Faculty Bibliography

Background/UNASSIGNED:The use of fine art in medical education has a long history. Numerous studies have investigated the potential benefits of incorporating art in medical education; however, there are gaps in knowledge regarding the efficacy, methodology, and clinical significance of these studies. Objective/UNASSIGNED:This scoping review of the literature aims to describe the available literature on the incorporation of art education in medical school and residency. Methods/UNASSIGNED:PubMed, Google Scholar, and MedEDPortal were queried from their inception dates through December 2019. English-language studies providing a detailed methodology and detailed analysis were included. A total of 37 studies were identified. Upon further screening of the studies' methodologies and results, 16 studies describing art education implemented with medical students and 12 studies describing art education implemented with residents were included for final review. Results/UNASSIGNED:Various methods of art education exist, including Visual Thinking Strategies (VTS), rigorous curricula, and unstructured roundtable discussions with art curators or artistically minded clinicians. Studies range in duration, art media, and type of analysis. Conclusions/UNASSIGNED:There has been an increasing effort to incorporate fine art education into medical training, primarily to enhance visual perception skills and empathy. Although there is limited research on its efficacy, and wide variations in study methodologies exist, results consistently indicate that participants find the incorporation of art into curricula beneficial. Further research analyzing which methodologies are most likely to yield statistically and clinically significant improvements in visual perception and empathy may lead to increased utilization of this teaching method.

The clinical phenomenon of a cosmetic procedure use disorder has not been formally introduced into the medical lexicon. However, anecdotal clinical experience from physicians and the popular media indicates that there may be a subset of patients who demonstrate addictive-like behaviours [Landsverk G. The 'human Ken doll' has spent more than $750,000 on 72 cosmetic surgeries, and doctors warn that his addiction has gotten dangerous. Available at: https://urldefense.com/v3/__https://www.insider.com/hu__;!!MXfaZl3l!PwVrW7_JP2tY0xvqxwLQjbKx-1gEoGBvlIefnofQPZZtBvMl4YTGebXm0UP5qVRx$ man-ken-doll-plastic-surgery-addiction-2019-10 (last accessed 14 April 2020]. To date, the only other investigation establishing a role of addiction psychiatry in aesthetic treatmentseeking behaviour is with ultraviolet light tanning (Warthan MM, Uchida T, Wagner Jr RF. UV light tanning as a type of substance-related disorder. JAMA Dermatol 2005; 141: 963-6). We aimed to investigate the possibility of a novel diagnosis of substance-related use disorder involving cosmetic procedures. We hypothesize that individuals with abuse or dependence on cosmetic procedures exist and can be captured through the administration of modified questionnaires designed to detect alcohol use disorder (AUD). We implemented a cross-sectional survey study of self-identified behaviour with cosmetic procedures. Two validated instruments, the CAGE (Cut down, Annoyed, Guilty, Eye-opener) questionnaire and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for AUD, were modified to evaluate patients for abuse or dependence on cosmetic procedures. Adults (> 18 years) were surveyed in a waiting room of a laser and skin surgery private practice in New York. Respondents were included if they indicated having received at least one cosmetic procedure in the past 12 months. A positive response on the modified CAGE questionnaire was a score of 2 or more out of four questions, which is similar to the cutoff for AUD screening. Positive findings on the modified DSM-5 questionnaire was defined as two or more out of 11 questions, which is similar to the cutoff for a diagnosis of AUD. Statistical association of the two diagnostic instruments was performed using the Pearson c2-test. Of the 55 participants, six (11%) met the modified CAGE criteria and 13 (24%) met modified DSM-5 criteria, indicating that a subset of individuals may qualify for abuse or dependence on cosmetic procedures. The results from both instruments were significantly associated (P = 0.0019). A novel type of substance-related disorder involving cosmetic procedures may exist. Further investigations with larger and varied study populations may validate these findings and ascertain the nature of the dependence and its relation to increased utilization. Validated screening tools may help physicians recognize these patients, guide informed consent, and provide risk-benefit counselling prior to the initiation of cosmetic procedures

BACKGROUND:Thread-lifting has experienced a recent surge in popularity as interest in minimally invasive techniques for facial rejuvenation continues to grow. By placing barbed sutures along specific trajectories to lift the superficial musculoaponeurotic system to address facial ptosis, thread-lifting carries several advantages over the traditional facelift. Over the past few decades, there have been ongoing advances in the implementation of thread-lifting using barbed sutures. OBJECTIVE:To review the current evidence regarding the safety and efficacy of thread-lifting for facial rejuvenation. MATERIALS AND METHODS/METHODS:An analysis was conducted of PubMed indexed English language literature regarding thread-lifting using barbed sutures. RESULTS:Early studies using nonabsorbable barbed sutures described high revision and complication rates. Newer techniques implementing absorbable sutures have fewer adverse events, although the long-term efficacy of these procedures remains unclear. CONCLUSION/CONCLUSIONS:Thread-lifts play a substantial role in minimally invasive techniques for facial rejuvenation. Additional studies are needed to better evaluate the safety and long-term efficacy of this quick, in-office procedure.

BACKGROUND:Botulinum toxin (BTX) injection is the most popular cosmetic procedure in the United States. Although facial rejuvenation is considered cosmetic, physical appearance has meaningful impact on quality of life (QOL), best measured by patient-reported outcomes (PROs). Patient-reported outcomes are now often required for Food and Drug Administration approval of new pharmaceuticals. OBJECTIVE:This review summarizes the PRO instruments and outcomes in evaluating patient QOL after aesthetic BTX administration. METHODS:PubMed, MEDLINE, Embase, Cochrane Library, CINAHL Plus, and PsycINFO databases were searched for prospective studies using PRO instruments to directly evaluate the success of cosmetic BTX intervention. RESULTS:Five psychometrically validated, facial rhytid-specific PRO tools are currently used in clinical research. Most studies addressing PROs after cosmetic BTX treatment use 1-item Likert scales evaluating overall satisfaction. BTX treatment generally resulted in improved satisfaction and QOL metrics, such as perception of youthfulness, attractiveness, restedness, affect, mood, and self-confidence. Combination treatments, whether of multiple facial areas or with multiple treatment modalities, may improve PROs even further. CONCLUSION/CONCLUSIONS:Validated, specific PRO instruments can be used to better understand patient expectations in regards to cosmetic treatment, thus helping aesthetic dermatologists maximize patient satisfaction and retention.