Hyderabad Plastic Surgery Blog

Are silicon breast implants safe?

2011-12-19T03:03:00.000-08:00

Mithali, a 29 year old mother of one, has always been conscious about her small breast size. She is tall, slim and good looking, but feels that she is unable to enjoy well fitted, fashionable clothes because of her relatively small breasts. She is considering breast implant surgery.

Women opt for breast augmentation (implants) for various reasons. Often, these reasons are very personal and unique to each woman. Women with smaller breast size or those who have lost their breast volume due to breastfeeding can greatly benefit from it. Women who have very small upper body relative to larger hips and lower body can balance their figure beautifully with breast implants. Size zero, which is otherwise fashionable, usually comes with the problem of flat chest. For them, breast enhancement allows to retain good body proportions by bringing the curves back.

According to Dr. Priti Shukla, Plastic Surgeon at Ambrosia Clinic, Indian women are increasingly embracing cosmetic surgery to get beautiful curves; yet, some are doubtful about the safety and outcome of breast implants. But once they are explained the facts, they go ahead with implants and are most satisfied with the surgery .Dr. Shukla dispels the myths that exist about this procedure and helps you understand breast augmentation surgery better to retain good body proportions by bringing the curves back.

Are silicon breast implants safe?

Yes, they are. Silicon is a high grade material used in a lot of life saving medical devices like artificial valves, joints and eye lenses. When placed in body its totally safe. It does not react with body in any way.

Can I breastfeed after having breast implants?

Yes, you can. Implants do not damage the breast. They are tucked in behind the breast . Breast implants are totally safe for your baby.

Will my breast feel heavy or unnatural?

No, they will look and feel like natural breasts. No one can tell by looking at or touching your breasts.

Are there going to be scars?

Scar of breast implants is small and well hidden in breast crease or in armpit.

Do I need to get implants replaced periodically?

Latest US FDA approved implants come with very long life, and lifetime warranty. There is no expiry date on implants. In course of lifetime, if ever implant gets damaged, you can easily have it replaced by a small surgery.

Is the surgery risky? Do I need a long time to recover?

Breast Augmentation is a day care surgery (you can return home the same day). The patient can resume work 2-3 days after the surgery, although it takes a month to return to full activities.

Breast implant surgery is the most popular cosmetic surgery for women in the world. Safety of implant surgery, like in any other surgery depends on plastic surgeon’s experience, quality of implant and standard of operating facility. US FDA approved implants are safe. Choosing the right implant and surgeon can help you get the best out of your breast implant surgery.

Cosmetic surgery of mind

2011-09-20T00:36:00.000-07:00

Cosmetic plastic surgeon is called “psychologist with the knife”. Minor changes that plastic surgeon makes on persons body or face have profound impact on patient,’s sense of selfesteem and wellbeing.

People often are self conscious about their appearance. This self consciousness can be minor where person tries to hide the defect by makeup, hair style or clothes. But in major cases person avoids meeting people and getting photographs clicked. People with body disfigurement- like male breast and flat chested woman may avoid sports activity, swimming and social gatherings. In most severe cases of body dissatisfaction person may become antisocial and stop studies and work.

Self conciousness is sometimes grossly disproportionate to actual problem. Nose, mouth , male breasts and female breasts are most commonly known to cause severe mental distress. Body image problems are also a product of social interaction. Quest for perfect faces and bodies make more and more teenagers feel inadequate. Teasing by family members or friends aggravates the problem.

Society at times stereotypes obese people as lazy and not serious about work. Man with a knife mark on face may be perceived as a violent person. People with burn mark on face may receive unwanted sympathy and pity.

In Indian scenario cosmetic surgery is very common around marriageable age. Arranged marriages bring out the insecurities. College going teenagers too are prone to have inferiority complex and fitting in issues . Women and men seek cosmetic surgery during midlife crisis when women feel insecure in relationship or if they are getting divorced and planning to turn a new leaf in their life.

Plastic surgery alone can not take care of all the psychological issues. Sometimes body image problems can persist even after correction of problem

Its very important that you should discuss all aspects of your surgery including its psychological effect with your plastic surgeon. This will help you get the best out of your plastic surgery .

Liposuction: myth and reality

2011-06-27T09:13:00.000-07:00

People who have tried diet and exercise, but are still unable to lose weight often turn to plastic surgeons for liposuction. Liposuction is believed to be the the final and ultimate weapon against obesity. Liposuction is popular, fashionable and available- but does it work for everyone, and always? Lets bust some myths and find out the facts.

MYTH : Liposuction can make one lose 20-30 kilos of weight in one sitting.

Fact: Majority of the plastic surgeons across the world agree that its safe to remove fat equal to 5-8% of body weight , in one sitting. So for a 100 kilo person 8 liters of liquid fat can be removed by liposuction in one sitting. Removing more than that is possible but not totally safe.

