Risk Benefit Ratio and Regular people

Hi all...

Welcome back to my blog.

This is in continuum with my previous blog regarding the program related to Cosmetic surgery. Now, in this blog, let us address the issue of cosmetic surgery as related to the “regular Joe or regular Jane” if I may.

Because of my first hand interaction with the people opting for cosmetic surgery , operating on them and then following them up, I would really like to put to rest a few common notions that are doing the rounds and which were also highlighted in the program.

1. Not on impulse: Contrary to what one may believe, none of my patients to date has come to me asking for a procedure just as a dare. Nor for the fact that they just woke up one morning and said..” Hmm what can I do different today.. OK!!! let me get a nose job!!” Most, if not all of them have had it in the back of their mind to do something about it and they would have thought about it many times even before picking up the phone to call for an appointment. This is true even for the west but more so in our country..

2. For others: It's usually said that one was forced to get something done by the husband, wife , mother in law, friend, so on and so forth. From what I have seen the actual percentage of people actually forced is minuscule. Most of such instances are only the final call that brought them to my office, which could be the husband or the wife. On inquiring more, its seen that it was something they themselves had been thinking about for quite a while. And as a rule I DO NOT operate on a patient who comes seeking a correction because someone else suggested it.

3. Only for Narcissistic People: I sincerely feel that everyone first has to love themselves before they can love others. If one feels good about oneself then his or her outlook to life changes. There is nothing wrong in trying to look good. One might argue that its whats inside that counts... Never judge a book by its cover..!!!
   

4. But talking honestly, who has the time nowadays to really see inside? STOP .. Read this carefully... I'm not saying what's inside doesn't count... what I am saying is that, in today's fast paced life no one has the time to really see inside. It's like choosing amongst the so many books lying on a book shelf. How does one pick up a book to read what is inside??? Yes... it's by looking at the cover. Once the cover has caught your attention, then it's easier to find out what's inside. Of course, if the content is worthless then anyway doesn't matter cover or no cover. Similarly beauty plays an equally important part in our daily lives to bring people closer to one another , to get to know the qualities one possesses.

5. Only for women: A totally wrong statement. Nowadays we have more men coming in for cosmetic procedures than ever before. Previously we used operate on 1 male for every 10 females. Nowadays we operate on 5-6 men for every 5 women. In many cases the wives come with their husbands. Yes the “ Metro sexual Male “ has arrived.

So , it would be very wrong to judge anyone without knowing their reasons for doing anything. And it cannot be an easy decision to take, be it for a female or a male. Unlike the west where mostly the decision to do a certain procedure is only limited to him or his immediate spouse, here the whole family and relatives have a say. People who have had surgery done and have lost weigh or look fitter, wouldn't want anyone to know that it was because of the surgery. They would rather talk about how they starved themselves and put themselves through a fitness regimen in spite of their busy busy schedules. That shows that the acceptance levels are still low. But anyway after a few days everything is forgotten and people move onto the next best thing to criticize.

It's sad that we criticize any effort anyone makes to look good, but at the same time if you look at the matrimonial columns and the glitzy advertisements, one can see the hypocrisy existing in our society.

But, the heartening fact is that (notwithstanding the so called “moral brigade”) at least in the general population there is more tolerance to the way people are reacting to what others do. Isn't it what democracy is all about? Accepting people for what they are and allowing them to do what they feel right without injuring or hurting others. But, then again its digressing from the topic of this blog.

So ,to put it in perspective, whether one likes it or not, this is a branch of medicine that is here to stay and grow. And medically speaking, it has improved how we treat reconstructions. Reconstructive surgery down the ages was always more concentrated towards function rather than aesthetics. But now the trend is changing to make reconstruction aesthetic too, along with being functional , which is a welcome change, be it in a child with a cleft lip or a man with a crushed hand.

Controversy regarding whether it is good or bad will be on for a long time to come. As a person involved in providing the service I would put in as a procedure which gives best results for those in whom it is indicated and for people with realistic expectations with good awareness of the pro's / con's and options.

