ISSN Online: 2177-1235 | ISSN Print: 1983-5175
Controversial themes in liposuction: national opinion survey of members of the Brazilian Society of Plastic Surgery (Update Liposuction Survey)
Temas controversos em Lipoaspiração: pesquisa de opinião nacional de membros da Sociedade Brasileira de Cirurgia Plástica (Update Liposuction Survey / SBCP)
Special Article -
Year2017 -
Volume32 -
Issue
2
Pericles Vitório Serafim Filho1; Ana Claudia Benjamim Burattini2; Hernanne Medina3; Luciano Ornelas Chaves4; Juan Carlos Montana Pedroso5; Lydia Masako Ferreira6
http://www.dx.doi.org/10.5935/2177-1235.2017RBCP0050
ABSTRACT
INTRODUCTION: Liposuction is the second most commonly performed surgical procedure worldwide. However, many liposuction procedures are controversial. In this context, expert opinion surveys may help elucidate topics lacking consensus. The objective of this survey was to interview plastic surgeons who are members of the Brazilian Society of Plastic Surgery (Sociedade Brasileira de Cirurgia Plástica [SBCP]), the Update Liposuction Survey (ULS/SBCP), to assess their opinions about controversial topics in liposuction.
METHODS: A link to a questionnaire containing 11 questions involving liposuction (ULS/SBCP) was sent electronically to all SBCP members. The email was sent in three instances and with the provision of incentives to promote a higher response rate.
RESULTS: Of the 4,957 contacted plastic surgeons, 917 responded (response rate, 18.5%). The results are being analyzed for publication in full.
Keywords:
Lipectomy; Research; Evaluation of results (health care); Surveys and questionnaires; Statistical analysis.
RESUMO
INTRODUÇÃO: A lipoaspiração é o segundo procedimento cirúrgico estético mais realizado no mundo. Entretanto, muitas condutas envolvendo a lipoaspiração permanecem controversas. As pesquisas de opinião com especialistas podem elucidar quais áreas encontram-se sem consenso. O objetivo é realizar uma pesquisa de opinião com cirurgiões plásticos membros da Sociedade Brasileira de Cirurgia Plástica, o Update Liposuction Survey (ULS/SBCP), a fim de esclarecer suas condutas em temas controversos em lipoaspiração.
MÉTODOS: Um link para um questionário contendo 11 perguntas envolvendo a lipoaspiração (ULS/SBCP) foi enviado eletronicamente a todos os membros da SBCP. O e-mail foi enviado em três momentos e com a oferta de incentivos para promover maior taxa de resposta.
RESULTADOS: Dos 4957 cirurgiões plásticos contatados, 917 responderam, resultando em uma taxa de resposta de 18,5%. Os resultados estão sendo analisados para posterior publicação na íntegra.
Palavras-chave:
Lipectomia; Pesquisa; Avaliação de resultados (cuidados de saúde); Inquéritos e questionários; Análise estatística.
INTRODUCTION
Liposuction is a surgical procedure that reshapes the body contour by removing excess deposits of subcutaneous fat1.
A review that aimed to obtain more scientific evidence on liposuction found a limited number of studies with high-level evidence, including randomized controlled trials of adequate power, to support the discussion of controversial themes including preoperative evaluation and anesthesia type2-5. In fact, plastic surgery and its history have been consolidated by studies with low levels of evidence6. Randomized clinical trials are scarce due to high cost, high time investment, and greater complexity of the field of surgery7,8.
Expert opinion surveys are a well-established tool for obtaining information about medical conduct9. Because medical experts play an essential role in the implementation of guidelines, changes in strategies, and use of new technologies, conducting opinion surveys with experts can provide vital data for the development of health policies and scientific research10,11.
METHODS
The present study followed the recommendations of the checklist published by Nolte et al.12 to conduct and publish opinion surveys. The Update Liposuction Survey of the Sociedade Brasileira de Cirurgia Plástica (ULS/SBCP) was developed to discuss controversial topics in liposuction. The controversial subjects included those in which the level of scientific evidence identified in literature reviews was low and those that generated controversy at scientific meetings promoted by the SBCP. Only closed-type questions were included. The final questionnaire included 11 questions (Annex 1).
All surgeons registered as specialists in the SBCP were consulted electronically between August and November 2016 using the e-mail provided by the SBCP members. The email contained a link from which the member accessed the questionnaire. A "Send" button was located at the end of the questionnaire.
Demographic variables including age, sex, region of the country, and area of expertise in the SBCP were collected using the electronic form. The SBCP Statute classifies SBCP memberships into three categories: Candidate, Associate, and Full. The last two are exclusive to those who obtained a degree of Specialist in Plastic Surgery. The member becomes a Full Member after spending at least 2 years in the Associate Member category and receiving monograph approval by an SBCP-designated committee.
The questionnaire was sent in three different groups. The first batch was delivered to the first 300 members who registered for parallel courses of the 53rd Brazilian Congress of Plastic Surgery held at the end of 2016 in Fortaleza, Brazil, as an incentive to participate. The questionnaire submission and electronic data collection were executed by a company outsourced by the SBCP (Data Tech, São Paulo, Brazil).
The statistical analysis was conducted using the two-proportions equality test for categorical variables and the ANOVA test for continuous variables. Values < 5% were considered statistically significant.
RESULTS
A total of 4,957 plastic surgeons affiliated with the SBCP were contacted electronically. Of the 4,957 specialists, 917 answered the questionnaire for a response rate of 18.5%.
