Brahmanand Clinic

A brachial plexus injury (BPI), also known as brachial plexus lesion, is an injury to the brachial plexus, the network of nerves that conducts signals from the spinal cord to the shoulder, arm and hand. It can occur as a result of shoulder trauma, tumours, or inflammation.

Cancer can be very devastating, it can tear families apart. The cancer virus generally kills all the healthy cells in your body and starts to destroy your organs one by one. When a person is affected by breast cancer, their breasts have to be removed so that the cancer virus doesn’t affect the rest of the body. In the society which we live in we are fed with the notion that breasts are an integral part of a woman’s body and only voluptuous breasts make a woman look more attractive. Survivors who have won the fight against breast cancer have had to surgically remove their breasts for survival.

They are left with an empty spot in their body as well as their lives. So, in such cases breast reconstructive surgery becomes extremely important. Breast reconstruction surgery implants a mound in place of the actual breast. So that it looks like an actual breast with the nipples and the areola.

How to get ready for a breast reconstruction surgery?
1. You should quit smoking if you are a regular smoker.
2. Avoid certain vitamins or supplements as prescribed by your doctor before the surgery.
3. Take someone with you to stay back during and after the procedure for moral support and to assist you with your stay in a hospital.

Possible complications:
1. Infection can occur after the surgery.
2. Hematoma or pooling of blood.
3. The implants can also break through the skin.
4. The implants can rupture and the silicon or saline can leak from the breast tissues.
5. Hard scar tissues can form around the implant.
6. It might not be enough for a woman who has had larger breasts.
7. Implants don’t last life-long. It needs to be replaced after a point of time.
8. Radiation therapy might damage the implants.
9. It can leave a scar from the region where the extra tissue was taken for constructing the breast.

Methods of breast reconstruction surgery:
1. Tissue expander
2. Flap reconstruction
3. Abdominal flaps
4. Mold-assisted reconstruction
5. Direct to implant procedure

Wrinkles are a normal yet unsightly sign of aging, which can come about due to various reasons including too much exposure to the sun, poor diet, excessive smoking and drinking, lack of proper sleep, advent of age, loss of moisture and elasticity as well as collagen, which creates a smooth and supple look, and other such reasons. Cosmetic and plastic surgeons are now turning to a variety of methods to lessen the pronounced look of wrinkles and remove them for younger looking skin. Here are a few methods currently in use.

1. Fillers: Fillers like collagen and others including poly lactic acid, Calcium Hydroxlyapatite and Hyaluronic acid can be used to restore the elasticity of the skin even as they provide precious hydration. These injectables can be used on the face as well as the hands for a smooth and supple look.

2. Botox: To get rid of the lines on the forehead and to prevent the onset of more pronounced wrinkles, Botox or Botulinum Toxin Type A is a favoured element used by many cosmetic surgeons and dermatologists. This is usually administered via injection.

3. Retinoids: This is administered with a surgical procedure in order to remove uneven pigmentation as well as the roughness of skin, which sets in with age and excessive smoking and sun exposure. It may cause skin peeling and redness.

4. Laser: The use of laser resurfacing can also help in stimulating collagen production of the skin, which restores some of its elasticity so that wrinkles may be removed and further wrinkles prevented.

5. Surgery: The use of surgical methods like face lifts, brow lifts and other cosmetic processes can help in giving the skin a tighter look which does away with the appearance of wrinkles. These are usually minor procedures from which one will heal fast.

6. Dermabrasion: This method is a surgical one that basically sands the surface of the skin in order to remove the wrinkles. It can cause side effects like permanent discolouration of the skin as well as scarring for particularly sensitive skin.

7. Peels: Glycolic acid peels and deeper peels that use elements like Salicylic acid can be used to go deep into the skin and making it smooth again. It basically makes a difference to the fine lines. There is a chance of side effects like scarring, bruising and general discolouration in this method as well.

Adequate sleep, good nutrition, avoiding excessive sun exposure and a good skin care regimen can help in keeping wrinkles at bay for a long time. Moisturising with products that contain plenty of vitamin A and E can also help in reducing fine lines.  In case you have a concern or query you can always consult an expert & get answers to your questions!

