Access to specialist plastic surgery in rural vs. Urban areas of Africa.
Plastic surgery is an essential yet underdeveloped field in many African nations, especially in rural areas. The demand for plastic surgery is increasing, but differences in access to respective services between rural and urban domiciles remain ever existent, despite the exponentiation of trauma, burns, and congenital disorders. According to this review, urban areas have access to better facilities and specialized surgeons, while rural areas frequently lack infrastructure, educated healthcare personnel, and medical resources. This review compares the quality and accessibility of plastic surgery services in African rural and urban settings in order to determine the variables influencing said differences in access.
This literature review was performed using electronic search databases comprising PubMed/MEDLINE, Google Scholar, and Africa Journals online (AJOL). Regional medical journals were also reviewed using keywords and associated Boolean operators pertaining to "plastic surgery", "plastic surgery in rural" and plastic surgery in urban" by selecting studies based on their relevance and content quality. Studies focusing on plastic surgery in Africa were included. A total of 37 articles were analyzed to provide insights into the disparities between rural and urban access to plastic surgery services in Africa. Studies not focusing on plastic surgery were excluded.
The review highlighted significant disparities in access to plastic surgery services between Africa's rural and urban areas. Rural areas usually lack medical resources, specialized surgeons, infrastructure, while urban areas have access to better facilities and specialized surgeons. Urban regions not only hail more training opportunities for surgeons but also foster further specialized facilities, greater training options, access to modern surgical equipment, sterile facilities and advanced instruments, contributing to clinical and surgical excellence alongside patient satisfaction and outcomes. However, there is a scarcity of qualified plastic surgeons in rural regions, including antiquated technology and a dearth of resources and expertise. Besides, socioeconomic variables that hinder said indifference between rural and urban areas, such as poverty, education, money, and cultural attitudes, precipitated limited access to critical surgical intervention in rural populations.
Further research should be done on how plastic surgery services differ in urban and rural areas. Availability of financial expertise and specialists who can provide specialized care in rural settings is recommended. To enhance patient outcomes, the implementation of technological innovation, improved healthcare infrastructure, and effective training initiatives should be implemented in rural Africa. Also, in the field of plastic surgery, emphasizing the use of telemedicine and mobile surgical units may aid universal healthcare for residents in rural domiciles. Significant progress towards ensuring equitable access to high-quality plastic surgery in rural Africa may be achieved through these initiatives.
Mugisha N
，Uwishema O
，Noureddine R
，Fatokun BS
，Byiringiro C
，Fawaz L
，Ghanem L
，Mukamitari V
，Wellington J
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《BMC Surgery》
It is time for reform: Results from a questionnaire survey on the current status of next generation HBP surgeons in Japan.
A questionnaire survey was designed and performed to assess the current status of "next generation" hepatobiliary and pancreatic (HBP) surgeons regarding surgical training, career, recruiting, and work-life balance in Japan. Using a valid email address, a questionnaire was sent to members of the Japanese Society of Hepato-Biliary-Pancreatic Surgeons (JSHBPS) who were under 45 years old. The questionnaire comprised 50 questions across the following four sections: (i) board certification of JSHBPS, (ii) research activity and overseas study, (iii) recruiting, and (iv) work-life balance. A questionnaire survey was sent to 1735 HBP surgeons and responses were received from 303 members (17.5%). In a survey with 303 respondents, over 45.9% were above 41 years old, 93.7% were male, and 91.0% were affiliated with university surgery departments. About 25.1% were JSHBPS board-certified, while 72.7% of uncertified doctors aspired for the certification. Research activity was deemed crucial by 74.9%. Recruitment targeting postgraduate years 1-5 was recommended, with the technical difficulty of surgery being the main reason for choosing HBP. Regarding work-life balance, excessive work and classical work style were regarded as a hindrance to the sustainability of working practices. This survey highlighted that next generation HBP surgeons are highly motivated to acquire advanced surgical skills and recognize the importance of research experience. However, they are facing long working hours and insufficient training opportunities. Fundamental reforms, such as revising the training curriculum, improving work styles, and enhancing recruitment, are necessary steps forward to ensure the sustainability of HBP surgery in Japan.
Kosai-Fujimoto Y
，Yoh T
，Hara T
，Umezawa S
，Maekawa A
，Matsuo Y
，Ishii N
，Okinaga H
，Endo I
，Ohtsuka M
，Eguchi S
，Shirabe K
... -
《-》
Trends in Surgical and Nonsurgical Aesthetic Procedures: A 14-Year Analysis of the International Society of Aesthetic Plastic Surgery-ISAPS.
As part of the International Society of Aesthetic Plastic Surgery, we present an analysis of our global aesthetic statistics, fulfilling the role of a worldwide organization of plastic surgeons with a clear mission to disseminate aesthetic education worldwide, promote patient safety, protect high ethical standards, and communicate.
