If you are in the process of considering a breast augmentation procedure, here is an insight into what you can expect. In general, or in the majority of the cases, the surgery encompasses three phases consultation, operation, and then the most important part, recovery. In most cases, the breast augmentation is completed under general anesthesia where the patient remains asleep through the procedure.

How is the surgery performed?
The surgeon makes an incision in the crease under the breast or under an arm or around the nipple to separate the breast tissues from the connective tissues and the muscles of the chest. This enables the creation of a pocket-like structure behind or before the pectoral muscle. Then the implants are inserted in this pocket and centered behind the nipple.

What may happen after the breast augmentation procedure?

Soreness and scars: After the surgery, some patients may suffer from soreness accompanied by swelling and bruising for around three weeks after the surgery. The scars tend to fade gradually with the passage of time even though a faint scar remains all through one s life.
Discomfort: Some may experience a slight or tolerable pain in the nipple after the surgery. In rare instances, patients undergo sharper, and burning pain with touch. A light massage can help ease the discomfort.
Swelling: Some people report that their breasts feel firm after the surgery though this is a passing phenomenon. As the swelling subsides, the patients feel natural tenderness in the breasts within a short span of time.
Things to take care during recovery: Sometimes, surgeons recommend wearing a compression bandage or sports bra for proffering extra support to the breasts and the implants. If there is a pain, then the patient is prescribed pain-relieving medications, as well. Though healing takes a long span of time, however, one can easily resume back to their daily activities within a week. It is advised not follow a strenuous job or continue with any strenuous workout for a few months or till complete recovery.
Avoid strenuous activities: It is advised to sleep in a recliner for the first 2 days after the surgery, as this reduces the pain and swelling. Also, one should refrain or minimize the number of times one raises the hands above the head. It is advised to refrain from exercising or strenuous workouts for at least 3 to 4 weeks after the surgery.
The week following the surgery will be most difficult, and therefore, it is advised to complete all the important jobs before the surgery so that the body gets the required rest and recovers quickly.

As you can see, it is important to know and learn about the whole process before undergoing the surgery or deciding to undergo surgery so that you can make an informed decision and go about it systematically.

Breast Augmentation - What to expect from the procedure?

Cellulitis is a common contagious bacterial skin infection marked by redness and swelling of the skin that feels tender and hot. It usually occurs when bacteria penetrate through a crack or a cut on the skin s surface. Although cellulitis can develop anywhere over the face or the body, it is your lower legs that are affected the most. It damages the tissues beneath the skin, spreading to the bloodstream and the lymph nodes. If left untreated, the infection might get aggravated and turn fatal.  


Prevention:
In case of a recurrence, preventive antibiotics may be recommended by the doctor. Adopting the below mentioned precautionary measures can help: 
1. Gently rinse the wound with soap and water on a daily basis, whenever you go in for a shower.
2. Apply an antibiotic ointment or a cream over the wound to get adequate protection.
3. Use a bandage to dress your wound and change it daily.
4. Watch out for signs of infections such as pain and redness and accordingly go for medical help.
5. People with diabetes often suffer from poor blood circulation. They require extra precautions in order to prevent any skin injury:
Minutely check for signs of injury, failing which you might be even more susceptible to infections. 
Moisturize and lubricate your skin daily to prevent peeling and cracking.
Trim your toenails and fingernails carefully so that they do not injure the ambient skin.
Wear appropriate gloves and footwear to protect your feet and hands.
Treat any infection developing on the skin surface at the right time because they might be contagious.


5 Tips to Prevent Cellulitis

While women strive to enhance the way their breasts look, the development of breast tissue in men can be embarrassing. This condition is known as Gynecomastia. It can affect one or both breasts in a symmetric or asymmetric manner and is caused by an imbalance of estrogen and testosterone hormones. It can also be caused due to a side effect of medication or because of other health problems such as an overactive thyroid or tumor. In some cases, this condition can get resolved on its own while in other cases, medication and surgery may be recommended.

