Dr. Yakup Avşar from Istanbul has developed a technique for cutting the nasal bones. His article with the name of ‘Nasal Hump Reduction with Powered Micro Saw Osteotomy’ was published at the first number of Aesthetic Surgery Journal (Official journal of American academy of aesthetic plastic surgeons) on January 2009. In this article Dr. Avşar discusses the advantages of nasal hump removal with powered micro saw technology.

This technique prevents the risk of bone destruction that may be occurred with breaking by the power of hammer. The fine micro motor cutting technology of Bien-Air Company (Switzerland) is used for this technique. Ultra micro saws and rasps reshapes the fine bony structure of the nose in its most precise form. Of course for big humps it is not enough by itself to rasp the bone, instead it is necessary to cut the hump step by step to reach the ideal plane and then rasp the bony edges to smooth it. The fine arrangement of micro saws is also used to mobilize the lateral nasal walls to make the wide noses more narrow.

Dr. Avşar denotes that the control of cutting in micro motor technology is completely in the hands of aesthetic surgeon without relying on the assistant to input the power of hammer. Also the direction of osteotomy is easily controlled in this system more better than controlling the hammer power.

The most advantageous side of this technology is its capability in designing the nose. The aesthetic surgeon designs the ideal nose for your face in computer and plan to do the surgery based on the difference between the two. With this micro technology the aesthetic surgeın will be able to strictly define the enough tissue that should be removed from the bone structure of the nose.

One of the most important poits in rhinoplasty is the ability of aesthetic surgeon in assessing the result of surgery during the operation. For this there should be no swelling in tissues. In this technology, the skin cover of the nose is protected from swelling with the aid of retractors especially during the rasping. From the other hand the surgeon sees and views all the steps of bone surgery under direct vision and also under endoscopic control.
So the risk of surprise prominences is deeply decreased when the swelling sets back after surgery.

Another advantage of surgical micro motor system is the ability to do all of the stages of bone surgery under direct irrigation cooling and this protect the tissues from heating and destruction. Irrigation complex of this system enables the plastic surgeon to lower the heat especially during rasping that may destruct the tissues and cause swelling.

Contact Yakup AVSAR MD: yakupavsar@yahoo.com
Cell Phone: 0090 532 527 75 24

‘Atomic Kitten’ band called the former star of the series of plastic surgery that finally started Katona’nın Kerry ended. Pregnant mother with four children failed to restore the body did. And of course, immediately exhibited a new body.
Kerry, aesthetic surgery after only 8 weeks with one-piece swimsuit and high-heeled shoes became Zoo Magazine cover.

Market chain 28-year-old Iceland ad star, mother to return to a previous image with a series of plastic surgery has gone through this path. Approximately 30 thousand dollars of the amount of surgery malolan this section, the program will start the show MTV Kerry’nin met soon. Gained a great view of the surgery shows the Kerry program will start this Sunday!

Building collapse, Liposuction breast Kerry, is already pregnant before aesthetic operations (ie, 4-5 years ago) was going to return to the thin body. Indeed, the former singer of the current TV star Kerry, said up to 36 fell from the 42-44 body.
Mother of four children Kerry: ‘I love this halime! Indeed, I saw IIK was screaming and I have Soke. I have smaller breasts değişim.Çok This is a big, ‘he said.

Kerry added: ‘It would feel more sexy. My confidence came back to myself very surprised to see me and everybody says. ”

Very pleased with the new display case body Zoo Magazine Kerry’nin says of the exposure with the new body would regain self-confidence.

“Her lips form such exaggerated …. It is not about a good eye,” says Estrella.

He thinks it is probably in three to four injections exit as Juvéderm its upper and lower lips, but argues that only one syringe was the case. In addition to his wrinkles, Dr. salt Hauer think he has in his cheeks padding - probably two to three syringes Radiesse.

“Her cheeks seem bit out,” he says. Another possibility? “Nikki could also injects his cheeks with the samples excess fat in the abdominal region,” explains Dr. Hauer salt. In any case, he considers it seemed better in the first photo. “She seemed much more natural.”

* Too angulations between the flag of the ear and the skull realizing the true “delamination” (helix valgus).
* Excessive size of the cartilage of the conch (see diagram) projecting the ear forward, which accentuates the look off (hypertrophy of the shell).
* A lack of kinking reliefs normal cartilage that fact that the flag of the ear has a too smooth, like “déplissé” (failure to kinking of anthélix).

Principles

The intervention aims to correct these anomalies finally remodeling cartilage in order to obtain ears recollées “symmetrical, size and natural aspects, thus putting an end to teasing and other remarks that could be the origin of psychological problems or conflicts at school.

A otoplastie can be done in adults or adolescents, but most of the time the correction is seen in childhood, where it can be done from the age of 7, when the child complains its appearance and suffers.

Structure of the ear
Before surgery

A close examination of the ear was made by the surgeon to analyze the changes.

A pre-operative assessment is normally done in accordance with

In case of anesthesia other than purely local, the anesthetist will be seen in consultation at least 48 hours before surgery.

Any medication containing aspirin should be taken within 10 days preceding the intervention.

For boys, a haircut is short of desirable. (For girls, a pony tail would be welcome)

The head and hair are washed thoroughly before the operation.

Depending on the type of anesthesia, he will be fasting (nothing to eat or drink) 6 hours before surgery.
Types of anesthesia and hospital procedures
Types of anesthesia

Three methods are possible:

* Local anesthesia pure analgesic where a product is injected locally to ensure insensitivity ears.
* Local anesthesia depth by tranquilizers administered intra-venous (anesthesia “guard”).
* General anesthesia classic, when you sleep completely.

The choice between these different techniques will be the result of a discussion between you, the surgeon and the anesthesiologist.
Terms of hospitalization

Usually the operation is performed in “ambulatory”, ie days in hospital with an output allowed the same day after several hours of surveillance.

