The layered arrangement of the jawline predisposes this region for subdermal and subcutaneous treatment options located superficial to the platysma. Subdermal subcision procedures might have a beneficial effect on the labiomandibular sulcus as the boundary between the different types of subcutaneous arrangement, which form the sulcus, is being smoothened.
The posterior temporal supraSMAS minimally invasive lifting procedure seems to be a valid technique to treat temporal volume loss and to reduce the signs of age-related changes in the middle and lower face, ie "marionett line" and jowl deformity.
Background: Non–board-certified plastic surgeons performing cosmetic procedures and advertising as plastic surgeons may have an adverse effect on a patient’s understanding of their practitioner’s medical training and patient safety. The authors aim to assess (1) the impact of city size and locations and (2) the impact of health care transparency acts on the ratio of board-certified and non–American Board of Plastic Surgeons physicians. Methods: The authors performed a systematic Google search for the term “plastic surgeon [city name]” to simulate a patient search of online providers. Comparisons of board certification status between the top hits for each city were made. Data gathered included city population, regional location, practice setting, and states with the passage of truth-in-advertising laws. Results: One thousand six hundred seventy-seven unique practitioners were extracted. Of these, 1289 practitioners (76.9 percent) were American Board of Plastic Surgery–certified plastic surgeons. When comparing states with truth-in-advertising laws and states without such laws, the authors found no significant differences in board-certification rates among “plastic surgery” practitioners (88.9 percent versus 92.0 percent; p = 0.170). There was a significant difference between board-certified “plastic surgeons” versus out-of-scope practitioners on Google search between large, medium, and small cities (100 percent versus 92.9 percent versus 86.5; p < 0.001). Conclusions: Non–board-certified providers tend to localize to smaller cities. Truth-in-advertising laws have not yet had an impact on the way a number of non–American Board of Plastic Surgery–certified practitioners market themselves. There may be room to expand the scope of truth-in-advertising laws to the online world and to smaller cities.
Purpose Photobiomodulation therapy (PBT) has emerged as a possible treatment for age-related macular degeneration (AMD) and diabetic retinopathy (DR). This review seeks to summarize the application of PBT in AMD and DR. Methods The National Clinical Trial (NCT) database and PubMed were queried using a literature search strategy and reviewed by the authors. Results Fourteen studies examining the application of PBT for AMD and nine studies examining the application of PBT for diabetic macular edema (DME) were extracted from 60 candidate publications. Discussion Despite notable methodological differences between studies, PBT has been reported to treat certain DR and AMD patients. DR patients with center involving DME and VA ≥ 20/25 have demonstrated response to treatment. AMD patients at Age-Related Eye Disease Study Stages 2–4 with VA ≥20/200 have also shown response to treatment. Results of major clinical trials are pending. Conclusion PBT remains an emergent therapy with possible applications in DR and AMD. Further, high powered studies monitored by a neutral party with standard devices, treatment delivery and treatment timing are needed.
Hospitals that perform a larger number of ventral hernia repairs, despite caring for a more complex patient population, may be associated with better patient outcomes than lower volume hospitals. However, these same high-volume centers demonstrate an extended length of stay and increased costs. Further research is needed to understand the reason for this gap in proper resource utilization in high-volume ventral hernia repair centers.
Purpose of reviewTo review the available data supporting the use of photobiomodulation therapy (PBT) in the treatment of age-related macular degeneration (AMD).
BACKGROUND AND OBJECTIVE: Although people of low socioeconomic status (SES) and certain racial groups are at greater risk of developing diabetic macular edema (DME), the extent these high-risk groups experience treatment differences is unknown. This study characterizes anti-vascular endothelial growth factor (anti-VEGF) injection use for DME. PATIENTS AND METHODS: Data were collected from an electronic health record at the Cole Eye Institute, Cleveland Clinic Foundation for patients who received anti-VEGF treatment for DME between 2012 and 2019 ( N = 500). RESULTS: White patients on average received more injections over a 1-year period than Black patients (4.93 ± 3.14 vs 3.20 ± 2.43; P < .0001) and had fewer no-show appointments (1.39 ± 2.08 vs 3.23 ± 3.39; P < .0001). There is an association between living in communities with lower average incomes and receiving fewer anti-VEGF injections (3.06 ± 2.70 vs 4.88 ± 3.19; P = .005). CONCLUSIONS: DME treatment differs based on race and SES. Racial and SES associations with anti-VEGF injections present potential obstacles for delivering optimal ophthalmic care. [ Ophthalmic Surg Lasers Imaging Retina. 2021;52:578–585.]
Objectives To characterize the use of virtual visits, as well as compare the characteristics to in-person visits during the pandemic period. Methods This retrospective study included patients who had virtual and in-person ophthalmology visits from March 19, 2020, to July 31, 2020, in a large multispecialty ophthalmic center. Exclusion criteria included patients aged less than 18 years old; canceled, incomplete, mislabelled, and duplicated visits. 2943 virtual and 56,174 in-person visits were identified. A random sample of 3000 in-person visits was created. Each visit was analyzed as an individual data point. Results 2,266 virtual visits (2,049 patients, 64.3% female, mean [SD] age 64.3 [16.6] years old) and 2590 in-person visits (2509 patients, 59.5% female, 65.9 [15.8] years old) were included. Most virtual visits were classified as comprehensive ophthalmology (34.6%), optometry-related (19.5%), and oculoplastics (13.0%). For in-person visits, the most common specialties were optometry (29.8%), comprehensive ophthalmology (23.9%), and retina and uveitis (17.3%). The most common diagnoses in the virtual group were from the eyelids, lacrimal system, and orbits group (26.9%), while in the in-person groups were choroid and retina conditions (19.3%). Conclusions Numerous ocular conditions were evaluated and managed through virtual visits, and external complaints and oculoplastic consults appear to be well-suited to the virtual format. Further studies focusing on visual outcomes and patient experience will be beneficial.
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