Pearl Health

Abdominoplasty is a surgical procedure where fat and loose skin is removed to tighten the tummy area. In addition to fat removal, the connective tissues and muscles in the surrounding area are tightened as well. It is usually preferred only if diet and exercise have failed to achieve the desired results.

Reasons to opt for abdominoplasty
- If the lower abdominal wall is weak
- If excess skin is present around your tummy
- If you have retracted scarring from previous pregnancies

There are certain cases where abdominoplasty is not recommended such as wanting to lose weight, if the person is affected by chronic conditions like diabetes and an unhealthy body mass index.

The procedure

Incisions are made in the tummy to eliminate the fat and the loose skin from the tummy. The skin around the bellybutton is contoured by removing the bellybutton and suturing it back to its regular position.

Once the surgery is completed, the incisions are covered with medical dressing. There could be some pain in the area which can be regulated by medications administered through intravenous injections. The excess blood and fluid will be drained out through tubes. An abdominal binder (supportive clothing) needs to be worn for about two months in order to provide proper support during the healing period.

Risks associated with the surgery

A common problem after this surgery is moderate pain and some local swelling in the area. It may also cause fatigue, mild bruising and a feeling of numbness.

Some major complications that may arise from this procedure are infections and blood clots. If you have any previous disorders such as ineffective blood circulation, heart disease or lung problems then the chances of complications after surgery is very high. These surgeries cause scars in the body which may not completely fade away.

Post procedure care

You need to follow certain precautions after the surgery is completed. You should avoid any strenuous activity to allow the area to heal properly. You also need to take care of the bandages as the area will be stitched and bandaged by the surgeon.

Women who have abnormally large breasts usually tend to develop them during adolescence or during pregnancy. Large breasts can cause physiological problems apart from being unsightly. Some of the problems commonly reported by women include back and neck problems. Let's explore one of the most common methods of breast reduction known as the keyhole method.

What is the keyhole method of breast reduction?
The Keyhole method of breast reduction is the most commonly prescribed form of breast reduction surgery. In this method the doctor places an anchor or a keyhole shaped incision around the areola extending to the underside of the breast. Then a small device is inserted to melt fat and a low power vacuum is used to extract it. After this is done the area is stitched up reducing the breast size.

The extent of the incision:
The length and breadth of the incision can vary from case to case. However, the following areas usually tend to have scarring: 

1. The area around the nipple known as the areola: A round circular incision is made around the areola to open up this section of the breast.
2. Downwards from the areola to underside of the breast: This is where the keyhole shape comes into prominence as this is an extension of the incision to open up the breast.
3. The area on the underside of the breast along a horizontal curve: This may vary in extent from patient to patient depending upon how much tissue needs to be removed and thus may be larger or smaller.

The advantages of keyhole method of breast reduction:
There are many valid reasons why this method is the most prescribed and most popular form of breast reduction. Let's look at some of the reasons below.

1. The most minimally invasive method: Conventional breast reduction may employ techniques, which open up the breast, which is a longer and more complicated form of surgery, and thus the keyhole method being the least invasive has its own advantages.
2. Lesser scars: With other forms of breast reduction, the scars along the incision lines may be much larger. With the keyhole method, much of the scarring is hidden away due the shape of the incision as well as the size being smaller.
3. Quicker healing: Most forms of keyhole surgery use liposculpture or the extraction of fat rather than full excision of tissues and thus it generally translates to quicker healing. Even in cases where excision is performed, healing still tends to be quicker with this method as the incisions tend to be smaller.

Dermabrasion is a skin related treatment used by cosmetic surgeons and dermatologists to cure a number of ailments that may leave your skin looking less than healthy. This method basically employs a technique that removes the upper layers of your skin with the help of a rough edged diamond wheel or a wire brush. These edges are called a burr or a fraise.

