College of William and Mary Plastic Operations Research Methods Analysis

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Read the case titled “Massachusetts General Hospital’s Pre-Admission Testing Area” by McCarty, Gallien, and Levi (2012). Analyze the case study by completing the following areas:

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1 Name: Degree: Output: Title: Abstract B.MM. (Hons) Media Arts Undergraduate Dissertation Demerits of Plastic Surgery Plastic surgeries have become part of many individuals' beauty living standards. Thus, plastic surgeries have been developed and helped by restoration, reconstruction, or alteration of the human body by performing surgery. After that, cosmetic surgery formed and is classified as a branch of plastic surgery. Nowadays, many people are going under the knife for the sake of appearances, having one or more cosmetic surgery. The research aims to show how plastic surgeries affected individuals and the world. Moreover, to display the factors that played a role in making plastic surgeries desirable such as social media and the high risks on health and society associated with cosmetic surgeries. The research will also discuss four cases of individuals who had cosmetic surgeries and how it impacted their life in a bad way. As more and more people have cosmetic surgeries, this research will serve as a tool to raise the knowledge of cosmetic surgeries' negative impacts on an individual and global scale. It will also give convincing evidence based on facts and statistics of why people shouldn't do cosmetic surgeries. This research will get to the root of the problem and thus serve to solve it as if you acknowledge a problem and work to fix it. Thesis Issue Plastic surgeries have a lot of great impacts which has also affected people who undergo this process negatively. It is reported that over 89% of people who consider plastic surgery are either unaware or have wrong information about plastic surgeries. The majority of these people are not well informed on the side effects that accompany 2 plastic surgery. People are not concerned with carrying out research or significant information about plastic surgery. On the other hand, the plastic surgery experts are concerned with how they can have many clients to the extent of not providing preliminary information on the risks that come along with the desired results. Over 70% of plastic surgery clinics do not have pieces of equipment for emergency cases. Most of these clinics offer contractual services to experts to maximize their gains (Sung-wook and Ki-hwan 2013). Plastic surgery often causes physiological, social phobia, depression, and several plastic surgery-related disorders (Sansone & Sansone 2007). This research aims to inform about plastic surgery, demerits of plastic surgery, and a brief understanding of cosmetic surgery. Keywords Plastic surgery, Cosmetic surgery, Demerits, Clinics Aim The Demerits of Plastic Surgery Objectives i. To review the health risks associated with plastic surgeries. ii. To review the economic effect of Plastic surgeries on individuals and the world. Thesis Plastic surgery is a procedure performed on a human's body to repair a body part Development damaged by an occurrence. It concerns tissues or skin repair. It is aimed at restoring tissue or skin functions to normalcy. The secondary function of plastic surgery is to improve body appearance. 3 CHAPTER 1 Plastic surgery was initially mentioned between 3000 and 2500 BC in a INTRODUCTION medical reference from Egypt. India was able to perform plastic related surgery 1.0 Overview - techniques by 800 BC. By the 6th Century, a physician called Sushruta came up with Plastic surgery an outstanding technique that had a positive contribution to plastic surgery. After Carpue took over 19 years studying about plastic surgeries in India, he was able to do his first outstanding surgery in 1815. It was the first case in the Western world. The Romans who were at the most superior leaders in technology and medicine were able to do the simplest plastic surgery operations in 1st Century BC. They did ear repairs as their first technique. The Roman religion could not allow them to do human or animal dissections. Heinrich came up with a repair process to restore a broken nose or make one in an instance where the nose is entirely unviable in mid of the 15th Century. The nose restoration process was done by removing some of the skin on the arm's back and setting it for the nose. It was an uncommon process because of the associated risks of the face and the pain endured in the process since there was no anaesthesia. It was until the 19th and 20th centuries when nose readers became very common. 1.1 Background of Research Sir Harold Gillies is considered the man who brought a turnaround in plastic surgery in the modern Century. He is often referred to as the father of Plastic surgery. 