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In This Issue of JAMA Facial Plastic Surgery
Mar/Apr 2018


JAMA Facial Plast Surg. 2018;20(2):95. doi:10.1001/jamafacial.2017.1529

Nellis and coinvestigators investigated the effect of rhinoplasty on social perceptions of attractiveness, health, and success. In a web-based survey, blinded casual observers viewed independent images of 13 unique patient faces before or after rhinoplasty. Observers rated the attractiveness, perceived success, and perceived overall health for each patient image. As perceived by these casual observers, rhinoplasty surgery was associated with perceptions that in patients appeared significantly more attractive, more successful, and healthier. Humphrey and Kriet provide an Invited Commentary.

Invited Commentary

Welshhans and colleagues sought to determine the relative value of specific facial plastic surgeon personal and practice attributes available online from the perspective of patients. The following variables were compared: outcome transparency, surgical training affiliations, online rating site scores, and price. Overall, 291 patients participated for a completion rate of 68%. Outcome transparency was the most valued attribute, and price was the least valued attribute. They conclude that patients highly value outcome transparency of facial plastic and reconstructive surgery practices during online searches and may be willing to accept tradeoffs in price, prestige, and rating website scores for those practices that excel in outcome transparency.

Gu and coinvestigators conducted a case series review of patients who underwent treatment of atrophic scars with a novel technique using condensed nanofat combined with fat grafts to improve atrophic facial scars by raising both the surface and the bottom of the affected area. Multiple preoperative and postoperative examinations included the use of the Patient and Observer Scar Assessment Scale to evaluate both the functional and aesthetic aspects of the atrophic facial scars. Punch biopsy specimens were stained for the presence of melanin, elastic fibers, and cytokeratin (CK) 14 and CK19. Results were supportive of this novel intervention as a method to effectively treat difficult scars.

Thomas and colleagues conducted a randomized clinical trial to evaluate the effectiveness of 3 commercially available botulinum toxin neuromodulators in the treatment of facial synkinesis. They found that all botulinum toxins demonstrated similar efficacy at 1 and 2 weeks after treatment based on Synkinesis Assessment Questionnaire scores. However, at 4 weeks, incobotulinumtoxinA had significantly less effect on Synkinesis Assessment Questionnaire score improvement than did onabotulinumtoxinA. Shorter intervals between treatments or larger doses may be required when using incobotulinumtoxinA treatment for facial synkinesis owing to its shorter duration of action.