Posted by: Dr. Sameer | September 8, 2010

The Basics : Why Lipo??

After the age of 18 years, the total number of fat cells in the body does not increase as fat cells neither regenerate nor multiply. The distribution of fat cells across the different areas of the body varies depending on the patients genetic / ethnic characteristics. As the person gains weight; the fat cells increase in size (like balloons) due to depositon of fat in these cells. As the patient loses weight and the fat is mobilized out and the fat cells decrease in size. However, due to the irregular distribution of the fat cells, some of the parts like the abdomen, love handles in the males; and the arms, hips, and inner thighs in females are more prominent due to a larger number of fat cells which make these deposits “exercise resistant”.
Liposuction can pick up where a healthy diet and exercise leave off to help you achieve your desired look. Liposuction has been used for several decades to remove unwanted fat from a man’s “love handles”, breasts, abdomen and neckline and a woman’s hips, thighs, knees, buttocks, abdomen, cheeks, and neck. It is the most commonly performed cosmetic surgery procedure the world over.
During internal / surgcal liposuction, fat cells are suctioned out along with the fat and are removed permanently. Therefore, the results of liposuction can be permanent. The subsequent weight gain tends to be uniform and not restricted to the “bulges”.
Liposuction is neither a substitute for dieting and exercise, nor is it a treatment for obesity. However liposuction can remove stubborn areas of localized fat that don’t respond to traditional weight-loss methods.
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Posted by: Dr. Sameer | September 6, 2010

The 4 Qs? of Lipo

1)Who are the best candidates for liposuction?
The best candidates for liposuction are normal-weight people with firm, elastic skin who have pockets of excess fat in certain areas. You should be physically healthy, psychologically stable and realistic in your expectations. Before you decide to have surgery, think carefully about your expectations and discuss them with your surgeon.

Age is not a major consideration; however, older patients may have diminished skin elasticity and may not achieve the same results as a younger patient with tighter skin.

Liposuction carries greater risk for individuals with medical problems such as diabetes, significant heart or lung disease, poor blood circulation, or those who have recently had surgery near the area to be contoured.

2)Should I diet and exercise to lose weight before or after liposuction?
People about 25 – 30% above their ideal weight are candidates for body contouring surgeries. Liposuction is an excellent way to change body contours, but it is most effective when the treatment can be focused on a few problematic areas. Therefore, Liposuction is best used as a treatment for diet-resistant areas of fat rather than diffuse collections of fat.

3)Is liposuction an alternative for diet and exercise?
Liposuction is not an alternative for diet and exercise. The number of litres of fat that should be removed through surgery is limited. The international norm is set at 8 – 10% of the total body weight. When somebody is excessively overweight, diet and exercise should be their first priority.

Liposuction is not a treatment for obesity its a body contouring / sculpting procedure

4)What happens if I gain weight after liposuction?
When fat cells are removed through liposuction, those cells never return. If the patient consumes more calories than are burned, those extra calories are stored as fat in the remaining cells. The areas treated with liposuction will never be as prominent as they would have been, but the patient is likely to have a generalized increase in size. Weight gain after surgery should be avoided.

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Posted by: Dr. Sameer | September 6, 2010

The VASER Lipo Advantage

Currently, liposuction is the most popular cosmetic surgical procedure with hundreds & thousands of people are opting for this surgery each year, but now many are looking for safer, less painful alternatives to traditional liposuction. VASER Lipo, or LipoSelection®, is an advanced body contouring & tissue-selective sculpting procedure, that selectively removes unwanted body fat while preserving other important tissues like blood vessels,nerves and connective tissue. In a recent survey, surgeons using VASER Lipo reported the following procedure benefits:

# Minimal avulsion (damage) to the tissue matrix
# Precise body sculpting and feathering
# Smooth contours in all body areas
# Improved skin retraction
# Reduced number of re-treatments
# Minimal post operative pain, swelling and bruising
# Fast patient recovery

Posted by: Dr. Sameer | September 6, 2010

The tech side of Liposuction

‘Lipoplasty’ is an all-encompassing term that refers to body contouring by sculpting or removal of fatty tissue. The market is flooded with advertisements, some mentioning the conventional, most the “latest” , with tag lines, catch phrases and tall claims. With all this jargon, the person opting for these procedures is faced with the obvious questions, “what actually works?, does it really work??” , “surgical or non surgical???” ,“which is the right procedure for me????”

