Liposuction is very popular as a relatively quick and safe cosmetic surgery to get rid of excess fat. At one time, the procedure was even touted as a better alternative to healthy diet and exercise. Regardless of such myths, liposuction is an important development in cosmetic surgery. Indeed in certain cases (of extreme weight gain) liposuction is the first surgical procedure performed on the patient. Like all surgeries, liposuction has a few do's and don'ts, and they are:

Do's
1. Keep your weight at a healthy level before surgery. The more the amount of fat is removed from your body, the greater is the risk involved in surgery, which is why controlling your weight pre surgery is important. Losing a large amount of weight leaves a lot of loose skin in your body, which can make your skin look saggy.
2. Wear your compression garments. Compression garments help your skin compress over the area where the fat used to be, leaving smooth, tight skin.
3. Continue exercising (with the go ahead of your doctor) after the procedure and follow a healthy diet to maintain your body.
4. Maintain gentle activity for two weeks after the procedure. This will help in removing fluid deposition in the surgical area and prevent complications.

Don'ts
1. Do not take anti inflammatory medicines like aspirin or ibuprofen as these medicines may cause bleeding complications. They also harm the body's immune system, which is detrimental to recovery.
2. Do not smoke or drink while recovering as Nicotine disturbs normal skin growth, which may lead to permanent scars, while alcohol interferes with the effect of some medicines.
3. Don't lift heavy objects or bend down immediately after the surgery. Your doctor will give you a more specific timeline as to when you can pursue such activities.
4. Don't expect results from day one. You will see results after you have recovered from the surgery.
5. Do not opt for liposuction specifically for weight loss. Liposuction is chiefly a procedure for shaping and contouring the fat in your body to give you that shape you always desired.

Do's and Don'ts of Liposuction

Orange Peel Scrub For Flawless Glowing Skin

An orange is much more than just a refreshing tangy fruit. Orange, rich in Vitamin C, is the best all rounder when it comes to your skin. It’s rich in antioxidants and helps your skin to get younger looking, glowing and healthy. It’s almost a miracle for your skin.

Ground orange peels (and nothing else) just on their own make for the perfect scrub. 

It has these 4 effects on your skin.

1. Scrubbing off Dead Skin: The leathery granular texture & calcium present in it, serves as a gentle but extremely effective scrub, removing layers of dead and decaying skin. 

2. Moisturizing: The natural oil & potassium present in orange peel moisturizes & hydrates your skin simultaneously. 

3. Anti-ageing: The antioxidants neutralize the free radicals keeping wrinkles and sagging cheeks at bay.  Vitamin C & Magnesium present in it make skin glowing, youthful & healthy.

4. Skin Lightening: The orange peel also serves as a natural bleaching agent which helps with skin whitening. 

How to Get the Glow: To get an instant glow, all you need to do is rub frozen orange peel cubes onto your skin.  Continue rubbing till the cubes dissolve onto your skin into a scrub/mask. Splash your face with water to reveal the magic!

If you would like to consult with me privately, please click on 'Consult'.

4 Magical  Effects Orange Peel Has On Your Skin

What are dermal fillers + how different it is from botox?

Dermal fillers are an artificial or naturally-derived material used for directly injecting into the skin. These soft tissue fillers are used with the aim to restore your facial appearance to address issues related to facial aging. Depending on the kind of filler that you opt for, the effects can vary from 6 months to 5 years. Nonetheless, they are used for a number of problems associated with facial aging such as:

  for smoothen out and add volume to creases known as laugh lines

  for enhancing thin lips

  for providing shape and fullness to cheeks so as to provide a youthful appearance

  for enhancing the under eye areas to the point that depressions or hollows are no longer visible

  for merging scars from chicken pox or acne with surrounding skin

  for adding volume to your temple or lower cheek area when shifting of fat pads (masses of tightly packed fat cells) underneath your skin surface occurs.

How are these fillers different from botox?

