Cosmetic surgery of the nose, technically referred to as Rhinoplasty, can cover a wide range of interventions or rather, of somewhat similar in features, but which have as purpose to correct different aesthetic defects of this part of the face.

Very often, the cosmetic surgery of nose aims to eliminate anti-aesthetic gibe present on the back of the nose: the nose shape, thus the harmony of facial profile, is undoubtedly a very important aspect for the beauty of the person, man or woman.

A nose can also be excessively voluminous, both in length and in width, therefore, an intervention of cosmetic surgery may be necessary in this sense, or the nasal septum can be deviated, and therefore require corrective action.

It should be pointed out also that the cosmetic surgery of the nose may be carried out both in the case where the nose of the present due to imperfections of various types of traumatic events, such as the breakage of the nasal septum, both in the case in which the nose has a shape natural unpleasant.

Like any surgery cosmetic surgery, Rhinoplasty requires a preliminary discussion between the patient and the doctor and it is the responsibility of professional intervention when assessing the feasibility of evaluating the reasons also psychological.

What is an intervention of Rhinoplasty? In essence, the surgeon first provides to separate the skin layer from the bone nasal, and after intervenes with adequate tools to consume the bone at the desired locations.

After surgery, there must be at least a couple of weeks of hospitalization, since appear of dark circles rather conspicuous on the face, and nose will remain swollen for several days.

The cosmetic surgery of the nose, if made in centers with good technologies and especially by medical preparations, is not dangerous.

Aesthetic medicine is increasingly preferred to cosmetic surgery, because of using special treatments that are performed through the use of injections can be made ​​of the aesthetic touches, without the risk of postoperative scars and suffer a require any intervention.

The most common treatments that you can do with the aesthetic medicine are: fillers, botulinum toxin or botox, peels, laser treatments, lymphatic drainage, but also follow other aesthetic medicine interventions such as pressure therapy, Carboxitherapy, RF, microdermabrasion, mesotherapy. These treatments are usually required to treat skin blemishes, aging, or due to excess weight.

In fact, treat cellulite when diets and sport do not work, can be cured with specific and targeted interventions of aesthetic medicine.

One of these is the lymphatic drainage, which is used to treat cellulite. This is done manually, using precisely the messages manuals, which serve to reduce and eliminate cellulite.

A very popular especially after pregnancy, when the appearance of stretch marks is most obvious and frequent, or even following a diet that has led to a decrease in the weight.

The operations of aesthetic medicine against wrinkles of the face have become very popular and customary. This kind of treatment is performed with injections of Botox or fillers.

These are just some types of cosmetic medical treatments, which, however, as well as others, are not invasive or painful, and can be done through the practice of experienced and professional staff.

This is a procedure that results in a reduction of the stomach that will literally impossible for the patient to eat more food than necessary for the proper functioning of your body.

Thus, the patient will have a much smaller stomach; you must eat less to achieve satiety.

Usually only recommend this type of surgery, which involves half a degree of complexity, patients whose life is endangered because of their very overweight (called “morbid obesity”). Gastric Bypass is the last resort before that his disease could cost him his life.

However, procedures of this kind are made with relative success since 1966, which arguably is a risk that the operation is unsuccessful is minimal.

There are different variants of the intervention but overall all shrink the stomach and connecting it directly to the small intestine. Therefore, weight loss will be due not only to eat less food but also the absorption of calories will be lower because the food does not pass through a portion of the intestine.

Recent studies have shown that more than half of overweight is lost in the first year and also recorded a high rate of recovery in patients with diabetes than with surgery and fail to reach normal values of plasma glucose.

In conclusion, gastric bypass is an option to consider for the obese they can not lose their weight through diet and exercise (as recommended) and it does not involve greater risk than a common surgery.

Bunions are one of the worst enemies that have the feet. In addition, it is estimated that over 60% of the population suffers bunions, a problem with a hereditary component.

Among the measures to combat bunions we find anti-inflammatory drugs and analgesics. This is one of the most immediate alternative, as alleviate the pain is the first thing to do. Similarly, physical therapy exercises can be done. Another option for addressing the bunions going to bring that template to make mulch foot on the shoe, particularly templates felt.