However, in some cases, a short hospitalization may be preferred. The entrance is then in the morning (or sometimes the previous day in the afternoon) and the output is usually allowed by the next day.
Intervention

Each surgeon adopts a technique of his own and that adapts to each case to get the best results. However, it may hold common basic principles:

* Skin Incisions: Usually they are located only in the retro-auricular sulcus, ie in the natural crease behind the ear. In some cases, small incisions will be made at the front of the flag, but they will be hidden in natural folds. It should be noted that at no time did the hair cut.
* Dissection: The skin is then peeled off as needed to access the cartilage.
* Remodeling cartilaginous: The principle is to create or enhance the natural landforms and refinement by kinking, possibly maintained by fine sutures deep. Sometimes, sections or resection of cartilage are needed. Finally, the flag is lowered in a good position compared to the skull and fixed by profound points.
* Sutures: Traditionally, the son resorbable are used, otherwise they must be removed to the 10th day.
* Dressing: It is realized with an elastic band around the head to maintain the ears in a good position.

Depending on the surgeon and the importance of correcting defects, a bilateral otoplastie can take half an hour to an hour and a half.

Incisions
FOLLOW-UPS

The pain is usually moderate and, if necessary, resisted by an analgesic treatment and anti-inflammatory.

Otherwise, a consulting surgeon or his team needed.

The first large bandage will be removed between the 2nd and 5th day after surgery. Beyond that, it will usually be replaced by another bandage lighter for a few days. The ears may appear swollen, with reliefs masked by edema (swelling). Blue more or less important are sometimes present. This possibility should not worry: it is transitory and does not the final result. A strip of restraint and protection (such as “strip tennis”) must be worn night and day for a fortnight, and then only at night for several weeks. During this period, physical activity or sport with a risk of contact should be avoided.

Exposure to extreme cold is not recommended for at least two months because of the risk of frostbite because of the transient decrease of the sensitivity of the ears.
The result

A period of one to two months is necessary to assess the final outcome. This is the time for fabrics that are relaxed and all the swelling was reduced, showing clearly the relief of the ear. After this time, only the scars are still a little pink and indurated before fading. The intervention will most effectively allowed to correct the discrepancies and get ears normally positioned and oriented, although Plicata symmetrical, size and appearance natural, not bloated.

In most cases, the results are definitive. However, a recurrence of the décollement (usually partial) may occur in the medium term, then may require a little re-intervention.

Overall, this simple in principle and in its realization allows generally correct effectively unsightly that are the ears that are the subject, particularly in schools, frequent teasing or remarks that could be the cause of school conflicts or psychological difficulties.
The result of imperfections

They can occur secondarily, for example due to unexpected reactions or tissue scarring unusual phenomena. Thus we can sometimes observe a slight asymmetry between the two ears, small irregularities reliefs or kinking a little too prominent, a narrowing of the orifice of the ear, or a perception of deep son.

These small flaws, when they exist, are usually mild and do not attract the eye. However, if any, they are always accessible to a small “touch” that will most of the time under simple local anesthesia.
The possible complications

A otoplastie, although carried out mainly for aesthetic reasons, remains a real surgery, which involves the risks associated with any medical procedure, however small.

We need to distinguish between complications related to anesthesia those relating to surgery.

Regarding anesthesia, during the consultation, the anesthetist inform itself on (the) patient (e) the risks anesthetics. You should know that anesthesia induced in the body sometimes unpredictable reactions, and more or less easy to control: the fact to use a perfectly competent anesthesiologist, engaged in a real fact that the surgical risks are now almost statistically insignificant.

Be aware, in fact, that the technology, products and anesthesia monitoring methods have made tremendous progress over the past twenty years, providing security, especially when the intervention is conducted outside the emergency and in a healthy person.

Regarding the surgery: choosing a plastic surgeon, qualified and competent, trained in this type of intervention, to minimize these risks, but not completely remove.

Fortunately, the real complications are very rare in the wake of a otoplastie made in the rules. In practice, the vast majority of happens without any problems and patients are fully satisfied with their result.

Nevertheless, and despite their rarity, you should be aware of the potential complications:

* Post-operative bleeding: it is more important than just a spot of blood on the dressing (which has nothing to worry about), this may justify a re-intervention to stop the bleeding at its source. The blood may not s’extérioriser and lead to a hematoma that it is often preferable to evacuate.
* Infection: it is fortunately very rare thanks to the measures of asepsis opératoire draconian. If it happens, however, it requires prompt treatment to prevent cartilage damage which could be serious.
* Skin necrosis: exceptional, it sometimes occurs because of problems with traffic on the thin skin of the front of the flag, next to a relief cartilage. The healing process occurs normally through dressings local beach leaving a small scar.

* Abnormal Scars: despite all the attention paid to the achievement of sutures, scars located behind the flag of the ear may be the site of inflammation and hypertrophy embarrassing, even an evolution “Keloidal Scar” (sustainability of scar hypertrophy) whose treatment remains difficult.

In total, we should not overstate the risks, but just be aware that surgery, even seemingly simple, always has a small share of hazards. The use of a qualified plastic surgeon can assure you that it has the training and expertise to know to avoid these complications, or treat them effectively if necessary.

The facial and neck lifting is the most frequently performed, is the surgical correction of aging in the neck and in the face from the temples of the region until the region jowls.

This aesthetic surgery but can not be covered by health insurance.
Objectives

The operation aims to address the sagging and loosening of the skin and muscles of the face (temples and eyebrows, cheeks, jowls, oval of the face) and neck.

The aim of such an intervention is not to change the shape and face. On the contrary, the mere restoration of the anatomical structures of the face and neck (skin, muscle, fat) allows the operator (e) to find the aspect for which it was a few years ago.
Principles

The muscles are being switched in order to correct their release. The skin is then redrapée the demand on new curves without excessive traction. This double action allows for a natural result (because the skin is not too fired), durable (because the plan is solid muscle), operating suites usually quite simple (the skin “mark” because it less is little traumatized because of the tension and décollement limited). Overload any fat can be treated by liposuction.

