Plastic Surgery Practice

Plastic Surgery Practice
Plastic Surgery Practice is the brand that 12,000 plastic surgeons rely on for the latest information on the clinical innovations, practice-management trends, emerging products and technologies, and news stories that drive their field. With well-thought-out articles by leading practitioners, PSP gets to the core of the most complex issues in plastic surgery, including controversial new treatments, the use of highly technical equipment, and physician-patient interactions.

The American Board of Facial Cosmetic Surgery Opens Applications for 2023 Certifying Exam
<div><img src=”” class=”ff-og-image-inserted”></div><p>The American Board of Facial Cosmetic Surgery (ABFCS) announces the opening of its application window for facial cosmetic surgeons interested in sitting for the board’s annual certifying exams. The medical board provides certification to surgeons focused on aesthetic procedures of the head, face, and neck.</p>

<p>“Our mission is to certify safe, skilled cosmetic surgeons who dedicate much or all of their practice to facial aesthetic procedures, helping patients locate a surgeon they can trust,” says ABFCS President Sheila Barbarino, MD, FAAO, FAACS, FACS. “The examinations are the core of that mission, and we are happy to offer interested surgeons a four-month application window.”</p>

<p>The certifying board accepts applications from experienced facial cosmetic surgeons who have relevant residency backgrounds like ophthalmology, oral and maxillofacial surgery, and plastic and reconstructive surgery. Among other rigorous standards—including residency training and primary board certification—surgeons who qualify to take the certifying exam must have&nbsp;<a href=”;l=en&amp;o=3711225-1&amp;h=749919402&amp;;a=demonstrated+skill+and+experience+in+facial+cosmetic+surgery” target=”_blank” rel=”noreferrer noopener”>demonstrated skill and experience in facial cosmetic surgery</a>. This experience may be obtained through either practice experience,&nbsp;<a href=”;l=en&amp;o=3711225-1&amp;h=199473999&amp;;a=fellowship+training+with+the+American+Academy+of+Cosmetic+Surgery+(AACS)” target=”_blank” rel=”noreferrer noopener”>fellowship training with the American Academy of Cosmetic Surgery (AACS)</a>, or equivalent fellowship training.</p>

<p>Barbarino states, “As a sub-specialty organization, we are proud of our diverse composition. Facial cosmetic surgeons from backgrounds like dermatology and otolaryngology have contributed to advancements in cosmetic surgery techniques and patient safety. And within the ABFCS, we have found that this diversity advances our individual skills further.”</p>

<p>The credentialing board will close applications on&nbsp;Feb. 28, 2023. The examination will be administered in two parts: a written exam on&nbsp;May 20, 2023,&nbsp;and an oral exam in&nbsp;August 2023.</p>

<p>Interested surgeons may&nbsp;<a href=”;l=en&amp;o=3711225-1&amp;h=4048771701&amp;;a=contact+the+ABFCS+directly” target=”_blank” rel=”noreferrer noopener”>contact the ABFCS directly</a>&nbsp;with questions or learn more about facial cosmetic surgery board certification and&nbsp;<a href=”;l=en&amp;o=3711225-1&amp;h=2329557968&amp;;a=review+full+application+requirements+online” target=”_blank” rel=”noreferrer noopener”>review full application requirements online</a>.</p>
Mon, 21 Nov 2022 16:57:18 +0000 Keri Stephens
Continuing Education

Prime Aesthetics Group Expands Footprint
<div><img src=”” class=”ff-og-image-inserted”></div><p>Prime Aesthetics Group, a healthcare partnership comprised of U.S. plastic surgery practices, announces that it has acquired Beverly Hills, Calif.-based NassifMD&nbsp;Plastic Surgery &amp; Med Spa.</p>

<p>“Since launching Prime three years ago, our vision was always to create a coast-to-coast operation, bringing unparalleled business acumen, innovation, and obsession with patient care to the entire country,” says James Chao, MD, FACS, co-founder and chief medical officer of Prime Aesthetics Group. “We’re thrilled to be fortifying our partnership with this truly iconic practice, which fits perfectly into our overarching strategy.”</p>