4 His motivation was to help soldiers whose faces were deformed due to blasts and facial injuries in WW1. His progress began with a facial injury ward and grew to a facial repair hospital in 1917. Gillies and his working team came up with several techniques that saw over 10000 operations. More than 5000 were soldiers who had gunshot injuries that resulted in facial damage. Gillies ran a private initiative to promote his facial repairs after the WW1. He became committed to plastic surgery in 1930 when his cousin joined him in his work. The actual excelling team was split up when WW2 broke out. This WW2 saw Gillies, Tommy, and Mowlem all go to different camps. McIndoe, who was a consultant, went to Sussex and founded Plastic surgery and Jaw Surgery centre. McIndoe went ahead to develop critical techniques for faces ad hands that got burned. He also recognized the significance of rehabilitating casualties. 1.2 Research Significance Plastic surgery has played an important role because of the impact it has had on those that have seen their facial damages restored. The other significant factor is how the social rehabilitation surrounding this process and techniques have helped several casualties get back to the normal lives. This research seeks to inform on the negative impacts or risks associated with plastic surgery and the economic impact of these surgeries. This research will help people to make considerable choices based on the outlined risks. People will also know the various types of plastic surgeries currently and the average cost of plastic surgery. 1.3 Objectives When people are informed of the advantages, risks, and costs, the plastic surgery 5 practice will see tremendous growth and improvements based on what the clients require. If the risks are more, it will force the industry to develop non-risky techniques to help clients. Without highlighting these risks, the industry will carry on with it, considering better plastic surgery techniques that are less harmful. 1.4 Research Questions 1.5 Problem Statement i. When can plastic surgery apply? ii. How available is plastic surgery? iii. What Plastic surgery techniques are there? iv. What risks do plastic surgery have? Plastic surgeries have seen a rise over the past years, especially the 20th Century. Faced with facial damages, several people have adopted the facial repair technique to keep their faces glowing with beauty allowing them to get to their normal activities without feeling that other people are overlooking them for special tasks because of how they look. There are various groups of people who consider plastic surgery, not for repairs, but beauty factors. Some feel that their facial appearances are not appealing and discover that plastic surgery can add to their facial appearance. With numerous skills and expertise coupled with the rising technology, plastic surgery has had a dramatic growth which has also brought numerous facial catastrophes and suffering amongst the clients. There are numerous risks involved in plastic surgery. These risks make up this research to inform the people, especially the young people who are currently 6 considering plastic surgery to boost their looks. Although plastic surgery is a considerable choice, it comes with various risks that must be addressed to consider other better choices. Today, there are so many clinics that offer plastic surgery services, yet they lack emergency services. This is a scenario that if clients understand, then they will be able to make informed choices. 1.6 Justification Some researchers have been done concerning the dangers of plastic surgery. The title is WARNING: COSMETIC SURGERY KILLS. It details how it kills and gives a few examples of people who have succumbed due to plastic surgery-related complications. This research is only based on cosmetic research. It, therefore, does not give many details on how plastic surgery complications are risky. It is in this research that people will get more than what meets the eye in their decisions. 1.7 Scope This research studies plastic surgery and the risks that are involved when one undergoes this operation. There are those cases that require the operation while there are those that can be handled with other techniques, or otherwise, the casualty is supposed to live that way to avoid the associated risks. The scope of this research is limited to the area of plastic surgery risks. The research methodology in this research is a Case study. This research studies the cases resulting from plastic research suing available data and conclusions to make deductions and evaluations that help clients in their future dealings regarding plastic surgery. The data collection is by observing the trends since 3000 BC to the modern 7 age plastic surgery techniques. 