In contrast, if the face is wasted, this can be corrected at the same time by re-injection of autologous fat (lipostructure).

Thus the face and neck are somehow “reconstructed”, “restructured.”

The skin incisions are needed for the most part hidden in the hair (at the temples and neck) and around the ear. The scar is almost completely hidden.

The lifting cervico facial can be done as soon as the signs of aging appear and a correction request is made reasoned, generally from 40 or 45 years.

This may be associated with another gesture of facial plastic surgery: eyelid surgery (blepharoplasty), correction of wrinkles and sagging of the forehead (frontal endoscopic lifting). It can also be supplemented by medical and surgical therapies (laserbrasion, dermabrasion, peeling, medical treatment of wrinkles and furrows, injections of botulinum toxin).

Before surgery

A preoperative assessment is normally conducted in accordance with the requirements.

The anesthetist will be seen in consultation at least 48 hours before surgery.

Any medication containing aspirin should be taken within 10 days preceding the intervention.

It will be almost a wash hair the day before the intervention and a thorough-up on the day of the intervention.

It is essential to remain fasting (nothing to eat or drink) 6 hours before surgery.
Types of anesthesia and hospital procedures
Types of anesthesia

The lifting cervico facial can be done under general anesthesia or under local anesthetic depth by tranquilizers administered intra-venous (anesthesia “guard”).

The choice between these different techniques will be the result of a discussion between you, the anesthetist and the surgeon.
Terms of hospitalization

Hospitalization of 24 to 48 hours is usually necessary.
Intervention

Each surgeon adopts a technique of his own and that adapts to each case to get the best results. However, it may hold common basic principles:

* The cut is largely hidden in the hair and around the ear.
* From the incisions, a detachment is made under the skin, its scope depends on each case, including the importance of relaxing the tissues.
* It then proceeds to the restoration plan muscular tension, extremely accurate and determined to correct the failure, while keeping his facial expression.
* In case of overload localized fat, liposuction is performed in the same operation: it can act on the neck, chin, the jowls and cheeks.
* The skin is naturally redrapée, the excess skin removed, sutures made without tension.
* At the end of the war, it has a bandage that goes around the head.

Depending on the surgeon and the importance of corrections, the procedure can last from two to three hours.
FOLLOW-UPS

The output may take place either tomorrow or the day after the operation.

The first days, we need to rest up and avoid any violent effort.

During these early days, the operation (e) should not surprise or worry:

* An edema (swelling) that may be more pronounced on the second day than the first,
* Bruises (blue) in the neck and chin,
* A painful sensation of tension, especially behind the ears, and around the neck.

The bruising and swelling disappear on average within 2 weeks after surgery.

After the first month, the swelling has almost disappeared in general. But there was a slight induration areas unstuck, more tangible and visible. The ears can recover their sensitivity normal one or two months later.

The scars are hidden in front of and behind the hair. The only slightly visible area in front of the ear, can be temporarily masked by hairstyling or makeup.

Basically it is:

* On the seventh day, presentable for intimate
* To twelve days, present for his friends,
* But to appear before the people we want to ignore the operation, it is necessary to provide for three weeks.

The result

After two to three months, we can have a good idea of the final outcome. But the scars are still a little pink and indurated and not to diminish as the sixth month.

Thanks to the progress and great technical detail, the result is often a significant rejuvenation effect, yet it is very natural: the face does not look “surgical” and found about the traits that were his eight or twelve years ago, giving a whole rested, relaxed and refreshed. The physical improvement is usually a better psychological.

In the long term, the lifting cervico facial allowed to struggle against the ravages of time, but aging continues to do its work and we can possibly consider a new type of intervention to lift after a decade .
The result of imperfections

It may be in essence:

* An edema (swelling) persist in certain areas beyond the third month and may need a massage,
* A partial relaxation of the tissues (ptosis), including the anterior neck when ptosis was important before surgery,
* Too visible scars or localized hair loss in the region of the temples (alopecia) that may require surgical touch distance (six months to one year).

The possible complications

A lifting cervico facial, although directed primarily for aesthetic reasons, remains a real surgery, which involves the risks associated with any medical procedure, however small it may be.

We need to distinguish between complications related to anesthesia those relating to surgery.

Regarding anesthesia, during the consultation, the anesthetist himself inform the patient of the risks anesthetics. You should know that anesthesia induced in the body sometimes unpredictable reactions, and more or less easy to control: the fact to use a perfectly competent Anesthésiste, engaged in a real fact that the surgical risks are now almost statistically insignificant.

Be aware, in fact, that the technology, products and anesthesia monitoring methods have made tremendous progress over the past twenty years, providing security, especially when the intervention is conducted outside the emergency and in a healthy person.

Regarding the surgery: choosing a Plastic Surgeon qualified and competent, trained in this type of intervention, to minimize these risks, but not completely remove.

Fortunately, the operating suites are generally simple setting of a facelift Cervico-facial made in the rules, and the real complications are rare.

In practice, the vast majority of happens without any problem and the patient (s) are satisfied (s) of their results.

Nevertheless, and despite their rarity, you should be aware of the potential complications:

* Hematoma requiring evacuation,
* A localized skin necrosis, responsible for a delay healing,
* Infection is exceptional when the intervention is carried out under normal asepsis.
* Nerve damage, particularly injury to a branch of the facial nerve, which can lead to paresis or facial paralysis are quite exceptional, and the consequences of such complications most often disappear within a few months.
* Abnormal scars, keloids or hypertrophic, creation and evolution unpredictable, can compromise the aesthetic outcome of treatment and require specific local often long.