MYTH : Whole body can be liposuctioned at a time.

fact: Maximum of 3 body parts can be liposuctioned safely during one sitting-for example abdomen , thighs and buttocks or abdomen chest and back. Total amount of fat removal should not exceed the safe limit of 8% body weight. People usually have some body parts disproportionately bigger than others. Those parts are preferred for liposuction to get the body in proportion. Other body parts can be liposuctioned during next sitting.

MYTH: Liposuction works for everyone who has bulging tummy.

Fact: Liposuction results differ from person to person. Liposuction can do wonders for people with good skin and muscle tone and with moderate fatty deposits. If skin and muscle tone is poor, like after pregnancy abdominoplasty is required to make a difference. Some men with pot belly have fat deposits inside the abdomen, rather than under the skin . Liposuction does not help much here.

MYTH: Liposuction may cause future problems related to pregnancy in women and fertility in men.

FACT: There is no basis for this fear. Liposuction does not cause any future problem.

MYTH: Person can become more fat after liposuction.

FACT: Liposuction does not affect body’s metabolism. If one maintains healthy lifestyle results can be long lasting. On the other hand those people who are steadily gaining weight- will continue to gain weight at the same rate after liposuction- unless they reduce their intake.

MYTH: Liposuction is the best option for those who are constantly gaining weight , and have become helpless with their weight.

FACT: Liposuction is best for people who are on weight loss trend or at least maintaining weight in last 6 months.If people who can not take healthy diet or who do not have time for exercise, do liposuction results will last for a very short time.

MYTH: Liposuction is for really fat people, not for those with nearly normal weight.

Fact: A lot of normal weight people and people with few extra kilos are completely out of shape. Imagine a slim woman with narrow waist but heavy thighs or fit man with female like breasts. These people may try the best with diet and exercise but get no result. Liposuction is the only answer for their problem.

MYTH: People can always get into shape with natural methods like diet and exercise, if they try hard enough.

FACT: Natural weight loss methods can not help in certain situations and liposuction or plastic surgery may be the best option. Example- chubby cheeks may remain after weight loss. After pregnancies is hard to get abdomen and breast in shape without plastic surgery. Large female and male breasts do not respond significantly to weight loss. People mistakenly try too hard with diet to get above problems in control –but end up becoming too thin or unhealthy.

MYTH: Vaser/ Smart liposuction are best and safer liposuction techniques.

FACT: Smart marketing leads people to put too much faith in technology. In fact the surgeon behind the machine is more important for the result and safety than the machine itself. You must first choose the plastic surgeon and take advise about what will work best for you.

MYTH: Liposuction is not a surgery and is an easy procedure.

FACT: Liposuction is a plastic surgery with all associated risks and benefits . It can be very safe and gratifying surgery with permanent results . When performed on wrong patient, by inexperienced or unqualified surgeon- results can be disastrous .

Is fitness your new year resolution?

2011-01-26T23:34:00.000-08:00

New Year often brings with it resolutions aimed at getting back into shape. Although some may start out ambitiously, following through on the promise to lose weight or get toned is often easier said than done. Getting into shape and losing weight continues to remain a challenge for majority . Lifestyles are getting busier, food tastier and clothes tighter, making it difficult for us to keep up with fitness.

Healthy diet and regular exercise remain the key to achieve and maintain your ideal weight . There are shortcuts like starvation, getting admitted into naturopathy centres, massages and such. These methods have some advantages, but only short term. Ninety five percent of so called “ diets” fail in long term. Most people who were disciplined in the naturopathy camp go into low metabolic state where body learns to sustain itself on minimum food by bringing metabolism down. Body fails to burn even the moderately excess food taken at home and weight bounces back.

And what about liposuction? This is something I specialize in and you can trust me when I say even this is not the trump card you can count on in the game of weight loss. Liposuction can not help you lose 20-30 kilos, contrary to what you may have heard or read. After liposuction if you do not maintain the healthy diet and regular exercise, you may gain the fat again. Common sense isn’t it? If you do not have time for exercising and you can not resist food then liposuction will give you only temporary result.

So get ready with your exercise gear and hit the gym , eat sensibly and aim to lose 2-4 kilos a month. Do cardio exercise like running and swimming to lose weight and weights and yoga to build tone and strength. Once you reach nearly normal weight and if still you are not in shape – be it resistant love handles, abdominal flab , saddle bags on thighs or heavy arms- you are then ready for liposuction, for those finishing touches towards the perfect figure.

Best wishes for a healthy and fit new year 2011.

Is fitness your new year resolution?

2011-01-26T23:24:00.001-08:00

Latest methods of fat removal- fad or fact?

