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SELECTED PLASTIC SURGERY STORIES FROM AROUND THE WORLD

Recent study shows anti-wrinkle injections may do more than just extinguish signs of ageing.

17/01/2013

A recent study conducted at the University of California, Los Angeles has indicated that the anti-ageing skin treatment BOTOX significantly improves pain and quality of life in people with chronic bilateral posterior neck and shoulder myofascial pain syndrome. Unlike surgical procedures such as breast augmentation or rhinoplasty (nose job,) BOTOX treatment is relatively straight forward, only requiring small anti-wrinkle injections of fluids under the skin.

BOTOX is already used commercially to treat other diseases which cause large amounts of pain and discomfort to victims. Many cosmetic and plastic surgery procedures such as breast augmentation or reduction and rhinoplasty have been reported to often help aid back and neck pain or respiratory problems. Individual's suffering from severe migraines; spasticity and cervical dystonia are all treated with BOTOX injections to help ease their discomfort, and the new findings provide encouraging news for both researchers and cosmetic surgeons alike.

BOTOX is classed in a group of medications called neurotoxins. When injected, BOTOX blocks the nerve signals which cause the tightening of muscle, leading to muscle relaxation. One of the leading causes of the appearance of ageing is muscle tightening, which is why BOTOX is considered so effective as anti-wrinkle injections. BOTOX and other anti-wrinkle injections are a good alternative for people considering having a cosmetic procedure completed to reduce signs of ageing, but are not wanting to undergo a significant surgical procedure like a breast augmentation or rhinoplasty (nose job) procedure.

These positive effects have now been applied to sufferers of acute pain, with the study, completed by Chronic Pain Management Specialists F. Michael Ferrante, M.D. and Andrea Nicol, M.D at UCLA showing that of the subjects given BOTOX to treat pain many described a significant reduction in the levels to which their pain affected daily general activities, their sleep patterns and enjoyment, pointing to an improvement of the subject's quality of life overall.

While there are many other clinical treatments used to help sufferers of acute pain, these latest findings from California offer some fascinating insights into the ways in which anti-wrinkle injections and other cosmetic treatments can be applied to other fields of medicine, with exciting results.

New statistics reveal the most popularly searched plastic surgery procedures of 2012

On the 17^th of December, Realself.com, the world's largest consumer review and information site for plastic surgery patients, released its annual list of the top plastic surgery treatments for 2012 based on research and data analysis of nearly 52 million searches performed on the page throughout the year.

According to RealSelf.com, the most popularly searched procedures in 2012 were:

Cellulaze - (search interest up 32%)

Approved for medical treatment in the United States in 2011, Cellulaze is a laser treatment designed to help combat cellulite. Realself.com received roughly 1.25 million searches for Cellulaze in 2012, making it easily the most searched procedure on the site.

Buttock Augmentation - (search interest up 28%)

According to realself.com, buttock augmentation was the second most searched procedure on the website in 2012. According to the statistics, the most popular type of buttock augmentation is the Brazilian Butt Lift, which takes fat from unwanted areas of the body and injects it into the buttocks to add volume and more definition.

Labiaplasty (Search interest up 22%)

Labiaplasty involves altering the labia through surgery. A labiaplasty usually involves the removal of excess skin and tissue from around the labia. There can be many motivating factors for a woman to consider a labiaplasty. Cosmetic, hygienic and medical motivators could all play a part in a woman's decision to undergo a labiaplasty operation.

RealSelf.com is the leading consumer resource within the $30B medical-beauty industry, which represents everything from elective cosmetic surgery to obesity management to cosmetic dentistry.

The results provide an interesting insight into trends that are on the rise within the plastic and cosmetic surgery community and give a good indication of what some of the most popular treatments in 2013 may be.

Symposium unveils new breakthroughs for Sydney plastic surgery

As part of the Sydney International Breast Cancer Congress (SIBCC,) held between the 23^rd and 26^th of October this year, the Australasian Foundation for Plastic Surgery (Limited) sponsored the plastic surgery symposium which ran in conjunction with other events over the three days.

The purpose of the symposium was to demonstrate to the wider plastic surgery community some of the breakthrough technological and procedural developments that have taken place over the course of the past year.

As the wider congress was convened to discuss research into breast cancer, the plastic surgery symposium focused mainly on developments in the ways in which the use of plastic surgery could aid women recovering from breast cancer treatment. Not only were new developments in breast augmentation procedures discussed, but many research and technological based developments were also proposed.

One of the key discussions of the event surrounded the unique position specialist plastic surgeons have found themselves in to help further research surrounding the advancement of tissue engineering for breast reconstruction.

Professor Wayne Morrison, Director of the Bernard O'Brien Institute of Microsurgery, outlined the fascinating results of a recent small scale trial where researchers attempted to encourage the re-growth of a patient's own breast tissue using fat cells removed from other parts of their body. The trial had close reflections of a more conventional breast augmentation procedure, albeit with a slightly more intriguing twist. The trial involved the insertion of an acrylic breast-shaped chamber with redirected blood vessels attached to the patient's fat cells taken from under her arm. Of the five women who participated, one woman was able to successfully regrow fat tissue to fill the breast chamber.

It was not only research developments that were discussed at this year's Australasian Foundation for Plastic Surgery Symposium. Many exciting new technological developments were discussed as well. One of the most intriguing of these came in the form of Dr Anthony Connell's Airxpander. This specialist piece of technology is a patient controlled breast tissue expander. Working by administering small amounts of CO2 gas into breast tissue, Dr Connell believes this new technology could provide an a more attractive alternative to a breast augmentation or the current process of administering saline solutions via needle injections in order to expand tissue.