In total, we should not overstate the risks, but just be aware that surgery, even seemingly simple, always has a small share of hazards. The use of a qualified Plastic Surgeon assure you that it has the training and expertise to know to avoid these complications, or treat them effectively if necessary.

Since 1975, doctors use botulinum toxin to correct strabismus in children, facial tics and uncontrollable blinking of the eye.

Botulinum toxin under the name BOTOX received in the United States, the authorization of the Food and Drug Administration (FDA) in 2002 for use in the treatment of wrinkles international eyebrow or wrinkles of the lion. ”

In February 2003, the French administrative authorities responsible for controlling drugs for the first time issued a license to market (AMM) in the interests aesthetic botulinum toxin under the name VISTABEL (laboratory ALLERGAN). This authorization for the use for cosmetic treatment of wrinkles of the glabella (wrinkles inter eyebrow or wrinkles of the lion “) under certain conditions competence of practitioners and terms of use.

In case of injections were performed in the field of aesthetic outside the sites, they would be made “off-label”.

In practice, the classic signs of botulinum toxin in the field of aesthetic concern wrinkles international eyebrow, forehead wrinkles and wrinkles on the feet.
Principles

The botulinum toxin is the use of muscle relaxation properties of this product.

The most often is to reduce the action of muscles located in the forehead and eyebrows to reduce wrinkles as well as horizontal vertical wrinkles caused by the contraction of the muscles.

This allows use to smooth the skin relief and get a rejuvenating effect upon release of muscle tension.

From a more global, we must realize that the position of the eyebrows is provided by a balance between two opposing forces, consisting of step-down muscle (located in the vicinity of the eyebrows), and an elevator muscle (the muscle front).

Horizontal wrinkles are caused by muscle contraction, which is front elevator. Wrinkles vertical inter-eyebrow are caused by muscle contraction step-down.
Objectives

The primary goal of treatment is to improve wrinkles and fine lines to rest and not to prevent muscle contraction: we therefore deem the result primarily on the appearance of wrinkles at rest.

As regards the balance between the muscles and step-down elevators, botulinum toxin by reducing the action of a group of muscles, reduces wrinkles caused by these muscles but frees the antagonistic action of muscles: the aim is to treat muscular balance and achieve a harmonization of the face.

Treatment with botulinum toxin should be designed and managed over time and should be treated gradually to avoid the possibility of “doing too much” during the first injections.

It is better to a first session moderately effective too efficient: it is not desirable to have a best result at the first injection.

In some cases it may be necessary to practice several sessions of injections prior to adapt the capabilities of the product for each patient (e).
Before injections

No preparation is necessary.

On the day of the injection, you do not need to be fasting. For women, there should be to come without makeup or to remove it before the injections.

It is very important to minimize the risk of bleeding treated areas to avoid taking aspirin during the 15 days preceding the injections and the 15 days that follow.

It is necessary to respect the against-the following:

* Neuromuscular diseases like myasthenia gravis.
* Pregnancy and breastfeeding: being pregnant, even a few days, necessitates postponing the date of injection after pregnancy and the cessation of breastfeeding possible. . It is therefore necessary in case of doubt to make the necessary examinations and to communicate the results to your doctor.
* Botulinum toxin is against-indicated in case of hypersensitivity to botulinum neurotoxin A or the serum albumin, and treatment with aminoglycosides (family of antibiotics which include including Amiklin and Gentalline).

It should also meet a number of precautions:

* If you are treated (e) otherwise by injections of botulinum toxin for pathological spasms, if you had an episode of paralysis of the muscles of the face, if you suffer from a neuro-muscular disease or disorder of the coagulation, you must participate in the practitioner who supports you for these injections of botulinum toxin. This judge then with your doctor about the advisability of injections on you and how to proceed as appropriate.
* If by injections, you are taking medicines like anti-coagulants or aspirin or antibiotics, or if you have any ill health (including infection, flu, abscessed tooth …) you must know your doctor before the injection.
* As a general rule, you should not hesitate to mention to your doctor, any health problems so that they appreciated the opportunity injection. In the same vein, you must provide him with all your questions and include all the treatments you may be or where you are still the object.

Type of anesthesia

No anesthesia is necessary.
Course of injections

The treatment will be done in the office of the practitioner or clinic according to the choices and habits of your physician.

This treatment is a series of injections in the face. The needle is fine, and injections are usually quite painful.

The duration of treatment is the order of minutes.
After the injections: suites

During the two hours after the injection, you are advised not to make sport intensive and not lie. It should also avoid handling facial or massage supported for 24 hours after the meeting.

It is very important to minimize the risk of bruising or bleeding treated areas during the two days before and two weeks after the injections (to reduce the risk of leakage of the product to the peripheral muscles which could lead unwanted effects).

Furthermore, during the three days following the injections, it is highly desirable to contract the muscles injected three times a day for about 5 seconds per muscle.

Usually the result of these injections are simple. Some brands remain somewhat inflated 20 to 30 minutes and then disappear. The patient (s) can resume their normal activities after the injections. Some rare side effects may occur. They are transient.

These may include:

* Redness: localized redness at injection sites has sometimes been reported and rarely persists beyond 3 to 6 days.
* Ecchymosis (blues): blueprints are rarely observed in areas of injection and can last several days.
* Edema: swelling, most often around the eyes, can gradually move into 4 to 5 days, then decrease in a few days to several weeks.
* Problems with sensitivity: a feeling of tension and fixity of the front of the mouth or neck, according to the injected areas, as well as changes in sensitivity often associated with a feeling of cardboard can persist for several days
* Pain or fleeting facial eye: such pain have been described in the areas injected in very exceptional.

Anyway, in the aftermath of these injections, do not hesitate to recall your doctor if you have any concerns.
The result

The result is a reduction of wrinkles with the conservation of small movements, it is obtained three to fifteen days after the injections.

Effects: The results are visible after a few days but for about 15 days, the effects on the face can be variable (see asymmetric at times) before eventually stabilize.