In addition, to combat the bunion also may resort to surgery. In fact, today there are over 130 ways to go under the knife and remove bunions. One of the fastest growing is the percutaneous surgery, carried out with a smaller incision and cosmetic result is more uniform.

Other measures to take to combat bunions is to wear a comfortable shoes. That is, the heels have a downside, and pushing the foot down and compress the big toe, forcing the figure of the bunion. Shoes with more than four inches high heels are not recommended for bunions.

Therefore, to combat the bunions should wear comfortable shoes, prevent chafing and protect the bunion area. In case of problems it is best to visit a doctor or podiatrist.

Women elected to develop this study were carriers of a tumor positive ErbB2/HER2, one of the most aggressive and worse prognosis and therefore at higher risk of mortality or relapse. This tumor affects 25% of patients with breast cancer and almost half of women younger than 40.

This therapy combines two drugs lapatinib and trastuzumab, both directed against the tumor’s molecular characteristics, although their combined use does not preclude subsequent surgery, it halved the chemotherapy (from 24 to 12 weeks), something significantly reducing its toxic effects.

In addition, patients who achieved tumor completely overcome their prognosis is “excellent” explained the researchers also hope to use it for other types of malignant tumors.

According to the study, 90% of patients responded to treatment, and that 50% of cases where the tumor is not removed, it has been reduced. In addition, patients who initially required a major intervention after treatment may undergo less aggressive surgery.

Neo-ALTTO has also allowed the collection of tumor tissue before and after treatment will help to obtain an assessment of proteins and genes expressed in the tumor, known as biomarkers, that may help predict the one hand, the response to treatment and, secondly, the prognosis of the disease.

I – Anatomophysiological Recalls:
The anatomy of the veins of the arms is quite variable from one individual to another, but there is, however, four superficial veins used: The cephalic vein, basilic, ulnar and radial. The preliminary study by the surgeon, vessels, is essential to achieving a quality FAV. The assessment will first be clinically by palpation of the pulse examination of veins with and without tourniquet, study of their discharge. It may be necessary to achieve an ultrasound or venography, especially in diabetics. The Allen’s test seems unnecessary.

It is essential to require teams of nurses, to maintain maximum capital of the renal vein, at any stage, by avoiding any aspiration or infusion of these veins.

II – Surgery:
The plexus block by axillary or subclavian is the most used, promoting vasoplegia. Sometimes local anesthesia with or without neuroleptanalgesia may be indicated, general anesthesia is reserved for some special cases, as it almost always accompanied by hypotension embarrassing perception clinic.

The intervention must be economical of veins and arteries, ideally 4 to 5cm, most fistulas eventually be complicated and require further surgery. The vessels should not be pinched, and irrigation serum throughout the intraoperative time may be necessary to prevent drying of tissue and blood vessels. The anastomosis is performed either in latero-lateral or latero-in terminal. Closure in two layers, a very precise way, avoiding areas of necrosis and secondary scarring.

A subcutaneous injection of Xylocaine containing a few drops of nitroglycerin can reduce the spasm and allows a better venous dilation clamping. Similarly, an injection of diltiazem periarterial eliminates arterial spasm during dissection.

Radial fistulas:
It is created near the wrist in the gutter of the pulse, by anastomosis of the radial artery and low dorsal vein of the thumb. If the vein is very close to the artery, it is often preferred a-side anastomosis. The anastomosis may also, depending on the quality of ships, be performed in more proximal position.

Ulnar fistulas:
They are made near the wrist between the ulnar artery and superficial ulnar vein.

III – Time after surgery:
The nurse should monitor the vibration by palpation, and the blast and its intensity with a stethoscope, the lack of bruising or bleeding. The member will be extended or slightly elevated, with a bending prohibited on the operated limb. He will learn during hospitalization, the patient, monitor his daily fistula.

Later, the patient may again use its normal member.

IV – Training of the AVF:
The high blood flow caused by the anastomosis will cause a gradual increase in the size of arterialized veins. Turbulence at the anastomosis are responsible for the perceived thrill to palpation, and received blows to the stethoscope. This must be heard to the elbow. After a few months, the AVF will evolve towards an equilibrium, with the occurrence of stenosis of variable localization. Over time can appear sinuosities arterial and venous induration and localized expansion, including puncture normal.