A retrospective analysis of the ISAPS Global Aesthetic Statistics was conducted annually from 2010 to 2023. The design and analysis of each survey was carefully developed and validated by Industry Insights, Inc. prior to distribution. Participants were recruited using an anonymous online questionnaire that focused primarily on the number of surgical and nonsurgical procedures performed in the previous year, as well as questions related to surgeon demographics and the prevalence of medical tourism. ISAPS invited all physicians in their data base who were board-certified plastic surgeons or equivalent and suggested National Societies to encourage their members to participate.
The latest survey reported a global increase in 3.4%, including 34.9 million surgical and nonsurgical aesthetic procedures performed by plastic surgeons in 2023. More than 15.8 million surgical procedures and more than 19.1 million nonsurgical procedures were performed worldwide. During the past decade, a steady increase in aesthetic procedures has been observed, which has been more pronounced since 2021. In the last 4 years, the overall increase in procedures was 40%.
The top five surgical procedures were liposuction, breast augmentation, eyelid surgery, abdominoplasty, and rhinoplasty. This trend has been stable for 14 years, with the exception of 2022, when breast lift surgery temporarily replaced rhinoplasty.
These procedures continue to be the most popular. This group included brow lift, ear surgery, eyelid surgery, facelift, facial bone contouring, facial fat grafting, lip augmentation or frontal surgery, neck lift, and rhinoplasty.
This group included abdominoplasty, buttock augmentation, buttock lift, liposuction, lower body lift, thigh lift, arm lift, upper body lift, labiaplasty, and vaginal rejuvenation. Over the past 14 years, body and extremity procedures have increased, with more than 5.1 million procedures in 2023 compared to 2.6 million in 2009.
The five most popular nonsurgical procedures are botulinum toxin, hyaluronic acid, hair removal, chemical peels, and nonsurgical fat reduction. In 2022, chemical peels will replace nonsurgical skin tightening in the top five.
Procedures performed on men continue to grow, with minimally invasive procedures dominating. The most recent survey reported that they represented 14.5% of the total. The top five surgical procedures were eyelid surgery, gynecomastia, liposuction, rhinoplasty, and facial fat grafting. The most popular nonsurgical procedures for men were botulinum toxin, hyaluronic acid, hair removal, nonsurgical skin tightening, and nonsurgical fat reduction. This trend has held steady for more than a decade.
This study analyzes the most recent data and experience of board-certified aesthetic plastic surgeons in surgical and nonsurgical procedures worldwide over 14 years and provides insight into future trends. More than 60 years have passed since the introduction of liposuction, being one of the most performed aesthetic procedures worldwide over the past 14 years and currently number one procedure performed by plastic surgeons. New trends and technologies have evolved over the years, however, plastic surgeons must be cautious, as history has shown that risks increase when new technologies are introduced. With the popularity of liposuction, other body contouring procedures began to gain interest, and in 2015, gluteal lipoinjections were added to the ISAPS global aesthetic statistics and with them complications arise. In 2018 and 2019, the major patient safety societies, ISAPS, ASERF, ASPS, and ASAPS, began a systematic educational campaign to inform their members about the inherent risks of performing gluteal fat transfer surgery and what techniques or equipment can be used to minimize risks. Another procedure added to the ISAPS statistics in 2010 was vaginal aesthetic surgery. With the new trend of vaginal aesthetics, many believed that they were just changing the appearance of the area, but today it is clear that they are here for much more, to truly empower women with their sexuality. Breast augmentation showed a decline for the first-time last year. However, breast augmentation and liposuction have been the most performed procedures by plastic surgeons worldwide for more than a decade. On the other hand, implant removal has been the fastest growing procedure since 2015, with an overall increase in 46.3% over the past 5 years. In relation to male aesthetic surgery, the number of men undergoing aesthetic procedures has remained stable in recent years at around 14%. Male aesthetics is certainly a growing trend, and our practices should be more inclusive. Another prominent field is regenerative medicine. In relation to plastic surgery, regenerative surgery strategies often involve adipose tissue with stem cells and preadipocytes, alone or in combination with scaffolds. In terms of prevention, regenerative medicine aims to improve the quality of the skin by improving our outcomes and would make it possible to avoid the need for facelifts in the future. Finally, given the increasing popularity of medical procedures abroad ("medical tourism") and the fact that safety regulations and guidelines vary widely from place to place, we encourage patients to choose a board-certified, specialized, trained and experienced plastic surgeon for their procedure and an accredited surgical facility to ensure the procedure in done under the highest patient safety standards.
Despite the obvious cultural and social differences from country to country that make certain procedures more desirable in some geographic areas and less so in other parts of the world, the results of this study show a significant overall increase in all surgical and nonsurgical procedures aimed at improving the aesthetic appearance of the body during14 years. As plastic surgeons, we are open to new possibilities in aesthetic procedures and are responsible for patient safety protocols and procedures.
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Triana L
，Palacios Huatuco RM
，Campilgio G
，Liscano E
... -
《-》
ResearchGate
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钛学术
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