1Division of Facial Plastic & Reconstructive Surgery ... · scar revision techniques remain...

1
You’re too pretty: The growing trend of assault by facial mutilation Namita R. Murthy, MD 1 ; Sarah Saxon, MD 1 ; Jeffrey H. Spiegel, MD, FACS 1, 1Division of Facial Plastic & Reconstructive Surgery, Department of Otolaryngology-Head & Neck Surgery, Boston University School of Medicine, Boston, Massachusetts Namita R Murthy, MD Department of Otolaryngology-Head and Neck Surgery Boston University Medical Center Email: [email protected] Contact Objectives: To raise medical awareness of the rising incidence of crimes wherein the attacker willfully creates severe facial mutilation in the victim in order to mar their appearance. These attacks are based upon jealousy of another's appearance. Methods: Case report Results: We describe a 23-year old woman who presented for consultation of scar revision after sustaining significant penetrating facial trauma for being “too pretty.” Conclusions: There have been an increasing number of reported cases of young women suffering severe facial disfigurement in the media. The common theme is that these women are targeted for their beauty and attractiveness. Facial Plastic Surgeons need to be aware of this new phenomenon and know how to counsel the patient and speak with the media regarding these new occurrences. Abstract 23-year old exotic dancer from the Dominican Republic presented for consultation of scar revision. Two years prior, she was assaulted while leaving work by a female coworker who told her, “Now you won’t be so pretty.” The jealous woman inserted a razor blade into her mouth and cut her from left oral commissure to tragus transecting Stenson’s duct. Her initial soft tissue and intraoral repair were followed by revision Z-plasty and multiple laser treatments with minimal improvement At our consultation, she was found to have a 9 cm irregular, hyperpigmented scar with both raised and depressed areas. She was treated with intradermal triamcinalone injections, re- excision of scar with geometric broken line closure and Dermabrasion. Scar revision continues. Case Report Facial Plastic and Reconstructive Surgeons are closely involved in treating victims of interpersonal violence. Hate crime assaults motivated by an offender’s jealousy of the victim’s attractiveness are on the rise globally. Facial Plastic and Reconstructive Surgeons should recognize this new phenomenon and the unique psychological and physical consequences it presents in their patients. Conclusions There are five media reported cases over the past three years of facial mutilation motivated by the assailant’s jealousy of the victim’s beauty and attractiveness. This kind of attack, while perhaps inconceivable in the past, seems to be a growing trend. Pervasiveness of photographs and social media, immigration with the expansion of regional crimes to expatriate communities, and social media videos of knife crimes all may contribute to the increase in this kind of violence. Surgeons should be aware of this type of attack so that they are prepared to help the victim medically and psychologically, as well as be mentally prepared to face their own reaction when presented with such a patient. The heinous nature of this crime can be difficult for the medical team. Regrettably, the attacker achieves her goals in these assaults as scar revision techniques remain imperfect. Geometric broken line closures, laser, dermabrasion, and other techniques can help improve the appearance of a facial scar but, particularly in darker skin tones, the pigmentation issues and scar appearance persist lifelong. Discussion Figure 1. 15 year old female attacked by two female teenagers for being “too pretty” and “too preppy” in recent media. A hate crime is defined as a “criminal offense against a person or property motivated in whole or in part by an offender’s bias against a race, religion, disability, ethnic origin or sexual orientation”. These new variants are hate crimes based upon jealousy of another’s appearance. Interpersonal violence is a dominant cause of facial trauma globally with many manifestations, typically blunt facial trauma. Rarely, however, is the cause of the attack the person’s attractive appearance. No literature exists regarding the increasing incidence of facial trauma motivated by an offender’s bias against a young woman’s beauty. Introduction Figure 2. 23 year old victim of assault by facial mutilation treated with scar re- excision with geometric broken line closure, intradermal triamcinolone injections and Dermabrasion. References 1. Federal Bureau of Investigation. Hate Crime Statistics. Dec 2014. Retrieved March 2015, from FBI.gov: http://www.fbi.gov/news/stories/2014/december/latest-hate-crime-statistics-report-released/latest-hate-crime-statistics-report- released 2. Federal Bureau of Investigation. Hate Crime-Overview. Retrieved March 2015, from FBI.gov: http://www.fbi.gov/about- us/investigate/civilrights/hate_crimes/overview 3. Hussain K, Wijetunge DB, Grubnic S, et al.: A comprehensive analysis of craniofacial trauma. J Trauma. 36:34-47 1994 4. Gassner R, Tuli T, Hachl O, et al.: Cranio-maxillofacial trauma: a 10 year review of 9,543 cases with 21,067 injuries. J Craniomaxillofac Surg. 31:51-61 2003 5. Wulkan M1, Parreira JG Jr, Botter DA.: Epidemiology of facial trauma. Rev Assoc Med Bras. 2005 Sep-Oct;51(5):290-5. 6. Llenas, Bryan. “Two teenage girls in Argentina viciously slashed in face for being 'too pretty’” Fox News Latino. Fox News Channel. 02 Oct 2014. Web. 23 Jan 2015. 7. Beever, Susie. Aspiring teen model left with slashed face and split skull after horrific machete attack. 11 Jan 2015. http://www.mirror.co.uk/news/uk-news/aspiring-teen-model-left-slashed-4959885. 8. Turk, Rose-Marie. "Model Changing Her Career After being Slashed." Los Angeles Times (1923-Current File): 1. Nov 06 1987. ProQuest. Web. 1 Apr. 2015 . 9. “Model, 18, has face slashed with razor blade by two women who smiled as they attacked her in crowded mall” Daily Mail. 18 Jan 2013. Web. 23 Jan 2015. 10. Goulart DR, Colombo L do A, de Moraes M, Asprino L. What Is Expected from a Facial Trauma Caused by Violence? J Oral & Maxillofacial Research. 2014;5(4):e4. doi:10.5037/jomr.2014.5404. 11. Lee, KH.: Interpersonal violence and facial fractures. J Oral Maxillofac Surg. 2009 Sep;67(9):1878-83. doi: 10.1016/j.joms.2009.04.117 12. Herek, Gregory M., J. Roy Gillis, and Jeanine C. Cogan. "Psychological sequelae of hate-crime victimization among lesbian, gay, and bisexual adults." Journal of consulting and clinical psychology 67.6 (1999): 945.

