Saglik 24 – All you need for mesothelioma and health

A tummy tuck is a serious medical procedure that many men and women undergo each year. Your commitment to recovery and self-care will ensure that your body has the best chance for full recovery. Following your physician�s instructions for post-operative care is the most important thing you can do for tummy tuck recovery.

After your tummy tuck, you will rest in a recovery room, or you might even be admitted to the hospital overnight. In either case, your physician will be monitoring you as you come out of general anesthesia, or the local anesthesia wears off. You will have swelling in the abdominal area, and it will be sore. You will be given antibiotics and painkillers to assist in your tummy tuck recovery. It is important that you communicate any allergies you have and any other vitamins, herbs or medications you take so that the medications prescribed for your recovery will be right for you. As with all antibiotics, it is important to take the full course of medicine, as prescribed.

Once you are released, most physicians will prescribe two to three days of bed rest. While they may seem like three very long days, it is crucial for your tummy tuck recovery that you follow your surgeon�s instructions. If possible, have a friend or family member stay with you for those initial days at home so that they can help you and keep an eye on you as you recover. You will receive personalized instructions on medication, compression, elevation and rest during this time. Your physician may even be able to give you advice on ways to minimize scarring.

After your initial tummy tuck recovery, you will slowly be able to return to your normal activities. Your level of fitness will ultimately determine how long your tummy tuck recovery takes. For most people, it takes about 6 months for full recovery. After your initial weeks of recovery, your physician will prescribe a diet and exercise routine to follow for optimal tummy tuck recovery. At any time, it is important to call your surgeon�s office if you experience excessive pain, swelling or bleeding. The office will be able to make suggestions, or schedule an appointment if necessary.

After your recovery is complete, scar tissue will continue to fade and your abdomen will have the flat, tight look that you desire. Great results are typically visible about 8 months after the operation.

While most people have heard of rhinoplasty or nose surgery, most do not know what the procedure entails once you enter the hospital operating room.

Once you are in the operating room and have spoken with the people who will take care of you during the surgery, the anesthesia will be administered. The exact type of anesthesia used will depend on the duration and complexity of the surgery about to be performed, any allergies you may have to any of the anesthesia drugs available, and the preference of the surgeon and anesthesiologist. Before any incisions are made, before any intrusive procedures begin, the nose is anesthetized with a local anesthesia either lidocaine or marcaine with epinephrine. This is used to numb the tissue, the surrounding cartilage and facial bones and further protect the patient from feeling any of the surgery. In addition, many surgeons use a diluted form of cocaine possibly mixed with epinephrine to shrink the mucous membranes inside the nose as well as to seriously reduce blood flow to the area.

There are two basic approaches to rhinoplasty and depending on the artistry and sophistication of the surgeon and the type of work required, either approach may be employed with equally indiscernible success.

1. Internal (endonasal) rhinoplasty � here the surgeon makes incisions only on the inside of the nose, opens the skin up and proceeds to do his work without making any incisions on the external facia. Internal rhinoplasty requires more skill and artistry to perform and can only be properly employed in cases where the amount of surgery being performed is minimal or at least of such a nature that all of the work can be reached from the interior of the nose.

2. External rhinoplasty or open-tip rhinoplasty means the doctor is making incisions on the outside of the nose, at the crease where the nose joins the face so that there is no discernible scarring after the procedure has been completed. Open-tip rhinoplasty is usually employed where the surgery requires more extensive removal or manipulation of the skin and cartilage tissue.

Either of these procedures can be performed utilizing a local anesthetic or a general anesthesia and can usually be completed anywhere from two to four hours again depending on the complexity of the work being performed. Using either the internal or the external incision methods, the skin and cartilage of the nose is exposed and the surgeon can then begin the artful process of sculpting the existing tissue to achieve the desired goals of the patient.

Remembering that rhinoplasty is really more art than surgery, the doctor will frequently refer to the photographs and notes he has made prior to the procedure. He will carefully check the symmetry of the shape of the nose and make sure that the changes he is making are the right ones to achieve the desired result. Very small alterations, incisions as small as a millimeter or two, can make large differences after the swelling has gone down in the overall appearance and balance of the finished look. This is the artistry of the surgeon you have selected.

