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Plastic & Resconstructive Surgery

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The choice to undergo plastic surgery is one of the most personal decisions you will ever make. So our plastic surgeon are committed to providing "total customer or patient care" in services, both clinical and individualized.

This section is devoted to "art" of plastic surgery, original from the Greek word "plastikos", because the plastic surgeon is in some way, like a sculptor. Like an artist creating a masterpiece, a plastic surgeon uses his skills and knowledge, to contour, transform and shape the body in a specific way to carry normal functional and anatomical body coverage. Through the surgery is searched to reconstruct the deformities and correct the functional deficiencies.

Our Procedures

Breast augmentation is not just a medical decision is a very personal decision. Currently, there are many options available to women who decide that the increase is most appropriate for them. The more knowledge you have of the procedure and options, the more security when making a decision.

The breast augmentation surgery is used to increase the size (cup) and improve the size of the breasts. Your decision is very important and must be done together with a plastic surgeon based on their needs, desires, individual expectations and individual real medical alternatives.

The breast consists of ducts and glandular lobes surrounded by fatty tissue which provides the shape and texture.

Factors such as pregnancy, rapid weight loss, and effects of gravity (laxity of tissues) associated with aging, which cause the skin to stretch, which can cause the breast to hang or "fall." In such cases, the placement of breast implants can help lift sagging breasts. Sometimes it is not sufficient only to lift the bust implant and must be done simultaneously an operation to lift the nipple areola complex and breast, known as mastopexy.

All women have asymmetry in the size or shape of a breast on the other from the female character development in adolescence. In cases where the asymmetry is very evident implants can be placed in shape and sizes for each breast. This achieves a more symmetrical result.

Incision sites for the increase:

Commonly, there are four places where you can make the incisions: around the areola (periareolar), the lower breast folds (inframammary) or under the armpit (axillary) and umbilical / endoscopic: This incision site has not been well studied and is not recommended by manufacturers of breast implants. By this approach only saline implants can be used.

Implant placement:

The breast implant can be placed either below the pectoralis major muscle (submuscular) or on the muscle and under the breast (subglandular). There are other places like the subfascial and dual plane.

The submuscular placement may cause the surgery take longer, recovery may be longer, and the patient may experience more discomfort when compared with subglandular placement. The potential benefits of submuscular placement is that it can result in less palpable implants, less incidence of capsular contracture, or hardening of the breast, and allow a better picture of the breast when performing imaging studies such as ultrasound or mammography.

The Subglandular placement allows surgery and recovery shorter, may be less painful and allows better access in case you need another operation, this surgery compared with submuscular. However, subglandular surgery may result in more palpable implants, as they will be less covered, higher incidence of capsular contracture, or hardening of the breast and can be difficult to obtain the image of the breast when performing imaging studies such as ultrasound or mammography.

¿Breast implants: saline or silicone?

A saline breast implant is a silicone covering or bag filled with saline solution. The implant is filled with saline, also known as "salt", through a small hose or connection, during surgery. These breast implants were developed in 1964 by a French company called Laboratoires Arion.

Is less natural and may result in more palpable implants compared to silicone breast implants. As the content is liquid, it will move by gravity, depending on the position of women, causing wrinkling of the top which can be visible or palpable.

Saline implants deflate when either saline drips through a valve poorly sealed or damaged, or by a break in the implant shell. Some implants deflate (or rupture) in the first months after being placed and others deflated after many years. You should be aware that the implant can be spent over time and will deflate or suffer ruptures.

In 1961, plastic surgeons Thomas Cronin and Frank Gerow developed the first breast implant silicone. One of the most important advances in implant technology was the introduction of high cohesiveness gel implants by Mcghan (Inamed Aesthetics) in 1993. These have the advantage that, not being liquid content, the implant maintains its shape; lowering the risk of wrinkles or irregularities like traditional silicone or saline implants. In case of rupture, the consistency of the gel prevents the silicone to migrate to other neighboring areas. The form is also easier to control with this material, so implants look and feel more natural and offer the best results.

Despite the misconceptions related to breast implants with breast cancer, there is no evidence to suggest that they are indeed related.

Although breast cancer incidence is not higher in women with silicone implants, the presence of implants makes cancer detection via mammography difficult, especially when the implants are placed in a subglandular or above the muscle.

There are two types of implants that can be used: the anatomical or round. The anatomical shaped like a drop, while the rounds are as the name suggests, and leads to a rounder shape. Both types are available in a range of sizes and profiles. Dr. Badilla will recommend that the implant is considered better for you and help you choose the size that fits your body better after listening carefully to your desires and expectations.

Anatomic implant or round implant?

The main difference is that the round implant will give more lump or volume at the top of the bust. In contrast, the anatomic implant will give a decline in the top of the breast. Round implants have a more round and globular appearance than that anatomical implants. Contoured implants mimic the naturalshape of the breast more accurately.

Advantages anatomical implants:

* Almost total absence of wrinkles or irregularities on the implant.
* Do not deflate as saline implants.
* Allows greater control over the width of avoiding excessive breast lump at the top.
* The form can be adjusted to the thorax of each individual case.
* The feeling and form is very natural.
* Do not irrigate or spread if the implant ruptures.
* Do not exert much pressure on the lower pole of the breast making it less likely that over the years fall or pull the lower pole.
* Also, it is assumed that the duration of these implants is greater.

Advantages of Implants round:

With round implants, upper breast is going to look more rounded and full. Some women prefer a more rounded in their breasts, in these cases; round implants are a good alternative. Another aspect to consider is that round implants are less expensive than anatomical cohesive gel implants.

Surgical technique and anesthesia.

Augmentation surgery performed in Costa Rica, usually on an outpatient basis. I.e., the patient leaves the same day of the operation.

Typically, general anesthesia is used, however, local anesthesia with sedation also an option. The surgery takes 1 to 2 hours. The doctor makes an incision and creates a pocket for the breast implant. The implant is placed and positioned within the pocket or space created. Finally, the incision is closed, usually with absorbable sutures and will place a special adhesive tape to provide added support. You can put gauze over the wound to promote healing.

It is usually not a painful procedure. The patient should rest two days and in a week you can make normal life, without making a lot of activity with your arms. Most patients at 3 or 4 weeks can initiate strenuous exercise or sports.

In any operation, no matter how small, it leads to inflammation. The degree of this varies from person to person and is very difficult to predict. This is a natural reaction of the organism. In this type of surgery, the first few weeks, the breasts are deformed and flattened appearance. This is because the rearrangement has been made of breast tissue, and inflammatory process is never symmetrical. Around the third week, they take a more natural and are hiding the scars, but the entire process takes 6 months or more. Once finish the healing process, the full process of inflammation dissipates.

Postoperative care:

* The sitting or standing position favors her to decrease the inflammatory process.
* It is recommended that you sleep on your back during the first ten days.
* A special bra or bandage, should be worn day and night the first 2 weeks postoperatively, and then only during the day for a month.
* You must use micropore ® for no rubbing or friction points directly to the wound with dressing while protecting the wound.
* Always shower every day, washing the wound with soap and water to which must be removed the bra and tap to wash it.
* If the wound crusts or grains, should be cleaned gently with hydrogen peroxide after bathing.
* The wound dressing should remain the same unless you have some kind of secretion, in which case we recommend covering it with gauze.
* Do not make an effort with your arms as heavy lifting, exercise, etc.., or lifting arms above the shoulders during the first 2 weeks. From the third week, you must start with moderate exercise and movement arms, little by little until you get to normal in one or two weeks.

The risks of breast augmentation:

Any surgical procedure produces a certain degree of risk. Although most patients experience no complications, it is important to understand the risks, potential complications and consequences of breast augmentation.

Bleeding (hematoma) - Although the risk is minimal bleeding into the space around the implant may occur after the operation. If this occurs, the patient will be taken back to the operating room to control bleeding. Keep in mind that this could produce an abnormal form of the breast and potentially lead to hardening of the breasts.

Infection - Some of the breast tissue normally contain bacteria and is likely to come into contact with the implant during breast surgery augmentation. For this reason, all patients are placed antibiotics before surgery and for several days after. The risk of infection is less than 1%.

The loss of nipple sensation - Some patients notice a change in nipple sensation after breast augmentation surgery. The change may result in an increase or a decrease in sensation and may last several weeks. However, the change is temporary. Permanent loss of sensation is very unusual.

Possible long-term complications:

Capsular contracture (hardening of the breasts due to the presence or contracted scar capsule that compresses the implant) - Each individual makes a scar around the implant. This is a normal response of the immune system to a foreign body. For unknown reasons, some people form thicker scars than others. A thick scar can distort and even cause chest discomfort. This problem has decreased since the use of silicone implants and submuscular placement, however, if warranted additional treatment, the scar is incised or is removed and the implant will be replaced.

Graft rejection - If the implant is rejected, a surgical procedure is relatively short and simple required removing the old implant and replacing it with a new one.

The ripple visible (rippling) - People with small breasts who have had a large increase may be at risk of having a visible rippling of the skin that covers it. This problem is more common with saline implants, and can be avoided by placing the implants under the pectoral muscle.

Interference with mammography.

Implants can do technically difficult to conduct and read mammograms. Implants placed behind the pectoral muscle allow the breasts are observed more effectively through a method called Eklund technique.

Mastopexy or breast lift is not a simple operation. The fall is probably the most common breast deformation in women, however, mastopexy, consists of removing excess tissue, especially skin.

Optimal candidates for mastopexy surgery.

Many times, mastopexy is considered by women who have had children, since pregnancy, and lactation causes the skin to stretch and has less volume inside. And also those with loose or weak skin due to aging and gravity forces.

The best candidates for this surgery are those with a small and ptotic breast, as they also are candidates for breast implant. However, breast lift can be performed in breasts of any size.

Procedure.

In this surgery, the nipple areola complex will be moved or shifted up and left in an ideal position or suitable for the patient.

There are different techniques that can be used depending on the size, shape and degree of fall of the breasts (ptosis) is distinguished by the resulting scars after surgery. Next, these techniques are described:

Mild ptosis: You can use a cut in crescent-shaped top that allows a minimum rising; this technique is used only when the degree of fall of the breast is very little and the size of the areola is adequate. It is more likely to use when combined with the use of implants as these help to fill the bag skin, helping to lift the breast.

Likewise, it can perform an incision around the areola type "donut" (periareolar), allowing to resize an aesthetically suitable diameter. Removing a strip of skin and a circumferential suture is made in the form of snuff bag to reduce the excess skin. Similarly, as the crescent technique, in these cases the use of implants helps to increase the lift.

