Aesthetic medicine

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Aesthetic medicine is a branch of modern medicine that focuses on altering natural or acquired unwanted appearance through the treatment of conditions including scars, skin laxity, wrinkles, moles, liver spots, excess fat, cellulite, unwanted hair, skin discoloration, spider veins [1] and or any unwanted externally visible appearance. Traditionally, it includes dermatology, oral and maxillofacial surgery, reconstructive surgery and plastic surgery, [2] surgical procedures (liposuction, facelifts, breast implants, Radio frequency ablation), non-surgical procedures (radio frequency skin tightening, non- surgical liposuction, chemical peel, high-intensity focused electromagnetic field, radio frequency fat removal), and a combination of both. [3] Aesthetic medicine procedures are usually elective. [4] There is a long history of aesthetic medicine procedures, dating back to many notable cases in the 19th century, [5] though techniques have developed much since then.

Contents

History

Upper lip deformity repaired using a skin flap from the forehead. Foreheadflap.illuatration.jpg
Upper lip deformity repaired using a skin flap from the forehead.

Physical beauty has been a consistently coveted notion. [6] Efforts to improve and enhance beauty through aesthetic medical practices can be seen as early as 2000 years ago, in India, where the 'forehead flap' was used to reconstruct the noses and faces of soldiers injured in war and criminal punishments. [7] This technique, though thoroughly developed and modified, is still used today as a common method to repair nasal defects. [8] Although Greek and Roman medical practices have been considered the foundation for European and modern-day medicine for a long time, ancient Egyptian texts have revealed that Egyptian medicine produced many key medical discoveries and the basis for many modern practices. [9] The Egyptians recorded their use of oils, waxes, Cyperus, [9] and other plant materials to reduce the signs of aging, like wrinkles and spots, and to restore youthful skin. [10] They studied bodily functions, like inflammatory processes, and were able to make discoveries that allowed them to treat cosmetic wounds and burns using therapies and medicines. This included the initial application of fresh meat to the wound, followed by the use of oil/lipids, honey, and fibers, generally woven linen, until the wound had healed. [11] As physicians have discovered more about medicine throughout history, these practices have been developed to be more efficient and sanitary and can be seen today in common skin reparation remedies. [9]

In more recent history, within the past 30 years, the industry of aesthetic medicine has been developing rapidly with the addition of and growing demand for "injectables," [12] a form of transcutaneous treatment used to rejuvenate and restore the skin of a patient. [13] These medical injectables have become well established due to their associated low risk, especially compared to other aesthetic surgical practices, as well as the practically non-existent recovery time needed after the procedures are performed. [14] Within the past ten years, the U.S. Food and Drug Administration has reviewed and approved [15] over 20 injectable products used for medical aesthetics, in response to the growing demand. [12] The most commonly used injectables in the industry today are botulinum neurotoxin, commonly referred to as botox, and hyaluronic acid fillers. [16] According to statistics from an annual survey conducted by the American Society for Aesthetic Plastic Surgery, from 1997 to 2011 the number of nonsurgical procedures performed by aesthetic physicians increased by 356%. [12]

Statistics

Aesthetic medicine advertisement targeting teenagers, in Japan Plastic surgery for teens, advertisement in Tokyo urban train.jpg
Aesthetic medicine advertisement targeting teenagers, in Japan
United States
United Kingdom
South Korea

Indications

Aesthetic medicine specializes in altering the cosmetic appearance. It has diverse applications for dermatological and surgical conditions. It includes indications related to minimizing signs of aging, such as skin laxity, wrinkles, and liver spots. Aesthetic medicine also plays a role in the treatment of excess fat, cellulite, and obesity. Laser based therapies can be indicated for the treatment of scars, unwanted hair, skin discoloration, and spider veins. [26]

Overall health is assessed by a physician to ensure that the symptom being treated (for example, weight gain and excessive hair) is not a sign of an underlying medical condition (like hypothyroidism) that should be stabilized with medical therapies. It is also very important for the medical aesthetician to be inclusive in providing a team approach for minimally invasive facial aesthetic procedures.

Techniques and procedures

Careers in aesthetic medicine

A career in aesthetic medicine can be approached from a number of professions. A multidisciplinary or team based approach is often necessary to adequately address an aesthetic need. To perform certain procedures, one must be a surgeon, medical doctor (Dermatologist/plastic surgeon/ENT surgeon/Oculoplastic surgeon) or maxillofacial surgeon /Cosmetic Dentist. [27] Medical Aesthetics requires specialized training and certification beyond a nurse license / aesthetic license. Counselors, psychologists or psychiatrists can help people determine if their reasons for pursuing aesthetic procedures are healthy and help to identify psychiatric disorders such as compulsive eating, anorexia, and body dysmorphic disorder. Reconstructive surgeons can help correct appearance after accidents, burns, surgery for cancer (such as breast reconstruction after mastectomy for cancer), or for congenital deformities like correction of cleft lip. Orthodontists work to improve alignment of teeth, often partially for aesthetic reasons, and oral and maxillofacial surgeons can perform cosmetic facial surgery & correct deformities of the mouth and jaw. Both orthodontists and maxillofacial surgeons can be assisted by dental technicians.

