4^th International Conference and Expo on Cosmetology & Trichology June 22-24, 2015 Philadelphia, USA

Diana Proshutinskaia, Ph.D, MD. She is a leading researcher of department of dermatology. She has published 30 papers in reputed journals. She is a member of EADV, ESPDrnrnVladimir Volnukhin, Ph.D, MD. He is a leading researcher of department of dermatology. He has published 80 papers in reputed journals. He is a member of EADV.

Introduction: There is a view of the impossibility of recovery of skin pigmentation in the long-existing vitiligo lesions. We studied efficacy of UVB phototherapy in long-existing vitiligo.

Materials and methods: The 80 patients enrolled in the study had non-segmental vitiligo with duration of disease from 4 month to 42 years. The 64 patients underwent Narrowband UVB phototherapy (311 nm) in the cabin Waldmann UV 7001K (Germany), 16 patients - ultraviolet excimer laser irradiation with a wavelength of 308 nm (XTRAC XL PLUS, PhotoMedex Inc, USA). Median number of procedures per course was 54.

Results: Analysis of treatment results showed the efficacy of phototherapy in long-existing vitiligo. In patients with duration of disease less 10 years (n=54) the average percentage of repigmentation in lesions after a course of phototherapy was 46,4%, in patients with duration of disease 10-20 years (n=15) - 26,9%, in patients with duration of disease more than 20 years (n=11) - 36,8%. The correlation analysis in the general group (n=80) revealed weak inverse correlation of percentage of skin repigmentation and disease duration (Kendall tau rank correlation coefficient is -0,15). Three of the 11 patients with duration of disease more than 20 years after treatment had the percentage of skin repigmentation more 70% in vitiligo lesions, four patients – from 30 to 50%, four patients – less 15%. The patient with duration of disease 42 year showed percentage of repigmentation 30%.

Conclusions : The findings suggest the ability of UVB phototherapy to stimulate repigmentation in vitiligo patients with long duration of disease, including more than 40 years.

Dr. Sameera Irfan is a Consultant Oculoplastics Surgeon & Strabismologist, in Mughal Eye Trust Hospital, Lahore, Pakistan. She completed her M.B.B.S from Fatima Jinnah Medical College, Lahore, Pakistan and she is a gold medalist in ophthalmology. She is an active member of various societies like, Royal College of Ophthalmologists, Royal College of Surgeons, Ophthalmological Society of Pakistan, Pakistan Oculoplastic Association, Pakistan Association of Pediatric Ophthalmology, All India Ophthalmological Society, Oculoplastic Association of India.

Introduction: Benign Essential Blepharospasm causes a lot of ocular morbidity. A new surgical technique is being introduced to offer these patients a permanent relief. This study was conducted to assess how efficient and safe this technique is to relieve blepharospasm in such cases permanently.

Materials and Methods: This is a prospective clinical, interventional study conducted at the oculoplastics department of a tertiary care centre. A total of 25 consecutive cases (50 eyes) were included in the study, conducted from Jan 2012 to Dec 2014. There were 19 females and 6 males between the ages 28-66 years (mean age 52 years). They were referred to the oculoplastics clinic because of their inability to keep their eyes open and frequent blinking. After a thorough history, a complete ophthalmological examination was carried out by a single examiner (SI). Any associated causes of ocular irritation like dry eyes, meibomitis and blepahritis were first treated with lid hygiene, lubricants, and tetracycline eye ointment massaged into the lid margins and wearing tinted glasses. After one month of this therapy, a limited orbicularis myectomy of both the upper and lower lids was performed under local anesthesia by a single surgeon. All cases were followed up after 1 week, one month, 3 months, 6 months and 1 year. The patients were asked about subjective improvement while the presence and extent of spasms was also noted objectively. Any complications like lid edema, lagophthalmos, and corneal exposure was also noted.

Results: A total of 25 consecutive cases (50 eyes) were included in the study, with 19 females and 6 males between the ages 28-66 years (mean age 52 years). A positive family history was present in only 3 cases (12%), the rest were all sporadic. After treating or removing the triggering factors and a meticulous control of their diabetes and hypertension, all patients underwent a limited orbicularis myectomy of all 4 eyelids simultaneously, under local anesthesia by a single surgeon. After the first post-operative dressing, ecchymosis of lower lids was noted in 13 cases (52%); a slight lid swelling at the lateral lid margin was present only in 3 cases (12%). No lad lag, lid asymmetry or corneal exposure was noted in any case. The patient satisfaction was 100%.rnConclusion: Limited orbicularis myectomy by this procedure was found to be effective in providing a long-term relief of spasms and was not associated with any complications. However, proper patient selection and treatment of triggering factors pre-operatively is mandatory.