Moderate ptosis: in these cases is indicated periareolar incision technique and vertically, which is resize the nipple areola complex and perform a skin removal a bit more extensive, resulting in a scar around the areola and a scar vertical. Initially, the vertical scar can be a bit wrinkled or creased and it is possible that the shape of the breast is not completely normal at first, however, the scar flattens and the breasts reach their proper shape after about 3 to 4 months. Has the advantage that avoids wide horizontal scar. This technique also can be combined with the use of breast implants to increase breast volume.

Severe Ptosis: in these cases, you must use a technique that involves placing scars around the nipple areola complex, vertically on the lower pole of the breast and horizontally along the inframammary crease. The result is an anchor-shaped scar or inverted T.

Incisions.

* After surgery is normal to have lots of bruises.
* The breasts will be swollen and uncomfortable for a day or two, but the pain is not severe.
* You must use a special bra that gives support 24 hours a day for 3 to 4 weeks, and a gauze pad or micropore ® so there is no rubbing or friction points directly to the wound with dressing.
* Surgery can leave the skin of the breast too dry, so that you can apply a moisturizer to skin several times a day.
* You will experience loss of sensation in the nipple and skin of the breast. This loss of sensitivity disappears when temporarily or permanently cedes inflammation.
* Avoid heavy lifting on the level of the head at least 3 or 4 weeks.
* Bleeding and infections usually never happen if you avoid the blows, weights, lifting the arms above the shoulders and if kept clean surgical wound in the breast.

Risks:

Complications are infrequent and usually minor, although no surgical procedure is without risk. Possible risks include bleeding, infection, temporary or permanent loss of sensation, visible irregularities in the skin, asymmetry, and the accumulation of fluid under the skin, which may need to be drained by aspiration or other surgical procedure.

Results:

Women who perform breast augmentation and mastopexy at the same time found that the results are more durable, since it increases the projection. Otherwise the duration of breast lift will depend on pregnancy, weight fluctuations and gravity.

Women usually feel really satisfied despite visible scars.

The breast reduction surgery, also known as reduction mammoplasty, is a commonly performed operation and is designed to make bigger breasts, smaller, lighter, symmetrical and more proportionate to the body of the woman. In many cases, the areola around the nipple is reduced in size, and nipples are elevated position. You can use liposuction to remove some of the excess fat, but it is absolutely necessary to cut and remove the glandular tissue and excess skin.

The reduction in breast reduction surgery for women with breasts too large who would like to resolve one or more of the following partners:

* Back pain, neck or shoulders.
* The pain and shoulder grooves due to the pressure of the strap fastener.
* Sleep disruption or restriction of physical activities.
* Irritation, rashes or chafing of the skin under the breasts.
* Fall of the breasts due to excess weight.

It is important to have realistic expectations about the results, so this should be discussed frankly with the surgeon. Each patient and surgeon also has different perspectives on what is a desirable size and shape for breasts. The purpose of surgery is to make your breasts proportionate, but it is difficult to guarantee the size of the cup that will result.

Procedure:

Techniques for breast reduction vary, but the most common procedure involves an anchor-shaped incision (like an inverted "T") around the areola, extends to below and follows the natural curve of the crease beneath the breast. The surgeon removes excess glandular tissue, fat and skin, and performs a transposition of the nipple areola complex in a new position and involves the skin on both sides of the bottom of the breast and around the areola, shaping the new contour of the breast.

In most cases, the nipple remains attached to its blood vessels and nerves. However, if your breasts are extremely large or very ptotic, it may be necessary to completely remove the nipple areola complex to place in a higher position. This would result in a loss of sensation in the nipple areola complex.

Risks:

Complications are infrequent and usually minor, although no surgical procedure is without risk. Possible risks include bleeding, infection, temporary or permanent loss of sensation in the breast and nipple areola complex, visible irregularities in the skin, asymmetry, and the accumulation of fluid under the skin, which may need to be drained by aspiration or other surgical procedure.

Results:

As a result of the operation scars on the breast are permanently, but they are placed with care to be relatively hidden once healed, and that can be hidden by the bra and swimwear. People who smoke may have a recovery process much slower and much larger scars. The procedure also can cause the breasts to be slightly disproportionate or the nipples to be positioned unevenly. There is no problem when breastfeeding, by contrast, is always recommended.

Rarely, the nipple areola complex will lose its blood supply and causing the tissue to die, but it exists. The areola and nipple can be reconstructed, however, however, using grafts of other body parts.

After surgery, we place a special bra, which must be used 24 hours a day during the first four weeks. You may have to place a small drain in each breast for a day or two to drain blood and fluids.

Micropore ® should be used for no rubbing or friction points directly to the wound with dressing while protecting the wound.

Aftercare:

You may experience occasional pain for a couple of weeks. It is important to avoid lifting or pushing heavy objects for three or four weeks. Most women can return to work, provided that their work does not require much physical effort; and to their social life in two weeks. You will have less strength for several weeks so you are advised to limit exercise to stretching and swimming until you feel your energy level is normal again. It is important to use a bra that gives support as detailed above, and cannot use a bra with a rod at least 6 weeks.

Although most of the swelling and bruising will disappear during the first weeks, it may take up to six months or a year for your breasts to accommodate its new shape. Even then, they may suffer fluctuations in response to hormonal changes due to weight and pregnancies.

Breast Reconstruction or reconstructive mammoplasty.

Breast reconstruction is a section within the more complete treatment of breast cancer.

Depending on the case, the reconstruction can be done in the same surgical amputation, and in other cases it will be advisable to do it after a few months after completing radiotherapy.

There are different techniques to reconstruct a breast, using techniques that enable own tissues to recreate a more natural breast and will not change much over time or with changes in posture, or with weight changes. On the other hand, the use of tissue expanders and breast implants may decrease the possibility of complications in certain cases.

Typically, breast reconstruction is posed in 2 or 3 operations:

1. Reconstruction of the affected breast with local flaps, regional or microsurgical. Or if local conditions allow the skin is performed reconstruction using temporary tissue expanders.

2. In sagging breasts (ptosis) may be necessary to change the other breast to get a good symmetry (or symmetry mastopexy).

3. Replacement of tissue expander for a permanent prosthesis.

4. Reconstruction of the nipple-areola complex in the reconstructed breast.

In TRAM flap, the abdominal flap breast reconstruction, moving tissue from the abdomen to the upper chest area, to create a new breast. To avoid the weakness of the muscles of the abdomen may be necessary to place a mesh to give strength to the abdominal wall. It is very important to patient selection, as there are risks, such as necrosis or total loss of the flap.

Reconstruction with tissue expanders and breast implants can offer, in some cases, excellent results. A tissue expander is a prosthesis that once introduced can be completed progressively to cause expansion of the surrounding tissues and thus create space for a definitive prosthesis. There once inflated expanders can be left in place permanently.

A tissue expander needs good skin coverage with a certain thickness and elasticity, so that the quality of the fabrics is very important in these cases, a chest that has been irradiated with radiation therapy may be a contraindication to the use of tissue expanders. The extended latissimus dorsi flap, allows obtaining tissue from the back and removing the thoracic scar to create a new breast.

Depending on the amount of tissue and needs, it may be necessary to use breast implants to achieve the desired volume.

Risks:

Complications of treatment of reconstructive mammoplasty are rare, although no surgical procedure is without risk. Potential risks include:

* Bleeding or hematoma.
* Seroma.
* Partial or complete loss of the flap.
* Asymmetry.
* Loss of skin sensation.
* Fat Necrosis.
* Unsatisfactory results.
* Infection, including in the surgical wound, lungs (pneumonia), bladder or kidney.
* Reactions to medications.
* Additional surgery.
* Respiratory problems.
* Deep vein thrombosis / pulmonary embolism.

The risks of breast reconstruction with implants are:

* The implant will break or leak present in 1 in 10 women in the first 10 years. If this happens, you will need more surgery.
* It can form a scar around the implant in the breast. If the scar becomes firm, the breast may feel hard and you may have pain or discomfort. This is called capsular contracture and need more surgery if this happens.
* Infection shortly after surgery, which would require removing the expander or implant.
* Breast implants may change slightly, which will cause a change in the shape of the breast.
* One breast may be bigger than the other (asymmetry of the breasts).
* There may be a loss of sensation around the nipple and areola, if this complex was not removed during mastectomy.

Gynecomastia.

Gynecomastia is a medical term used to describe the abnormal enlargement of the male breast. It is a fairly common condition that affects nearly half of men in adolescence and can occur in one or both sides of the chest.

Gynecomastia can be caused by hormonal changes, extreme weight loss, hereditary conditions, diseases or the use of certain drugs. It is characterized by excess glandular tissue, excess localized fat - or a combination of both - in the breast area, and in some cases, may extend to the sides and back as well.

The breast reduction surgery can help men look and feel better, creating a more masculine chest contour and accentuating the anatomical features of the pectoralis major pectoral region to show a more athletic figure.

Men with gynecomastia, which have healthy and relatively normal weight, may consider breast reduction surgery as an option - although a full medical checkup is necessary to rule out any medical cause of breast enlargement. Surgical correction of gynecomastia is best performed in men whose condition cannot be corrected through alternative medical treatments.

Techniques:

There are several techniques that can be used for treating gynecomastia, depending on the size and shape of the breast. In general, the procedure involves making an incision in the lower edge of the areola to remove the gland. In cases where gynecomastia is at the expense of fat (lipomasty) is used liposuction to remove excess fat deposits localized. In some cases, it is necessary to combine both surgical procedures and also perform other procedures to remove him more glandular tissue, fat and excess skin.

Aftercare:

You will need to wear a vest over two to three weeks to compress the skin and aid in the healing process.

Micropore ® should be used for no rubbing or friction points directly to the wound with dressing while protecting the wound.

Drains (if necessary after surgery) can be removed after one or two days. Sometimes you can see small areas of crusting along the incision line, which must be kept clean. They should not be touched and fall on their own after about 15 days.

Recovery is rapid, but it is important to limit physical activity for optimal recovery. Avoid any heavy exercise, lifting, pushing or pulling heavy weights four to six weeks. Heavy exercise can hinder the process of healing of incisions and lead to complications such as delayed healing or pathological scars. Direct exposure to sunlight should be avoided for about six months.

Risks:

Complications of treatment of gynecomastia are infrequent and usually minor, although no surgical procedure is without risk. Possible risks include bleeding, infection, temporary or permanent loss of sensation in the chest and / or nipple areola complex, visible irregularities in the skin, asymmetry, and the accumulation of fluid under the skin, which may need to be drained by aspiration or other surgical procedure.

Surgery forehead and eyelids:

Our outward appearance is not always as good or how we feel physically young. Heredity, skin abuse, overexposure to sun, aging and eventually make the forehead, eyebrows and temporal region is loose and wrinkled. Excess skin on the eyelids and fat deposits which form bumps or protrusions (eyelid bags and dark circles) are the main signs of aging.