The answers to these questions lie in all the current scientific medical literature and research published in peer reviewed medical journals, not medical advertising pieces claiming the latest, best etc. In the final run up, this is how all the technologies stack up with regards to what they can achieve in terms of results and volumes of fat reduction.


Liposuction/Suction-Assisted Lipoplasty (SAL )

This technology started it all and has been around for more than 30 years. It has undergone improvement and refinement down the years. Suction lipectomy, tumescent liposuction, syringe liposuction, and micro-cannula technique are all suction-based techniques commonly referred to as Suction-Assisted Liposuction,or ‘SAL’. SAL requires the infusion of a wetting solution into the adipose tissues first, followed by the insertion of a suction cannula that is attached to a suction source. The cannula tears and sucks out the fatty tissue fragments which are deposited into a canister.

The procedure is reliable, has been used and studied extensively making it the gold standard for comparing the results of newer technologies. SAL has been used for small to very large volumes of fat removal in lipoplasty.

Power-Assisted Lipoplasty (PAL )

Power-Assisted Lipoplasty (PAL) is essentially a liposuction cannula (SAL) with the addition of a motor-driven reciprocating handle. The primary advantage of this technology is that it makes passage of the suction cannula through the tissues easier for the surgeon but represents no clinical improvement in outcomes or safety relative to SAL for the patient.

PAL is generally used for medium to large volumes of fat removal, as it may be too aggressive for smaller, more delicate areas.

Vibro Lipo

Vibro Lipo is again a liposuction cannula (SAL) with the addition of a motor-driven vibrating handle. This motion dislodges the fat and lessens the surgeons effort, but again represents no clinical improvement in outcomes or safety relative to SAL for the patient.

Posted by: Dr. Sameer | July 31, 2010

More women try the Botox way to stay young

The number of women resorting to Botox, lip-plumping and similar treatments in an attempt to stay young has jumped by 15 per cent in a year.
More than one million treatments are now being carried out each year for the first time, confirming a desire to copy the beauty secrets of the rich and famous.
There are well known concerns that Botox injections into the face produce a number of undesired effects, not least creating a mask-like expression devoid of normal movement and expression.

The number of women resorting to Botox, lip-plumping and similar treatmentsin an attempt to stay young has jumped by 15 per cent in a year.More than one million treatments are now being carried out each year for the first time, confirming a desire to copy the beauty secrets of the rich and famous.There are well known concerns that Botox injections into the face produce a number of undesired effects, not least creating a mask-like expression devoid of normal movement and expression.

However, it appears that cosmetic procedures are increasingly being seen as a normal part of the beauty regime.

Research by retail analysts Mintel suggests as many as 19million people – men as well as women – would have some form of cosmetic enhancement if they could afford it.

Botox and its ability to freeze facial muscles, so smoothing away wrinkles, is by far the biggest element of the non-surgical cosmetic treatments offered. The market is worth £18million a year in the UK.

Posted by: Dr. Sameer | July 28, 2010

Cosmetic Surgery for Modern Men

Cosmetic Surgery

Cosmetic Surgery for Modern Men

Cosmetic medical procedures for women have been performed for many years. Cosmetic medical procedures for men have just become popular. According to the American Society of Plastic surgeons, 1.1 million cosmetic medical procedures were performed on men in 2008, and the numbers have kept increasing year after year. The cosmetic procedures help to achieve a more youthful appearance,more self confidence & more comfort in daily interactions.

