Single Center and Surgeon's Long-Term (15-19 Years) Patient Satisfaction and Revision Rate of Round Textured Eurosilicone Breast Implants

BACKGROUND: Breast augmentation is one of the most commonly performed aesthetic plastic surgical procedures, with over 250 thousand procedures in the United States in 2020 alone. However, the safety of breast implants should be closely researched and monitored, especially on the long-term. OBJECTIVES: This study was undertaken to evaluate the long-term results of round micro-textured Eurosilicone (Eurosilicone S.A.S, Apt Cedex, France) Cristalline Paragel breast implants from a single centre, single surgeon experience, regarding both patient-reported outcome measures as well as revisions. METHODS: A retrospective cohort study was undertaken of 84 patients who underwent primary breast augmentation with round micro-textured Eurosilicone Cristalline Paragel breast implants, either submuscular (dual-plane) or subglandular placed, in the period between 2001 and 2004. All patients were contacted for informed consent and after approval, the validated BREAST-Q questionnaire was sent and used to analyze patient satisfaction. In addition, objective data regarding revisions, including capsular contracture, rupture rate, pain and/or aesthetic causes needing revision surgery, were analyzed. RESULTS: High BREAST-Q scores (67-100% for 0-100 scale variables and 66.0-77.3% of the patients scored "very satisfied" on categorical variables) were found without clinically significant differences between patients with dual-plane placed implants and subglandular placed implants. The overall revision rate was 29.8%, also with no significant differences between both groups (p=0.317). CONCLUSIONS: This study showed high patient satisfaction and relatively low revision rates after 15-19 years follow-up of round micro-textured Eurosilicone Cristalline Paragel breast implants. No clinically relevant significant differences were found between dual-plane and subglandular placement of the implants

Standardized reporting of co-morbidity outcome after bariatric surgery: low compliance with the ASMBS outcome reporting standards despite ease of use

Background: Despite the publication of the American Society for Metabolic and Bariatric Surgery (ASMBS) Outcome Reporting Standards in 2015, there is still a great variety in definitions used for reporting remission of co-morbidities after bariatric surgery. This hampers meaningful comparison of results. Objective: To assess compliance with the ASMBS standards in current literature, and to evaluate use of the standards by applying them in a report on the outcomes of 5 co-morbidities after bariatric surgery. Setting: Two clinics of the Dutch Obesity Clinic, location Den Haag and Velp, and three affiliated hospitals: Haaglanden Medical Center in Den Haag, Groene Hart Hospital in Gouda, and Vitalys Clinic in Velp. Methods: A systematic search in PubMed was conducted to identify studies using the ASMBS standards. Besides, the standards were applied to a cohort of patients who underwent a primary bariatric procedure between November 2016 and June 2017. Outcomes of co-morbidities were determined at 6 and 12 months after surgery. Results: Ten previous studies applying ASMBS definitions were identified by the search, including 6 studies using portions of the definitions, and 4 using complete definitions for 3 co-morbidities or in a small population. In this study, the standards were applied to 1064 patients, of whom 796 patients (75%) underwent Roux-en-Y gastric bypass and 268 patients (25%) underwent sleeve gastrectomy. At 12 months, complete remission of diabetes (glycosylated hemoglobin <6%, off medication) was reached in 63%, partial remission (glycosylated hemoglobin 6%–6.4%, off medication) in 7%, and improvement in 28% of patients (n = 232/248, 94%). Complete remission of hypertension (normotensive, off medication) was noted in 8%, partial remission (prehypertensive, off medication) in 23% and improvement in 63% (n = 397/412, 96%). Remission rate for dyslipidemia (normal nonhigh-density lipoprotein, off medication) was 57% and improvement rate was 19% (n = 129/133, 97%). Resolution of gastroesophageal reflux disease (no symptoms, off medication) was observed in 54% (n = 265/265). Obstructive sleep apnea syndrome improved in 90% (n = 157/169, 93%). Conclusions: Compliance with the ASMBS standards is low, despite ease of use. Standardized definitions provided by the ASMBS guideline could be used in future research to enable comparison of outcomes of different studies and surgical procedures

An overview of surgical techniques and non-surgical treatments in lifting the eyebrow including current treatments available

The eyebrow is a complex structure of the human face, which has both functional (communication) and aesthetic aspects and contributes to a persons' individual appearance. Ptosis of the eyebrow is a common condition, especially among the elderly and smokers. Facial appearance is disrupted by eyebrow ptosis, and in many cases, correction and treatment are needed. No specific type of browlift has been shown to be superior to another, and since there is a wide variation in treatment preference between patients, it requires an individual approach to each specific patient. This review provides an overview of the history of the browlift, non-surgical treatment and current surgical techniques available. Level of evidence: Not ratable

Enhancing Participation in Disadvantaged Urban Neighbourhoods

Participation in neighbourhoods is a highly valued phenomenon. Participation is the basis of a shared social life, but it also makes everyday life, and the lived experience of people participating in it, political. From a public administration perspective, governance and formal policy-making are increasingly reaching out to citizens, instead of drawing solely on representative mechanisms of local government. This paper investigates how practitioners working in disadvantaged neighbourhoods in Dutch cities enhance participation. Using empirical data from research in disadvantaged neighbourhoods in The Netherlands, the paper shows that these practitioners either start projects that connect people in their own life world or connect policy-makers and policy to initiatives on the ground. As a result, they create the opportunity for many to develop their citizenship and become a more active participant in their local communities