2010-06-05T00:32:00.000-07:00

A lot of people are trying to lose weight and get into shape. Some of them are grossly obese and as a result suffer from physical effects like joint pain, reduced mobility, diabetes, hyperlipidemia, hypertension etc. . These people are looking to lose weight in tune of 20-40 kilos or more. Some others are moderately overweight and want to have good figure by losing 5-7 kilos. Some others are not overweight but have problem areas like bulging tummy , flabby arms or heavy thighs. They want to lose weight specifically in some parts. Then there are those who are very fit, hit the gym and take healthy diet- but still do not have enviable muscular physique. And last but not the least are women who are unable to get into their favorite clothes, after having a baby.

There is no one weight loss solution for all these people . Most commonly people try dieting and exercise half heartedly, do not get the desired result and lose hope. Some blame the genetics, long working hours or hormonal problems and give up. But being overweight affects their self esteem, confidence and health. This is when they start looking for options where they can lose weight without any effort from their side.

Various options are available in market for weight loss and inch loss. But actually there are very few that really work or can be proven scientifically. Lets go through each of them and find out the truth.

1. Massages and steam: Neither massage nor can steam help you melt fat. Only one to lose weight is the masseur.

2. Heating pads and vibrating belts: There is no scientific basis in these methods. Application of heat to skin may increase the blood circulation to the part or may make you sweat and get dehydrated and thus lose few hundred grams of weight( water). But it certainly not known to reduce fat or increase metabolism.

3. External ultrasound or radiofrequency application to the skin: This is a nonsurgical technology wherein ultrasound energy is applied to fatty area . These waves can penetrate upto 1 cm below the skin level and are said to break down fat under the skin. It has not been proven what really happens to the fat .Are the cells broken down permanently or the cells are intact and only the fat come out of the cell. Where does the fat go then? Is it not absorbed back by the body? There is no study to prove that blood levels of fat increase after this procedure, which should happen if fat is really being broken down and then being carried to liver for metabolism.The waves penetrate to just below the skin –so obviously they can not work when the fatty layer is several cms thick .These technologies are classic examples of manufacturing companies’ eagerness to hype and sell a product without proper research .

4. Liposuction: Liposuction and its various avatars like VASER and smartlipo are surgical techniques to remove fat from localized body parts. This is done under general or local anaesthesia and fat is actually taken out of body with a suction machine. Moderate amount of liposuction upto 5-7% of body weight ( 7 kilos in hundred kilo person) from 1-3 selected body parts in a sitting is safe and scientifically proven to be effective. But does it benefit everybody? The answer is no. Liposuction works best and is permanent for those people who are determined to maintain their weight with healthy diet and exercise. Even though the fat cells are removed from liposuctioned part , the remaining fat cells of the area and other body parts can store fat if lifestyle is not changed. Very obese( 30-50 kgs overweight) can not lose all the weight by liposuction alone. Without balanced diet and exercise the fat lost by liposuction may come back in next couple of months. If one is trying to lose weight for health reason like blood pressure, diabetes and heart problems liposuction is not the ideal solution. Unless one makes appropriate lifestyle changes, he/she does not get health benefits of weight loss. Liposuction is ideal for those who are already on balanced diet and exercise program , but are stuck with resistant areas of fat like love handles, double chin , tummy, hip etc. Liposuction in moderation is great and permanent but expecting 20-50 kilos of weight- all by liposuction alone- is unrealistic and impractical.

5. Bariatric surgery: Bariatric surgery acts on the stomach and intestines. Various types of bariatric surgery procedures are available to reduce stomach size and intestine size. After this surgery person can not eat much or absorb much and ends up losing most of extra weight in next 1-2 years. During this time he/she heeds to maintain proper nutrition under dietician’s supervision and also exercise to maintain muscle and bones. Bariatric surgery is not for moderately overweight people(BMI less than 35), because of low risk benefit ratio in this group. For people with BMI above 35 or grossly obese who suffer from other weight related health problems bariatric surgery is worthwhile . Can one gain the weight back after bariatric surgery- yes , unless one changes to healthier lifestyle.

6. Diet and exercise: This is mentioned last, because it is common sense. Everyone in their heart knows this is the healthiest , safest , permanent ,cheapest and most sure shot method of losing weight. But modern lifestyle, busy schedules and easy availability of rich food makes it very difficult . Yet there is no escape from it. One has to take limited , balanced diet and has to be physically active to maintain the result of weight loss surgeries. There are certain situations though where diet and exercise does not help. Heavy female breasts, male breasts, love handles, saddle bags and fat around the waist are commonly found even in otherwise normal weight fit individuals and in women after pregnancies. Loose skin does not go with exercise nor does exercise and diet help in spot reduction.All of these problems are beyond the scope of diet and exercise and need plastic surgical procedures for correction.