One of the leading types of cosmetic surgery in the world is breast augmentation through implants. These implants are prosthetic inserts which are put into your breasts surgically to enhance the look, shape, feel, size, and balance in your body. Although these are primarily used for cosmetic purposes, they may also be used for reconstructive surgery after an accident or after mastectomy (breast removal surgery).

Types of breast implants
There are primarily two types of breast implants: Silicone and saline. The sacs that contain both forms of implants remain the same. The sac holding the material in both the cases is made out of silicone. The two primary types are explained below

1. Saline implants: As the name states, saline implants are sacs filled with saline water. In the case of saline implants, the sacs are inserted into the breast through an incision. After the sacs are put inside the breast, they are filled with saline water and once the desired shape, contour, and size are achieved, the implants are sealed off and the incision is closed.
2. Silicone implants: In this type of implant, the sac is pre-filled with silicone gel. This option is considered to have a more natural look and feel as it resembles human fat. The size of the implants however has to be decided beforehand. The doctor will make an incision on the underside of the breast, where the crease lies and then insert the implant into the breast. The incision is then closed and after healing, the scar will be hidden under the crease of the breast.

Considerations before surgery
1. Complications 
This form of cosmetic surgery is one of the most commonly performed around the world. However, there could be a few complications that can arise after the surgery –

1. Infection after surgery
2. After surgery, scar tissue formation may cause the shape of the tissue to change
3. The implants may leak or rupture
4. Pain in the breasts
5. Change in the breast sensations and the nipples (although in most cases this temporary)

2. Other considerations post surgery
Some of the other considerations that you might have to consider before surgery would be –

1. Breastfeeding: While some women have stated that they were able to breast feed successfully after an implant, others have reported problems. Thus you may need to talk to your doctor about this especially if you want to have children post surgery.
2. Complications in getting a mammogram: Mammograms to check for breast cancer and growths in the tissue may become complicated as the implant will block a straight view. However, pictures from other angles can be taken.
3. Getting breast implants won’t stop your breasts from sagging: If you have sagging breasts, then you will need to opt for a breast lift surgery instead of breast implants as implants won’t correct sagging.
4. Breast implants may not last a life time: Breast implants may require to be changed after a few years as your body shape may change and you may gain or lose weight. Implants may even rupture or leak, resulting in the change of the breast shape and thus, may require corrective surgery again.

Lip augmentation is a restorative (cosmetic) procedure where your lips are reshaped to make them appear fuller. Cosmetic procedures are done for aesthetic improvement, but surgical lip augmentation is performed if the lips are affected by any congenital condition or tissue trauma.

Dermal fillers are mostly used to enlarge the lips. Previously, collagen was the most popular filler, but currently, due to various health reasons, doctors do not use it as often as before. Now, hyaluronic acid fillers are the most popular dermal filler.

Hyaluronic acid is naturally available in your body, especially in your neural, epithelial and connective tissues. The fillers that doctors presently use are chemically similar to hyaluronic acid. It is extremely beneficial in adding volume to your lips.

Applications of Hyaluronic acid

• Hyaluronic acid fillers improve your lips’ appearance by boosting their shape, structure and volume.
• The effects of such fillers last approximately for six months; you would require more injections after that.
• Restylane and Juvederm are the most popular hyaluronic acid fillers used currently. These also contain lidocaine in them, which is a local anaesthetic.

Hyaluronic acid fillers also include the following benefits:

• The amount of filler to be injected is easily controllable, so the doctor can regulate the amount of volume to create.
• The injections are given at a steady pace, so the development can be carefully monitored to achieve the desired result.
• Any bump or lump caused by moving the lips too much is easier to correct.
• In relation to other dermal fillers, there will be reduced swelling and bruising.
• Results last for a longer duration, but they are not permanent.
• Collagen fillers required an allergy test before the procedure could begin, but that is not the case with hyaluronic fillers. Hyaluronic acid fillers are not allergens since they are made from similar substances found in the body.