Dr. Sameera Irfan is a Consultant Oculoplastics Surgeon & Strabismologist, in Mughal Eye Trust Hospital, Lahore, Pakistan. She completed her M.B.B.S from Fatima Jinnah Medical College, Lahore, Pakistan and she is a gold medalist in ophthalmology. She is an active member of various societies like, Royal College of Ophthalmologists, Royal College of Surgeons, Ophthalmological Society of Pakistan, Pakistan Oculoplastic Association, Pakistan Association of Pediatric Ophthalmology, All India Ophthalmological Society, Oculoplastic Association of India.

Introduction:

There are many surgical techniques to correct involutional entropion, but they either lead to over-correction or recurrence. A new surgical technique is described here that takes care of both these problems.

Materials & Methods: In a prospective study done at an Oculoplastic unit, 25 consecutive cases ofrninvolutional entropion with no remarkable horizontal lid laxity were included. There were 16 primary cases and 9 recurrent. The mean age of patients was 67.5+/-7.4 yrs. (S.D) with a range of 56 - 78 yrs. All were operated by a single surgeon (SI) using the procedure described below. They were reviewed at 1 week, 6 weeks and 1year postoperatively. The position of lower lid was recorded at each visit.rnrnSurgical technique:rnrnUnder local anesthetic infiltration, skin incision was made 4 mm below the lash line, extending from lower punctum to lateral canthus. Orbicularis muscle was split; inferior orbital septum was divided to expose lower lid retractor complex. It was opposed to the lower border of tarsal plate by two 6/0 vicryl sutures tied in slipknots kept outside the skin wound. The skin was closed with continuous vicryl suture. The next morning, if over-correction noted, the knots were opened, the lid was gently massaged upwards; this loosened the sutures and the overcorrection was un-done. The sutures were tied and ends cut short.rnrnResults: Out of 25 cases, 9 (36%) needed correction. On repeat follow-up, none of the patients developed recurrence or over correction.

Conclusion: This is a simple technique, easy to learn, avoids recurrence and overcorrectionrn

He has worked as a Chemist for over 39 years. He has been associated with different Multi-National Corporations - Bristol-Myers Squibb, Hoffmann-La Roche, Helene Curtis Industries, Inc., Lever Brothers, Menley & James, Quaker Oats, Procter & Gamble, Elsag Bailey, Siemens, PerkinElmer and Johnson & JohnsonrnHe has developed over 420 products that are widely used today all over the world. I have worked in most of the current chemical industries and have contacts throughout these industries.

Introduction: A panel of 300 people will be monitored over time from three hair colors: blond, redhead, and brunette. Hair sample from each person will be taken over a three year span every week. The hair strands will be tested by a 3100 prism genetic analyzer to determine sequences common to each hair color yet different from each other. Each week the hair samples will be graded for brittleness and luster fading by experts in the field. After the three year study, using the panel results and the genetic sequence data, correlation studies will be done to verify which hair type is affected more over time with the 2 various hair problems.

If there is a genetic basis for this, treatment of hair early in the person life could help prevent the person’s proclivity for problems. In conclusion this data can be studied by chemo metrics to correlate the testing to a simple FTIR test to in seconds help proscribe a treatment for a subjects future hair concerns.

Hair swatches are split into 2 parts-one for DNA extraction and the other for FTIR. Swatches of hair are treated and the DNA extracted. The sequences are determined by ABI Prism 3100. The sequences found to be identical for each hair type are used to segregate each hair type and individual. The hair swatch not DNA extracted is run on a ABB MB160 NIR FTIR spectrophotometer. This procedure is repeated each week for 3 years to collect data. Hair experts examine the hair of each individual over each week over the three year span listing grades for brittleness on a 1-10 scale and luster on a 1-10 scale. The results are logged in a chart to follow the change of the hair over the span of the testing.