V – Complications:
A – Thrombosis:
This is the most common complication, often a result of poor venous, or sometimes, a technical foul. In case of unexplained thrombosis (intervention perfectly satisfactory and successful initial operation), it will be done laboratory tests to search for a bleeding disorder.

B – hematoma:
It is not uncommon, but it is unusual for its size leads to a compression requiring surgical evacuation.

C – Hemorrhage:
Early and moderate bleeding is usually due to a lack of hemostasis on a small vein pressurization after fistula creation. Moderate compression, associated with elevation of the limb, often helps to address this situation.

By cons, an early arterial bleeding, often abundant, follows a lack of anastomosis, requiring further surgery in an emergency.

Ischemia may occur, especially in diabetics, variable, ranging from simple hand feel cold to acute ischemia, sometimes requiring, again, an emergency reoperation.

D – stenosis:
She sits in a privileged way near the anastomosis and anatomical peculiarities (valves, bends), but can be consecutive to frequent venipuncture prior to arterialization. Stenosis causes an obstacle to the flow of blood, then the agency seeking to circumvent it by developing collateral circulation could be significant.

Stenosis causes a low throughput, a thrill and a low breath, and difficulty of the puncture, sometimes requiring hemodialysis sessions with tourniquet!

E – Infection:
It may be discreet, limited to redness at the puncture site, or own a clot on an ulcer, or conversely, take the form of an abscess puncture associated with inflammation free, pulsatile hematoma or ulceration sanious. The infection can be extremely serious because it may diffuse away on heart valves in particular.

F – Other complications:
Note also, but had not developed specifically names speak for themselves:

The aneurysm and the lack of development of the AVF.

For the same reasons doctors propose a re-education Penis active. The clearest example is when men undergo prostate surgery. When a surgeon operates on a patient’s prostate, try not to touch the nerves of erection, not to alter the sexual possibilities of the patient.

But even being among hands an excellent surgeon, for a time longer have erections. This is normal, because of the impact experienced operative. Indeed, the nerves are affected after the manipulation necessary to treat the prostate, and need time to function again properly.

During the first three months following the intervention of this magnitude, erections are weak or nonexistent. After six or nine months, spontaneously reappear. But what is certain is that after 8 to 24 months, the erection becomes to develop, enabling the penis to maintain normal sexual relations.

It may take up to two years before the sexual intercourse are again full. Two years is too long without oxygen to the penis. To prevent this prolonged apnea, should be performed education Penis active.

The gesture reeducator is an injection in penis, With the help of a very fine needle, a substance capable of causing an erection.

During the first three months, the dose of the product is weak, so that will be allowing blood flow to favor oxygenation. After three months of treatment, may increase the dose to cause an erection sufficient to maintain a normal sexual relationship.

These injections should put one or two times per week for ten days, depending on each patient and the reactions of the body that is to retrain.

This kind of belief makes them resort to surgery, which is totally a hoax, as such liposuction decreases the volume and remove a few kilos but no are achieved with her benefits level heart or metabolic who did get through diet and exercise.

The Liposuction making is eliminate fat cells complete found beneath the skin but does not reduce the size of those remaining nor does it remove the fat that is accumulated in other tissues.

According to studies, for weight loss, preventing diabetes, heart and hypertension traditional methods are the best, so the opinion is fewer calories and increased exercise.

For example, a study published in the journal ‘New England Journal of Medicine’, gave details on how to lose weight improves health and reduces the risk for diabetes and diseases heart.

“Liposuction removes fat cells entire located under the skin but does not reduce the size of the remaining or decrease the fat that accumulates in other tissues such as muscle, liver or heart, may be necessary to reduce the size of fat cells and their content in other tissues key”. says Samuel Klein, MD, professor in the Faculty of Medicine and Nutrition Danforth (USA) and principal investigator of the study.

An excess fat abdominal is associated with a difficulty that the insulin to regulate the processing of sugars and fats, which can result diseases such as type 2 diabetes and high blood pressure, lipids and heart disease.