As long as the complications do not outweigh the risks involved I wouldn't mind doing them, which again brings us to the “ RISK BENEFIT RATIO” which is not as skewed in favor of a procedure as in celebrities . So awareness is the key, knowing all your options is the key and of course knowing whom to go to for the said procedures.

So for anyone out there contemplating a procedure, go meet someone qualified to do your procedure, do your due diligence in finding out all you can about the procedure.

Once you have done that, do your own Risk Benefit Ratio analysis. It will help you take an educated decision about your procedure. And trust your doctor and share all your doubts with him/her and make that educated decision.

And remember it “HAS” to be “YOUR” decision ,,, not your husband's/ wife's/ relative's / friend's or doctor's decision.

'm sure everyone has a point of view on this and would really appreciate comments.

Dr.Surindher

Bolly wood Nip Tuck and the Risk Benefit Ratio !

Hi all...

Sorry for the long break...!

Day before yesterday I was watching a programme on a news channel dedicated to Bollywood stars undergoing cosmetic surgery to improve their looks.

The issue was that is it a good thing and also if they should do it. Second part of the programme was discussing about the fact that men and women ( regular people) are going in for cosmetic procedures more now than in the past. Let me also divide the issue into two parts.

The issue reminds me of one of my earlier posts....

Cosmetic surgery a Taboo??

So taking off from there after seeing the programme I though I could pen down a few of my views on the topic....Open to comments of course!!

I personally feel that there is no need to make such a big issue about it. The first thing that we need to realise is the fact that we cannot equate them to the regular joe's and jane's. A cosmetic procedure for most of these people might be something that they do to further their respective careers apart from the fact that it might be something they did want to do even otherwise. This is a facts that we know when we interact with the people from the "glamour industry".

They have to look good to stay in the business its a plain and simple fact. We could be all judgemental and talk about the cliche's like " Inner beauty is what matters! / If you have talent it will take you places.." and all that.. But, fact of the matter is that though you cannot judge a book by the cover a good cover definitely makes people reach out to it to at least read a little to find out whether the contents are good enough. Secondly if they were not without talent they would not survive anyway not by looks alone but good looks can definitely compliment talent.

Would any of us complain if Sachin bought a new bat to help him score better?? I don't think we would . So why complain when bollywood stars are getting cosmetic surgery done on themselves to help their careers? Yes, it is not as simple as buying a new bat& hence that brings us to the so called " Risk benefit ratio".

The "Risk benefit ratio" is a factor which will help decide whether to go ahead with the proposed procedure for that particular individual. I'm sure all plastic surgeon use this in their own ways to assess the need to do any procedure or anyone.

The Risk Benefit Ratio is used to see if the benefits in doing a particular procedure on the said individual is worth the risk to make it justifiable to that individual. In the case of someone in the "glamour industry" the risk/benefit ratio balance shifts and hence the benefits make the risks worth it which is why people opt for it.

Sometimes the people from the glamour industry are better patients from regular patients. This is because once educated about it they are more open minded to accept the risk and the scars than most of the regular patients who want the best results but totally without the risks. As I always say.. its true for anything in life.. " No Pain No Gain".

But then , we have people like " Micheal Jackson". The host of the show called him the poster boy " for Cosmetic Surgery". I would say that he is a poster boy for "Whom not to do cosmetic Surgery On". In normal circumstances we see about 10% of patients who come in with unreasonable demands but in the segment of people coming in from the glamour industry the percentage maybe as high as 30%. These are patients with unreasonable demands or requests and these are the patients who ultimately end up with problems.

I have people telling me that why this issue is important is because of the fact that people in general can be influenced and they might try to emulate their stars.. But with all due respect to these critics, getting cosmetic surgery done is not as easy as maybe picking up and lighting a cigarette. Its a much more serious and longer process and involves many more people. I think we as doctors too believe and practice ethical medicine where the risk benefit ratio is brought into the picture to help educate the patient and help him / her make and educated decision regarding the same.

