Journal of

Risks of Ghaderi’s Phenomenon

Reza Ghaderi^1*

¹Professor, Department of Dermatology, Faculty of Medicine, Birjand University of Medical Science, Birjand, Iran

Received: June 20, 2019      Revised: July 30, 2019         Accepted: August 04, 2019

Dear Editor

"Beauty has so many forms, and I think the most beautiful thing is confidence and loving yourself". Kiesza

Beauty has classically been considered amongst the definitive values, goodness, justice, integrity, and loyalty. Beauty, cutaneous body image, quality of life, self-esteem, and self-confidence are intertwined together (1-2). Life quality consists of a feeling of joyance and satisfaction with life. However, life quality, self-esteem, and self-confidence in patients with dermatoses have not adequately been attended to so far. As regards, dermatoses affect general health, well-being, and social adaptation of the individual (3-5). In a study, the majority of the female patients who were candidates for Bariatric Surgery declared high body image concerns (6). Modern cognitive approaches to Body Dysmorphic Disorder suppose that appearance-related intrusive cognitions and their functional outcomes determine the disorder (1).

The Body Dysmorphic Disorder is a common debilitating disease worldwide. Patients manifest a disabling preoccupation with a few perceived defects, frequently well-marked by poor insight or delusional thoughts (2-7). According to the results of a study, rhinoplasty candidates reported high body image concern (8). Accurate interviewing of the patients who are candidates for rhinoplasty is very important to evaluate their level of body image concern in order to diagnose any available disease and prescribe required treatments (8).

More and more people worldwide are using hyaluronic acid injections for skin rejuvenation and better cutaneous body image and self-esteem
(5- 7). Cosmetic injectable treatments are progressively common. However, a few studies have investigated modifications in psychosocial functioning following these procedures (9). Some studies were performed to evaluate changes in cutaneous body image, self-esteem, and life quality following cosmetic injectable procedures with neuromodulators and soft tissue fillers (9). Cosmetic injectable treatments associated with an increase in body image satisfaction. Further investigation using modern cosmetic surgery-specific devices can supply new insights into the psychosocial advantages of cosmetic injectable treatments (9). Millions of cosmetic and surgical procedures of the face are administrated each year; however, objective clinical criteria that assess surgical procedures, such as complication rates, have limited efficiency when applied to cosmetic procedures. While there might be subjective improvements in cutaneous body image, it is very important to assess if these procedures have an effect on patients in other domains, such as psychosocial functioning (10).

Most studies showed moderate improvements in psychosocial functioning, including a self-body image, self-esteem, and life quality. Unluckily, the global quality of evidence is limited due to a lack of control groups, short follow-up periods, or loss to follow-up (10). The current evidence shows that a number of psychosocial realms can improve following facial cosmetic procedures. In spite of the marked rise in nonsurgical cosmetic treatments, there is a deficiency of information about the effect of chemodenervation and soft-tissue enhancement on psychosocial functioning (10).

On the other hand, due to cultural issues in some countries, only the faces of women can be exposed and the lips in the center of the face are always at the attention of the ladies who especially like their lips to be the same as a famous Hollywood Beautiful actress, Angelina Jolie, which I call the "Phenomenon of Angelinaphilia" or "Ghaderi’s Phenomenon". The attempt to have cosmetic facial surgeries has been increasing over the past years. Fillers for tissue enhancement are acquiring great popularity (11). For this purpose, the filler injection is used in the lip, especially the upper lip (12-15). Hyaluronic acid soft tissue fillers consist a range of productions (i.e., Voluma, Restylane Silk, Restylane, Restylane Lyft, Juvederm Ultra, Juvederm Ultra Plus, and Belotero Balance) that are applied frequently for the augmentation of facial features and facial rejuvenation. Although these productions are the same in many ways, they are not substitutable and have distinctive specifications that need to be noticed  (13 -14).

There have been no large-scale analyses of complications related to filler injections (12). Liquid silicone which is also known as polydimethylsiloxane relates to a group of polymeric compounds that are frequently called silicones. These fillers have been applied as injectable filling agents for soft tissue enhancement and cosmetic lip augmentation (11). In a study, recently severe edema, erythema over cheeks and neck, and several irregularities were reported following lip augmentation with polydimethylsiloxane (11).

Despite the fact that specific adverse event profiles differ by material and injection site, common complications, such as swelling and infection are related to injectable filling agents. More severe complications include vascular events resulting in necrosis and visual loss; these complications are also increased in cases involving legal proceedings (12). Uncertified productions based on oleic solutions are used by uneducated personnel, thereby increasing the risk for specific adverse events, such as lipogranuloma formation, irritant and allergic contact dermatitis, and infections (15). On the other hand, the incidence of squamous cell carcinoma of the lip is high. It constitutes 25% to 30% of all oral cancers which is much more common in the lower lip than the upper lip (16- 19). The role of cumulative ultraviolet radiation in squamous cell carcinoma of the lip is well established (19). These filler injections for cosmetic lip augmentation cause the upper lip mucosa to become more exposed to sun exposure

In my opinion, therefore, Ghaderi's phenomenon will greatly increase the risk of squamous cell carcinoma of the lip, especially in the upper lip. Accordingly, squamous cell carcinoma of the lip can be considered as a new complication following using filler injections for cosmetic lip augmentation.

"The future belongs to those who believe in the beauty of their dreams". Eleanor Roosevelt

Conflicts of Interest

There is no conflict of interest to be declared.

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