Cosmetic Gyneacology - A new concept???

Hi all.....

Today, I'm gonna be talking about a relatively new topic ( at least in the general public's mind) especially in the Indian scenario. I have been getting many queries and emails regarding this, but the common factor in all those being the fact that very little is know about it and there seems to be a lot of confusion regarding the same.

The topic is “Cosmetic Gynaecology”.

Though the procedures that come under this heading have been performed for quite a few years now, the term seems to be recently coined. It basically involves correcting cosmetic problems related to the female genitalia. The procedures which come under this are:

1. Labioplasty ( Reducing size of the lips)

2. Hymenoplasty

3. Vaginoplasty or Vaginal Rejuvenation ( Tightening of the vagina)

4. G spot amplification

These procedures can be done together or separately or in various combinations depending on the need of the patient. Sometimes certain other urological or gynaecological procedures maybe be combined if there is a associated medical problem.

Let us briefly discuss each of these procedures separately.

1.Labioplasty:

This refers to the procedure by which the labia ( lips) minora most commonly or sometimes both the majora and minora are reduced surgically if they are too long. Many women are bothered about it as they know how it was and they feel it is not the same as time progresses and they feel uncomfortable about it. In normal course the labia minora are smaller and hidden within the labia majora as in the younger age groups. So, this is an attempt to bring it back to the way it was.

It is a relatively simple procedure which can be done under local anaesthesia or regional anaesthesia and the patient can go home the same day.

Some times this maybe be accompanied by fat grafting of the labia majora to increase their volume & give them a more youthful look.

2.Hymenoplasty:

This refers to a procedure of recreating the Hymen. Also called "Revirginization".

Not very commonly a part of the combination of procedures. It involves recreating the thin layer of skin at the vaginal opening to give it an impression of being virginal. Though the fact remains that the hymen can rupture because of many reason other than intercourse. But it is done more for personal and religious beliefs than for medical reasons.

The procedure involves recreating the hymen with the help of tissues in and around the vagina. It is a relatively simple procedure and the patient can go home the same day. The stitches dissolve on their own in a week or 10 days.

3.Vaginoplasty or Vaginal Rejuvenation:

Classically vaginoplasty refers to recreating the vagina in patients with a congenital absence. But here in context of cosmetic gynaecology, it refers to tightening the vagina. Because of child birth and repeated intercourse and lack of exercise the pelvic muscles surrounding the vagina become loose. This may sometimes cause problems during intercourse because of the lack of proper grip for both the partners.

Vaginal tightening can be done with the help of LASER's where the light from the LASER tighten's the mucosa and some part of the underlying muscle. This is a good option if the patient has a decent muscle tone. The other procedure is to surgically tighten the muscles outside the vagina. The procedure is done from within the vagina and the stitches dissolve on their own. The patient can go home the same day or the day after.

This is usually combined with a labioplasty and fat grafting of the labia. The patient can resume normal sexual activity in three to four weeks time. There is an increase in sensations and pleasure during intercourse for both partners.

There are some pelvic exercises which all women can do to naturally tighten their pelvic muscles and delay the need for such a procedure. Some centers also have equipment which will help tighten and strengthen the pelvic muscles.

4.“G Spot” Amplification:

This is a relatively new addition to the procedures. The “G Spot” or The Gräfenberg spot, is a female erogenous zone, which when stimulated leads to high levels of sexual arousal and powerful orgasms.

Though anatomically the “G spot” has not be identified as a distinct physical entity some studies and anecdotal evidences from different women have shown a very sensitive and thickened area in the anterior wall of the vagina. Some studies done also showed this thickening when the women is sexually aroused. Women claimed the experience of a “deeper” orgasm when their her G-spot was stimulated.

Despite professional and scientific criticism and skepticism in general by the public, the G-spot, as a concept, has been widely accepted. Even in India judging by the mails, the awareness has definitely increased.

“G Spot” amplification is an extension of the same concept. As stimulation of the “G spot” is supposed to give greater arousal to the woman, the procedure involves identifying the spot and increasing the size by an injection. It is a relatively safe and simple procedure done as an office procedure. The injection lasts for 6-8 months and can give enhanced pleasure during intercourse by increasing the size of the “G spot” during that time.

But in some cases the results may not be up to the mark because of the difficulty of finding the “G spot”. The injection can be repeated as and when the effect wears off and the woman feels she wants the extra help to get aroused.

The awareness of these procedures and the inquiry regarding the same has increased over the past few years as woman are becoming more aware of their bodies and their own needs. Though there will always be controversies regarding the procedures, like for all other cosmetic procedures the options are there for people who want to get it.

