Breasts Augmentation , Too High After Surgery

I am a little worried because I had a breast augmentation three weeks ago ( high profile silicone 350 CC's). they are too high , will they come down eventually? Should I consider another surgery, and if so, when? I have read that breast massages are very good to let them down, but I also read this is not recommended in texturized implants. Can you give me an advice?

 Answer: Implants may be slightly higher in the initial phase for several weeks, but they will come down if the pocket has been properly dissected. Many surgeons will use a compression band to combat this and also recommend downward massage efforts in the weeks following surgery.

 It is often the case that after breast augmentation, the implants seem to be too high. Your breast size is larger now and this results in that the breast feel too high, especially with high profile implants. Without doubt, they will come down and appear more natural with time. This is objectively true as gravity takes effect and the weight of your implants settle in.

 Since you are only three weeks out I would not begin to worry just yet The native inframammary fold appears high with a short and (at least mildly) tight inferior pole. The markings on the chest wall suggest that the inferior pocket was created for proper implant positioning. Certainly at 3 weeks post-op it is common to have implants positioned high since they have not had enough time to settle into place. If smooth surface implants were placed, there is certainly a good chance that these implants would settle into a lower position over several months, with potential stretching of the of the inferior pole skin occurring afterward; and this could be enhanced by implant displacement exercises and the use of a compression band over the upper pole.

 agree, your implants are too high on your chest wall. Having said that, I would be patient, the implants will "drop" or settle into place over time. I would wait at least 3 months and 6 months would be better. If the implants are still too high, than you will need to have them repositioned into a lower position. 

It seems that you have a "high crease", the distance between your nipple and the inframammary crease is too short. The surgeon should have lowered your crease during the procedure, if it does not happened. I would be surprised if you do not need a secondary procedure to correct this.

Capsular Contracture ,What is the Best Way to Treat it at Home?

Capsular Contracture ,What is the Best Way to Treat it at Home? 

    I would like to know if deep tissue massage regularly is the best way? using a massage machine that vibrates and pulsates at different levels regularly? also what about medicine? I appreciate any advice towards my question, thanks.

Answer:

 Capsules form around breast implants within days of their placement. The capsules are basically scar tissue that surrounds the implants .The formation of scar around the breast implant is normal as a breast implant capsule.. When it is excessively thick and/or tight scar tissue around the breast implant tight it is known as a capsule contracture. We do not know why or how this happens. For a variety of reasons muscle like contractile cells can appear in the capsule wall. When they contract we see/feel a hard breast (capsular contracture) with variable degrees of surface outline distortion, from the outside the breast implant is deformed from the capsule that is progressively shrinking. That is usually seen at months or years after surgery. The longer the contracture has been present the harder it is to treat and the more aggressive the treatment/surgery that is required. 

  

  and the severity of the capsule can be assigned to one of three categories:

 Category 1: Breast is more firm than usual, but not visibly different or painful
 Category 2: Breast is firm and visibly different in shape or appearence 
 Category 3: Breast is firm, visibly different, and painful 

      The best way to prevent capsular contracture is to do breast massages both medially and superiorly 3x per day. You should do this for at least the first year after breast augmentation and continue it daily thereafter for the duration of the implants to minimize closure of the capsule. Massage is usually recommended immediately following the surgery and can be continued for months to years , but is absolutely no scientific evidence that it helps prevent contractures.

    If the capsular contracture has only be present for a few days or weeks it may be amenable to non-surgical treatment such as deep massage. It really depends on how long you have noticed it…If it is just starting, then I have had patients have success with alternating deep massage. Home massage, however will not likely make a difference if the capsule is already significant or contracted.

     Endermologie (the combination of rollers and suction pressure applied to the skin surface) can be a good way to get the massage movement deep enough under the skin to stretch and soften the capsule.

    Singulair and Vit E can be used but likely have very little effect. Singulair is a widely used asthma medication that can sometimes help. This is an off label use of this medicine. but this does not necessarily work in every patient. Time likely will either help relax the capsule somewhat or keep it relatively unchanged 

      There is nothing you can do to treat established capsular contracture at home. Overly aggressive pressure maneuvers may cause damage to your implants. Finally surgery is an option to correct this by removing the capsule entirely or releasing it in areas to accommodate the implant.

Breast Lift

BREAST LIFT

Many women, particularly those who have had children, will notice that their breast tissue will droop and “deflate” following breast-feeding. This phenomenon is not limited to mothers, however, as changes in weight as well as hormone fluctuations can cause these same issues. Some women, in fact, are born with breasts that may not be as “perky” as they would like. Many patients who complain of this breast deflation, or “breast ptosis” in medical terms, benefit from an elevation of the breast tissue, known as a breast lift or 





mastopexy 

Breast lift achieves the following:

  Brings the breast to a more attractive position 
  Reduces the size of Areola 
  Helps the breast to become more perky . 

There are several ways to go about providing true or apparent lifting of the breast tissue.

