Mummy Makeover - II

Mum Makeover Part II – Interventional options

In Mummy makeover part I we discussed about some options of preventing problems & non-interventional options to get back to the pre pregnancy state.

Here in this post we shall discuss about the interventional options available and a few of the same.

For ease of understanding, let me divide them according the regions of involvement and the options.

Broadly we can divide the changes into:
1. Generalized skin changes.
2. Changes to the face
3. Changes to the breasts
4. Changes to the Abdomen
5. Changes to the hips / thighs

GENERALISED SKIN CHANGES:

Generally there aren’t too many changes that occur in the skin proper except for maybe more of dryness, cracking of the lips, and most importantly the “dreaded Stretch marks”.

Dry Skin:
As with any other reason for dryness, keeping the skin soft and supple is accomplished by using moisturizing & body lotions. Generally twice a day massages will help take care of this problem.

Cracked lips:
are problems especially during the later stages of pregnancy and early period post delivery. Same as with the skin, moisturizing with the use of lip balms and keeping yourself hydrated will go a long way in controlling this problem. Wetting the lips by saliva and biting them will only worsen the problem and also cause the lips to darken.

Stretch marks:
I wish I had a sure shot solution to this problem. If I did, I would be a millionaire in a few years. But, as I already mentioned in my previous blog on the same subject, the best way to treat stretch marks is to prevent them. But, am sure many of you are thinking that I’m the doctor here and I should be offering some solutions instead of saying it is untreatable. Well, there are a few options, but all have their limitations and none of them has a 100% success rate. This is because the stretch marks are due to breakage of the inner elastic dermal layer of the skin while the epidermis is still intact over it and all the treatments we have are external and aiming at promoting collages and scar deposition in the broken dermal layer of the skin.

The treatments work better in early stretch marks which are “pinkish or reddish” in appearance but not very promising in late established “white” stretch marks.

1. Chemical peels: there are various types of chemical peels which are basically long acting peels which promote collagen deposition in the deeper dermal layers of the skin. Some of the peels also tend to lighten the hyper pigmented areas, which are often associated in the stretch marked areas, which causes them to stand out more. By lightening the darker areas it helps camouflage the stretch marks better.

2. Dermaroller: This is an instrument, which works on the principle of “Microneedling” which basically means to puncture the skin with small micro needles so that there is no pain but the injury promotes collages synthesis in the deeper layers of the skin where the actual problem lies. This has shown decent results but it takes a long time for the results to be apparent. The procedure itself takes around 15 minutes to an hour depending the size of the affected area. The procedure is repeated every 4-6 weeks for 5/6 times..

3. LASER: Laser’s use the power of light to heat the deeper layers of the skin thereby promoting collages synthesis in the deeper layers. This works well in early stretch marks (pink stretch marks). Multiple sittings are required, at intervals of @ 4 weeks.


CHANGES TO THE FACE:

Most of the changes that occur during pregnancy like puffy face, dry skin and lips, are reversed post delivery. The most common change that stays on usually are pigmentation problems especially in the cheek area called “ Melasma”.

This is a problem that can be treated with a combination of peels, microdermabrasion and some skin lightening medication. But of course, skin protection from sun is an important part of the post treatment care.

As the hormonal status returns back to normalcy, the water retention and puffiness of the face also comes down. But gentle toning exercises help speed up the process.


CHANGES TO THE BREASTS:

The breasts and the abdomen are the commonest areas to bear the brunt of pregnancy. The most common problems following childbirth and breast feeding are, loss of breast volume, sagging breasts, stretch marked skin excess.

This is because during pregnancy the milk glands in the breast enlarge to replace fat in the breasts and post breast feeding involute to their original size. But, sadly the fat does not return to the breasts and if the skin has a lot of stretch marks, it does not shrink to the new reduced volume, causing sagging.

There are a few options when it comes to correcting these problems. If one feels comfortable with the size of her breasts when wearing a bra and is worried only about the sagging, she needs a “Breast Lift”. If she feels, the size in a bra is small, then an increase in volume is also needed, wherein a “Breast Augmentation or Breast Augmentation with Lift” is indicated.

1. Breast Lift (Mastopexy): This is a procedure designed to address the sagging glandular tissue of the breast as well as removing the excess skin. The basic procedure is the same, but many approaches like the classical “anchor incision”, “short scar vertical mastopexy” or a “circum areolar mastopexy” can be used. The gland is reshaped and suspended to the chest wall, the excess skin being tailored to the new breast mound to give it a proper shape.
Problems with a breast lift are usually a scar and the healing time. But apart from that it is a reasonably well tolerated procedure.

2. Breast Augmentation +/- Mastopexy: When the skin excess is not much, only an increase of breast volume in the form of an implant would suffice. In cases where the skin is in excess, augmentation using an implant is combined with a mastopexy. Here the augmentation is performed first and the breasts reassessed for residual sag. If present, the sag is taken care of by a mastopexy at the same sitting.


CHANGES TO THE ABDOMEN:

The abdominal changes are the most common and the most “visible” stigmata of pregnancy and childbirth.

The most common changes seen are loose flabby skin, stretch marks, fatty deposits, lower abdominal bulge and sometimes an upper abdomen bulge too.

The reasons for this have been discussed in the previous post “Mummy makeover- I”. Stretch marked skin does not contract and shrink, hence the loose flabby skin. Because of it the fat deposits stay and the loose muscles inside also contribute to the bulge.

The procedure to correct this deformity is commonly called the “Tummy Tuck” or an “Abdominoplasty”. There are two main variants to this procedure.

