Aesthetic medicine

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.

History

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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

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Aesthetic medicine advertisement targeting teenagers, in Japan
United States
United Kingdom
  • There were 50,000 cosmetic surgery procedures performed in 2013-2014.[22]
  • Surgical aesthetic procedures account for 10% of the cosmetic procedures, and non-surgical techniques constitute the remaining 90%.[23]
South Korea

Indications

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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

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Careers in aesthetic medicine

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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.

References

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  1. ^ "Editorial". Aesthetic Medicine Journal. Retrieved 2021-08-01.
  2. ^ "What is Aesthetic Medicine?", American Academy of Anti-Aging Medicine
  3. ^ International Association for Physicians in Aesthetic Medicine, IAPAM.
  4. ^ Honigman, Roberta J.; Katharine A. Phillips, David J. Castle (2004-04-01). "A review of psychosocial outcomes for patients seeking cosmetic surgery". Plastic and Reconstructive Surgery. 113 (4): 1229–1237. doi:10.1097/01.prs.0000110214.88868.ca. ISSN 0032-1052. PMC 1762095. PMID 15083026.
  5. ^ Krueger, Nils; Luebberding, Stefanie; Sattler, Gerhard; Hanke, C. William; Alexiades-Armenakas, Macrene; Sadick, Neil (2013-07-01). "The history of aesthetic medicine and surgery". Journal of Drugs in Dermatology: JDD. 12 (7): 737–742. ISSN 1545-9616. PMID 23884484.
  6. ^ Lupo, Graziella (1997-09-01). "The History of Aesthetic Rhinoplasty: Special Emphasis on the Saddle Nose". Aesthetic Plastic Surgery. 21 (5): 309–327. doi:10.1007/s002669900130. ISSN 1432-5241. PMID 9298998. S2CID 28088314.
  7. ^ Shokri, Tom; Kadakia, Sameep; Saman, Masoud; Habal, Mutaz B.; Kohlert, Scott; Sokoya, Mofiyinfolu; Ducic, Yadranko; Wood-Smith, Donald (2019). "The Paramedian Forehead Flap for Nasal Reconstruction: From Antiquity to Present". Journal of Craniofacial Surgery. 30 (2): 330–333. doi:10.1097/SCS.0000000000004976. ISSN 1049-2275. PMID 30531275. S2CID 54474239.
  8. ^ Krueger, Nils; Luebberding, Stefanie; Sattler, Gerhard; Hanke, C. William; Alexiades-Armenakas, Macrene; Sadick, Neil (2013-07-01). "The history of aesthetic medicine and surgery". Journal of Drugs in Dermatology: JDD. 12 (7): 737–742. ISSN 1545-9616. PMID 23884484.
  9. ^ a b c Hartmann, Anke (April 2016). "Back to the roots - dermatology in ancient Egyptian medicine: Dermatology in ancient Egyptian medicine". JDDG: Journal der Deutschen Dermatologischen Gesellschaft. 14 (4): 389–396. doi:10.1111/ddg.12947. PMID 27027749. S2CID 21190678.
  10. ^ González-Minero, Francisco José; Bravo-Díaz, Luis (September 2018). "The Use of Plants in Skin-Care Products, Cosmetics and Fragrances: Past and Present". Cosmetics. 5 (3): 50. doi:10.3390/cosmetics5030050. ISSN 2079-9284.
  11. ^ Sipos, Péter; Gyõry, Hedvig; Hagymási, Krisztina; Ondrejka, Pál; Blázovics, Anna (2004-02-01). "Special wound healing methods used in ancient Egypt and the mythological background". World Journal of Surgery. 28 (2): 211–216. doi:10.1007/s00268-003-7073-x. ISSN 1432-2323. PMID 14708054. S2CID 1210892.
  12. ^ a b c Carruthers, Jean; Fournier, Nathalie; Kerscher, Martina; Ruiz-Avila, Javier; Trindade de Almeida, Ada R.; Kaeuper, Gina (March 2013). "The Convergence of Medicine and Neurotoxins: A Focus on Botulinum Toxin Type A and Its Application in Aesthetic Medicine—A Global, Evidence-Based Botulinum Toxin Consensus Education Initiative: Part II: Incorporating Botulinum Toxin into Aesthetic Clinical Practice". Dermatologic Surgery. 39 (3 pt2): 510–525. doi:10.1111/dsu.12148. ISSN 1076-0512. PMID 23458295. S2CID 13072916.
  13. ^ Kontis, Theda C.; Lacombe, Victor G.; Faris, Sarah E., eds. (2019). Cosmetic Injection Techniques: A Text and Video Guide to Neurotoxins and Fillers. Stuttgart: Georg Thieme Verlag. doi:10.1055/b-006-160134. ISBN 978-1-62623-457-4. S2CID 239388844.
  14. ^ Goodman, Greg J.; Liew, Steven; Callan, Peter; Hart, Sarah (August 2020). "Facial aesthetic injections in clinical practice: Pretreatment and posttreatment consensus recommendations to minimise adverse outcomes". Australasian Journal of Dermatology. 61 (3): 217–225. doi:10.1111/ajd.13273. ISSN 0004-8380. PMC 7497045. PMID 32201935.
  15. ^ Health, Center for Devices and Radiological (2021-11-04). "FDA-Approved Dermal Fillers". FDA.
  16. ^ "2020 Global Survey from ISAPS Sees Significant Changes in Aesthetic Procedures During Pandemic". BioSpace. Retrieved 2023-02-28.
  17. ^ Statistics on Cosmetic Procedures Worldwide (PDF) (Report). International Society of Aesthetic Plastic Surgery. 2014. Archived from the original (PDF) on 2015-01-31. Retrieved 2015-01-14.
  18. ^ "Botched foreign cosmetic surgery leaves thousands of Brit health tourists scarred for life and NHS with £30million bill". Mirror. 11 February 2018. Retrieved 13 February 2018.
  19. ^ Statistics on Cosmetic Procedures Worldwide (PDF) (Report). International Society of Aesthetic Plastic Surgery. 2015. Archived from the original (PDF) on 2017-02-01. Retrieved 2015-12-28.
  20. ^ Cosmetic Surgery National Data Bank Statistics (Report). The American Society for Aesthetic Plastic Surgery. 2013.
  21. ^ a b Cosmetic Surgery National Data Bank Statistics (Report). The American Society for Aesthetic Plastic Surgery. 2013.
  22. ^ Britain sucks (Report). London, UK: The British Association of Aesthetic Plastic Surgeons. 2014. Archived from the original on 2014-12-27. Retrieved 2015-01-14.
  23. ^ Review of the Regulation of Cosmetic Interventions (PDF) (Report). UK Department of Health. 2013.
  24. ^ "Best Korean Plastic Surgery". Best Korean Plastic Surgery - Guide to Information and Facts. December 27, 2015. Archived from the original on December 10, 2019. Retrieved December 27, 2015.
  25. ^ ISAPS (July 8, 2015). "ISAPS International Survey on Aesthetic/Cosmetic" (PDF). ISAPS. Archived from the original (PDF) on February 1, 2017. Retrieved December 27, 2015.
  26. ^ Medical Aesthetics Clinical Skin Protocols 2014
  27. ^ Kaplan, J.; Volk, A. S.; Ashley, J. R.; Izaddoost, S.; Reece, E.; Winocour, S. (2019). "A Systematic Review of Resident Aesthetic Clinic Outcomes". Aesthetic Surgery Journal. 39 (9): NP387–NP395. doi:10.1093/asj/sjz020. PMID 30715241.