 Wise Pattern Breast Lift: 
The standard and effective technique to lift the breast is known as a Wise pattern mastopexy Classically, breast lifts were done through a pattern similar to classical breast reductions, resulting in a scar around the nipple, down the center, and underneath of the breast, which you can think of as an anchor type of configuration. While this operation works well for many patients, it provides a lot of scarring, and can, in certain patients, give rise to a breast that lacks proper projection. Efforts were subsequently made to try and improve the deficiencies of this operation, and a plastic surgeon named Dr. Lejour developed a breast surgery that eliminated the scar under the breast and improved postoperative breast form. This is called the vertical mastopexy.

 Vertical Breast Lift:
 The vertical mastopexy has become one of the mainstays of the breast lift here in my practice. This operation works well for most women who do not have massive breasts, and allows some degree in reduction of the size of the breast if this is what you are looking for. Alternatively, the vertical breast lift can be combined with a breast implant in order to increase the breast size. In either situation, the scars from this vertical breast lift look like a lollipop- around the nipple and down the center of the breast. The concept behind the vertical mastopexy is the rearrangement of the breast tissue itself to a higher position, rather than creating a skin sling to suspend the breast tissue. This breast tissue rearrangement is felt to give a more pleasing shape and a longer lasting result.

 Benelli Breast Lift:
 For those patients that require only minimal lifting and who may be adverse to the longitudinal scar of the vertical breast lift, an alternative may be what is called a purse-string, or Benelli mastopexy. This operation is performed by resection of an eccentric area of skin around the nipple, which can be thought of as an oval shaped doughnut where more skin is resected above the nipple than below it. Following a small amount of dissection in the breast tissue to strengthen the breast lift, this incision is closed with a purse-string suture that “cinches” the breast envelope centrally and upward to provide a lift. The scar resulting from this breast lift operation is only around the nipple along the transition between the pigmented areola and the skin of the breast. This operation does have the limitation of lifting the breast tissue only one to two centimeters, however, and so only patients with minimal ptosis may be candidates for this procedure.

 The Use of Breast Implants With Your Breast Lift: 
With any breast lift procedure, the result may be enhanced with the ancillary use of a breast implant to increase volume and fullness. 
A breast implant may be used with the classic breast lift, the vertical breast lift, or the Benelli breast lift procedure. Placement of large breast implants during these procedures is discouraged because of the following safety issue. When dissection of the breast tissue is performed in order to achieve a higher and more youthful appearance, careful attention must be given to the blood flow to the breast tissue that is being rearranged. Large implants placed under this dissection can put undue tension on the lifted breast tissue, causing compromise of the nipple. breast implants that are not excessively large may be used at the time of your initial breast lift operation as a single procedure. Discussion regarding your individual anatomy and expectations will allow a plastic surgery plan to be tailored to your specific situation. The quality of scar can also be improved if your surgeon is committed and places deep suture to avoid widening of the scars

Scarless Breast Lift

Scarless Breast Lift

I'm sort of on the verge of needing a breast lift and wondering if the scars are not worth the trade-off... what kind of incisions or techniques leave the least amount of scarring?

Marian

Answer :

This is a great, and very common question. The principle thing that I would recommend to you is to avoid compromising the form of your breast for fear of the scarring. Any qualified plastic surgeon will be able to minimize the scarring with suture techniques, and although there are no guarantees, you should hopefully end up with fine white lines for your scars that progressively fade with time. You are better off having a great breast form and a little more scarring than a breast shape that is inadequate or unattractive with one scar less.

If you are indeed borderline, it is likely that you will require less, rather than more incisions to re-create a youthful breast form. Several options with or without breast implants are available to you, with varying degrees of correction and size changes. The key is choosing the right operation for you, and that involves a careful discussion with a caring and qualified plastic surgeon.

There is not some thing as a scarless breast lift.  The real question is do you need a lift and if so how much. Some patients with very minor or grade one ptosis with obtain a lift and increased fullness with breast augmentation alone. Others require minimal lift which can sometimes be done with only a periareolar incision and and implant. In the majority of cases a better lift is achieved with  the addition of at least a vertical incision

This is a brief outline of the scars that can be expected after a breast lift, in order of increasing amounts of preoperative breast sagging:

1.  Scar Around the Top Half of the Areola:  this is best for patients with no more than an inch of nipple/breast sagging and no need for entire breast reshaping

2.  Scar Around the Entire Areola:  this is best for patients with about an inch of nipple/breast sagging and need for minimal tightening of the breast skin

3.  Scar Around the Areola and a Vertical Scar Down the Breast:  this is best for patients with a moderate degree of breast/nipple sagging, some loss of superior breast fullnes, and need for moderate reshaping of the breast. 

4.  Scar Around the Areola, Down the Breast, and in the Breast Crease:  this is best for patients with significant breast/nipple sagging, total loss of fullness of the superior breast, and need for total reshaping of the breast.