1.Regular Adbominoplasty: This is the classical method of correction of the problem. Skin excess is removed (the stretch marked skin below the level of the umbilicus), fat is sucked out with liposuction, the muscles are repaired and the hanging umbilicus, is repositioned to a normal position. This involves hospitalization for a day or two and a scar within the panty line, basically like an extension of the usual “Caesarean scar” but extending from one flank to the other. Simultaneously in selected cases the muscles can be tightened inside to bring the waist in also.

Usually there are drains left in after the surgery to drain out any excess secretions. These come out in 24-48 hours.

It is a common and well tolerated procedure, the main drawbacks being a long scar, though within the panyline. Getting back to routine activities takes around 3-4 days and regular normal work can be resumed within a week in normal circumstances.
Exercises can start within 2-3 weeks but abdominal exercises can be started only after 6 weeks. The patient has to wear a pressure garment (corset) for 6-8 weeks to help with swelling.

2.Mini Abdominoplasty: This is a variation of the regular abdominoplasty in the fact that skin excision is limited and there is no umbilical repositioning. But, liposuction and muscle repair are often needed. This is indicated when the skin excess is not much but there is muscle weakness. The scar is not as extensive as a regular abdominoplasty.


CHANGES TO HIPS / THIGHS:

Changes to the hips and thighs are usually related to weight gain. As mentioned in my previous posts, hips and thighs are genetically prone areas for weight gain in women. Pregnancy weight gain in this area is just an extension of the same. Post delivery exercising does help to get rid of this excess.

In case it cannot be done for whatever reason, then operative options are there in the form of a liposuction. Liposuction as mentioned in previous posts is a procedure to contour certain areas of the body by sucking out the excess fat using small 1cm cuts.


As you can see, many changes do occur during pregnancy leading to changes in the body, some temporary and some permanent. There are options to try and get the body to the way it was but maintenance is required.

As mentioned before, there are no short cuts. All the surgeries are procedures are aimed at bringing the body as near to as it was, but maintenance is required to keep it that way.

Also, as mentioned in my previous post “Mummy makeover –I”, many of these problems can be avoided by a little care during pregnancy and post child birth. So spread the word, pregnancy and childbirth doesn’t have to be so problematic for a woman.

Try and prevent these problems and if you already have them, most of them can be corrected. There is no reason for one to live with them, as there are “options available”!!!


Dr.Surindher

CosmesisIndia

Whom to Meet ??? What to do next???

I think these are the most common questions that pop up in any one's mind when he or she is contemplating a bodily change.

Day in and day out we are bombarded with ads promising the earth, the sky and everything in between. Marketing is meant to sell a product and hence needs to highlight only the positives and hide the negatives of any product. So on we go checking “ it” out.

Guaranteed fairness , guaranteed inch loss, guaranteed weight loss, guaranteed hair growth, guaranteed this guaranteed that!!! Sounds familiar??? I'm sure it does.

I have nothing against these ads but as the saying goes... “ If its too good to be true.. most probably it isn't true !!!” Similarly promising guaranteed, results on a body where no two bodies are similar is “too good to be true”.

All this adds to the confusion already prevailing in one;s mind. So one might say, that then why do people go for it? I think it all is because of :

1. The basic fear people have regarding going under the knife, hospitals, doctors and all that.

2. That treatment has “ Guaranteed results”

3. We as doctors tell the limitations of the procedure and the possible complications which puts people off.

4. As doctors we cannot take short cuts, the basic work up and the whole procedure has to be done , which is another deterrent.

So just to put things into perspective, I thought of putting all the points one has to think about before going for a modification of one's body. Sort of like a “ DUMMIES guide to .......” Ill put it in three headings:

1. From a patients point what one should know

2. What and how to know about the procedure

3. What to look for in the treatment provider

What a patient should know:

Read about it in my blog link already posted here

http://cosmesisindia.blogspot.com/2007/01/whos-up-for-makeover.html

Know about your Procedure:

1. Once you know what you want to get done, read about the procedure.

2. You can find information about the procedure on the net by doing a search on any of the popular search engines. Google, Yahoo, Alta Vista, etc being a few of them

3. Read about all the options available for what you want to get done

4. Search for possible complications with regards to the procedure.

Educating your self about the options and the procedure will give you new insights into the procedure and will help you mentally prepare for them.

What to know about your treatment provider:

1. Read about your procedure and know who is qualified to such a procedure. You will find lots of people claiming to do certain procedures in certain center's.

2. Surgical procedures are done by plastic surgeons, only they are trained to do them and licensed by the Medical Council of India to perform them.

3. The Association of Plastic Surgeons of India ( APSI) is the the authority granting certification to all the plastic surgeons in India.( www.apsi.in)

4. Don't feel shy of asking your doctor about his certification and training. I have many of my patients asking me these questions. Patients coming from abroad make it a point to find out these details.

5. Talk to your surgeon in detail. Place in front of him all you fears and apprehensions. Most of your doubts will be cleared but don't get offended if they do no respond to some questions by giving you the worst possible scenario. It is done so you realize that all surgeries are serious matters .

6. Always beware a doctor who does not tell you the complications or tell you that there are no complications at all. Either, he hasn't done enough surgeries to see complications or he is lying about them.

7. Don't rush into a procedure. Always take your time to think about it after discussion with your doctor. I NEVER operate on a patient after one consultation. I always call them at least a second or third time before I operate on them. This is because I want them to be sure of what they are undergoing.

So keeping all these in mind, just to recapitulate:

1. Be clear about what you want.

2. Vague requests get vague results, if at all anyone operates on them.

3. Educate yourself about the procedure, who should do them, the various options and the possible complications.

4. As far as the body is concerned “ Guarantees don't work !!!” Every thing has its limitations and one has to work within those limitations to achieve the best results.

5. Know about the credentials of your doctor.

6. Surgical procedures have to be done in properly equipped Operating theaters and not in some “ clinic”, with care regarding sterility and safety equipment.