When the surgeon has completed the sculpting process, he will carefully check the blood vessels in the area to see if they have been affected by the surgery, he will measure the nostril openings to see if they conform to his pre-op notes and measurements and then he will begin the process of closing up the nose. Small sutures will be used to close the incisions made during the procedure whether internal or external. These incisions are similar in size and form to the ones employed by heart surgeons when they are closing up small veins and arteries after cardiovascular surgery.

Finally, a small protective splint is placed around the nose. Your surgeon will have fitted you for the splint prior to the surgery and you will be expecting it when you awaken. After about 24 to 48 hours, on your next visit, the splint will be removed and your new nose will be ready to �face� the world. You�ll be left with some swelling, a small amount of pain and some antibiotics to ward off infection.

The cost of a rhinoplasty procedure can vary greatly from region to region, city to city and doctor to doctor. Just as in any field, including medicine, there are groups and people that provide low cost, operations for large volume client bases on low budgets and higher cost operations to superstar medical personalities willing to pay astronomical prices. After doing research beforehand and paying attention to published reports on plastic surgery, one can easily find the names of plastic surgeons in the Southern California area, or any area, who have worked on famous celebrities. However, whatever your budget and approach, you can save money by researching the topic, making an informed decision and consulting with several doctors or groups until you find the one who makes you feel comfortable, and who is charging what you are willing to pay for the procedure.

Simply stated, without honing in on a specific location or naming a particular doctor, rhinoplasty costs should range from a minimum of $3,000 to no more than $12,000. This is the cost of hiring the surgeon only � there are a variety of other fees involved in the procedure regardless of who performs the work and where it is performed. The amount of work necessary is also a predominant factor in the final cost.

By using this simple cost analysis, dividing the total amount of money spent on rhinoplasty cost over several years compiled by the American Society of Plastic Surgeons (ASPS) and arriving at an average total cost, each rhinoplasty performed in America averages out to approximately $4,500. That total appraisal includes the surgeon, the anesthesiologist, the facility fee and any other charges that a particular doctor or group of doctors may charge. If your quote from a doctor you have consulted with is substantially lower than the average, be sure to ask questions and ask to speak with former clients. Find out if this man has a philanthropic approach to medicine. Find out if there have ever been lawsuits filed against him. Keep asking until you leave or until you feel comfortable enough to proceed further in the relationship. Just like anything else in life � if it sounds too good to be true, it usually is.

In general, unless your rhinoplasty procedure is of the most minimal type, perhaps a small bump or growth being removed or altered, you�re going to need to be asleep for the procedure and that requires the skill of a good anesthesiologist. Usually, when you hire your doctor, you don�t have a choice over the anesthesiologist � you simply use the one he�s got on his staff or the one that he�s most comfortable working with. In general, an anesthesiologist should charge approximately $700 to keep you safely asleep for the time necessary for the operation. Remember to tell everyone you speak to if you have any allergies to any medicines or if you are currently taking any medicines as they may unfavorably interact with the anesthesia.

No matter where the doctor and the anesthesiologist are going to perform the surgery, there will be a cost for the facility. This cost includes and nurses or other staff necessary for the procedure, equipment and supplies to be used and the facility�s general overhead. If the work must be performed in a hospital, there is going to be a higher charge involved than the fee charged for a simpler office procedure. Finally, this fee will include any costs involved in the anticipated recovery after the surgery. If a small procedure has been performed and a local anesthetic was administered the patient may be up, walking around, feeling fine and ready to leave after a final examination by the surgeon. However, if the work was more complex, if an anesthetic was necessary to keep the patient asleep for several hours, and if the pain quotient is expected to be higher due to the nature of the problem being addressed, it will be several more hours before the patient is examined and allowed to leave. All of these factors will affect the facility fee and should be completely discussed beforehand.

