Sooner-than-expected progression to statewide lockdown at the height of the coronavirus disease 2019 pandemic left minimal time for medical specialty boards, including The American Board of Plastic ...Surgery, to issue guidance for their respective programs. As a result, programs were tasked with developing creative alternatives to their standard resident curricula and department schedules.
To capture attending and resident experience of the coronavirus disease 2019 lockdown in narrative form and to understand what specific changes enacted to maintain adequate education should be considered for continuation after the pandemic's conclusion.
Qualitative, semistructured interviews of residents, fellows, and faculty of the Section of Plastic and Reconstructive Surgery during 2019 to 2020 academic year were conducted on the following topics: (1) general reflection on lockdown, (2) resident maintenance of daily logs, (3) multi-institutional collaborative lectures, (4) modified didactic curriculum, (5) virtual 3-dimensional craniofacial planning sessions, (6) maintenance of department camaraderie, and (7) effect on preparation to become a surgeon.
Twenty interviews (response rate 77%) were conducted between October 2020 and February 2021. Of residents, 100% felt observing the craniofacial planning sessions was beneficial, with many explicitly noting it provided a unique perspective into the surgeon's thought process behind planned manipulations, to which they usually are not privy. Of residents, 100% felt confident at the time of the interview that the lockdown would have no lasting effects on their preparation to become a surgeon.
Rapid changes enacted at Yale enabled resident training to advance, and documentation of the success of these changes can inform future curriculum design.
Abstract Background Although extensive research has explored why women undergo labiaplasty, little attention has been paid to societal and professional abilities to distinguish between altered and ...unaltered labia, impacting both patient concerns and broader societal perceptions. Objectives This study aimed to evaluate the accuracy of the general public and healthcare professionals in identifying labiaplasty and to pinpoint the misconceptions driving their perceptions. The goal was to inform more effective patient counseling strategies and challenge existing stigmas around cosmetic genital surgery. Methods The authors conducted an online survey of 511 lay adults and a group of 21 gynecologists and aesthetic vulvar surgeons. The survey assessed the participants’ ability to detect labiaplasty from images, focusing on aesthetic appearance, hair patterns, and size. The analysis involved Pearson correlation and Z-tests to compare perceptions against actual operative status. Results Analysis of the survey findings revealed a pronounced difficulty among participants in accurately discerning labiaplasty, with neither group showing a significant ability to identify surgical alterations. Misinterpretations were notably influenced by expectations of aesthetic appearance, with 49% associating an “odd” or “fake” look with surgery, and hair and size misconceptions also misleading respondents. Additionally, 20% of participants mistakenly related surgical changes to gender-affirming surgery or female genital mutilation. Conclusions The study highlights a gap in the ability of both the general public and medical professionals to accurately identify labiaplasty, pointing to a broad misunderstanding of cosmetic genital surgery's visual outcomes. Addressing these misconceptions through targeted education could substantially improve patient counseling and help dismantle the stigmas associated with labiaplasty. Level of Evidence: 3
Labiaplasty: The Stigma Persists Sasson, Daniel C; Hamori, Christine A; Placik, Otto J
Aesthetic surgery journal,
05/2022, Letnik:
42, Številka:
6
Journal Article
Recenzirano
Abstract
Background
Heightening interest in labiaplasty has driven potential patients to online fora, permitting the dissemination of material by potentially unqualified or inexperienced individuals. ...The discourse surrounding this procedure has been injected with strong opinions that are not entirely consistent with medical best-practice or evidence-based knowledge.
Objectives
The aim of this study was to explore the rationale for ongoing public opposition to labiaplasty and to investigate if awareness of the similarities between labiaplasty and breast reduction can alter an individual’s perception.
Methods
Four hundred and forty-eight adult women were surveyed concerning their opinion of a surgical procedure to reduce the size of an unspecified organ related to a woman’s sexuality, breast reduction, and labia reduction.
Results
Reduction of an unspecified organ and breasts was met with significantly greater acceptance than labia reduction (P < 0.0001). Presenting responders with an educational tool comparing each procedure’s indications, risks, and potential benefits did not alter respondent opinions, indicating notions about sexual surgery are relatively fixed. The most common reason respondents persisted in their relative opposition to labia reduction was a perceived deficiency in social acceptance (27.1%), followed by a perceived similarity to female genital mutilation (14.8%).
Conclusions
Attitudes towards labiaplasty seem firmly based on emotion or correlation to other unacceptable practices. Informational resources do not sway these biases; thus, there is a limited role for surgeon-led education in the normalization of labiaplasty because it requires a societal shift in acceptance. Labiaplasty is a procedure whose time for popular acceptance has not yet come.
Transgender and nonbinary (TGNB) adolescents and young adults (AYA) designated female at birth (DFAB) experience chest dysphoria, which is associated with depression and anxiety. Top surgery may be ...performed to treat chest dysphoria.
To determine whether top surgery improves chest dysphoria, gender congruence, and body image in TGNB DFAB AYA.
This is a nonrandomized prospective cohort study of patients who underwent top surgery between December 2019 and April 2021 and a matched control group who did not receive surgery. Patients completed outcomes measures preoperatively and 3 months postoperatively. This study took place across 3 institutions in a single, large metropolitan city. Patients aged 13 to 24 years who presented for gender-affirming top surgery were recruited into the treatment arm. Patients in the treatment arm were matched with individuals in the control arm based on age and duration of testosterone therapy.
Patients in the surgical cohort underwent gender-affirming mastectomy; surgical technique was at the discretion of the surgeon.
Patient-reported outcomes were collected at enrollment and 3 months postoperatively or 3 months postbaseline for the control cohort. The primary outcome was the Chest Dysphoria Measure (CDM). Secondary outcomes included the Transgender Congruence Scale (TCS) and Body Image Scale (BIS). Baseline demographic and surgical variables were collected, and descriptive statistics were calculated. Inverse probability of treatment weighting (IPTW) was used to estimate the association of top surgery with outcomes. Probability of treatment was estimated using gradient-boosted machines with the following covariates: baseline outcome score, age, gender identity, race, ethnicity, insurance type, body mass index, testosterone use duration, chest binding, and parental support.
Overall, 81 patients were enrolled (mean SD age, 18.6 2.7 years); 11 were lost to follow-up. Thirty-six surgical patients and 34 matched control patients completed the outcomes measures. Weighted absolute standardized mean differences were acceptable between groups with respect to body mass index, but were not comparable with respect to the remaining demographic variables baseline outcome measures. Surgical complications were minimal. IPTW analyses suggest an association between surgery and substantial improvements in CDM (-25.58 points; 95% CI, -29.18 to -21.98), TCS (7.78 points; 95% CI, 6.06-9.50), and BIS (-7.20 points; 95% CI, -11.68 to -2.72) scores.
Top surgery in TGNB DFAB AYA is associated with low complication rates. Top surgery is associated with improved chest dysphoria, gender congruence, and body image satisfaction in this age group.
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