The top five cosmetic surgical procedures performed on men in 2008 include:

The top five minimally-invasive cosmetic procedures performed on men in 2008 include:

  • Botox
  • Laser hair removal
  • Microdermabrasion
  • Chemical peel
  • Laser skin resurfacing

To indulge oneself, first & foremost it is important to select a board-certified plastic surgeon who focuses on cosmetic procedures. Over the years, plastic surgeons have found differences in the approach, the extent and the outcome of procedures in males. There may be alternative procedure choices for men. Once you have selected a qualified plastic surgeon, it is important to seek the doctor’s advice and discuss all of the options to select the best treatment for your individual goals.

Men are faced with unique considerations when considering a cosmetic procedure. The anatomy of a man is quite different from a woman; muscles tend to be bulkier & a greater variance in exposed skin areas may be a consideration . In addition, men can not cover scars in the facial area as well as women. Hairstyle and makeup can cover a lot for women. Post operatively, men are usually much more concerned about privacy than women, and may need to be off work longer following facial cosmetic procedures.

These are some of the common cosmetic surgery procedures with considerations specific to the men:

Hair Transplantation: The location of the hairline and the angles it creates on either sides is different for a man. Today the gold standard in surgical treatment for balding is “micrografting” of hair or the follicular unit hair transplant. These procedures make it difficult to spot a person who has had a transplant as opposed to 10 years ago when small groups of hair “plugs” were transferred. One or two hair shafts are transposed individually, creating a less obvious and more natural look.

Liposuction is often performed in men to remove love handles or reduce breast size due to gynecomastia. Results for men with liposuction are usually much better because they tend to have great skin elasticity (than a woman). Therefore the body contour and definition achieved is superior. VASER Hi Def Liposelection is a new procedure using state of the art 3rd generation internal ultrasound and can help sculpt the much desired six pack abdomen in males.

A full abdominoplasty (tummy tuck) in men is required when they have lost an excessive amount of weight over the abdomen resulting in loose skin or in men with a poor muscle tone. Most often, obese patients or those who have undergone weight loss surgery such as gastric bypass or sleeve gastrectomy are the only men who may be candidates for a full abdominoplasty. A “mini-abdominoplasty,” which involves liposuction of the abdomen and removal of minimal excess skin over the lower abdomen near can result in a tighter abdomen (and a scar concealed by even the smallest swimming trunks).

Quite a few men opt for facial implants as they result in better facial definition. Chin implants can help men achieve a stronger chin and are occasionally performed in conjunction with a rhinoplasty for a facial makeover. Jaw implants can help men strengthen and define their jaw line. Cheek implants or malar implants are another popular form of male facial augmentation that can provide facial fullness in men with hollow, concave cheeks.

Chest Implants, also referred to as male breast implants or pectoral implants, are gaining in popularity as increasing numbers of men are realizing there are some things that push-ups just can’t do. Pectoral implants can help the chest look fuller and more muscular. Similarly, calf implants, can help men with thin, shapeless calves, beef up their lower legs.

The risk of complications is present with every medical procedure. Men bleed more than women and therefore are at an increased risk for excessive bleeding or a hematoma (blood clot under the skin). The incidence of smoking being higher in males, puts them at a higher risk with regards to post of wound healing complications too.

Everything said and done cosmetic surgery procedures work well for most men. Extensive research, selecting the right plastic surgeon, understanding preoperative and postoperative care can reduce the risk of complications. Having realistic expectations and understanding the limitations of each procedures also helps one to cope up with post operative disappointments if any. The increasing popularity of cosmetic surgery amongst men continues to grow, affording men the same anti-aging & body contouring benefits as women.

Posted by: Dr. Sameer | July 27, 2010

VASER Liposelection – The Next Gen in Body Contouring

Vaser Liposelection

Vaser Liposelection

VASER Liposelection a term which is slowly becoming popular. Though still unfamiliar, this new method is the least painful and most effective way to shed that excess “exercise resistant” body fat with minimum downtime and it looks to revolutionise the way liposuction is performed.

So what are the benefits of having VASER liposelection over the traditional methods? VASER uses the state of the art 3rd generation ultrasound technology which unlike the previous ultrasound based treatments delivers much less intensity of power to the tissues. Vaser lipo is tissue selective (fat selective) & therefore gives more uniform results, decreases the blood loss (allowing larger volume liposuction), achieves excellent skin retraction post op and as previously stated, a shorter recovery time, with a lesser bruising and pain.

