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what is liposuction?

“Lipo” (from the Greek “lipos) means fat. And liposuction is a cosmetic surgical procedure by which excess fat is broken down and sucked out from under the skin. ​​Liposuction can be used to target fat under the chin, neck, cheeks, upper arms, breasts, abdomen, buttocks, hips, thighs, knees, calves, and ankle areas.

When performed by our expert plastic surgeons, liposuction can help reshape your contours – body and face. While it is certainly not a shortcut to drastic and instant weight loss, It eliminates those stubborn pockets of fat and restores youthful definition where it matters most: your midsection, thighs, flanks, and arms.

what is liposuction?

“Lipo” (from the Greek “lipos) means fat. And liposuction is a cosmetic surgical procedure by which excess fat is broken down and sucked out from under the skin. ​​Liposuction can be used to target fat under the chin, neck, cheeks, upper arms, breasts, abdomen, buttocks, hips, thighs, knees, calves, and ankle areas.

When performed by our expert plastic surgeons, liposuction can help reshape your contours – body and face. While it is certainly not a shortcut to drastic and instant weight loss, It eliminates those stubborn pockets of fat and restores youthful definition where it matters most: your midsection, thighs, flanks, and arms.

what is liposuction?

“Lipo” (from the Greek “lipos) means fat. And liposuction is a cosmetic surgical procedure by which excess fat is broken down and sucked out from under the skin. ​​Liposuction can be used to target fat under the chin, neck, cheeks, upper arms, breasts, abdomen, buttocks, hips, thighs, knees, calves, and ankle areas.

When performed by our expert plastic surgeons, liposuction can help reshape your contours – body and face. While it is certainly not a shortcut to drastic and instant weight loss, It eliminates those stubborn pockets of fat and restores youthful definition where it matters most: your midsection, thighs, flanks, and arms.

what is liposuction?

“Lipo” (from the Greek “lipos) means fat. And liposuction is a cosmetic surgical procedure by which excess fat is broken down and sucked out from under the skin. ​​Liposuction can be used to target fat under the chin, neck, cheeks, upper arms, breasts, abdomen, buttocks, hips, thighs, knees, calves, and ankle areas.

When performed by our expert plastic surgeons, liposuction can help reshape your contours – body and face. While it is certainly not a shortcut to drastic and instant weight loss, It eliminates those stubborn pockets of fat and restores youthful definition where it matters most: your midsection, thighs, flanks, and arms.

what is liposuction?

“Lipo” (from the Greek “lipos) means fat. And liposuction is a cosmetic surgical procedure by which excess fat is broken down and sucked out from under the skin. ​​Liposuction can be used to target fat under the chin, neck, cheeks, upper arms, breasts, abdomen, buttocks, hips, thighs, knees, calves, and ankle areas.

When performed by our expert plastic surgeons, liposuction can help reshape your contours – body and face. While it is certainly not a shortcut to drastic and instant weight loss, It eliminates those stubborn pockets of fat and restores youthful definition where it matters most: your midsection, thighs, flanks, and arms.

what is liposuction?

“Lipo” (from the Greek “lipos) means fat. And liposuction is a cosmetic surgical procedure by which excess fat is broken down and sucked out from under the skin. ​​Liposuction can be used to target fat under the chin, neck, cheeks, upper arms, breasts, abdomen, buttocks, hips, thighs, knees, calves, and ankle areas.

When performed by our expert plastic surgeons, liposuction can help reshape your contours – body and face. While it is certainly not a shortcut to drastic and instant weight loss, It eliminates those stubborn pockets of fat and restores youthful definition where it matters most: your midsection, thighs, flanks, and arms.


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DermatologySkin

Corns and Calluses

July 2, 2020

Overview

Corns and calluses are fairly common problem in male and female that occurs in soles, toes, palms and fingers. It is a benign condition caused by constant pressure and friction.

Symptoms

Corns are small round hard lesion that is painful on pressure and commonly occurs at the bottom of the sole, over the toes and in between toes. It is very uncommon in hands.

On the other hand, calluses are flakes of hard keratinized skin that forms like an onion layer. It is painless unless infected or inflamed due to injury. They are Irregular and broad in shape unlike corns that are small round and often well defined.

Are Corns and calluses the same thing? Although the causes are the same but they behave differently.

