Articles on surgery

Jaw Surgeries for a Proportional Face

Dr. N Srinivas, Dentist
It may take more than a new smile to help you look your very best.Having a great smile is undoubtedly an asset, regardless of other aspects of your appearance. However, your smile is only one part of the whole composition of your face. Once you have improved your smile, you may be inspired to make a few other changes to look your very best, and it may be necessary to look beyond your dentist to help.If you are unhappy with your facial profile,the condition of your skin, or specific facial features such as your lips, nose or chin. An oral and maxillofacial surgeon reveals how repositioning the jaws can improve not only your bite but also your entire facial appearance, especially in profile.What is orthognathic surgery?Orthognathic surgery involves dividing and repositioning the jawbones to bring them into better alignment. It is typically used to correct bite problems that cannot be fixed by orthodontics alone.Often bone or soft tissues may be removed or augmented to further enhance facial esthetics. Orthognathic surgery can bring about significant changes in your appearance.Is orthognathic surgery right for me?Orthognathic surgery is typically performed by an oral and maxillofacial surgeon and can achieve dramatic improvement in facial esthetics. Orthognathic surgery may be the best option if you:1. Have jaw problems that can be treated only by surgery.2. Can pay for the procedure, as its a bit expensive.3. Feel strongly that your condition is inhibiting your success and happiness.4. Are willing to experience some discomfort and inconvenience.5. Understand and accept all associated risks.Communication is critical to success!1.It's important that you tell your doctor exactly what you want to correct.He or she may zero in on a particular problem,and you need to be sure that problem is also your primary concern.2. Your surgeon will design a highly specialized treatment plan for you based on information gathered by obtaining casts of your teeth, photographs,video images,and special x-rays.3. It's highly important that you know what results to expect from treatment.Some surgeons will use digital imaging to give you a good idea of what you'll look like after surgery;others may show you tracings of your new profile based on your x-rays.4.It's also essential that you understand each step of the surgical procedure that you're to undergo.The main risks and possible outcomes should be explained thoroughly, and it's then up to decide which procedures you wish to have performed.What can orthognatic surgery do?Problems that can be addressed using orthognathic surgery include. Recessive or protruding lower jaw and/or chin.. Chin that is too short,too long,or otherwise unattractive.. Open bite(teeth do not meet). Lower and/or upper jaw positioned to one side or a narrow arch. Discrepancies in upper and lower facial height (gummy smile or lack of enough tooth or gums showing)What does an oral and maxillofacial surgeon do?Oral and maxillofacial surgeons do more than just tooth extractions and jaw surgeries.If  you're interested in cosmetic procedures to enhance the appearance of your face and neck,talk to your surgeon about including them your overall treatment plan.

Cosmetic and Plastic Surgeries

Dr. Parthasarathi Dutta Roy, Dermatologist
Being beautiful and charming is very important in every stage of today’s life. Most of people become upset for not receiving attractive physical structure, nose alignment, slim physic and many more. But medical science creates revolution for establishing two significant surgeries named cosmetic surgery and plastic surgery. These are very helpful for treating any kinds of physical disorders.Effectiveness of Cosmetic and Plastic SurgeryThrough cosmetic surgery anybody can change their facial or body structure which is not desired. Plus from ageing lines to wrinkles can be reduced through method of cosmetic surgery.Plastic Surgery is basically used for reconstructing the facial or body features. Any kinds of birth defects, injury imperfection and disease feature can beautifully be repaired by plastic surgery.Features of Cosmetic SurgeryTwo types of cosmetic surgery are categorized in medical science- addition and deletion. Through cosmetic surgery with collagen injection something can be added for giving proper shape and size of the body parts if one is not satisfied with their parts, size and shape of the body. Breast augmentation and lips plumping are the best examples. Alternatively excess mass on some parts looks ugly; the cosmetic surgery helps to delete the volume to give the perfect shape.Procedures of Plastic Surgery:Many procedures can be performed through plastic surgery. But here are some most popular procedures which is remarkable possible to treat are described below.Breast Augmentation: The women having small breast can get beautiful and attractive big breast through breast augmentation procedure of plastic surgery.Rhinoplasty: Defect of nose can be treated through rhinoplasty.Blepharoplasty: To give redesign and shape of the eye lids, blepharoplasty is just incomparable plastic surgery.Liposuction: Excess fat is cut down through this liposuction procedure for giving attractive body structure.

Do I Have Appendicitis? Do I Need Surgery?