Secondly I think by saying this the critics are not giving the general population its due credit. Am sure the public at large is much more mature and discerning.The percentage of people who would blindly follow anything that a star does is very small.

I'm not here to justify anything. Its just that there is no need to make such a big fuss about who's bust is becoming bigger or lips are becoming fuller, as long as they are not hurting anyone else. I think we have that freedom in our country.. at least when I last checked.

So , without being hypocritical, everyone wants to look better and feel good. If you don't believe me just open today's paper and check out the matrimonial columns or check out the social networking sites or fashion and clothing wear and the cosmetics sales. Everyone wants to look the part so to speak.

I have restricted myself in this post to only to the issue about cosmetic surgery and glamour industry. I will talk about the regular people in my next blog to take this discussion further.

I'm sure everyone has a point of view on this and would really appreciate comments.

Patient Speak -III ! " Breast Augmentation"

There isn't a single person in this world who can look into the mirror and go "Fantastic! I love the way I look! There isn't a thing I'd like to change".

We would all like to change one thing or another about our appearance. Say a smaller nose, bigger eyes, bigger breasts, flatter stomach and so the list goes on. However, not everyone is so troubled by their flawed appearance that they actually want to do something about it and change the way they look be it via simpler ways such as makeup and exercise or through slightly less common and more intimidating measures like cosmetic surgery.

Having undergone one such cosmetic procedure about six months ago, I guess I can say I was too troubled for comfort about a flaw I had perceived in my appearance....the size and shape of my breasts.

I have always been very conscious about my looks, I love to dress up and although one of the popular notions is that "Looks don't get you anywhere....they're superficial and not important....Beauty isn't skin-deep...blah....blah". I firmly believe that knowing she looks like a million bucks can do wonders to a woman's psyche, her confidence levels and self-esteem both in her personal as well as work life. The modern woman wants to look her best 24/7 and in today's world where everything has a price, if there's a way by which money can get you something that "god" and nature failed to gift you with, y not go ahead and get it? What's stopping anyone?

People say looks are insignificant...you're gonna get old...you are gonna loose your looks...they ain't gonna stay with you forever. But when you're young and looking good gives you a kick, if something as "insignificant" as a flaw in your appearance becomes a significant cause for your being unhappy and a safe solution is right under your nose, you would have to be of below average intelligence to ignore it.

In no way am I trying to justify letting your flawed looks bother you too much or going under the knife to change this and that, but I believe the bottom line is to live a happy life and if anything is a hindrance to that, but can be uprooted without hurting anyone, it should be done.

It was with a lot of apprehension that I went to meet Dr.Surindher for the very first time. I had never discussed my problem with anyone before and was anxious about several things such as letting someone see my flaws for real for the very first time, the pain involved in surgery, the cost of surgery, my family's reaction to this, etc.

However, Dr.Surindher was very professional and put me at ease very soon after I walked into his chamber. Before examining my breasts, he gave me an overview of the breast augmentation procedure explaining the different kinds of implants, the types of incisions, the expected results,the likely risks involved, common myths about the procedure, etc. I was fascinated by the amount of information he gave me. There was so much I hadn't known, although I had done some research myself about the procedure.I asked him a few questions about the surgery and what happens thereafter and got enlightening answers.

He then examined my breasts, made me try on some sample implants so that we could decide on the appropriate size for me. He also explained to me very clearly in what way the appearance of my breasts would change after implantation. One of the main problems with my breasts was that I had flatness on the upper side of my breasts as compared to the lower side where I was a little fuller. As a result, I've always had to wear slightly busty bra's to give me a fuller look. Dr.Surindher told me that implants would give me a good rise on the upper side of my breasts and also enhance the projection of my breasts to give me a fuller look. After a few trials, my asking some questions and stuff, we decided on a size and I was told I'd have to take up some routine tests before deciding to proceed with surgery. Dr.Surindher had also penned down details about the procedure so that I could review them and perhaps come back with more questions later.