As one of my patient's said... "Doc...I know it's not a necessary procedure... but , Its nice to know we have options !!!!!"

Dr.Surindher

www.cosmesisindia.com

Saddle Bag's... Not the bags women want...!!!!

I HATE my cones...!!! I was surprised when I heard that from a patient of mine. “Cones?? I asked...”

“Yeah.... these...” she answered, pointing out to the sides of her hip. Well that was the first time I heard someone refer to them by that name.

The area she was talking about is an area which has had different names,the most common unflattering ones being "saddlebags" and "riding breeches".

This refers to the hips, upper outer thighs and buttocks that are disproportionately large relative to the rest of the body.

A woman's hips are an overt sign of her fertility and sexuality. Ask your friends, and they'll probably agree that the hips should be part of that classic hourglass figure that women constantly seek. However, there's a big kink in that goal. Most women are genetically programmed to store fat in their hips and outer thighs... the “pear shape” as compared to the “apple shape “ of a man.

As men and women pursue more idealized body proportions, they usually find that they cannot rid themselves of their saddlebags with diet and exercise alone. The reason for this is that the shape and size of our hips is largely determined by our genetic makeup. There's nothing to be ashamed of. The fat in the hips and thighs are highly resistant to diet and exercise. Even women with small frames can have a large lower body that is simply too full to be proportionate. In other words, fat deposits on the sides of the legs tend to be the last fat to go.

Many patients do ask me why they have it, in spite of having a good exercise regime. Various reasons apart from genetics. Its the area where you first put on fat and the area where you loose it last. Secondly its situated above an area which has a tendon rather than active muscle, which makes it all the more difficult to get rid of by exercise alone.

Many women are experience frustration when large thighs and/or saddlebags force you to buy clothing with different sized tops and bottoms and many of them try to squeeze into their clothes and have the saddle bags sticking out more prominently rather than going in.

Though it's an unfortunate situation, it's not beyond fixing.

What are the options one may ask?

1. Exercise: Lie on your side, head waist and legs in straight line, suck your tummy in and raise your leg straight up from the hips without bending your knees. Repeat this for 10 times and repeat the cycle 3-5 times according to your comfort level. Breathe out while raising the leg and breathe in while lowering it. Repeat on the opposite side too.

2. Injection Lipolysis: This is a good area to be treated with Injection Lipolysis if that is the only problem. Multiple small injections of the lipolytic solution are injected in the area. The dissolved fat has to be absorbed by the body and eliminated. The injections are repeated every 3-4 weeks for about 4-5 times.

3. Liposuction: Offers a one time and immediate solution to the problem. The procedure involves inserting a small canula though a 0.7-1cm incision and suck out the fat and contour the area in proportion to the hips. Post operatively a pressure garment is necessary for the next few weeks to help the skin mold to the new shape of the hips.

4. Lipo Contouring: Sometimes it may be required to inject fat into the in between segment between the two bulges to give it a more proper contour which is call “ Lipo Contouring”. Post operatively a pressure garment is necessary for the next few weeks to help the skin mold to the new shape of the hips.

It is therefore no surprise that saddlebag liposuction is the most requested type of liposuction. Since the area is mainly meant for fat storage, a liposuction operation to remove your saddlebags can completely alter your waistline. You could have a smooth hourglass figure without those bulges if you combine a hip and outer thigh liposuction together. That's because the fat in your hips and thighs doesn't grow back. Once you've got the right curves, your new body shape will not revert.

After a successful saddlebag liposuction, you'll be able to fit into jeans, dresses, and skirts in a way you've never imagine before. Your entire body will feel more complete and you'll have a big boost in confidence.

So ladies, do not fret, its not a major problem. It can be treated. But, if you opt for surgery then make sure you go to the proper trained surgeons and not to untrained people claiming different things.

Dr.Surindher

Celebrating 'Woman's Week"

Hi all,

CosmesisIndia

on the occasion of World Woman's Day

Celebrates

" Woman's week"

Between 10-15th of March

at

Cosmesisindia
17/1, Hosur Road, Richmond Town

Opp.Fatima Bakery

Bangalore 25

FREE CONSULTATION FOR WOMEN..!!!!

& Many more discounts on packages and surgeries

Timing : 12-6pm

For appointments contact: Ph: 080-41750075

9945780075

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.

BREAST CANCER AWARENESS

Hi friends... sorry for the long break in between..just been lazy I guess.

What spurred me to write my next post on the blog was an interview by RJ Malvika with Mrs.Jayshree on RadioIndigo ( fm91.9). Mrs. Jayshree is a Breast Cancer Survivor and she was talking about her whole experience with the disease and its aftermath and how she coped with it.