Dr. Maruthesh Gowda, Bariatric Surgeon
First thing we need to understand is that appendicitis is an surgical emergency. When treated appropriately complications are very few.What are the symptoms of appendicitis?It has dull aching pain around the umbilicus and slowly localises to right lower side. It is associated with vomiting and anorexia (patient does not feel hungry). If ignored then might lead to temperature, high heart rate (tachycardia).How is appendicitis diagnosed? It's based on history and clinical examination. Blood tests will reveal infection (Increased WBC, CRP). Ultrasound of abdomen might help to confirm the diagnosis but negative ultrasound scan does not rule out possibility of appendicitis. Ultrasound is more important in females as problems in ovaries, fallopian tube and uterus might present in the similar way and ultrasound helps to rule out those possibilities. What is the treatment of appendicitis?  In short treatment of appendicitis is immediate surgery. It is not I am busy for next few days and will have surgery later and this might lead to serious complications.Now a days surgery is done laparoscopically (Key hole) and involves three small cuts which will be barely visible with time. Most patients go home 24 hours later being able to do regular activities. There will be no food restrictions. Only restriction being not to lift weights for 1 month. Can appendicitis be treated with medicines? if so what are the complications?There are times when patients want antibiotics and not surgery. While this is proven treatment it is logistically difficult to apply in Indian settings unless patients and affordable and ready to take risks.Medical proof so far tells us to treat appendicitis with antibiotics we need to do CT scan and prove that there is no collection of pus inside abdomen. Once this is done admit patient for Intravenous antibiotics (IV) for 48 hours. Regularly review patient to make sure infection is not spreading. If infection does not settle down or patient suffers complication then do complicated surgery with more risks involved.What we have to be very careful is young females with appendicitis as untreated or poorly treated appendicitis might lead to infertility in the future by affecting the movements of fallopian tubes.In all patients treated with antibiotics there is small risk of long term abdominal pain and very rarely appendicitis might recur needing surgery.

What is orthognathic surgery?

Dr. N Srinivas, Dentist
Having a great smile is undoubtedly an asset, regardless of other aspects of your appearance. However,your smile is only one part of the whole composition of your face. Once you have improved your smile,you may be inspired to make a few other changes to look your very best,and it may be necessary to look beyond your dentist for help.If you are unhappy with your facial profile, the condition of your skin,or specific facial features such as your lips, nose or chin, surgeon reveals how repositioning the jaws can improve not only your bite but also your entire facial appearance, especially in profile.What is orthognathic surgery?Orthognathic surgery involves dividing and repositioning the jaw bones to bring them into better alignment. It is typically used to correct bite problems that cannot be fixed by orthodontics alone. Often bone or soft tissue may be removed or augmented to further enhance facial esthetics. Orthognathic surgery can bring about significant changes in your appearance,particularly as you are seen in profile.What can orthognathic surgery do?Problems that can be addressed include:Recessive or protruding lower jaw and or china chin that is too short, too long, or otherwise unattractiveOpen bite (teeth do not meet)Lower or upper jaw positioned to one side or a narrow archDiscrepancies in upper and lower facial height Communication is critical to success!It's important that you tell your doctor exactly what you want to correct. The doctor may zero in on a particular problem and you need to be sure that problem is also your primary concern.The surgeon will design a treatment plan based on information gathered by obtaining casts of your teeth, photographs, video images, and special x rays.It's highly important to know what results to expect from treatment, either by digital imaging or tracings of your new profile based on x-ray.It's essential to understand each step of surgical procedure that you undergo.

How Do I Behave When I Am Undergoing Cataract Surgery?

