Abstract:
BACKGROUND:Running parallel with-and perhaps driven by-the huge increase in demand for cosmetic surgery, office-based anesthesia (OBA) is the fastest growing segment of anesthesia practice. Despite this, only 2% of anesthesiology residencies provide exposure to OBA, and many practicing anesthesiologists are not convinced that OBA techniques provide safe, reliable, and effective anesthesia care. OBJECTIVE:To examine OBA techniques and safety records while addressing some of the commonly held beliefs among anesthesiologists regarding OBA. METHODS:A review of 4800 patients undergoing 5264 cosmetic surgical procedures performed between 1997 and 2007 at Dudley Street Operatory (licensed in Rhode Island as a Physician Office Setting Providing Surgical Treatment and certified by the American Association for Accreditation of Ambulatory Surgery Facilities) was conducted. The primary anesthetic technique was deep sedation with a propofol ketamine infusion, combined with local anesthetic injection. Intercostal nerve blocks were performed before surgery in patients who had breast surgery and/or abdominoplasty. Endotracheal or laryngeal mask airway techniques were not used, nor were paralyzing agents, anesthetic gases, or vapors. RESULTS:There were 16 unanticipated postoperative admissions in 10 years, all but 3 from surgical complications (hematoma, infection, and pneumothorax during dissection for breast implants). One patient had an acute reaction to a small volume of local anesthetic injected into the nasal septum, one patient with a history of panic attacks had an acute anxiety attack manifested as chest pain, and one patient refused discharge from the operatory to home after a face lift, despite meeting postanesthesia care unit discharge criteria, and was admitted overnight to the hospital. There were no hospital admissions because of pain, nausea, or excessive sedation. CONCLUSIONS:In experienced hands, OBA techniques deliver an anesthetic for office-based cosmetic surgery superior to the usual general anesthesia performed in hospitals and ambulatory surgical centers. These techniques are safe, do not require expensive equipment other than an infusion pump and vital signs monitor, avoid sore throats and nausea, provide postoperative analgesia, and are well received by patients and surgeons. OBA presents an opportunity for anesthesiologists and aesthetic surgeons to partner for greater patient satisfaction.
journal_name
Aesthet Surg Jjournal_title
Aesthetic surgery journalauthors
Blake DRdoi
10.1016/j.asj.2008.07.012subject
Has Abstractpub_date
2008-09-01 00:00:00pages
564-70; discussion 571-2issue
5eissn
1090-820Xissn
1527-330Xpii
S1090-820X(08)00235-5journal_volume
28pub_type
杂志文章abstract:BACKGROUND:Although placement of silicone implants remains the standard technique for gluteal augmentation, lipoinjection of autologous fat obtained from lipoplasty is emerging as an alternative procedure. OBJECTIVE:We report the results of large-volume lipoinjection of the gluteal region in a series of 96 patients. ...
journal_title:Aesthetic surgery journal
pub_type: 杂志文章
doi:10.1067/maj.2002.121960
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND:Breast augmentation is the most popular cosmetic surgery procedure in the United States. Postoperative striae is a known but incompletely understood complication of breast augmentation. OBJECTIVES:The authors investigated their own patient population to discern risk factors for new-onset striae after cosmet...
journal_title:Aesthetic surgery journal
pub_type: 杂志文章
doi:10.1177/1090820X14541121
更新日期:2014-09-01 00:00:00
abstract::This study was designed to evaluate the short- and long-term histologic consequences of some common skin resurfacing methods. Grids were tattooed on the sides of a Yucatan minipig, the standard model for human skin experiments. Each grid cell was treated with one of the following: Jessner's solution, lactic acid, glyc...
journal_title:Aesthetic surgery journal
pub_type: 杂志文章
doi:10.1016/s1090-820x(98)80018-6
更新日期:1998-01-01 00:00:00
abstract::Rhinoplasty is generally considered to be one of the most challenging, complex, and exciting of all the plastic surgery procedures. In this article, the authors discuss key concepts related to patient evaluation and analysis, as well as techniques and maneuvers that reliably lead to favorable long-term results in rhin...