Tips for safe recovery after large volume liposuction

2010-06-01T02:16:00.000-07:00

Liposuction of fat more than 5 percent of person’s body weight is referred to as large volume liposuction. This term is used to differentiate it from small volume liposuction which is much simpler and safer. Smaller volumes of fat can be removed under local tumescent anaesthesia , without hospitalization with minimal blood loss. Large volume liposuction on the other hand requires much more preparation, hospitalization and recovery time. If you are well prepared you can get the best out of your liposuction .

Preparation for large volume liposuction:

Healthy diet before liposuction: Your nutritional status determines the healing capacity. A lot of obese people are actually iron and vitamin deficient, especially if they have been on crash diets. You should start taking Iron and multivitamin supplementation and avoid crash diets 1-2 months before planned liposuction. Diet control should be done under supervision of qualified dietician.

See the plastic surgeon early: It helps to consult the plastic surgeon 3 months in advance. This will help in assessment of your general health. If any problem like anaemia or hypothyroidism are detected they need to be treated adequately before you can have the liposuction. This can take time- so plan in advance

Reveal your complete medical history to the plastic surgeon: For your total safety under anaesthesia it is absolutely necessary that the doctor knows about all your current or past medical and surgical history. Keeping secrets from your doctor can prove dangerous.

Discuss all your medication and supplements with doctor: Do not take any medications and supplements in the month preceding liposuction without discussing with your plastic surgeon. Certain health supplements sold in gym, weight loss medicine, birth control pills, common painkillers – all these need to be stopped 2-3 weeks before surgery. Certform also about your allerain other medicines interact with anaesthetic drugs and anaesthetist must know about them.

Prepare for 2 weeks of rest time after liposuction: After large volume liposuction, body takes a couple of weeks to recover from its effects. Giddiness , aches and pain are maximum during first week and gradually come down during second week.

Have someone to help you at home after liposuction: during first week after liposuction you will need someone to take care of your and your family’s needs.

Stage the liposuction: It makes sense to not just limit the amount of fat removal in one sitting but also the number of areas from which you get the fat removed. Try to limit the liposuctioned areas to 1 or two areas at a time. Do not push the surgeon to remove fat from all over your body. It will make your recovery too painful. Keep at least 2 months time between two sittings to recover fully.

Choose the right surgeon : An experienced plastic surgeon and anaesthetist team makes a safe large volume liposuction possible.

Choose the right hospital facility: Large volume liposuction should be performed only in hospital setting where postoperative monitoring and emergency care( I.C.U.) is available. 24 hrs availability of anaesthetist to deal with any emergency situation is mandatory.

Liposuction: Then and Now

2010-05-29T22:32:00.000-07:00

Liposuction is a very popular plastic surgery – among top 3 worldwide. Liposuction involves removing localized fat from the body , with the help of hollow metal cannula( pipe). Technique of liposuction has changed a lot since liposuction was first started 30 years ago.

Liposuction was initially done for removing localized small fat deposits( like bulges on outer thigh) A hollow metal cannula was introduced close to the fatty bulge, through small incision less than a centimeter in size. Tumescent fluid was not injected into the fat prior to liposuction( dry liposuction). Cannula was attached to suction machine. Back and forth vigorous movement of sharp cannula by the surgeon broke down the fat, which was sucked out into the suction machine. Results were good but there was significant blood loss . Therefore only small amount of fat could be removed safely. Those days fat removal was limited to 1000 ml or less.

Tumescent liposuction and usage of blunt cannula were the next major step forward for liposuction. Tumescent or wet liposuction involved injecting special tumescent fluid into the fat 10-20 minutes prior to liposuction. This fluid helped shrink the blood vessels and made fat softer. Usage of blunt cannulas with holes on side reduced the trauma to blood vessels. As a result the proportion of blood to fat aspirated came to less than 100 ml for 1 liter of fat removal. This enabled surgeons to remove larger amounts of fat , upto 5-8 percent of body weight . For example in a person weighing 100 kilograms 5-7 liters of fat could be removed safely without transfusing blood. Addition of local anaesthetic to the tumescent fluid made the fat deposit numb and liposuction could be done under local anaesthesia.

Ultrasound assisted liposuction (UAL) was the next breakthrough in late seventies. Here a special solid liposuction cannula was used which emitted Ultrasound waves at the tip. When the cannula was introduced into the fat through one or more small cuts( about 1 cm), ultrasound waves broke down the fat into liquid. Liquid fat was then was sucked out into the machine. More fat removal was thus possible even from tough areas like back, with minimal blood loss for the patient. UAL went out of vogue after a decade because of increased rates of complications like skin burn and altered sensation of liposuctioned part .

Power assisted Liposuction( PAL) was the next big thing introduced in nineties. PAL or vibroliposuction cannula was designed to vibrate at the tip. This helped in reducing physical strain to the surgeon. Vibrating cannula broke down the fat in tougher areas with a lot more ease.