In select patients, the scar burden necessary to perform a breast lift can be minimized by simultaneous placement of a breast implant.  A breast implant is able to affect a small degree of breast lift and restore superior breast fullness without the need for larger scars associated with a traditional breast lift.

Breast lift achieves the following:

·        Brings the breast to a more attractive position

·        Reduces the size of Areola

·        Helps the breast to become more perky(Agile)

It is important to know  If the skin and fat above the nipple in the upper poles of the chest are adequate then a subglandular placement with silicone implant would probably give you the most natural look and feel  . Subglandular placement is acceptable if you have at least 2cm of tissue pinch in the upper pole.

If you have minimal ptosis (or sagging) of your breast, a subglandular placement might give a nice result with fewer scar lines or incision lines, If you have significant sag then I would  typically recommend a submuscular implant with a complete breast lift, though you will have more scars.

   A dual plane mastopexy with a reasonable size implant can give your nipple a lift and move your breasts off your chest wall.  It will also give you fullness in the upper quadrant. 

Why do breasts sag?                                                                                                                                                      There is too little volume or too much skin. Many women, particularly those  who have had children, will notice that their breast tissue will droop and “deflate” following breast-feeding. This phenomenon is not limited to mothers, however, as changes in weight as well as hormone fluctuations can cause these same issues. Some women, in fact, are born with breasts that may not be as “perky” as they would like.

Greater degrees of excess skin require greater amounts of skin removal, resulting in larger scars. 

I believe  in taking an aggressive approach to scars in this situation, with progressive suturing techniques and postoperative scar treatments as a complimentary service to my breast lift patients, so that they will never feel like the improved shape was not worth the scars they have.

 I also strongly believe that the technique for breast lifting should be determined by the patient's goals for breast shape, and the shape they are starting with. Each different technique (I do 4 different types) will tend to produce a characteristic change in the shape of a breast, and so the technique needs to be matched appropriately to the patient, using her examination and her goals as guides- otherwise you may end up with a small scar, but a funny or unfavorable breast shape.

The degree of lifting and the amount of scars required to restore to you a youthful and toned breast depends on how much droopiness you have. The key relationships are where the nipple lives relative to the crease under the breast and whether it points forward or downward. The farther down, the farther it needs to come up to look good and the more incisions it takes to get there. The other key issue is the degree of horizontal skin laxity or excess skin present.

.

Some patients have a periareolar or "Benelli" lift, with an incision just around the areola, in hopes of avoid the incisions of a conventional Wise pattern lift. When a large breast lift is attempted through such an incision, characteristic problems can occur, with gathering of the incision, decreased areolar circulation (some patients can actually have nipple death), and large resultant nipple-areolar complexes. It is in my opinion a mistake to attempt too great a lift through too small an incision Periareolar.When lifts require an implant , They are good for patients whose needs for lifting are less with their nipples above the crease and pointing forward to start with. If overextended, this lift will result in a flat, baggy looking breast with a large areola with poor scars around it. Vertical lifts, "L" lifts, short"T" lifts and full"T" lifts are the next level and can be done with or without implants. They have more scar but provide a better looking conical projecting breast in the hands of an excellent sculpting surgeon. Nobody wants scars but everybody wants the best shape and the scars are a trade-off for that. They fade with time and generally most all patients will trade their best shape for the scars to get there

here simply is no way to perform a breast lift surgery without some type of scar. The only thing that can be done is to try to optimize the position or quality of the scars that are made. In general, the best scars are seen when incisions are placed under the least amount of tension.The good news is that most of the scars fade nicely and are specifically placed to be as inconspicuous as possible

The idea of a scarless surgery is an attractive one ,  It is better to think of it as minimizing the length of any scar and optimizing its position in order to obtain the best result.

Liposuction, Liposculpture , Liposelection - What's the Difference?!

Liposuction, Liposculpture , Liposelection - What's the Difference?!

Question

What is the difference between all of these types of lipo: Liposuction, Liposelection, Liposculpture? What type works the best?

Helen

Answer:

Liposuction is the basic technique, the simultaneous mechanical breaking down of fat together with suctioning using a tube attached to a vacuum device (aspirator) .But We sometimes use the word  liposculpture, because we are focusing on shape more than on volume (we always focus on both) which suggest superior results.

Liposuction is formally referred to as Suction Assisted Lipectomy, whereby fat cells are removed using a small cannula and a vacuum assisted device. The technique is well recognized, safe, and commonly used by most plastic surgeons. Recent advances have changed the scope of liposuction to include an added benefit of not only removing the fat through suction, but also dissolving the fat with energy. The energy types are ultrasound energy (VASER) or laser.

The process of ultrasound assisted liposuction is well documented and involves a process of cavitation, whereby sound waves are used to break open and kill fat cells prior to the liposuction. This results in improvement in contour for patients. Basically the result you will get depends far more on the nature of your skin and its ability to shrink , A small amount of heat can have the beneficial effect of causing more contraction of tissues. Heat also increases the chance that the body may respond by making more fluid (called a seroma, which may need to be drained). Then in the 90's, ultrasonic liposuction was introduced from Europe with the idea of breaking down the fat first and then removing it. This was thought to be less traumatic to other tissues like blood vessels and fibrous supporting tissue.

