Facial feminization surgery appears to be safe and satisfactory for patients. Further studies are required to better compare different techniques to more robustly establish best practices. Prospective studies and patient-reported outcomes are needed to establish quality-of-life outcomes for patients. However, based on these studies, it appears that facial feminization surgery is highly efficacious and beneficial to patients.
The clinical importance of vitamin A as an essential nutrient has become increasingly clear. Adequate vitamin A is required for normal organogenesis, immune competence, tissue differentiation, and the visual cycle. Deficiency, which is widespread throughout the developing world, is responsible for a million or more instances of unnecessary death and blindness each year. β-Carotene is an important, but insufficient, source of vitamin A among poor populations, which accounts for the widespread nature of vitamin A deficiency. It has only recently become apparent that the bioconversion of traditional dietary sources of β-carotene to vitamin A is much less efficient than previously supposed. The other major carotenoids, particularly lycopene, lutein, and zeaxanthin, have been found to have important biological properties, including antioxidant and photoprotective activity, and high intake has been linked in observational studies with reduced risk of a number of chronic diseases. But, to date, no clinical trials have proven the clinical value of ingested carotenoids individually or in combination, in either physiologic or pharmacologic doses, with the excepton of the provitamin A activity of carotene. Indeed, several trials have suggested an increased risk of lung cancer among high-risk individuals (smokers and asbestos workers) who were given high doses of β-carotene alone or in combination with other antioxidants. Much more evidence is needed before commonly encountered claims of the value of ingesting high doses of non-provitamin A carotenoids are validated.
Telemedicine holds special promise in increasing the efficiency of postoperative care for microsurgical procedures, improving care coordination and management of burn wounds, facilitating interprofessional collaboration across time and space, eliminating a significant number of unnecessary referrals, and connecting patients located far from major medical centers with professional expertise without impinging on-and in some cases improving-the quality or accuracy of care provided. Teledermatology consultation was found to be safe and has a comparable or superior efficacy to the traditional in-patient consultation. The system was consistently rated as convenient and easy to use by patients, referring physicians, and consulting dermatologists. Teledermatology has also been used as an educational tool for patients. A significant number of studies detailed strategies to improve the current state of teledermatology, either by implementing new programs or improving technologies. Telemedicine use is widespread among plastic surgeons and is enabling the spread of expertise beyond major medical centers. Further research is needed to conclusively demonstrate benefit in routine clinical care.
Phalloplasty techniques are evolving to include a number of different flaps, and most techniques have high reported satisfaction rates. Penile replantation and transplantation are also options for amputation or loss of phallus. Further studies are required to better compare different techniques to more robustly establish best practices. However, based on these studies, it appears that phalloplasty is highly efficacious and beneficial to patients.
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