The result of these phenomena is a sad look old, tired, which gives sometimes angry appearance. Fortunately, plastic surgery can correct these defects, restoring youthful and fresh look of the person.

Solutions:

The operation that corrects the signs of aging on the eyelids is called blepharoplasty or eyelid plastic surgery. This is done in upper and lower eyelids, removing excess or excess skin and fat bags prominent. The incisions are made on the natural folds, making them almost invisible once healed. Blepharoplasty minimizes the signs of aging in the eyelids have no effect on the forehead and cheeks.

Often the problem of excess skin on the upper eyelids is accentuated by associated eyebrows and forehead wrinkles. In these cases, we recommend, in addition to blepharoplasty operation known as coronal forehead lift or lifting. This operation raises the eyebrows, the forehead, temples and minimizes many of the wrinkles of the forehead. The forehead lift incisions are hidden in the hair of the frontotemporal region, leaving barely visible or hidden by the hair.

Also, it can be done by 3 small incisions in the scalp, separating it with care and repositioning the forehead that was sagging. The hair is collected in bundles with rubber bands and makes three small incisions in the scalp. After separating the forehead of the underlying bone, the skin is repositioned, and three small strips of scalp are removed to produce the desired appearance. After the elevation of the forehead, a dressing is placed around the entire head. Every effort is made to minimize scarring and to hide the scars, the direction of the hair follicles.

These operations, both blepharoplasty and forehead lift can be done separately or in conjunction with a facelift or facelift or other facial surgeries.

Anesthesia:

The most widely used technique for eyelid surgery (blepharoplasty) and / or forehead lift is local anesthesia combined with a sedative. Thus, the patient is sedated allowing a faster recovery and ambulation. Sometimes, especially when combined with other procedures may be required general anesthesia or if the patient so desired.

Postoperative:

Patients are advised to rest as much as possible during a week after surgery.

After the operation it is normal to have swelling and bruising. Much of the inflammation is removed during the first weeks and generally the "bruise" is deleted in a week or two. Keep your head elevated and applying cold compresses to keep swelling minimal. Where necessary they are allowed a bandage to decrease seroma or hematoma formation, for at least seven days.

There may be discomfort or mild pain, but is easily controlled with medication. Severe pain is extremely rare. Sutures are removed during the first week and allow the patient to use makeup a few days later.

With the removal of excess skin and fat around the eyelids and / or elevation of the eyebrows, the patient will have a more youthful look with fresh eyes and rested. The amount of improvement depends on the individual characteristics of each individual and the extent of surgery performed.

Risks:

The risks in this operation are minimal. But there certainly are inherent in any surgical procedure. Possible risks include bleeding, infection, wound dehiscence, asymmetry of eyelids or forehead, prominent scars, hair loss at the incision site, facial nerve injury and fluid accumulation under the skin, which may need to be drained by aspiration or other surgical procedure.

Plastic surgery of the eyelids (blepharoplasty), brow and forehead (frontal lifting) can help improve their image and their self-confidence.

Otoplasty is a surgical procedure in order to reshape the ear or pinna. You can use a variety of techniques and different methods to reshape congenital prominence of the ears or to restore damaged ears.

Each person seeking an otoplasty is a particular situation, both in terms of the appearance of their ears as it looks on the surgical outcomes of otoplasty. It is important that before surgery you talk in detail about what you expect with your plastic surgeon.

¿How is the surgery?

The surgery begins with an incision behind the ear in the crease where the ear joins the head. Otoplasty usually involves surgical removal or replacement of cartilage and skin to achieve the proper effect. In some cases, the cartilage is cut to shape it to a more desirable form, and then bends back with permanent sutures to anchor the ear until healing, which can naturally keep it in place.

Although it is a common operation in adults, the most common is that they are done in children over 6 years of age. It is an ambulatory procedure. Generally, in young children is done under general anesthesia and in adolescents or adults under local anesthesia. It requires 5 to 7 days of rest and about a month without intensive physical activities or sports. It is essential to use for a month of compression garments on the ears.

Risks:

Every surgical procedure involves a certain amount of risk. The choice that an individual takes to undergo a surgical procedure is based on comparing the risk to potential benefit. Although most patients do not experience these complications, if you are considering this, you should discuss each of them with your plastic surgeon and make sure you understand the risks, potential complications and consequences of otoplasty surgery.

Hemorrhage: It is possible, though unusual, to experience an episode of bleeding or bleeding during or after surgery. If postoperative bleeding is likely to need emergency treatment to drain accumulated blood (hematoma). Do not take any aspirin or anti-inflammatory medication for a week before surgery, as this may increase the risk of bleeding.

Infection: Is very rare to get an infection after the operation. In case of an infection, it may require treatment with antibiotics or additional surgery.

Changing skin sensitivity: Usually at the beginning is no loss of sensation or numbness in parts of the ear. You may not recover fully for the decline (or loss) of the capacity of sensation in the skin area of the ear after otoplasty surgery.

Trauma to the ear: Physical injury after otoplasty operation would affect the results of surgery. It should be very careful and protect the ear or ears from injury during the recovery process. Additional surgery may be necessary to correct the damage.

Asymmetry: The human face is normally asymmetrical. There may be differences between the ears normal with respect to the shape and size. You can have different results in one ear or the other.

Deep sutures: Some surgical techniques use deep sutures and nonabsorbent. The patient can touch or feel these objects after surgery. It may happen that the sutures pierce the skin and visible spontaneously or produce irritation, which is required for extraction.

Additional surgery required: If there are complications, it will require additional surgery or other treatments. Even though risks and complications occur infrequently, the risks cited are particularly associated with otoplasty. There may be other complications and risks associated with anesthesia or other procedures, but are much less common.

Chronic pain: Pain may rarely have chronic pain because the nerves are trapped in scar tissue after otoplasty.

Rhinoplasty or nose surgery:

The operation of plastic and reconstructive surgery that eliminates or improves the deformities of the nose is known as rhinoplasty, is one of the most common procedures in the industry. This surgery involves removal of excess bone and / or cartilage shaping the nasal structures. In some cases, it is necessary to place implants of bone or cartilage defects to highlight or fill in parts of the nose.

Most rhinoplasties are performed in people who want to improve the aesthetic appearance and / or functional, but there are cases where the older, deformed nose will progressively lead to difficulty breathing.

All noses are different, some very long, some wide, some with "humps" or very small, and so on. Rarely can you find two identical noses. The plastic surgeon shapes the nose for it to be in accordance with the facial features.

¿At what age is recommended rhinoplasty?

If there is a deformity and / or severe respiratory defect should be corrected in childhood. Otherwise, you must wait for the nose is sufficiently developed or mature. This is a woman around 14 years and man approximately at 16 years. At these ages usually the nose is sufficiently developed for surgical correction. Although it is necessary to individualize each case, as some patients noses "mature" at younger ages.

Early correction of unwanted nasal deformities gives greater confidence and self esteem to the person. Also in many cases rhinoplasty is performed as part of a complete facial rejuvenation program to eliminate the effects of aging nose.

Technique.

A nose surgery is performed under general anesthesia, although there may be cases in which a local anesthetic. This will depend on the intensity or complication of the procedure performed. Preferably local anesthesia is used together with a sedative to keep the patient relaxed and asleep. In difficult cases, the operation takes approximately one to two hours.

To ensure that any scar to occur is not visible, incisions are made inside the nose. Only in very complicated or individual external incisions will be made to correct all the deformities. During the process, the skin over the nose is separated from the structure of cartilage and bone. Rising the skin, Dr. Badilla proceeds to sculpt the support frame to achieve the desired shape. The level of restructuring depend on the needs and wishes of the patient and the problem he / she is present. When you finish this stage of the procedure, the skin is repositioned on the bone and cartilage.

After the surgery, a small bandage or adhesive "tape" is placed on the nose, which is kept for a week and if necessary plaster cast is placed on the nasal dorsum for 5 days.

During the first 24 hours you place a small gauze pad at the entrance of the nose, to collect the secretions. If necessary, put blockages in the nostrils, thus, patients have a more comfortable postoperative swollen and usually less. The patient can leave at 6 hours after the operation safely.

Postoperative:

The patient should not expect to see results immediately after the operation. There is a normal healing process in which there is inflammation and "bruises" which are gradually eliminated. After a week of surgery the "bruises" and inflammation largely disappear. The patient can usually return to school or work at this time. Overall, about 80% of inflammation disappears within 2 weeks, 90% in two to three months. Obtain the final result per year and in some cases, it takes longer.

The percentage of improvement depends on the extent of the correction and the basic structure of the nose. A deformed nose frankly shows a dramatic change. A small "hump" or point a little broad, show discrete changes. The intention of the surgeon should be artistically molded nose according to the features of the person and not making dramatic changes, or noses "artificial" noticeable over long distances that they are operated noses.

Complications:

• Abnormal shape of the nose (pinched tip, polly beak, pug nose, should be corrected by secondary surgery, often to use a nasal implant.
• Airway obstruction.
• Reaction to anesthesia.
• Asymmetry.
• Bleeding (may require nasal packing to control).
• Depression.
• Discoloration.
• Extrusion (implants).
• Infection (risk is less than 1%).
• Signs of infection: pain, swelling, heat, redness.
• Internal scar / adhesions (synechiae).
• Keloid (thick scar).
• Loss of smell.
• The loss of structural support.
• Nerve damage.
• Numbness.
• Pain.
• Septal perforation.
• Permanent numbness (risk is less than 1%).
• Reactions to medications.
• Septal hematoma.
• Sinusitis (treatment with antibiotics and drugs that reduce the size of the nasal mucosa).
• Irregularities of the skin.
• Skin necrosis or skin death (1500% more likely with smokers).
• Slow healing.
• Swelling.
• Visible scar.

Lesion of blood vessel :

After surgery, small broken blood vessels appear as tiny red spots on the skin surface. These are generally small, but may be permanent. This rarely happens, but it is a possibility that should be considered.

Epistaxis :

Bleeding may occur for up to four weeks after the operation. The patient should resist any temptation to shake or touch your nose to minimize bleeding.

Wound infection:

The rate of wound infection following rhinoplasty is less than 2%. Abscesses, cellulitis or granuloma can be treated with antibiotics and drainage. The use of an implant increases the likelihood of infection.

Risk of smoking:

Smoking reduces your body's circulation and vascularity. This means the difficulty of bringing much needed oxygen to tissues and greatly increases the risk of slow healing and other complications. It is important to stop smoking for at least 4 weeks before and after surgery.