<p>NassifMD&nbsp;Plastic Surgery &amp; Med Spa is a full-service cosmetic surgery practice specializing in in facial reconstruction and rhinoplasty. The practice will continue to be led by Paul Nassif, MD, a plastic surgeon and star of the&nbsp;<a href=”;l=en&amp;o=3712612-1&amp;h=2956303602&amp;!&amp;a=E!” target=”_blank” rel=”noreferrer noopener”>E!</a>&nbsp;reality series&nbsp;<em><a href=”;l=en&amp;o=3712612-1&amp;h=164179668&amp;;a=Botched” target=”_blank” rel=”noreferrer noopener”>Botched</a></em>, which highlights his expertise as he remedies the most extreme plastic surgeries gone wrong. Season 8 of Botched is currently under production and expected to release next spring.</p>

<p>“I’ve worked hard to develop a reputation in our industry and been approached countless times over the years by private equity groups interested in purchasing our practice. None of those opportunities interested me,” says Nassif. “Simply put, Prime is different. I’m truly excited to partner with Dr. Chao and all the surgeons in our group to build an organization with exceptional patient care as its cornerstone.”</p>

<p>To date, Prime has acquired eight practices. The company recently completed a capital investment round with White Oak Global Advisors, an alternative debt manager which has deployed more than&nbsp;$10 billion&nbsp;in transactions since 2007. Proceeds from White Oak Global Advisors have been utilized to fund the three most recent acquisitions, including Nassif, and White Oak anticipates continuing to partner with Prime on future similar acquisitions.&nbsp;&nbsp;</p>
Fri, 18 Nov 2022 18:46:34 +0000 Keri Stephens
company news
NassifMD Plastic Surgery & Med Spa
Prime Aesthetics Group

FDA OKs Xironetic Augmented Reality Surgical Software
<div><img src=”” class=”ff-og-image-inserted”></div><p><a href=””>Xironetic</a>, an Oklahoma City-based early-stage healthcare technology company, announces that the U.S. FDA has cleared its IntraOpVSP augmented reality (AR) visualization software for complex surgical cases.&nbsp;</p>

<p>IntraOpVSP displays patient CT and MRI as three-dimensional holograms in AR headsets, helping surgeons visualize surgical plans, anatomical targets, and cutting guides alongside or overlayed on the patient. The software can be used during surgery and pre-operative planning and includes hand tracking and voice recognition features.</p>

<p>Current and planned use cases for IntraOpVSP are expected to align to the needs of physicians across numerous surgical disciplines including plastic surgery.&nbsp;</p>

<p>“IntraOpVSP is an extension to virtual surgical planning tools used today, bringing the insights of 3D visualization of CT and MRI data into the operating room to support improved surgical outcomes,” says Christian El-Amm, MD, Xironetic founder, and chief pediatric surgeon at Oklahoma Children’s Hospital. “Our software is a huge step forward for surgeons and their patients, and the FDA’s clearance is another important milestone in getting it into operating rooms everywhere.”</p>
Thu, 17 Nov 2022 13:34:20 +0000 Keri Stephens

Plastic Surgery and the Body Dysmorphic Disorder (BDD) Patient
<div><img src=”” class=”ff-og-image-inserted”></div><h2 id=”h-the-secret-of-personal-attraction-is-locked-up-in-our-unique-imperfections-flaws-and-frailties”>“<em>The secret of personal attraction is locked up in our unique imperfections, flaws, and frailties.</em>“</h2>

<h6>By Alexander Zuriarrain, MD, FACS</h6>

<p>The quote, from social researcher and author Hugh MacKay, underscores the message we as cosmetic and plastic surgeons must deliver to our patients in the presence of a growing prevalence of body dysmorphic disorder (BDD).&nbsp;</p>