Even though both these procedures involve the use of injections, they are completely different from one another. Botox or botulinum (a purified, natural protein) works by numbing muscles that contract to create facial lines. It is mostly used around the eye and forehead areas for stopping the movement of muscles that cause wrinkles to form. Moreover, it treats active lines, which are visible when you smile, frown or squint.

Dermal fillers, on the other hand, treat wrinkles that are very deep and static, which you can only be seen when the face is in a restful state. Furthermore, it serves to enhance the skin while lightly swapping the collagen (a protein that helps connective tissue in the body to remain strong) that gets lost as you age. When it comes to swelling and bruising, botox reports minimal effects and dermal fillers a certain amount of swelling and bruising that disappear within 7-10 days.

If you would like to consult with me privately, please click on 'consult'.
Related Tip: 6 Face Washing Mistakes that are Damaging Your Skin, Every day!

For Your SKIN: What are Dermal Fillers + How Different it is from Botox?

Yauvan pidika or acne vulgaris is an inflammatory skin disorder which is prevalent in both males and females. When the sebaceous glands present on skin produce excessive sebum, the hair follicles present on skin get clogged leading to the formation of acne. According to ayurveda, kapha, pitta &amp; rakta and meda or fat dhathu are responsible for producing acne.

Ayurvedic treatment aims to eliminate the problem from its root. Herbs like lodhra (symplocos racemosa), manjishtha (rubia cordifolia) and kushta (saussurea lappa) are known for their properties to reduce acne. Turmeric (curcuma longa) and chandana (santalum album) are also effective in treating acne. The application of jaiphal (myristica fragrans) and khas-khas (vetiveria zizanioides) is believed to provide satisfactory results. Neem (azadirachta indica), guduchi (tinospora cordifolia) are known for their blood purifying properties, which can lessen the occurrence of acne and pimple in the long run.

The following are some of the ayurvedic remedies for treating acne:

1. To reduce the growth of pimple, rub water on jamun (syzygium cumini) seed and apply it on the pimple.

2. The peel of orange has medicinal properties that can be used effectively in the treatment of pimple. Make a paste of orange peel powder and rose water; apply it on your face on a regular basis. It is an effective remedy that cures acne and improves the skin tone.

3. To achieve an immediate result, apply a paste of lodhra (symplocos crateigodies), vach (acorus calamus) and dhania (coriander). Improvement will be noticed within 7 days.

4. A paste of red chandan (red sandalwood) and jaiphal (nutmeg) are also effective in reducing the appearance of acne and pimples.

5. Apply a paste of masoor dal (red lentils) with milk, ghee and camphor on your face. It reduces the appearance of acne and clears the scars which are left behind.

6. Prepare a paste of lemon, kalaunji (seeds of fennel flower) and milk. Apply it on your face on a regular basis before going to bed. Wash your face with lukewarm water in the morning. This remedy ensures speedy disappearance of acne.

7. Make a mixture of nimbu (lemon), extracts of tulsi (basil) and black kasundi (coffee pods), dry it in sun and apply the mixture on face. It is a powerful remedy that is known to cure the problem of acne.
Besides these home remedies, a balanced diet and healthy lifestyle will also enable you to reduce the risk of recurrent acne.

Ayurvedic Treatment for Acne

Hypothyroidism is a condition in which the thyroid gland is not producing the thyroid hormones adequately. This is a fairly common condition.

What is thyroid gland?

The thyroid gland is a small butterfly-shaped gland located just below Adam s apple. It encircles the windpipe or the trachea. It is about 4 cms in height and weighs about 18 gms. This gland is responsible for the secretion of thyroid hormones. Hormones are chemicals produced by special glands like thyroid, adrenals, ovaries etc. They act as messengers and are carried by the blood to the various target organs.

What are the hormones produced by thyroid gland and what do they do?