This is how VASER works in the simplest possible terms. The procedure is similar to the one used to break up cataracts in the eye; using ultrasound technology (also used to treat kidney stones). The ultrasonic technology breaks the fat cells & emulsifies (liquefies) fat, allowing it to be suctioned out easily, leaving the veins, nerves, blood vessels and connective tissue unscathed without collateral damage.

VASER lipo can be done under local anaesthetic and sedation if it involves small areas , rather than general anaesthesia. This in turn means that after the liposelection, people can be back at work only days after having the procedure. VASER liposelection is generally used for treating excess fat on the thighs, buttocks, abdomen, underarm, to get rid of the ‘love handles’, double chin, ‘saddle bags’, ‘banana rolls’ and ‘man breasts’ (gynaecomastia).

VASER also allows for better sculpting in tougher and fibrous areas like back. It is an effective procedure for both sexes.

There will be around a week of swelling, which will then recede aided by pressure garments. One will continue to have noticeable results for up to six months, as the skin continues to retract and achieve the new sculpted form.

Liposelection is a surgical procedure used for body contouring and not for weight loss. However, VASER liposelection confers an edge over the conventional procedures by allowing removal of larger amounts of fat which was unsafe due to blood loss. Recovery after a large volume liposuction is faster with VASER.

VASER has now been used in more than 100,000 procedures all over the world and has proven to be safe with improved results. Hi- def liposelection with VASER is gaining popularity amongst men for the much desired six pack abdomen. VASER lipo is the next gen body sculpting surgical procedure and the preferred alternative to traditional harsher liposuction techniques. Its Liposelection not Liposuction.

Hair Transplant

Hair Transplant

There are many reasons for hair loss but 90% of all cases in men are due to a condition called “androgenetic alopecia.” This is commonly referred to as “male pattern baldness.

You may loose 80 to 100 strands of hair per day. But this hair is not dead as all the hair that falls gets replaced with new growing hair. The hair goes through a generation, growth and fall cycle which continues again with generation of new hair. You do not become bald because you are loosing more hair, you will become bald when the lost hair is not replaced with new hair.

Patients with grade 3 hair loss respond with medicines alone; unless the patient desires to change the hairline or bring forward the temporal receding on either sides. Anybody below age of 23 years or not having hair loss beyond Grade III is not considered for hair transplant surgery. Patients with grade 4 hair loss and more require medicines and surgery to achieve a desirable result.

Pre-treatment/pre-conditioning of hair with medicines which stop hair fall, induce new hair growth and strengthen the hair roots in the recipient area prior to the transplant is recommended. It stops hair loss in 2 months, and thinning of hair in men and women will get corrected by 60 – 70% with cyclical medicines within 4 months. Moreover, pre conditioning the hair roots ensures a predictable and guaranteed result following the hair transplant.

The gold standard in hair restoration surgery is the Follicular Unit Hair transplant also known as follicular unit hair grafting or “the strip method”. A follicular unit is the naturally occurring group of hair containing from 1 – 3, occasionally 4 hair. The hair follicles on the back and side of the head (the “donor area”) are genetically programmed to be permanent (i.e. they do not fall).

A hair transplant involves transferring a persons own live hair roots, which are genetically programmed never to fall, to an area of baldness. The grafts can be inserted into tiny needle- sized sites in the recipient area. A combination of these different sized grafts is used in the hair restoration, with the one-hair grafts in an irregular pattern along the hairline, and the two & three hair grafts placed further behind to create more density. By transplanting follicular units, the way hair grows naturally, the results of the hair transplantation are virtually undetectable.

Hair transplant is done under local anaesthesia along with sedation (if required) to make you relaxed and comfortable. As many as 2000 grafts can be transplanted in a single procedure lasting 6 – 10 hours. You can go home the same day.

Antibiotics & mild pain pills to reduce the chance of pain & swelling are taken the first three days after the procedure. You can shampoo your hair with a mild shampoo on day 3 following surgery and can return to work and most regular activities.

