Facial Rejuvenation

Facial rejuvenation refers to the combination of cosmetic procedures used to restore your facial features to their previous youthful appearance. While a facelift is often the anchor or foundation for many facial rejuvenations, other procedures can complement and enhance the result. Surgical procedures such as eyelid surgery, brow lift and facial implants can help correct specific problem areas on the face. Nonsurgical treatments including fillers, neurotoxins (botulinum toxins) and fat injections can be used for volume enhancement and wrinkle and fold eradication. Laser skin resurfacing or other light modalities can be utilized to improve skin texture and correct skin blemishes or age spots.

When to Consider Facial Rejuvenation

• If you want to reverse the signs of aging and restore a more youthful appearance
• If your face and neck are sagging, or if you are losing volume in your cheekbones and contour along your jawline
• If there are crow’s feet at the corners of your eyes, fine lines and folds around your mouth, and frown lines and furrows in your forehead
• If there is drooping skin and wrinkling changes in your upper eyelids, upper and lower eyelid bags, and dark circles under your eyes

 

How is a facial rejuvenation procedure performed?

Careful planning and sequencing of procedures is necessary for facial rejuvenation. Your aesthetic plastic surgeon will determine the best order of procedures in your particular case.

• If volume enhancement using fat transfer is desired for facial rejuvenation, it is typically performed first with fat grafting to deficient regions. The fat is harvested from other areas of the body and then transferred into the desired regions.
• Depending on the degree of skin laxity (looseness) in the face, either a limited incision (for minimal to moderate laxity) or a more extensive facelift is performed. Eyelid surgery, brow lift or facial implants can also be performed.
• For facelift, the skin flaps are lifted and trimmed or undermined as needed, then the flaps are moved to remove excess skin and secured with sutures.
• Once the incisions are closed, laser resurfacing can be used to improve the quality of the skin surface, erasing wrinkles around the mouth and the eyes, eliminating blotchy pigmentation, diminishing the appearance of bags under the eyes, and helping to reverse skin damage as result of sun exposure.

After healing from the surgical component of facial rejuvenation, additional refinements can be performed during follow-up office visits.

• Neurotoxins can be injected in the muscles of the forehead to smooth it, eradicate wrinkles, and provide a brow-lift effect.
• Fillers can be injected to erase the fine lines around the mouth, to add volume to the lips, and to fill the folds extending from the nose to the mouth.
• Fat can also be used at this point to add volume to the lips and to camouflage the deep line that runs from the corner of the lip to the jawline (often called the marionette lines).

Limitations and Risks

What is carpal tunnel syndrome?

Carpal tunnel syndrome is numbness, tingling, weakness, and other problems in your hand because of pressure on the median nerve in your wrist.his is a common occurrence among IT professionals and sedentary workers who are working on laptops for long duration.

The median nerve and several tendons run from your forearm to your hand through a small space in your wrist called the carpal tunnel . The median nerve controls movement and feeling  in your thumb and first three fingers (not your little finger).

What causes carpal tunnel syndrome?

Pressure on the median nerve causes carpal tunnel syndrome. This pressure can come from swelling or anything that makes the carpal tunnel smaller. Many things can cause this swelling, including:

• Illnesses such as hypothyroidism, rheumatoid arthritis, and diabetes.
• Making the same hand movements over and over, especially if the wrist is bent down (your hands lower than your wrists), or making the same wrist movements over and over.
• Pregnancy.

What are the symptoms?

Carpal tunnel syndrome can cause tingling, numbness, weakness, or pain in the fingers or hand. Some people may have pain in their arm between their hand and their elbow.

Symptoms most often occur in the thumb, index finger, middle finger, and half of the ring finger. If you have problems with your other fingers but your little finger is fine, this may be a sign that you have carpal tunnel syndrome. A different nerve gives feeling to the little finger.

You may first notice symptoms at night. You may be able to get relief by shaking your hand.

How is it treated?

Mild symptoms usually can be treated with home care. You can:

• Stop activities that cause numbness and pain. Rest your wrist longer between activities.
• Ice your wrist for 10 to 15 minutes 1 or 2 times an hour.
• Try taking nonsteroidal anti-inflammatory drugs (NSAIDs)to relieve pain and reduce swelling.
• Wear a wrist splint at night. This takes pressure off your median nerve.

The sooner you start treatment, the better your chances of stopping symptoms and preventing long-term damage to the nerve.