  • Corns: It is also called as clavus. It is thickening of the skin due to pressure and friction resulting in hyperkeratosis and is associated with pain. It appears like a “top” with round elevated surface but has a narrow deep root that reaches deeper than dermis and hence it is painful on pressure. There are three kinds of Corns- Hard corn or heloma durum that is dry; soft corn or helom molle that are macerated and soft and occurs in between toes and periungual corn occurs on the top of toes.
  • Calluses: Are flaky hyperkeratotic layers over the skin also due to excess friction and pressure. They develop over a broader surface and grow outwardly and do not have a root or deep core. It is not painful and can occur in soles, toes, and dorsum of foot, hands and fingers. It is very common among atheletes like weight lifters and tennis players. It is also very common among physical labors and people who do not wear footwear most of the time.

 

When to see a doctor

It is best to see the doctor as soon as you notice the lesions. As with correct advice it can be controlled. And also it is easier to treat in the early stages.

Causes- Both are caused by constant or intermittent pressure and friction, corns are due to localized pressure points whereas callosities are due to more wider pressure areas hence corns are smaller and narrower than calluses. Corns are also known to form within a callus.

Risk factors. Apart from pressure and friction some deformities can also cause corns and calluses eg hammer toe, telipus equinovarus, amputated stumps etc. The risks are higher in people with diabetes and neurological problems.

Prevention. Wearing correct footwear avoiding excessive pressure is key to prevention. But moisturizing foot and hand also helps. If there is tendency for excessive dryness in the foot, apply moisturizer and wear socks.

 

Some FAQs

  1. How effective is salicylic acid for treating corns and calluses?
    – SA is very effective as it works as Keratolytic agent by increasing moisture in the skin and dissolving the keratin layer allowing it to flake off. It can them be gently scrubbed off with puma stone.
  2. Is salicylic acid as a calluses remover painful?
    – It is not painful at all when it is applied on thick kearitnised skin. It may have burning sensation when it is applied to think skin or after the callus is peeled off.
  3. What happens when you cut off a corn or calluses yourself?
    – Corns and calluses should be gently and carefully shaved layer by layer. If not done carefully you can injure your skin and cause bleeding and infection. An experienced doctor can carefully shave off using a magnification to ensure safety.
  4. How should I get rid of corns or calluses permanently?
    – Apply SA once daily , after 304 days start using puma stone or gently scrub off during bathing. It may help to soak feet in warm water before scrubbing. Check with the doctor regularly to get it examined. At the same time get correct footwear and use soft silicone pads at pressure points. If the cause is removed the treatment can have longlasting results.
  5. What is the safest way to cut off corn or calluses?
    – There are two ways to treat Corns, First apply SA solution until it is soft then visit a doctor who will use sterile instrument to gradually shave the corn until it reduces in size then rest of it is surgically excised under local anaesthesia. I personally don’t prefer suturing the wounds after excising the corn as they break and cause more pain and discomfort. I allow it to heal by secondary intention.  Second option is to keep apply SA lotion until it flakes off completely.On the other hand callosities are never surgically excised. They are shaved down to skin level and then the area is protected using silicone cushion.
  6. How to painlessly remove a corn or calluses?
    – By regularly applying SC lotion and scrubbing with puma stone or careful shaving is a painless way to remove.
  7. Is there any side effects of using salicylic acid?
    – SA is very safe to use on the keratotic skin. In normal skin or thin skin it may cause skin burns. So careful application is necessary.
  8. Do treatments for removing corns or calluses cause them to spread?
    – Corns and calluses do not spread like warts which are due to virus. Corns and calluses can only increase by continuso pressure and friction.

Dr. Sanjay Parashar

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Body Lift

Body Lift Surgery – Challenges, techniques and what patients need to look for before going for a Body Lift surgery after Massive Weight Loss

March 21, 2020

Massive weight loss is a common thing these days. People are losing weight dramatically sometimes more than 50% of their body weight. This is scientifically defined as “massive weight loss”.  There are many weight reduction methods such as dieting, lifestyle changes, over the counter pills, paranormal ways such as bulimia and bariatric surgery.

Even after losing a large amount of weight, simply being within normal range is insufficient for most people. They want look as attractive and as normal as possible.