journal_title:Aesthetic surgery journal
pub_type: 杂志文章,评审
doi:10.1177/1090820X10380388
更新日期:2010-07-01 00:00:00
abstract:BACKGROUND:Improvements in skin erythema and elasticity have been observed with topical application of platelet-rich plasma after fractional laser (FXD) treatment. Injections of nanofat via small needles into the dermis improves tissue thickness, discoloration and wrinkle depth. OBJECTIVES:The aim of this study was to...
journal_title:Aesthetic surgery journal
pub_type: 杂志文章
doi:10.1093/asj/sjz240
更新日期:2020-07-13 00:00:00
abstract::The author demonstrates his method of achieving optimal contour in the aging neck. Primary features of the technique are horizontal cuts in the vertical bands of the platysma muscle combined with a corset Z-plasty medial suture and bilateral rein plication suture. This combined procedure, which effectively lifts the s...
journal_title:Aesthetic surgery journal
pub_type: 杂志文章
doi:10.1016/j.asj.2007.12.006
更新日期:2008-03-01 00:00:00
abstract:BACKGROUND:Volume loss and muscular hyperactivity are two major components of the aging process that contribute to the formation of the folds and wrinkles. Tear trough deformity is one of the most difficult depressions to correct surgically. OBJECTIVE:The authors evaluate the results of periorbital filling with hyalur...
journal_title:Aesthetic surgery journal
pub_type: 临床试验,杂志文章
doi:10.1177/1090820X10395505
更新日期:2011-02-01 00:00:00
abstract:Background:Labiaplasty has become an increasingly popular procedure. However, the psychological outcomes of this procedure, such as the effects on women’s sex lives and psychological well-being, have received little attention from researchers to date. In addition, the investigation of factors which predict satisfaction...
journal_title:Aesthetic surgery journal
pub_type: 杂志文章
doi:10.1093/asj/sjw190
更新日期:2017-03-01 00:00:00
abstract:Background:While recent studies have reported modest to no difference in breast aesthetics for shaped and round implant types in breast augmentations, the anatomy and biomechanics in the setting of breast reconstruction is different. Objectives:Accordingly, we endeavored to evaluate whether two implant types impacted ...
journal_title:Aesthetic surgery journal
pub_type: 杂志文章
doi:10.1093/asj/sjx210
更新日期:2018-05-15 00:00:00
abstract:BACKGROUND:Adipocyte viability is affected by fat preparation and processing methods, but rigorous and objective studies of these relationships are lacking. OBJECTIVES:The authors conducted a comprehensive evaluation of variables affecting adipocyte viability prior to injection of fat at the recipient site. METHODS:L...
journal_title:Aesthetic surgery journal
pub_type: 杂志文章
doi:10.1093/asj/sjw106
更新日期:2016-11-01 00:00:00
abstract:BACKGROUND:Although interest in penile augmentation procedures is increasing, there is a significant lack of research into the psychological and psychosexual outcomes of these procedures. OBJECTIVES:To investigate the psychological and psychosexual outcomes of nonsurgical medical penile girth augmentation. METHODS:Th...
journal_title:Aesthetic surgery journal
pub_type: 杂志文章
doi:10.1093/asj/sjy108
更新日期:2019-02-15 00:00:00
abstract:BACKGROUND:The suspension of orbicularis oculi during lower blepharoplasty presents a logical surgical addition for further support of the lid, as well as further improvement to its contour profile. It has traditionally been performed as an extension of the skin-muscle flap procedure, but more recently, and aggressivel...
journal_title:Aesthetic surgery journal
pub_type: 杂志文章
doi:10.1093/asj/sjw052
更新日期:2016-06-01 00:00:00
abstract::The purpose of this article is to describe the necessary steps to correct both primary and postblepharoplasty lateral canthal and lower eyelid malpositions at the time of endoscopic face lifting. Endoscopic surgery is traditionally considered only for brow and forehead lifting. However, in our practice we have success...