Is study also was designed to test the effectiveness of liposuction in people obese. The aim was to assess the sensitivity of insulin in the liver and adipose tissue, where some participants had diabetes type 2. Surgery could eliminate 44% of volume of fat in the abdomen, in women who had tolerance normal to glucose and 28 % in those with diabetes type 2.

But after 12 weeks of liposuction could not be any improvement in insulin sensitivity in tissues, which means that the liver did not reduce production glucose nor were changes in markers coronary risk or other and blood pressure, cholesterol or glucose. That while removing a large amount of subcutaneous fat could not be seen benefits at the medical.

It is also possible to establish that it is possible remove a large amount of fat and do it safely through Liposuction, Which is not what is being discussed, but the fact that it is advisable to use traditional methods of balanced diet and more exercise for the treatment of obesity.

Ideally, then , remains to consume fewer calories than you burn and this goes beyond simply eliminating fat cells by liposuction.

The first is to discuss the matter with the specialist, who is best suited to provide information on different types of surgery and what is the best suited to each case. However, having information about the advantages and disadvantages of each type of surgery will give a broader view on the subject.

It is necessary to note that there is no intervention better than another, all have their pros and cons, the decision in any case will depend on various factors such as current weight, ability to control what you eat, health status, among other variables.

Currently, surgery is most commonly practiced gastric bypass, but for some people the best choice might be the so-called gastric banding and biliopancreatic diversion for others.

Consider then some characteristics of the most important weight-loss surgery:

• The intragastric balloon: This is a non-surgical procedure is performed by placing a balloon in the stomach which is then filled with a liquid. This makes the remaining space for food and maintains a sense of satiety.





• The gastric band: Is a “belt” that is placed around the stomach and is then inflated, compressing it until it is in the form of an hourglass, where the top is smaller and narrower passage communicates to the bottom at which food must move slowly into the digestive system. A result that you get more fullness on less food.
• Gastric bypass surgery: This type of operation also divides the stomach into two parts, the difference is that food does not pass from one party to another, as with the gastric band, but an artificial connection is made to arrive in the form directly to a lower portion of the intestine. Thus, leaving aside the sections where most absorption occurs as a result there is greater satiety and less fat absorption. However, they also absorb less vitamins and minerals, therefore the patients should be taking supplements to compensate for this deficit.
• Biliopancreatic diversion: As in the case of gastric bypass, is to proceed to cut a part of the stomach and diverts the passage of food and juice, to join in a lower part of the intestines. In this type of intervention does not create two stomachs, one to collect food and the other to produce gastric juices, but directly off most of the stomach.

In general, if the patient has few health problems and for a better outcome, you are advised to use the gastric band, being less invasive than bypass and did not change anything in the digestive system, has less surgical risk postoperative complications and is a reversible process, but weight loss is less than that achieved with other interventions.

In patients suffering from diseases such as hypercholesterolemia, hypertension and diabetes, in which their health may deteriorate seriously in the long run, the best is the gastric bypass or biliopancreatic diversion. However, these operations have a higher surgical risk that the band and when you choose them is because it is certain that if unchecked obesity are greater health risks than those of the operations themselves.

Gastric bypass also recommended for people who can not control the consumption of high calorie foods such as soft drinks, candy, ice cream and they can pass easily if they had the gastric band, weight loss boycotting. In contrast, the bypass would suffer the so-called “dumping syndrome” which is a series of symptoms that are caused by consumption of sweet foods, such as suffering from nausea, vomiting and upset stomach, running as an impediment to this problem.

The biliopancreatic diversion is a type of intervention that produces a greater weight loss but is more invasive, since it removes much of the stomach, also presenting a higher risk of deficiency of vitamins and minerals, as the section of intestine is removed is large.