Nice to hear her experience and am sure it will help other women too. But I thought that some issues needed to be emphasized more from the point of view of the disease process and the options. So this being a awareness month with special emphasis on Breast Cancer, i thought i need to try and compile certain aspects of the same.

I think the first aspect to be dealt with should be the awareness issue regarding breast cancer, then comes the issue of dealing with it , then the treatment options and of course the rehabilitative aspect.

Awareness regarding breast cancer though picking up, is still not reach the extent to which it should. Many reasons behind it and one of the main reasons in our context is the taboo behind talking about anything related to sex. As the breast is a sign of femininity and female sexuality any talk about it is taken as taboo and hence women also tend to shun away from seeking knowledge about the same. Education is the only way to improve awareness. We see many women with advanced stages of breast cancer because they were shy to seek treatment or talk to anyone.

The first thing that any women should know and realise is that breast cancer is another disease and as with any other disease the earlier it is detected the easier it is to handle. The most important person in this “ early detection” sequence is the woman herself. “ Self Breast Examination” is an easy,simple, quick, painless test that any woman can do at her convinience.

Not every cancer can be found this way, but it is a critical step you can and should take for yourself.

Many a times the reason a woman does not want to do a SBE is because she feels so many things and feels confused. The more you examine your breasts, the more you will learn about them and the easier it will become for you to tell if something unusual has occurred.

Try to get in the habit of doing a breast self-examination once a month to familiarize yourself with how your breasts normally look and feel.

Examine yourself several days after your period ends, when your breasts are least likely to be swollen and tender. If you are no longer having periods, choose a day that's easy to remember, such as the first or last day of the month.

Don't panic if you think you feel a lump. Most women have some lumps or lumpy areas in their breasts all the time. Eight out of ten breast lumps that are removed are benign, non-cancerous.

What's important is that you get to know the look and feel of YOUR breasts' various quadrants. Has anything changed? Bring to the attention of your doctor any changes in your breasts that last longer than you monthly period cycle or are getting bigger with time.

Studies show that regular breast self-exams, combined with an annual exam by a doctor, improves the chances of detecting cancer early.

How to do a Self Breast Examination?

I could also write about self breast examination but will only serve to increase the already 1,630,000 pages on breast examination which you get on doing a google search. I'd like to highlight a few pages one could visit to know more about it.

1.Cancer patients Aid Association(CPAA) which has a lot of information and free download brochure

http://www.cpaaindia.org/infocentre/bookreview_breast.htm

http://www.cpaaindia.org/infocentre/SelfBreastExamination.doc

2.DOCTOR NDTV which has an article on breast examination

http://www.doctorndtv.com/topicsh/Breast%20Self-Examination.asp

3.Breast Self Exam is another good site which will talk you through it

http://www.breastselfexam.ca/

4.The Susan G. Komen Breast Cancer Foundation has a online breast self examination module which is also available in Hindi

http://www.komen.org/intradoc-cgi/idc_cgi_isapi.dll?IdcService=SS_GET_PAGE&nodeId=480

Here's hoping this can spur some if not all women to start making self breast examination a part of their routine and help create more awareness regarding the same.

My subsequent blogs are going to be dealing with some of the surgical options for breast cancer and more importantly I will be touching upon the options for breast reconstruction which is a topic many of the breast cancer patients are not aware of or do no even consider.

Dr.Surindher
www.cosmesisindia.com

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!!

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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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NDTV " We the people" Experience

Hi all......



Sorry for the break!!!

Been busy sorting out a few things. But, I had a nice experience of being invited to the NDTV studios for a talk show hosted by our favourite show anchor " Barkha Dutt" !!!!

Yes I'm talking about the show " We the People"! Well, it was a nice experience, though rush rush and of course an eye opener in many ways to me. The topic was whether cosmetic surgery is becoming a dangerous trend and whether people are willing to undergo cosmetic surgery just to look good to conform to social " beauty preferences"!

I won't go into the things that people felt and said but yes there were a few things I thought I should highlight. I felt that there are a lot of misconceptions about the whole plastic surgery and cosmetic surgery issue as a whole.

1. One recurring theme that came out during the discussion was about " putting people into a mould" or like something that came out of an assembly line.

Firstly, I would like to refute the fact that we try to put people into moulds. Which mould are we talking about? Is there a mould at all? In fact this is what we try to emphasize that, the essence of cosmetic surgery is to bring about the necessary changes BUT preserving the attributes which make the individual the person he or she is...... which is the real challenge.

Also, what looks good on one person will not necessarily look good on another because every individual is different, so it can't be one size fits all. This is what makes it all the more challenging. So, the concept of having assembly line beauties will never happen.