Liposelection i
s a name coined by the makers of one current generation of ultrasonic-assisted liposuction machines , They call it Vaser ultrasonic liposelection. The reason for the name is that the way the ultrasonic energy is generated both at the tip and along the shaft of the probe makes the fat cells split apart from each other .,Vaser is useful for treatment of areas that are densly fibrous such as the back and male breasts ,gynecomastia ,. When used for a lipo-abdominoplasty, it is great because it allows "lipo-sculpting" of the abdomen and torso at the same time.

 You can also have laser-assisted liposuction, such as the SmartLipo Triplex. SmartLipo is a machine that has a laser to melt the fat.  The fat has to be suctioned out in addition to the fat melting part. The devil is in the details here - if the surgeon that is doing the liposuction doesn't do a good job getting the patient numbed up or doesn't do a good job getting the fat out, you can end up with a mess on your hands.

"Liposculpture" is just a usage that connotes an artistic approach to contouring. You might say it means that what is most important is what is left behind, the final shape. Since the underlying body is obscured by excessive fat, the removal of that fat to reveal the body shape can be called lipo-sculpting , either with the aid of ultrasound or with laser energy (Smart Lipo, etc).

Questions:
0034_913862327
www.medicalstetic.org

Side Effects of Hyalurnic Acid

Question:

I am planning on having Hyalurnic Acid done on the lines that lead from nose to jawline. Has anyone had any bad side effects from this filler?

Answer.
Hyaluronic Acid  is abundantly present in your skin.Rare complications may occur, It has been in use for many years and overall is a very safe treatment. Ac. Hialuronico  has proven to be a fantastic treatment for the nasolabial folds and other   facial wrinkles


 Although there are a lot of rare side effects that one will hear about, the most common side effects are temporary and not dangerous which are typically covered by makeup in the relatively unlikely instance they are noticeable, These include pain at injection site, swelling, bruising, redness and lumpiness. The redness and lumpiness will resolve without any complication.


Icing (cold compresses ) immediately after injection will reduce the swelling and the risk of bruising.  Ac. Hialuronico  can also  cause some urticaria like reaction at injection sites, which resolve shortly after injection. Side effects increases when injecting the frown lines between the eyes so I would use caution and inject only a small amount

 Two mainly complications are  bruising and lumpiness. Bruising  disappears in  2 days (or longer if you take Aspirin, Vitamin E, Garlic, Gingko or Ginseng) avoiding aspirin and anti inflammatory medication for two weeks prior to your injection and one week after . Lumpiness can be corrected at the time of the injection by massaging. there is also a condition called the Tyndall effect which occurs when  hyaluronic acid product is injected too superficially.  This effect is seen as a bluish or grayish haze on the skin and can be reversed with hyaluronidase (an enzyme that breaks down Restylane) injections. 

There are also very, very rare reports of allergic or inflammatory reactions to Ac. Hialuronico(note: this is true with any of the fillers). infection, hematoma, discomfort, asymmetry, undesirable effect  are posible  and rare complications. This filler  around the eyes has a higher chance of untoward effects and must be applied with great care. The other very  rare complication is plugging up a blood vessel that can “choke” off the blood supply to the overlying skin which create a bad scab and then a discolored permanent scar. Hyaluronidase can be used immediately if this is noted and the filler gets dissolved and the complication can lessen.You should see the full-effects of your treatment in 7-14 days. 

Cellulitis , Treatments

Question:

I'm looking for a good cellulite treatment. Are there any cellulite treatments that are more effective than others? What are my options?

Answer:

I'm looking for a good cellulite treatment. Are there any cellulite treatments that are more effective than others? What are my options?

……………………

……………………….

The best single way to reduce cellulite is to lose weight through a great diet and regular exercise. Everything else we provide as doctors is second best to this solution. True cellulite is caused by irregularities in the very superficial fat of the skin. Cellulite is caused by excess fat cells pushing out on the skin from underneath and fibrous bands pulling in on the skin.  Unfortunately, that is very close to where the blood supply of the skin is, in the subdermal plexus

There is no way to actually get rid of cellulite although there are treatments to reduce its appearance. All of the following treatments have been touted for their effectiveness in either decreasing or eliminating cellulite

Endermologie treatments incorporated with diet, exercise and drinking plenty of water will offer the best results to fight cellulite.Endermologie is a painless and noninvasive mechanical massage that stimulates the reactivation of fat release and production of collagen and elastin.With a series of at least 10-14 weekly treatments Endermologie produce visible improvement in the cellulite.Once your desired results are achieved, returning for treatments once a month for maintenance is recommended. Endermologie temporarily improves the look but if you stop the treatments, 2 months later all the cellulite is back.