Once all the data is collected a chemometric correlation will be performed on the datasets to see which hair type may have a proclivity to this kind of future hair damage. Once the calibration curves are determined, then a person of a particular hair type can have their hair tested by the NIR instrument which can give a probability that the person may be prone to the brittleness or luster fade in the upcoming years. If a person is prone steps can be taken to soften the hair and add luster using the various commercial products available over the counter. A preemptive strike as it were. The final prototype instrument is still years away but it is something we can look forward to in the future.

Dr Harris Zavrides graduated from the Medical School of Patras University in Greece and received his PhD degree from the Medical School of Athens University. He is a board certified Plastic Surgeon from the Medical School of Athens University. Dr Harris Zavrides maintains a private practise at “Harris Zavrides Plastic Surgery Center” in Nicosia - Cyprus. He is a Professor in Aesthetic Plastic Surgery and Wound Healing at Frederick University, Nicosia – Cyprus.

Objective: The word “plastic” comes from the Greek verb “platho” which means “to mould” or “to give form”. Plastic Surgery is the medical specialty that enables the moulding and the re-forming of the human body. Plastic Surgery helps us to regain our self-esteem and self–respect.

Introduction: All the procedures that aim the natural renewal of the face (face lift, neck liposuction, neck lift, blepharoplasty, eyebrow lift, dermabrasion) can be carried out together constituting one procedure. In my opinion, the international medical community must introduce a new term; “prosopoplasty” which will include all these procedures. Non aesthetic surgical procedures like tumour resection, facial burns and skin cancer, non surgical procedures like laser and botox, procedures that change the characteristics of the face like rhinoplasty and otoplasty, procedures that change the profil of a face like geneioplasty do not belong in “prosopoplasty”.

Results: Face means “prosopo”. The word “prosopo” comes from the Greek phrase “pros opa”. “Pros opa” in the ancient Greek language means “the part of the head which is towards the eyes”. I personally agree with this term and I am in favour of this new terminology, mainly because of its Greek origin. All the terminology in Plastic Surgery has Greek origin as it express the procedures in the best way; blepharoplasty, rhinoplasty, abdominoplasty, otoplasty, mastoplasty.

Conclusions: “prosopoplasty” is the operation that includes the aesthetic surgical procedures on a face for facial rejuvenation.rn

Dr. Nikolaos Manoloudakis finished Medical School in Patras, Greece on 2008 and completed his General Surgery residency in order to become a plastic surgeon on 2012. Since then he moved to United Kingdom to continue his training in Plastic Surgery since he has been accepted as a Clinical Fellow in Plastic and Reconstructive Surgery Department in Addenbrooke’s Hospital, Cambridge, UK where he was working for almost a year. He continued his Fellowship in Lister Hospital Stevenage UK in the Plastic and Reconstructive Surgery Department for more than a year and since then he is working as a Registrar in Plastic Surgery and Laser Department in Bedford Hospital UK. Dr. Nikolaos Manoloudakis has several publications in Surgery and Plastic Surgery. Also on 2014 has been awarded his MSc title in Health Management from the Greek Open University.

Introduction: Literature indicates an increased risk of suicide among women who have had cosmetic breast implants. An explanatory model for this association has not been established. Some studies conclude that women with cosmetic breast implants demonstrate some characteristics that are associated with increased suicide risk while others support that the breast augmentation protects from suicide. A systematic review including data collection from January 1961 up to February 2014 was conducted. The results were incorporated to pre-existing suicide risk models of the general population. A modified suicide risk model was created for the female cosmetic augmentation mammaplasty candidate. A 2–3 times increased suicide risk among women that undergo cosmetic breast augmentation has been identified. Breast augmentation patients show some characteristics that are associated with increased suicide risk. The majority of women reported high postoperative satisfaction. Recent research indicates that the Autoimmune syndrome induced by adjuvants and fibromyalgia syndrome are associated with silicone implantation. A thorough surgical, medical and psycho-social (psychiatric, family, reproductive, and occupational) history should be included in the preoperative assessment of women seeking to undergo cosmetic breast augmentation. Breast augmentation surgery can stimulate a systematic stress response and increase the risk of suicide. Each risk factor of suicide has poor predictive value when considered independently and can result in prediction errors. A clinical management model has been proposed considering the overlapping risk factors of women that undergo cosmetic breast augmentation with suicide.

Young-Joon Jun, MD, PhD., MBA, he is the Director of the scientific committee named Korean wound management society, also he is the director of Department of Plastic and Reconstructive Surgery, St. Mary’s Hospital Referral Center, The Catholic University of Korea Bucheon St. Mary’s Hospital. He is the Chairman of Information & Communication Committee, and The Korean Society for Aesthetic Plastic Surgery, South Korea.