Here is everything you need to know about the procedure as well as the results that it can yield:

• Areas and Conditions: The most common areas where this procedure is conducted include the face as well as the neck. It is mostly used to treat people who want to remove fine lines that form around the eyes and the mouth, as well as patients who are suffering from acne scars and other inflammation causing skin ailments as well as abrasions due to injuries.
• Preparation: The procedure includes cleaning and marking the area that is being treated. This is the first step that helps in seeing exactly what needs to fixed, the extent of the damage and the intensity of the treatment to be employed. Following this process, the doctor will administer a local anaesthesia such as, Lidocaine that will numb the area before the actual treatment begins so that the patient does not undergo any discomfort. Also, with this purpose in mind, the dermatologist may also apply ice packs on the face and neck of the patient so as to make the skin even more numb and remain like that for a longer period of time. Additionally, the skin may be sprayed with a freezing cryogenic spray in order to retain the numbness and keep the skin firm enough for effective treatment. If the doctor is going to treat deeper abrasions or the entire face, then pain killers and general anaesthesia may be used.
• Procedure: To begin with, a small area is exposed to the treatment at a time, rather than the entire area or face at one time. After the freezing spray is administered, the doctor may run the rotating brush or burr to remove the top layers of the skin. Gauze will be kept handy so as to stem any bleeding that may take place during the process. Finally, the area will be covered with the help of ointment and dressing.
• Results: The recovery time is said to take anywhere between five to eight days. But this also depends on the severity of condition that was treated, as well as the area that was covered. Little or no pain may follow and regular cleaning will be required. To prevent re-occurrence or re-growth of the problem, follow up visits to the dermatologist will be required.

What is FUE Hair transplant?
Follicular Unit Extraction is most widely used and the most reliable method of hair transplant being utilized for the permanent and scar-less restoration of hair. FUE is so effective surgical method that it is impossible to distinguish transplanted hair from natural hair. Results are natural and undetectable.

How is FUE done?
The procedure is performed in the OPD under Local Anaesthesia. Anaesthesia is given to prevent any discomfort to the patient during the procedure.

FUE is the method of extraction donor hair directly from donor site in a follicular unit hair transplant procedure. An instrument is used to make small circular incisions in the skin around a follicular unit while separating it from the surrounding tissue. The follicular unit is directly extracted from the scalp leaving a small open hole.

This process continues until the surgeon accumulates large number of follicular units for the planned hair restoration. For single session, this procedure can take two to three hours whereas for long session, it may be accomplished over two consecutive days. The donor scars are approximately 1mm in size which completely heals within ten days.

Before the grafts are harvested, tiny 'recipient sites'; are made in the balding area of the scalp using a fine needle-point instrument. The follicular units are then placed into the recipient sites where they will grow into healthy hair-producing follicles. The creation of recipient sites and the placing of follicular unit grafts are essentially the same in both FUE and FUT procedures. The difference lies in the appearance of the donor area and in the quality and quantity of grafts obtained with each technique.

How is the healing phase after an FUE?
The donor wounds, approximately 1-mm in size, completely heal over the course of seven to ten days, leaving tiny white scars buried in the hair in the back and sides of the scalp.

When does the hair begin growing?
The transplanted hair generally shed within 2 to 6 weeks after the surgery as roots enter in resting phase. Within three to eight months, transplanted roots start sprouting hair. It takes ten to twelve months to have denser hair as hair continue to mature and thicken gradually. Once transplanted hair begin to grow, it will continue to do so for lifetime.

What is biostimulated FUE?
It comprises of hair transplantation by FUE along with 3 sessions of Platelet rich plasma therapy which simultaneously enhance residual hairs as well as transplanted hairs by presence of high concentration of growth factors directly near the hair roots and stimulation of STEM CELLS.

In this hair follicles to be transplanted are preserved in a special solution enriched with patient's own growth factors and at the end of surgery this concentrated solution of growth factors is injected into the whole affected area.

With biostimulation, a good proportion of transplanted hairs remain in growth phase (ANAGEN) and directly start growing after transplantation.