The thyroid hormones are of two types   T3 (Tri iodo thyronine) and T4 (Thyroxine). These hormones are mainly responsible for the body s metabolism - a process in which food is converted into energy in the cells. They influence growth and development and regulate various bodily functions which are mentioned below:

Heartbeat
Body temperature
Breathing
Body weight
Metabolism of fat
Menstrual cycles in females
Functioning of Nervous system
Digestion
Burning calories etc.
What is Hypothyroidism?

Inadequate production of hormones by the thyroid gland is termed as hypothyroidism. This is also called Underactive thyroid state. Hypothyroidism can make the body s development to slow down and reduces metabolism rates.

What are the causes of Hypothyroidism?

Hypothyroidism can be caused by a number of factors:

Hashimoto's thyroiditis: This is the commonest cause. This is an autoimmune disorder (normally body s defence system fight against external infections. In autoimmune disorder the defence system attacks the healthy cells of the body by mistake). In Hashimoto s thyroiditis the immune system/defence system produces antibodies that attack the thyroid gland and destroy it.
Iodine deficiency in diet. For the production of thyroid hormones iodine is very important. The body does not produce iodine normally, so it needs to be supplemented from outside. Iodine is mainly present in the food we eat. It is mainly present in shellfish, salt-water fish, eggs, dairy products. If a person does not eat iodine rich foods, he may end up with iodine deficiency leading to hypothyroidism. Currently, this causative factor is on the decline due to government initiative of table salt with iodine.
Surgery: Surgery to remove thyroid gland (for e.g. thyroid cancer treatment, overactive thyroid etc.)
Radiation to the neck (to treat cancer in the neck area): The thyroid gland cells are damaged due to the radiation.
Treatment with radioactive iodine: This treatment is used for managing hyperthyroidism/overactive thyroid, where the thyroid gland produces excessive thyroid hormones. One of the treatment modalities is by radioactive iodine. Sometimes this radiotherapy destroys normal functioning cells which lead to hypothyroidism.
Certain medicines: Certain medicines used to treat heart conditions, cancer, psychiatric conditions etc.   for e.g. amiodarone, lithium, interleukin-2, interferon-alpha.
Pregnancy: Pregnancy (the reason is unclear but it has been noticed that the thyroid may get inflamed after delivery   this is called Postpartum thyroiditis.
Damage to the pituitary gland: Pituitary gland is a gland which is present in the brain. It produces a hormone called TSH (Thyroxine-Stimulating hormone).The TSH tells the thyroid gland how much thyroid hormone it should make. If the levels of thyroid hormone in the blood are low, then the TSH will stimulate the thyroid gland to produce more Thyroid hormone.
Hypothalamus disorders: This is an organ in the brain. This produces a hormone called TRH (Thyrotropin Releasing Hormone) which acts on the Pituitary gland to secrete TSH. So any disorder of Pituitary gland will indirectly effect the production and secretion of Thyroid hormones. These are very rare disorders.
Congenital thyroid defects: Some babies are born with thyroid problems. This is due to the thyroid not being developed normally during pregnancy. Sometimes the thyroid gland does not function normal. This can be identified by screening for thyroid disorders in the first week after delivery. This is usually by a blood test using a small drop of blood from the baby s heel.
What are the different types of hypothyroidism?

One classification is based on whether the defect is with the thyroid gland or not:

Primary hypothyroidism: The problem is in the thyroid gland itself and thus there is reduced production /secretion of thyroid hormones.
Secondary hypothyroidism: Here the problem is with the Pituitary gland or the Hypothalamus. This results in abnormal production of TSH or TRH, which indirectly leads to less production and secretion of thyroid hormones.
Another classification is based on the symptoms and levels of the thyroid hormones and TSH:

Overt hypothyroidism: Here the patient is having the symptoms. Further the T3/T4 are low and TSH is high
Subclinical hypothyroidism: Here patient may or may not have symptoms. The T3/T4 levels are normal but TSH is high. In this situation the patient is at an increased risk of developing overt hypothyroidism in the future especially if he has Thyroid peroxidase antibodies on testing.
Who are at risk of developing Hypothyroidism?