Hence after a very satisfactory first visit, I made up my mind and decided to go ahead with the surgery. Just a few routine blood tests and I was back at the hospital where the physician declared me fit for surgery. Surprisingly, I was hardly nervous the morning I was to undergo surgery. I was thrilled actually 'coz I had never undergone surgery before and was curious about various things including anaesthesia. Once I was wheeled into the OT however, I was completely relaxed and the staff there were very cheerful and amicable and made it seem like I was there to have some fun.

Anaesthesia was hardly disturbing and when I came to after like I don't know how many hours, I was in hell. I don't know if it was just my extremely low threshold for pain or what but yes, I was hurting terribly. I was unable to move any part of my body. I was quite confused actually 'cos I had read women don't go through much pain and are up and about in like 48 hours after breast augmentation.

My breasts felt like lead and my back and arms were rendered immobile. It was sometime in the afternoon when I woke up from surgery and I knew I had to wait at least another couple of hours before I could see Dr.Surindher and ask him why I was in so much pain. I was given strong painkillers and sedatives for three days and while they did ease the pain a little, when the effects wore off after a few hours, I would get all impatient and desperate for relief once again. What bogged me down most was I was unable to leave my bed for almost four days after surgery despite Dr.Surindher constantly pushing me to get up, move my arms, take a walk, etc. I don't know if it was because this was my first surgical experience or due to my low tolerance for pain, I felt more agonized every time I was urged to move around. While I understood that constantly trying to move around would definitely ease the pain and make me more comfortable,it was simply too difficult.

I remember feeling like a school girl at one point of time when I started dreading Dr.Surindher's visits 'cause I knew he'd pull me up from bed and urge me to walk around and try moving my arms. He had begun to be more stern with me 'cause I was always refusing to leave my bed out of fear of pain. I think it was on the fourth day after surgery that I finally decided I couldn't do this alone and asked my mom to come over. She did and I don't know if it was the work of that magic wand all mothers have or what but I felt instantly better after she arrived and showed tremendous progress both physically and psychologically within 24 hours.

The next time Dr.Surindher came to visit me, he was very happy because I was up and walking around pretty effortlessly. I was immediately taken off the strong painkillers and was put on some mild tablets and antibiotics instead. On the fifth day,when I left the hospital,I hardly felt any pain,just a little tightness in my breasts. I had started wearing a supportive bra on the fourth day itself and that made me feel better.

Before I underwent surgery, Dr.Surindher had also explained to me what kind of bra's I should wear to ensure that my breasts are well supported. For a week after I was discharged, I stayed home, took some mild painkillers and antibiotics and kept myself as active as I could. By then I was pretty much able to indulge in my everyday activities and at the end of two weeks I felt well enough to travel by myself to visit Dr.Surindher again. This time, Dr.Surindher taught me how to massage my breasts regularly for the next 6 months and also gave me some creams to lighten the surgical scars under my breasts.

As for the way my breasts looked two weeks after surgery,the projection was certainly enhanced,my breasts were bigger and there was a good rise on the upper side of my breasts(not the flatness I had before) but since a pretty big implant had been fitted into me, my skin was all tented which gave my breasts more of a cone-shaped look rather than rounded fullness. However, Doctor told me that with regular massaging over the next 6 months the breasts will eventually fill up and take on a fuller look.

It has now been about 6 months since I underwent surgery and although I can't say I have been perfectly regular with my massages (twice everyday,mornings n evenings...it ain't easy :-) ), I have carefully followed Dr.Surindher's instructions and have been using the scar-lightening creams he gave me and have visited him for periodical examinations and the progress has been great. Like he said, within a couple of months after I began massaging, my breasts started losing their tented look and took on a rounder, fuller shape.The scars have become way lighter than they were before and will continue to fade over time is what I've been told.