1.8 Dissertation When can plastic surgery apply? Plastic surgery is used in cases where tissue or skin repair is required. Damages to the skin or tissue may result from injuries that vary in nature or where a cancer tissue is removed. There are other cases where there are abnormalities from birth. These abnormalities are cleft lip and palate. There are also webbed fingers and birthmarks. Plastic surgery helps casualties have self-esteem and a better view of self. How available is plastic surgery? There are those reconstructive surgeries that are offered freely. Availability varies in different places often determined by clinical commissioning groups. Reconstructive plastic surgery is usually carried out free of charge on the NHS. But availability varies around the country and is determined by local clinical commissioning groups (CCGs). Most casualties are referred to as NHS. One can also be fined Plastic surgery in private clinics registered to offer plastic surgery, but the cost is quite high. It is a great decision to talk to a specialist before any consultation for the operation is taken. Various available specialists can offer the best options and decide if referrals are necessary. What Plastic surgery techniques are there? The existing plastic surgery techniques are: i. Skin grafts: a healthy skin or an area that has not been damaged is removed. This skin is used to repair lost or damaged skin. ii. Skin flap surgery: a body tissue is taken to another part of the body. The 8 transferred tissue has blood vessels and still alive. iii. Tissue expansion: it involves stretching tissues to make the body grow more skin. The extra skin can be used to repair a damaged area. What risks do plastic surgery have? i. Medical Risks Plastic surgery is associated with dangerous medical side effects and complications which result in death. The most common complications include: 1. Hematoma This is a complication that results from the facelift. It is a collection of blood in the operated area. It causes more damage by affecting the surrounding tissues if it is not treated urgently. The treatment is by another operation to drain the blood. 2. Seroma It occurs when serum accumulates under the skin surface. It results in swelling and causes pain. A needle drains them. 3. Blood loss Plastic surgery leads to blood loss. Excessive loss of blood can lead to unbalanced blood pressure. It comes with deadly results. 4. Infection Skin infection occurs when plastic surgery. An infection can be internal. Sometimes it is severe. Severe infections require intravenous (IV) treatment. 5. Nerve damage Plastic surgery may lead to the damaging of the nerves. The signs are the body becomes numb and tingling. 9 6. Organ damage Plastic surgeries can result in perforations. If the internal organs are probed, it may require another surgery. 7. Scarring Plastic surgery brings scars. The scars are always troubling. 8. Appearance dissatisfaction It is possible to be disappointed with the plastic surgery outcomes. 9. Complications of anaesthesia Anaesthesia is making a casualty unconscious. The procedure causes the patient to be operated on without feeling any pain. This technique causes often causes serious complications such as lung infection, heart attacks, or death. ii. Appearance Plastic surgery results in scars. The scars are red and thick. These scars do not fade, which is not easy to hide. Some issues make the skin sag. The results of plastic surgery are not always what the client wants. iii. Cost The cost of plastic surgery is high. The average cost of plastic surgery is around $139 for a single operation. The high cost which was recorded was the lower body lift. The cost was listed as $7,976. Other costs are involved, such as hospital fees and related medical costs. iv. Addiction There are numerous addictions, especially substance use. It is also possible to find people who get addicted to plastic surgery. Anyone with low self-esteem will find 10 facial procedures addictive. Addiction makes a person correct even the smallest laws. Cosmetic surgery It focuses on enhancing appearances. It is involved with techniques that seek to transform the casualty's appearance. Cosmetic Surgery Operations: a) Breast Enhancement b) Facial Contouring c) Facial Rejuvenation d) Body Contouring e) Skin Rejuvenation Analysis and evaluation of relevant sources Purpose and intended audience The sources cited in this research are for providing information. It also advocates for better or other means to persuade casualties to consider other options for bettering their appearances and facial damages. This research's audience is the general public for those young ones born with abnormalities and those that get injuries while working or injuries caused by natural calamities. It also addresses those that would want to increase the looks and appearances. Accuracy and reliability This is a well-researched paper with references and in-text citations. The information in this paper can be verified from other sources. Individual cases of Plastic and cosmetic surgery Adianet Galván aged 30 at the time had procured a plastic surgery procedure 11 called Brazilian Butt Lift. It was done at the New Life Surgery centre. The doctor who did the procedure had convinced her mother that it would be in and Adianet would be safe after the procedure. It was unfortunate that Adianet was confirmed to be brain dead. It was decided that she be disconnected. It was June 04, 2018. Adianet's death was because of the surgery. Her vein was perforated, leading to the complication. Another case is that of Evita Nicole. She was 29 when she died. She met her death at the operating table. She was also getting a Bazilian Butt lift. Kimberley Taylor, who was aged 53 when she died met her death after two surgeries. Taylor had been injected with anaesthesia making her unconscious during the procedure. She stopped breathing during the operation and got a cardiac arrest. She was placed on life support, but she could not make it. She died after ten days. A 61-year-old patient Sharon Carpenter died in August 2010. This was after a prolonged surgery after she went unresponsive. She had paid $100,000. 