Transcript of 1Division of Facial Plastic & Reconstructive Surgery ... · scar revision techniques remain...

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You’re too pretty: The growing trend of assault by facial mutilation

Namita R. Murthy, MD1; Sarah Saxon, MD1; Jeffrey H. Spiegel, MD, FACS 1,

1Division of Facial Plastic & Reconstructive Surgery, Department of Otolaryngology-Head & Neck Surgery, Boston University School of Medicine, Boston, Massachusetts

Namita R Murthy, MD Department of Otolaryngology-Head and Neck Surgery Boston University Medical Center Email: [email protected]

Contact

Objectives: To raise medical awareness of the rising incidence of crimes wherein the attacker willfully creates severe facial mutilation in the victim in order to mar their appearance. These attacks are based upon jealousy of another's appearance. Methods: Case report Results: We describe a 23-year old woman who presented for consultation of scar revision after sustaining significant penetrating facial trauma for being “too pretty.” Conclusions: There have been an increasing number of reported cases of young women suffering severe facial disfigurement in the media. The common theme is that these women are targeted for their beauty and attractiveness. Facial Plastic Surgeons need to be aware of this new phenomenon and know how to counsel the patient and speak with the media regarding these new occurrences.

Abstract • 23-year old exotic dancer from the Dominican Republic presented for consultation of scar revision. • Two years prior, she was assaulted while leaving work by a female coworker who told her, “Now you won’t be so pretty.” • The jealous woman inserted a razor blade into her mouth and cut her from left oral commissure to tragus transecting Stenson’s duct. • Her initial soft tissue and intraoral repair were followed by revision Z-plasty and multiple laser treatments with minimal improvement • At our consultation, she was found to have a 9 cm irregular, hyperpigmented scar with both raised and depressed areas. • She was treated with intradermal triamcinalone injections, re- excision of scar with geometric broken line closure and Dermabrasion. Scar revision continues.

Case Report

• Facial Plastic and Reconstructive Surgeons are closely involved in treating victims of interpersonal violence. • Hate crime assaults motivated by an offender’s jealousy of the victim’s attractiveness are on the rise globally. • Facial Plastic and Reconstructive Surgeons should recognize this new phenomenon and the unique psychological and physical consequences it presents in their patients.