7. Please remember if a doctor is saying “NO “ to a procedure there must be a reason behind it. Ask him the reasons and trust his decisions. All doctors want to provide you with a good result and most will refuse a patient if they know what he or she expects is unrealistic.

8. Always follow orders with regards to quitting smoking , cleaning the wound, wearing garments, taking medicines and taking rest.

9. Remember you can rush yourself and the surgeon but you cannot rush your body to heal. It will take its own time.

10. Trust your doctor ,be sure to keep in touch with him and inform him of any problems you might be facing, instead of going to another doctor who doesn't know what exactly was done.

The aim of this blog is to help you make educated decision about the procedure , to educate you as to where to go to and what to do as a next step, once a decision to undergo a procedure has been taken. A well educated , motivated patient is a happy patient as he is fully aware of the consequences and the expected outcome.

Hence don't be afraid, go ahead, take the decision, but just make an educated decision which will be of a great help to you and to your doctor.

Dr.Surindher

www.cosmesisindia.com

Move over ladies... The Men R Here!!!!

Any reporter or journalist who has met me has invariably put this question to me....." do men get cosmetic surgery done too???"

Well, the answer to this is very simple.. " Yes!!!"

But hidden in that " yes" are a lot of other things. Men have been getting cosmetic surgery even in the past but the ration of women is to men undergoing the procedure was maybe 9 women to 1 man or less. But in the last few years there has been a sea change in the number of men who are exploring surgical options, with the ratio almost coming to about 5 women to 5 men. So hows that for equality?

With a change in attitudes in today's world , the classical image of a man rugged n unkempt has taken a beating. Women of today like their men well groomed, smelling good, with manicured hands as well as a close shave and of course they want their men to be fit too, hence emerges the " New METRO SEXUAL Male " of today.

So the man of today doesn't mind taking care of what he wears , how he dresses and how he looks. I can tell by my own experience, when 11 years back my sister suggested I get a facial before my marriage..Ii scoffed at the idea and threw a tantrum at her ,but recently when my dermatologist suggested I come in for a peel, Ii said yes... though haven't been able to get to it. But it surprised me as just as much as it did my sister when I told her this.

Skin, be it a man's or a woman's needs to be taken care of in the same way.. and more for the man because of repeated trauma daily in the form of shaving, traffic and being out, etc. Similarly as people are becoming more health conscious, so also there is a perceptible increase in consciousness about their " Body Image".

More and more men are coming in asking for solutions to a variety of problems. But each problem has its differences as to the approach to it in a male and in a female because of differences in the body composition . Hence this blog will just try and touch on different aspects of cosmetic surgery for men and the common sought out procedures.

1.Gynaecomastia: ( Male Breast)
A very common condition. Here there is a slight increase of tissue under the nipple areas on the chest. This usually starts in adolescence due to the pubertal hormonal changes and in many it persists into adult hood. This becomes very embarrassing when a person goes to the gym, swimming pool or in the locker room. This is one of the few conditions where we operate on teenagers too, when the condition warrants it. This has taken over the number one spot as the most commonly sought after procedure by men.
The treatment consists of liposuction of the fat with or without a gland removal. The excess skin has to shrink back, for which the patient is required to wear a custom made pressure garment to give him the best results. This is a procedure that definitely gives immense satisfaction to the patient as well as the plastic surgeon. But this is a surgery which can be very easily botched up also, so proper doctor selection is again important.

2.Rhinoplasty( Nose Job)
Till a few years back this was the most common surgery even in men. The procedure is the same as for women with a few basic differences, like the skin in males being more thick, nose tip surgeries have limited results as far as sharpness of tip is concerned, which is one of the commonest requests that we as surgeons get.
Read more about rhinoplasty at

http://cosmesisindia.blogspot.com/2007/02/i-hate-my-nose.html

3. Liposuction :
This is another procedure which is often asked for by men and women equally. The areas to be targeted being the famous " INDIAN PAUNCH" and the "LOVE HANDLE'S". Here fat is sucked out from the abdomen and flanks through small 1cm cuts, 2 or 3 of them, depending on the amount of fat that has to be sucked out and the areas to be targeted.
Post operatively the patient is required to wear a pressure garment vest for the next 3 months to help the skin shrink back and as also helping the swelling go down.


4. Scar Revisions:
"Scarface", was a rage once upon a time , though the movie is still a rage, a scarred face doesn't hold the same charm or intrigue it used to. So scar revision is another common procedure performed. But the problem here is that " Once a scar always a scar"!!!! The only way to correct a scar is by not having it in the first place. A scar can only be revised, reduced, camouflaged.. it can never be erased.
Depending on where and how many scars are present various procedures are done to help reduce the scars or camouflage them into normally present facial creases.

5. Problems with deep lines and wrinkles
Fillers ,BOTOX and CONTOUR threads are now equally becoming a part of a man's schedule as a females. Be it forehead wrinkles, laughter lines around the eyes, deep nasolobial creases all are being tackled with increasing frequency.

6. Hair Transplants :
Another area which is very unique to men and very common affliction with genetic and hormonal influences. Its a whole chapter in itself and just enough to mention here that its a time consuming process and needs a very motivated patient to be able to go through with the procedure and wait for the hair to grow to the necessary length and also go in for second sittings as and when required.
Nowadays, follicular hair transplants are being done where a strip of skin from the back of the head is taken out and from it single hair follicular units are dissected out and transplanted into the bald areas.

Apart from these common operations, other procedure performed for males in varying frequencies are chin and malar implants, jaw reshaping, dermabrasions, calf augmentation , lip reductions, penile lengthening, etc.

So to wrap it up, cosmetic surgery for men is on the rise and is here to stay. But as mentioned earlier properly motivated patient with valid reasons to have a surgery will have the best effort to satisfaction ratio.