1.9 New There are numerous upcoming plastic surgeries, but people should take caution Developments knowing that the surgery table can link to one's death. There are other avenues that people can use to achieve the desired appearances without having to do plastic surgery. People should also learn to be confident in the way they appear. Reference Dangerous cosmetic surgery killed 14 women in five years—Center for Health Journalism. (, 2020). Retrieved December 22 2020, from https://centerforhealthjournalism.org/fellowships/projects/dangerous-cosmetic-surgery-killed-14women-five-years. 12 Cosmetic Surgery's Risky Move: Tucsonan's Death After Office Procedure Kindles Concern; 'Nobody Regulates This' - Redorbit. Redorbit. (, 2020). Retrieved December 22 2020, from https://www.redorbit.com/news/health/835969/cosmetic_surgerys_risky_move_tucsonan s_death_after_office_procedure_kindles/. Flawless.org. (2019, February 19). Advantages and Disadvantages of Cosmetic Surgery. Retrieved December 06, 2020, from https://flawless.org/journal/advantages-anddisadvantages-cosmetic-surgery/ Former Encino cosmetic surgeon convicted in patient’s death – Daily News. (, 2020). Retrieved December 22 2020, from https://www.dailynews.com/2015/01/22/former-encinocosmetic-surgeon-convicted-in-patients-death/ Punctured lung killed an Australian woman during cosmetic surgery. Mexico News Daily. (, 2020). Retrieved December 22 2020, from https://mexiconewsdaily.com/news/puncturedlung-killed-australian-woman/. Sansone, R., & Sansone, L. (2007, December). Cosmetic surgery and psychological issues. Retrieved December 06, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2861519/ Sung-wook, W., & Ki-hwan, K. (2013, October 28). Deaths highlight plastic surgery risk. Retrieved from https://koreajoongangdaily.joins.com/2013/10/28/socialAffairs/Deathshighlight-plastic-surgeryrisk/2979578.html 13 Wrong, S. (2020). Suing for Wrongful Death Over Cosmetic Surgery Gone Wrong – HafifStonehouse Law Group. Hafiflegal.com. Retrieved December 22 2020, from https://hafiflegal.com/suing-for-wrongful-death-over-cosmetic-surgery-gone-wrong/. 1 Name: Degree: Output: Title: CHAPTER 2 B.MM. (Hons) Media Arts Undergraduate Dissertation Demerits of Plastic Surgery Plastic surgery is one of the novel techniques in busty that have attracted a huge LITERATURE amount of positive as well as negative emotions. According to Branford et al. (2016), REVIEW plastic surgery has several techniques all of which are geared to achieve cosmetic and 2.0 Introduction reconstructive changes. The techniques of plastic surgery are based on the purpose and background they should achieve on the human body. The modification of different parts of the human body calls for different techniques to use. Among the common techniques noted by Davis and Rosenfield (2015) include flap surgery, laser surgery, endoscopic surgery, skin graft, and tissue expansion. However, these techniques have a couple of shortcomings as well as strengths that motivate their use and rejection in the various treatment avenues. The doctors are e new adopting evidence-based practices in plastic surgery which calls for inclusions of practices that have a direct positive impact on the cosmetic process. According to Wood, Kim, and Chung (2019), the use of evidencebased practices has improved exponentially in the last 30 years indicative of the need for optimum healthcare in plastic and reconstructive surgery. Despite these, the risks of plastic surgery are still eminent and most of these risks can only be addressed through extensive literature exposition. There is a need for more high-quality information to inform the best practices that plastic surgeons ought to adopt in improving the safety of plastic surgery operations. 