The result after the first session lasts an average of 3 to 6 months after which, the injection may be renewed.

Frequency of injections: injections must be performed several times with intervals of 3 to 6 months to get some stability with the result. Starting from the second injection, the results can be more sustainable (6 to 8 months). It should then repeat injections every 3 to 6 months.

It is recommended not to bring within 3 months of injections sessions to avoid creating resistance to produce a vaccine effect. ” The aspect of the result can be stabilized beyond 3 injections but in some cases, should be made to at least 8 to 10 injections to get some stabilization of the result.

In contrast, it should be noted that if you stop the injections, the muscle with its treaty before the injections.
The result of imperfections
LOCALIZED IMPERFECTIONS:

In some cases, localized defects (persistence of small wrinkles) can be observed only without real complications. They depend on the surface appearance of the skin that may, even before the injections, a “break” indelible due to length of the ride.

There may also insufficient results and even asymmetric: they are due to the fact that we have the muscles more or less powerful, and especially often asymmetrical.

These shortcomings are generally treated by a complementary injection of botulinum toxin, one month after the injection.

It should be noted that if an additional local injection may be advisable after an injection to make the result, it need not be conducted before the 15th day since the muscular balance (balance between muscle groups) take about 15 days to settle.
ASYMMETRY RESIDUAL:

A mismatch on both sides of the face and wrinkles more pronounced on one side than the other, exist in most cases before the injection.

Finally, the muscle responsible for the ride may be more powerful on one side than the other. This is usually analyzed before the injection. In such a case, injections will be using a technique slightly different from one side over another. Despite this precaution, a residual asymmetry may persist and may be eligible for a supplementary injection.

The acts referred to aesthetic aim to make it more happy and satisfy you in realistic proportions. Sometimes, however, and expected the effect is not achieved and that such acts contrary to the increase of psychological pre-existing. The experienced post-injection can be extremely different from one patient to another, even with a similar aesthetic result.

In the case of toxin Bolutique, rejuvenation is obtained in return for a reduction or even disappearance of some facial expressions. This aspect has been reviewed with you to avoid the risk of setbacks, especially if you are an actor, presenter, etc. …
The possible complications

Complications are rare.

The possible complications to date are:
LOCO-REGIONAL COMPLICATIONS:

* Headaches: they may be present in the setting of the first injection and disappear after a few hours to several days.
* Ptosis eyebrows: the injection of the front may cause a slight lowering of the eyebrows. This descent is usually due to the fact that the eyebrows were already low position before the injection. This slight lowering of the eyebrows usually regresses within a few weeks.
* Eyelid Ptosis: injection lion rides can cause a partial collapse of the upper eyelid, which can last 4 to 8 weeks. It is rare (less than 1% of cases), and always disappears beyond a few weeks.
* Discomfort or smile and swallowing: injection in the lips can cause discomfort to smile or small abnormal movements. The injection in the neck can lead to difficulty in swallowing.
* Dry eye: by decreasing lacrimal secretion may cause keratitis, particularly among patients with contact lenses (it should, in this case, be sure to moisten the cornea).
* Paradoxical contraction of a muscle disorder and mimicry: in the days following the injection, the treated muscles may have some paradoxical movements (spontaneous contractions) without gravity.

GENERAL COMPLICATIONS

They are quite exceptional:

* Allergic reaction: skin rash, hives, general allergic reaction.
* Nausea, dizziness
* Fatigue, fever, flu syndrome
* Dry skin or mouth.
These risks must be added the unpredictability of life and aspects, and finally, hazardous, or even unknown risks inherent in any medical procedure.

In total, we should not overstate the risks, but just be aware that any injection in the face still a small share of hazards.

The use of a qualified practitioner can assure you that it has the training and expertise to minimize these complications know where best to manage if necessary.

These are the elements of information that we wanted to bring you in addition to the consultation. We advise you to keep this document to read it again after the consultation and reflection “at their leisure.” This reflection can be lead to new questions for which you wait for additional information. We’re here to talk at a future consultation by phone or even the same day injections where we meet again, anyway, before they are made.

Breast hypoplasia is defined by a volume of breast underdeveloped compared to the morphology of the patient. It may exist at the outset (small breasts since puberty) or appear secondarily, as a result of weight loss or pregnancy followed by breast-feeding.

It can be isolated or associated with ptosis, ie a failure in the gland and distention of the skin. This aesthetic surgery but can not be covered by health insurance.
Objectives:

A mammoplasty increase is to correct the volume breast deemed insufficient by the development of implants (prosthetic) behind the mammary gland.
Principles:

All breast implants currently used are made of an envelope, and a filling. The envelope is always made of silicone rubber band (silicone elastomer). It can be smooth or rough (textured).

With regard to the filling product, only now are allowed in France on saline and silicone gel because they are known and used for nearly 40 years.

The implant is said pre-filled when the product has been incorporated filling factory (and silicone gel or saline). The range of volumes is determined by the manufacturer.

Inflatable implants to saline are completed by the surgeon who can adapt to some extent the volume of the prosthesis during surgery.
Before the speech:

The location of the scar, the location of the implant relative to muscle, the type and size of the prosthesis have been decided in consultation, depending on the context in particular anatomical and desires expressed by the patient. This way they come after a clear presentation of different methods to choose what is best in each case. A pre-operative assessment is normally conducted in accordance with the requirements. The anesthetist will be seen in consultation at least 48 hours before surgery.

In addition to the pre-operative examinations usual, it may be useful to check the breast imaging (mammography, ultrasound). Any medication containing aspirin should be taken within 10 days preceding the intervention.
Types of anesthesia and hospitalization:
Type of anesthesia:

It is usually a general anesthetic classic, when you sleep completely.
Terms of hospitalization:

A one-day hospitalization is usually sufficient.
Intervention

Each surgeon adopts a technique of his own and that adapts to each case to get the best results. However, it may hold common basic principles:

Skin incision

The implant is introduced by a short incision located:

* Or on the areola,
* Be in the region of the armpit,
* Either in the crease under breast.