Additional surgery required:

If there are complications, it will require additional surgery or other treatments. Even though risks and complications occur infrequently, the risks cited are particularly associated with rhinoplasty. There may be other complications and risks associated with anesthesia or other procedures, but are much less common.

When rhinoplasty is performed by a qualified plastic surgeon, complications are rare and usually minor. However, all surgery carries the risk of complications and unwanted results. You can reduce your risks by closely following your surgeon's instructions both before and after surgery.

Rhytidectomy or Facelift or Rhytidoplasty:

From the Greek word "rythid" means wrinkle the skin, the suffix "ectomy" is removed, so the word Rhytidectomy is the medical term used for the operation that removes wrinkles or stretched and flabby tissues in the face and neck.

This operation reduces sagging and a wrinkle caused by stretched skin, and lifts and repositions the fatty tissues of the face and neck that tend to sag with aging. The operation is indicated by any of the following two reasons: to help prevent the progression of aging in young (under 40 years) and have them remain with a youthful appearance, or to assist a person that is wrinkled, with sagging skin look younger and fresh.

How long is the result of the operation?

Perhaps this is the most frequently asked question by the individual seeking a facelift. The duration of improvement depends on many factors such as type of skin care that is given to it, sun exposure, diet, etc... In an obese person, the duration of improvement of a facelift is very short. In people of normal structure can be said that the duration ranges from 5 to 10 years depending on the factors mentioned. There is no operation on an ongoing basis to prevent aging, but the operated individual will ever be seen as old as it would if he had not had surgery.

Rhytidectomy or facelift has become one of the most popular operations in plastic surgery because the medical and technological advances have increased considerably in life expectancy and so many women and men find that they look older than how they feel physically and mentally.

Post-operative:

It is normal after the operation to present some swelling and bruising. The swelling gradually disappears after the first day. The "bruise" may last a little longer, but they blend easily with makeup that can be started using a week of operation. To help minimize the inflammation process is recommended the patient to avoid the sun, alcohol and snuff during the first weeks, and also, it is recommended to rest, avoid talking much and laugh the first few days.

They are left with a bandage to decrease seroma or hematoma formation, for at least 2 weeks.

They may experience mild discomfort after surgery, but this is easily controlled with medication. The severe pain is rare. Sutures are removed during the first week.

A facelift or rhytidectomy is a procedure that can help improve your appearance and look younger. This will definitely help you feel better and more encouragement for their daily activities. The risks involved are minimal. However, there certainly are inherent in any surgical procedure you undergo.

Risks:

Every surgical procedure involves a certain amount of risk, although most of patients do not experience these complications.

Bleeding or Bruising: It is possible, though unusual (less than 2%) experienced a bleeding episode during or after surgery. In that case, it may require emergency treatment to drain accumulated blood. Hypertension (high blood pressure) that is not well controlled can cause bleeding during or after surgery.

Infection: Infection is unusual after surgery. If infection occurs, it will require additional treatments with antibiotics or surgery.

Healing: although it is expected good healing after surgery, abnormal scars may be given, they occur due to genetic predisposition or other causes peculiar to the wound. Scars may be unattractive and of different color than surrounding skin. You may remain visible marks from sutures. Additional treatments may be needed to treat scarring.

Nerve injury: although it is very unlikely to happen, they can injure nerves during surgery of this type. Nerve damage can cause temporary or permanent loss of movement and sensation in the face. Such injuries usually improve over time.

Asymmetry: the human face is normally asymmetrical. It can vary from one side to another in the results obtained from a facelift procedure.

Unsatisfactory: you may be disappointed with the results of surgery. Although this is rare, you may need additional surgery to improve your results.

Hair loss: Hair loss can occur in areas of the face where the skin is elevated during surgery. The appearance of this is not predictable.

Slow recovery: it is likely that certain areas of the face may not heal normally or take a long time to recover. There are areas of skin that may be lost or necrotic. This happens primarily in smokers or people with poor circulation. In this case, frequent changes may be required to cure or further surgery to remove tissue that has not been recovered. Smokers have an increased risk of skin loss and complications in wound healing. It is my policy not to operate absolute smokers, to ensure patient safety and prevent complications. Patients who smoke are strongly encouraged to stop smoking for at least one month before and one month after surgery.

Long-term results facelift does not stop the aging process or produce permanent tightening of the face and neck. Weight loss or increased sun exposure, or other circumstances may influence the results of this surgery. Surgery or other treatments may be necessary to maintain the results of cosmetic surgery.

Facial Fat Grafting.

Body fat is excellent filler for soft tissue. Fat injection (also called autologous fat grafting) consists of a fat transfer part of the body to another body part. In the face is used to reduce frown lines, nasolabial folds (smile lines), enhance the lips and give better definition to areas like the cheeks and chin. Also, can be used to fill depressed scars or depressed in any area of the body. Sometimes the fat used to augment or fill in the buttocks. Fat injection is not permanent, and it is very likely to require re-injected in the future.

Technique:

The donor (e.g., abdomen, buttocks, or thighs), and the treatment site are injected with local anesthesia. A special solution is injected into the donor site to facilitate the collection of fat. Fat cells are extracted through a small needle with a syringe. The fat is then processed to remove excess fluids and reinjected with another needle in the desired area. Generally, it fills a little more than necessary, because the fat absorption during the first weeks after treatment. The fat also may be taken during a lipoplasty (liposuction), in any area of the body, and then reinjected into another area.

Advantage:

It is a natural filler does not cause allergies or rejection.

Outpatient procedure that generally takes less than an hour.

Injections may last from several months to be permanent.

Requires little or none inactivity.

Minimal discomfort, which can be controlled with medication.

The patient's body fat, does not require a test before, and the fat is not rejected.

Other considerations:

The duration of results may vary significantly from patient to patient. It is common for some swelling and bruising in the first 2-3 days. The patient should avoid the sun for 3 weeks.

Not every area is suitable for injection of fat. Injecting fat into a breast, for example, makes cancer detection difficult by mammography, and is strongly condemned by the scientific community. The fat keeps longer when injected in relatively stationary areas, such as the cheeks and lips.

Risks:

As is the case with all cosmetic treatments, fat transfer involves risks (but mild) along with the benefits. The benefits of fat transfer through the injection well established, including the correction of the imperfections of the face and adding a volume with autologous material (i.e., the patient's own body). It is important to consider the risks and benefits of fat transfer before choosing to undergo this procedure. The benefits discussed below, followed by a detailed description of the possible risks and complications of fat transfer.

Benefits of facial fat transfer:

Fat injection as a cosmetic treatment is natural, versatile, durable and safe. Fat transfer has become a preferred method of facial volume increase for patients who are allergic to traditional dermal fillers such as collagen of bovine origin. One of the biggest benefits of increased volume through fat injection is that there is absolutely no chance of an adverse allergic reaction.

The fat transfer risks are few, rare and minimal. Pain and swelling are possible but are not experienced by each patient. The most important drawback of this procedure is that its face or lips can absorb all or most of the fat injection. The chances of this happening cannot be predicted for a given individual, but it happens in up to half of all patients who receive fat injection treatments.

The complications include an allergic reaction to local anesthesia, permanent discoloration caused by a ruptured blood vessel in the treatment site, calcification, a distorted look, if carried out overcorrection; perioperative bleeding, bruising, swelling, blood clot blood in the treatment or the donor site, infection, scar tissue and fat embolism caused by a wrongly-directed fat injection into a blood vessel.

Being disappointed with the results of a fat transfer procedure could also be considered a "risk". The placement of fat transfer may not be appropriate, the duration of the effect of fat injection may not be as long as you wish, or your face can not "take" fat transfer. Your face or lips may not be exactly as you expected.

Neck Liposuction.

Liposuction improves body contour as it removes unwanted fat deposits from specific areas in women and in men. Through a small incision, a small tube or cannula is used to suck fat accumulation.

A suction lipoplasty is not a substitute for weight reduction, but it is a method for removing localized fat that does not respond well to diet or exercise. It is a body contouring procedure that removes the bumps to create a more aesthetic body profile.

This surgery is usually performed when the fat cells to be treated have been infused with a saline solution containing epinephrine to decrease blood loss, allowing them to be extracted more easily and reducing post-surgical discomfort. The most common areas where liposuction is performed chin, neck, upper arms, abdomen and back, thighs, buttocks, knee area and calf.

Several types of techniques are used in liposuction; however, the 'traditional' method performed by Dr. Badilla remains the most commonly used by surgeons worldwide.

Technique:

The procedure lasts approximately from 1 to 3 hours. It depends on the areas that need to be treated.

A liposuction is usually done under anesthesia, but the type used depends on the amount of fat that is planned to suck out and from which part of the body will be removed or extracted. For small areas, Dr. Badilla can use local anesthesia (which numbs only the region to try). Usually, the doctor administered a sedative (oral or injected) with local anesthesia to relax the patient. Alternatively, one can provide an epidural, which blocks the sensations of an entire part of the body (e.g., hip down). Complete anesthesia also can be used when a large amount of fat will be removed. As with most liposuction procedures that are currently performed, the doctor injects local anesthetic as part of a fluid mixture.

When the patient is properly anesthetized, Dr. Badilla continues to make a small incision in the area where fat will be removed. Then, through this opening, he inserts a hollow tube made of stainless steel (called a cannula) to reach the lower layers of fat. Working with these layers is much safer to work with layers and no risk of damaging the skin. The doctor will continue to pull the tube as it passes through the layers of fat, as the cannula is been move, it breaks up or fragments the localized fat cells while a suction pump removes it from the body.

When finished, small stitches are apply in the incisions. You need to use a compression garment or girdle around the region suctioned to prevent excessive inflammation and accelerate the recovery process for at least three weeks. Micropore ® should be used for no rubbing or friction points directly to the wound with dressing while protecting the wound.

Risks:

Each medical or surgical procedure involves a certain amount of risk. To minimize the risks of liposuction and side effects, patients should learn about the different types of liposuction procedures, while talking about their expectations and concerns with your doctor.

Possible risks of liposuction:

With any type of cosmetic surgery, including liposuction, complications can occur but are rare. Some dangers of liposuction include infection, reaction to anesthesia, blood clotting, and fluid loss. Risks of liposuction include less severe "bruising" and scars, problems with numbness of the skin, and moderate, such as changes in skin pigmentation.

Complications of liposuction may include:

Infection.

Prolonged healing time.

Inflammation.

Allergic reaction to medication or anesthesia.

Fat or blood clots: clots can migrate to the lungs and lead to death.

Excessive loss of fluids: fluid loss can cause shock and in some cases, death.

The accumulation of liquid - liquid should be drained.

Friction burns.

Damage to the skin or nerves.