So men don't need to be ashamed of attempting to look good. You are not the first one taking the decision to undergo a cosmetic procedure and believe me you wont be the last. But educate yourself properly as to what can be done safely and who is qualified to do it.

Along with proper diet, nutrition , exercise, grooming and clothes, a cosmetic procedure will definitely help in improving one's own body image , helping you feel good about yourself when you look in the mirror or wear that tight t shirt when u go to the gym to work out.


Dr.Surindher
www.cosmesisindia.com

FREE Cosmetic Surgery Consultations for Women

Cosmesisindia proudly wishes to announce


FREE Cosmetic Consultations for Women


on the occasion of " World Woman's Day"

I. On 4th March Sunday 10 AM - 1 PM

Venue : The Bangalore Hospital, 202 R.V.Road, Bangalore, 4

Contact: 41187628 for registration and details

II. On 11th March Sunday 10 AM - 1PM

Venue : The Apollo Clinic, 51. Jyothi Nivas College Road, 5th Block Koramangala, Bangalore -95

Contact:25633833 for registration and details.



Dr.Surindher
www.cosmesisindia.com

Body Piercing and Body art !!!!

BODY PIERCING

" Doc, I got my belly button pierced at C. Street and now its got infected, I'm afraid!"

" Doc , I got my ear pierced at my local jeweller, now its paining and scar is growing!"

Very common complaints that one sees in consultation room's. Is it avoidable? Is it necessary? Is it just a fad that youngster's get into? Well, not really..!

Body piercing has been in vogue in our culture from times immemorial. So also the case in many other civilizations across the ancient world as a way of beautifying the body.

But now it has moved to a different level with people becoming more adventurous and wanting to make a statement. It may be done alone as in most of the cases or in some cases as a part of a whole body modification process which is the other extreme.

Piercings can be done in different areas of the body depending on the personal preferences. The most common in INDIA being the ears, nose and navel. The more adventurous go onto to the lips, cheeks, eyebrows and even genitals.

Though a very simple procedure in terms if it being done, there are lots of things that can go wrong if not done properly by properly trained professionals. It has to be done by people well versed with the anatomy of the part, versed with sterility techniques and after care.

From the point of view of the person undergoing the piercing, some points to remember.

Know what you want , understand the healing time for the piercing, take care of it as advised, don't neglect any problems that you might have with it and don't remove or change the jewelry until it has completely healed.

Healing time after a body piercing varies according to the pierced area. Ranges from 6-8 weeks in the ear or eyebrow to a year in the navel and ear cartilage. In this too, there is the initial healing phase which lasts for a week or so where the body forms a lining to cover the raw area, but it takes the specified amount of time for it to heal completely. This healing period will be explained by the surgeon performing the procedure.

Though it is a simple procedure certain problems can occur, which should be kept in mind before undergoing the procedure. The common ones being infection ,non healing and Keloids. Care should be taken to have it done from properly trained personnel to prevent infection. Secondly till the healing is complete do not change over to normal jewelry.

Keloids are scar tissue that continues to form even after the healing process and some areas and some people are very prone to form keloids. As of now there is no effective way to cure Keloids, they can only be controlled.

Points to remember :

1. Read about the procedure and assure yourself that you want it. Remember that once done it's going to be there for life if not the jewelry, at least the scar.

2. Always go to a qualified professional or a surgeon. Most importantly if the centre looks unhealthy or dirty ...Walk right out.

3. Allow the piercing to heal properly before you change the ornament.

4. Clean the piercing regularly as advised and don't neglect any signs of infection or pus

5. "Spin" the ornament (turning the jewelry to allow the ointment to reach all areas of the piercing) as advised regularly.

6. Look for jewelry where the gems are mechanically set into the metal rather than glued. Glued jewelry cannot be sterilised

Remember you can rush yourself and the surgeon but you cannot rush your body to heal! So, give it proper time according to the area.

Daily Care Routine

· Do not touch your piercing unless you are cleaning it.

· While healing, your piercing will need to be cleaned once daily.

· Cleaning more often than this will harm your piercing.

· You will need to use an antibacterial soap (e.g. Dettol Liquid Soap).

1. Wash your hands with antibacterial soap and wet the piercing with luke warm water.

2. Put a few drops of antibacterial soap on the piercing and work them into a lather with a cotton bud(ear bud).

3. Try to loosen any crusted discharge and tease it off the jewelry and your skin with the cotton bud.

4. Leave the antibacterial soap on the piercing for a few minutes while moving the jewelry back and forth( spin), allowing the disinfectant to penetrate the piercing.

5. Rinse with water and air dry thoroughly. Do not dry with a towel, which may get entangled and pull on the jewelry and may also carry bacteria.

So the best way to have a beautiful body accessory is to be educated about the procedure, knowing what you want, taking care to get it done by qualified professionals, using proper medical grade jewelry and not neglecting any problems that may arise.

By keeping in mind all the necessary points in mind you will be able to make that statement, look sexy, look different and at the same time keeping your body safe.

Dr.D.S.A.Surindher
http://www.cosmesisindia.com/

Take care of ur skin.!!!!!

SkinCare
Skin is the largest organ of the body, it forms the protective covering over our body and bears the brunt of all that we do and all that we consume. So, care of this protective covering is as essential as taking care of your cholesterol or your blood pressure though the ill effects of not doing so, are not fatal.

The condition of the skin also reflects about the general health of a person. When a person is happy and healthy you find people commenting on how glowing they look and similarly a person who is sick, they can be seen to have dry dull lifeless skin.

Basically, there is not much that it asks you to do for it and most of the time it looks after itself. Even in the ancient times all major civilizations have had their own methods of skin care, which have been written down in their texts. But going down to it, the basics have always remained the same.