All bariatric operations use different mechanisms to control the weight that can be:

1. Restrictive: They reduce the size and/or capacity of the stomach. At the same time the constraint may be internal in the case of gastric balloon or externally in the case of vertical gastroplasty, which is created in the upper stomach a gastric pouch that has a smaller capacity and aims to retain the longer food in the stomach pouch and feel full after eating a small amount of food.
2. Malabsorptive or derivative: In what they altered the absorption of the feed to increase weight loss.
3. Mixed: A combination of mechanism restrictive and malabsorptive weight or derivative, adding as a bonus the advantage of hormonal changes, and amending a number of hormones and neurotransmitters that send nerve signals to the brain to tell you when to eat or when it should not do so. The procedure that uses this mechanism is the gastric bypass.

Partly, the bariatric surgery procedures can be performed by open system, called laparotomy or laparoscopy. In this type of surgery an incision is made in the upper abdomen of 15 cm with the laparoscopic technique small cuts are made through the abdominal wall, they are introduced micro instruments and cameras that make working inside abdomen.

Any obesity surgery material change in the digestive system, so will require changing habits regarding food and physical activity.

Before treatment
In a preliminary study assessed skin condition and the expected results discussed.

After treatment
It is important that the patient is fully informed and feel comfortable with the above – like style questions.

At appraisal provide a physician prescription for the patient. On treatment days, the patient two hours before meeting time take the first dose of each prescription on the preparations to ensure no infection in the treated area. The patient can not be processed if it has active cold sores in the mouth.

Treatment
Consideration of the entire face is taken into full anesthesia. Treatment of small areas can be carried out under local anesthetic.

With a CO2 laser removes the outer skin cells. The skin smoothed, and the old collagen fibers tightened up. You can with the naked eye to see how the pores diminishes and the skin tightened up when driving the laser over a wrinkled and lax skin. Laser effect on the skin means that there’s a recharge of the skin’s delicate network of collagen fibers. These are shorter than the old and thus prefers the skin together, which gives a smoother and firmer surface than before. The thicker skin, the more layers you can remove.

It is important that the patient is fasting before anesthesia. Fixed rules mean that the patient may eat solid food (including candy) or drink milk-containing liquids until six hours before the meeting date. Do drink water, juice, coffee and tea without milk/cream until two hours before the meeting date. It is important that patients do not fast longer than stated here. Moreover, it is recommended that the patient drink a glass of sweet juice two hours before the meeting date.

The patient can go home shortly after treatment but may not even drive home. There should be a second adult patient the first night after treatment. For reading, it is recommended also that have a shirt that should not be pulled over the head.

After treatment
After laser treatment the skin covered by a thin film, except the eyelids smeared as a disinfectant ointment. The skin fluids slightly in subsequent days. This liquid dries and sets as a crust on the treated area. The crust should be kept dry and remain attached until they are removed at the clinic one week after treatment. Eyelids should be applied disinfectant ointment 2-3 times daily until after approx. Three days formed a scab.

The entire face will, depending on the treatment area could increase after treatment. Especially your lips will become fat and if treated forehead, eyes will raise up strong. The swelling is worse on the second and third days.

There may be some pain and suffering the first few days. For the relief of this extradited painkillers.

Healing may provide a slight itching of the skin.

If the patient is treated on the mouth, it will, because of the rigid film bandage and swelling of the lips, be difficult to eat food to be chewed too much. Eat small mouthfuls at a time, might be the easiest liquid diet.

Before the scab is removed, can also be brushing something difficult. It may be easier with an electric toothbrush or a solo toothbrush.

Control
After one week the patient must meet to control. The evening before the patient coating is applied a thick layer of vaseline on the attached movies. This softens the crust and facilitates the removal. Vaseline is provided by the treatment itself.

When the film is removed, the skin’s surface to be red, slightly bumpy and swollen and there may be small wounds remain. They heal up in about 3 days. After approx. one month it is common to follow up with a final check.

The new skin
The new, fresh skin is red and delicate at first. Flushing buyer usually entirely within 1-3 months. When the film is removed can face wash with a mild facial soap or cleaning with clean milk.

The skin will be dry and need a good moisturizer. Ask your pharmacist.
The red skin can be covered with a good creme. The new skin should not be exposed to direct sunlight for the first 3-6 months after treatment. Sunlight may cause permanent pigmentation changes – either lighter or darker than the surrounding skin. It is therefore recommended that daily use a sunscreen with a high protection factor, eg factor 25 or factor 60 – ask your pharmacist.