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Thursday 16 November 2017

Rhinoplasty – For All Who Expect More…!


“My nose is long and flabby at the end…” “Whenever I smile, my nose looks wide and ugly…” “I’ve got my nose distorted in an injury, and now I suffer from breathing problems everyday…” – these complaints are common. It’s a fact that half a million people are unhappy with the nose with which they were born, and are living with such worries… Rhinoplasty is the best solution for all such people – it is not just a procedure with complex series of steps, and it is not as bad as you may think! Here we are gonna review various aspects and possibilities of Rhinoplasty, which may help people who wish to, enhance the appearance of their nose.
Understanding Rhinoplasty…
    Rhinoplasty is one of the most popular cosmetic procedures available today to reshape the nose. It involves making the nose larger or smaller, changing the symmetry or angle of the nose with respect to the upper lip, altering the nose tip, correcting the bumps, indentations, or other defects in the nose, to bring it into better proportion with the rest of your face. Rhinoplasty may also restore structural problems with the nose that cause chronic congestion and breathing problems.
    Rhinoplasty are generally carried out by surgeons who are trained either in plastic surgery, otolaryngology (ear, nose, and throat specialty), or both.

The Procedures Involved…
During rhinoplasty, your surgeon will first access the bone and the cartilage support of the nose through smaller external incision made at the base of your nose, between your nostrils. Followed by this, the underlying bone and cartilage is readjusted to create a newly framed structure. For example, if you are dejected with the tip of the nose which is too large, your surgeon will sculpt the cartilage in this particular area, as a means to reduce its size. In case, if you feel that some portion of your nose is disproportionately small, cartilage or soft tissue grafts can be placed in order to create a more pleasing profile. Now, if the issue is that the bridge of the nose has a prominence, your surgeon will reduce this to yield better harmony. The angles of the nose in regard to the upper lip or the forehead can also be remolded by further sculpting the nasal support structure.
Next, the tissues are re-draped over the new frame and the incisions are closed. A small splint is then placed outside the nose to help maintain the new shape of the nose, as it heals.

Life after Rhinoplasty…
    All rhinoplasty techniques are different – so, recovering time varies from patient to patient, somewhat depending on how much your nose is altered during surgery. However, here are few things, which you can expect during your recovery stage.
  • In the first week of rhinoplasty, it’s very common to have swelling and bruising around eyes and nose, sore throat, headaches, and nausea. Cold compresses and over-the-counter pain relievers will be recommended to help you abate these symptoms. Keeping your head elevated can also help to minimize swelling.
  • While it’s crucial that you follow your surgeon’s post operative instructions, ensure that you take your antibiotics religiously.
  • It’s still important that you should watch for any signs of infection, including worsening pain, redness, swelling, fever, red streaks or pus. If any such concerns occur, report immediately to your surgeon.
  • Avoid any activities that would increase the risk of injury (For example, heavy lifting, excessive exertion, sun exposure etc.).
  • It is indispensable to make sure that you don’t blow your nose and avoid any impact to the nose while the structures are healing.
  • If you are a person who wears glasses, you must be very careful not to exert excess pressure on the nose bridge.
  • Majority of the patients can return to work during the second week of recovery, as long as you do not work on any strenuous activities. At this time, gentle washing of the face can be resumed and a little makeup can be applied, as well (of course, that’s your choice!).
  • By week three, you can recognize the new changes and start appreciating the brand new shape of your nose!

Even though rhinoplasty surgery is a minor surgery, there are complications, risks and recovery time to consider, as with any surgery. However, with proper analysis, combined with the skills of a qualified surgeon, rhinoplasty will become a very rewarding procedure for all.