journal_title:Aesthetic surgery journal
pub_type: 杂志文章
doi:10.1093/asj/sjy244
更新日期:2019-04-08 00:00:00
abstract:BACKGROUND:Although adipose-derived stem cells (ADSCs) and nanofat exert antiaging effects on skin, they contain cellular components that have certain limitations in clinical practice. Cell-free fat extract (Ceffe) is a fraction purified from nanofat through removal of cellular components and lipid remnants that contai...
journal_title:Aesthetic surgery journal
pub_type: 杂志文章
doi:10.1093/asj/sjz306
更新日期:2020-07-13 00:00:00
abstract::Full and high cheekbones are considered a desirable component of facial attractiveness. The aging process can result in a loss of facial volume and changes in facial contours. Cheek augmentation can replace lost facial volume, rejuvenate facial appearance, enhance cheek prominence, and improve facial symmetry. A new, ...
journal_title:Aesthetic surgery journal
pub_type: 杂志文章
doi:10.1016/j.asj.2009.03.004
更新日期:2009-05-01 00:00:00
abstract:BACKGROUND:A well-defined supratarsal crease has often been considered attractive, representing a significant component in a beautiful upper eyelid. Approximately 50% of East and Southeast Asian women are born with either a minimal or absent supratarsal eyelid crease. Among people of Chinese descent, the creation of a ...
journal_title:Aesthetic surgery journal
pub_type: 杂志文章
doi:10.1177/1090820X14523020
更新日期:2014-03-01 00:00:00
abstract:BACKGROUND:Perioperative hypothermia can lead to surgical complications, including bleeding, infection, increased patient discomfort, and longer recovery time. Plastic surgeons have become increasingly aware of this important patient safety issue. OBJECTIVES:The authors evaluate the impact of perioperative warming in ...
journal_title:Aesthetic surgery journal
pub_type: 杂志文章
doi:10.1177/1090820X12449342
更新日期:2012-07-01 00:00:00
abstract::With continuous technical and functional advances in the field of breast reconstruction, there is now a greater focus on the artistry and aesthetic aspects of autologous reconstruction. Whereas once surgeons were most concerned with flap survival and vessel patency, they are now dedicated to reconstructing a similarly...
journal_title:Aesthetic surgery journal
pub_type: 杂志文章
doi:10.1093/asj/sjaa223
更新日期:2020-11-17 00:00:00
abstract:BACKGROUND:The transaxillary approach for breast augmentation has gained popularity because of the absence of scarring on the breast. However, the effects of this procedure on breast cancer detection and treatment (which rely heavily on the results of axillary status studies) remain under debate. Specifically, sentinel...
journal_title:Aesthetic surgery journal
pub_type: 杂志文章
doi:10.1177/1090820X11404399
更新日期:2011-05-01 00:00:00
abstract:BACKGROUND:In order for aesthetic surgery to participate in the movement toward evidence-based medicine, a system that quantifies aesthetic outcomes must be developed based on reliable and reproducible data. Previous studies have investigated the attractiveness of averaged (or composite) faces. Data has shown that thes...
journal_title:Aesthetic surgery journal
pub_type: 杂志文章
doi:10.1177/1090820X10369370
更新日期:2010-03-01 00:00:00
abstract:BACKGROUND:A number of randomized controlled trials (RCTs) have investigated the role of perioperative corticosteroids in rhinoplasty. Each of these trials however has an insufficient sample sizes to reach definitive conclusions and detect harms. Three recent reviews have analyzed edema and ecchymosis outcomes followin...
journal_title:Aesthetic surgery journal
pub_type: 杂志文章,meta分析,评审
doi:10.1093/asj/sjv138
更新日期:2016-02-01 00:00:00
abstract::Rhinoplasty is perhaps the most complex cosmetic surgery procedure performed today. It is characterized by an intricate interplay between form and function, with patient satisfaction being dependent not only on improvement of nasal appearance but also resolution of preexisting airway symptoms. The prerequisite for suc...
