Reconstructive Surgery. 126(2):602-610, August 2010.

The most popular cosmetic surgery, according to the data, is liposuction, followed by breast augmentation, eyelid surgery, rhinoplasty and tummy tuck.  Although procedures varied among different countries, the U.S., Brazil, China, Mexico, India and Japan represented the bulk of the top five surgical procedures.  The total estimated number of cosmetic procedures performed by board-certified (or equivalent) plastic surgeons was 17,295,557.

Interestingly, plastic surgeons reported more non-surgical procedures than surgical procedures, with the most common treatment being botulinum toxin injections (Botox or Dysport).

The survey data was released in time for the 20^th Biennial Congress of ISAPS, which is taking place right now in San Francisco.  Read more on isaps.org or prnewswire.com

Various networks have introduced programs with a significant focus on cosmetic surgery.  On cable networks, cosmetic surgery has been shown on programs such as Real Housewives of Orange County or Extreme Makeover.  On network television, you might see plastic surgeons featured on The Doctors or The Biggest Loser. The question posed by researchers was, how do these programs affect one’s opinion about cosmetic surgery?

According to studies from psychology professors at Rutgers University in New Jersey, when compared to television shows with a “neutral message,” these shows spur greater interest in altering your appearance through cosmetic surgery.

In one study, the authors surveyed 170 participants and found that those who favored reality television shows about cosmetic surgery were more likely to show interest in pursuing their own procedure.  In a second study, 189 participants were split into two groups, with one viewing a television program about a surgical makeover, while the other half was exposed to a neutral message.  Participants viewing the surgical makeover program indicated greater interest in cosmetic surgery than the participants exposed to the neutral message.

But are these programs presenting a realistic picture of cosmetic surgery?  If viewers are as impressionable as the study goes to show, there’s surely a need to present a more realistic and less sensational documentation of cosmetic surgery.

Read the study mentioned here, “A correlational and experimental examination of reality television viewing and interest in cosmetic surgery” on PubMed.

Two clinical trials were cited during the approval process, along with studies that compared XEOMIN to Botox®.  According to a study cited in the Journal of Neurological Sciences, [XEOMIN] showed “non-inferiority” to Botox® when used in equivalent doses for the treatment of blepharospasm.

The difference between XEOMIN and its competitors, according to the manufacturer Merz Pharmaceutical, is that “XEOMIN does not require refrigeration prior to reconstitution. “  The company says this could “simplify product distribution and storage, and help ensure product integrity at the time of injection.”

Merz is also acquiring Bioform Medical, a California company that manufactures Radiesse dermal filler.  The German company seems poised to create a significant presence in the U.S. aesthetics market.  When the acquisition of Bioform Medical is complete, the company will be rebranded “Merz Aesthetics.”

Authors of a previous study found a link between high quality care and the doctor’s satisfaction in his or her job.  Knowing these statistics on plastic surgeons can therefore give us a general picture of the “health” of this profession in America and how it might affect the care you receive.

A questionnaire was mailed to 708 doctors who are members of the American Society of Plastic Surgeons, half of them male and the other half female.  The inquiry posed several questions about career satisfaction such as:

• Was a career in plastic surgery the right choice?
• Would you choose this career again if you had to do it over again?

Other questions inquired about income, switching specialties and retiring early.  The results are very positive, i.e. it appears that plastic surgery is a generally satisfying career in the United States.  93 percent of respondents said it was the right career choice and 78 percent said they would make the choice again if they had to.  Only a small percentage said they regretted the choice to become a plastic surgeon.

The most interesting outcomes of the survey were 1) the data regarding differences in satisfaction between surgeons who are “intellectually isolated” and those who are actively involved with their colleagues, and 2) the difference in satisfaction between surgeons who are focused primarily on reconstructive surgery and those who “balanced” their focus between reconstructive and cosmetic operations.

The study is published online ahead of print and you can access it through the journal’s website.

Source

Satisfaction with Career Choice among U.S. Plastic Surgeons: Results from a National Survey.   Streu, Rachel; Hawley, Sarah; Gay, Ashley; Salem, Barbara; Abrahamse, Paul; Alderman, Amy K . Plastic & Reconstructive Surgery.

A recent study published in Psychiatry Research provides the most recent update on the prevalence of BDD, examining the population demographics that are most affected and the tendency of those affected to seek cosmetic surgery.  2,510 German people were analyzed in the research study, and 45 of them were showed symptoms of BDD.  Symptoms (or inclusion criteria) included the following:

• Preoccupation with an imagined defect in appearance
• Concern is markedly excessive
• Causes clinically significant distress / impairment in function

Of those 45 people experiencing the above symptoms, 7 of them had undergone cosmetic surgery.

As a general rule, cosmetic surgeons do not operate on patients who have this disorder — for many reasons, including the high chance for the patient to be dissatisfied with the results.  However, patients do not always report symptoms of BDD to their cosmetic surgeon.  They may be embarrassed about it or they may be unaware that such behavior (preoccupation with a perceived appearance defect) is abnormal.  Subjects in the study showed an intense, frequent preoccupation and dislike of body parts such as the ears, nose, stomach, hips, buttocks, skin and breasts.

