3 crucial points you must know about breast enhancement

Breast augmentation is a surgical procedure designed to enhance as well as improve the symmetry and fullness of the breasts through implants (gel-like fluid in a flexible sac); or to bring back breast volume lost as a result of pregnancy, aging or weight loss. Before opting for such a procedure, there are certain points that you absolutely must consider, which are:

1. Picking silicone or saline implants: when it comes to implants, you have two options available - saline or silicone. Providing a uniform shape and firmness, saline implants come filled with sterile salt water. In contrast, silicone breast implants contain elastic gel, giving them the look of natural breasts. In terms of elasticity, saline implants can be adjusted more easily as you can inject or remove liquid from the implant. In contrast, silicone implants cannot be adjusted as they are already filled with the gel.

2. Getting the right size: choosing the right size for breast augmentation is very important. It's wrong to believe that bigger implants are not always good. The size of implant should be decided after proper assessment of the breasts.

Mammography should be done before putting breast implants. In general, size selection is made based on your natural breast size. Whether you opt for a saline implant or a silicone one, implants come in varied sizes ranging from 120-180 cc. When you choose a size for yourself, you'll have to keep in mind your body frame as well as appearance you wish to have post surgery.

3. Incision options: depending on the results you expect, you'll also need to consider which incision (a surgical cut made in your skin before the operation) option you should select before undergoing surgery. Incisions can range anywhere from 1-4 inches, with their lengths increasing as the implants expand in size. There are also certain incisions, such as the belly button incisions that are really small and don't leave behind visible scar tissue.

Apart from belly button incision, some of the other incision options that a surgeon may employ for breast augmentation could be:
- armpit incision (incision made in the underarm area for breast implantation through the armpit)
- nipple incision (incision made on the areola, which is the circular area of pigmented skin surrounding a nipple)
- crease incision (incision made in the crease area below the breast for implantation).

Fat grafting of breasts is another alternative or a complementary procedure to the breast implant. If you're considering breast augmentation surgery, be sure to check with your doctor about these factors and which options are best suited to you, before proceeding.

If you would like to consult with me privately, please click on 'consult'.
Related Tip: Why Breast Cancer is No 1 Cancer in India? + How To Avoid it

3 Crucial Points You Must Know about Breast Enhancement

6 Best Home Remedies To Get Rid of Acne

Acne causes skin damage and leaves marks that ruin appearance. Although these scars cannot be completely removed, they can be reduced to an extent that they become invisible.

Give your skin these tested remedies to get rid of pimple scars-

1) Cleansing of Lemons: Lemons, as you know are rich in vitamin C, which helps in the synthesis of collagen (the connecting tissues of skin) in the body. Therefore, regular use of lemons helps in keeping your skin free from blemishes or scars. Treating with lemon includes consuming lemons as well as application of lemon juice on the scars and washing it off.

2) Smoothening of Aloe Vera: Aloe Vera gel application is extremely beneficial for skin, it not only reduces the scars but also soothes the skin. It also smoothens out the skin as well as lightens the complexion.

3) Soothing of Sandalwood: Sandalwood or chandan is antiseptic and anti inflammatory in nature. It is therefore highly effective at cleansing of scars as well as soothing facial skin. Regular application of sandal wood powder mixed with rose water gives a glow to your skin that nothing else can.

4) Healing of Fenugreek: Fenugreek or Methi seeds are anti-inflammatory and are also a smoothening agent. It heals skin conditions and greatly reduces acne scars. Its extract can be applied externall for the reduction in the intensity of the scars  appearance.

5) Protection of Neem Leaves: Neem leaves are effective against a lot of skin problems, from acne and eczema to ringworm. Its alkaloids content gives Neem its antibacterial, antiviral and antifungal properties. Neem also helps in removal of toxins from the body. It can be crushed and externally applied in the form of a pack or its bitter juice can be comsumed.

6) Care of Apple cider vinegar: Vinegar promotes peeling off skin, which is helpful when you have scars. It is also antiseptic in nature.  It can be applied on the scalp using cotton, with a little dilution. The vinegar is particularly helpful in dandruff.

Have any further questions on how Ayurveda can help you get beautiful skin? Click on consult privately to ask me.

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6 Best Home Remedies To Get Rid of Acne

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!