Related Research Articles

<span class="mw-page-title-main">Botulinum toxin</span> Neurotoxic protein produced by Clostridium botulinum

Botulinum toxin, or botulinum neurotoxin, is a highly potent neurotoxic protein produced by the bacterium Clostridium botulinum and related species. It prevents the release of the neurotransmitter acetylcholine from axon endings at the neuromuscular junction, thus causing flaccid paralysis. The toxin causes the disease botulism. The toxin is also used commercially for medical and cosmetic purposes. Botulinum toxin is an acetylcholine release inhibitor and a neuromuscular blocking agent.

<span class="mw-page-title-main">Plastic surgery</span> Medical surgical specialty

Plastic surgery is a surgical specialty involving the restoration, reconstruction, or alteration of the human body. It can be divided into two main categories: reconstructive surgery and cosmetic surgery. Reconstructive surgery includes craniofacial surgery, hand surgery, microsurgery, and the treatment of burns. While reconstructive surgery aims to reconstruct a part of the body or improve its functioning, cosmetic surgery aims to improve the appearance of it. A comprehensive definition of plastic surgery has never been established, because it has no distinct anatomical object and thus overlaps with practically all other surgical specialties. An essential feature of plastic surgery is that it involves the treatment of conditions that require or may require tissue relocation skills.

Dermatology is the branch of medicine dealing with the skin. It is a speciality with both medical and surgical aspects. A dermatologist is a specialist medical doctor who manages diseases related to skin, hair, nails, and some cosmetic problems.

<span class="mw-page-title-main">Rhinoplasty</span> Surgical procedure to enhance or reconstruct a human nose

Rhinoplasty, commonly called nose job, medically called nasal reconstruction is a plastic surgery procedure for altering and reconstructing the nose. There are two types of plastic surgery used – reconstructive surgery that restores the form and functions of the nose and cosmetic surgery that changes the appearance of the nose. Reconstructive surgery seeks to resolve nasal injuries caused by various traumas including blunt, and penetrating trauma and trauma caused by blast injury. Reconstructive surgery can also treat birth defects, breathing problems, and failed primary rhinoplasties. Rhinoplasty may remove a bump, narrow nostril width, change the angle between the nose and the mouth, or address injuries, birth defects, or other problems that affect breathing, such as a deviated nasal septum or a sinus condition. Surgery only on the septum is called a septoplasty.

Oral and maxillofacial surgery is a surgical specialty focusing on reconstructive surgery of the face, facial trauma surgery, the oral cavity (mouth), head and neck, and jaws, as well as facial cosmetic surgery/facial plastic surgery including cleft lip and cleft palate surgery.

<span class="mw-page-title-main">Reconstructive surgery</span> Surgery to restore form and function

Reconstructive surgery is surgery performed to restore normal appearance and function to body parts malformed by a disease or medical condition.

<span class="mw-page-title-main">Blepharoplasty</span> Surgical modification of the eyelids

Blepharoplasty is the plastic surgery operation for correcting defects, deformities, and disfigurations of the eyelids; and for aesthetically modifying the eye region of the face. With the excision and the removal, or the repositioning of excess tissues, such as skin and adipocyte fat, and the reinforcement of the corresponding muscle and tendon tissues, the blepharoplasty procedure resolves functional and cosmetic problems of the periorbita, which is the area from the eyebrow to the upper portion of the cheek. The procedure is more common among women, who accounted for approximately 85% of blepharoplasty procedures in 2014 in the US and 88% of such procedures in the UK.

Lip augmentation is a cosmetic procedure that modifies the shape of the lips using fillers, such as collagen or implants. The procedure may be performed to increase lip size, correct asymmetry, create protrusion, or adjust the ratio of the top and bottom lips. The procedure typically involves surgical injection, though temporary non-surgical alternatives exist.

<span class="mw-page-title-main">Buttock augmentation</span> Cosmetic and corrective surgery

Gluteoplasty denotes the plastic surgery and the liposuction procedures for the correction of congenital, traumatic, and acquired defects/deformities of the buttocks and the anatomy of the gluteal region; and for the aesthetic enhancement of the contour of the buttocks.