Position of the implant

The lodge is built by décollement and in which the prosthesis is located is:

* Is behind the mammary gland and to the pectoralis major muscle,

* Is behind the gland and behind the pectoralis major muscle,
Gestures associated

In case of breast ptosis (droopy breasts, areola bass), it is desirable to involve a gesture of reducing the skin envelope which implies a larger ransom cicatricial (periareolar, vertical).

It is possible that a drain is left in place a few days after the operation so that the blood or liquid that can be collected are eliminated.

At the end of intervention, dressing models, with elastic in the shape of a bra is made.

Depending on the surgeon and the possible need for a complementary partner gesture, intervention can take 1 to 2 hours.

After intervention: follow procedures

FOLLOW-UPS can be painful the first few days, especially when the implant is placed behind the pectoralis major muscle. Then use a painkiller for a few days. In the best case, the patient felt a strong sense of tension.

Edema (swelling) and ecchymosis (blue) breast discomfort to the elevation of the arms are common at the beginning. The first dressing was removed after 24 to 48 hours and replaced with a lighter dressing, making a sort of elastic bustier made to measure. The release took place 24 to 48 hours after the operation, then the patient is reviewed in consultation two to three days later. We put in place a bra ensuring good contention.

Wearing this bra is recommended for about a month, day and night. If the son of suture are not absorbable, they are removed between the eighth and fifteenth days after surgery. Consideration should be given to recovery and a work stoppage for a period of 8 to 10 days.

It is advisable to wait one to two months to resume sporting activity.
The result

It can be appreciated from the third month, the time needed to easing breast and stabilization of prostheses. Beyond the aesthetic improvements, the psychological impact is most beneficial.
The result of imperfections

It is possible that the scar is an abnormal evolution in the form of thickening or retraction. Breast pain, disorders of the sensitivity mamelonnaire are also possible. On the other hand, a result of dissatisfaction aesthetics can motivate a reoperation after consulting the surgeon.
The question of the duration of the implant

A prosthesis, it is filled with silicone gel or saline for a period of uncertain life that we can not estimate a priori since it depends on the possible occurrence of complications. Thus, the life of the implant can not be guaranteed.

A woman with breast implants is at risk of using a complementary alternative to that effect is maintained. Nevertheless, there is basically an implant quality does not have a lifetime limited theoretically there is no deadline beyond which the change of implant is mandatory. Thus, in the absence of wear or complications, the implant can be kept as long as the patient wants.
The possible complications

The increase in breast prostheses, although carried out mainly for aesthetic reasons, remains a real surgery, which involves the risks associated with any medical however slight it.

We need to distinguish between complications related to anesthesia those relating to surgery.

* With regard to anesthesia, during the consultation, the doctor-anesthetist himself inform the patient of the risks anesthetics. You should know that anesthesia induced in the body sometimes unpredictable reactions, and more or less easy to control: the fact to use a perfectly competent Anesthésiste, engaged in a real fact that the surgical risks are now almost statistically insignificant. Be aware, in fact, that the technology, products and anesthesia monitoring methods have made tremendous progress over the past twenty years, providing security, especially when the intervention is conducted outside the emergency and in a healthy person.
* As regards the surgery: choosing a Plastic Surgeon qualified and competent, trained in this type of intervention, to minimize these risks, but not completely remove. The operating suites are generally simple setting of an increase in breast prostheses. However, complications can occur, some inherent in all breast surgery, others related to the establishment of a foreign body in the womb: the risks specific to breast implants.

1 / The complications inherent in all breast surgery:

- The occurrence of an infection requires antibiotic treatment and sometimes surgical drainage.

- Hematoma may require an act of evacuation.

- Changes in the sensitivity, especially mamelonnaire can be observed, but the sensitivity appears normal in most cases within 6 to 18 months.

- Especially the development of scars can be detrimental to the development of hypertrophic scars or keloids, creation and evolution unpredictable, which can compromise the aesthetic outcome of treatment and require specific local often long.
2 / The risks specific to breast implants:

They fall into three categories, which vary depending on the nature of the filling of the implant (see table). This is the formation of wrinkles or waves, the occurrence of capsular contracture peri-prosthetic and the risk of rupture or deflation.
Formation of wrinkles or aspect of “waves”:

The implant, to remain flexible, never filled with tension. As a result, the folds of the envelope of the prosthesis can be visible under the skin, while giving an aspect of “vague” especially in the upper, outer and lower breast. This is limited at the top when implemented in retro-muscular position. This phenomenon is much more common when the prosthesis is filled with saline solution, especially if its wall is textured. It exposes women at greater risk of rupture and deflation by premature aging of the envelope at a trick.
Capsular contracture and fibrous hull

The formation of a fibrous capsule around the implant is required. It is a normal reaction of the body that form a sort of fibrous membrane around any foreign body in order to isolate and protect themselves (or membrane capsule exclusion “). In some cases, this membrane is the seat of an adverse trend similar to keloid scars skin thickens it, shrinks and forms a real fibrous hull around the implant. This is the capsular contracture. There are four stages of firmness ranging from normal, undetectable to severe forms of shells with within hard, round, set and sometimes painful.

The frequency of this complication can not be estimated because it generally depends on the indication of the type of prosthesis and the operative technique. This complication is more common in cases of implant filled with silicone gel. The hull does not increase the risk of rupture but sets a complication aesthetic. Surgery can correct this by section contracture of the capsule (capsulotomy).

Several authors have proposed technical solutions to reduce the appearance of this contracture:

* The position of the implant behind the pectoral muscle,
* Manufacture of rough walls on the outside surface of the implant (textured prostheses)
* The use of implants filled with saline.