Women have a higher risk of suffering from hypothyroidism than men.
Older people are at increased risk.
People suffering from other autoimmune diseases like Coeliac disease, Type-1 Diabetes Mellitus, Vitiligo, Pernicious anemia, Multiple sclerosis, Rheumatoid arthritis, Addison s disease etc.
People with psychiatric conditions such as bipolar disorder
People with Chromosomal abnormalities like Down syndrome, Turners syndrome also have a high risk of suffering from hypothyroidism.
What are the symptoms of hypothyroidism?

Symptoms vary from person to person. They may also mimic other conditions and hence be difficult to diagnose. Symptoms may also develop very slowly over a span of moths-years. Some of the characteristic symptoms of this disease are:

Depression
Constipation
Hair loss
Dry hair
Dryness of the skin
Tiredness
Body pains
Fluid retention in the body
Irregular menstrual cycle
Increased sensitivity to cold
Reduced heart rate
Increase in size of the thyroid gland   called Goitre. This is due to constant stimulation of the thyroid gland by TSH.
Weight gain
Carpal tunnel syndrome
Hoarse voice
Infertility
Loss of libido/sex drive
Confusion or memory problems especially in the elderly
What are the symptoms to look for in a baby if you suspect hypothyroidism?

Infants suffering from congenital hypothyroidism may show no symptoms or exhibit signs of excessive drowsiness, cold hands, cold feet, constipation, hoarse cry, poor growth or absent growth, poor appetite, bloating of abdomen, puffiness of face, swollen tongue, persistent jaundice.

How to diagnose hypothyroidism?

Blood tests:

TSH: This hormone is made in the pituitary gland and it stimulates the thyroid gland to produce thyroxine. If the thyroxine levels are low in the blood, the pituitary gland produces and secretes more TSH into the blood to act on the thyroid gland to produce more thyroxine. A raised TSH level indicates hypothyroidism. Other tests are not usually necessary unless a rare cause of hypothyroidism.
T4: A low level of thyroxine indicates hypothyroidism.
T3: these levels are generally not needed to diagnose hypothyroidism
Anti-Thyroid peroxidase antibodies (anti-TPO antibodies) or Anti- thyroglobulin antibodies are present in 90-95% of patient with autoimmune thyroiditis.
Other blood tests include Creatinine Kinase, Serum Lipids, Complete blood picture etc.
Ultrasound of the neck is done if the patient presents with a thyroid swelling.
What is the treatment of hypothyroidism?

Overt hypothyroidism is treated by synthetic Thyroxin hormone which should be taken every day on an empty stomach at least 30   45 minutes before breakfast. The treatment is continued for the rest of the patient s life. Regular thyroid function tests are done once every 8 weeks-12 weeks to adjust the dose of the thyroxine in the initial period of diagnosis. Once the thyroxine dose is stabilised, the tests can be done even once a year. This treatment is quite effective.

Sub-clinical hypothyroidism is only treated if the patient is a woman and is contemplating pregnancy, in patients with symptoms or if the TSH is quite high.

What are the side-effects of thyroxine medication?

There are few side effects if any. Most people tolerate these medications quite well. An important consideration before starting medication is to check if the patient has chest pain/angina. These people are started on the least available dose. If these patients are started on a higher dose they notice a worsening of their angina pains.

Side effects mainly occur if the thyroxine dose is high which leads to hyperthyroidism. The symptoms of this could be palpitations 9increased heart beat), weight loss, profuse sweating, anxiety, irritability etc.

There are some tablets which increase with thyroxine tablets. These include carbamazepine, iron supplements, calcium supplements, rifampicin, phenytoin, warfarin etc.

What are the complications of hypothyroidism?