But firstly we have to understand the different skin types. Normal skin is clear, soft, supple, uniformly textured & pigmented, neither too oily nor too dry. Normal skin is not too sensitive to climate, cosmetics or the body’s own internal environmentDry skin is dull, feels tight on washing, even with the mildest of soaps flakes, scales and chaps easily. Oily Skin feels relaxed and supple,but thicker,looks shiny and is much more prone to outbreaks of spots. Mature Skin is leathery and has wrinkles and folds, loss of elasticity.

Understanding the factors which damage or affect the skin will go a long way in understanding the care which has to be taken.

External factors most important of which is the sun, which causes photodamage to the skin because of UV rays and the next being pollution and dust. Apart from these, are air conditioning which causes dehydration of the skin, smoking , stress, late hours, etc all of which harm the skin.
Internal factors like diet which forms the major form of insult, not enough intake of water, minerals, vitamins and taking too much of junk food and alcohol. All these damage the skin or inhibit its reparative capacity, hence there is no time for the skin to recover from one insult before another is added.

Skin care can be divided into generalized care and then local care.

Generalized care- being in the form of eating healthy, drinking plenty of water at least 3 liters a day, eating plenty of green vegetables and fresh fruits, which have antioxidants. Avoiding smoking goes a long way in getting healthy skin because, apart from the fact that smoke harms the skin it also produces constriction of small blood vessels in the skin. Vitamin C is very good for the skin as it is important for regeneration as well as the fact that it is the most natural sun block one can get which acts from within the body.

Local care- basically consists of cleansing, toning and moisturizing.

Cleansing and toning - Wash the face with a mild unperfumed soap, lather briefly and rinse thoroughly. Because soap is an alkaline substance, washing will temporarily raise the ph of the skin, which is normally slightly acidic . Most skins have an inbuilt ability to readjust the balance within 20 minutes of washing, though sensitive skin types take longer. If the skin is oily, citrus based toning lotions or astringent can be used after cleansing.
If the skin feels dry and tight after washing, try using a super fatted soap that incorporates emollients such as lanolin or mineral oil into the soap base. Other causes of dryness are over washing, incomplete rinsing, hard water (calcium and magnesium salts in the water combine with the soap to form a drying scum on the skin) or sensitivity. In case of very dry skin try a cream cleanser.

Moisturizing - Moisturizing cream is used for dry skin and lotion for oily skin. All moisturizers can be made to work more effectively by dampening the skin first

The use of exfoliating agents to peel the epidermis & superficial dermis dates back to ancient Egypt. Sour milk baths were used by ancient Egyptians to soothe the skin. This helps by removing the dead cells which are clogging the new skin giving you a new glow to the skin. It can be either mechanical or using various agents commercially available in the market. This need not be done everyday.

Sun Protection- Dark skinned people have natural pigment which acts as protection but even then sun block will help prevent damage to the skin as has been proven by studies. Sun block or sunscreen with an SPF(sun protection factor) 20 to 30 should be used, unless you are planning to go to the beach or swimming when a higher SPF would be useful. The sun screen should be ideally applied at least 15 minutes before one goes out into the sun and should be reapplied every 3 hours.

Some people might say that they are in cold climates or if cloud cover is present, you don't need sun protection. the statement is False, UV damage can occur even other wise and reflected sunlight is enough to cause damage so using sun screen will go a long way in protecting your skin.

Taking care of your skin will go a long way in keeping it healthy and preventing the inevitable signs of aging from creeping in on you suddenly. Yes, turning back the clock or rather keeping it at the same hour for a longer time is possible to a certain extent naturally, by some simple measures.

So take that few minutes out from your daily routine and pamper the largest organ of your body.

Patient Talk- Post 1- Tummy Tuck

This was a feed back I got from a very sweet patient of mine. SO i thought I had to share with you all. And she even offered to talk to anyone who is contemplating a surgery.

I thank her for her kind comments. SO here goes.....She call's it...

Absolving the Ab

All my life, I had always been careful and particular about my appearance, though only to the point of looking well-groomed and neat. My self-esteem needed that and so did the job I was doing.

After my son was born, for ten years now, every morning, when I looked in to my wardrobe trying to decide what to wear to work, I would get in to a fit of depression. None of my favourite blouses fit well any more, my favourite trousers wouldn’t hide that bulge any longer. I am not fat as in fat, I was alright from the front but I hated my silhouette from the side as there was no hiding that tummy, the big fold of skin in the lower abdomen that no tights or body shapers could flatten. I would settle for clothes which were made of thicker firmer material, 2 sizes larger than what I should actually wear, desperately trying to hide the ab’s abnormalities.

I have been in to exercising for as long as I can remember, inconsistently yes, but enough to realize that no amount of crunching had any effect on those bulges. That’s when I read about abdominoplasty.

As the days went past, and fitness caught on as a raging fire in India, I saw more and more folks my age around me, doing things to get fitter and look better. I felt more compelled to do some thing and soon. Every time there was a milestone in my life, I would say this is the time to do it.

But then fear of pain from past surgeries (have gone through 2 earlier) and lack of enough awareness about these options, would scare me away. I would put it off.

Another reason I was putting it off each time, was because I was misguided in to thinking that I would need to take 4-6 weeks off to do this. Given my current commitments, there was no way I could afford to take this much time off for something that wasn’t mandatory.
So came another of that milestone thing and here I was reconsidering surgery. I said I would at least ask around and gather information afresh. That’s when I chanced upon the website of “Cosmesis India( www.cosmesisindia.com)” – a group of doctors in India, with a presence in Bangalore who were in to cosmetic and plastic surgery.