The truth is I'm a much happier person today than I've ever been before. It has been a great relief to ditch the busty,uncomfortable bra's I used to wear before. The surgery and the entire process of healing and development had been a life-altering experience for me and the results were exhilarating. The way my body looks now has done wonders to my self-esteem and confidence levels and this has had a positive impact on both my professional and personal life.

Considering I had several apprehensions about undergoing the surgery and was in hell a lot of pain once i did, was it all worth the trouble??? Hell yeah!!

I'm sure Dr.Surindher can never really completely understand what a big difference this has made to my life. To me, this is the best decision I have ever made and if I had been able to do it sooner, I would have. I feel complete now and absolutely wonderful and one can't put a price on that!!

....................................................................................................................................

Dr.Surindher : - I would like to thank KS for this write up to help other patient's understand the procedure and be of help to other people who might be considering such an option.

The reason I asked her to write about it because this is the patient's point of view. I might write and explain a lot but, when it comes from the patient herself, then the whole experience is different.

She has been a wonderful patient and has been very patient even with my firmness at time understanding that it was for her own good. So as always, I once again take the opportunity to thank all my patients and for her article, especially KS.

Read more about breast augmentation on my blog http://cosmesisindia.blogspot.com/2007/02/mammamia.html

Patient talk- II

Hi Doctor Surindher,

I have written a testimonial for the rhinoplasty procedure. I hope you publish this on your website so that others can benefit from it too :)

Regards,

P.

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I am very grateful to Dr Surindher and Dr. Shekhar for the change they have made to my appearance. My nose was hooked and too long for my face, and I wanted to get it corrected by means of cosmetic surgery.

After reading a lot on the internet about the procedure as well as patients' experiences, I decided to go forward with it. I mailed doctor Surindher about my problem and got a very prompt reply, after which we fixed an appointment to examine my nose. Subsequently, I underwent reduction rhinoplasty to correct the hump on my nose.

After the surgery, I had a plaster/splint on for about a week, after which it was removed and I must say, I was very satisfied with my new nose. I didn't experience any pain as such, because of the pain killers administered to me during the first 5-6 days.

It's been almost 4 months since I was operated on, and everyone compliments me about how perfect my nose looks on my face--and there are absolutely no marks left-over from the surgery.

If you're looking for a nose job too, my sincere advice is to have complete trust in your doctor and have patience to see the full result.

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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

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/

Mamma...mia.!!!!

Since times immemorial breasts have always held the fascination of mankind irrespective of the age. And the fact is just as true today as it was many years ago. But the only thing that has changed is the fact that women themselves also are starting to take notice of them. So let us examine and learn a few things about breast augmentation or as it is fondly called " A boob Job!"

Who undergoes a breast augmentation….?. Is it the celebrities or routine people?? What drives them to get the operation? Do they understand the risks involved and about the procedure???

For the first question the answer is no! It is not only the celebrities, but routine people, the housewife, the teacher, the software engineer, the doctor… people from all walks of life who undergo the procedure.

What drives them to get the procedure done?? Well a few have pathological problems in the chest area and hence have to go in for an augmentation. But, majority of the women undergo the procedure because either the volume was less to start off with or decreased with age and multiple pregnancies or sudden weight loss.

What drives them is the fact that breasts are a sign of femininity and these women feel that the decreased volume of the breasts affects the way they see themselves.

First of all let us understand some facts regarding breasts :
1. Breast size is variable in people and there is no fixed size which is the norm. Several deciding factors like the amount of breast tissue, heredity, how fat the person is and the fact that whether the person has been pregnant before all contribute to breast size. And of course age is a contributing factor as always

2.There is nothing like a perfect breasts.Usually perky breasts without a sag and nipples pointing forwards and a little laterally are acceptable as the norm but they vary with the size. Small perky breasts look good if the person is thin but not on a well built female. So its all about proportion.

3. 99.9% women have asymmetrical breasts the left usually being larger than the right. The nipples may be erect, flat, inverted, the areola may be large or small, with or without few hairs growing long, or the areola may be bumpy all of which are normal.