Damage to organs.

Serious complications of liposuction:

Serious complications associated with liposuction are rare but must be taken into account when deciding whether liposuction is right for you. Serious complications include adverse reactions to anesthesia, cardiac arrest, cardiac arrhythmia, internal blood clots, excessive bleeding, serious drug interactions, and allergic reactions to medications, permanent nerve damage, seizures and brain damage from anesthesia.

Dangers of excessive liposuction:

The most common dangers of liposuction include risks associated with the removal of excess fat from specific areas, at a time and have too much liposuction on a single day. Excessive liposuction can cause problems such as subsidence, bumps and sagging skin. In order to minimize surgical complications and side effects of overexposure to anesthesia, patients should schedule multiple liposuction procedures at least several days apart.

Minimization of complications:

Minor complications of liposuction, problems, and general dissatisfaction can be minimized by fully understanding the risks and benefits associated with liposuction and by having realistic expectations. It is very important to choose a plastic surgeon that goes on to explain clearly and thoroughly the possible side effects and risks of liposuction.

To maximize the success of liposuction surgery and minimize the risk of complications, always follow your plastic surgeon for surgical preparation and postoperative care. If you smoke, your plastic surgeon will advise you to leave four weeks before and after liposuction surgery. You can also choose another way to eliminate fat. There are non surgical alternatives available for patients who are not good candidates for liposuction or just prefer other methods.

Abdominoplasty or tummy tuck

Abdominoplasty is a surgical procedure used to remove excess skin and fatty tissue of the abdomen and to affirm the abdominal wall muscles. Abdominoplasty is not a surgical treatment for overweight people. The obese individual who wants to lose weight should postpone all forms of surgery designed to shape the contours of the body until they are able to maintain their weight.

Alternative forms of management of this condition consist of not treating the areas of loose skin and fat deposits. Liposuction can be a surgical alternative to abdominoplasty if you have good skin elasticity and localized abdominal fatty deposits when the individual is of normal weight. The diet and exercise regimens may be beneficial in the overall reduction of excess fat.

Protruding abdomen as a result of weak abdominal muscles (due to pregnancy, aging, obesity), stretched skin and excess fat, causes dissatisfaction daily in thousands of people. This condition does not respond well to diet and exercise as the skin and underlying muscles are stretched or separated.

Surgical Technique:

Complete abdominoplasty usually takes 2-4 hours, depending on the extent of the work. During the procedure:

There are several surgical techniques; they may vary depending on the surgeon and the particular case. The most frequently used consists of a transverse incision along the lower abdomen from hip to hip just above the pubic area (when necessary perform a vertical incision from the pubis to sternum or circumferential incision is made, if necessary. These techniques will be discussed previously. A second incision is made around the navel to free it from sagging skin and keep it in place. Then the layers of skin and fatty tissue are separated or lifted of the abdominal wall.

The next step is to strengthen and raise the abdominal muscles toward the midline. This maneuver flattens the abdomen and better defines the waist.

Subsequently, the skin is pulled inferiorly and removes excess or surplus, leaving the skin carving. In this step, the surgeon makes a small opening on the skin to exteriorize the umbilicus that has always remained in place. Finally, the wounds are sutured; drainage tubes are placed under the skin to drain any excess fluid from the surgical site. The drains are exteriorized in the region of pubic hair through tiny holes, and removed about a week after surgery, and an elastic band is placed around the abdomen, which should be used for 4 weeks. Micropore ® should be used for no rubbing or friction points directly to the wound with dressing while protecting the wound.

Indications and contraindications:

Abdominoplasty or tummy tuck, is an abdominal surgery in which you can reduce protruding abdomen, carving the skin stretched and flabby muscles. It is not a treatment for obesity or a substitute for weight loss. It is indicated in those who fail to correct their defects with diet and exercise, particularly when the skin and muscles have been stretched as in multiple pregnancies or large weight increases and decreases. Patients with a weight within normal limits, but flabby abdominal muscles, excess skin and fat are the best candidates for this operation. The loss of elasticity of the skin that occurs in people over 45 years with mild obesity is another condition that can be improved by this operation.

Remember that this is not a substitute for weight reduction or a treatment for generalized obesity. The best candidates are those with a weight within normal limits with flabby abdominal muscles and stretched or excess skin, who do not improve with diet and exercise. Liposuction or suction of fat in these cases is not an option, since in this case the fat is removed, but it increases the sagging of the skin, resulting in poor results.

Abdominal lipectomy or abdominoplasty is an operation with very good results and of great benefit when it is done under precise indications that these results are very durable, virtually for life, provided that the person does not incur in drastic changes in weight or pregnancy after the operation.

Risks:

The decision to have tummy tuck surgery is very personal and you'll have to decide if the benefits meet your goals and if the risks and potential complications are acceptable. Your plastic surgeon and / or staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and the risks and potential complications.

Risks include: Scars unfavorable, Bleeding (hematoma), Infection, Accumulation of fluid, Poor wound healing, Loss of skin, Blood clots, Numbness or other changes in skin sensitivity, Risks of anesthesia, Skin discoloration and / or prolonged swelling, Fatty tissue found deep in the skin might die (fat necrosis), Major wound separation (dehiscence), Asymmetry, The recurrent looseness of skin, Pain, which may persist, Deep vein thrombosis, cardiac and pulmonary complications, Persistent swelling in the legs, Nerve damage, Possibility of revision surgery and Suboptimal aesthetic results

Brachioplasty or Arm lift.

Arms tissues relax and decrease with age cause by the gravitationally forces and weight loss. The fall of the skin is due to the loss of fat medium. The loose skin can result in a deformity from the armpit to the elbow.

Surgery

There are varying degrees of deformity of ptosis (drooping). The arms lipectomy can remove excess tissue and reduce the circumference of the upper arm. Surgical correction depends on the amount of extra skin and who loose are the supporting tissues. The extra skin is removed through incisions along the inner arm. The incision should be placed at the site where the tissue may tighten better.

The most common incisions extended from the elbow to the armpit. This allows the removal of excess skin placed in the middle. It may be necessary to make an amendment to limit the incision scar contracture in the axilla.

In cases where very little extra skin, the incision can be hidden in the armpit. This can hold the tissue in some cases, but not a good choice when there is excess skin.

Combined excision may limit the length of the scar between the elbow and armpit. In some cases when there is loose skin on the side of the chest, the incision can be extended to remove that extra tissue.

Before surgery the doctor will mark the spot at which to perform the excision. The incision will be done on curved or zigzag to minimize scar contracture. Liposuction may be useful for contouring the fat layer. They may place a small drain after surgery to remove fluid. You must use a vest or compression garment to minimize the formation of seromas or hematomas, for at least three weeks. Micropore ® should be used for no rubbing or friction points directly to the wound with dressing while protecting the wound.

Risks

Every surgical procedure involves a certain degree of risk. Although most patients do not experience complications, it is important to understand the risks, potential complications and consequences of arm lift surgery.

Bleeding: Although this is very rare, some patients may experience bleeding problems during or after surgery. Accumulations of blood under the skin may delay healing and cause scarring. Should post-operative bleeding occur, it may require emergency treatment to drain accumulated blood. In extreme cases, a blood transfusion may be necessary. Medical conditions such as hypertension can cause bleeding during or after surgery. A physical examination is necessary before surgery to be able to program. Patients also are advised not to take aspirin or anti-inflammatory medications for ten days before surgery, as this contributes to an increased risk of bleeding. Infection: Infection is unusual after an arm lift, and prophylactic antibiotics are used to avoid this complication. Should an infection occur, additional treatment including antibiotics or surgery may be needed.

Infection: Infection is unusual after an arm lift, and prophylactic antibiotics are used to avoid this complication. Should an infection occur, additional treatment including antibiotics or surgery may be needed.

Scars: Scar different people in different ways. While most patients are cured very well, abnormal scars may occur in individuals who have a genetic predisposition for it. Scars may be unattractive and of a different color than surrounding skin. Additional treatments are available for scar treatment, if necessary. Given the level of the incisions, the visibility of scars is a major concern. It is a choice between hanging skin and scar caused by the surgery. Meticulous surgical technique and postoperative good care can limit the degree of scarring. The used clothing can help camouflage the scar, but no help with skin hanging there before surgery.

Delayed healing: Some of the areas around the incision may not heal normally or may take longer to heal. In rare cases, some areas of skin may die. If this happens, surgery may be necessary to remove the scar tissue.

Asymmetry: The human body is normally asymmetrical. May be a slight variation from one side to another in the results obtained from an arm elevation procedure.

Nerve injury: In rare cases, motor or sensory nerves may be injured during surgery arm lift. Nerve damage can cause temporary or permanent loss of motion and decreased sensitivity of the skin. This surgery is not recommended after a mastectomy or operations in the lymph nodes under the arms. Those with multiple infections of the sweat glands are not candidates for arm lift surgery, that because the drainage of the arm is altered and surgery could lead to permanent swelling of the arm.

Anesthesia

This surgery is ambulatory and can be performed under general anesthesia or local anesthesia with sedation. The type of anesthesia will depend on the extent of the operation; however, many patients feel more comfortable performing it under general anesthesia.

Post-operative Care

The recovery takes one to two weeks depending on the work being performed. Returning to work will depend on the activity being performed, but generally, you can return within two weeks. It is necessary to protect the wounds after surgery. It is important not to lift objects as possible. You can raise your arms through pillows, this will give comfort. It may take up to 6 months or more to see how the scars evolve.

Fat transfer technique:

A buttock augmentation can be obtained using different techniques depending on the patient's wishes. Autologous fat injections, take fat from one part of the body of the person to add volume to the buttocks. Donor sites may include the abdomen, hips, back and thighs. Fat cells are removed using liposuction and then injected into layers in the buttocks. A disadvantage of this technique is for the fact that it is difficult to predict how much fat the body reabsorbed, because of this; multiple sessions are sometimes necessary procedure.

Usually, this surgery is performed under general anesthesia. And its duration will depend on the individual patient.

A buttock augmentation procedure needs to average around 250-350cc of fat for each side. Indeed, this is a good amount of fat and, therefore, this surgery is not recommended for very thin people.

When fat is removed, purified and is carefully processed; consequently, only a small percentage of the initial amount will qualify to be transplanted.

After processing the fat, the injection phase can be carried out. The doctor injects small amounts of fat in various regions of the buttocks and at different depths, only this way we can achieve lower rates of permanent absorption. The whole procedure therefore requires many micro-fat injections which are essential to give a natural look, even and smooth appearance to your "derrière".

Because the buttocks augmentation procedure is quite meticulous, it can take between 2 to 3 hours to carry it out successfully.