In some instances, the doctor may be offering a package price. If this makes you uncomfortable for any reason or if the total price for the work you are requesting does not feel proper, ask for a breakdown. If his breakdown does not conform with these averages, or if his explanations do nothing to allay your concerns, get a second opinion.

Deviated Septum Definition
Deviated septum occurs whilst nasal septum (thin wall) within your nose is displaced to one area. The septum divides your left and right nasal cavity and the ideal place is in perfect axis of the nose, split the nose equally. Conversely, 80% of people have non-ideal form where their nasal septum is displaced, so one nasal have smaller opening than the other does. Serious deviated septum will block the smaller diminish the airflow, producing problems in breathing. Other indications and sign of severe deviated septum are frequent infections of sinus, nosebleeds, and nasal congestion.

Symptoms Management
Deviated septum usually presents as the effect of an injury, or could be present at the birth. Deviated septum first remedy together with medications to manage the symptoms. Your physician might prescribe decongestant, nasal cortisone sprays, or antihistamine. Those medications are only takeover the symptoms and will not repair or correct the deviated septum. When you start to experiencing bothersome symptoms, such as chronic sinusitis, frequent nosebleeds, or significant obstruction of breath, you may consider nasal surgery as a method to correct your deviated septum for good.

Septoplasty or Surgical Repair
The septoplasty is a technique to restore your deviated septum. This surgical repair will reposition your nasal septum to the middle of the nose. The ways may comprise cut and remove some ideal right spot properly. You can look ahead to some improvement as the end result of septoplasty surgery that depends on the harshness of your deviation. Some signs, such as nasal obstruction and nosebleeds, usually resolve wholly. Conversely, if you have allergies that accompany your nasal or sinus troubles, it can’t be repaired with septoplasty surgery.

Rhinoplasty or Reshaping your Nose
Surgical treatment for remodeling the nose is called rhinoplasty. In some cases, rhinoplasty is needed and carries out at the same session as septoplasty surgery. Rhinoplasty surgery entails readjusting the bone of the nose and the cartilage to alter the shape or size, or both. Thinning a thickened blockade of the septum, moving distorted exterior configuration, and make straight a curved septum all can get better certain airways. Sometimes turbinate size can be expanded with mindful partial deduction. Disproportionate deduction on the turbinate might cause sore breathing because the compromised humidification. Rhinoplasty has many surgical possibilities for modifying the shape and characteristic of a nose, such as:
• Make even the nose bridge
• Restructuring the tip of your nose
• Add or reduce the total size of your nose
• Modifying the angle of the nose from the upper lip
• Repair defects caused by an injury
• Correct imperfections that present at birth
• Breathing difficulty improvements

The assessment toward rhinoplasty surgery will take times for analysis, evaluation, and consultation. Human body is not comparable to a picture or computer image. Despite the fact that computer software might be used to explain the form of the nose after surgical treatment, but you shall realize that not all-surgical treatment can duplicate computer imaging as it is. Comprehend the procedures and expecting the realistic result is solution to be converted into a happy customer.

No matter where the doctor and the anesthesiologist are going to perform a rhinoplasty surgery, there will be a cost for the facility. This cost includes and nurses or other staff necessary for the procedure, equipment and supplies to be used and the facility�s general overhead whether that is a rhinoplasty being performed in an office or one being done in a hospital. Obviously, if there is a reason that the work must be performed in a hospital, there is going to be a higher charge involved than merely the fee charged for a simpler office procedure. And finally, this fee will include any costs involved in the anticipated recovery after the surgery. If a small procedure has been performed and a local anesthetic was administered, a short time after completion, the patient may be up, walking around, feeling fine and ready to leave after a final examination by the surgeon. However, if the work was more complex, if an anesthetic was necessary to keep the patient asleep for several hours, if the pain quotient is expected to be higher due to the nature of the problem being addressed, it will be several hours after the surgery has been completed before the patient will be awake and several more hours before the patient is examined and allowed to leave.

