Breast augmentation techniques using the submuscular and subglandular planes to introduce the implant are well known and widely used procedures. The authors have been using the subfascial dissection plane, a new concept for breast augmentation. From October of 1998 to September of 2001, 263 patients underwent breast augmentation. In all cases, the implants were inserted into the subfascial plane. McGhan 410 anatomic biodimensional, cohesive gel implants (size, 155 to 310 g) were used. There are additional benefits using this technique; these include avoiding implant deformation or distortion (as seen in the retromuscular position), leaving additional soft tissue between the implant and the skin, and minimizing implant edge prominence (inherent to retroglandular placement). These technical details lead to fewer patient complaints. Morbidity is similar to that of other techniques.
Video endoscopy for breast hypoplasia and glabellar frown lines has been used since 1996 at our private clinic. Breast augmentation with an S-shape incision for transaxillary access is utilized to introduce the implant, in a submuscular or subglandular and, recently (since October 1998), in a subfascial location. From August 1998 through January 1999, 62 patients underwent endoscopic surgeries; 49 were submuscular, 5 subglandular, and 8 subfascial. McGhan 410, anatomical biodimensional implants 155 to 235 g, were used. We observed three cases of complications, two of them malpositioning (rotation), needing reoperation, and one hematoma, treated with drainage. Patient satisfaction was high, especially regarding the axillary incision. There have been no capsular contractions to date.
The Ultrapulse CO2 laser (Coherent Inc., Palo Alto, CA, USA) was used in 239 patients, from March 1996 to July 1998, for full-face laser resurfacing. In 106 (43%) of these patients rhytidectomy was performed in the same procedure. All patients submitted to laser resurfacing were prepared for 1 to 2 months beforehand with retinoic acid and hydroquinone. The procedures were done under local anesthesia controlled by an anesthesiologist. A clear film dressing impregnated with silicone gel (Silon TSR; Bio-Med Sciences, Bethlehem, PA, USA) was used for 6 to 7 days and complete healing was observed in 7 to 10 days. Complications were exclusively dermatologic, without relation to surgery. No necrosis of the cutaneous flap was observed. Skin biopsies of 10 consecutive patients undergoing the combined procedures revealed no vascular impairment to the dermis. The patients were able to resume their activities 2 weeks after the procedure.
RESUMO Objetivo: este estudo analisou o conhecimento dos estudantes de medicina sobre publicidade médica nas redes sociais. Método: Trata-se de estudo transversal realizado entre janeiro e maio de 2022 com 179 acadêmicos de medicina de instituição pública e privada em Curitiba - PR, por meio de questionário estruturado com nove situações-problemas sobre publicidade médica. Foi estabelecido como conhecimento “suficiente” o acerto ≥70% das situações-problemas com base nos códigos e resoluções profissionais vigentes. Resultados: cinco questões tiveram maior percentual de acerto decorrente da aquisição de conhecimento de diferentes fontes. A maioria dos estudantes não aprendeu sobre publicidade médica na graduação (84,9%), já divulgou imagens de pacientes pelas redes sociais (89,9%), e sente falta de mais discussões sobre publicidade (96,6%). Conclusão: há necessidade de direcionar o ensino da graduação para o uso ético da publicidade visando melhor preparo para o exercício profissional.
Objective: this study analyzed medicine students’ knowledge regarding medical advertising on social media. Method: this is a cross-sectional study carried out between January and May 2022 with 179 medical students from public and private institutions from Curitiba - PR, using a structured questionnaire with nine problem situations on medical advertising. It was established as “sufficient” knowledge ≥70% of the problem-situations based on current professional codes and resolutions. Results: five questions had the highest percentage of correct answers resulting from the acquisition of knowledge from different sources. Most students did not learn about medical marketing in their undergraduate course (84.9%), having already shared patients’ pictures on social media (89.9%), and fell the lack of discussions about medical advertising (96.6%). Conclusion: there is a need to direct undergraduate education towards the ethical use of advertising in order to better prepare them for professional practice.
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