These developments are certainly very exciting for plastic surgeons globally. We will most certainly monitor these, not to mention the myriad of other developments discussed at the AFPS surgery symposium with great interest.

Cosmetic surgery growing in Afghanistan

In Afghanistan, a growing middle class has resulted in a growing number of men and women going under the knife, investing in nose jobs, face lifts and tummy tucks.

The reporters met girls in their early 20s who had fled abusive marriages and wanted to have surgery to boost their confidence and take control of their appearance. They also met women who were seemingly under pressure to have surgery from their husbands.

One woman saved for months to get a nose like Angelina Jolie.

Others are going to the clinic with much deeper motivation: seeking nips and tucks to disguise their ethnicity.

Plastic surgery for teenagers

Plastic surgery is usually associated with Hollywood and celebrities, but what you didn't know is that it's not always the case. The number of plastic surgery procedures has been increasing among teenagers. A recent case was American student Nadia Ilse, age 14, who looked to plastic surgery due to bullying.

This has sparked a debate on whether the procedure should be considered an effective option in dealing self-esteem and bullying issues. Some experts have said that surgery was too extreme as it doesn't solve everything and that teenagers should learn to deal with bullying naturally, that is ignoring the ridicule and seek counselling.

The idea of plastic surgery as a solution to bullying can send a wrong message. Vivian Diller, a New York-based psychologist, said on ABC News, When you don't give those young people the chance to see how they naturally evolve, you give them the feeling that it's required that they do something radical to fit in rather than allow them to grow into the person they are.

Nadia has acknowledged that the surgery wouldn't solve her problems and has agreed to take counselling sessions. "You have got to make them see who you are now, so they don't just see your face. They see who you are, and they can look beyond it." She said.

Plastic surgery can give you satisfactory but it would create more stress and concerns over the end result of the procedure, especially for a teenager. Plastic surgery impacts on one's life depending on the end result. It's advisable to consult with a therapist for self-esteem issues before undergoing plastic surgery, and consult with a highly qualified and reputable plastic surgeon as they need to know your goals to achieve great results. Usually, plastic surgeon wouldn't accept those who wish to undergo the procedure for self-esteem issues, seeing that the issues need to be solved first.

Fat transfer for bigger breast

In the wake of a breast implant scandal, plastic surgeons are looking at using a woman's fat stores for breast enlargements.

Lose the fat from your bottom and use it to boost your breast size. It sounds too good to be true, but Australian plastic surgeons are pushing for the green light for a pioneering breast augmentation procedure that does exactly that.

The procedure, known as fat grafting (or autologous fat transfer), uses fat from a person's thighs, stomach or buttocks and implants it in the breast.

It is already performed in the US and Europe, but is not widely available in Australia as most medical indemnity insurers here will not yet cover the procedure. That could change within a year, with the Australian Society of Plastic Surgeons (ASPS) in talks with insurers over the technique.

Dr Graham Sellars, NSW president of the ASPS, believes the procedure has the potential to become "one of the main techniques for both cosmetic and reconstructive breast surgeries".

In the wake of the health scare surrounding the PIP (Poly Implant Prothèse) silicone breast implants, consumers are more wary of putting foreign objects in their bodies, which makes fat grafting an appealing concept. "People will prefer to have their own tissue to something synthetic if it gives comparable results," Sellars says.

However, Sellars cautions the procedure is more expensive and time-consuming than implants, and can only provide a modest enlargement.

Dr Kourosh Tavakoli, a Sydney plastic surgeon who specialises in breast augmentation, says he opposes the technique. "Fat grafting for breasts is still in its infancy, and has too many disadvantages over implants," Tavakoli says.

How it works

The first stage of fat grafting usually requires the patient to wear a special bra for about a month, for several hours each day. The bra has a suction device, which helps to expand the breasts in preparation for extra fat. Then there is the surgery, usually done under local anaesthetic, where fat is removed from one section of the body and inserted into the breast.

After the surgery, the suction bra is worn again for a week or so.

Fat grafting itself is not new. In the late 1980s and 90s, it was widely used in facial augmentations and began to be used for breast enlargements. However, it fell into disrepute because of the risk of the fat tissue calcifying and forming hard lumps when transferred in large amounts. This not only affected how the breasts looked and felt, but was also a problem for mammograms, as the lumps were often mistaken for breast cancer and led to unnecessary biopsies.

Since then, fat-grafting techniques have been refined, as have mammogram interpretation techniques. In 2010 the Royal Australasian College of Surgeons published a review of evidence that stated fat grafting was as safe as other forms of breast augmentation, though more high-quality studies were needed. Last year a US study found that after six months, the majority of fat-grafting patients had no masses or abnormalities in their breasts.

Benefits and risks

Apart from the appeal of using one's own tissue, Sellars says the main benefits of fat grafting are that if successful, the transplant will feel more natural and last longer than an implant. "A silicone implant will wear out. But it's possible to have this kind of enlargement for life," he says.

Tavakoli believes the time and money needed for a successful graft are not worth it. While an implant is one surgery that lasts one to one and a half hours, a fat-grafting surgery takes twice that time. Multiple surgeries are sometimes required, especially if enlarging the breasts by more than one cup size, because about 30 per cent of the fat transferred will be reabsorbed, and there is a limit to how much fat can be safely grafted in a single surgery.

The procedure is also not suitable for very thin, flat-chested women, as they won't have enough body fat, and it does not have the 50 years of refinement silicone transplants have.

"You're going to get a more predictable result with a silicone implant," Sellars says, "but there's now an alternative for people who don't want implants."