journal_title:Aesthetic surgery journal
pub_type: 杂志文章
doi:10.1093/asj/sjw093
更新日期:2016-10-01 00:00:00
abstract::BotulinumtoxinA (BoNT-A) is now widely established for the main approved indication of reducing glabellar lines, and is also widely used off-label to improve the appearance of wrinkles and lines in other parts of the face. The number of aesthetic procedures continues to increase as the patient population becomes more ...
journal_title:Aesthetic surgery journal
pub_type: 杂志文章,评审
doi:10.1093/asj/sjx005
更新日期:2017-05-01 00:00:00
abstract::Gluteal augmentation with fat has become one of the most common cosmetic procedures worldwide. Gluteal augmentation is designed to increase the volume and contour of the gluteal region. Intramuscular lipoinjection has been linked to multiple reports of severe complications, including death due to macro fat embolism (M...
journal_title:Aesthetic surgery journal
pub_type: 杂志文章
doi:10.1093/asj/sjz151
更新日期:2019-08-22 00:00:00
abstract::Abdominoplasty, the removal of excess skin combined with muscle plication of a patient's abdominal region, can yield pleasing postoperative results alone, but adding significant concurrent circumferential abdominal liposuction to the procedure can dramatically improve the overall shape and contour of the final result....
journal_title:Aesthetic surgery journal
pub_type: 杂志文章
doi:10.1177/1090820X11412487
更新日期:2011-07-01 00:00:00
abstract:BACKGROUND:Abdominoplasty, a commonly performed aesthetic procedure, is considered to have an increased risk of venous thromboembolism (VTE) events. At present, routine VTE chemoprophylaxis following abdominoplasty remains controversial. OBJECTIVES:This study evaluates the authors' experience with rivaroxaban, an oral...
journal_title:Aesthetic surgery journal
pub_type: 杂志文章,多中心研究
doi:10.1093/asj/sjv117
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:Transgender patients may seek nonsurgical methods for facial masculinization and feminization as an adjunct or alternative to undergoing surgical procedures. OBJECTIVES:The authors reviewed the existing literature regarding this topic and provided an overview of nonsurgical techniques for facial masculiniza...
journal_title:Aesthetic surgery journal
pub_type: 杂志文章,评审
doi:10.1093/asj/sjy253
更新日期:2019-04-08 00:00:00
abstract::Rhinoplasty utilizes cartilage harvested from the nasal septum as autologous graft material. Traditional dogma espouses preservation of the "L-strut" of dorsal and caudal septum, which is less resistant to axial loading than virgin septum. Considering the 90° angle between dorsal and caudal limbs, the traditional L-st...
journal_title:Aesthetic surgery journal
pub_type: 杂志文章,评审
doi:10.1093/asj/sjy301
更新日期:2019-11-13 00:00:00
abstract:BACKGROUND:Several studies have attempted to define the dimensions of an aesthetically pleasing eyebrow. However, these dimensions represent the views of plastic surgeons and cosmetologists, not necessarily the general public. We hypothesized that many patients who present to their plastic surgeon for periorbital rejuv...
journal_title:Aesthetic surgery journal
pub_type: 杂志文章
doi:10.1016/j.asj.2005.05.002
更新日期:2005-07-01 00:00:00
abstract:BACKGROUND:Tranexamic acid (TXA) is an antifibrinolytic agent shown to decrease intraoperative bleeding, reduce transfusions, and improve outcomes across multiple specialties. Within plastic surgery, initial reports are encouraging but formal studies are lacking. OBJECTIVES:The aim of this study was to determine wheth...
journal_title:Aesthetic surgery journal
pub_type: 杂志文章
doi:10.1093/asj/sjaa072
更新日期:2021-01-25 00:00:00