In today s world, females have advance techniques available for shaping up their breasts. It is a part of their overall persona and beauty. Breast augmentation is one of the greatest plastic surgery operations that is done in hospitals across the globe. 

Gone are the days, when you would sit back at home and blame nature for your saggy breasts. You have the gift of plastic surgery at your rescue. Breast augmentation can enhance the beauty of your breast and uplift its features. In this process, the implant is put under the pectoral muscle so that you can still breastfeed your infant if needed.
The process is executed with the help of a small 4 cm incision. The recovery process takes a week s time. Breast augmentation can be carried out in a surgical centre or in any hospital s outpatient facility. It doesn t require a hospital stay in most cases. In some selected cases only, the procedure is done using local anaesthesia. In those cases, the patient stays awake. The breast region is made numb.

What to expect during the procedure?

The woman opting this must know what all are expected to happen during the procedure. The surgeon will insert the breast implant by making a single cut in one of the following three areas:

1. In the crease under breast 
2. Underarm (axillary)
3. Around the nipple (periareolar)

After the incision is done, the surgeon will try and separate the breast tissue from the patient s muscles and connective tissue. This will lead to the creation of a pocket either behind or in front of the pectoral muscle. After this, the surgeon will put the implant into the newly-created pocket. It will be centred behind the nipple. 

Saline implants are put in an empty form and then filled with sterile salt water. Silicone implants are, however, pre-filled with silicone gel. After the implant is over, the cut is stitched with sutures and the skin is bandaged with adhesive and tape.

What to expect after the procedure?
For a few weeks, the patient might experience Soreness and swelling. It is also possible to develop bruises. Your scars will fade away with time. It is quite possible that the scars will not vanish permanently ever in your lifetime. You must wear a compression or sports bra at the time of healing. You might be required to take painkillers, as advised by the surgeon.

Breast Augmentation - What to Expect from the Procedure?

Urticaria, commonly known as hives, usually occurs due to an allergic reaction. Sheetapitta is a similar condition in Ayurveda, as the symptoms are similar. Sheetapitta is comprised of two words-  sheeta  (cold) and  pitta  (warm). The condition occurs due to dominance of cold (existing in kapha and vata dosha) over pitta dosha.

Causes of Sheetapitta/urticaria-
Ayurveda believes, sheetapitta is caused due to the following reasons-

Excess intake of pungent (katu) and salty (lavana) food, mustard
Over consumption of sour gruels
Sleeping during the day
Contact with cold substances
Exposure to cold wind
Improper emesis (vomiting)
Insect bite (keeta damsha)
Coming in contact with poisonous bugs and insects (krimi samsarga)
Effect of seasonal changes on the body
Due to the factors mentioned above, especially because of exposure to cold wind, kapha and vata doshas become aggravated, and inevitably combine with pitta dosha. These spread all over the body and produce rashes on the surface of your skin.

Symptoms-
A person having sheetapitta/urticaria will encounter these symptoms-

Itching/pricking sensation
Nausea/vomiting
Fatigue
Tastelessness (aruchi)
Thirst (pipasa)
Lethargy
Reddish discoloration of the eyes (rakta lochanata)
Fever
Ayurvedic approach to cure Sheetapitta-

Ayurveda focuses on eradicating the doshas and purifying of the body toxins with Ayurvedic medicines & Panchkarma procedures. This is the essential part of Ayurvedic approach to cure urticaria. Abhyanga (massage), svedana (fomentation), vaman (induced vomiting) and virechen (induced lose motion) are very effective in treating Urticaria.

Ayurvedic treatment for Urticaria (Sheetapitta)-
Ayurvedic treatment for urticaria involves body purification therapy like Samshodhana, and oral medications. Some popular, effective techniques used in the treatment are-

Applying mustard oil all over the body
Applying mustard oil mixed with Saindhava lavana and Yavakshara
Use of a herbal powder named Eladi choornam that contains natural ingredients like elaichi
Applying medicated paste prepared from Haridra and Doorva, Kushta and Ghee over the rashes
Apart from these, herbs such as Guduchi, Yashtimadhu, Amalaki are recommended in the treatment of sheetapitta
Although urticaria is not a fatal condition, it can seriously affect one s quality of life. Many people suffer from urticaria for several months or years. Continual intake of conventional medicines reduces body s immunity. Moreover, the incidence of recurrence of this condition is often found. Thus, Ayurveda has an upper hand in treating hives, as it offers a comprehensive and permanent solution for this problem.

Sheetapitta - Causes, Symptoms & Ayurvedic View On It!

Unani is an ancient medical practice of the Middle East that people sometimes use to try to help alleviate conditions of psoriasis. It involves incorporating a special diet, use of herbal compounds and other additional supportive medical practices.

What is Psoriasis?
It is a common immune-mediated skin disease that is characterized by chronic and inflammatory scaly deposits on the skin called plaques. The dry flakes and skin scale deposits occur due to rapid build-up of skin cells. It has a substantial impact on the quality of life with reported impairment in physical and mental functioning.