Technique implants:

Buttock implants are an alternative way to give a new shape to the buttocks. This procedure is performed by making an incision in the crease between the buttocks and inserting a silicone implant in the "pocket" created intramuscularly, this positioning has been proven as the safest for the implant.

This surgery is performed under general anesthesia and usually takes about 1 to 2 hours to take place. The area where the implant is placed is previously determined and marked just before going to surgery.

Through the incision, the gluteus maximus is elevated to create a large enough opening for the implant. When the implant is placed, the doctor will continue his work on his other buttock, by examining the two and ensuring that the results are symmetrical and look completely natural.

When desired results are achieved, the incisions are sutured with a few stitches and a compression garment or girdle short is put on the buttocks to remain compressed, reducing the level of inflammation and discomfort for the patient. Micropore ® should be used for no rubbing or friction points directly to the wound with dressing while protecting the wound.

What are the main risks and potential complications of buttock augmentation?

Like any major surgery, buttock augmentation has potential risks and complications. Therefore, you should consider as seriously as you would any major surgery. Also, keep in mind that increased implant has a much higher rate of complications compared with fat injection.

What are the most common minor complications of importance or the consequences?

Changes in skin sensitivity: This is a normal consequence that occurs throughout the world to varying degrees. You may experience "paresthesia" which is an altered sensation at the site of liposuction. This can be either in the form of increased sensitivity (pain) in the area, or loss of any feeling (numbness) in the area. This sensation is permanent in very rare cases. However, in almost all patients is within the first two to four months after surgery. Massaging the area of liposuction helps increase circulation and facilitates the recovery of normal sensation of the skin.

Swelling: This, too, is a normal event that occurs in every patient. Compression garments and post-operative massage helps minimize this risk, and reduce its duration to less than two months.

Bruising: There will be bruising in many areas that were aspirated or grafted, and in areas adjacent or dependent. For example, you will also consider the bruises and swelling on the back of the thighs and genitals. Bruising, usually move downwards due to gravity. Some bruising can last a long time or even lead to permanent skin pigmentation. Sunbathing immediately after surgery can cause these injuries to become permanent skin stains.

Skin irregularities and holes: Injection areas of fat can develop contour irregularities, including elevations and dimples in terms of its elasticity of the skin and the degree of fat injection. Usually, post-operative massage helps to soften these areas.

Asymmetry: No two body halves are identical. Therefore, after buttock augmentation may appear to be very slight differences between the contour and size of the two parties. Disorders Scoliosis or other spine can magnify body asymmetry.

Muscle spasm: It is very common to get temporary muscle spasm or cramping in the muscles of the buttocks. This usually resolves quickly by itself or can be helped by massage or local heat.

Pain and discomfortr: You should expect to have pain or discomfort similar to the feeling of having worked too hard. Some of this may feel like a stabbing pain in the area increased, and in adjacent areas. Usually can be administered for pain medications, and generally lasts a few weeks.

Seroma or fluid collection: After fat injection or implant placement, straw-colored fluid from the blood, in the areas of the buttock. Your surgeon can alleviate these by draining a small needle in an office procedure.

Absorption of fat and fibrosis: Approximately 30% of the injected fat survives and is not absorbed. If this happens unevenly, there may be areas that you feel or see dimples or dents due to excessive fat reabsorption. Furthermore, in the areas of fat absorption scarring can occur which causes the fabric to feel hard.

Thigh Lift or thighplasty:

The surgery known as thigh lipectomy is a procedure to remove loose skin of the thighs. When weight loss is successful and excessive it can cause flabby skin of the inner thighs. The constant rubbing on the inside of the thighs can cause irritation and skin infections, etc., and interfere with personal hygiene. It may also hinder the dressing which will cause psychosocial concerns because of the disfigured appearance. However, comfort and appearance may be improved with plastic surgery, in this case, the thigh

The thigh lift involves resection of abundant tissue in the thigh. The excess tissue in the thighs can be extended to the buttocks and the back of the thigh. To remove the excess skin and fatty tissue of the inner thigh using incisions those are placed parallel to the folds of the groins. The thigh lift is usually performed on the inner surface of the thighs, but may include the outer and buttocks if the doctor deems necessary.

Risks:

The decision to undergo surgery thigh lift is extremely personal and will have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable. Your plastic surgeon and / or staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and the risks and potential complications.

Possible risks of thigh lift surgery include:

Unfavorable scars: thigh incisions usually stretch during the healing process, Bleeding (hematoma), Infection, Accumulation of fluid, Poor wound healing, Loss of skin, Numbness or other changes in skin sensitivity, Risks of anesthesia, Skin discoloration and / or inflammation, Fatty tissue found deep in the skin might die, Major wound separation (dehiscence), Asymmetry, Pain, which may persist, Unsatisfactory results such as highly visible surgical scar location, unacceptable visible deformities, bunching and rippling in the skin near the suture lines or at the ends of the incisions, The recurrent looseness of skin, The sutures may arise spontaneously through the skin, become visible or produce irritation that require removal, Possibility of revision surgery

The post-operative care of a thigh lipectomy includes frequent cleaning of the wound, antibiotics, use compressive belts or clothing for at least two weeks and lots of rest because you cannot perform strenuous activities. Micropore ® should be used for no rubbing or friction points directly to the wound with dressing while protecting the wound.

Liposuction improves body contour as it removes unwanted fat deposits from specific areas in women and in men. Through a small incision, a small tube or cannula is used to suck fat accumulation.

A suction lipoplasty is not a substitute for weight reduction, but it is a method for removing localized fat that does not respond well to diet or exercise. It is a body contouring procedure that removes the bumps to create a more aesthetic body profile.

This surgery is usually performed when the fat cells to be treated have been infused with a saline solution containing epinephrine to decrease blood loss, allowing them to be extracted more easily and reducing post-surgical discomfort. The most common areas where liposuction is performed chin, neck, upper arms, abdomen and back, thighs, buttocks, knee area and calf.

Several types of techniques are used in liposuction; however, the 'traditional' method performed by Dr. Badilla remains the most commonly used by surgeons worldwide.

Technique:

The procedure lasts approximately from 1 to 3 hours. It depends on the areas that need to be treated.

A liposuction is usually done under anesthesia, but the type used depends on the amount of fat that is planned to suck out and from which part of the body will be removed or extracted. For small areas, Dr. Badilla can use local anesthesia (which numbs only the region to try). Usually, the doctor administered a sedative (oral or injected) with local anesthesia to relax the patient. Alternatively, one can provide an epidural, which blocks the sensations of an entire part of the body (e.g., hip down). Complete anesthesia also can be used when a large amount of fat will be removed. As with most liposuction procedures that are currently performed, the doctor injects local anesthetic as part of a fluid mixture.

When the patient is properly anesthetized, Dr. Badilla continues to make a small incision in the area where fat will be removed. Then, through this opening, he inserts a hollow tube made of stainless steel (called a cannula) to reach the lower layers of fat. Working with these layers is much safer to work with layers and no risk of damaging the skin. The doctor will continue to pull the tube as it passes through the layers of fat, as the cannula is been move, it breaks up or fragments the localized fat cells while a suction pump removes it from the body.

When finished, small stitches are apply in the incisions. You need to use a compression garment or girdle around the region suctioned to prevent excessive inflammation and accelerate the recovery process for at least three weeks. Micropore ® should be used for no rubbing or friction points directly to the wound with dressing while protecting the wound.

Risks:

Each medical or surgical procedure involves a certain amount of risk. To minimize the risks of liposuction and side effects, patients should learn about the different types of liposuction procedures, while talking about their expectations and concerns with your doctor.

Possible risks of liposuction:

With any type of cosmetic surgery, including liposuction, complications can occur but are rare. Some dangers of liposuction include infection, reaction to anesthesia, blood clotting, and fluid loss. Risks of liposuction include less severe "bruising" and scars, problems with numbness of the skin, and moderate, such as changes in skin pigmentation.

Complications of liposuction may include:

Infection, Prolonged healing time, Inflammation, Allergic reaction to medication or anesthesia, Fat or blood clots: clots can migrate to the lungs and lead to death, Excessive loss of fluids: fluid loss can cause shock and in some cases, death. The accumulation of liquid - liquid should be drained, Friction burns, Damage to the skin or nerves and Damage to organs.

Serious complications of liposuction:

Serious complications associated with liposuction are rare but must be taken into account when deciding whether liposuction is right for you. Serious complications include adverse reactions to anesthesia, cardiac arrest, cardiac arrhythmia, internal blood clots, excessive bleeding, serious drug interactions, and allergic reactions to medications, permanent nerve damage, seizures and brain damage from anesthesia.

Dangers of excessive liposuction:

The most common dangers of liposuction include risks associated with the removal of excess fat from specific areas, at a time and have too much liposuction on a single day. Excessive liposuction can cause problems such as subsidence, bumps and sagging skin. In order to minimize surgical complications and side effects of overexposure to anesthesia, patients should schedule multiple liposuction procedures at least several days apart.

Minimization of complications:

Minor complications of liposuction, problems, and general dissatisfaction can be minimized by fully understanding the risks and benefits associated with liposuction and by having realistic expectations. It is very important to choose a plastic surgeon that goes on to explain clearly and thoroughly the possible side effects and risks of liposuction.

To maximize the success of liposuction surgery and minimize the risk of complications, always follow your plastic surgeon for surgical preparation and postoperative care. If you smoke, your plastic surgeon will advise you to leave four weeks before and after liposuction surgery. You can also choose another way to eliminate fat. There are non surgical alternatives available for patients who are not good candidates for liposuction or just prefer other methods.

Dupuytren's disease or contracture:

Dupuytren's contracture is a fibro proliferative disease of the palmar fascia, capable of producing a disabling flexion contracture of one or more fingers, progressive and irreversible nature. It has not yet come to fully understanding the exact cause of this proliferation of fibrous tissue and, therefore, the etiology of the contracture. The only consistently effective treatment is surgical excision.

Causes:

The disease has been associated with Epilepsy: in patients with prolonged treatment with phenobarbitaland with Diabetes: related to the duration of this, the incidence rises to 80% in patients over 20 years of evolution.

Clinical signs are more common on the middle finger instead of the little finger. His appearance is mild, with only thickening of the palmar fascia, rather than contraction. It is said that alcoholism may be predisposing factors, dyslipidemia, smoking, liver cirrhosis, chronic lung disease, tuberculosis, trauma or recurrent micro trauma.

Treatment:

There is general agreement that the only effective treatment for Dupuytren's contracture is surgery, which always keep in mind that the disease may recur if not fully removed the diseased tissue and in some cases surgery may worsen. There are three types of operations: fasciotomy, fasciectomy regional and radical or extensive fasciectomy, which are indicated, not by the presence of the disease, but by the severity of the contracture and joint involvement. The primary goal of surgery is to improve functional capacity, reduction of the deformity and decreased recurrence. The 2 surgical principles are the longitudinal strain relief and proper handling of the skin.