You also may need medicine for carpal tunnel syndrome or for a health problem that made you likely to get carpal tunnel syndrome.

Surgery is an option. But it’s usually used only when symptoms are so bad that you can’t work or do other things even after several weeks to months of other treatment.

How can you keep carpal tunnel syndrome from coming back?

To keep carpal tunnel syndrome from coming back, take care of your basic health. Stay at a healthy weight. Don’t smoke. Exercise to stay strong and flexible. If you have a long-term health problem, such as arthritis or diabetes, follow your doctor’s advice for keeping your condition under control.

You can also try to take good care of your wrists and hands:

• Try to keep your wrist in a neutral position.
• Use your whole hand-not just your fingers-to hold objects.
• When you type, keep your wrists straight, with your hands a little higher than your wrists. Relax your shoulders when your arms are at your sides.
• If you can, switch hands often when you repeat movements.

Dengue fever is transmitted by the bite of an Aedes mosquito infected with a dengue virus. The mosquito becomes infected when it bites a person with dengue virus in their blood. It can’t be spread directly from one person to another person.

Symptoms of Dengue Fever

Symptoms, which usually begin four to six days after infection and last for up to 10 days, may include

• Sudden, high fever
• Severe headaches
• Pain behind the eyes
• Severe joint and muscle pain
• Fatigue
• Nausea
• Vomiting
• Skin rash, which appears two to five days after the onset of fever
• Mild bleeding (such a nose bleed, bleeding gums, or easy bruising)

Sometimes, symptoms are mild and can be mistaken for those of the flu or another viral infection. Younger children and people who have never had the infection before tend to have milder cases than older children and adults. However, serious problems can develop. These include dengue hemorrhagic fever, a rare complication characterized by high fever, damage to lymph and blood vessels, bleeding from the nose and gums, enlargement of the liver, and failure of the circulatory system. The symptoms may progress to massive bleeding, shock, and death. This is called dengue shock syndrome (DSS).

People with weakened immune systems as well as those with a second or subsequent dengue infection are believed to be at greater risk for developing dengue hemorrhagic fever.

Diagnosing Dengue Fever

Doctors can diagnose dengue infection with a blood test to check for the virus or antibodies to it. If you become sick after traveling to a tropical area, let your doctor know. This will allow your doctor to evaluate the possibility that your symptoms were caused by a dengue infection.

Treatment for Dengue Fever

There is no specific medicine to treat dengue infection. If you think you may have dengue fever, you should use pain relievers with acetaminophen and avoid medicines with aspirin, which could worsen bleeding. You should also rest, drink plenty of fluids, and see your doctor. If you start to feel worse in the first 24 hours after your fever goes down, you should get to a hospital immediately to be checked for complications.

Is Platelet count very important?

Contrary to the popular public opinion, platelet counts are not important for the child’s treatment. Platelet tends to decrease during infection and increase during recovery. Administering platelets doesn’t hasten recovery. However, rarely doctor might order platelets when there is visible bleeding.

It is not the drop in platelet count, but the drop in blood pressure which can be fatal.

It makes more sense to follow up marker of leakage called hematocrit rather than platelet count. Further level of platelet count doesn’t predict if the child is going to be sick. It is best to prevent paranoia around platelet count and running around blood banks for get platelets.

Preventing Dengue Fever

There is no vaccine to prevent dengue fever. The best way to prevent the disease is to prevent bites by infected mosquitoes, particularly if you are living in or traveling to a tropical area. This involves protecting yourself and making efforts to keep the mosquito population down. Eat some fruits like pomegranate, papaya, kiwi fruit etc for increasing blood platelet count.

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If your wound is severe, you may have to undergo debriding, which is the removal of dead tissue, prior to reconstructive surgery.

Once that is done, there are several types of wound treatments your plastic surgeon may suggest:

• Skin grafts. This is often used for burn patients; skin is removed from one area of the body and transplanted to another. There are two types of skin graft: split-thickness grafts in which just a few layers of outer skinare transplanted and full-thickness grafts, which involve all of the dermis. There is usually permanent scarring that is noticeable.During a skin graft, a special skin-cutting instrument known as a dermatone removes the skin from an area (the donor site) usually hidden by clothing such as the buttocks or inner thigh. Once removed, the graft is placed on the area in need of covering and held in place by a dressing and a few stitches. The donor site is also covered with a dressing to prevent infection from occurring. Recovery time from a split-thickness skin graft is generally fairly rapid, often less than three weeks. For full-thickness skin graft patients the recovery time is a few weeks longer. Aside from burn patients, skin grafts can also be used during breast or nose reconstruction.