Monday 11 September 2017

Facial rejuvenation - Restoring the triangle of Youth




Many of us are happy with the wisdom and composure we attain with age , But few are happy with the wrinkles, folds, jowls and deflation of the face. The pursuit for a youthful facial appearance may involve everything from healthy diet, exercise, facials, anti-ageing creams,  to lasers , skin tightening procedures, botox and injectable fillers. However with time the traingle of youth turns to the pyramid of age. Traingle of youth refers to the widest part of the face between the two cheek bones in young person with  the narrow point at the chin. With ageing, it reverses and the widest part becomes the jawline , with the narrow tip at the bridge of nose. This is because of the midface deflation, fat pad loss, bone resorption, skin wrinkles and jowls. Skin becomes thinner, collagen and elastin breaks down and hyaluronic acid is lost resulting in  crow’s feet, nasolabialfolds, tear trough and  marionette lines .Usually this starts around the age of 35 ,with further deflation and midface bone resorption at 45-50 years. Many of the non surgical procedures like botox, fillers , lasers help in defying the age, but are effective only upto a point.

Restoring the triangle of Youth


A modern face lift procedure is customized or individualized to patients needs because not every face  is the same. It not only lifts the deeper tissue and removes extra skin but also fills the midface volume loss with fat grafting. The windswept unnatural look  with lift-alone procedures has given way to the more pleasing and rejuvenated fuller facial profile with the current facelift surgery.

Mini facelift- Patients who exhibit a mild degree of jowling and sagging skin are often good candidates for a mini-facelift.This is a less invasive technique that allows to tighten deep facial tissues through shorter incisions, typically located along the natural creases surrounding the ear. It can be done under local anesthesia with sedation or under general anesthesia. Structural tissue around the cheeks are lifted and plicated to refine the jawline and restore the midface. Advantages include shorter scar, quicker recovery and lesser complications.

Standard face lift- This procedure will more fully address moderate to advance aging of the midface and neck .It involves incisions starting in the temple region extending  to ear running in front, around and then behind the ear and back into the scalp. Facial skin on the cheeks and neck is dissected free and underlying muscle and fascia of the face and neck is dissected and tightened. Excess skin is trimmed and the incisions are closed. It take around 4-6 hours for the surgery, recovery is longer but the outcomes can be rewarding.

Blepharoplasty or the Eye rejuvenation surgery-  Many a times the telltale signs of aging can first appear in  and around the eyes. This can be droopy upper eyelids and brows , puffy bags under the lower lids, or  sunken eyes and  tear trough. This can make you look old and tired and sometimes interfere with the vision too. Blepharoplasty is a surgery that removes excess skin ,plicates the muscle in upper lid to lift it up , and redistributes the fat in lower lid to attain a smooth lid-cheek junction. The incisions follow the natural creases of upper lid and just below the lashline in lower lid. A lateral canthopexy is also incorporated to tighten the outer part of eye.This can be combined with a brow lifting procedure for a sagging lateral brow.

Autologous fat grafting for facial rejuvenation- Fat transfer techniques using fat from the other parts of body and transferring it to elsewhere has become more widespread and established technique. It has been used for breast augmentation, buttocks augmentation( Brazilian Butt lift) , hand rejuvenation and also for facial aesthetics. Micro and nano fat harvested from abdomen or inner thighs are  injected in the planes of facial tissue with blunt cannulas. Clinical applications include  filling of the malar prominence, tear troughs, nasolabial folds and  fine lines along the lips. The  adipose derived stem cells in fat tissue are critical in tissue regeneration and repair. The effect lasts for 3-5 years unlike fillers which has to be injected every 6-9 months.

Adjuvant procedures for face

Thread lift- Bioabsorbablethreads with barbs or cones are inserted  underneath the skin in specific areas of face to lift the eyebrows, lift the sagging skin over cheek , reduce nasolabial folds, define jawline and reduce the neck folds. The procedure can be done with patient being fully conscious and they can approve the look of their thread lift while the surgeon works . This innovative technique assures a subtle yet a noticeable change .

Double chin Injectables- Submental fullness or  fat under the chin can be treated with injectable deoxycholic acid in 4-6 sessions spaced at 1 month interval. This treatment has been approved by FDA. Deoxycholic acid is a naturally occurring molecule in the body that aids in the breakdown of the fat cells resulting in a noticeable reduction in fullness of the chin.