Aftercare:

You must raise the member within 48 hours to prevent swelling, stiffness and reflex sympathetic dystrophy. During the first 2 days hand is raised and performs a bulky compressive bandage, with or without a ferrule, to keep the hand in operating position. From the second day and into the second week, apply a light dressing with stimulation and early mobilization of the fingers.

Complications:

20% of surgical patients present complications. The more radical the procedure, the more likely complications occur. These fall into two groups: Early: hematoma, skin loss, infection, nerve damage or digital artery, and edema.Late: loss of flexion or rigidity of the more common after radical excision of recurrence and reflex sympathetic dystrophy is five times more common in women.

Tenosynovitis "trigger fingers or spring":

The patient actively flex or extend fingers, has a painful clicking not associated with tenderness in the palm of the hand instead it comes from the finger flexor tendons pulling abruptly through an A1 pulley tensioned portion of the flexor sheath . Apparently, what triggers this condition is a repeated trauma to the flexor tendon, repetitive bending of the fingers and direct trauma to the site of the stenosis on the head of the palmar metacarpal distal to the capsule thickening of the tendon and causes formation of a nodule. When the node hits the annular transverse ligament (A1 pulley) is a snap. If the nodule grows or thickens the annular ligament, the node cannot pass through the fiber ring, so that the finger becomes fixed in a flexed position.

Treatment:

It is rare spontaneous resolution of trigger finger in the long term. If untreated, this condition will remain a painful annoyance, however, if the finger becomes entrapped, the patient may suffer permanent joint stiffness.

The goal of treatment in trigger finger is to eliminate the locking and allow full movement of the finger or thumb without discomfort. It should reduce the inflammation around the flexor tendon and the tendon sheath to allow smooth gliding.

In early stages treatment can be performed by splinting, this may be beneficial in 50-70% of cases and the use of oral anti-inflammatory. It is an alternative for those patients' candidates for corticosteroid injection in which they are refused or are contraindicated.

Only about one third of the patients get relief of symptoms lasting less than three shots, which means that approximately two thirds will require surgery. This surgery is a relatively simple outpatient procedure performed under local anesthesia. It has an earn recovery average of around 90%. Complications are rare but can occur: nerve injury, infection, hematoma or persistent pain.

Rehabilitation protocol:

Active motion of the finger generally begins immediately after surgery. Normal use of the hand can usually be resumed once comfort permits own surgery. Some patients, more than others, can feel pain, discomfort, and inflammation in relation to the area of surgery.

Occasionally, hand therapy is required after surgery to regain better use.

• After the injection of corticosteroids:

- No physical therapy is usually necessary for the movement because most patients can recover it once it resolves the pain, discomfort, and inflammation of the trigger.

• After the injection of corticosteroids:

- 0-4 days: active mobilizations to MCP joints, proximal interphalangeal and distal interphalangeal joints.

- 4 days: Remove bulky dressing and cover the wound with a bandage.

- 4-8 days: Continue mobility exercise. Remove sutures 7-9 days.

- 8 days-3 weeks: Mobilizations active / passive with mobility aid metacarpal phalangeal joint, proximal interphalangeal and distal interphalangeal joints.

- +3 weeks: Mobilizations resisted for strengthening. Return to unrestricted activities.

DeQuervain tenosynovitis.

Other tenosynovitis to be mentioned is called DeQuervain disease or tenosynovitis or tenovaginitis of tenosynovitis.

The Swiss surgeon Fritz DeQuervain in 1895 described a form of tenosynovitis affecting the tendons of the adductor longus and extensor pollicis longus at the radial styloid, leaving his name permanently associated with this clinical entity.

This condition was also called "sprain of the washerwomen." The tendons of abductor longus and extensor pollicis run together by a tendon sheath on a slider located above the radial styloid. On the radial styloid there is a shallow groove, which forms the floor duct underlying between bone and ligament or the first radial compartment, whose roof is formed by the dorsal carpal ligament.

De Quervain's tenosynovitis can be caused by any process that produces swelling or thickening of the tendons or an alteration of shape or diameter of the slide.

The most common cause of disease is related to repetitive movements of grasp-release or repetitive rotational movements, usually in connection with work.

The repetitive motion causes the thickening and inflammation of the tendon sheath at the radial styloid, causing pain at that level, which may radiate to the thumb or, on the radial side of forearm to the shoulder.

Pain is the predominant symptom, either starts acutely or gradually.

Treatment is usually conservative. Initially with NSAIDs and functional braces that limit the mobility of the first finger or thumb, with good results in patients with few symptoms. Another treatment option is the local infiltration with corticosteroids, with better outcomes in isolation which together with immobilization splints. Surgical treatment would be indicated in case of failure or relapse, with complete recovery in up to 96% of cases.

Tendon Injury.

Injuries affecting the upper extremity and in particular the hands come to expect, as described in some studies, one third of workplace injuries.

The hands are critical to carrying out daily activities, from the rudimentary to the most technical and sophisticated. Most crafts require the use of potentially dangerous machinery. In connection with his hands, the highest risks of these activities are determined by avulsion-shears, and injured amputees subsection-bruised, crushed and cut with small objects. The injured were mainly young men (mean age 33 years), in relation to falls, cuts and shock. When considering treatment and possible consequences of a hand it is fundamental production mechanism and location of lesions. Among the occupational accident injuries increasingly become more important than those caused by traffic accidents.

The hand has three main functions: the smart clip and grip, dependent on the median nerve and ulnar nerve gripping. Always maintain the function of 1st and 2nd fingers, with the 4 Th and 5 Th expendable.

The tendon is poorly vascularized structure, composed 30% of collagen and elastin 2%, and infused in an extracellular matrix with 60% water. Collagen is synthesized by fibroblasts and constitutes 70% of dry weight of the tendon, and its breaking point closer to the steel and provides the tensile strength.

The structural unit of collagen is the tropocollagen, consisting mainly of collagen type I, chains rich in glycine, proline and two amino acids, hydroxyproline and hydroxylysine, which increase its resistance. The orientation of the fibers takes place in direction of the tensile forces experienced by the tendon.

With a tendon in tension forces applied quickly and obliquely promote rupture. The maximum dynamic capacity of the tendon decreases with age, being highest around the third decade of life.

The tendon wound healing is similar to the healing of soft tissue injuries in three phases:

1. Inflammatory phase.

2. Fibroblastic proliferative phase.

3. Phase production of collagen or scar remodeling.

Diagnosis:

The diagnosis of tendon injuries is mainly clinical. Section of both flexor tendons in a finger, produces a complete extension of this. The deep flexor injury leads to a loss of flexion of the distal interphalangeal joint. The injury only to the superficial flexor does not cause posture changes in the finger. When diagnosing a partial injury of a tendon is a decrease of force, with pain on mobilization against resistance, maintaining range of motion. The injury of all the flexor tendons at the wrist will cause a completely hand extension, supination of the wrist.

The extensor tendons occupy a surface position on the dorsum of the hand, being less protected and more exposed to injury. Its diagnosis is simpler than that of the flexor tendons.

At the level of distal phalanx, the extensor tendon injury causes the hammer toe deformity, with inability to extend the distal interphalangeal. In proximal lesions impossibility of extension is easy to verify.

Treatment:

When it's time to do the repair of the tendon, the anatomy of the various structures involved in the injuries of the hand, determines the procedure and results. The existence of a tendon tissue viable, adequate skin coverage, the conservation of circulation and sensitivity as well as reducing potential bone injury associated, are all necessary prerequisites for a successful repair of tendon function. Primary repair of all structures, regardless of the complexity of the injury, simplifies the procedure and improves outcomes. We understand that primary repair is carried out within 24 hours after injury; if performed subsequently, it is considered a delayed primary repair.

Complications:

The formation of adhesions (tenodesis) is the most common complication in the treatment of tendon injuries. Methods to prevent adhesions can be mechanical or biological.

The mechanical types include postoperative mobilization protocols, conservation of the components of the pods and pulleys and a traumatic handling of the tendon and its sheath. Biological methods are an area under investigation.

The release of these adhesions can be performed by surgery: tenolysis. Would be indicated when the range of motion does not improve within a period of time, despite correct treatment with splints and mobilization. There must be a minimum joint contracture with a nearly normal range of motion.

Other complications are rupture of the tendon or suture failure, usually in case of early withdrawal of immobilization or inadequate rehabilitation, but may also be related to the poor treatment compliance by patients (removal of the splint, heavy lifting ...) According to several studies, in the case of the flexor tendons, the rupture rate between 4 and 5.7%.

Joint contractures may be due to different causes: cutaneous fibrosis, tendon adhesions, fractures or vascular nervous injuries associated tears or scars of the volar plate or collateral ligament contractures. They may also be due to inadequate mobilization and use of dynamic flexion splint.

The finger may occur after tendon repair of flexor tendons in relation to thickening in the area of repair.

Hand in quadriga is the inability to achieve full flexion by the uninjured fingers of the hand. This complication is due to a shortening of the deep flexor tendon of the fingers on the injured finger, which affects the function of the same muscle in the rest of the fingers. The swan neck deformity, which is a hyperextension of the proximal interphalangeal joint associated with bending of the distal interphalangeal joint, is a rare complication. This in connection with isolated rupture of the common flexor and superficial lesions of the volar plate.

In the case of flexor tendons, breakage of the pulley causes a tendon guitar string. A2 and A4 pulleys, located on the proximal phalanx and a half respectively, play a key role in mobility and strength of the fingers. The rupture of a pulley causes a large change in the efficiency of the route, strength and mobility of the tendons.

The paradoxical extension of the interphalangeal joints of the injured finger while trying to forced flexion or lumbrical plus deformity, is related to a function ineffective or avulsion of the flexor digitorum profundus.

Among the complications that can occur in the treatment of tendon injuries is the Reflex Sympathetic Dystrophy, which may appear in connection with any trauma or surgery of the hand.

The minor labia, which are two structures that are inside the major labia, close the entrance of the vagina and protect the clitoris and urethra, and for various reasons enlarge and hang from the external genitalia. In these cases apart from the unaesthetic it may produce discomfort.

• When using pads or sanitary napkins, When making long trips where you sit for long time, When using small type string bikinis, When you do exercise like spinning, Horseback riding, biking. When using tight clothing And especially in sexual relationships.

It is, then, when we apply the best solution is what we call labiaplasty reduction. That is to cut and reshape the minor labia, under local anesthesia with sedation, and in a little over half an hour the procedure is perform, the next day you can resume your normal working life in two weeks and resume your normal sex life.