• Microsurgery. Have you lost a finger, toe, ear, or even a lip? Microsurgery may allow for those to be re-attached. Simply stated, it is a procedure in which the surgeon uses a microscope for surgical assistance in reconstructive procedures. By using a microscope, the surgeon can actually sew tiny blood vessels or nerves, allowing him or her to repair damaged nerves and arteries. This may also be a method to relieve facial paralysis or reconstruct breasts. Microsurgery is frequently used with other surgical procedures such as the free flap procedure.

 

• Free flap procedure. A free flap procedure is often performed during breast reconstruction or following surgery to remove head or neck cancer. During the procedure, muscle, skin, or bone is transferred along with the original blood supply from one area of the body (donor site) to the surgical site in order to reconstruct the area. The procedure often involves the use of microsurgery. Healing of the surgical site can be slow and require frequent wound care. Total recovery may take six to eight weeks or longer.

 

• Tissue expansion. Tissue expansion is a medical procedure that enables your body to “grow” extra skin for use in reconstructive procedures. This is accomplished by inserting an instrument known as a “balloon expander” under the skin near the area in need of repair. Over time, this balloon will be gradually filled with saline solution (salt water), slowly causing the skin to stretch and grow, much the same way a woman’s skin stretches during pregnancy.Once enough extra skin has been grown, it is then used to correct or reconstruct a damaged body part. This procedure is especially common for breast reconstruction.Tissue expansion has many advantages in that the skin color and texture are a near perfect match for the area in which it is needed and there is little scarring since there is no removal of skin from one area to another. The major drawback to tissue expansion is the length of the procedure, which can be as long as four months. During this period, as the balloon expander grows, the bulge under the skin grows with it. This bulge may be desirable for a breast reconstruction patient; however, for patients undergoing this procedure for scalp repair, the bulge may be uncomfortably noticeable.

What Happens After Surgery for Wound Treatment?

For any surgery involving the removal and transplantation of skin, it is extremely important that you follow the general instructions and guidelines for the care of your wound once you are sent home.

Daily Activity After Cosmetic Surgery

Easy does it! Remember, your energy level will decrease when you return home after cosmetic surgerycompared to when you were in the hospital. Patients often report being more tired and easily fatigued when at home than while they were in the hospital. You may find it helpful to set up a regular routine, but remember to pace yourself. If you are tired, take time to rest. Do not overdo it.

Skin Changes After Cosmetic Surgery

Be patient with your healing after cosmetic surgery to repair burns or wounds! As you continue to heal, you will notice changes in the color, appearance, and feeling of your skin at the surgical site. You also may notice numbness, a tingling sensation, or minimal feeling around your incisions. This is normal. These sensations will continue to improve over the next few months.

Perfusion and Circulation After Cosmetic Surgery

After your cosmetic surgery, it is important to monitor perfusion (passage of fluid) and circulation of the wound site. Avoid wearing clothing that constricts or applies pressure around your wound. Also, your doctor may give you a additional instructions to help with circulation to the wound.

The following are signs indicating that there may be an infection at the surgical site. Notify your doctor right away if you experience any of the following symptoms:

• White pimples or blisters around incision lines.
• An increase in redness, tenderness, or swelling of the surgical site.
• Drainage from the incision line. Occasionally, a small amount of bloody or clear yellow-tinged fluid may drain. Notify your doctor if it persists or if it changes in consistency.
• A marked or sudden increase in pain not relieved by the pain medication.

You may experience some other, more general signs of infection that will require medical treatment. If you notice any of the following symptoms of infection, it is important that you call your health care provider as soon as possible.

• A persistent elevation of body temperature greater than 100.5 degrees Fahrenheit (Take your temperature daily, at the same time each day
• Sweats or chills
• Skin rash
• Sore or scratchy throat or pain when swallowing
• Sinus drainage, nasal congestion, headaches, or tenderness along the upper cheekbones
• Persistent, dry or moist cough that lasts more than two days
• White patches in your mouth or on your tongue
• Nausea, vomiting, or diarrhea.
• Trouble urinating: pain or burning, constant urge or frequent urination
• Bloody, cloudy, or foul-smelling urine