I decided to go for a consultation – a single consultation wouldn’t harm, would it? So I was talking to Dr. Surindher and I went to meet him. He confirmed the same inference – only surgery could get rid of that skin fold. When I asked him the benefits of this non-compulsory procedure, all he said was that his earlier patients came back and told him that they can now look at themselves in the mirror without hating themselves. He also said I would recover in 1 week – I could go back to normal routine in a few days as opposed to the 4-6 weeks I had heard earlier.

So this is quite feasible, isn’t it ? – I began thinking. The more I talked to the doctor, the more convinced I was that I wanted to do it now and with this institution.

I was very apprehensive about the whole procedure, knowing fully well what a surgery entails having been through 2 earlier. I knew I wanted to do it – been wanting to for years now. After talking to the doctor, I was quite convinced now that they only way to get rid of the ugly bump in my lower ab was through this surgery, but garnering courage to face it was quite a feat.

I must thank the doctors(anaesthetist included) for trying to put me at ease. They assured I will be covered by pain killers for the first few days. I am terrified of pain, so no matter what they said, I WAS terrified.

But somewhere at the back of mind, based on the diagnosis and explanation of the doctor, I knew I had to go through it. So I mustered courage and prepared to face it. Having thus made up my mind, I tried not think anymore about the decision…I did not let anyone talk me out of it.

I went through the pre-op motions like an automaton – trying not to let my mind think..blanking out completely. Actually on the operating table as I waited to get in to the OT proper..I shut my mind, closed my eyes and drifted off to sleep until a nurse woke me up.

Then I was asked to pose for “Before” pictures, I wish I could have seen my own dead-pan face at that time..pity the doctor took pictures of my ab only.

During my previous surgeries, I had tried to fight the anaesthesia…but of course nobody wins the fight, just that it takes longer to settle down in to that deep sleep and I used to come around out of it in quite a troubled way.. So this time, I just decided to give in to it quietly and calmly.
But I do know I was breathing hard out of tension, again both the Surgeon and the Anaesthetist tried to relax me. The Anaesthetist, true to his word, fixed the IV with little pain and then gave me heads up that he was going to give me anaesthesia. I then just closed my eyes and let myself fall asleep. And I did, real real quick.

When I came around, it was trouble less and peaceful this time. I looked around, strange surroundings, I knew I was in the post operative ward. I asked the nurses for the time, they said 3.00 p.m. and I was like..Wow…I remember only up to about 10.30 a.m. I kept feeling thirsty and wanted to keep sipping some water.

Not much of pain, just a weird feeling lingered. Then, they wanted to shift me to my room. This was quite a job and since they moved and jostled me a little bit, it hurt.

Then I was back in my room, but kept drifting in and out of sleep. Did not feel nauseous until the doc asked me if I was..then I did. Retched and puked a few times – this hurt too. The doc said that he thought I must have been cursing him. Truth is, I wasn’t cursing him, but the agony of it all had begun to catch up with me, and I was beginning to curse myself for the decision to get this surgery done.

Can I forget the mother of all surgical agonies ? The IV drip and the endless bottles the nurses keep changing ? Needless to add, the thrombosis and the coldness in the arm. I couldn’t sleep at all, kept looking at the fluid go drip drip drip into my other arm (cause the previous one had already bulged). My thoughts on whether all this was really worth it, began to strengthen. I begged the nurse to not add another bottle, but she wouldn’t give in. She finally did, at about 3 a.m., only after which, I fell asleep.

Second day – I woke up to a good cup of coffee. The nurse promptly came back and started the drip again. Legs and whole ab area felt like dead wood. I noticed there were two blood drain pumps on either side of me and one end of each… long tubes..were inside my ab!!! Yes, really inside. The nurses came frequently to clear the blood that collected in these pumps. Wasn’t a pleasant sight for sure.

And you know what was more frightening than the sight of those pumps ? The thought that they had to come out sometime and surely that wasn't going to be painless. Then another doctor came- I did not know what he was up to, but he was trying to get me to sit up. Sit up, can you imagine that on the very next day ? – he explained that it was necessary to move to ensure the seeping blood does not clot. But I just couldn’t, was feeling so tired and faint, not to mention the pain. It was such a big effort, thought I will just pass out. After a lot of hard work, I was finally on my feet, but then I couldn’t walk !! Fear..nothing else, the doctor assured me. He helped me sit in a chair, wasn’t too bad once I sat down, just a very tired feeling. So that was my first attempt at getting out of bed post surgery. Of course, I got back in to bed with some difficulty(nurses again helped me a lot here), vowing never to get up again !!

But no, come evening, and the doctor had a mind of his own !!! He promptly came and made me get up again, this time made me walk a bit too. Not too bad again. Slept peacefully that night because I had succeeded in cajoling them in to removing the IV drip even though I could still see a couple of bottles remaining on the table. To top it, he made me put on a tight garment on the abdomen as if the existing agony there wasn’t enough. He said that was important to keep the swelling in check. Yeah ok..whatever !!

Day three – so far so good. My worst fears were going to come true…the doctor came by again – this time with an agenda to remove those tubes stuck inside me. I was hoping he wasn’t serious but he was. He wouldn’t give me local anaesthesia, said it won’t pain much. It did – to be honest – not much though. But like I had been reassured, I was indeed feeling less constrained now and bolder to sit up, walk about a little more.

That night, I couldn’t sleep – was this all worth it ?? That question kept coming back to me.

Day four, woke up to renewed energy, got up, freshened up and was cleaning the room. Yes, cleaning the room myself, putting things in proper places. The Doctor walked in on me, he said he was happy to see me up and about. I forced a smile on my face.

He said I could go home.
So again, I went through the process of getting discharged like an automaton. Reached home – climbing 2 flights of stairs – was in deep pain.

Physically, I was a lot more comfortable now. And I actually began realizing that the tight pressure garment that the doctor gave me, was indeed helpful in feeling more secure about the tummy whenever I moved.