If untreated hypothyroidism can lead to:

heart problems like heart attack due to increased levels of bad cholesterol like LDL, or heart failure due to fluid retention
obesity
infertility
joint pains
depression
A pregnant woman with hypothyroidism is at increased risk of giving birth to a baby with congenital hypothyroidism, also known as cretinism. Further, the woman may have pregnancy related complications like pre-eclampsia, premature delivery, low birth weight baby, anemia, post-partum haemorrhage (bleeding after delivery) etc.
Myxoedema is another complication where the patient has extremely low levels of thyroid hormone. The body temperature drops drastically making the person lose consciousness or go into a coma.
References:

2013 ETA Guideline: Management of Subclinical Hypothyroidism; European Thyroid Association (Nov 2013)
Management of primary hypothyroidism: statement by the British Thyroid Association Executive Committee; British Thyroid Association (2015)
The diagnosis and management of primary hypothyroidism; Royal College of Physicians and others (June 2011)
Suh S, Kim DK; Subclinical Hypothyroidism and Cardiovascular Disease. Endocrinology Metabolism (Seoul). 2015 Aug 4.
UK Guidelines for the Use of Thyroid Function Tests; British Thyroid Association (2006)
Gaitonde DY, Rowley KD, Sweeney LB; Hypothyroidism: an update. American Family Physician. 2012 Aug 1 86(3):244-51.
Bindra A, Braunstein GD; Thyroiditis. American Family Physician. 2006 May 15 73(10):1769-76.
Wilson GR, Curry RW Jr; Subclinical thyroid disease. American Family Physician. 2005 Oct 15 72(8):1517-24.
British National Formulary; NICE Evidence Services (UK access only)
Baumgartner C, Blum MR, Rodondi N; Subclinical hypothyroidism: summary of evidence in 2014. Swiss Medical Weekly. 2014 Dec 23 144:w14058. doi: 10.4414/smw.2014.14058. eCollection 2014.

Know Everything About Hypothyroidism

When an injury happens, the normal tendency of the skin is to repair itself from inside out, until it is completely closed and healed. However, in some cases, due to various reasons, excessively large scars can form. These hypertrophic scars are known as keloids. Here is everything you would like to know about keloids:

Features of keloids:

Benign, fibrous, smooth, hard growths that form over a healed wound
Can be bigger than the original wound
Most commonly found on chest, ear lobes, cheeks, and abdomen
Pregnant women are usually at the risk of developing keloids
Though they do not develop into malignant lesions, they are a cosmetic issue, especially when the visible portions of skin are affected
They are localized, flesh-colored and red in color
They are raised from the surrounding tissue and are prone to repeat injury
It continues to grow with time
Could cause discomfort and irritation when it comes in contact with clothing
Sun exposure or tanning can worsen it and cause tenderness
Common injuries that can lead to keloid formation include burns, surgical incisions, skin piercings, chicken pox scars, tattoos, etc.
Treatment for keloids may not always be effective and need repeat treatments
Treatment options: If the keloid is not in a visible area and does not cause any problem, it is best to leave it untreated and observe for any changes. The following changes could indicate the need for treatment.

Change in color from pale pink to red (indicating inflammation)
Severe increase in pain/tenderness
Sudden increase in size, which could indicate malignancy (keloids are an area where benign growth can turn cancerous)
A biopsy can be done to identify if treatment is necessary. This involves removing a small part of the tissue by injection and sending it for laboratory examination.
Treatment options include both nonsurgical and surgical. Nonsurgical methods are tried first before resorting to surgery.

Steroid injections into the keloid to control growth and inflammation
Moisturization to keep it soft and avoid dryness and cracking and bleeding
Freezing the tissue (cryotherapy) to freeze the growth can help in further increase in the size of the tissue
Laser to remove the tissue, especially if it is small. Alternately, this could be used as a secondary measure after the keloid is excised to prevent further growth
Radiation therapy to shrink the growth
Surgical excision, where the keloid is quite visible or large. This could be followed by radiation or laser to prevent further growth.
Also, in people who are prone to develop keloids, surgical incisions can be treated for a longer time with pressure dressings and silicone pads.

Keloids - Know About Its Treatment!

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