Hair fall has a direct impact on the way you feel about yourself, your self esteem and confidence. It is also true that it is a very common problem and can be controlled and stopped completely through proper treatment. Ayurvedic treatment for hair fall has long term effects and it brings out the best results since the issues get rectified from the inside, preventing them from coming back.
 
Ayurveda and Hair Loss
 
According to Ayurveda, hair fall is associated with body type that varies from person to person and also the stability of mind-body structure. Hair is considered a byproduct of bone formation, as stated by Ayurveda. The tissues which are responsible for the development of bones are also responsible for hair growth. Diet, yoga, meditation and medicated herbal oil massage are the Ayurvedic treatments generally recommended for hair loss.
 
Here are some ways through which Ayurveda addresses the problem of hair fall:
 
1.    Dietary modifications 

It is important to identify the lifestyle habits that cause hair fall problems. Consumption of alcohol, meat, coffee, tea and smoking are some of these habits. Hair fall can also be aggravated due to intake of too much greasy, spicy, oily, sour, fried and acidic foods.
 
Here are some ways suggested by Ayurveda to beat hair fall:
 
1.    Hair growth can be stimulated by drinking fresh juices of Pomegranate, carrot, spinach and Kokam.

2.     Sesame seeds promote hair growth as they are rich in magnesium and calcium.

3.     Cow's Ghee is a trusted remedy to resolve all scalp-related problems.

4.     Green vegetables and fruits are rich in fiber and hence help in preventing hair fall.

5.     To make the roots of hair strong, foods rich in vitamin C, vitamin B-complex, sulphur and zinc must be consumed, which are found in whole grains, soybeans, buttermilk, nuts and milk.

6.     Yoga and meditation: Inverted asanas help in stimulating the blood flow to the head. Additionally, practicing deep breathing exercises to control anxiety, stress and keep the mind balanced is also advisable.

7.     Ayurvedic herbs and medicated oil: Bhringaraaja, Brahmi, Amla, Neem, Ritha and Ashwagandha are some ayurvedic herbs rich in essential nutrients that help in reducing stress and promoting hair growth. Different types of oils including coconut oil, brahmi oil, amla oil or mustard oil are useful to control hair fall.

How To Control Hair Fall Through Ayurveda

One of the effects of ageing is the double chin that is caused due to extra fluid or fat under the chin. It could also be due to increased weight, sagging skin, or merely genetic. Given that it produces an aged appearance, people with double chin are constantly trying to find ways to hide it. There are two main muscles in the neck area, and toning them helps to remove the double chin appearance. There are grooming tips like specific kinds of clothes, hairstyle, and makeup to conceal it. There are also some exercises which are believed to reduce the prominence of the double chin. However, these are temporary measures, and for a permanent solution, surgical correction is the only method of choice.

Some of the new methods to get rid of the double chin are listed below with some important additional details. Talk to your surgeon and understand what to expect before going ahead with the surgical correction.

Kybella: Approved by FDA, this is the new wonder drug to correct double chin. With no surgery involved, all it takes is about half an hour. The area is injected with a local anaesthetic and then Kybella. This contains deoxycholic acid, which is an enzyme that the body also produces naturally. This helps break down fat cells and so after a couple of weeks, the double chin gradually begins to literally melt away. Depending on the desired results, repeat injections might be required at monthly intervals. There could be mild swelling in the initial couple of days, which will subside shortly. The result would be a more defined chin line, producing a slimmer appearance.
CoolMini: This involves freezing the fat and massaging it to remove the double chin. This is a form of chin sculpting and is preferred in people with good skin tightness. Results will be evident in about 1 to 3 months.
Skin tightening using infrared light: A beam of infrared light is aimed at the double chin which causes tightening of the skin by stimulating the underlying collagen and elastin layers.
Chin liposuction: In people with excess fat deposition, chin liposuction where the excess fat is suctioned off is a good treatment option. This is a time-tested method and produces results more immediately than the above-mentioned procedures.
Subsequent to any of the above procedures, it is better to make some lifestyle changes so that the double chin does not return. Weight management and regular exercise can go a long way in preventing recurrence of the double chin. Speak to your doctor to draw up a weight management plan and an exercise regimen that can help in the same.

Double Chin - Ways You Can Get Rid Of It!

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

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