2.1 Plastic Surgery Plastic surgery can be done on several occasions including in facial burns and accidents. However, the assessment has to be done on the degree of reconstruction 2 Techniques needed to determine the technique to be used. Patel and Brandstetter (2016), deliberates on the deep impacts of solid implants on the facial skin which projects to similar inherent risks and complications in other types of surgery. Facial reconstruction comes with multiple defects due to the challenge of reconstructing the bonny tissues of the skin in the temporal and frontal regions. The interconnections of the muscles in the facial area make it difficult for the surgeons to maneuver and deliver the cosmetic surgery processes. Trussler and Tabbal (2012) also deliberate on the risks associated with delivering plastic surgery process on the facial region. He claims that close to 40% of the facial plastic surgery operations that involve the insertion of the solid structures on the facial area end up in a botched process due to a lack of proper mastery of facial topography. As a recommendation, he claims that doctors engaging in facial therapy should have intensive training to avoid the tragic mistakes that present time after time in the related cosmetic surgeries. Patel and Brandstetter (2016) advise on the adoption of allogenic implants as a viable alternative to autologous grafts that have been the major focus in facial reconstruction in the past. Of all the plastic surgery techniques, facial reconstruction remains the most challenging and risky. Adoption of alternative measures is key alongside sensitization of the surgeons on the need to adopt evidence-based practices as well as less risky procedures. Collectively, sensitization on the less risky surgical procedures is on the rise posing an admirable landscape on plastic surgery. 2.2 Patient Safety in Plastic Surgery Patient safety in the plastic surgery process is a potent topic that has been taken on from myriads of angles. On one side the governmental bodies have striven to control the context and the personalities involved in the process. On the other side, the 3 activism bodies are campaigning against the use of certain techniques in plastic surgery as they are of increased risk to the health of the individuals. According to Trussler and Tabbal (2012), there are specific factors that contribute to patient safety in the plastic surgery process. One of the practices to be adopted by the majority of plastic surgeons is a selection of patients who may present with a high risk for adverse complications like venous thromboembolism, bleeding diathesis, preoperative hypertension, and hypothermia. These complications have shown increased mortality and morbidity rates in the patients who go through plastic surgery processes. Preventive treatment is one of the modern healthcare approaches that medical practitioners are striving to adopt (Branford et al., 2016). One sure way of reducing the associated risks relies on identifying the risks and incorporating them within the treatment procedures followed by the drafting of evidence-based practices. Hunsicker et al. (2017) claim that evidence-based practices have come as a vital tool in solving the myriads of challenges presenting in plastic and other surgery procedures. Evidence-based practices involve identifying vital risks and treatment loopholes and documenting the measures to be taken in the process of avoiding their impact on the patient treatment process. Chung et al. (2009) cements the need and use of evidencebased practices and the utilization of the rich global scope of data to support plastic surgery practice. The same intellectual concerns are held by Eaves III, Rohrich, and Sykes (2013) claiming that the only way to take the plastic surgery practice to another level is the incorporation of data and using the data to craft out safety havens for the practicing medical doctors. 2.3 Risks of Plastic The risks that come with plastic surgery can come with either short or long- 4 Surgery time risks all of which need to be screened properly to reduce the disadvantage on the side of the patient. Reconstruction of the breast can sometimes be done as a way of treating breast cancer condition. While the practice is sanitized in medical corners most of the patients suffer long time impacts that many are not aware of precipitated by the plastic surgery treatment process. Henriksen et al. (2003) possess that these impacts be outlined to the patients before the practice and mitigation plan put alongside the surgeries. According to Hunsicker et al. (2017), complications of breast reconstruction like local neurosis or infections are human-related errors that can easily be avoided or eliminated through advanced practice. The propagation of these complications comes hand in hand with a degree of negligence and the use of outdated methods in practice. The response towards these complications precipitated a detrimental impact on the patients including whole tissue removal and other adverse procedures that implies a long-time complication on the patient. For this reason, scholars like Brandel, Reid, Parmeshwar, Dobke, and Gosman (2017) recommend informed consent to the patients when they have to navigate such treatment options. 