Many more liposuction techniques are available now like syringe liposuction, laser lipo and vaser liposuction. In syringe liposuction negative suction pressure is created by large 60 ml syringes and fat is collected in syringes. This is the gentlest liposuction technique and suited for small fatty deposits. Fat collected in syringes can be used for injecting into fat deficient areas like hollow cheeks, buttocks or into breasts . This technique of fat redistribution is called liposculpturing.

Laser liposuction cannula has Nd YAG laser beams coming out of the tip. Cannulas are finer and laser seals blood vessels, resulting in less trauma and bruising. Surgeon exertion is understandably less.

Vaser liposuction is 3rd generation ultrasound assisted liposuction . It is safer than original US assisted liposuction, because vaser delivers less ultrasound energy at the tip.

Tumescent liposuction is a misunderstood term. Originally tumescent liposuction was used to enable small liposuction under local anaesthesia . Nowadays tumescent solution injection is an integral part of all types of liposuction. No one does dry liposuction anymore.

Despite so many different technologies available for liposuction, standard( wet/tumescent) liposuction using hollow cannulas and suction machine remains gold standard . Worldwide majority of surgeons use this technique to deliver safe and consistent results. Other techniques like UAL, PAL, Vaser and laser liposuction have not proved to give better results , although they have some advantages for surgeon like less physical effort. Other claims like less pain, less blood loss , faster recovery are not always true. The surgeon behind the machine is more important in delivering better results with more safety, than the machine itself.

Ribbon Lift

2010-02-24T20:05:00.000-08:00

Ribbon lift

Ribbon lift has caught the imagination of public thanks to certain celebrities like Angeline Jolie , who is rumored to have had ribbon lift done recently to restore her once chiseled jaw line. Celebrities and others who are constantly watched and captured on camera tend to start early with facelifts. They particularly seek surgery that is least invasive and gives subtle results with least downtime and scarring . Ribbon lift fits the bill perfectly.

Loss of jawline definition is one of the earliest signs of ageing and starts usually in early thirties. Overweight younger individuals in their twenties too can face this problem because of fat accumulation in lower face, upper neck and under chin. But with the onset of thirties even people with normal weight can lose the sharpness of their jawline because of the effect of gravity , loss of elasticity of skin and sagging of platysma muscle of the neck. Younger people tend to consider nonsurgical options like thermage or laser facial rejuvenation which claim to lift the face. None of the nonsurgical devices available can actually lift the sag of the muscles because muscles are too deep and outside the reach of nonsurgical methods. Plastic surgeons have constantly strived to find a solution that can actually lift the muscle with least amount of scarring or downtime, to suit the need of younger people with active lifestyle.

Ribbon lift involves placing a certain ribbon like device under the jawline between the skin and platysma mucle, to pull the skin and muscle in unison towards the ear. Ribbon , in this endotine devise is made up of absorbable material , is about one fourth of an inch wide and has hooks on the undersurface to grasp facial mucles . Ribbon is inserted through small incisions either behind earlobe or above the ear , within the hairline, where it will not be seen . Ribbon lift procedure is done under local anaesthesia . After engaging the hooks on the muscle, when ribbon is pulled towards the ear , the jawline stands out . If a lot of skin is seen bunched up , the excess skin may be removed through a short incision around the ear lobe. Procedure is quick and painless. Downtime usually is one week or less.

Ribbon lift is somewhat like older thread lift with “contour” or “happy” threads. Threadlift technique used absorbable or nonabsorbable thin barbed threads, which were inserted with needle under the skin of face and neck and pulled upwards similar to the ribbon. Multiple threads were required to hold the tissue. Since they were inserted blindly and the barbs were small and delicate results were short lasting and unpredictable. Endotine ribbon in contrast has broader and stronger grip and is placed more predictably and securely after surgical dissection. Therefore one can expect longer results with ribbon.

Who will benefit the most with Ribbon lift? Younger men and women who have minimum fat or excess skin on jawline are ideally suited to Ribbon lift. Typically people in late thirties and early forties, who shy away from conventional surgical facelift will benefit with Ribbon lift. Conventional facelift and even short scar versions involve an incision in front and behind the ear . This is a high price to pay for men and women with shorter or pulled up hairstyles and those who do not need extensive lift . Ribbon lift scars, in contrast , are smaller and well hidden. Facelift surgery involves more extensive dissection which leads to a downtime of 2-4 weeks. Ribbon lift has minimal downtime of less than one week. Of course less surgery also means lesser cost and lesser risk .

So can Ribbon replace the good old facelift completely? The answer is no. Conventional facelift and necklift is the only option when skin excess and sagging is significant. Facelift surgery results last longer 5-10 years whereas results of a ribbon lift may last much less . Ribbon is completely absorbed by body in about an years time. After that the fibrosis around the ribbon is supposed to be holding the sagging tissues for some more time. Since ribbon lift is a relatively newer technique long tem follow up is not available.