Often after massive weight loss, people end up having loose and saggy skin, lax muscles, oddly shaped protuberances, vestiges of fatty tissue (bags containing fatty acids and triglycerides) remain in form of flabs and unexpected folds, pleats, puckers and creases. [Reference- An outcomes analysis of patients undergoing body contouring surgery after massive weight loss. Shermak MA, Chang D, Magnuson TH, Schweitzer MA Plast Reconstr Surg. 2006 Sep 15; 118(4):1026-31.]

According to Pittsburgh rating scale there are ten anatomical areas that undergo maximum changes after excessive weight loss-

  • Arms
  • Breasts
  • Abdomen
  • Flanks
  • Mons pubis
  • Back
  • Buttocks
  • Inner thighs
  • Hips and lateral thighs
  • Lower thighs and knees

In my opinion there are two other areas that get significantly affected face and neck and hair loss.

The deformities range from

  • Grade 0 meaning appearance is within normal range.
  • Grade 1 is mild deformity that may require some minimal invasive procedure
  • Grade 2 is moderate deformity that often requires correctional surgery and
  • Grade 3 is severe deformity that requires multiple procedures.

What happens when you lose weight quickly?

Weight loss not only causes loss in volume but it has detrimental effect on skin collagen that reduces the elasticity and quality of skin.  What that means is when you stretch the skin normally it recoils back immediately, but when elastin and collagen is reduced the skin does not recoil back and keeps stretching as you keep pulling it.

How to Lose Weight Correctly?

I always recommend my patients to gradually loose weight and ensure that they eat healthy nutrition with supplements to ensure the skin and hair integrity are significantly affected. I also recommend to do muscle building exercises because as you loose fat and volume the skin sags, but if that volume is compensated by muscles to some extent the skin will drape back.

Men have advantage as they can build up muscles and beef up in the chest, arms, back and thighs thus firming up the skin. The only problem area that remains are abdomen, face and neck because you cannot beef up the muscles in these areas.

Women have more challenges; they cannot beef up significantly to prevent masculinization. Yet I do recommend them to build muscles in chest, back, arms and thighs.

What happens after massive weight loss?

Let me explain what happens after excessive weight loss in different regions of the body.

  • Face and Neck: Due to weight gain fat cells increases in face and neck and stretches the skin but as you loose weight the volume reduces and skin starts sagging. The face may appear gaunter and emaciated and neck develops loose skin folds like “turkey neck”.
  • Chest in Men: Men develops a condition called pseudogynaecomastia where the skin sags along with residual fat bags and gives an appearance of man breasts.
  • Breasts: There is extensive thinning of breasts and sagging and they develop loose folds in bra roll areas.
  • Abdomen: Both in men and women form folds and rolls of skin in the tummy region sometimes one or two and in many cases three rolls. The skin is not only saggy in vertical direction but they have excess skin in horizontal direction. Often the underlying muscle is also stretched out and weak.
  • Mons Pubis: There is significant changes in mons region with hanging skin, droopy genitals, buried penis etc.
  • Back and Buttocks: Multiple rolls develop in the back region and the buttock sags with wrinkling and distortion of the shape. Hip fat and skin forms rolls and folds laterally.
  • Thighs and knees: excess skin develops in thighs in both directions circumferentially and vertically causing sagging, skin folds, cellulites and abnormal protuberances. The kneecap disappears due to skin folds over the knees.
  • Arms: likewise develops flabs like “bat wings” and skin folds develop above the elbows.

Body Contouring Surgery and Body Lift Surgery

Body contouring surgery involves removal of loose skin and residual fat bags along with suspension of skin.

The wide breadth and variety of deformities means surgical options are also endless. If one has to address each and every problem than one may have to go through the following list of surgeries.

  1. Face and Neck lift with or without fat grafting
  2. Breast lift with or without implants
  3. Tummy tuck- only conventional or T shaped abdominoplasty also called as “Fleur De Lyse”
  4. Brachioplasty- vertical and or horizontal
  5. Lateral chest lift or axillary lift
  6. Back lift
  7. Buttock lift
  8. Thigh lift- vertical and or horizontal
  9. Knee lift
  10. Male breast lift

This is an exhausting list of surgeries to correct all most of the problems. But surgeries come with a cost not only financial burden but trauma, pain, scars, risks and side effects.

Over past 25 years I have integrated some refinements and combinations of procedures that is safer and has better long-term results.