2.4 Demerits of Plastic Surgery Demerits of plastic surgery overlap life-threatening complications that outweigh the benefits that the individuals can ever perceive. Pannucci et al. (2012), notes that plastics surgery predisposes the patients to high-risk thromboembolism as measured using the caprine risk score. For people with other challenges like nerve damage, patients have to be more careful in registering for facial reconstruction therapies. According to Pannucci et al. (2016), patient advocacy has been upheaved in the recent past owing to the stern need for safety in the plastic surgery processes’ dangers imposed on the patients are even more, more serious but silent. Most patient 5 dies not to have the time to diagnose the impact and therefore report to relevant authorities. Saad, Parina, Chang, and Gosman (2014) also outlines the mixture of adverse outcomes in plastic surgery operations is not raised due to lack of enough longitudinal data of the same. People need to be educated on the risk associated with plastic surgery and how o ensure that their doctors adhere to safe surgical practices. Additionally, as noted by Pannucci et al. (2016) majority of these safe practices can be installed in clinical settings to reduce the impact of adverse complications coming with plastic surgery but their installation will present cost challenges to the clinicians. The risks are manageable but only within strict clinical practice setups. Reference Brandel, M. G., Reid, C. M., Parmeshwar, N., Dobke, M. K., & Gosman, A. A. (2017). Efficacy of a procedure-specific education module on informed consent in plastic surgery. Annals of plastic surgery, 78(5), S225-S228. Branford, O. A., Kamali, P., Rohrich, R. J., Song, D. H., Mallucci, P., Liu, D. Z., ... & Lin, S. J. (2016). # PlasticSurgery. Plastic and Reconstructive Surgery, 138(6), 1354-1365. Chung, K. C., Swanson, J. A., Schmitz, D., Sullivan, D., & Rohrich, R. J. (2009). Introducing evidence-based medicine to plastic and reconstructive surgery. Plastic and reconstructive surgery, 123(4), 1385. Davis, C. R., & Rosenfield, L. K. (2015). Looking at plastic surgery through Google Glass: part 1. Systematic review of Google Glass evidence and the first plastic surgical procedures. Plastic and reconstructive surgery, 135(3), 918-928. Eaves III, F. F., Rohrich, R. J., & Sykes, J. M. (2013). Taking evidence-based plastic surgery to the next level: report of the second summit on evidence-based 6 plastic surgery. Aesthetic Surgery Journal, 33(5), 735-743. Henriksen, T. F., Hölmich, L. R., Fryzek, J. P., Friis, S., McLaughlin, J. K., Høyer, A. P., ... & Olsen, J. H. (2003). Incidence and severity of short-term complications after breast augmentation: results from a nationwide breast implant registry. Annals of plastic surgery, 51(6), 531-539. Hunsicker, L. M., Ashikari, A. Y., Berry, C., Koch, R. M., & Salzberg, C. A. (2017). Short-term complications associated with acellular dermal matrix-assisted direct-to-implant breast reconstruction. Annals of plastic surgery, 78(1), 35-40. Pannucci, C. J., Barta, R. J., Portschy, P. R., Dreszer, G., Hoxworth, R. E., Kalliainen, L. K., & Wilkins, E. G. (2012). Assessment of post-operative venous thromboembolism risk in plastic surgery patients using the 2005 and 2010 Caprini Risk Score. Plastic and reconstructive surgery, 130(2), 343. Pannucci, C. J., MacDonald, J. K., Ariyan, S., Gutowski, K. A., Kerrigan, C. L., Kim, J. Y., & Chung, K. C. (2016). Benefits and risks of prophylaxis for deep venous thrombosis and pulmonary embolus in plastic surgery: a systematic review and meta-analysis of controlled trials and consensus conference. Plastic and reconstructive surgery, 137(2), 709-730. Patel, K., & Brandstetter, K. (2016). Solid implants in facial plastic surgery: potential complications and how to prevent them. Facial Plastic Surgery, 32(05), 520531. Petit, J. Y., Rietjens, M., & Garusi, C. (2001). Breast reconstructive techniques in cancer patients: which ones, when to apply, which immediate and long term risks?. Critical reviews in oncology/hematology, 38(3), 231-239. 7 Saad, A. N., Parina, R., Chang, D., & Gosman, A. A. (2014). Risk of adverse outcomes when plastic surgery procedures are combined. Plastic and reconstructive surgery, 134(6), 1415-1422. Trussler, A. P., & Tabbal, G. N. (2012). Patient safety in plastic surgery. Plastic and reconstructive surgery, 130(3), 470e-478e. Wood, S. M., Kim, Y. J., & Chung, K. C. (2019). Writing an Evidence-based Article in Plastic Surgery: Translating Research into High-quality Care. Plastic and Reconstructive Surgery Global Open, 7(12)
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Running Head: DATA ANALYSIS AND RESEARCH FINDINGS

DATA ANALYSIS AND RESEARCH FINDINGS
Student's Name
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DATA ANALYSIS AND RESEARCH FINDINGS

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Chapter 4 DATA ANALYSIS AND RESEARCH FINDINGS
INTRODUCTION
This section depicts the assessment of data followed by a discussion of the investigation
revelations. The disclosures relate to the investigation tend to that guided the examination.
Information was inspected to perceive, portray and explore how people have used plastic
operations to change a couple of bits of their bodies and the connected impacts. Information was
procured from self-coordinated surveys and outlines wrapped up by 300 volunteers who took part
in the assessment.
A total of 300 surveys was obtained; regardless, only 285 reviews were usable for this
exa...

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