Rupture and deflation

Such an incident occurs as a result of an alteration of the envelope of the prosthesis, ie the container (silicone elastomer). Phenomena of porosity, open or puncture real gap may be involved and appear as a result of violent trauma, sometimes of a manufacturing defect, but especially because of the length of the prosthesis (phenomena wear).

For a prosthesis with saline solution, it can also be a problem sealing the filling valve. This type of prosthesis deflation suffered partial or total, fast or slow. If this is a prosthesis pre-filled with silicone gel, the gel is still mostly in the fibrous envelope surrounding the implant (intra-capsular leakage). The leak was then no clinical. However, this seepage intracapsular can promote the development of peri-prosthetic shell.

Much more rarely, in cases of breach in relation to significant trauma or violent to the needle puncture, freezing escapes beyond the fibrous envelope (extracapsular rupture). In small amounts, it can cause the appearance of a foreign body granuloma as a nodule (siliconome). In case of extra-capsular rupture important (trauma), the gel diffuses into surrounding tissues, breast takes a very soft consistency, inflammatory reactions may occur: the explantation surgery is necessary.
Questions: What you should know about breast implants
Is it possible to breastfeed?

The introduction of breast implants behind the mammary gland appears to have no impact on breastfeeding.
The breast protèses they promote the emergence of breast cancer?

The relationship between breast cancer and implant was searched but no link between the two has been highlighted and the establishment of a breast does not the risk of breast cancer. Surgeons of cancer centers regularly use for breast reconstructive surgery.
The monitoring of the breast is possible?

The prosthesis was behind the mammary gland, clinical monitoring is simple. The presence of an implant can affect the ability of X-rays to detect breast cancer. The patients carrying a breast implant should be made clear that the radiologist can use specific methods and adapted (ultrasound, digital mammography).
What about the controversy over silicone gel?

Breast implants filled with silicone gel have been accused of being responsible for the onset of autoimmune diseases in some patients. Today, all the scientific work on this issue has demonstrated that there was no significantly increased risk of autoimmune disease among women with breast implants and in particular those filled silicone gel.
Is there surveillance after the establishment of an implanted breast?

It is necessary to undergo post-operative visits, depending on the request of the surgeon. Subsequently, the presence of a breast implant does not need to conduct reviews in addition to the usual medical surveillance, but it is essential to clarify the doctor that you are carrying a breast implant. It is imperative for a variation of a breast (hardening or softening the contrary) to consult a doctor (family physician, gynecologist, surgeon) who will judge whether it is necessary to use an X-ray or ultrasound.

These are the information that we can now scientifically and honestly you make in the field of surgery by increasing breast prostheses. In total, we should not overstate the risks, but just be aware that surgery, even seemingly simple, always has a small share of hazards.

The use of a qualified Plastic Surgeon assure you that it has the training and expertise to know to avoid these complications, or treat them effectively if necessary.

This information brought to you in addition to consultation, we advise you to keep this document to read it again after the consultation and reflection “at their leisure.” This reflection may raise new questions for you wait for additional information. We’re here to talk at a future consultation, either by phone or on the day of intervention where we will in any case before anesthesia.

They may relate only to the two upper or lower eyelids, or the four eyes at once.

A blepharoplasty can be done alone or combined with other aesthetic surgery of the face (frontal lifting, lifting temporal, lifting cervico-facial), even a medical-surgical therapy (laserbrasion, peeling, dermabrasion). These acts are likely to be made during the same speech or during a second operation.
Objectives

A blepharoplasty proposes to correct the signs of aging present on the eyelids and replace the “tired” of the eye with a more rested and relaxed.

The misfortunes of the most commonly involved are:

* Upper eyelid drooping and heavy with excess skin forming a decline more or less marked,
* Slumped lower eyelid and wilted, with small horizontal wrinkles consecutive distention skin
* Hernias fat, responsible for “bags under the eyes” at the lower eyelids and upper eyelids eat.

The intervention is aimed at correcting these misfortunes in a sustainable manner, surgically removing the excess skin and muscle and the fat protrusions, and this, of course, without altering the essential functions of the eyelids.

It should be noted that many other alterations may be present, but their treatment is possible by using techniques more complex than just a traditional blepharoplasty, or through the use of additional surgical procedures. This applies to the collapse of the front and the fall of the eyebrows, wrinkles “lion” between the eyebrows, wrinkles “of the feet” on the corner of the eyes, “dark” eye ” Hollow “Eye” sad “with droopy eyes corner, and small surface imperfections of the skin (scars, stains …).

The operation, performed as well in women than in men, is commonly made from quarantine. However, it is sometimes carried out much earlier, when the misfortunes are constitutional (hereditary factors) and not related to age, as some “fat pockets”.
Before surgery

An interview followed by an examination of the eyes and eyelids have been made by the surgeon to search for anomalies that may complicate the intervention, even against-designate.

A specialized eye exam will be frequently asked in addition to detect any eye disease.

A pre-operative assessment is carried out as required.

The anesthetist will be seen in consultation at least 48 hours before surgery.

Any medication containing aspirin should be taken within 10 days preceding the intervention.

Depending on the type of anesthesia, you may be asked to remain fasting (nothing to eat or drink) 6 hours before surgery.

Types of anesthesia and hospital procedures
Type of anesthesia

Three methods are possible:

* Local anesthesia pure analgesic where a product is injected locally to ensure the insensitivity of the eyelids.
* Local anesthesia depth by tranquilizers administered intra-venous (anesthesia “guard”).
* General anesthesia classic, when you sleep completely.

The choice between these different techniques will be the result of a discussion between you, the surgeon and the anesthesiologist.
Terms of hospitalization

The operation can be performed in “ambulatory”, ie with an exit on the same day after several hours of surveillance.