I thoroughly counsel the patients followed by complete tests and examinations to ensure their fitness for surgeries. I help make a plan for the patients with various permutations and combinations of the surgeries.

My recommendations begin with following advice:

  1. Work hard to replace some volume by building muscles.
  2. Ensure you have stabilized your weight and health with good nutrition and regular exercises.
  3. It is not possible to chase all the loose skin
  4. Goal is to minimize number of scars and number of surgeries
  5. There is a limitation on number of surgeries that can be performed in one person.
  6. Time is essence to minimize risks and complications, so my goal is to limit surgeries to 4-5 hours. Less time of anesthesia means better recovery and minimal complications.
  7. Although the skin appears very tight immediately after the surgery but depending upon your collagen it will loosen up in 5-6 months time. There is a thin line between over tightening of skin and wound breakdown or scar stretching and migration.

Preoperative assessment before a Body Lift Surgery

I prefer to do a complete medical checkup with blood tests to minimize risks and complications. The key tests include bleeding and coagulation profile, protein and haemoglobin level and kidney and liver function tests. An ECG and X ray chest may be necessary in patients above 40 years of age, chronic smokers and other comorbid conditions.

A well controlled diabetes mellitus and or hypertension is not a contraindication for surgeries.

Planning of Body lift Surgery

The commonest procedure people need after massive weight loss is Abdominoplasty or tummy tuck and breast/chest lift in male or female.

Abdominoplasty can be an extended abdominoplasty with incision from one hip bone to the other or a circumferential body lift with incision going around to the back also called a Belt Lipectomy. This procedure allows some extent of buttock lift as well.

Very few people may need a combination of vertical and horizontal tummy tuck called as “Fleur De Lyse” abdominoplasty however the vertical scar is not a very pleasing scar and I recommend only for people who has very unsightly abdomen with huge excess skin, than scar is not a big deal.

If I am doing a buttock lift, I recommend “autoaugmentation gluteal lift” which means I will use the fatty tissue around the buttock area to augment and give volume to the buttocks. [Ref- Hunstad JP, Repta R. Purse-string gluteoplasty. Plast Reconstr Surg. 2009;123:123e–125e.]

Augmentation Mastopexy is a procedure that combines use of breast implant along with lift and skin tightening of the breasts. Very few patients may get away with just a breast lift if they have good volume or they choose not to have any implants. The preferred breast lift technique is anchor shaped to give a good long-lasting lift.

Arm sagging is the next common area of concern mostly in female patients. Brachioplasty is a arm lift procedure and it can be done as a vertical only or “T” or “L” shaped brachioplasty.  I prefer to keep the scar at the seam of the arm so it is less visible from front and back and can be seen if patient lifts her arms.

I use “J Plasma” from Bovie Company to further tighten the skin internally. It is a new technology that is now used in combination with Vaser during liposuction to improve the collagen in the skin.

Thigh lift is necessary in patients with excessive sagging thighs. The ideal technique is “T” thigh lift that addresses removal of excess circumferential skin and also lifts the thigh upper in the groin crease areas.  In some patients doing limited thigh lift in combination with Liposuction and J plasma skin tightening can minimize the scars.

Face and Neck Lift is rarely necessary in patients as there are many nonsurgical and minimal invasive options to firm up the skin in face and neck.  Ultherapy lift, Thread lift, filler injections and fat grafting are some procedures that helps improvement of face and neck skin.

Procedural Combination

The combination of procedure depends upon the priority given by patients, the severity of the problem, medical fitness, duration of surgery and recovery period available for the patients.

My recommended combinations are-

  • Lipoabdominoplasty with lateral thigh lift
  • Circumferential abdominoplasty with buttock lift
  • Lipoabdominoplasty with breast lift/ augmentation mastopexy
  • Lipoabdominoplasty with brachioplasty
  • Brachioplasty and back lift/ bra roll lift
  • Thigh lift and breast lift

How to prepare for Body Lift surgery?

  • A thorough understanding of the procedure and its limitations are important. Ensure you get all the information.
  • Stop Smoking at least 2 weeks prior to the surgery day
  • Get all the necessary tests recommended by your surgeon
  • Eat healthy to ensure your protein and haemoglobin levels are good.
  • It may be required to have iron injections or even blood transfusion before or after the surgery, a good haemoglobin level is key to good healing and recovery.
  • Ensure you have all the pressure garments and medications necessary after the surgery.

