Volume Loss, Not Just ‘Sagging,’ Causes Upper Lip Aging

Are aging-related changes in the face related more to “deflation” or “sagging”? A new study helps settle the debate, showing significant loss of volume in the upper lip in older adults, reports the February issue of Plastic and Reconstructive Surgery, the official medical journal of the American Society of Plastic Surgeons (ASPS).

“Our results suggest that the aging perioral area is affected with a combination of soft tissue lengthening, thinning, and volume loss,” concludes the new research, led by Patrick L. Tonnard, MD, PhD, of Coupre Centre for Plastic Surgery, Ghent, Belgium. For plastic surgeons, the findings may help to inform and improve evidence-based approaches to facial rejuvenation.

The researchers analyzed magnetic resonance imaging (MRI) scans of the head obtained for other reasons in 200 adults: 100 women and 100 men. Participants were divided into a younger group aged 20 to 30 and an older group aged 65 to 80. Detailed measurements of the “upper lip unit” were analyzed to evaluate differences between the two groups, with an average age difference of nearly 50 years.

The measurements revealed several age-related differences in the anatomy of the upper lip. These included significant lengthening of the upper lip in older adults: about 19 percent longer in women and 18 percent longer in men, compared to the younger group.

The older group also had decreased soft tissue thickness of the upper lip: by about 41% in women and 33% in men. Most of the reduction in tissue thickness occurred at the “alar nasolabial fold” – the top of the lines running from the base of the nose to the corners of the lips.

The findings suggest that age-related lengthening and thinning of the upper lip represents more than just “sagging.”

“[V]olume loss is an obvious feature of the aging upper lip,” Tonnard and colleagues write. Loss of soft tissue volume also seems to contribute to deepening of the nasolabial folds, a prominent feature of the aging face.

“The mouth and perioral area play a primary role in emotional expression and attractiveness of the face,” according to the authors. “Unfortunately, the mechanisms of centrofacial aging are poorly understood” – as illustrated by the debate over “sagging versus deflation.”

The new study provides insights into these mechanisms, based on detailed MRI measurements in a large sample of older versus younger adults.

Lengthening, thinning, and volume loss all contribute to aging of the area around the mouth, the study suggests. The findings add to the evidence base underlying plastic surgery and other cosmetic procedures for facial rejuvenation.

Tonnard and colleagues plan a follow-up article to discuss the clinical implications of their findings, including the role of dermal fillers for minimally invasive volume augmentation.

[Source(s): Wolters Kluwer Health, EurekAlert]

Age Alone Doesn’t Increase Complications of Free-Flap Breast Reconstruction in Older Women

Breast reconstruction using a “free flap” from the patient’s abdomen is a safe procedure with a high success rate in older women opting for reconstruction after mastectomy, reports a study in the December issue of Plastic and Reconstructive Surgery, the official medical journal of the American Society of Plastic Surgeons (ASPS).

Although the risk of some complications is higher, free-flap reconstruction has “generally good outcomes” in women aged 65 or older, according to the report by ASPS Member Surgeon Oren Tessler, MD, MBA, and colleagues of Louisiana State University Health Sciences Center, New Orleans.

“Older women desire breast reconstruction after mastectomy, and should be offered all reconstruction options available,” Tessler comments, in a media release from ASPS.

To read the full press release about the study, visit www.eurekalert.org

Balance Adam’s Apple Surgery Satisfaction with Need for Caution, Study Notes

Cosmetic surgery to reduce the masculine appearance of the “Adam’s apple” has a high patient satisfaction rate, according to a study in Plastic and Reconstructive Surgery–Global Open, the official open-access medical journal of the American Society of Plastic Surgeons (ASPS).

But plastic surgeons performing this procedure must balance the cosmetic results against the need for caution to prevent irreversible voice changes, according to the outcomes study by Jeffrey H. Spiegel, MD, and colleagues of Boston University Medical Center. Their study presents a new questionnaire for use in assessing the cosmetic outcomes and quality-of-life impact of Adam’s apple reduction surgery in transgender and other patients.

Read the full press release at www.eurekalert.org

American Society of Plastic Surgeons Names Alan Matarasso, MD, as New President

Alan Matarasso, MD, Clinical Professor of Surgery at Northwell Health System/Hofstra University, Zuckerman School of Medicine and a private practice plastic surgeon based in New York City, was named president of the American Society of Plastic Surgeons (ASPS), the world’s largest organization of board-certified plastic surgeons. Dr. Matarasso took office at Plastic Surgery The Meeting, the Society’s annual scientific meeting, in Chicago and will serve for one year.