Facial rejuvenation is a cosmetic treatment, which aims to restore a youthful appearance to the human face. Facial rejuvenation can be achieved through either surgical and/or non-surgical options. Procedures can vary in invasiveness and depth of treatment. Surgical procedures can restore facial symmetry through targeted procedures and facial restructuring and skin alterations. Non-surgical procedures can target specific depths of facial structures and treat localized facial concerns such as wrinkles, skin laxity, hyperpigmentation and scars.

Injection lipolysis is a controversial cosmetic procedure in which drug mixtures are injected into patients with the goal of destroying fat cells. This practice, using drugs generally based on phosphatidylcholine and deoxycholate (PCDC), evolved from the initial intravenous use of those drug formulations to treat blood disorders.

Carboxytherapy is a non-surgical cosmetic medicine treatment for dermatology. Carboxytherapy employs injections or transdermal application to infuse gaseous carbon dioxide below the skin into the subcutaneous tissue through a needle or skin. It has a necrotizing effect on fat tissue fat cells, stimulates blood flow, improves the skin's elasticity and reduces the appearance of cellulite. It has also become a popular treatment for stretch marks. It is non-toxic and less invasive than operations like liposuction. Carboxytherapy leads to a temporary decrease in subcutaneous fat but has shown to reoccur again after a 28 week period. It can be applied for those with androgenic alopecia or alopecia areata.

<span class="mw-page-title-main">Liposuction</span> Surgery to remove unwanted fat

Liposuction, or simply lipo, is a type of fat-removal procedure used in plastic surgery. Evidence does not support an effect on weight beyond a couple of months and does not appear to affect obesity-related problems. In the United States, liposuction is the most common cosmetic surgery.

<span class="mw-page-title-main">Laser medicine</span>

Laser medicine is the use of lasers in medical diagnosis, treatments, or therapies, such as laser photodynamic therapy, photorejuvenation, and laser surgery.

Non-surgical rhinoplasty is a medical aesthetic procedure in which injectable fillers, most commonly hyaluronic acid ones like Restylane and Juvederm or calcium hydroxyapatite (Radiesse), are used to alter and shape a person's nose without a surgery. The procedure fills in depressed areas on the nose, lifting the angle of the tip or smoothing the appearance of bumps on the bridge. Non surgical rhinoplasty is an augmentation procedure, so it cannot reduce the size of someone's nose. The cosmetic procedure carries the risk of causing serious skin damage or distant complications like blindness. If the filler product is injected into an artery, filler can travel in the arteries and blocks smaller size arteries like ophthalmic artery and cause blindness. If blood vessels of the skin is blocked, skin necrosis can develop. Hyaluronic acid based fillers can be reversed even if injected into a blood vessel with an enzyme called hyaluronidase, which can be also injected like fillers.

<span class="mw-page-title-main">Jan Stanek</span>

Jan Stanek is a British cosmetic surgeon, lecturer and broadcaster. He is a Fellow of the Royal College of Surgeons, a member of the British Medical Association, the Royal Society of Medicine and The American Academy of Cosmetic Surgery. He has a private practice in central London.

Cosmetic surgery, also referred to as aesthetic surgery, is a surgical procedure which endeavours to improve the physical aspects of one's appearance to become more aesthetically pleasing. The continuously growing field of cosmetic surgery is closely linked with plastic surgery, the difference being, cosmetic surgery is an elective surgery with the sole purpose to enhance the physical features of one's appearance. Plastic surgery is performed in order to rectify defects to reinstate normality to function and appearance. Cosmetic surgical procedures are generally performed on healthy functioning body parts, with the procedure being optional not medically necessary. The inevitable aim of cosmetic surgery is to enhance one's image, encompassing reducing the signs of aging and/or correction of a believed deviation on one's body in turn it is surrounded by controversy. Although the implementation of cosmetic surgery within Australian society is growing, the trade has struggled to find its place within the Australian culture.

<span class="mw-page-title-main">Mauricio de Maio</span> Brazilian plastic surgeon

Mauricio de Maio is a Brazilian plastic surgeon who works with injectable fillers and botulinum toxin. He is the co-author of three textbooks on plastic surgery.

<span class="mw-page-title-main">Venkataram Mysore</span>

Venkataram Mysore is a dermatologist, dermatopathologist, and hair transplant surgeon from Bangalore, India. He has over 30 years experience as a dermatologist, 18 years as a teacher and is currently the director of the Venkat Center for Advanced Dermatology and Post-Graduate Training.

Fat removal procedures are used mostly in cosmetic surgery with the intention of removing unwanted adipose tissue. The procedure may be invasive, as with liposuction, or noninvasive using laser therapy, radiofrequency, ultrasound or cold to reduce fat, sometimes in combination with injections.

References

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