The demographic data of the plastic surgeons who answered the questionnaire are shown in Table 1. Most responders were men aged 32-41 years who worked in the Southeast region and were classified as Associate Members of the SBCP. The mean membership durations of the Associate and Full Members who participated in the survey were 9.7 and 18.4 years, respectively (Table 2).
The answers of the plastic surgeons to the 11 formulated questions are being analyzed for later publication in its entirety.
COLLABORATIONS
PVSF Conception, setup and questionnaire application.
ACBB Conception, setup and questionnaire application.
EM Conception, setup and questionnaire application.
LOC Institutional revision.
JCMP Writing the manuscript.
LMF Conception and design of the study; writing the manuscript and critical review of its contents.
REFERENCES
1. Tabbal GN, Ahmad J, Lista F, Rohrich RJ. Advances in liposuction: five key principles with emphasis on patient safety and outcomes. Plast Reconstr Surg Glob Open. 2013;1(8):e75. DOI:10.1097/GOX.0000000000000007. DOI: http://dx.doi.org/10.1097/GOX.0000000000000007
2. Chia CT, Neinstein RM, Theodorou SJ. Evidence-Based Medicine: Liposuction. Plast Reconstr Surg. 2017;139(1):267e-274e. DOI:10.1097/PRS.0000000000002859. DOI: http://dx.doi.org/10.1097/PRS.0000000000002859
3. ISAPS. ISAPS International Survey on Aesthetic/Cosmetic Procedures Performed in 2015. Published 2016 [cited 2017 May 19]. Available from: https://www.isaps.org/Media/Default/global-statistics/2016ISAPSResults.pdf
4. Matarasso A, Levine SM. Evidence-based medicine: liposuction. Plast Reconstr Surg. 2013;132(6):1697-705. DOI:10.1097/PRS.0b013e3182a807cf. DOI: http://dx.doi.org/10.1097/PRS.0b013e3182a807cf
5. Wells JH, Hurvitz KA. An evidence-based approach to liposuction. Plast Reconstr Surg. 2011;127(2):949-54. DOI:10.1097/PRS.0b013e318204afaf. DOI: http://dx.doi.org/10.1097/PRS.0b013e318204afaf
6. Rohrich RJ. So you want to be better: the role of evidence-based medicine in plastic surgery. Plast Reconstr Surg. 2010;126(4):1395-8. DOI:10.1097/PRS.0b013e3181ea4222. DOI: http://dx.doi.org/10.1097/PRS.0b013e3181ea4222
7. Voineskos SH, Coroneos CJ, Ziolkowski NI, Kaur MN, Banfield L, Meade MO, et al. A Systematic Review of Surgical Randomized Controlled Trials: Part 2. Funding Source, Conflict of Interest, and Sample Size in Plastic Surgery. Plast Reconstr Surg. 2016;137(2):453e-461e. DOI:10.1097/01.prs.0000475767.61031.d1. DOI: http://dx.doi.org/10.1097/01.prs.0000475767.61031.d1
8. Blencowe NS, Brown JM, Cook JA, Metcalfe C, Morton DG, Nicholl J, et al.; Members of the MRC Hub for Trials Methodology Research Network Workshop. Interventions in randomised controlled trials in surgery: issues to consider during trial design. Trials. 2015;16:392. DOI:10.1186/s13063-015-0918-4. DOI: http://dx.doi.org/10.1186/s13063-015-0918-4
9. Klabunde CN, Willis GB, Casalino LP. Facilitators and barriers to survey participation by physicians: a call to action for researchers. Eval Health Prof. 2013;36(3):279-95. DOI:10.1177/0163278713496426. DOI: http://dx.doi.org/10.1177/0163278713496426
10. Klabunde CN, Willis GB, McLeod CC, Dillman DA, Johnson TP, Greene SM, et al. Improving the quality of surveys of physicians and medical groups: a research agenda. Eval Health Prof. 2012;35(4):477-506. DOI:10.1177/0163278712458283. DOI: http://dx.doi.org/10.1177/0163278712458283
11. Mo A, McQuilten ZK, Wood EM, Weinkove R. Red cell transfusion thresholds in myelodysplastic syndromes: a clinician survey to inform future clinical trials. Intern Med J. 2017;47(6):695-8. DOI:10.1111/imj.13434. DOI: http://dx.doi.org/10.1111/imj.13434
12. Nolte MT, Shauver MJ, Chung KC. Structure and establishing validity in survey research. Plast Reconstr Surg. 2015;135(1):216e-22e. DOI:10.1097/PRS.0000000000000794. DOI: http://dx.doi.org/10.1097/PRS.0000000000000794
1. Head of the Plastic Surgery Service of the Napoleão Laureano Hospital/Coordinator of the Liposuction Commission of the Brazilian Society of Plastic Surgery
2. Head of the Plastic Surgery Service of Pérola Byington Hospital/Member of the Liposuction Commission of the Brazilian Society of Plastic Surgery
3. Member of the Liposuction Commission of the Brazilian Society of Plastic Surgery
4. President of the Brazilian Society of Plastic Surgery
5. Adjunct Professor of the Discipline of Plastic Surgery of UNIFESP, São Paulo, Brazil
6. Professor of the Discipline of Plastic Surgery of UNIFESP, São Paulo, Brazil
Institution: Sociedade Brasileira de Cirurgia Plástica, São Paulo, SP, Brazil.
Corresponding author:
Pericles Vitório Serafim Filho
Av. Epitácio Pessoa, 871
João Pessoa, PB, Brazil Zip Code 58030-000
E-mail: periclesfilho@gmail.com
Article received: April 10, 2017.
Article accepted: June 15, 2017.
Conflicts of interest: none.
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