<p>BDD is a psychiatric disease that causes a preoccupation with illusory flaws in one’s features or body shape and affects both men and women, especially adolescents and younger adults. Experts contend the increased incidence of the disorder is being driven, in part, by social media and society’s fascination with “selfies.”&nbsp;</p>

<p>In fact, a 2018 article published in&nbsp;<a href=”″><em>JAMA Facial Plastic Surgery</em></a><em>&nbsp;</em>indicates that more than half of plastic and cosmetic surgeons report having conversations with patients who want to undergo aesthetic procedures, particularly facial fillers, rhinoplasty, and liposuction, to improve the way they look in “selfies.”</p>

<p>Moreover, authors of a 2020 study in&nbsp;<a href=””><em>Dermatology Reports</em></a><em>&nbsp;</em>find&nbsp;BDD to be “significantly associated with longer duration spent on Snapchat and Instagram<em>.”&nbsp;</em>These same investigators describe manifestations of BDD as “excessive mirror checking or mirror avoidance, camouflaging certain body parts, seeking reassurance, and excessive evaluation. Patients with BDD are frequently seen seeking correction at plastic surgery and dermatology clinics.”</p>

<h2>Importance of BDD Pre-Procedure Screening</h2>

<p>The physician authors of a 2021&nbsp;<a href=””><em>Psychology Today</em></a>&nbsp;article contend the “unattainable desire” for appearance perfection “can lead to plastic surgery addiction…, a&nbsp;compulsion to continuously alter one’s appearance with cosmetic surgery.” And they call on plastic and cosmetic surgeons to use questionnaires or other screening tools for signs of BDD, such as a patient’s overconcern about appearance or attempts to hide aspects of it, belief facial flaws or body shape is impacting quality of life and relationships with other people, an impaired self-image, and the desire to obtain aesthetic procedures on multiple occasions and in rapid succession.&nbsp;</p>

<p>“The ability to help patients with BDD get treatment for their condition [by referring them to psychiatrists or therapists] is as important to the plastic surgeon’s repertoire as their surgical skills&nbsp;are,” these physicians write.</p>

<p>Further, a survey involving more than 170 respondents from Dutch associations in aesthetic plastic surgery, dermatology, and cosmetic medicine indicates “most cosmetic professionals have some degree of awareness of body dysmorphic disorder, although the number [of BDD patients] they report encountering in clinical practice departs from prevalence figures,” say the questionnaire’s authors. Their study appears in an issue of&nbsp;<a href=””><em>Plastic and Reconstructive Surgery</em></a><em>.</em></p>

<p>However, scientists writing in a 2020 edition of the&nbsp;<a href=”″><em>Journal of Cosmetic Dermatology</em></a><em>&nbsp;</em>state, “The incidence of body dysmorphic disorderis high. Even though treating patients with this disorder may worsen symptoms and is fraught with potential complications, [surgeon] screening is low, due in part to a lack of knowledge of the disorder, as well as inadequate screening tools.” These same investigators indicate respondents to a survey “sent to nearly 3,000 practicing dermatologists and members of the American Society for Dermatologic Surgery (ASDS),&nbsp;estimated that 13% of all new patients likely had BDD. [But] only 60% [of responding surgeons] routinely asked new patients about psychiatric history, and 37% did not consider BDD to be a contraindication to cosmetic treatment, despite the acknowledgement…that patients with BDD who received treatment became more focused on the defect or found new defects to focus on after the procedure.”</p>

<h2>Cosmetic Procedures Most Desired by BDD Patients</h2>

<p>Cosmetic rhinoplasty, facial fillers, abdominoplasty, and liposuction are procedures commonly sought by patients with BDD. In a 2019 report in&nbsp;<a href=””><em>Aesthetic Plastic Surgery</em></a><em>,&nbsp;</em>scientists note finding a “high prevalence of BDD and moderate to severe appearance-related obsessive-compulsive symptoms…among aesthetic rhinoplasty candidates.”</p>