Who wants to be similar to the rest... everyone is fighting to be unique .. don't you think?


2. The other thing that came up was that, we are forcing people to change .. which is an uncalled for statement. We are offering a service but not forcing anyone to come and undergo a procedure. One can't even force another to have coffee with them, let alone ask them to undergo surgery. Right???

So, it is basically people who have always thought about it or felt the need to have a certain feature corrected who come enquiring for options. And when they do, our job is to guide them.

Of course we talk to people who come with unreasonable demands asking for unnecessary things and I can speak for my fraternity when I say that most will refuse to do something which is not warranted or is potentially dangerous for the patient. This is the reason for such blogs and discussions, so that people are aware of what is good and what are the risks involved.

And as even the panelists said that day .. We are not asking people to change- if one is happy the way he/she is.... then one would NOT come asking for a change in the first place.

Ever so often in any party or get together that I go to, the Q that I'm most often asked when people get to know I'm a plastic surgeon is " What would u like to do on me?? or What should I get done? ".... and for all these questions there is only one answer.. " NOTHING".

We do no solicit patients.

3. Another thing which came up was, if it was such a good thing then why don't people come out into the open and "admit" they have undergone a cosmetic procedure.

I think there are quite a few who do. But since most of them get it done for their own satisfaction I don't think there is any need for them to advertise it openly. Like one of the patients said... " do you go out and tell people that you had waxing done?? " Similarly, where is the need to tell anyone that they had a cosmetic procedure done? A fair argument one would say.


4. Cyrus Sahukar, brought out a valid point that a beautiful face always elicits more responses. A child responds more positively to a beautiful face so who are we to fight something that is natural.

Everything in nature has a balance. When things are in balance there is equilibrium and harmony ensues from it. Hence the aim is to bring things into balance thereby paving the way for harmony.

5. Ms.Akhila, my co panelist brought out a point that not much is being done for people with leprosy and transsexuals who are in the hands of wrong people.

With due respect I would like to say that, many of my colleagues are performing free surgeries for leprosy patients in many of the leprosy missions. DO I do it?? No, I don't now!!! I Salute my colleagues doing the less glamorous tasks of our profession.

I'd like to bring out a point though. Though there are many centres doing such surgeries the sad part is people themselves do not want to go and get the corrections done.

A prime example is the the " SMILE TRAIN PROJECT " which I am a part of .. providing free surgeries to children with cleft lip and palate. We at our hospital along with Smile Train have provided free surgeries to around 1200 children suffering from cleft lip and palate, free of charge. BUT, at the same time there are two children at the traffic junction next to the hospital with the condition and we have not been able to get them in for surgery. the reason for this being.... if they get corrected then no one will give them alms...!!! THAT is the sad fact, which holds true for many poor leprosy patients too and yes I'm not generalising the statement. Just stating what we do come across.

As for surgeries for transsexuals and them being in the clutches of middle men and other's, it is a political and social issue. We can do the surgeries provided they come to us instead of going to quacks.


6. Another factor which was brought up was, the affordability factor. Yes it is not an essential procedure so it need not be done as an emergency . People can go for it as and when they are comfortable. And previously the cost factor was a major issue but nowadays as more and more people have come forward to take up the profession , the costs have come down.


7. Is it a dangerous trend?

Yes, like anything in this world it can get dangerous when people start getting strange ideas about what all can be done. Which is the reason I made the following statement on the show - " I DO NOT operate a patient after the first consultation itself."

I give them the risks involved, the possible complications and the expected results. By doing this, we are giving the chance to back off if they are not keen on it.

If a survey is done, I'm sure all doctors will tell you that there are many patients who are refused surgery because either they do no need it or their demands are unreasonable.

And, of course, its not a miracle solution to anything. We doctors, DO NOT claim any miracles like " loose 5 inches in 1 week"..." get fair glowing skin in 15 days ".. so on and so forth because, we best know that the body doesn't work that way.

Apart from surgery and drugs, proper care of diet, exercise and lifestyle changes are necessary to have a lasting effect.

Overall, it was a nice experience. All the panelists were brilliant. The audience was very co-operative though many said they wouldn't undergo a cosmetic procedure.

Lastly, but not the least... the crew and support staff of NDTV both in front of and behind the camera... were all awesome and very helpful. A few names I'd like to mention are - Vasudha, Neha, Lancy, Chitrita, Maya.... and of course our favourite TV host - Barkha Dutt.

It was a wonderful experience, though only the tip of the iceberg could be scraped because of lack of time. Hope we have more such similar shows which will help dispel myths about plastic and cosmetic surgery!!!!


Dr.Surindher
www.cosmesisindia.com

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