What's New in Liposuction : VASER

2010-02-19T20:24:00.000-08:00

Popularity of liposuction for unwanted fat removal has generated demand for better technology which can make liposuction safer, painless and quicker. Patients and plastic surgeons alike have constantly seeked solutions that can make liposuction a better and more satisfying procedure. VASER is the latest technological offering in this context.

VASER has been around since 2002, when it was approved by USFDA for fat removal. And no, VASER has nothing in common with similar sounding LASER, which also has been used for liposuction. VASER stands for Vibration Amplification of Sound Energy at Resonance. Simply put it adds the benefit of ultrasound technology to the standard liposuction procedure. Ultrasound waves are sound waves at specific frequency and one commonly comes across it during ultrasound cleaning of dental plaque and while looking at the growing baby in mother’s womb. Usage of ultrasound for liposuction itself is not new. Ultrasound assisted liposuction ( UAL)was very popular in eighties. Vaser has resurrected ultrasound in liposuction. Vaser is 4th generation ultrasound assisted liposuction technology which offers more safety than earlier ultrasound technologies. Speciality of Vaser is “ liposelection” – meaning it caused damage to fat cells only without damaging other tissues.

Vaser liposuction is a surgical procedure like the good old liposuction, only technology and results differ. VASER is performed in sterile operation theatre by qualified plastic surgeon. General or local anaesthesia is used . Tumescent solution which may contain local anaesthetic is injected into the fat to be liposuctioned. Injection of tumescent solution shrinks blood vessels, provides anaesthesia and also creates safe environment for VASER by completely soaking the fat tissue.Vaser probe , which is a solid titanium rod of 3-5mm diameter is then introduced into the fatty layer through small 3-5 mm cuts in the skin. The ultrasound energy is delivered at accurate dosage at the tip of the probe, while moving the probe through fat in all layers all over the area . Ultrasound energy selectively destroys fat cell membrane and liquefies fat. Since the blood vessels, nerves and skin are resistant to lower doses of ultrasound, they are safe. Liquified fat is then vaccumed out with hollow suction metal cannulas attached to vaccume suction machine.

Depending of how much fat was removed VASER liposuction can be a same day surgery or may require hospitalization. Antibiotics and painkiller tablets are prescribed and usage of compression garments is mandatory for 1 month or more after VASER liposuction.

Tissue swelling is natural after any surgical procedure. After VASER liposuction results are seen gradually over next one month onwards as gradually swelling comes down and skin retracts. This is facilitated by wearing compression garment.

So what is the special advantage of VASER liposuction? Vaser liposuction enables larger amounts of fat removal which was hitherto unsafe due to blood loss. So one can have more fat removal, without the need for blood transfusion. Recovery after large liposuction is faster with VASER. Vaser also allows for better sculpting in tougher and fibrous areas like back and male abdomen. High definition liposculpture with VASER is gaining popularity for creating six pack abdomen look. Vaser has been used in more than 100,000 procedures all over the world and has proven to be safe.

WHAT IS THE IDEAL BREAST SIZE ?

2009-10-31T11:26:00.000-07:00

Beauty is in the eyes of the beholder . The parameters of beauty also differ from one culture to another and also change with time and fashion. Ancient Indian sculptures and art depict women with full hemispherical breasts. Such breasts are still in vogue in India especially with women who prefer traditional saris other ethnic dresses. West in contrast has seen a lot of change in fashion –as related to breast size.

Breasts should be proportionate to woman’s body frame and built. The concept of 36-24-36 inches , though quite exaggerated, basically refers to breast size being equal to hips, with a significant narrower waist in between.

Breast size is commonly referred to in terms of cup size, B C and D cup sizes being most common. C cup is moderate and pleasant size for woman average built. B cup may look adequate on petite athletic women. A lot of western models are cup size B. D cup size breasts are full and look good on women of larger frame. A lot of Indian women seeking breast augmentation like D cup size, especially married women who have had children.

Younger, unmarried women tend to prefer smaller breasts.Woman’s body built is important because if the arms or tummy is bulky then breasts will have to be bigger to give the right profile. In thinner women relatively smaller size breasts will give the same look.

Ideal breast size is also determined by the lifestyle. Active sporty women like moderate sized breasts. Women who wear heavier clothing like saree want larger breasts . In contrast women who wear western clothes may prefer moderate size breasts. Women in entertainment industry prefer larger breast size.

Lot of women with breasts smaller or larger than average ,are perfectly satisfied with their size. Some women on the other hand are uncomfortable or embarrassed about their breast size. Sometimes their partners are dissatisfied. In such circumstances plastic surgical augmentation or reduction of breast can help women achieve what they desire.