What is the postoperative care after body lift surgery?

  • You will require 5-7 days of good rest at home; some procedures may require you to stay for 2-4 weeks.
  • It is recommended that you move around at home and do regular breathing exercises to prevent risks of deep vein thrombosis and chest infection.
  • Stop smoking preferably forever, but at least 2-4 weeks during the recovery period.
  • Keep taking your prescribed medications
  • Keep in touch with your surgeon and ensure you attend all follow up schedules
  • I personally prefer to keep the wounds dry and cover only with soft pads such as sanitary pads that absorb moisture and keep wound clean. I recommend not applying strong antiseptics/ alcohol or sealing the wounds, as it may be the cause of skin inflammation and infection.
  • Eat healthy

What are the risks and how to avoid them?

  • Any surgery may have risks of bleeding, hematoma, infection or wound breakdown. The surgeon would recommend you to stop all blood thinners such as aspirin, vitamin supplements etc. ensure you do not have any preexisting infection like boils, skin ulceration or cold and flu. During the surgery we take special precautions to avoid the above risks by giving Perioperative IV antibiotics, using tumescent fluid to prevent excessive bleeding and secure the wounds with multiple level of repair.
  • Risk of Deep vein thrombosis can happen if the surgery is prolonged and if there are comorbid conditions such as varicose veins, obesity, chronic smoking etc. I strongly follow DVT prevention protocol that includes stockings stating previous night of surgery, sequential pneumatic compression during the surgery and postoperatively while in hospital, injectable Klexane that helps thin the blood without increasing risks of bleeding.
  • Scar migration or stretching may happen due to inherent tissue weakness and collagen deficiency. We try and secure the wound along with anchoring to prevent this complication. Over-excision or overambitious tightening may also cause poor scar formation.
  • Residual skin laxity and bulges with asymmetries may happen and is often due to primary asymmetry in body, poor skin quality and lack of perfect judgment due to position of patient during surgery.
  • Changes in the result with time may happen due to continuing gravity effect, weight fluctuation, collagen breakdown. The tissues that appear very tight in the beginning always loosen up with time, the surgeon uses strong sutures to anchor the tissue but the body needs to eventually hold and heal in that position by producing enough and strong collagen.
  • Breast surgery carries the highest risk of dissatisfaction and loss of result with time. The surgeon will do his/ her best to choose the correct size implant with adequate breast lift. But it’s a marriage of inconvenience between two opposing forces of breast skin tightening and implant volume that may have unpredictable long-term outcome. Hence a revision surgery may be necessary in 6-9 months period. [ref- Paolo Montemurro,Mubashir Cheema, Per Hedén, Benchmarking the Outcomes of Single-Stage Augmentation Mastopexy against Primary Breast Augmentation: A Single Surgeon’s Experience of 905 Consecutive Cases Plastic and Reconstructive Surgery • August 2019 ]

Classification of Contour Deformities after Bariatric Weight Loss: The PittsburghRating Scale Angela Y. Song, M.D., Raymond D. Jean, M.D., Dennis J. Hurwitz, M.D., Madelyn H. Fernstrom, Ph.D.,John A. Scott, M.S., and J. Peter Rubin, M.D. Pittsburgh, Pa.

 

About Me.

I am Dr. Sanjay Parashar and have spent several years working with and learning from some of the best plastic surgeons in the world. I have been practicing for almost 3 decades and have performed over 12,000+ surgeries. My primary practice is based out of Dubai, UAE, but I travel to Delhi, mumbi and Ludhiana frequently to attend to VIP and celebrity cases in India. My specialties include:

  • Breast Surgeries
  • Breast Augmentation using Implants or/and Fat Grafting
  • Breast Lift
  • Body Lift
  • Breast Reduction
  • Facial Aesthetic Surgery
  • Rhinoplasty
  • Facelift
  • Occuloplastic Surgery (Eye surgery)
  • Reconstructive Surgery
  • Robotic Hair Transplant
  • Body Contouring –Liposuction and Liposculpting
  • Six Pack Surgery using Vaser Technology
  • Chest and Biceps Augmentation
  • Abdominoplasty (Tummy tuck)
  • Mommy Makeover
  • Facial Contouring
  • Fillers and Anti-ageing treatments
  • Brazilian Butt Lift
  • Gynecomastia (male breast reduction)

Dr. Sanjay Parashar

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General Dentistry

Hollywood Smile, what it is, what to expect and how to differentiate?