All of these factors will affect the facility fee (as well as all other costs involved) and should be completely discussed beforehand. Applying the total monies spent on facility fees and dividing that by the number of surgeries performed, we arrive at an approximate average facility fee, nationally, of $700. If you are being charged substantially more or less than that you should ask why and the doctor�s answers should adequately explain the difference.

In some instances, the doctor may be offering a �package price� which would include his fee, the anesthesiologist� fee and the facility fee as one number. If this makes you uncomfortable for any reason or if the total price for the work you are requesting does not feel proper, ask for a breakdown.

Remember, the numbers quoted here are from compiled figures published by American Society of Plastic Surgeons (ASPS) under the category rhinoplasty cost. There are two factors to take into account with these numbers:

1. The category �rhinoplasty cost� includes any surgery performed by a licensed surgeon operating on the nose. This can range from the removal of a simple bump, the repair of a simple skin tear or even hiding a small scar, up to a complete nasal reconstruction. As the complexity of the work increases, as the skill and artistry required of the surgeon increases, so does the cost.

2. Many rhinoplasty costs are hidden by doctors who have no problem billing their work to unsuspecting insurance companies as a repair of a �deviated septum� to �improve breathing difficulties� which would then be partially covered. This practice has become prevalent in the industry as the work can be performed and the client can save 60% or more of the total costs. Be aware if your doctor intends to bill your insurance company. If this is not something you wish to be involved in, make your desires known.

Revision rhinoplasty occurs when any further surgery is required on a nose to either repair poorly executed surgery, to correct some irregularity from a previous surgery or to hide scars or other surgical marks from a previous rhinoplasty. The important factors guiding revision rhinoplasty are:

1. How the nose looks now

2. What is the problem/irregularity that needs to be addresses/repaired

3. How much scarring is present from previous surgeries

4. The mental state of the patient requesting the revisions, i.e., is he/she an unsatisfiable perfectionist, a surgery junkie, or psychologically unbalanced in any way that is causing an unjustifiable surgical request

5. Is the problem correctable

If all of these factors are in order, then a patient who is not satisfied with her previous rhinoplasty is now requesting a second rhinoplasty from either the same surgeon who performed the primary rhinoplasty or a surgeon who specializes in revision rhinoplasty. A surgeon who specializes in revision rhinoplasty is specially trained in the field and it is important to ask pertinent questions of any surgeon who is offering to do this work for you. While it is rare for a nose to be completely beyond repair, it is important to analyze the patient�s motivation behind requesting multiple surgeries.

According to statistical analysis, revision rhinoplasty procedures need to be performed in 17% of the total number of primary rhinoplasty surgeries in the United States. However, it is important to note that a large percentage of the cases, a very small irregularity, or bump is the specific cause of the revision rhinoplasty and for the most part, these are predominately office procedures done on an outpatient basis and for a very small fee. It is the rare case that requires extensive revision rhinoplasty work unless something, for some reason, has gone awry. Furthermore, the majority of the remaining �clean up� cases are the result of those rare instances when the patient himself has caused some damage to the nose after surgery by falling, bumping the nose or some other physical trauma requiring surgical attention.

As rare as it may be, some patients have decided after rhinoplasty that their nose is now too small for their face and that it was not the fault of the primary physician but in their own request for changes. In these instances, revisionary surgeons can add tissue, spread the nostrils a bit, stretch the cartilage and expand the nose to more properly fit the face. There is almost no condition of the nose that cannot be fixed, repaired or improved. Other instances of requests for revision rhinoplasty have to do when patients request a certain �look� for a new nose. They bring in a photo of a celebrity or a historical figure and request a nose identical to the one in the photo. And even when the computer imaging does not justify the look they demand to look just like their favorite celebrity. Oftentimes the final result simply does not look good on them and they seek out a trained revision rhinoplastic surgeon to make their nose look �normal� again, that is, to restore it to it�s original state. As bizarre as this sounds, it is quite common for patients to receive exactly what they wanted and then to change their minds afterwards.