Radio frequency devices will also temporarily help the problem but not completely . Alma Accent :skin cellulite can be improved with this new unipolar radiofrequency device, with fewer treatments and longer lasting results as compared to older options. The older options have typically been bipolar radio frequency and low-level laser devices which have been proven to produce mild skin tightening of cellulite; this new treatment is far more sophisticated . .Another the non-invasive procedure is called Thermage . Thermage is extremely safe, and it takes about one and a half hours in the office. There is no anesthesia, no down time, and no scar. So, for many women, it is worth a try. La radiofrecuencia produce un calentamiento profundo de la piel y del tejido graso que aumenta la circulación de la zona, favorece el drenaje linfático, permite mejorar el metabolismo del tejido graso subcutáneo y estimula la formación de colágeno de las capas más internas de la piel. Este calor consigue de forma inmediata el estiramiento del tejido cutáneo reduciendo los signos de flacidez y deja la piel más tersa. Se utiliza para el tratamiento de la celulitis, de la flacidez, para mejorar la piel.

Cellul
ite is a difficult problem to fix , creams, massages and ultrasound  can  help but are not  so efective. Also, in my opinion, treatments such as lipolysis, mesotherapy,have limited efectiveness.

Microcanula liposculpture improves cellulite by breaking these little fibrous bands and by removing the fat cells pushing out on the skin. It is done under local anesthesia and is probably the only permanent way to help cellulite. Although it is not 100% effective, it is the best we got at this time. Liposculpture at deep levels can sometimes break the septae, or interconnections of deposits of fat, and thereby reduce (not eliminate) the appearance of cellulite. It can certainly make the appearance of cellulite better.

Botox , Side Effects

Question

Has Botox some side effects like droopy eyelids. Is Botox safe?
Helen


Answer

Botox is considered to be generally safe and has received FDA approval as a result. Like any other form of medical treatment, there are associated side effects Botox, such as droopy eyelids.The most common side effects of Botox include mild discomfort at the site(s) of injection, temporary redness at the injection site and possible bruising. Rarely, patients may experience a headache. The incidence of an eyelid droop is very rare occurring in about 1% of patients. It is temporary and usually resolves in a few weeks. Botox is contraindicated in individuals with neurological conditions. . Botox only lasts 3 months, so if you did get a droopy eyelid it would subside when the Botox wears off.
There is no full proof technique to avoid botox side effects. Nobody can actually guarantee that you won't have complication, because there can be occasional variations in a person's muscle distribution width. So side effect can happen to anyone.
Botox is one of the most widely-investigated products on the market. There are over 20 years of strong evidence that points to its safety when it is injected properly by an experienced doctor. botulinium-based drugs are used to treat cerebral palsy and other ills. These patients are receiving Botox in doses that are many, many times larger than the small dose that is used for cosmetic treatments. Like any treatment, it does have some side effects, even when used perfectly. These can include pain, bruising, and allergies in extremely rare cases. Avoid aspirin, ibuphen, vitamin E, and some herbal products to reduce bruising seven days before treatment. Apply ice at the site to minimize bruising & swelling.
It is critical to inject the right dosage or strength of Botox in the right muscles of the face to minimize some common side effects, such as droopy or heavy eyelids or eyebrows.

Bruising is a risk with any injection, so avoid taking anything that can thin your blood for at least 10 days before your treatment such as aspirin. To reduce your risk of a droopy eyelid with a brow injection, do not rub the area that was injected and avoid strenuous activity for several hours after your treatment . Several things I encourage my patients to avoid after Botox: 1) avoid rubbing the treated area for 24 hours, 2) avoid facial massage, Microdermabrasion for 24 hours after the procedure, 3) avoid aspirin, fish oil, excess vitamin E for 1 week before and 24 hours after the procedure
Botox injections can cause side effects if not done properly. However, complications are more frequent when doing the mouth, neck, etc A good plastic surgeon will start with a lower dose and adjust the dosage to get the desired results...we begin first time patients in limited areas and very carefully diagram areas treated and amounts used. From the initial response we can modify what we will later do.
Your plastic surgeon should examine your eyes to determine if you have a compensated preexisting eyelid ptosis. In this case, Botox in the frontalis will reveal your eyelid ptosis. If there is no preexisting ptosis then Botox can cause paralysis of the levator palpebrae. 0.5% apraclonidine drops have been used to improve a Botox induced eyelid ptosis (~2 mm elevation) by contracting the Mueller muscle inside the eyelid.
Droppy eyelids from botox are extremely rare. What is more common is a lower or flatter brow from too much relaxation from botox in the forehead. If your forehead becomes completely relaxed then you may not be able to raise your eyebrows - this leads to a feeling of heavy brow and can make the brow flat and seem like you have droopy eyelids but the eyelids really are just weighed down by the heavy, relaxed brows that are no longer raised up by forehead muscles. The goal of botox is to acheive a balance betwen the muscles that pull down on the brow (the muscles between the eyebrows) and the muscles that raise or elevate the brow - the forehead muscles - so that the net effect is a slight overall improvement of the brow arch making the eyes look more youthful and rested.