<p>Another study, this one in&nbsp;<a href=””><em>Laryngorhinootologie</em></a><em>,&nbsp;</em>indicates “the central position of the nose in the face makes the nose one of the most common areas of concern in patients with BDD. Thus, aesthetic rhinoplasty is suspected [of being] one of the most frequently requested and performed surgical procedures in this population.”&nbsp;</p>

<p>The authors of this study go on to say that “BDD should be considered a contraindication for aesthetic rhinoplasty, as favorable outcome is unlikely. In order to prevent patients from undergoing unsatisfying surgery, and in the context of the increasing importance of medico-legal arguments, the rhinoplasty surgeon should be familiar with BDD.”</p>

<p>Additional research has found links between BDD and requests for liposuction&nbsp;<em>(</em><a href=””><em>Dermatologic Surgery</em></a><em>)</em>&nbsp;and abdominoplasty&nbsp;<em>(</em><a href=”″><em>Aesthetic Surgery Journal</em></a><em>).&nbsp;</em>In fact, the authors of the&nbsp;<em>Aesthetic Surgery Journal</em>&nbsp;article say, “Body contouring surgery is most frequently sought by patients with BDD&nbsp;and those with eating disorders.” Other researchers find eating disorders and BDD to be interrelated and prevalent in plastic surgery patients and suggest both disorders are “contraindications to surgery.”</p>

<p>Moreover, in an online article in&nbsp;<a href=””><em>Cosmetic Treatments and Body Dysmorphic Disorder</em></a><em>,&nbsp;</em>experts suggest as many as 40% of BDD patients pursue cosmetic treatments. In one study, as many as 14% of patients in cosmetic dermatology clinics “met the criteria” for having BDD, the authors write, adding that these patients were more likely to be dissatisfied with their treatment outcomes and seek additional procedures.</p>

<h2>Key Takeaways</h2>

<p>So, what is the key takeaway? As aesthetic and plastic surgeons, we must do a better job of recognizing patients who suffer from symptoms of BDD. That means learning as much as possible about the disorder and finding appropriate screening tools. Scientists, writing in&nbsp;<em><a href=””>Tijdschrift Voor Psychiatrie</a></em>, conclude: “Preoperative screening of BDD patients is vital so that efficient psychiatric treatment can be initiated, and patients not subjected to surgical interventions which may be ineffective or even harmful.”</p>

<p>Cosmetic surgery is not a first-order treatment protocol for BDD and can expose a patient to unnecessary surgical risks. In fact, one study showed that only 2% of BDD patients who had undergone cosmetic surgery were satisfied with the end results.</p>

<p>Historically, experts in our field have advised that BDD be treated first as a psychiatric disorder before any surgery is performed. Of course, as we better understand the disorder, we might consider what some experts call “more nuanced decision-making” concerning suitability of specific patients for cosmetic procedures.</p>

<p>According to authors of an article in the&nbsp;<a href=””><em>International Journal of Womens Dermatology</em></a><em>,&nbsp;</em>“some studies report…those [patients] with mild-to-moderate BDD, [who have] no significant impairment in overall functioning, [are without] localized appearance concerns, and [maintain] realistic psychosocial expectations may benefit” from appearance-enhancing surgery. Indeed, cosmetic surgery could improve their overall mental perspective and health.</p>

<p>And research published in the&nbsp;<a href=””><em>Journal of Plastic, Reconstructive &amp; Aesthetic Surgery</em></a><em>&nbsp;</em>suggests just that: A majority of the studied rhinoplasty patients diagnosed with mild to moderate BDD experienced remission of their BDD symptoms and expressed satisfaction with the results of their cosmetic procedure one year postoperatively.</p>

<p>Perhaps, our message to patients, especially those suspected of having BDD, should be what the author of an online&nbsp;<a href=””>article</a>&nbsp;titled “Body Dysmorphia and Cosmetic Surgery<em>”&nbsp;</em>wrote. Beauty, balance, harmony of the face and body “work in concert with other perceived elements, making us like and even feel attracted to someone. Alongside…good looks, authenticity and vulnerability are two very underrated elements of attraction. Visible flaws are there to offer this sense of vulnerability and authenticity. They make you a certified human.”</p>