After rhinoplasty surgery, your doctor will send you home with an instruction sheet listing many things to be aware of and take heed of after the surgery and before your next office visit. He�ll give you contact numbers to phone in case of any emergency that may arise or if you have any questions or concerns after you�ve left the office. He�ll ask you to keep your head elevated for the next two to three days. That is, if you sleep face down, he�ll ask that you consciously make the effort to sleep face up, on your back. This will help reduce the swelling and keep your blood flowing properly throughout the area. A common sensation is a feeling of stuffiness and a desire to blow your nose which you must resist. You�ll be breathing through your mouth for a few days and most people describe this as uncomfortable.

Drink a lot of liquids and keep your talking to a minimum and this will help you get through this unavoidable situation. It is also common to experience a feeling of heaviness on your face. This is common and can be quite easily relieved with some simple pain killers which will also help in the case of any headaches. If you have difficulty sleeping, your doctor may prescribe several days worth of mild sleeping pills but would rather not as they will slow down the healing process just a bit. Rarely do patients have a truly terrible time after rhinoplasty. The adjustments are temporary and the rewards for a job well done far outweigh the minor post surgical inconveniences which can mostly be addressed with simple procedures and medications.

You can expect discoloring of the skin and tissue surrounding the nose after the surgery. This black and blue look will begin to dissipate within a week or so especially after the splint has been removed. Small amounts of makeup and skin covers may be used as long as they do not irritate the area. Try to avoid putting makeup directly onto the incisions if at all possible to avoid possible infection. During this period, make extra sure that nobody touches your nose or face, that you do not bump your nose, or do anything that could slow down the healing process. Watch out especially for kids who don�t mean to hurt you but will display great curiosity about Mommy or Daddy�s new nose and pets who just don�t know any better. You should also avoid the sun, avoid wearing eyeglasses (use contacts during this period if possible) and try not to rub the nose too hard when you wash your face.

The most common reaction people have upon seeing their new nose is disappointment. Yes. I said disappointment. Patients, even the most informed ones, expect to see a perfect nose upon removal of the splint and any packing, if used. This will not happen. You can expect to see swelling, sutures (if done externally), bruising, some broken blood vessels and that overall black and blue, just been in a fistfight look, that you did not expect. Relax. In a few days, the swelling will start to go down, the bruising will fade and your new nose will start to emerge. If you�ve selected the right surgeon and asked for the right changes, you should be pleased in a short period of time with your new look, the new shape of your nose and the new harmony of your face. Remember, your nose will continue to improve slowly for many weeks and even months after the surgical procedure has faded from your memory.

You�ve done your research, had several consultations, selected your surgeon and scheduled the surgery. Now what? Following some prudent �rhinoplasty before and after� suggestions can shorten your recovery, help to protect and preserve your health and improve your outcome. Here�s a typical scenario of things to keep in mind before your rhinoplasty surgery.

The night before the procedure, do not eat or drink anything after midnight. If your doctor has more stringent protective measures, by all means follow them � he�s only looking out for your health and safety. Some patients take this as a license to eat as much as they possibly can until the cutoff time. This is not a good practice as most of what you eat will still be in your digestive system at the time of the surgery. So eat lightly, rest well and go into the surgery at your best.

Arrive early. Your doctor will give you an arrival or check-in time. Whether or not you are having the surgery done as an office procedure or as a hospital patient will affect the amount of time necessary for your check in. Hospitals require more hours for pre-op examinations than offices merely because of the volume of patients they see on a typical day. Most hospitals, these days, have established less formal, lower traffic operating rooms to accommodate plastic surgeons and separate rhinoplasty patients from more serious surgeries. At this point, regardless of your location, you will probably be asked to give blood, perhaps urine samples and to complete any unfinished paperwork. Then you�ll be undressed and placed on a gurney to await anesthesia. Your doctor will visit you before the anesthesia is administered to allay your fears, briefly discuss the surgery about to be performed and to make you feel at ease about the course of events about to unfold.