“I am honored to lead the world’s largest organization of board-certified plastic surgeons,” Matarasso notes, in a media release. “As President, I will ensure that ASPS continues to advocate for patient safety and provide members with practice support, educational opportunities and resources to ensure we advance and improve the quality of care for plastic surgery patients.”

Read the full press release at www.prweb.com

IDEAL IMPLANT Developed as a Solution to Address ‘Silent Rupture’

Thousands of US women with FDA-approved silicone gel implants do not realize their implants have ruptured, according to cross-referenced data from the American Society of Plastic Surgeons (ASPS), the American Society for Aesthetic Plastic Surgery (ASAPS) and silicone gel implant rupture rates monitored by the FDA.

As an MRI is recommended by FDA after the first 3 years then every two years to detect silicone gel implant rupture, conservative estimates point to over 150,000 women across the country living daily with “silent rupture”— and sticky silicone gel in contact with their tissues.

“Replacing ruptured silicone gel implants has been a very common surgery for plastic surgeons, due to the rates of rupture and capsule contracture,” explains Newport Beach Plastic Surgeon Larry Nichter, in a media release.

“This is driving demand for new technology advancements like the structured IDEAL IMPLANT. It’s internal baffling structure provides a similar natural look and feel to silicone gel implants, it has a very low rupture risk, easy rupture detection by looking at the breast, and only saline coming into contact with body tissue if the implant shell is compromised. So it’s clear why more women are choosing this third option.”

ASPS reports that 4.93% of the 158.3 million women in the United States have undergone breast augmentation surgery. As the top cosmetic surgery procedure in the US for over a decade, according to the release, procedures are up 40% since 2000, with over half of patients choosing silicone gel or “gummy bear” implants since the FDA allowed them back on the market in 2006. With rupture risk ranging from 8.7% to 24.2% over 10 years, and no way to easily detect rupture without a potentially costly MRI, tens of thousands of women with ruptured silicone gel implants are unaware of what is happening inside their body.

Even if many women are in the dark about whether their silicone gel implants are intact, this doesn’t mean they aren’t worried. According to survey results of 1,143 women presented at the March 2018 ASPS meeting, 97% said they would want to know if their silicone gel implants were ruptured, with 95% wanting the faulty implant replaced, even if it was not causing symptoms. Anxiety about potential rupture also ran high, with most women reporting they would be “very” or “constantly” concerned of silicone gel silent rupture (73%), including 68% of women who already had silicone gel implants, the release continues.

“After years of struggling with ruptured silicone gel implants in my practice and hearing countless patient concerns, I felt women shouldn’t have to choose between the natural look and feel of a silicone gel implant and the peace of mind of saline in their body,” explains Robert S. Hamas, MD, president and CEO of Ideal Implant, the maker of the IDEAL IMPLANT Structured Breast Implant approved by both FDA and Health Canada in 2014.

“We all expect technology advancements in every aspect of our lives, and it was time to develop a third option that provided the benefits of both of the earlier implant choices without the drawbacks—truly an ideal solution.”

For more information, visit IDEAL IMPLANT.

[Source: IDEAL Implant]

Plastic Surgery Societies Issue Urgent Warning About the Risks Associated with Brazilian Butt Lifts

Gluteal fat grafting, more commonly referred to as the popular Brazilian Butt Lift (BBL) procedure, has resulted in an alarming rate of mortality, estimated to be as high as 1:3,000, a rate of death far greater than any other cosmetic surgery.

In response to these unusually high figures, the American Society of Plastic Surgeons (ASPS), the American Society for Aesthetic Plastic Surgery, International Society of Aesthetic Plastic Surgery, International Society of Plastic Regenerative Surgeons and the International Federation for Adipose Therapeutics and Science, formed the Task Force for Safety in Gluteal Fat Grafting with the goal of conducting studies to develop specific safety guidelines. The task force, which represents plastic surgeons worldwide who are board-certified by the American Board of Plastic Surgery (ABPS), issued an advisory to surgeons this week, urging discussion of these risks with patients and providing additional recommendations for the safe performance of the procedure.

Read the full press release at PR Newswire.