A brow lift is also known as a forehead lift, is a surgical cosmetic procedure that corrects flaws in the skin above the eyes. It flattens the lines and wrinkles on the skin, tightens the sagging skin that appears to advance in age and restores youthful skin. More and more people are undergoing the treatment every year with a high rate of success.

Features that can be corrected with brow lifts:

1. Sagging and horizontal eyebrows that create an expression of exhaustion
2. Deep horizontal folds on the forehead skin
3. Excess fatty skin that droops over the eyelids
4. Frown lines between the eyebrows

Types of brow lift and the respective procedures

1. Traditional or coronal brow lift: The patient is put under general anesthesia and an incision is made on the forehead, just below the hairline to hide the scar. The excess skin is removed and the necessary skin tissues are lifted and tightened for a smooth appearance. Finally, the incision is stitched up.
2. Endoscopic brow lift: This surgery is also done under general anesthesia, but a number of tiny incisions are made on the scalp. An endoscope is put in through the incisions so that the area of surgery is seen on a computer screen. Other surgical instruments are used to lift the skin tissue on the forehead, reposition the eyebrows and remove all the extra skin and muscle tissue. Then, the incisions are closed with stitches.
3. Temporal incision brow lift: This procedure is done with eyelid surgery. It requires larger incisions than those of endoscopic brow lift and these cuts are made just above the temples. Then the tissues above the eyebrows are repositioned, extra tissues between the eyebrows are also removed to flatten the frown lines.

Post-surgical care and recovery

1. You have to stop smoking and taking anti-inflammatory or blood thinning medication for a few weeks before and after the surgery.
2. Using a cold compress is recommended in case of post-surgical pain. There may also be prescribed ointments that are applied at the cut.
3. Your head needs to be kept elevated when lying down for a few days.
4. You should have gauze and clean towels readily available in case of minor bleeding.
5. You may also experience slight swelling and bruising on the non-operated areas of the face. The pain and itching sensations experienced during recovery are milder in case of traditional brow lift than in case of endoscopicbrow lift.

Immediately after hair transplantation, you need to exercise little extra care to derive the best benefits. This includes immediate postoperative care, some common with most other surgeries and some very specific to hair transplantation. 

The following things will happen immediately after transplant, throughout the first week: 

• Immediately after surgery, like any other surgery requiring anesthesia, there will be slight drowsiness and so it is advisable to arrange for a drive.
• Expect some mild swelling and soreness that can be managed with rest and anti-inflammatories.
• There will also be a tight and itchy feeling in areas where transplant has been done.
• Spray water or saline every half an hour to keep the scalp moist in both the recipient and the donor sites. This promotes healing and also reduces the itchy feeling in these sites.
• Thermal shock would be applied to areas to damage the existing follicles and new stem cells would be transplanted. This can also produce a warm feeling, sometimes referred to as 'thermal shock'.
• In some people, there could be scab formation which occurs due to fall of the topmost transplanted hair follicles.
• If you have undergone a micrograft, then you will have a compression bandage around your head. This should be in place for a day and will cause a tight feeling.
• Sleep with your head elevated with a couple of pillows.
• The first day after surgery, hair needs to be washed under the supervision of a physician or a nurse. Use a shampoo, which contains tea tree oil.
• It is recommended to shampoo your hair regularly from day 2, as it is required to remove the dirt, blood, and oil that often accumulates at the recipient's site. This also helps to controlling infection, which is common post surgery.
• Wait for at least 14 days before you resume coloring your hair, use of hair sprays, gels, and other hair care products.
• All transplant surgeries require stitches. If the suture material is absorbable, there is no need to follow-up for removal. If it is not of absorbable material, they need to be removed after 2 weeks' time.
• Please do not get into a regular exercise routine for up to 6 weeks. Cycling, gymming, swimming, golfing, etc., are to be avoided until the scalp is completely dry and to avoid stretching of the scar.