Medications

Before undergoing treatment for Gynecomastia, it is essential to ascertain that you are in fact suffering from this condition. This is because gynecomastia and the buildup of fat tissue in the chest can look similar, but are treated differently. When treating this condition, medication needs to be supplemented with controlled calorie intake and physical exercise. It is also cheaper than surgical treatment.

Surgical Treatment

Surgery is often the preferred mode of treatment for significantly enlarged male breasts. Surgical treatment for gynecomastia is of two types:

    Liposuction: This removes fat from the breast, but leaves the breast gland tissue in place. Liposuction can be performed in a number of ways. It involves making two or more incisions through which narrow tubes are inserted into the chest area. This tube is gently moved around to loosen the excess fat tissue that is then sucked out.
    Mastectomy: This procedure removes the breast gland tissue itself. It is performed endoscopically and hence has a quicker recovery time and involves less scarring.

You may feel a slight discomfort after the surgery for a few days. You will also be advised to wear a chest support brace for a few days to allow your body to heal without putting any pressure on the site of the surgery. Normal activities can be resumed within 2 to 3 days but avoid strenuous activities of heavy lifting for a month after the surgery.

As long as you follow a healthy lifestyle and have a balanced diet, either of the above surgical procedures should have a lasting effect. This makes surgery a more preferred form of treatment than medication.

Apart from this, certain exercises can also help tone chest muscles and reduce fat tissue. This includes inclines dumbbell presses, push-ups and exercises that focus on pectoral muscles. However, this is a very gradual process and hence suitable only for mild cases of gynecomastia.

Gynecomastia Treatment

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

For most us tattoos are a form of expressing their personalities. However, the things you identify with, in your teens may not be something you want to be associated with as you grow older. In some cases, a tattoo may not come out as you imagined it to be and this may leave you with a permanent adornment that you don t like. Thankfully, though tattoos are permanent, it is possible to remove them. As with getting a tattoo in the first place, removing it is not as simple as it sounds and can be quite painful. 

Here are a few things to keep in mind before opting to remove a tattoo.

Complete removal is not guaranteed: Not all tattoos are the same, the deeper tattoo ink is injected into the skin, the harder it is to remove. In many cases, tattoo removal may leave behind a faint shadow of the tattoo or cause permanent scarring.
How you got your tattoo made affects its removal: Professional tattoo artists have a steady hand and inject ink at the same depth, unlike amateurs who inject ink at varying depths. Thus removing a professional tattoo is easier than removing one made by an amateur.
It is painful: As when getting a tattoo made, removing it is also painful. The amount of pain felt depends largely on the location of the tattoo. In the case of laser treatment, this can be described as the feeling of having an elastic band repeatedly strike the skin. You could ask for local anesthesia or a numbing cream to be applied before starting the procedure to reduce the pain.
Multiple sessions are required: On an average 6-10 sessions are required to remove a tattoo. However, the actual number of sessions depends on a number of factors including the location of your tattoo, the number of colors in it etc. you will also need to wait at least 6 weeks between sessions to reduce the risk of side effects.
There are side effects: Some of the side effects you may notice after a tattoo removal session are blistering of the skin, bleeding, redness or darkening of the skin and inflammation of the tattooed area. These are temporary and should subside in a few weeks. However, darkening or lightening of the skin can last for up to a year. Scarring, burns and textural changes to the skin are other potential side effects. These can often be permanent.

Tattoo Removal - 5 Things You Need To Know Before You Go For It!

Raise a toast to great skin with vodka!

The Russians love their national drink, the vodka, as much as the french love their fine wines. And just like wine, vodka can be easily used in your daily beauty regime to add a much wanted healthy white glow to your skin.

Vodka is a great astringent or toner. Soak a cotton ball in a mix that is equal parts vodka and water and then lightly dab all over your skin. It will cleanse the skin and tighten pores.

You can add a dash of lemon juice to the mixture and freeze it. Rub these beauty cubes onto your face to bring down skin bloat as vodka and lemon juice together tighten pores and brighten the skin.

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


Raise a Toast to Great Skin with Vodka!

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