The skill part of injecting Botox is understanding the anatomy of the facials muscle, especially around the eye. It is also critical to inject the right amount of Botox in the right places to avoid side effects. If too much Botox was injected above your eyebrows or if some Botox migrates into the levator palpebrae muscle that elevates the upper eyelid, you could get a lid droop .Most of the "side effects" described for Botox are associated with the Botox spreading to adjacent areas that you don't want to treat. Droopy eyelids can occur if botox is administered too close to the brow or if Botox treatment to the glabellar area (corrugator muscles - located medially above your brow) involves migration of the medication to effect other muscles outside your treatment zone. This is very uncommon, but having droopy eyelids can occure when the botox reaches the muscle that lifts up your eyelid. With a smaller volume of seroum with the same amount of botox, the botox is less likely to reach that muscle. Also to avoid reaching that muscle its important to stay away from the eye or the orbital part of the eye.

Labioplasty,Labioplasty Recovery – how long does it take ¿

  


Hi
Labioplasty Recovery – how long does it take ¿
thanks

Answer:
Most women experience only mild discomfort and swelling after labiaplsty and return to work within 4-5 days. The majority of the swelling resolves within 3 weeks and sutures are self dissolving. Intimate activity may be safely resumed at 4 weeks and light exercise between 3-4 weeks. The Labiae start to look kinda freakish. This resolves but can worry some patients in the short term.

I ask my patients to stay in bed for two days after the labia minora reduction procedure with ice on the area. Most patients are able to return to work 3 to 4 days after surgery (not strenuous). Some swelling and spotting after the procedure is common and I asked my patients not to be concerned about the appearance of the area for the first month given that the swelling may cause unnecessary anxiety.
I also ask my patients to avoid horseback riding, bicycle riding, prolonged sitting, and sexual intercourse for approximately one month after surgery. This timeline may change depending on how the patient is doing during the postoperative visits.
What to expect after Labiaplasty Surgery?



1. swelling for about 4 weeks, with the majority of improvement seen by the second week . you will
generally need 3-4 days at home to recover.
2. back to work within 3-4 days, if not physical in nature
3. pain is well tolerated with Tylenol and decreases significantly by the end of the first week . DO NOT take aspirin or ibuprofen because they can increase bruising and bleeding.
4. showering is permitted the following day after surgery
5. sexual activity may be resumed 4 weeks post Labiaplasty
6. sutures used are mostly resorbable a will fall off on their own by the 4th to 6th week
7. Swelling and tenderness should disappear within 6 weeks.
8. It will take between 6 months to a year before you will see the absolute final results.

Labioplasty, How Do I Know if I Need Labiaplasty?

Hi
How Do I Know if I Need Labiaplasty?

Answer:




The demands for labiaplasy (any procedure to alter the size and shape of the labia) seem to have increased in the recent past. Labiaplasty procedures have gained significant popularity over the past 5 years due to changes in fashion and grooming as well as due to further education and media exposure. With grooming trends limiting amount of genital hair, a woman's long or asymmetric labia (or inner lips) are more apparent.
The typical patient that presents desiring labiaplasty has a very similar combination of signs and symptoms. Essentially all patients have relatively large inner labia that hang out past the outer labia and therefore are always visible whether sitting, standing, or laying down - this is the most common aesthetic concern. Some have functional problem from this such as drying, chafing, frequent infections, and/or uncomfortable in activities such as bicycle riding, running, and during sexual intercourse. The pain could be described as pinching, rubbing or irritation of the excess skin and to have discomfort with certain tight fitting clothes and pinching of the “excess” tissue in tight fitting clothing.
Labiaplasty is a surgical technique to reduce the amount of skin and mucosal tissue in the labia of a female patient.This is performed to rejuvenate the appearance of the labia and to improve the patient's comfort. Surgery typically takes approximately 1 hour and performed under local anesthesia approximately 80% of the time.

Best Laser for Depilation

The clinics near me offer a number of different laser machines. names like Light Sheer, IPL, Yag, Duet, Cool Glide. What do the medical expert here think works best in laser hair removal? --Julie


Answer:Older generation lasers were slow, very painful and worked only on individuals with very dark hair and very light skin. Today, lasers can work on all skin colors and some lasers are even safe for treating tanned skinned. Lasers for hair removal can be performed on any (yes, any) area of the body
There are several lasers for hair removal available differing in wavelength used to target the hair follicle as well as the manufacturer. No one laser is ideal for every individual. Depending on your skin color and hair color, some lasers will be more effective than others. The effectiveness of any laser hair removal treatment depends on the patient's skin color, hair color and on the abilities of the person providing the treatment. Choose a practitioner with a lot of experience. Know that hair must have pigment to be well treated, grey and blond hair is not sensitive to the laser. Electrolysis may be your best bet for permanent hair reduction in this case. Darker skin is more safely treated with an ndYag laser

The Ruby Laser: This is the "original " hair removal laser. Its deep red color at 694nm is very well absorbed by the melanin pigment in hair, making it an excellent choice for fine and light hair. However, because melanin is present in the skin as well, the Ruby laser cannot be used on patients with skin that is not very light, including tanned skin. Because of this limitation, slow repetition rate, and relatively small spot size, Ruby lasers have become less popular for laser hair removal in recent years.