Patients find that their “new” hair falls out within 2 – 3 months after surgery. This condition is normal and almost always temporary. After hair falls out, it will take another 2 – 3 months before hair growth resumes. To help accelerate the growth of the transplants, we recommend the patient to start the medicinal treatment protocol again following the removal of the sutures.

Remember, the only permanent remedy for hair loss is surgical hair restoration, or hair transplantation. Once transplanted, these hair will continue to grow for a lifetime; they can be groomed, shampooed and require haircuts like normal hair. The results of hair replacement surgery can enhance your appearance, self-confidence and change your persona…..forever.

Posted by: Dr. Sameer | July 27, 2010

“Scarless” Videoendoscopic Breast Augmentation

Scarless Breast Augmentation

Scarless Breast Augmentation

Breast implants are changing the shape of the world. Breast augmentation, also known as augmentation mammoplasty, has been a evolving areas of plastic surgery every year for the past decade. It is one of the most popular cosmetic surgery procedure performed the world over.

Breast augmentation is popularly done through the inframammary (breast fold) / peri areolar (along the junction of the black portion of the nipple with the skin) approach which leave scars on the breast. The Transaxillary Videoendoscopic Breast Augmentation is a technique of breast enlargement where  silicone breast implants are placed through an incision in the arm pit. Most  patients and their partners prefer the armpit incision because it:
1) Avoids scars on the breast : Most patients do not desire to have a scars on the breast, no matter how inconspicuous the scars are.This technique leaves the breast aesthetically intact.
2) Avoids cutting through the breast tissue when placing the breast implants underneath the muscle.
3)The armpit scar heals well. Since the armpits normally remain concealed, the scars are highly inconspicuous, even if they do not heal properly.

In addition, patients who have not had a pregnancy or whose areola is small may not be able to have a periareolar approach for the breast augmentation. Endoscopic transaxillary breast augmentation is ideal for these patients.

The incision is about 5 – 5.5 cms, well hidden in the depth of the armpit. When the incision heals, it is barely noticeable.  A videoendoscope allows the entire breast augmentation procedure to be visualized on a television monitor, while carefully developing the pocket for the implant. As a result the surgeon has total control of the operation and there is no blind dissection of the tissues. The fold below the breast (inframammary fold) as well as the medial aspect of the pocket (the cleavage area)  can be defined precisely. The technique allows the placement of the implants below or above the chest muscle. With the visual guidance of the endoscope, the implants can be placed precisely in the proper position.

As in all breast augmentation procedures, the operation is performed under general anesthesia. The breast augmentation procedure takes approximately 2 – 4 hours. Patients remain in the recovery for about 2-3 hours after surgery until they are fully awake. Pain with breast augmentation surgery varies from patient to patient but normally lasts 1 to 2 days and is well controlled with pain relief medications. The pain is usually related to the placement of the implants underneath the muscle whether this is done through the armpit, periareolar or crease incision. Thus, the armpit incision is no more painful than the other incisions.

Post operatively the armpit should be washed once a day and antibiotic ointment applied. The stitches dissolve on their own. Deodorant can be used in 2 days. Shaving can be resumed in 2 days with care.The armpit incision is barely seen and blends in with the natural creases of the armpit. Many patients believe that it heals better than the periareolar or crease incision.If a second surgery is necessary to adjust an implant, replace a leaking implant or correct a capsular contracture, this can be done through the original armpit incision. In rare or severe cases, a separate incision on the breast may have to be performed.

One of then potential drawback of the transaxillary incision often cited in literature is the risk of less than perfect placement of the implants. This is attributed to the surgeon working further away from the actual surgical destination, leaving more possibility for error. However, when a surgeon is trained and experienced with the transaxillary technique, the risk of error in implant placement is very low.

Not every plastic surgeon performs the armpit incision for breast enhancement. Transaxillary breast augmentation requires special training, instrumentation and expertise. Your plastic surgeon should be able to perform breast implants through a variety of incisions including the armpit, periareolar or crease incision to give you the most options and can recommend what is best for you, cos at the end of the procedure, its you, who has a scarless breast.