Prior to the surgery your doctor will have taken �before� photos of the way your nose looks prior to the surgery. As many angles as necessary will be incorporated depending upon the work being performed and the requested final result. In addition, computer simulations of the �finished product�, morphed onto your face will be prepared so both you and he are on �the same page� regarding exactly the outcome you are expecting. The doctor will use these photos to plan the sequence of events in the surgery and to guide his artistry in creating your �new look� to the best of his ability.

Once these steps are taken, you will be ready to begin surgery. Soon after, you should have the nose and face that you desire.

Labiaplasty is increasing in popularity as a surgical procedure among women of various ages. Many women choose to undergo labiaplasty to reduce the size of the labia or to improve the look of the vaginal area. Factors including child bearing, sexual activity, congenital anomalies, and aging are medical and aesthetic reasons women are seeking cosmetic surgery.
Ideal candidates for the procedure include women with enlarged or hypertrophic labia minora that cause discomfort and even psycho-social issues. Local irritation, problems with personal hygiene, interference with sexual intercourse, discomfort during physical activities such as cycling, horseback riding, sitting, and chaffing while walking and running are indications for surgical labia reduction.
Depending on the severity and complexity of the case, the procedure may be performed under a local or general anesthesia. The procedure involves removal of any excess tissue, asymmetry, or irregularities from the inner labia minora, which covers the clitoris and vagina. In some instances, the outer labia majora may also be improved if necessary.
Care is taken to avoid over-resection or trimming of the labia and to avoid interference with the clitoris and the urethral opening. The judicious reduction of the labia minora serves to improve the physical discomfort and sexuality of the patient. Internal dissolvable sutures are used and incisions are minimal and discrete. Sensitivity is normally unaffected.
This 25-year old patient was born with severe excessive labia minora and wanted to have labiaplasty surgery to improve the look and discomfort she experience for so long.
Recovery time can vary from patient to patient. Bed rest is recommended for the first 2-3 days to ensure proper healing. Ice cold compresses during the first few days will help minimize swelling. The patient is instructed to avoid strenuous activity including sexual intercourse, tampon use, biking, and running for about 4-6 weeks.
Final results are usually seen at about 4-6 months. The request for labiaplasty consultations are in demand and many women feel that they will benefit from the procedure to help improve their self-image and confidence.

Selecting the right surgeon for you is both the fun part and the biggest challenge you�ll face when electing to do rhinoplasty. There are several national organizations and many state and local organizations where talented, certified professionals band together to offer the public a safe place to find competent, honest rhinoplasty surgeons. One I mentioned earlier in this text was the American Society of Plastic Surgeons (ASPS) a respected organization that provides listings of professional surgeons around the country as well as all the information one could possibly need in getting help in selecting the right doctor. Another one is the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS).

The internet, your local library or even your family doctor can help you find the listings and certifications of registered physicians in your area to talk to. Remember, it�s up to you to decide who you trust to do the work on your nose. Interview as many doctors as you can until you find the one who understands exactly who you are and what you want and is willing to do the work on the budget that you have in mind. Many doctors have waiting lists so time is obviously a factor. If for some reason you feel a need to have the work done quickly then a large number of doctors, who may be booked for months in advance, will not be the right ones for you. If you have the time to wait for the right doctor then you have a wider group to choose from.

Probably the best way to find a doctor is to ask people, friends, who they know who might have had some �work� done on their faces. You�ll be surprised at the response. People you wouldn�t have dreamed would have had plastic surgery will suddenly come forward with their stories. And best of all, if you didn�t know they had the work done, it was probably excellent work. Most people don�t want a drastic change to their faces. They want some irregularity fixed, some aging reversed or some childhood trauma finally taken care of. If you can�t tell the work was done, if the person has no complaints about the price he/she paid, the treatment he/she received, and most importantly, about the look and feel of the finished product, then this is most probably a doctor you want to talk to about working on your nose.

The best advice you�ll ever receive about plastic surgery, about choosing a doctor, about altering your appearance for the better is to do your homework, ask questions, don�t rush into anything, find out as much as you possibly can about the work you want done and the people you�re considering trusting with the job. The more time you invest in advance, the better your odds are of getting exactly what you want � or more!