The medicines I was asked to take, covered most of the pain unless of course I was delaying the next dose. There was intense burning under the skin of my stomach some times. There was also the feeling of lots of creepy crawlies playing under the skin – this was something the doc had warned me about. If not for his warning, I would have surely been petrified by that feeling – since its truly weird and something one wouldn’t have experienced earlier.

A few more days passed. Each day, I was visibly feeling better physically. I was moving around more and more. But what about my mental state ? Still confused, as I was feeling like there is a big block of dead wood tied to my stomach. A few folks who visited me did say I looked like I had lost weight – that did not help much. Also, the next event – Suture removal, was on the top of my mind now. I had had a bad experience (appendicectomy) – a very painful suture removal it was. I now couldn’t think of anything else.

I talked to the doctor about it and he suggested I apply a local anaesthetic cream before going for it. So, I did that and went to see him..gingerly…tensed. But just as he said, it wasn’t bad at all. Only thing was, he revealed then, that there is an inside layer of sutures that he would remove a few days later. My heart sank again (how do you apply local anaesthetic cream for internal sutures ??)

So one week had now passed, I was back to doing my usual stuff at home but did not feel good enough to go to work – so I decided to take that week off too. Stayed at home, relaxed, read, ate, slept – blissful existence, coming to think of it. But wait, what about my mental state again ?

That was worse, none of my clothes fit – I was so miserable. Here I was thinking I would be trim again and may have to buy smaller sized trousers, etc – and none of my existing clothes fitted..they were actually tight !!! I cant explain in words, how disappointed I was. So was all this effort just to come to this point ???

I asked the doctor this, he said, it’s the swelling, which will subside soon and I shouldn’t worry. But to us women, unless we actually can get in to those sizes we want to and zip up easily, no amount of anyone else telling helps. I tried not to be miserable, kept trying to hope based on what the doctor said.

New years eve came, decided to get out of this place as I badly needed the change, the doctor said it was ok to travel short distances if I were flying. I did get a change from the miserable disappointing feeling I was having though I still couldn’t sit up or move around for too long without having to lie down flat on my back at regular intervals.

Second week was over too, had to go back to work – also had to remove those internal sutures. Again, I applied the local anaesthetic cream and went to see the doctor on my way to work that morning. Yes, it did hurt a bit more burning than pain though. Subsided quickly and I went to work.

So I went to work wearing my loosest pair of jeans – others still did not fit. Everyone I met remarked that I looked trimmer. But remember that supreme validation that only clothes can give to women ??? I wasn’t convinced still.

The first few days at work were trying. With every passing day, it improved dramatically. By the end of the third week, I was feeling almost normal. Buoyed by this feeling of normalcy, I began trying my other old clothes again. Voila, more were fiiting me now and better than before !!! This edged me on and I mustered enough curiosity to try the acid test – my sheer georgette saree – which I had long given up wearing since georgette has no mercy on unwanted bumps. I actually wore the saree, looked at myself in the mirror – and…and…. I couldn’t believe my eyes !!! It was so nice, my stomach and the whole mid-section looked so neat, due to which the saree draped so well !!! Cry, I did… I wish I could have danced too at that moment. So was this really true ? Had I gotten my contour back after more than 10 years ???? I kept rechecking to confirm. I was thrilled !!

I hadn’t felt that happy in a long time. Believe me, it does wonders to one’s self-confidence. The first person I shared this with was my doctor, without whose firm and gentle support, I couldn’t have gotten to this point at all – I would have chickened out some time earlier and continued to be truly miserable about my tummy for ever.

The fourth week has just ended – a very significant month has flown past !!! I did go and buy a pair of smaller size trousers and a blouse last evening !! And when I try them on now, I cant help spiraling around and preening in front of the mirror. I looked trimmer, firmer and shapelier – therefore younger.

The most impacting comment I got – my father remarking that he felt I was now looking more like his young daughter’s image that was imprinted in his mind (an image that had frozen a few years back for him). Did I need more validation ???

It was worth it after all !! Well and truly worth every moment of it !!

I feel on top of the world !!! Something has changed for me this year...can you guess what ???

Dr. Surindher, Cosmesis India and Bangalore Hospital, Cant thank you folks enough !!!!
I wish more and more women will come forward to help themselves. We are worth it !!

aashu

aashuthegreat@hotmail.com

Who's Up for a Makeover??

Often wondered about the whole " Cosmetic Surgery thing???"

Well here are a few questions answered and few points one should know before considering a cosmetic procedure.

Q. What is the difference between cosmetic surgery and reconstructive surgery?
A. Cosmetic surgery enhances specific features to improve one’s appearance and boost one’s self esteem. Reconstructive surgery is done to provide or improve / restore form and function in patients affected by birth defects, trauma, tumors, infection or developmental abnormalities.

Q. Who is a good candidate for cosmetic surgery?
A. A good candidate for cosmetic surgery is one who understands the procedure, is realistic about the expectations and risks of surgery and of course is motivated by his/ her own desire. Also, the candidates must be willing to follow orders and willing to tolerate unavoidable inconveniences like healing time, time for the swelling to come down, avoiding exposure to direct sunlight, refraining from smoking, etc.

Q. Will it hurt?
A. During the procedure our anesthetist’s will ensure that you are comfortable and feel no pain since you will be asleep. In cases where local anesthesia is used only the initial discomfort of a needle prick is felt. After surgery any pain or discomfort you experience will be dealt with by medication and usually subsides within a few days.

Q. How soon can I get back to work?
A. Depends on the procedure done. In procedures not requiring hospitalization, usually 2 – 3 days is enough, but larger operations may require some additional time away from work. But remember, you can rush urself and the doctor but u cant rush ur body to heal. So, give it the necessary healing time.