Dr. Manoj Rai Mehta, Ophthalmologist
Cataract Surgery nowadays is usually performed under 'topical anaesthesia' that involves instillation of drops of the anaesthetic agent on the eye surface.  The patient retains the power to close the lids and move the eyeball during surgery, feel no pain but touch and pressure sensations are unaffected.  A peribulbar block anaesthesia may be used at times on surgeon's discretion that involves an injection of anaesthetic agent around the eyeball with a short needle.  This takes away lid and eye movements to a large extent but some control may remain with the patient.     Operating Surgeon expects the patient to follow the instructions for a smooth surgery.  It is important to have a surgical counselling session with the doctor to understand the procedure and expected sounds/conversation during the operative procedure.  The sequence of events should be understood and played in your mind while you move through the surgical suite.You should be wearing loose, comfortable hospital pyjama suit.  Do not hesitate to change it if it is tight around your neck.  Some hospitals have the policy to allow you to wear your own loose clothes and give you a hospital gown over them.  Please ensure you are not wearing tight fitting clothes and your neck is free.  Ladies to tie their hair in a ponytail with a band or a soft bun with no clips or claspsSit quietly in the pre-operative area and use the washrooms before going to the OR.  You may take sips of water if your mouth feels dry but do not hydrate yourself too much.You may be given a cap and eye marked for surgery.  The antiseptic solution will be painted around the eye.  Let the solution dry and do not touch your eye. OR assistant will help you lie down on the OT table with a rubber ring under the head to prevent rolling from side to side. You should be comfortable and be able to breathe rhythmically while lying down.  Ask for a head raise if neck extension is hurting you and get the ring adjusted to your comfort and if it is hard for you to ask for a softer ring.When you are comfortable allow the staff to put monitoring devices which could be a pulse oxygen meter alone or additional cardiac electrodes.  Breath rhythmically and try to relax.Sterile Drapes will be placed around your head and an adhesive eye drape on the eye to be operated upon.  Please maintain your head in a position as required and adjusted by the surgeon.  Do not move your head or lower your chin.  The surgeon works under a microscope and any movement shifts the focus and obstructs in smooth surgery.There will be several sounds in the OR that you should ignore-beep of monitors, hum of air circulation unit, trolley wheels, the doctor would be giving instructions to staff and asking for instruments etc.  Try to keep your attention focused towards surgery only.Coughing and snorting during surgery can create complications, always ask the surgeon to stop the surgery if you feel like doing so.  Do not try to suppress a cough or sneeze by holding breath.  Do not bear down or move.Follow instructions of a surgeon and do not start a conversation. Answer only when a question is directed towards you.  The surgeon may ask you to look in a particular direction.  You have to follow the command by moving your eyes and not head unless the specific instruction is made. The first touch of the instrument will increase your confidence.  Do not wince, squeeze your lids or make a jerky movement if you feel some pain.  Inform the doctor, who will reinforce anaesthesia.Cataract Surgery machines also produce different types of sounds during different phases of surgery and also have synthesised verbal outputs.  Do not get distracted by the same.You will see movements in front of the eye during surgery and also perceive vibrations.  Light intensity will increase towards the end of surgery.  A calm patient who is having a regular rhythmic breathing and a regular normal pulse rate makes a surgeon's job easy.(In case of specific problems additional monitoring and specialised anaesthetic cover may be required which the operating surgeon will discuss before hand).               

Liposuction: The Most Misunderstood Surgery in the World

Dr Deepali Agarwal
The procedure involves fat removal but is not an alternative to dieting and exercise. It is not a means of weight reduction but body contouring and sculpting. Although following a good healthy diet and a daily exercise is a better idea but localized fatty deposits such as on thighs, hips and abdomen etc may be inherited traits and may not be corrected by just a good lifestyle. In such cases liposuction rather we should say liposculpting is a good option.Some fast facts about the surgery are as follows:The length of the surgery varies from 30minutes to 5 hours depending on the extent of fat removal.It is done under local anesthesia, intravenous sedation, epidural block or general anesthesia.The length of the stay at the hospital is usually 1 day.Initially there is mild to moderate discomfort. You can go back to work after 10 days but sternous exercises should be avoided for atleast a month.Most of the swelling subsides within a week while mild residual swelling goes after 3 months.The scars are minute and inconspicuously placed.Complications are possible but unlikely if done by a well trained and experienced plastic surgeon.To conclude would like to emphasize on the point that the success of the procedure lies in the understanding of the patient that the procedure is not for weight reduction but spot reduction i.e. localized fatty deposits. It is the most frequently done aesthetic procedure in the USA and worldwide which seems to be a truly magical procedure than any other aesthetic procedure.

Steps After Cataract Surgery for Optimum Outcome

Dr. Vaibhev Mittal, Ophthalmologist
Cataract is the most commonly performed eye surgery. With modern advanced phacoemulsification techniques and better anesthetic drugs, there is a shift in paradigm from large incision suture based surgeries (Extra capsular cataract extraction) to minimal incision sutureless surgeries. Now cataract can be operated even under topical anesthesia (No injection required to anesthetize the eye) which speedens the recovery and minimizes the need for post operative bandage.What to expect on first Post operative day?With new techniques involving minimal intervention, sometimes, it becomes difficult to differentiate operated eye from normal eye. In most patients eye is usually white with clear vision. But it is not unusual to see red eye on first day which could be damage to small blood vessels present in conjunctiva. This redness usually resolves over 2-3 weeks without any visual disturbance.Sometimes, the vision may be blurred on first day which could be due to mild corneal swelling which resolves over 1 week. It takes nearly 4 weeks for eye to heal completely after cataract surgeryPrecautions to be taken in first post operative week for best results after surgeryThough cataract surgery is a quick and painless day care procedure but still few precautions need to be taken for optimal resultsMost devastating complication after cataract surgery is infection. Usually doctors take preventive measures both pre and  intra operatively but still antibiotic eyedrops should be used as prescribed by doctor during post operative period to reduce the risk of infection. Cataract surgery is also associated with minimal inflammation in eye. For that doctors prescribe steroids along with NSAID eyedrops.Other precautions that need to be exercised are:Avoid rubbing eyes as it may cause wound leak and increases risk of infectionCover your eyes by dark glasses to prevent exposure to dust and irritantsAvoid swimming and exposure to water for atleast 10 days after surgeryAvoid lifting heavy weight or strenuous exerciseAvoid bending  or gym for initial 2 weeksKeep using medicines as advised by doctorClean eyes with cotton dipped in hot waterThese are simple precautions that should be exercised for optimal visual outcome