February 24, 2020

A ‘Hollywood’ Smile Makeover is a cosmetic procedure that aims at achieving a beautiful, perfectly shaped, righty colored and sized teeth for an individual.  The procedure is performed using thing Veneers which are placed on top the individual’s existing teeth.

Almost 100 years ago, in 1928 Dr. Charles Pincus invented veneers to change the appearance of an actor’s teeth temporarily. Which later on became the preferred procedure for celebrities to correct their smiles and always be ahead in the game. Hence the name Hollywood smile makeover.

Today, the Hollywood smile makeover is a very common procedure, especially in Dubai. You will hardly find a known personality or an individual with the means, who cares about his or her appearance and was not born with a perfect smile, who has not had a smile makeover.

Let’s talk about What are veneers?

Veneers are thin, yet very strong layers material which are placed over a tooth. Veneers not only improve the aesthetics of the smile; but also protect the tooth’s surface from damage.

There are two main type of materials used to make a veneer – porcelain and composite. Porcelain is stronger than composite, as it is made in labs. Composite is also strong, but not as strong as porcelain, though offers the advantage – that they can handcrafted directly in the mouth of the individual. Which gives more control to the dental doctor and individual on how the outcome is. The shape, color, size can be enhanced to achieve perfection immediately on-site. Whereas in porcelain veneer, the teeth impressions are taken and send to a lap to fabricate the veneers and it’s very difficult to make changes once the veneers are fabricated. Though we make temporary veneers first in case we are doing porcelain veneers, to ensure the new smile suite the individual and is happy with it. And we can make the changes needed, before the final veneers are fabricated in the lab. This does add more time to deliver the new smile and can take 3-4 weeks to finish the full makeover. Whereas in composite based makeover, I can do it in a single sitting.

What to expect when going for veneers or smile makeover?

First things first. The Dentist will evaluate the individual’s oral heath first to see are you a right candidate for the procedure. At my practice here at Cocoona Centre for Aesthetic Transformation Dubai, I see about 5-6 news patients every week looking for a smile makeover. Not everyone is an ideal candidate to start immediately. Some needs simple correction before we are able to proceed, some need lengthy orthodontist treatments like braces before we proceed with the smile makeover. Examination and correcting the necessary is the most important not only to achieve a perfect smile, but also to ensure the life of the veneers.

During this stage we take X-rays and impressions of the teeth as well, to analyze everything thoroughly.

Once both me and patient are satisfied with the outcome of the examination it will be time to choose the new smile.  I then counsel the patient on the kind of smile that will look nice on him or her. First, we decide the shape and number of the teeth, I show them pictures, actual samples of veneers and advice on what can be achieved. During this stage is when we decide on the number of veneers needed.  Some patients with minor imprecations only need one or two, some need only the top 5 ,but most of the patient need 10 top and 10 bottom teeth which are visible in smile.. The number entirely depends on how many teeth are visible when the individual smiles.

An import thing I insist on while advising my patients on the shape is: Perfection is not in having perfectly even teeth. It having a smile that make the other person admire it beyond his or her control. I like natural shapes and contours as oppose to the common box shaped teeth, that run through an individual’s mouth. Such smile may stand out from a mile, but will tell everyone that you have had a smile makeover. The beauty and art of a smile makeover is in delivering a smile that people lovely madly and cannot tell if was from birth or made in a clinic.

Now we move on to the next step, which is deciding the color. This is easy, most people want white, but the right shade of white that complement the complexion of the individual is also very important. So we ensure we have the right shade. I always want the veneers to look as natural as real teeth , so for that I always prefer the veneers with translucency and this can be done with porcelain veneers.

Now we finalize the material: porcelain or composite. I take the patient through the advantages and disadvantages of both kinds, the steps and time involved for treatments and the associated costs. I also recommend what will work best for the individual based on her/his oral health, kind of corrections needed and results wanted. More information can be found at here

How to differentiate, with a smile makeover.