The Alexandrite Laser:This laser produces reddish light. With its large (up to 18mm) spot size and high repetition rate, the Alexandrite laser is the fastest hair removal laser, and is suitable for rapid treatment of large body areas in patient with light to olive complexion. An entire back can be treated in less than 30 minutes. The absorption of light by melanin (which is the pigment found in hair) is closest to the wavelength of the Alexandrite laser. This laser is by far the best for people with fair skin. since it has the greatest pigment absorption with sufficient depth of penetration to treat hair. Because of its excellent absorption by pigment, darker skin types should be treated more cautiously and I do not treat darker Hispanic, Middle-Eastern, or Asian, or any African-American skin with this laser The NdYag laser is better for darker skin individuals and is also the deepest penetrating laser. since it has the greatest pigment absorption with sufficient depth of penetration to treat hair.

The Diode Laser: This laser, consists of a high power laser diode emitting infrared (invisible) light at ~800-808nm. The longer wavelength allows deep penetration into the skin and safety for darker skin types, but with less efficacy for lighter and finer hair. A smaller spot size means a longer treatment. That may mean a more expensive treatment. A longer treatment may also increase discomfort and a need for topical numbing. The Diode laser doesn't penetrate deep enough to kill all of the hair follicles and may just damage them causing them to fall out, but they will probably grow back again


The long pulse Nd:YAG: This laser can be used on all skin types, including tanned skin. Large spot sizes and fast repetition rates allow large areas to be treated quickly. Then disadvantage is less effective clearance for fine and light hairs than some other hair removal lasers. For darker skin types, the safest, most effective laser is the Long-Pulsed Nd:Yag laser. As it does not pick up pigment as well-- finer hairs may not respond as well as the Alexandrite, but it is very safe in all skin types. The Nd:YAG laser delivers laser in the 1064 wavelength which is absorbed by the pigment in the hair follicle. The other major categories of hair removal lasers are either of the 800nm wavelength (diode) or 755nm wavelengths However, they are not safe for use in darker or tanned skin tones. An attempt to treat darker toned skins by reducing the energy would lead to less effectiveness. Conversely, increasing the energy levels would cause burns.GentleYAG laser hair removal is used for any area of the skin which has unwanted hair, including the face, neck, chest, back, bikini area, underarms, arms and legs.

IPL devices are not lasers, because they emit non-coherent light of many different wavelengths. However, because most of the light energy is in the shorter wavelengths, treatment of darker skin types is less effective than with the appropriate laser. The light based technologies are not as specific as their laser counterparts however. They generally have broad applications (eg facial rejuvenation, leg vein treatment and hair removal) without being particularly great in any one specific indication
A larger spot size offers not only the advantage of faster treatment, but also additional safety and efficacy. As spot size increases, a lower percentage of the delivered light energy scatters outside of the treatment area, increasing the depth of pentration, and allowing a lower energy setting to be used for treatment.
It is important that a laser have consistent cooling in order to ensure patient safety and comfort. Although complications with new lasers for hair removal are rare, in the event of a complication, you need to know who will provide medical attention.
Because every person will respond at a slightly different rate, and some individuals will require more treatments than others for complete clearance


Final: Light sheer laser Not only is it five times faster but the comfort level is significantly better. Not a single patient has complained of pain or discomfort with this laser. The results have been excellent on all skin types and many patients who were reluctant to treat large areas, such as the legs, chest and back, have gone ahead with this laser mainly because it is so tolerable and fast. Like other lasers, however, it does not work on blonde or white hair. it is the fastest and most comfortable way of getting rid of unwanted hair.
Cutera CoolGlide Yag Laser uses a sophisticated light energy source for permanent hair reduction. The light is absorbed by the pigment in your hair, which effectively disables the hair follicle. The CoolGlide technology is considered the gold standard in the laser industry because of its long history of safety and effectiveness on all skin types—even on tanned skin, which is a nice benefit to patients in the summer months. It can treat not only coarse hair but fine hair as well. It is permanent, safe and effective. The CoolGlide can remove hair from the face or body; for example, the arms, underarms, legs, backs, and even particularly sensitive areas like the upper lip.
It is sometimes hard to tell how many treatments you might need in advance. Hair develops in phases and we can only treat hair in its active, visible stage. Therefore, the number of treatments depends on how quickly the untreated hairs appear. For significant clearance, most patients require a course of four to six treatments, which are spaced at least six to eight weeks apart.
Patients will feel a series of short snaps, somewhat like a rubber band snapping, but no local anesthesia or pain medication is necessary. Sensitivity varies from person to person, and we have a topical blocker that works quite well. Treatment times vary depending, of course, on the size of the area, but it typically takes 60 minutes to treat the upper and lower legs and 45 minutes for a man’s back. Underarms for women are fast. it effectively destroys the hair itself without harming the surrounding skin. You may be a little red afterward, but that typically goes away in a matter of hours. Unlike with waxing, you should shave beforehand since the treatment is targeting the hair follicle itself – not just hair.
No laser or light-based system can treat blonde, white, red or gray hair since there is no melanin in it to absorb the light, but with our CoolGlide system people with any other color hair, any skin type, and even tanned skin can receive treatment.