Risks of lip augmentation
Like every surgical procedure, lip augmentation too has certain risks involved. Some of the contraindications (situational dangers of certain drugs or procedures) include:

• Facial nerve disorders
• Intermittent herpes simplex sores
• Diabetes
• Critical hypertension
• Allergies
• Autoimmune disorders

Breast reconstruction is the surgical procedure of creating a new breast shape. In some cases, it is done after the removal of the whole breast or part of the breast. In typical cases, breast reconstruction surgeries take place during or after mastectomy, which is the surgical procedure of removing a woman's breast. But it can be done even years after a mastectomy.

1. Factors to consider before opting for the surgery - Conditions like obesity, smoking, diabetes, cardiac dysfunctions and high blood pressure are few of the many points that should be considered before opting for reconstruction. The presence of these conditions may complicate cases and in some episodes may pose a significant threat to a patient's life.

Also, women diagnosed with breast cancer or at a high risk of developing such in the future may have to opt for mastectomy. In such cases, the doctor may suggest breast reconstruction after the process.

2. The process of the surgery - Typically, breast reconstruction surgeries are done using an implant. Implant breast reconstruction includes the restoration of the shape and volume of the breast. The newly formed breast will not droop with age and may appear higher than the other one.

Implant reconstruction is also useful for women with small and firm breasts as it avoids the need for other extensive surgeries. 

Another type of breast reconstruction would include a procedure where one's own tissue is used. Tissue from the abdomen, buttocks, and inside of the thigh is generally used to replace the existing breast tissue. Similar to this is the procedure where a patient's own fat is processed and used to create a breast. This is commonly known as fat injection.

3. Limitations of a breast reconstruction surgery - There are certain limitations present in the process of breast reconstruction. Reconstructed breasts will not look or feel exactly the same way as before. Several appointments and cosmetic treatments might be required to obtain the best results. In usual cases, reconstructed breasts do not have a nipple. But one can be created using surgery at a later date. In case you have a concern or query you can always consult an expert & get answers to your questions!

Liposuction is a cosmetic surgery that involves the removal of small bulges of fat from the body, which diet and exercise fail to reduce. This type of surgery is most commonly performed on the hips, thighs, abdomen, buttocks and arms. Since it is an inch loss procedure (and exactly the one that is used for weight loss), it is not recommended for morbid obesity.

Before opting for this procedure, you need to keep in mind these vital points:

The types of liposuction
There are two types of liposuction, and your doctor will help you decide which is more appropriate of the two for your condition.

• Ultrasound-assisted liposuction:This form of liposuction makes use of ultrasonic energy to liquefy the fat, which is then removed from your body. 
• Tumescent liposuction: In this technique, a solution made up of saline, anaesthesia and epinephrine (a drug that helps in the contraction of your blood vessels) is first injected into the fatty area of your body before the fat is removed. This solution makes the removal of fat an easier process, helping to reduce blood loss as well as easing pain during surgery. 

The process of liposuction
Depending on the type of liposuction you opt for, you may be allowed to go home on the same day when the surgery takes place.  But if large amounts of fat are required to be removed, you may have to stay overnight.  At the very start of the operation, you?ll be injected with either local or general anaesthesia, again that being dependent on the amount of fat to be removed. 

After this, the surgeon will make a small incision on the area to be operated, and will insert a suction device that will remove the extra fat from the body (by making use of a large syringe or a suction pump). The duration of the operation is dependent on how much fat is going to be removed.

There is a wide range of options to get rid of wrinkles. Laser treatments are considered to be one of the best ways to eradicate wrinkles for a long time. There are other treatments such as microdermabrasion, photo facials, and chemical peels as well. Dermal fillers are used to treat deep wrinkles. Wrinkles of the forehead and the eye are best treated with Dysport and botox.

There is a wide range of options to get rid of wrinkles. Laser treatments are considered to be one of the best ways to eradicate wrinkles for a long time. There are other treatments such as microdermabrasion, photo facials, and chemical peels as well. Dermal fillers are used to treat deep wrinkles. Wrinkles of the forehead and the eye are best treated with Dysport and botox.

How Does Laser Work?