Regarding understanding the procedure and the risks involved, I’m sad to say that though most of the patients are educated women, hardly 10% of them really know about the procedure and the risks involved.

Broadly there are two categories of women undergoing the procedure. The first category or age group is the young women who are in their 20's who want to increase their bust size because they have underdeveloped breasts.

The second category or age group of patients are those in their 30's who are usually mother's who have finished with their families and now have their children off to school and have done with their responsibilities and want to get back into shape and feel they way they used to maybe 10 years and two children back. This section of patients has seen a steady increase and I'm sure we are going to see more of them. But in this group many a times they might require certain ancillary procedure along with a breast augmentation which is usually a breast lift or a areola reduction or the such.

Breast augmentation surgery was first performed in 1962 by a Texas plastic surgeon who used silicone breast implants to enhance the size of a woman’s breasts. 1997 HBO film "Breastmen" starring David Schwimmer and Chris Cooper shows a cinematic representation of the introduction of the concept of the breast implant to increase breast sizes and the early days of breast augmentation surgery and its pitfalls. Breast augmentation surgery has come a long way since then with lots of advancements in the type of implants and techniques, though the basic methods remain the same.

A common fear amongst women is the fear of cancer with implants. This is totally unfounded as per research done by various medical fraternities. Recently even in the US, the FDA has cleared the use of Silicone Gel implants. Otherwise, silicone gel implants are used widely all over Europe, South America, and Asia, though saline implants are also equally in vogue though more in North America..

Implants are commonly filled with saline or silicone gel. Both implant types have advantages and disadvantages. The saline implants are silicon bags into which saline is injected to fill it up. The advantage of this is that smaller incisions to place the implant can be used and the sizes can be increased or decreased in case of volumetric discrepancies between the right and the left breasts. But the disadvantage is that some of the saline may leak over a period of many years and the implant may have to be replaced.
The silicone gel implants are permanent as they do no deflate. But they require a larger incision size. They have a natural feel and the new highly cohesive gel implants do not leak even if they are punctured or cut. The choice of the implant is usually left to the patient.

The implant can be inserted in three ways either through the armpit or through a cut below the breast or through a cut around the nipple/areola. The approach is determined by the size of the implant and the individual patient. Recently the so called “Scar less Breast Augmentation” has been in demand also known as the “TUBA” Here a saline filled implant is inserted through the belly button and hence the scar is hidden giving it the name scar less.

The implant can either be placed in front of the muscle of the chest wall, “Sub glandular” or behind the muscle, “Sub muscular”. Placement of the breast implant under (behind) the pectoralis muscle is preferred in women with anatomically less breast tissue since the results are more aesthetic. Placement behind the muscle does not stop you from using those muscles, though body builders and weight lifters tend to prefer placement over the muscle.
Placement under the muscle allows for a more natural look and feel than placement over the muscle. Also, the incidence of capsular contracture is decreased with this placement. Placement behind the muscle allows easier breast self-examination and improved images with mammography when compared to placement in front of the muscle, all this because it is far away from the normal breast tissue.

The common problems after a breast augmentation surgery are mild pain and discomfort after the procedure. This is a little more in the sub muscular placement of the implant. Scar maybe a problem if you have an incision below the breast which will be seen in the initially but fades over a period of time. You might be required to do some regular massages for the next 6 months which your surgeon will explain after the surgery.

The most common cause of dissatisfaction amongst women undergoing the procedure worldwide has been the size of the implant with most women feeling that they should have gone in for a bigger implant. The cause for this is that initially because of the swelling the size looks more and as the swelling settles down the size feels a little smaller . But the size has to be determined by the amount of tissue she has, the incision , the type of implant.

In the end one has to realize that the final decisions are taken after a proper consultation and examination. Also the fact that, all surgeries have their associated risks and complications, which every surgeon operating on you will surely address.

This article was aimed at educating women about the procedure of breast augmentation, allay few fears and misconceptions and to help them make educated decisions regarding the same.