In the event that the labia have thinned cause weight lost or age have declined, then the augmentation labiaplasty is performed, which involves making a micro liposuction in most cases is done on the mound, which itself alone is already a problem when there is an accumulation of fat in that area, or anywhere on the body and infiltrates the labia making turgid lips and youthful appearance.

Risks:

As with all surgical procedures, reducing risks labia contains despite being regarded as a safe surgery. The surgeons reported a complication rate of 1% in the case of labiaplasty, making the risk minimal.

Bleeding: Lips contains a large amount of blood vessels, and cut it produces a large amount of blood. In some cases, this bleeding continues for 24 hours.

Infection: Any type of surgery that requires incisions carries the risk of infection. To minimize this threat is very important hygiene. Most infections can be stopped very quickly and simply with the use of antibiotics.

Changes in color: Surgery of the labia may cause the color of your lips change, although this is rare.

Decreased sensation: Some women, but few have reported a loss of sensation in the area after surgery. This may be due to nerve damage, and often can be recovered over time. Sometimes, however, the effects of this are permanent.

Facial trauma, also called maxillofacial trauma is physical trauma to the face. Facial trauma may involve soft tissue injuries such as burns, lacerations and contusions and fractures of facial bones, and nasal fractures and fractures of the jaw, and trauma, such as eye injuries. The symptoms are specific to the type of injury, for example, fractures may involve pain, swelling, loss of function, or changes in the shape of the facial structures.

In developed countries, the main cause of facial trauma used to be the motor vehicle accidents, but this mechanism has been replaced by interpersonal violence, but car accidents still predominate as the cause in developing countries and remain a major cause elsewhere. Therefore prevention efforts include awareness campaigns to educate the public about safety measures such as seat belts and motorcycle helmets, and laws to prevent drunk driving and insecure. Other causes of facial trauma include falls, industrial accidents and sports injuries.

The facial bones are injured or broken, including the nasal bone (nose), the maxilla (the bone that forms the upper jaw) and mandible (lower jaw). The zygomatic bone (cheekbone) and the frontal bone (forehead) are other sites for fractures. Fractures may also occur in the bones of the palate and coming together to form the eye socket.

Signs and symptoms:

Fractures of facial bones, like other fractures may be associated with pain, bruising and swelling of surrounding tissue (these symptoms may occur in the absence of fractures as well). Fractures of the nose, the base of the skull or the jaw may be associated with heavy nosebleeds. Nasal fractures may be associated with deformity of the nose and swelling and bruising. The deformity of the face, for example, a sunken cheek or teeth that do not align correctly suggests the presence of fractures. The asymmetry may suggest facial fractures and damage to nerves. People with mandibular fractures often have pain and difficulty opening the mouth and may have numbness in the lips and chin. With maxilla fractures, midface is movable relative to the rest of the face or skull.

Treatment:

A bandage may be placed on wounds to keep them clean and to facilitate healing, and antibiotics can be used in cases where infection is likely. People with contaminated wounds that have not been immunized against tetanus within ten years must receive an injection of tetanus vaccine. The wounds may require stitches to stop bleeding and facilitate wound healing with minimal scarring as possible. Although not common as bleeding from the maxillofacial region, it remains necessary to control the problem. The Nasal packing can be used to control bleeding from the nose and bruising that can be formed in the septum between the nostrils.

Treatment aims to repair the face of natural bone architecture and leave little trace apparent injury as possible. Fractures can be repaired with metal plates and screws. The bone graft is another option to repair the bone architecture to fill the remaining sections, and to provide structural support. The medical literature suggests that early repair of facial injuries in a matter of hours or days, resulting in better results for the function and appearance.

Plastic surgeons that usually address specific aspects of facial trauma are trained in the comprehensive management of trauma to the lower, middle and upper face.

Prognosis and complications:

By itself, facial trauma rarely presents a threat to life, though often associated with severe injuries and life-threatening complications.

Even when facial injuries are not life threatening, they have the potential to cause disfigurement and disability, with long-term results physically and emotionally. Facial injuries can cause eye problems, the function of the nose or jaw and can endanger sight. The nerves and muscles can be trapped by the broken bones in these cases; the bones need to be put back into their proper places. In facial wounds, tear ducts and nerves of the face may be damaged. Fractures of the frontal bone, it can interfere with drainage of the sinuses and cause sinusitis.

Infection is another potential complication.

Botox® treatments are quick, painless (if topical anesthetic is applied), minimally invasive and cost-effective. It is a simple way to counteract the signs of premature aging.

Botox ® is a drug extracted from the bacterium Clostridium botulinum. In small doses this toxin can heal painful muscle spasms.

Botulinum toxin blocks nerve impulses, temporarily paralyzing the muscles that cause wrinkles; this provides a smoother skin and a refreshed appearance.

Not all older skin is alike. There are internal and external factors that determine how and when this damage occurs.

The apparent age does not always match the actual age; part of aging depends on the lifestyle, the environment and everyday gestures. The lines are formed with daily gestures. Angry, surprised or laugh cause an involuntary movement in some muscles and thereby form or accentuate wrinkles.

Botox® is a:

1. Simple treatment: your application is fast, as it applies in the office in minutes.

2. Safe treatment: does not require anesthesia, it is a nonsurgical procedure.

3. Effective treatment: the results are fast, at 72 hours notice the change and the effect lasts 3 to 6 months.

Botox ® is applied in the lines "of expression" that form on the forehead, around the eyes (crow's feet), eyebrows, lips (lip area), nose (nasolabial furrow or groove) and neck.

Botox ® relaxes the muscle making wrinkles disappear. Its application is in small areas of the face so you do not miss the natural expression of it.

Botox ® has no age restrictions may be applied preventively, from very young in a corrective way to adulthood, applying both men and women. Clinical studies of prestigious researchers in many parts of the world support the effectiveness of Botox ®.

The procedure:

Before applying the product using a topical local anesthetic, once absorbed this anesthetic procedure is performed. Botox ® is injected through the skin using a fine needle directed to the muscles to be addressed. In general, patients experience minimal discomfort. The treatment is performed in minutes. The patient should not disrupt everyday activities, but it is recommended to avoid exposure to excessive heat, sun and is best to avoid exercise for 72 hours. In some patients, small hematomas may occur in the treated area; they go away quickly and can be easily hidden with makeup.

The results can be seen in a few days and last up to 6 months.

Side effects:

Adverse reactions have been reported rarely. Some side effects include temporary eyelid droop, nausea, localized pain, infection, inflammation, tenderness, swelling, redness and / or bleeding.

Dysport®:

This is another botulinum toxin with slightly different properties. The dose and onset of action are different.

Directions:

Dermal fillers can be used to fill soft tissue contour of the face. These fillers can be used for lip augmentation, effacement of wrinkles and facial lines, and to fill in areas of the cheeks, nose, lips and chin, and hands. The type of filler can vary and the most common are: Perfectha ®, Juvederm ®, Restylane ®, Radiesse ®, Evolence ®, Prevelle ® and Sculptra ®.

These fillers can immediately improve the appearance of your face or hands, making them look younger. The fillers will last for a period ranging from several months to possibly a year or more. In some cases, different fillers are appropriate for different body areas.

The fillers may be based on collagen and hyaluronic acid or basic substances are found naturally along the face and human body. Radiesse ® has small beads of calcium hydroxyapatite and Sculptra ® is an absorbable matrix component that can stimulate collagen growth (poly-L-lactic acid). Your surgeon may recommend specific filler to suit your aesthetic needs individuals.

Treatment:

Depending on the part of the face and body, you may receive a local anesthetic in combination with ice packs to numb the area. The surgeon then gently inserts in the filler material through a fine needle in the affected area. Several small injections can be administered. You can apply some ice afterwards to help with swelling.

Aftercare:

You should avoid excessive movement of the injection site for 24-48 hours (this includes the aggressive exercise of the whole body). Small inkjet marks will fade in the day. Occasionally, there may be some small bumps or irregularities, and these may be slightly softened through manual massage with your fingers. Expect a certain degree of swelling in the early days, and this should disappear by the end of the first week.

Complications:

Slight asymmetry or some persistent lumps may occur rarely. Over time, these complications should disappear in the absorption process of natural materials. Among others are: bleeding, inflammation and infection.

What is Platelet Rich Plasma (PRP)?

EIs a product obtained by differential centrifugation of autologous, i.e., extracted from the same patient, obtaining a platelet concentrate product which when combined with calcium chloride starts activation.

Platelet Rich Plasma (PRP) to be used by microinjections in the most flaccid of the face and neck, stimulates the production of collagen, elastin and skin tissue, resulting in a more youthful, smoother and better.

What is the Biostimulation with Platelet Rich Plasma?

Since one of the major manifestations of skin aging are the appearance of wrinkles, the application using microinjections of growth factors alone or combined with other drugs to provide active ingredients will allow activating the skin cell regeneration, especially keratinocytes basal layer and fibroblasts, and stimulate the production of glycosaminoglycans, collagen and elastic fibers necessary to replace those affected. It's a simple outpatient technique based on intradermal injection of Platelet Rich Plasma (PRP) to naturally activate the functions of fibroblast cell responsible for determining the structure and quality of the skin.

When is your application recommended?

This treatment is recommended after age 30, the age when skin begins to lose its power of regeneration or simply when the visible signs of aging. It can be applied as a preventative treatment for youthful skin, or as restorative in aging skin.

How many sessions are needed?

The protocol with platelet rich plasma is specific for each patient depending on the degree of aging and the characteristics of your skin, can be provided from 1 to 3 times per year.

When do you see the results?

The improvement is noticeable from the early days and is maximal at 20 or 30 days, remaining stable for many months. The result of the last meeting with platelet rich plasma is approximately one year, at which time will require booster session.

What results can you see?

Increased skin tension. Increased volumetric cheekbones. Healthy skin appearance (brightness, color, smoothness, softness). Microwrinkles decreased. Decreased flaccidity. Advantages over other treatments: adverse events are discarded because the Platelet Rich Plasma (PRP) is a preparation made with the patient's own blood (autologous), thus avoiding the risk of transmission of infection or disease, allergic reactions and also for its rich composition hemostatic factors, prevents bruising.

Can there be complications or drawbacks?

For Platelet Rich Plasma there is no allergic reaction to be obtained from the patient. Depends micropunturas areas may be minor bruising to disappear spontaneously without treatment in days.

How long it takes to obtain Growth Factors (Platelet Rich Plasma)?

The extraction is performed immediately before application in practice. The entire procedure, from extraction to the preparation and implementation by microinjections, takes about 45 minutes.