Laser treatments such as the Fraxel and the fractional CO2 make tiny pores in the skin. These pores or incisions have two purposes. The first is to make sure that the skin produces collagen and the second is to ensure that the skin heals quickly. The laser can address wrinkles in areas such as eye, face, hands and legs. Out of all the treatment plans, laser treatment is by far the costliest one. They are typically used by maxillofacial surgeons having in-depth knowledge of physiology. Treatment of this kind might require more than one session depending on the extent of wrinkles.

How Does Dermal Filler Work?

Dermal fillers are a popular method to address wrinkles and are used to destroy wrinkles around the mouth and the eye. Lasers can also diminish hollowness and dark circles near the eye. Moreover, they are very effective in making up the lost volumes of the jawline, temples, and cheeks. Dermal fillers, however, last for about a year and needs to be redone to hold on to the facial changes. They are typically safe and contain limited side effects. A consulting session with the doctor will help to know more about the potential risk of this treatment.

Removing wrinkles from under the eye-

Botox and Dysport are two of the most popular options to get rid of wrinkles under the eye region. While lasers can diminish the appearance of wrinkles, botox and Dysport can permanently get rid of it. They also ensure that the wrinkles do not come back for quite some time. Some other wrinkles that botox and Dysport can fix include wrinkles of the forehead, eye, and the brows.

How Effective Are Wrinkle Creams?

In comparison to botox and lasers, wrinkle creams are far less effective. This being said, they are extremely popular for the fact that they are readily available over the counter and are very cheap. Most wrinkle creams contain retinol that helps to increase collagen production and stimulate turnover of the skin. Wrinkle creams that are designed for the eye do not contain retinol since they are an eye irritant and can cause damage to the eye. These creams also contain anti-oxidants that help the collagen to hold their own and stop the interference of free radicals.

Laser treatments such as the Fraxel and the fractional CO2 make tiny pores in the skin. These pores or incisions have two purposes. The first is to make sure that the skin produces collagen and the second is to ensure that the skin heals quickly. The laser can address wrinkles in areas such as eye, face, hands and legs. Out of all the treatment plans, laser treatment is by far the costliest one. They are typically used by maxillofacial surgeons having in-depth knowledge of physiology. Treatment of this kind might require more than one session depending on the extent of wrinkles.

How Does Dermal Filler Work?

Dermal fillers are a popular method to address wrinkles and are used to destroy wrinkles around the mouth and the eye. Lasers can also diminish hollowness and dark circles near the eye. Moreover, they are very effective in making up the lost volumes of the jawline, temples, and cheeks. Dermal fillers, however, last for about a year and needs to be redone to hold on to the facial changes. They are typically safe and contain limited side effects. A consulting session with the doctor will help to know more about the potential risk of this treatment.

Removing wrinkles from under the eye-

Botox and Dysport are two of the most popular options to get rid of wrinkles under the eye region. While lasers can diminish the appearance of wrinkles, botox and Dysport can permanently get rid of it. They also ensure that the wrinkles do not come back for quite some time. Some other wrinkles that botox and Dysport can fix include wrinkles of the forehead, eye, and the brows.

In case you have a concern or query you can always consult an expert & get answers to your questions!

As the effects of ageing set in, we all dread looking at the mirror as the image that stares back at us, is not very appealing. The dark spots, pigmentation, sagging chin, wrinkles, etc., are not something we want to admire. Almost everybody wishes to turn back time and go back to youthful, glowing skin. With this constant urge to look and feel young, cosmetic surgery has made significant advancements to restore youthful looks. One such advancement is rhytidectomy or known as facelift in layman terms.

What is it? In its current form, it does more than just remove wrinkles. It includes a combination of multiple surgeries and exercise routines, which are aimed at restoring a youthful appearance. The surgeries are aimed at removal of excess facial skin that causes the sagging, may include tightening the underlying connective tissues which are responsible for the firmness of the skin, and redraping of the skin over the face again. This is followed by an exercise regimen that continues to improve the tone of the facial muscles.