Capsular Contracture in Breast Aumentation & it´s Signs

Question:


There are 10 years after my breast aumentation surgery with prothesis and stick out more. They feel somewhat harder, but is this the implant or capsular contracture? How does a doctor determine if a patient has this problem?


Answer:
Increased firmness 10 years after breast implant surgery is certainly a capsular contracture. The implants themselves do not get firm. Capsular contracture is when the tissue surrounding the implant gets more dense and tightens arounds the implant squeezing it. If it tightens enough, the implant will get very firm and become shaped like a ball. Remember that the smallest space an object can occupy is a perfect sphere, and if the scar tightens enough, the implant will become a sphere. And, further tightening can even become painful.
There are four grades of breast capsular contracture - The grading is as follows ( according to the Baker system ) :
• Grade I the breast is normally soft and looks natural
• Grade II the breast is a little firm but looks normal
• Grade III the breast is firm and looks abnormal
• Grade IV the breast is hard, painful, and looks abnormal
If you are a Grade 2, I would do nothing. Grade 3, but only mildly distorted and you may need replacement of the implant and removal of the surrounding scar capsule(called a capsulectomy). Capsule contracture is the most common complication of an augmentation mammoplasty.
Some patients have had some softening of the encapsulation using the medication Singular, which is an anti-leucotriene. Add an anti-prostaglandin to that, such as Aleve, and you may have some relief natural Vitamin E complex
The following techniques have been employed to fight capsular contracture:
1. submuscular breast implant placement
2. using textured implants
3. limiting handling of the implants and skin contact prior to insertion
4. irrigation with triple-antibiotic solutions
the study examined saline vs. silicone capsular contracture rates , actually found silicone to be higher but this was likely secondary to the fact that a RUPTURED silicone implant causes much more of an immune response and is likely to cause capsular contracture. However the most reliable and common way to treat capular contracture is to remove the capsule and replace the implant
The causes have not conclusively been determined although some things that increase capsular contracture are: 1) Infection, 2) Hematoma (collection of blood around the implant), 3) History of breast radiation, and 4) History of previous capsular contracture .It is believed that capsular contracture is primarily a response to the presence of low-virulence or non-virulent bacteria (i.e. not the kind that generally produce an actual infection, with redness/tenderness/fever etc) that adhere to the implant surface on the day of surgery, and which over weeks and months following surgery stimulate the cells that make collagen (called fibroblasts) to make more collagen - thickening the capsule and stimulating it to contract and tighten around the implant. It is not an actual infection; there are no symptoms that this is going on, and taking antibiotics will not prevent the process or reverse it. The source of these non-virulent bacteria is thought to be the patient's skin, or the ductal systems of the breast that lead to the nipple, as both are normally colonized with bacteria.
The older implants are known to have greater gel bleed which allows smaller particle size silicone molecules to bleed out from the implant shell over time. This is though to incite a low grade inflammatory reaction and potentially contribute to capsular contracture.
A capsular contracture is diagnosed by physical exam and symptoms – . If the implant is firm and does not move around or starts to ride up on the chest more so on one side than the other, then more than likely you have it. imaging can show scar but not contracture . Encapsulated implants will feel very distinct from the surrounding breast tissue, are usually firmly attached to the chest wall, and the breast tissue will sometimes hang off the implants. Often times they may feel painful to the touch as well, which can occur in more advanced forms of this condition. You can try to massage the implants to relieve some of these signs/symptoms
Capsular contracture can occur on one or both sides, and while it can develop early (weeks) or late (years) after a breast augmentation surgery, in the vast majority of cases it is evident fairly early following the procedure. So the good news is that once you are six to 12 months out from your surgery, if your augmented breasts are soft and supple then they are likely to stay that way for the long term.
The more difficult decision is what to do. If the contracture does not bother you, it may be best to adopt a wait and see. Surgical options typically involve replacing the implants and either removing the capsule itself, or changing the position of the implant.
1. If it doesn't bother you, capsular contracture is not medically worrisome, and you could consider doing nothing if the process is stable.
2. If it is mild and early but bothers you, certain medications (Singulair, Accolate, Vitamin E) show promise in reducing or at least preventing progression of capsular contracture.
3. If it is moderate to severe, you may wish to consider surgery to loosen or remove part or all of the capsule (capsulectomy or capsulotomy) with implant replacement.
I would encourage you to perform breast implant excercises to prevent or minimize ongoing contracture.