Causes and symptoms of psoriasis
Heredity is a crucial factor when it comes to psoriasis. There is no definite cause of this skin condition, but consuming opposite foods, trauma on the skin like bruises, cuts, skin irritants, excessive smoking/drinking and mental stress can be some reasons causing it.

Here are some common symptoms of psoriasis:
  Silvery scales on skin
  Itchy and burning skin
  Pus-filled skin bumps
  Dry skin patches and skin redness
  Blisters
  Bleeding patches in skin
  Restricted joint motion
  Inflammation and pain in skin

The Unani view
There are several topical drugs, phototherapy and systemic medications available for psoriasis. However, according to studies, almost 50% of the patients were dissatisfied with their treatment. In the absence of satisfactory cure in modern medicine, the traditional system of Unani medicine is highly beneficial in treating Psoriasis. According to the Unani view, psoriasis occurs due to burnt melancholic humour that has an irritant nature. As a result, it destroys the skin and produces intense itching, roughness and scaling. The unique formulations of Unani aims to eradicate the skin disorder.

How can Unani help treat psoriasis?
Under the banner of the Unani system of medicine, physicians emphasize to apply emollient over the affected part in the form of ointment (Margham) or oil (Rogham). In addition to this, they also advise avoiding sweet or sour items in the diet. Herbal formulations and natural ingredients are used in these topical applications. When applied to the skin lesions over a prescribed course of time, it eases the skin and gets rid of psoriasis.

Risk and safety considerations
There are several studies undertaken to prove the effectiveness of Unani medications to treat Psoriasis, most of which are positive. The Unani medicines have not shown much side effects and can be taken for a prolonged period of time to yield positive results.

Unani medicine has been proven to have a positive effect on the PASI score of the patients, which assesses the severity of psoriasis. A proper diagnosis at an early stage followed by the appropriate treatment under Unani medicine yields remarkable results.

Effective Unani Medicine for Psoriasis 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

Do birth control pills help in controlling acne?

An outbreak of a pimple is perceived as a cause of embarrassment and concern as it gives rise to skin damage. Coming to the cause of acne, it generally occurs due to excess oil (sebum) production. The oil on your skin combined with dead skin cells, blocks your skin pores, thereby promoting bacteria growth and causing acne breakouts. 
The use of birth control pills to cure acne is usually recommended when topical medications and oral antibiotics don’t help in clearing up the problem. 
Here’s how they work on acne. 

Possessing properties that can regulate your hormone production, birth control pills contain the two hormones that your body naturally makes – oestrogen and progesterone. Present in different amounts in the pills, they act by lowering the amount of androgens (male sex hormones, which give rise to excessive sebum production) produced by your body. As a result, with a reduction in sebum production, there is also a decrease in the breakout of acne on your skin. However, you shouldn’t expect instant results from their use. 

Many a times, birth control pills can cause a flare-up of the problem before it can be contained. This can result in your acne getting worse before getting better. 
Although birth control pills can help to control acne, it’s still important to maintain a proper skincare routine comprising of washing, toning and moisturising for a healthy and glowing skin. 

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

Do Birth Control Pills Help in Controlling Acne?

Cosmetic surgery has made it possible for almost everyone to have the body they desire. Having small breasts is one of the most common reasons women choose to undergo cosmetic surgery. This type of surgery is known as breast enhancement or breast augmentation.

For this procedure, the doctor will make a small incision along the natural crease lines of the breast. The breast tissue is then lifted to create a pocket in the breast area and an implant is placed in the pocket. These implants can be filled with saline or silicone. The surgeon will then close the incision and reshape the breasts to accommodate the implant.

Breast augmentation is a relatively safe procedure but as with any other invasive surgery, it does have a few risks. Some of the risks associated with this procedure are:

Reaction to anesthesia
Pain for the first 48 hours after surgery
Hematoma
Infection and bleeding
Numbness and temporary loss of sensation in the breasts
Asymmetric breasts
Scarring
Recovery time from breast augmentation surgery varies from person to person. However, to be on the safe side, avoid any sort of strenuous activity or exercising for a few days. Also, avoid running, jumping or any activity that will make your breasts bounce or potentially dislodge your implants. Swimming should also be avoided. The surgical dressing will need to stay in place for a few days after which you may be advised to wear a support bra. Do not wear under-wired bras until your doctor says you can. You should be able to return to work within a week. During this time, surgical sutures, if any, will also be removed. Avoid sleeping on your stomach or on your side for atleast a month after the surgery.

Follow the aftercare regime prescribed strictly to speed up the healing process. Avoid alcohol for as long as you are taking medication and do not self-medicate yourself in any form. Massaging your breasts can help deal with the scarring unless you have been advised not to.

Most women notice a drastic difference in the way their breasts look after a month. However, for the implants to completely settle into your breast tissue it will take around 3 months. During this time, they become softer and shift until they are placed just behind the nipple. In some cases, you may require a follow up surgery and hence it is best to stay in touch with your cosmetic surgeon. 

Breast Enhancement - Safety, Procedure and Aftercare

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