Types of facelifts: Though facelifts are advised for people above 50 years of age, depending on patient requirements, it could be done even in younger people. The type of facelift depends on the problem that is being corrected. Some of the common types are:

1. SMAS: This is used to lift the layer of tissue under the skin which eliminates sagging in the facial and neck area.
2. MACS: This technique is useful when there is mild sagging around the neck area.
3. Full facelift: Reduces ageing effects from all regions of the face.
4. Mid facelift: Sagging of the cheek area, flattening of the nasolabial folds, and eyelid surgery are done to improve the appearance of a face that is flat around the cheek area.
5. Thread lift: Sagging in the eye, forehead, etc., can be corrected by inserting a thread and literally pulling up the underlying tissue.

Plan for recovery: Depending on the extent of surgery, facelifts require considerable time to recover. It is advisable to plan for this, be it time off from work or household activities. It is important to give sufficient time for complete recovery.

Time for results to show up: Initially, there would be significant bruising, discomfort, and swelling. These will subside over a week to 10 days but bear in mind that for the actual result to show up, it could even take up to 6 months.

Surgeon’s Experience: Choosing a right surgeon is extremely essential, as an inexperienced surgeon can do more harm than good. Have a detailed discussion and set the right expectations to avoid disappointment.
If the ageing effects are really bothering you, go ahead and get a facelift.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Good morning, everybody I am Dr Adhishwar Sharma I am a plastic surgeon with a microvascular training I have done my MBBS from MKCG Berhampur, Odisha in 1992. We recently celebrated 25 years of entry in MBBS course and followed by after finishing my MBBS in 1997 I went in 98 I joined PGI Chandigarh, where I did my training in joint surgery and after finishing my joint surgery training and passing MS Joint surgery I work for another 3 years in PGI as a registrar followed by 3 years in Civil Hospital, Karnal and then I joined Jensen plastic training in Safdarjung Hospital, New Delhi which is one of the most largest departments of plastic surgery in India. After finishing my in 2010 I join 2007 and I finish in 2010 and from 2011 and 12 I spend doing fellowships in hand surgery and head and neck surgery in which I learned about the microvascular surgery, hand surgery above treatment of breaking blood cells which is my passion and my keen interest in treating patients of red blood cells and preferred nerve surgery. And then I spend another 6 months in head and neck Namrata learning head and neck surgeries, how to do head and neck reconstruction and various head and neck tumor management and other things and in 2012 generally I entered practice and briefly about and then I was working in Central Hospital Faridabad for 2 years then nowadays I am mainly working in Fortis Gurgaon and little bit of my work is there in Metro Hospital Faridabad and plus I do my own clinic in Brahmanand clinic in Faridabad which is located in near BK Chowk, NIT. And I want to talk about by the key passion that is brachial plexus injuries, my brachial plexus injuries are basically nothing but the flex of nerves which comes from the cervical cord and it supplies the from downwards from shoulder to hand, it control every movement of your hand. So hand is a very critical and very key component of human body. It’s a key means you're not gainfully employed, your potential is a human being is not fulfilled, if you don't have a functional and upper limb and from function upper limb including the hand. So these injuries are nowadays increasing because they are of mainly two types one is paediatric injuries and other is adult, paediatric is mainly birth canal injuries children are their plexus is damage during birth and these are basically low and other is the adult injuries, adult injuries are mainly high-velocity injuries suffered by the teenagers or the young adults during while driving motorcycle or having fallen from height and there are few injuries which are caused by tumors and hydrogenic dissection during an injury during surgery or another thing. So main bulk 90% of causes from the roadside traffic accidents and you see the breaking plexus injury doesn't kill the person but it effectively puts a person out of his employment and his social life, he is handicap for life unless he that armed he is functions are restored and that person cannot achieve its economic potential as well as potentially a human being. So treating these injuries and having these injuries is not only rehabilitate human being but you also make society more productive. So we have a lot of experience of treating these injuries in my clinic and Fortis Gurgaon and this thing I have done more than 200 cases of these injuries and I have been writing a blog about as a plastic surgeon, as a doctor, as a human being, we touch so many human beings in my life time and in my practice, so I have been writing all those interesting stories in my blog Brahmanand Clinic at BlogSpot and Brahmanand Clinic at WordPress, there are two blogs and there is another 3rd blog herbs and breaking plexus injuries.blogspot.com. So if you visit this blogs you will see how as a plastic surgeon, as a doctor we test that people's lives and we make them more productive and we conclude to the society. Thank you very much.