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.
Saturday, May 29, 2010
Wednesday, February 24, 2010
Ribbon Lift
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.
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.
Friday, February 19, 2010
What's New in Liposuction : VASER
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.
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.
Saturday, October 31, 2009
WHAT IS THE IDEAL BREAST SIZE ?
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.
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.
Wednesday, October 21, 2009
CAN PLASTIC SURGERY CHANGE ONE’S IDENTITY
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.
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.
Saturday, August 22, 2009
Stretch marks: Can they be removed?
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.
Saturday, March 14, 2009
Liposuction for weight reduction
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 .
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 .
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