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Posts Tagged ‘General Anesthesia’

Breast Implant Placement and Techniques

January 27th, 2010

While many women consider only the end result, breast implants or “boob jobs” can be inserted using several techniques. These techniques differ in the amount of recovery time needed and in the quality of the end result. Hence, depending on the body characteristics and the wishes of the patient, a surgeon might give preference to a particular technique. In breast augmentation surgery, technique refers to (a) the location of the breast implant with respect to the pectoralis muscle (chest muscle) and (b) the location of the incision.

Breast Implant Placement

The implant can either be placed above or below the pectoralis muscle.

With subpectoral implants (i.e. when placed under the muscle), there is a lower risk of capsular contracture and there is less interference with mammography. Such implants give a better cosmtic result in women with small breasts and worse results in athletic women. Procedures involving subpectoral implants have a longer recovery period, more pain and swelling. General anesthesia is needed.

With subglandular implants (i.e. placed above the muscle but below the breast tissue), there is a greater risk of capsular contracture and greater interference with mammograms. It does not look so good in women with small breasts but looks better in athletic women. It has a shorter recovery period, less swelling and pain. Local anesthesia is sufficient for such procedures.

Location of Incisions

Breast implants can be placed through four main incision techniques:

  1. Inframammary technique—is by far the most common technique. The implant is inserted in the fold where the breast meets the chest wall. Scars are thus hidden by the crease that the breast does with the chest wall. Milk production capability is preserved as glandular tissue and nerves are not touched. However, there may still be a reduction in milk production if the implant is placed above the pectoral muscle as it can then exert pressure on the ducts and glands.
  2. Transaxillary technique—the incision is made near the armpit in order to avoid any visible scars. Such implants are usually placed below the muscle. Impact on milk production is minimal as glands and nerves are not touched. The disadvantage here is that there is poor visibility for the surgeon who sometimes have to use an endoscope for the procedure.
  3. Transumbilical technique—the incision is made at the navel and the implant is inserted there. It is then manoevered into place in the breast. No incisions are made in and around the breast tissue although breast tissue may be damaged when the implant is placed. A camera scope is usually used. Here also, there is minimal impairment of milk production. However, this technique is more difficult and takes longer to complete owing to the difficulty to place the implants accurately.
  4. Periareolar technique—incision is made around the areola. The advantage is that scars will be effectively hidden by the nipple. However, in this position, the implant causes a lot of damage to glands and ducts, impairing milk production significantly. Moreover there is increased risk of loss of nipple sensation.
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Rhinoplasty Procedures explained

January 26th, 2010

Nasal corrective surgery is split into three main types of procedure:

  1. Rhinoplasty: full nose correction including that of the bridge, nose tip and nostrils
  2. Septoplasty—focuses on the septum, the wall separating the two nostrils. It usually involves patients having difficulty in breathing due to nasal obstruction.
  3. Rhinotip—tip correction and nostril adjustment.

However each procedure is as serious as the other so before just choosing one that takes your fancy it is always advisable to talk to a qualified cosmetic surgeon or drop in to your local clinic.

Rhinoplasty

The set of surgical procedures that is collectively known as rhinoplasty can be classified as open and closed.

Closed rhinoplasty is minor reshaping of the nose. It involves tiny incisions within the nose and insertion of an instrument to separate skin from the bone and cartilage. When exposed in this manner, the bone and cartilage can be removed, reshaped/rearranged and placed back. The skin is spread back over the newly-shaped structures and the original incisions are closed.

Open rhinoplasty is a more complicated job. This involves incision of the columella, the vertical strip of skin that separates the nostrils. The whole nose skin is then lifted giving the surgeon access to the whole area inside the nose. This is a riskier practice which is only carried out when major reshaping of the nose is warranted.

In both cases, general anesthesia is needed.

Septoplasty

Septoplasty is a surgical operation to correct deformity of the nasal septum, for example, septal deviation. Septal deviation is when the septum bends to one side or when an irregular shelf of cartilage or bones develops (septal spur). In many cases, this leads to bent noses. It may occur as a result of trauma, but in many cases it simply happens with ageing. Few adults have a septum that is completely straight.

The purpose of septoplasty is to improve breathing but it can also be done to allow examination of the inside of the nose in cases of treatment of polyps, tumors, and inflammation. It can be performed on general or local anesthesia. The procedure is as follows:

    1. Incision inside the nose
    2. Detachment of tissues from the deviated cartilage
    3. Removal and straigtening of cartilage before re-insertion
    4. Addition of splints to hold the structure in place and to facilitate breathing during the healing process.

Rhinotip Surgery

Rhinotip surgery is done when the area to be treated is limited to the tip of the nose (in cases of injury to that part alone or cosmetic surgery that necessitates treating the tip only). Since there is no need for a total reshaping of the nose, there are fewer risks and complications associated with rhinotip surgery. Common rhinotip surgery interventions include narrowing or shortening of the tip; correction of nasal tip droops.

Unlike other rhinoplasty procedures, rhinotip surgery is done under local anesthesia. It is a relatively simple procedure that can be over within an hour or two. The patient can be home on the same day.

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