Conclusions

• There are five media reported cases over the past three years of facial mutilation motivated by the assailant’s jealousy of the victim’s beauty and attractiveness. This kind of attack, while perhaps inconceivable in the past, seems to be a growing trend. • Pervasiveness of photographs and social media, immigration with the expansion of regional crimes to expatriate communities, and social media videos of knife crimes all may contribute to the increase in this kind of violence. • Surgeons should be aware of this type of attack so that they are prepared to help the victim medically and psychologically, as well as be mentally prepared to face their own reaction when presented with such a patient. The heinous nature of this crime can be difficult for the medical team. • Regrettably, the attacker achieves her goals in these assaults as scar revision techniques remain imperfect. Geometric broken line closures, laser, dermabrasion, and other techniques can help improve the appearance of a facial scar but, particularly in darker skin tones, the pigmentation issues and scar appearance persist lifelong.

Discussion

Figure 1. 15 year old female attacked by two female teenagers for being “too pretty” and “too preppy” in recent media.

• A hate crime is defined as a “criminal offense against a person or property motivated in whole or in part by an offender’s bias against a race, religion, disability, ethnic origin or sexual orientation”. These new variants are hate crimes based upon jealousy of another’s appearance. • Interpersonal violence is a dominant cause of facial trauma globally with many manifestations, typically blunt facial trauma. Rarely, however, is the cause of the attack the person’s attractive appearance. • No literature exists regarding the increasing incidence of facial trauma motivated by an offender’s bias against a young woman’s beauty.

Introduction

Figure 2. 23 year old victim of assault by facial mutilation treated with scar re-excision with geometric broken line closure, intradermal triamcinolone injections and Dermabrasion.

References 1. Federal Bureau of Investigation. Hate Crime Statistics. Dec 2014. Retrieved March 2015, from FBI.gov:

http://www.fbi.gov/news/stories/2014/december/latest-hate-crime-statistics-report-released/latest-hate-crime-statistics-report-released

2. Federal Bureau of Investigation. Hate Crime-Overview. Retrieved March 2015, from FBI.gov: http://www.fbi.gov/about-us/investigate/civilrights/hate_crimes/overview

3. Hussain K, Wijetunge DB, Grubnic S, et al.: A comprehensive analysis of craniofacial trauma. J Trauma. 36:34-47 1994

4. Gassner R, Tuli T, Hachl O, et al.: Cranio-maxillofacial trauma: a 10 year review of 9,543 cases with 21,067 injuries. J Craniomaxillofac Surg. 31:51-61 2003

5. Wulkan M1, Parreira JG Jr, Botter DA.: Epidemiology of facial trauma. Rev Assoc Med Bras. 2005 Sep-Oct;51(5):290-5.

6. Llenas, Bryan. “Two teenage girls in Argentina viciously slashed in face for being 'too pretty’” Fox News Latino. Fox News Channel. 02 Oct 2014. Web. 23 Jan 2015.

7. Beever, Susie. Aspiring teen model left with slashed face and split skull after horrific machete attack. 11 Jan 2015. http://www.mirror.co.uk/news/uk-news/aspiring-teen-model-left-slashed-4959885.

8. Turk, Rose-Marie. "Model Changing Her Career After being Slashed." Los Angeles Times (1923-Current File): 1. Nov 06 1987. ProQuest. Web. 1 Apr. 2015 .

9. “Model, 18, has face slashed with razor blade by two women who smiled as they attacked her in crowded mall” Daily Mail. 18 Jan 2013. Web. 23 Jan 2015.

10. Goulart DR, Colombo L do A, de Moraes M, Asprino L. What Is Expected from a Facial Trauma Caused by Violence? J Oral & Maxillofacial Research. 2014;5(4):e4. doi:10.5037/jomr.2014.5404.

11. Lee, KH.: Interpersonal violence and facial fractures. J Oral Maxillofac Surg. 2009 Sep;67(9):1878-83. doi: 10.1016/j.joms.2009.04.117

12. Herek, Gregory M., J. Roy Gillis, and Jeanine C. Cogan. "Psychological sequelae of hate-crime victimization among lesbian, gay, and bisexual adults." Journal of consulting and clinical psychology 67.6 (1999): 945.