CAN PLASTIC SURGERY CHANGE ONE’S IDENTITY

2009-10-21T23:25:00.000-07:00

You see it all the time in soaps and cinema. There you see someone who is changed completely, so much so that they live with their friends without being identified. You also hear of international criminals taking another identity reportedly with the help of plastic surgery in some unknown faraway countries. And do you believe this is possible?

Let us examine the facts one by one. Face is the most identifiable part of a person. What can plastic surgery do for the face? Plastic surgery is commonly performed to improve one’s features. Take the case of nose. Plastic surgery can turn a flat nose into a prominent one, a thick nose into a slender and shapely one, a very big nose into smaller one. This is done through concealed scars and no one can make it out. Some people have excessively large or small chin. With plastic surgery bone can be shaped and new bone or an implant can be added to give a pleasing look. People who have flat cheeks can get cheek implants done for better definition of face. Sunken cheeks can be made chubby by injecting fat into them which is sucked out from another part of [persons body with a syringe. If the cheeks are too chubby they can be reduced in size by removing a little fat through a cut inside the mouth. If the lips are too thick they can be reduced in size by cutting out a thin strip and if the lips are too thin they can be made thicker with certain filler injections or by filling them with one’s own tissue by surgery. In older individuals facelift surgery can remove loose skin and make one look 10 years younger. In middle aged people filler and fat injections can smoothen the face and botox injections can remove the wrinkles, making one look younger. The acne or pock marks on the face can be smoothened by dermabrasion surgery. Scars on the face can be removed or improved by plastic surgery. If the ears are shapeless or too big they can be fixed. Double chin can be corrected by sucking out fat. Bald head can grow hair with plastic surgery .

The shape of body can be changed markedly with plastic surgery. Liposuction surgery can remove fat from any part of body and can give an enviable figure. Shape and size of breasts can be changed by plastic surgery. A woman can have a Pamela Anderson look with breast implants . Silicone implants can be placed in buttocks to give them J Lo curves. Implants can be inserted in male chest and calves to give the appearance of bulging muscles. If there is a tattoo or scar anywhere, it can be removed.

People opting for sex change often go for plastic surgery to change from a feminine to musculine look or vice versa. Since they also change their clothing, hair and makeup they can be virtually unidentifiable.

Coming back to the million dollar question, can plastic surgery change one’s identity to the extent that even family and friends do not know? Plastic surgery is commonly done to improve the looks , correct deformities and reverse the signs of aging. After such a surgery person gets compliments that he looks better, or younger and most of the times people do not guess that this is because of plastic surgery. But what if person is already young and he or she has no significant deformity or imbalanced features which require plastic surgery. Theoretically it can still be done by abovementioned procedures but result is usually ugly. For example a beautiful nose can be made crooked .

Even if some of those changes are made person can still be identified by his friends and family due to his body language, voice, expressions , height etc. In other words it is possible in movies but not in real life. Also in real life no plastic surgeon will be willing to do such a job . It is completely unrealistic , unsustainable and sometimes downrightly illegal .It’s a great savior for some of the screen scripts though.

Stretch marks: Can they be removed?

2009-08-22T21:44:00.000-07:00

Stretch marks are white, pink or bluish streak like marks on skin commonly noticed during pregnancy and when body is growing rapidly during adolescence.

Pregnant women notice the stretch marks on their growing belly after 4th or 5th month. Stretch marks in adolescents and men are usually seen on a variety of body parts parts like abdomen, hips, thighs, chest ,breasts , shoulders and arms. People who are on a muscle building exercise program , and those who take supplements containing steroids , also tend to develop stretch marks.

Stretch marks are medically called’Striae”.The term stretch mark is misleading. Stretching of skin is not the real cause of these marks . Stretch marks are seen is thin individuals as well . When plastic surgeons actually stretch the skin 2-3 times its size during some surgeries like tissue expansion, stretch marks do not appear. When someone is suffers from Cushings disease ( excess steroid hormones) the body develops stretch marks. Stretch marks happen due to excess circulating steroid hormones in the body- like during pregnancy, vigorous exercise etc and also due to increased sensitivity of skin to those hormones. Indian women are more prone to develop stretch marks during pregnancy than their white skinned counterparts.

All stretch marks are not the same. Mild stretch marks are like faint scratches whereas severe stretch marks are as wide as half a centimeter and also deep. You can feel the thin papery skin at the bottom of a wide stretch mark. All stretch marks look pink initially but gradually turn pale white over next few months. Deep and wide stretch marks tend to look bluish due to visibility of blood vessels through the thinned out skin.

Variety of stretch mark creams containing cocoa butter, Vit E etc sell like hotcake because people are desperate to treat stretch marks. These creams provide moisture but do not really do much for stretch marks. So what is the alternative? How do some actresses continue to wear skimpy clothes even after pregnancies without a sign of stretch mark?