Everyone's body is unique and responds differently to hair transplantation. Go for periodic review with your doctor to understand how your body is responding.

In order to have healthy volume of hair on your head, the rate of hair loss and replacement should be in tandem. With age, your hair growth cycle shows signs of slowing down and factors like age, disease, and hormonal changes among others affect the pace at which an individual hair follicle moves through the 3 phases of the hair cycle. A disruption in your hair cycle can give rise to loss of hair that’s rapid and unexpected. Hair loss or alopecia can affect both men and women.
So what can cause your hair to fall at an alarming rate?

The reasons behind hair loss could be many, but here are 6 major ones:
1. Lack of protein in your diet
When you exclude protein from your diet, your body starts to conserve the protein that it has by altering the growth cycle of your hair. In such cases, your hair enters into the resting stage, resulting in zero hair growth.
In India, 9 out of 10 people are said to suffer from low amounts of protein in their diet, with 91% vegetarians reporting protein deficiency.

2. Iron deficiency
Iron plays a very important role in the transportation of oxygen to the different organs of the body. Lack of iron in your diet (which is the principle reason behind anaemia) can give rise to several health problems including hair loss. Your body attempts to direct oxygen to important organs so as to support their functioning. As a result, your scalp witnesses a low supply of oxygen, which causes hair loss.


3. Vitamin D-3 deficiency
Deficiency of vitamin D-3 gives rise to a type of hair loss called Telogen Effluvium (TE). This is a temporary hair thinning phenomenon that takes place when the all the hair on your scalp enter the resting phase at the same time, subsequently causing you to shed a large amount of hair later on.

4. Smoking
Smoking can also affect the health of your hair, especially the rate at which it falls and the number of strands lost in a day. A research carried out by the Harvard School of Public Health has revealed that smoking can cause a rise in a hormone called dihydrotestosterone (DHT).
An increase in DHT level prevents new hair cells from growing and causes hair follicles to reduce in size with each hair cycle. As a result, the area on your scalp that gets affected by DHT experiences a lack of hair growth.

5. Use of testosterone supplements in gym
Intake of testosterone in the form of supplements and injections to build muscle mass can trigger hair loss in men. This takes place when the testosterone in these supplements gets changed into DHT, thereby affecting your hair loss rate and amount.

6. Past illnesses (dengue, TB and typhoid)
Falling of hair can also be brought on by illnesses such as typhoid, TB and dengue as the hair growth cycle comes to a stop. Hormonal or metabolic stress that is experienced during the course of such diseases may cause hairfall.

What are the treatments available to cure hair loss?

1. Hair transplant
Hair transplant is a minimally invasive surgical technique that transfers hair follicles taken from other parts of your body to the balding area. Known by the name of Follicular Unit Transplantation, this hair loss treatment can help to bring back the natural appearance of a fuller head of hair. Hair follicles are harvested using two procedures- follicular unit extraction and strip harvesting. Procedure can vary from 4-8 hours or more depending on the case.

2. Platelet- Rich Plasma (PRP)
Platelet- Rich Plasma (PRP) is another treatment alternative that can reverse hair loss. It’s a simple non-surgical procedure that lasts about 60-90 minutes. In this form of hair treatment, the patient’s own blood cells, more specifically blood platelets are injected into the scalp. Usually 8 sittings are required with each sitting being 2 weeks apart for better results.

3. Low Level Laser (Light) Therapy (LLLT)
This form of hair therapy utilises light energy of a specific wavelength and threshold to stimulate cellular activity, thereby promoting hair growth. Various controlled clinical tests have revealed its effectiveness in encouraging hair growth in both the genders.
 

Vitamin D- deficiencyPlatelet Rich Plasma

With cosmetic surgery, today, it is possible to reshape the contours of your face anyway you like. Rhinoplasty is one of the most common types of cosmetic surgeries. This is a surgery to restructure the shape and size of your nose. This procedure can be done under local or general anesthesia. Depending on the amount of restructuring needed, the surgery can be performed as an outpatient procedure or may require an overnight stay at the hospital. 