Dr.Surindher
www.cosmesisindia.com
#Note: This article is the sole property of cosmesisindia.com and Dr.Surindher. No part may be reproduced in complete or in part without permission from Dr.Surindher.

I Hate my Nose..!!!!!!!!

RHINOPLASTY :
“I don’t like my nose!!!!”
How many times have we heard that statement by people around us?
“My nose is too big / small!!”
“Because of my nose deformity I feel that I’m not able to perform well at work…!!!”
“People make fun of me, because of my nose!!!”
These are a few of the remarks with which patients come to us. If we ask 100 people 95 % will say that they are not satisfied with their noses. But not everyone is so dissatisfied, that they come seeking correction.
For the ones who come for correction a few things we have to think about. Are they really so dissatisfied with their noses?? Will a correction help them?? Will they be satisfied with the new nose?? Will it be acceptable??
Rhinoplasty is one of the most common operations performed by cosmetic surgeons. This procedure is designed to improve the appearance of the nose & involves any or all of the following procedures:
 Reduction of forward projection of the nose
 Removal of humps
 Correction of deviation of the nose and the septum
 Narrowing of the bridge of the nose
 Narrowing the tip
 Reduction of nostril size
 Correction of depressed nose
Rhinoplasty in most cases involves modifying the underlying skeleton (bones and cartilage) to produce the necessary changes. The aim is to bring the nose in balance with the rest of the face. The nose has to be seen as part of the face rather than as a single entity alone.
No single nose can be an ideal nose! A nose which looks beautiful one person will not necessarily look good on another person. Attempts are made to keep the nose in conformity with the rest of the face, keeping in mind the necessary specific changes which the patient came to us for.
Many patients feel that the change in shape will be so much that it might be the subject of discussion amongst family & friends. But, in reality neither the patient nor the patient’s relatives or friends really remember the original shape of the nose a few weeks after surgery.
The incisions for rhinoplasty are usually made inside the nose. The nasal skin is lifted away from the cartilage & bones. Then the necessary modifications to the skeleton (bones and cartilages) are made. The excess skin re drapes itself onto the new framework over a period of time.
The procedure of rhinoplasty involves very minor changes in the region of millimeters, but the overall effect is of a balanced nose as with respect to the shape and size. Also the final result of the procedure is evident only after 3 months when all the swelling abates and the skin is well draped over the new framework. This is the normal healing period.
The final results depend on the initial deformity, the healing capacity of the person and most importantly the skin type. People having thin skin have the best results as the results are better seen through thin skin. Hence females have better results as compared to males and westerners have better results as compared to most of our patients.
In some cases the bridge of the nose is depressed whereas the rest of the nose is apparently normal. In such cases an augmentation rhinoplasty is performed. Augmentation is done by inserting either cartilage from the nose / ear or bone from the rib / hip or silicone implants. Each of the materials which are inserted, have their pro’s and cons which the surgeon will advise you about when you go in for the surgery.
In others the whole nose is bulky where a reduction rhinoplasty is performed which will involve reduction of all the structures of the nose.
As the face has to be viewed as a whole unit and the nose not being seen separately, sometimes it is seen that the chin is disproportionate making the face seem unbalanced. In such cases chin enlargement or reduction might be needed, which can be performed simultaneously to enhance the facial balance.
Another aspect of rhinoplasty that has to be touched upon is the fact that so many people blame the nose for their lack of progress in work or life in general. The nose cannot be seen separately it is a part of the person and hence it alone cannot be the cause for any problems in life for the patient. Because it is the first thing that anybody sees as he or she wakes up in the morning, it’s the first to be blamed. In such cases a rhinoplasty might not solve the inherent problems and may not help in other aspects of a person’s life.
Dr.D.S.A.Surindher
www.cosmesisindia.com
#Note: This article is the sole property of cosmesisindia.com and Dr.Surindher. No part may be reproduced in complete or in part without permission from Dr.Surindher.