Certain vascular lasers like Pulse dye laser can lighten bright pink stretch marks to pale white. If the stretch marks are already pale vascular laser will not be of any use. Other treatments like chemical peels, microdermabrasion can slightly improve certain superficial stretch marks only. A lot of sittings over many months are needed and the results are unpredictable. Recently fractional laser has been used for treatment of stretch marks. Light stretch marks can be improved upto 50 percent . Like with most lasers 6-10 sitting are required at one month intervals. Cost of laser treatment of marks on lower abdomen can be 1-2 lakh(2000-4000USD) rupees.

The fact remains that the most common type of deep stretch marks on the abdomen , post pregnancy can not be treated by any of the above methods. Tummy tuck or abdominoplasty is a surgical option. Apart from stretch marks there is also loose skin and bulging abdomen after pregnancies, which is resistant to proper diet and exercise. All these issues can be tackled with tummy tuck, which involves removal of fat, tightening of muscles and removal of all the skin below naval . Abdomen ends up looking pretty much same as it did before pregnancies. Even if the marks are extensive and going above the naval, they can be shifted very low down. Downside of tummy tuck is a long scar. Fortunately this scar is placed very low near pubic hair and it can be cleverly hidden in bikinis and low waist jeans. Cost of tummy tuck in India is Rs and 75000-1.5 lakhs( USD 1600-3000) upwards depending on gepgraphical location and surgeon.

Liposuction for weight reduction

2009-03-14T05:18:00.000-07:00

I am a plastic surgeon. A lot of people who are overweight approach me everyday for getting a good body shape by liposuction. Those who are within 10 percent of their ideal body weight( for example if ideal weight for someone is 60 kilos and he weighs 66 kilos or less) are ideal candidates . Thats because their fat is usually localized in one or two body parts, like belly, thighs hips or arms .By removing a limited quantity of fat- say 5-6 kilos from those specific parts I can give them nearly perfect figure ,without compromising their safety . But quite often patients are really obese and want to reduce 10-20 or even 30 kilos by liposuction. This is a different scenario altogeather.

Lets first briefly consider few facts about liposuction. Liposuction is a plastic surgery procedure wherein fat from any body part can be extracted in liquid form through multiple tiny( 4 mm) cuts. Since procedure takes 1-4 hours to perform depending on the amount of fat and number of body parts treated- it is performed under some kind of anaesthesia inside a fully equipped operation theatre. There are no stitches but in every other way it is a major surgery with risks of surgery and anaesthesia. There is a healing time and period of rest involved.

People often ask if liposuction is safe? My answer is- yes it is , if done within safe limits. Liposuction involves removal of fat but invariably some amount of blood is mixed in the fat. By using tumescent technique blood loss can be minimized but can not be completely eliminated. Just like in case of blood donation where 300 ml blood can be safely donated by a healthy person , liposuction if done under strict quality conditions fat equivalent to 5-7 percent of person's body weight( 7 kilos for person weighing 100 kg) can be removed safely in one sitting.

People who are fat all over and 30-40 kgs overweight sometimes ask for liposuction , to reduce weight primarily. There are several problems in this scenario.First of all reducing a lot of fat like 10 kgs or more is risky, involves blood transfusions, long operating time and more dose of anaesthesia drugs. This risk though small is not justified just for losing weight which can be done in healthier and safer weighs. Results of liposuction are also inferior in large volume liposuctions due to surgeon working hastily and getting tired instead of doing a fine sculpting job. Irregularities and asymmetries are common after large volume liposuctions .

Then there is the question of long term maintenance of results. If patient says he is obese because he can not diet and has no time for exercise , I ask him how he is going to maintain the results? Fat gain is related to more calorie consumption relative to calorie burning. Weight can be regained if same lifestyle is faulty.

In a moderately overweight person removal of fat from one or 2 areas of body 5-7 kilos in a sitting can result in a great figure with safety. One can opt for another sitting after 2-3 months gap if more fat from another are needs to be removed. Very obese people( BMI 35 and above ),for example a person of height 5'3" weighing 100 kilos do not get appreciable improvement in one sitting unless they accept higher risk of high volume liposuction.

For such people I first of all want to know if their weight has been stable in last 6 months. There is no point wasting efforts on person who is still gaining weight because liposuction is not going to stop further weight gain. For obese people who have started healthy diet and moderate regular exercise and who have stopped gaining weight- liposuction can sometimes serve as a kickstart for weight loss . After removal of 5-7 kilos of fat from tummy or thighs often person feels more comfortable exercising and feels motivated to lose weight by further efforts of his/her own.The psychological barrier is broken . After some weight loss on his own person can then reward himself with another sitting of liposuction if needed. This approach takes care of weight loss safely with higher chances of long term maintenance, that the shortcut, quickfix method of large volume liposuctions .