To change the structure of the nose, the surgeon makes an incision on the nose to access the bones and cartilage. This incision can be made inside the nose to keep the scar from being visible after surgery. Depending on how the nose is to be structured, bone and cartilage may be removed or tissue from another part of the body may be added. Once this is done, skin and tissue is re-draped over the bone structure. A splint is added outside the nose to support it while it heals. 

This splint and internal dressings remain in place for about a week. The area around your nose and eyes will also feel swollen and appear bruised. This swelling and bruising will take at least a fortnight to subside. The swelling may make your nose feel congested and cause slight bleeding and drainage of mucus. Cold compresses and pain medication can help relieve the discomfort. 

Here are a few other tips to help speed up the healing process:

• Keep your head elevated and relatively still for a few days after the surgery
• Take bucket baths instead of showers while the nose is bandaged
• Avoid blowing your nose
• Avoid making extreme facial expressions
• Limit movement of the upper lip by brushing your teeth gently
• Eat fiber rich foods to avoid constipation
• Avoid wearing clothes that need to be pulled over your head and instead wear front closing clothes
• Avoid strenuous activities like aerobics and jogging
• Do not wear sunglasses or spectacles that put pressure on your nose for at least a month
• Protect your nose from the sun by using sunscreen whenever outdoors
• Limit your salt intake

To be completely satisfied with the results of your rhinoplasty surgery, will require patience. It can take a few months for the cartilage and tissues to settle into place. It is also necessary for you and your doctor to be aligned as to the kind of correction needed.

If hair fall is a problem that’s troubling you more with each passing day, then you should take it seriously before going bald. Needless to say, that your decreasing strands results in decreasing confidence and you spend your time horrified by the thought about what you should do to help the condition. Of all the methods that promise to bring back your lost tresses, the hair transplant surgery is the most effective one. It will not only cover up the bald patches, but aid in restoring a young and self-confident appearance.

Choosing the best option:
Patients who feel like undergoing the process of hair transplantation treatment come across the two common terms FUE and FUT while doing their research. The problem is that in most cases it becomes difficult to decide which one should one go for. When you are in this kind of dilemma, the best way to get the best advice is to consult a cosmetic surgeon who can determine the most suitable treatment option based on your clinical history, personal preferences and budget.

Understanding the difference:
There are two ways in which a cosmetic surgeon can remove the hair follicles from the donor areas of the scalp one is follicular unit transplantation, and the other is follicular unit extraction and are known as FUT and FUE respectively.

FUT – Follicular Unit Transplantation
In the follicular unit transplantation or FUT method, a thin strip of hair is removed from the region of the scalp with relatively high rate of hair growth. Then the hair follicle is harvested from the strip by a professional surgeon before they are individually transplanted to the areas with lesser hair growth.

FUE – Follicular Unit Extraction
On the other hand, in the case of follicular unit extraction or FUE, each single hair graft is removed from the donor area one by one with the aid of a punch tool. In this process, the hair follicle is removed randomly which results in unnoticeable changes in the donor areas. No matter whether you choose the FUT or FUE method, the process of transplanting the grafts remains the same.
FUE is highly recommended than FUT because it is a comparatively safer process that doesn’t require many professionals to carry out the task. Another reason is that many patients complain that FUT is not quite comfortable and there have also been instances of swelling and pain in the areas where the tissue was removed. Although this could be controlled and managed with the medication and other associated medical aid, one should talk to his doctor regarding which method should be chosen.

The primary difference between the hair transplant process and any other hair loss treatment is the permanence of the results. When you opt for this treatment, you will not only be able to flaunt your hair, but they will be so natural that no one would understand that you have undergone a hair transplantation process. Hence, with the modern treatments available, hair fall management has become more promising than ever. If you wish to discuss about any specific problem, you can consult a Cosmetic/Plastic Surgeon.