The disorder poses a significant threat to one’s health.  Aside from being a general hindrance, BDD is linked to increased thoughts about suicide and suicide attempts.  Therefore, as authors of the study suggest, awareness of body dysmorphic disorder should continue to increase and careful screening by healthcare providers should be initiated to help people suffering from it.  A disorder like BDD also reinforces the need for cosmetic surgery patients to be completely open and honest about their reasons for seeking surgery and their medical history.

You can access this study, “Updates on the prevalence of body dysmorphic disorder: A population-based survey” through Elsevier Journals or Science Direct.

Although we may try to judge people purely on their personality, character, or competence in the workplace, there are other biases at work, the report suggests. “Looking good is no longer something we can ignore or dismiss as frivolous or vain,” argues reporter Jessica Bennet.

If society were not biased in favor of attractive people, would these statistics be true?

• “A good-looking man will make some $250,000 more than his least-attractive counterpart, according to economist Daniel Hamermesh.”
• “Fifty-seven percent of hiring managers told Newsweek that qualified but unattractive candidates are likely to have a harder time landing a job.”
• “More than half of those hiring managers advised spending as much time and money on “making sure they look attractive” as on perfecting a résumé.”

Lots of surprising statistics are cited throughout the report, but what’s more interesting are the biological and psychological explanations for the beauty advantage.  Is our bias an appreciation of the Platonic ideal form?  Are we unconsciously surrounding ourselves with attractive people in order to produce healthy offspring?  It’s unlikely that a single answer can satisfy our curiosity on this topic.

For many people in our generation, it comes down to an individual choice: how far will you go in your pursuit of beauty?  In the continuum of choices you can make to change your appearance, it’s not always clear where to draw the line.  Many people are quite satisfied with little more than a stylish wardrobe or haircut, but not every person begins their pursuit with the same beauty advantage.

The use of collagen-based dermal fillers has noticeably dropped off in recent years—and it shows in the announcements by two leading makers, Allergan and Johnson & Johnson, that they will stop producing their respective collagen products (the human-derived CosmoDerm and CosmoPlast, the bovine Zyderm and Zyplast for Allergan; the porcine Evolence for Johnson & Johnson).

For a long time, collagen was the dermal filler of choice for plastic surgeons and dermatologists. Considering donor tissue origins, however, it is understandable that questions might arise with the use of collagen. Plus, collagen-based fillers require skin allergy testing and are relatively short-lived compared to the newer generation of fillers.

As in many markets, demand and money drive the evolution of new products, and dermal fillers are no exception. The popularity of non-animal hyaluronic acid (HA) fillers (known as replacement fillers because they replace lost volume) and PLLA and PMMA fillers (known as stimulatory fillers because they stimulate collagen and fibroblast production) has been strong in the recent past. Restylane, Radiesse, Perlane, Juvéderm, and Sculptra currently dominate the US market. Dermatologists report these hypoallergenic HA, PMMA, and PLLA fillers as being more versatile, longer-lasting, bulkier, and better for deep-volume filling than collagen.

But what about fine and thin line use, such as for foreheads or smokers lines around the mouth? Collagen was usually considered better for those applications. But Restylane Fine Lines is one HA product that makers hope to take over what used to be collagen territory.

What will the world of dermal fillers look like in the future? It’s difficult to say but change is definitely underway. Although fillers that indirectly stimulate fibroblast production are holding sway, direct injection of fibroblasts with Human Dermal Fibroblasts (HDFs) may be a trend. UK dermatologists are currently testing Valveta, a filler derived from the foreskins of male babies that is reputed to repopulate skin with healthy young cells and be long-lasting, if not permanent.

With all of the sources for patients to reference, some are still lacking important information before they undergo breast surgery. By analyzing interviews with 48 patients, the authors of this article sought to uncover what is missing and report on the informational needs of women who undergo breast reconstruction, breast reduction, and breast augmentation.

They found 2 predominant themes among breast surgery patients: unexpected outcomes and helpful/unhelpful information.  Both themes have some clinical implication for plastic surgeons performing breast surgery – namely, “the need for more comprehensive education to better prepare women undergoing breast surgery and to help create more realistic expectations.”

Most patients in the study reported a positive outcome and high satisfaction with their surgeries, but most of them also experienced an unexpected event. Swelling, numbness, discomfort, sensations in the skin, and a “just plain weird feeling and uncomfortableness” were reported by patients in the study group.  Had these patients received more complete information before surgery, they would have been psychologically prepared for these events, the authors suggest.

Patients in the study also named the most helpful information sources that prepared them for breast surgery:

• The surgeon’s before and after photos
• Stories about the experiences of other women
• Online forums

These sources are readily available online, but you should still seek a plastic surgeon who is willing to provide comprehensive information about breast surgery and what to expect during recovery.

You can read the article “Not What I Expected: Informational Needs of Women Undergoing Breast Surgery” through PubMed.gov or journal, Plastic Surgical Nursing.

Only the first 10,000 people who donate will receive the Latisse free trial certificate. You may remember last year’s campaign led by Brooke Shields. This year, the campaign is led by lifestyle designer Kathy Ireland, professional ballroom dancer Chelsie Hightower and style guide Bobbie Thomas. Watch the video to learn more about the campaign and see important product information about Latisse.

“With approximately 1.5 million bottles sold since launching the product a little more than a year ago, LATISSE is giving back by helping the Make-A-Wish Foundation grant the wishes of children. Through the campaign, we will double each individual’s donation, with a maximum donation of $250,000, through October 31,” said Robert Grant, President of Allergan Medical, a division of Allergan, Inc.