However, in some cases, a short hospitalization may be preferable. The entrance is then in the morning (or sometimes the previous day in the afternoon) and the output is allowed by the next day.
Intervention

Each surgeon adopts a technique of his own and that adapts to each case to get the best results.

However, we can retain the common basic principles.
Skin incisions

* Upper eyelids: they are hidden in the groove located halfway up the lid, between the mobile and fixed part of the eyelid.
* Lower eyelids: they are placed 1 to 2 mm below the eyelashes, and may extend a bit beyond.

The route of these incisions is of course to the future location of scars, which will be hidden in natural folds.

Note: For lower eyelids, where pockets alone (without excess skin removed), we can achieve a blepharoplasty by trans-conjunctival, ie using incisions placed inside of the eyelids and thus leaving no visible scars on the skin.

Resections

From these incisions, hernias removed unsightly fat and excess muscle and skin is removed released. At this stage, many technical refinements may be made to adapt to each case and according to the habits of the surgeon.
Sutures

They are made of very fine son, usually non-resorbable (to withdraw after a few days).

Depending on the surgeon, the number of eyelids to operate, the scope for improvement, and the possible need for additional gestures, the response may last for half an hour to two hours.
FOLLOW-UPS

There is no real pain, but possibly some discomfort with a feeling of tension of the eyelids, a slight irritation of the eyes or some visual impairment.

The first few days we need to rest up and avoid any violent effort.

The operating suites are essentially marked by the appearance of edema (swelling) and ecchymosis (blue), whose importance and duration vary from one individual to another.

There is sometimes the first few days in an inability to completely close the eyelids or a slight loosening of the external angle of the eye that no longer applies perfectly on the globe. We should not worry about these signs that comply quickly reversible.

The son is removed between the 3rd and 6th days after the operation.

The scars of the operation will gradually diminish, allowing a return to social life after normal working days (6 to 20 days depending on the size of the suites).

The scars may remain slightly pink in the first weeks, but their makeup is quickly authorized (usually from the 7th day).

A slight induration loosened zones may persist a few months, but is not seen by the family.
The result

A period of 3 to 6 months is required to assess the result. This is the time for the tissues have regained their flexibility and that the scars were blurred at best.

The intervention has most often served to offset sagging skin and remove fat hernia correcting the appearance of aged and tired look.

The results of a blepharoplasty are usually among the most durable plastic surgery. The removal of the pockets is almost final, and they usually do not recur. Against the skin, continues to age and the resulting laxity may, over time, replicate the folding of the eyelids. However, it is rare that a new intervention to be considered before a dozen years.
The result of imperfections

These can result from a misunderstanding about what we can reasonably expect. One example is the collapse of the front and the fall of the eyebrows that can not be corrected by lifting fronto-temporal.

They can also occur because of unexpected reactions tissue or scar unusual phenomena. We can continue to see some changes (especially fine wrinkles) or get a look a little too low (edge of the orbit bone visible) or see a slight downward retraction of the lower eyelids, or that a small asymmetry scars or too “white”.

These flaws can be corrected, if necessary, by a small “touch” that will most of the time under simple local anesthesia, from the 6th month after the initial intervention.
The possible complications

A blepharoplasty, although carried out mainly for aesthetic reasons, remains a real surgery that involves the risks associated with any medical procedure, however small it may be.

We need to distinguish between complications related to anesthesia those relating to surgery.

Regarding anesthesia, during the consultation, the anesthetist himself inform the patient of the risks anesthetics. You should know that anesthesia induced in the body sometimes unpredictable reactions, and more or less easy to control: the fact to use a perfectly competent Anesthésiste, engaged in a real fact that the surgical risks are now almost statistically insignificant.

Be aware, in fact, that the technology, products and anesthesia monitoring methods have made tremendous progress over the past twenty years, providing security, especially when the intervention is conducted outside the emergency and in a healthy person.

Regarding the surgery: choosing a Plastic Surgeon qualified and competent, trained in this type of intervention, to minimize these risks, but not completely remove.

Fortunately, the real complications are rare following a blepharoplasty performed in the rules. In practice, the vast majority of happens without any problem and the patient (s) are fully satisfied (s) of their outcome.

Nevertheless, and despite their rarity, you should be aware of the potential complications:

* Hématomes: Most of the time are not serious, they can be evacuated if they are too high.
* Infection: exceptional at a blepharoplasty, except a few micro-abscesses developed a suture and easily treated with small care. A simple conjunctivitis be prevented by systematic prescription eye drops the first few days.
* Abnormal healing: very rare in the eyelids or skin, very fine, usually heals virtually invisible, it may happen that the scars are not, ultimately, as discrete as expected.
* Epidermal Cyst: they may appear along the scars; removed often spontaneously or are easily removable and do not compromise the quality of the final result.
* Injury to the ocular surface often accidental, they are usually not serious, and properly treated, declining rapidly and without sequelae.
* Chémosis (swelling of the conjunctiva which is a gelatinous): rare after blepharoplasty simple, its disappearance may take one to three weeks.
* Troubles in the secretion of tears: a persistent tearing is less a “dry eye syndrome” which has sometimes décompenser deficit existing in tears.
* Ptosis (difficulty to fully open the upper eyelid): very rare, except beyond 70 years where a pre-existing deficit can be increased by the intervention.
* Lagophthalmos (inability to completely close the upper eyelid): possible in the first days after the procedure, it persists beyond a few weeks should not meet.
* Ectropion (shrink down the lower lid): the major form is rare in the setting of a properly performed blepharoplasty. The minor ( “round eye”) occurs on the eyelids sometimes little tonic subject to retraction cicatricial unintended but ends mostly by fading after a few weeks of massage pluriquotidiens to loosen the lid.
* Finally, very exceptionally diplopia (double vision), glaucoma (ocular hypertension) and even blindness after blépharoplasties were reported in the international scientific literature.

In total, we should not overstate the risks, but just be aware that surgery, even seemingly simple, always has a small share of hazards.

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