Q. How long before the final result can be seen?
A. This varies with the type of operation. Generally, there will be swelling and bruising for some time. 80% of the swelling abates within a few days, but it takes 3 – 6 months for the final results to be seen.

Q. Will there be scars?
A. Yes, but they probably won’t be noticeable. All efforts are made to keep the scars as minimal as possible and to try and hide them in natural lines and skin creases. In majority of the cases the scars settle with time and are barely noticeable. In few cases they might become hypertrophic, this depends on the person’s healing capacity. So, if you have any hypertrophic scars please bring it to the notice of the surgeon.

Q. Are there any risks and complications?
A. As with any operation, there are risks. But in an otherwise healthy individual there is no increased risk of any kind. The most common risks are anesthesia related, bleeding, infection and significant scarring. Though these are infrequent, they do occur sometimes. Since potential complications vary with each procedure, these are usually discussed with you at the time of the consultation.



Points to ponder before coming for a consultation:

# Take some time to think about the specific problem you have.
# Think and mark the specific attributes accounting for your dissatisfaction with your appearance.
# Have realistic expectations.
#Be ready to bear the inconveniences related to the procedure like healing time and to refrain from smoking temporarily.
#Examine the benefits and limitations of the procedure and carefully weigh your options before making a decision to undergo a procedure.
# Each patient, operation, surgeon and result is unique.

SO make it a pleasurable experience to yourself by taking care fo these things and preparing yourself for the procedure so you can enjoy the benefits of it.


Dr.Surindher
www.cosmesisindia.com

Why is Cosmetic Surgery still on the Taboo list in India?

Is the above statement true??? Why is Cosmetic Surgery still on the “taboo” list in INDIA?
Is undergoing a cosmetic procedure a bad thing?? I think not. If that were the case then the insurance companies would not be excluding cosmetic procedures from their purview. It goes to show that even the medical insurers are aware of the fact that if given a chance many of their clients would be willing to undergo a cosmetic procedure.

A few years back there was an article in a leading magazine written by a socialite about “ the Great Indian cover up!” It referred to the common dress in India, the salwaar kameez, which worked well in concealing a lot and also worked well in covering up a lot of excess baggage, only to be revealed after marriage.

Well, as more and more people, especially women are coming out to work or party and the attire changing from the traditional salwaar to a more corporate one and trousers, jeans or even our traditional Indian sari in a new look becoming the norm, the Indian woman is being uncovered.
Now, people want to look good in their new roles be it as officers or corporate employees or even as young mothers, let alone celebrities in the limelight like, actors or models. Also, it is no more a bastion of the fairer sex, so to speak.

Even the “ metro sexual “ male of today is bothered about his appearance, be it a paunch, a receding hairline or a crooked nose. Keeping fit, being healthy and looking good is the “ new mantra” of the young and not so young generation equally. This can be seen by the tremendous increase in the number of procedures performed on men in the last few years.

Does cosmetic surgery really have an impact on person undergoing the procedure?? Sure it does. Ask the teenager who wears a cap so his scar doesn’t show, the lady who wears a baggy dress to cover her love handles or post pregnancy stretch marks or an adolescent boy who doesn’t go swimming at school because his friends tease him about the little excess breast tissue he has. In some cases the psychological impact is huge and very palpable.
Let us examine a bit more closely the enigma called "Cosmetic Surgery". Yes, it is not necessary like maybe a cardiac bypass or an appendicectomy, but it sure helps the person it is intended for.

An ideal cosmetic procedure is one, which tries to correct the problem but, preserving the attributes, which make the person the individual, he or she is.
But, care has to be taken from the patient’s point of view to the fact that they understand the procedure, they are realistic about the expectations and risks of surgery and of course are motivated by their own desire

Is cosmetic surgery associated with any risks? Yes, as any other surgical procedure a cosmetic procedure has its share of risks, which any plastic surgeon operating on a patient will always explain. But, the risks are not always appreciated because the procedure is not “a necessity”. This is the reason why a complication, which may be accepted elsewhere, is not accepted in a cosmetic procedure. But, these instances are rare.

The problem if any is not because of cosmetic surgery per se’ but more because of it not being done properly and not being done by qualified personnel.
With so many “Cosmetic centers” burgeoning all over the place, people tend to be enamoured by the so called “ guaranteed results” which is shown in block letters and miss out on the “ results may vary from person to person” which is in small letters in one small corner of the advertisement.

Hence being well aware and educated of the procedure is the first step before you actually go ahead with the procedures. There is enough and more information available on the World Wide Web about all these procedures, which will help you know, about the risks, problems and results.

So, cosmetic procedures like any other surgical procedure require proper personnel to perform it, along with all the proper pre and peri operative care. It also requires co-operation of the person undergoing the procedure in terms of regular follow-ups care as advised by the surgeon and undergoing minor inconvenience in the form of quitting smoking or alcohol or fatty / junk food.

Also, the candidates must be sure of the credentials of the surgeon and most importantly should be willing to follow orders and willing to tolerate unavoidable inconveniences like healing time, time for the swelling to come down, avoiding exposure to direct sunlight and refrain from smoking, etc.

Cosmetic surgery is no more only for the rich and famous and is here to stay, with more and more people going in for that nose correction, tummy tuck, breast augmentation or liposuction.
Combined with proper nutrition and exercise, an aesthetic procedure may help you look good, feel better about the way you look and improve your overall self-image. It is not a fly by night operation and is definitely not a miracle solution as nothing in this world is.

Cosmetic surgery is coming out of the “ taboo” list as can be seen from the fact that China hosted the first ever “Ms.Plastic Surgery Contest”!!!!
There is no need for it to remain an enigma!!!

Dr.Surindher
www.cosmesisindia.com