<p>Or, as author Norhafsah Hamid one said:&nbsp;<em>Do not have expectations. We humans are created imperfect…we have flaws.</em></p>

<p><em><em>Alexander Zuriarrain, MD, FACS, is a board-certified plastic surgeon and owner of&nbsp;<a href=”” target=”_blank” rel=”noreferrer noopener”>Zuri Plastic Surgery</a> in Miami.</em>&nbsp;<em>Listen to a podcast PSP did with him&nbsp;<a href=”” target=”_blank” rel=”noreferrer noopener”>here</a>.</em></em></p>
Wed, 16 Nov 2022 21:27:34 +0000 Keri Stephens
Client Objectives

Revance Publishes 2 Papers on Daxxify Injectable
<div><img src=”” class=”ff-og-image-inserted”></div><h2 id=”h-revance-published-two-peer-reviewed-papers-on-its-daxxify-wrinkle-treatment-in-the-aesthetic-surgery-journal”>Revance published two peer-reviewed papers on its Daxxify wrinkle treatment in the Aesthetic Surgery Journal.</h2>

<p><a href=”” target=”_blank” rel=”noreferrer noopener”>Revance Therapeutics</a> announced the publication of two peer-reviewed papers about its Daxxify treatment in the<a href=”” target=”_blank” rel=”noreferrer noopener”> Aesthetic Surgery Journal</a>, the official journal of The Aesthetic Society.</p>

<p>The publications highlight the nuances of glabellar line (GL) injection technique and aim to improve patient outcomes, irrespective of the neuromodulator used.</p>

<p>The first publication, Impact of Glabellar Injection Technique with DaxibotulinumtoxinA for Injection on Brow Position, demonstrates the impact of subtle variations in glabellar line injection technique on eyebrow position.</p>

<p>The second paper, Integrative Assessment for Optimizing Aesthetic Outcomes When Treating Glabellar Lines with Botulinum Toxin Type A: An Appreciation of the Role Of The Frontalis, proposes a structured and comprehensive assessment algorithm focused on anatomical principles, allowing for an individualized treatment approach.</p>

<p>“These newly published manuscripts demonstrate Revance’s commitment to improving aesthetic patient outcomes,” said Conor Gallagher, vice president of medical affairs and scientific innovation at Revance. “We show for the first time, with supporting data, that small differences in glabellar line technique can impact both static and dynamic brow position outcomes. Although glabellar line treatment is often considered straightforward, secondary effects on eyebrow position can impact the broader aesthetic outcome, beyond the simple reduction of the frown lines.”</p>

<p>Daxxify (DaxibotulinumtoxinA-lanm) for injection is an FDA-approved long-lasting peptide-formulated neuromodulator product for use in adults for the temporary improvement of moderate to severe frown lines.</p>

<p>It can deliver results that last up to a year for patients with potentially only two treatments per year and has been shown to be effective, generally safe, and well tolerated, according to Revance. Daxxify is powered by a cell-penetrating peptide technology (Peptide Exchange Technology), Revance’s proprietary, synthetic, 35-amino-acid stabilizing excipient with a highly positive charge, and is free of human serum albumin or animal-based components.</p>

<p><em>Photo&nbsp;<a href=”″ target=”_blank” rel=”noreferrer noopener”>139310522</a>&nbsp;©&nbsp;<a href=”” target=”_blank” rel=”noreferrer noopener”>motortion</a>&nbsp;|&nbsp;<a href=”” target=”_blank” rel=”noreferrer noopener”></a></em></p>
Tue, 15 Nov 2022 23:58:45 +0000 Steven Martinez
Aesthetic Surgery Journal
glabellar lines
revance therapeutics
The Aesthetic Society

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