Hair Restoration Surgery in Young Patients

Dr. Amrendra kumar, Dermatologist
Many patients come to look for hair transplantation at a very young age as early as 16 to 18 years; these people may have low self-esteem and also come in distress because of peer pressure most of these patients actually looking for rapid results, with unrealistic expectation managing this kind of situation often becomes challenging for the treating physician. Every case may be a different case so before embarking on the treatment it is important to look after all the factors and expectations. Some may need even consultation with psychiatrist.Expectations must be confronted with the reality and the treatment should be explained well before with realistic results emphasizing that there are no miracle or magical treatment available.Conservative treatments like medications, platelet rich plasma therapy or low level laser light therapy must be taken into consideration before embarking on hair transplantation in such patients. Most of these patients have very little temporal regression of thinning in the frontal area which can be managed with these treatments.Future hair loss is possible with younger patients. It should be explained that even after hair transplantation further hair loss may be possible and hair transplantation is not the end treatment or have quick results.As the number of hair restoration surgeons are increasing, there is an increase in competition between them naturally and many treating doctors take such case as a challenge which should be discouraged.Before hair transplantation we need to understand the cause of Hair loss - beside androgenetic alopecia, other factors that might contribute to hair loss like health conditions, diet and genetics.If it is caused by pattern hair loss, it is not possible to determine the pattern of hair loss at such a young age and future progression. Family history may play a crucial role as it might give the clue about future progression.Before surgery, Patients can try the oral drug Finasteride and /or topical minoxidil to slow hair loss. He can re-examine the patient at regular interval to see the progression or if the drugs have slowed further progression.If even after that the progression continues and a surgeon determines to go for the surgery he should go for the minimum grafts need for the correction and try to avoid transplantation in the vertex area. Risk of  future hair loss will always be factor so the best way is to  wait until the condition has progressed, at least enough for a physician to identify a surgical plan and till then, managing the case  with medications or other adjutant therapies is a good idea.

3 Reasons Why You Shouldn’t Be Nervous About Implant Surgery

Dr. Ishwari Bhirud, Dentist
Dental implants have gained a popular reputation for their life-like appearance and longevity. Much of the latter is attributable to the titanium post embedded in the jawbone. Because titanium has a natural affinity with bone, new cells will grow and adhere to the dental implant over time, making their connection strong and durable.Of course, to achieve that requires implant surgery — a prospect that gives many people pause before choosing this replacement option. But implant surgery is a routine undertaking, causes very little discomfort and in trained hands has a very high success rate.Here are 3 reasons why implant surgery is nothing to be nervous about.The procedure is precisely planned. Implant surgery is a relatively minor procedure, mainly because all the placement details are often mapped out ahead of time. For complex situations your dentist can use x-ray or CT imaging to determine the exact location for each implant and create a surgical guide to use during the procedure to make incisions and create the small channel that will hold the implant.Implant surgery can be performed with local anaesthesia. Implantation is usually easier than tooth extraction — if you’re healthy enough for that procedure you should have no problem undergoing implant surgery. With a local anaesthetic, your dentist will numb only the implant site and surrounding tissues while you remain conscious. If, however, you have any anxiety your dentist can also include a sedative or anti-anxiety medication before proceeding.There’s minimal discomfort afterwards. Thanks to the pre-planned surgical guide and advanced implantation techniques, there’s very little tissue disruption and incised tissues are normally stitched with self-absorbing sutures. While some cases may require stronger pain relievers, most of the time a mild non-steroidal anti-inflammatory drug (NSAID) such as aspirin or ibuprofen is sufficient for discomfort afterwards.The implant site heals fairly quickly and predictably with a 95-97% success rate. A few weeks after bone integration your dentist will attach the permanent like-like crown, and you’ll be ready for many years of full function and a confident smile.