Purpose :
An orbital blowout fracture is a commonly occurring facial trauma disorder that accounts for 7.6% of isolated facial fractures, and post-operative complications include diplopia, enophthalmos, hypoesthesia and optic neuropathy. Among these complications, optic neuropathy is a potential blinding complication of an orbital blow out fracture. The most common form oftraumatic optic neuropathy is an indirect injury to the optic nerve due to intraorbital hemorrhage, vascular insufficiency ora nerve sheath injury whereas direct damage to the optic nerve during dissection and insertion of implant materials is also possible.

We report a case of a patient with post-operative traumatic optic neuropathy due to indirect nerve damage after traction forced was applied to release a severe adhesion during a dissection procedure.

Method :
A 35-year-old female patient was referred from the ophthalmology department complaining of right eye enophthalmos and presented for surgical correction of a right-sided upward gaze limitation (Fig. 1A & B). Visual acuity was within the normal range on the right 0.9 and left sides 0.7. Computed tomography (CT) images of facial area, showed a focal bony dehiscence accompanying the inferior rectus muscle and fat entrapped in the medial aspect of the inferior wall of the right orbit (Fig. 2). An orbital tissue hernia including the inferior rectus muscle within the bone defect was released, and the orbital floor was reconstructed using a 2.0 ×3.0 cm synthetic resorbable implant. Careful dissection was difficult because of the severe adhesion surrounding the inferior rectus muscle.

Result :
On post-operative day 2, a physical examination, revealed that vertical eye movement remained restricted and that there was a superior visual defect with decreased visual acuity from 0.9 to 0.15. No evidence of optic nerve compression was detected on the immediate postoperative CT images but demonstrated improvement in the right inferior rectus muscle entrapment was observed (Fig. 3A). The patient was treated with intravenous and oral corticosteroid and the synthetic resorbable implant was removed under local anesthesia on day 2 after the operation. Mild fibrosis and thickening around the inferior rectus muscle was confirmed on magnetic resonance imaging 3 weeks after surgery without optic nerve injury (Fig. 3B).

Conclusion :
In our case, the fibrous adhesion was severe and indirect injury due to traction force applied during massive dissection to the optic nerve and its surrounding orbital structures appear to be the most common cause of optic neuropathy. The possibility of direct injury to the optic nerve was low as we performed dissection < 3.0 cm from the margin of the inferior orbit where the depth was 3.5–4.5 cm from the margin of inferior orbit to the optic foramen.

*[Figures are included in the attached PDF]

He is an Assistant Prof. in Plastic surgery.

Background and Objectives: Hypospadias is defined as an abnormal ventral opening of the urethral meatus, with or without an abnormal ventral curvature of the penis (chordee). Snodgrass first described the tubularized, incised plate (TIP) urethroplasty for distal hypospadias repair in 1994. objectives of this study is to find out whether there is any difference in the outcome and fistula rate with the use of ventral versus dorsal dartos flap.
Methods: Between May 2009 and July 2014, tabularized incised plate urethroplasty was performed for correction of hypospadias (coronal to mid penile) at Rizgary Teaching Hospital and Raparin Pediatric hospital in Erbil for 112 patients with age groups ranging from 1-32 years. Exclusion criteria were proximal hypospadias, moderate to severe chordee and previous repair. Five patients were excluded from the study because of lack of adequate follow up, therefore; only the remaining 107 patients were included in the analysis. Data were analyzed using the statistical package for social science (SPSS) V. 19.
Results: In this series urethral fistula occurred in seven cases (6.5%). We found that the use of an additional reinforcing second layer for the tubularization has significant effect in decreasing the fistula formation with p-value of 0.05. The fistula rate is slightly lower with dorsal dartos flap (3/56, 5.4%) than ventral dartos flap (4/51, 7.8%), however; statistically insignificant with p-value of 0.603. We found high satisfaction of parents (96, 89.7%) and surgeons (89, 83.2%) with the final result.
Conclusion:- We believe that the urethral plate, when dissected, should be thick enough to allow for tubularization in two layers, namely the first subepithelial together with a second reinforcing one. Both dorsal and ventral dartos flaps are effective in preventing urethral fistula formation.
Key words: Hypospadias, dartos flap, fistula