The answer to this is simple, keep it as natural as possible. We don’t want our patients to look like billboard for a smile makeover, we want you and your teeth to look healthy, beautiful and perfect.

After care process for Veneers:

It’s very important to take care of one’s oral hygiene. I recommend all my patients:

  1. to maintain good oral hygiene by brushing at least twice a day and preferably after every meal.
  2. Floss at least once a day.

These two steps are critical to minimize the risk of gingival (Gum) diseases and teeth decay.

  1. Regular dental examination with Dentist. It is recommended to do checkups each six months for scaling or cleaning and polishing of your veneers. This as well will let your dentist to detect any sign of dental cavities or issues.
  2. I also advise on using a night guard, if the individual has teeth grinding habit. A night guard will protect your Veneers and give you a sounder sleep.

 

About me.

I am Dr. Homeira Ahmadi , graduated from Ajman University and have five years’ experience in UAE. At my dental practice here at Cocoona in Dubai I do the following treatments and procedures.

  1. Veneers
  2. Root canal therapy
  3. Crown and Bridges
  4. Scaling and polishing
  5. Teeth whitening
  6. Pediatric (children) dental treatments
  7. Extraction
  8. Preventive Dental treatments

You can read more about me at here

 

Dr. Sanjay Parashar

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Liposuction

High definition body sculpting – Where art meets surgical science

February 17, 2020

Since the existence of mankind, human body has been seen as a work of art. Throughout the history, human form has been elaborately expressed by artists and sculptors. It all began in 5th century BC by the Greek sculptor Polykleitos with his bronze sculpture Doryphorus. It showed the perfectly harmonious and balanced proportions of human body.

This was followed by artistic versions of human body by various artists and sculptors. The merging of art and anatomy is perhaps most evident and glorious in the works of Leonardo da Vinci.


(De Humani Corporis Fabrica by Vesalius)

Michelangelo’s David represents one of the most recognized sculptures and showcases the human body in all its strength, athleticism, and youthful beauty.


(Michalengalo’s David)

It is very interesting how the ideas of art based on perception of genius artists in the past can be used with a deep knowledge of human anatomy to carve a beautiful structure in a human body through liposuction (hence the term ‘Liposculpture’)


(Some of my sketches on artistic presentation of an aesthetic muscular male and female body)

Using the artistic perception from the historic times, plastic surgeons have been inspired to recreate a similar form in their surgeries. This takes liposuction or fat removal to the next level and gave rise to the concept of lipo-sculpture or 3D/4D liposuction.

APPLICATION OF ART IN SCIENCE GAVE US HIGH DEFINITION LIPOSUCTION

Liposuction isn’t a new technique and it has been done since 1980s.

The market has seen changes from traditional liposuction (manual liposuction) to the use of energy based devices like Laser, Vaser, Radiofrequency assisted and J Plasma (Plasma with Radiofrequency).

Also there have been different methods of performing liposuction like Manual Liposuction, Power-assisted liposuction, Vibration assisted Liposuction, Nutational Infrasonic Liposuction, etc.

“Using the knowledge of anatomy and infusing it in science with an artistic perspective is High definition liposuction.”

High definition Liposuction is a form of liposuction which not only removes fat excess but in addition removes fat between muscle groups accentuating the margins and the lines of light and shadows between the muscles creating a more athletic appearance.

 Ref. : (VASER-Assisted High-Definition Liposculpture : Alfredo E. Hoyos, MD, John A. Millard, MD. Aesthetic Surgery Journal, Volume 27, Issue 6, November 2007, Pages 594–604)

TWO TYPICAL RESULTS OF HIGH DEFNITION LIPOSUCTION

The above patient is a 40-year-old male who had stubborn resistant fat in the tummy and love handles which despite regular exercises and good diet refused to shed off.

He promised to be committed to exercise and diet. I removed 3 liters of fat from the abdomen and defined his muscles (body sculpting). Following the surgery, he started working out while recovering and here he is after 3 months.

The Six-pac abs are very prominent, and most importantly they are natural. it’s the patients own muscle, and not FAT bases packs that looks extremely fake and poor.

The above patient is a 25 year old female who had stubborn resistant fat in the tummy and love handles despite regular workout and good diet.

I removed 3.5 liters of fat from the abdomen and defined her muscles (body sculpting). Following the surgery, she works out 3-4 times a week, focusing mainly on her abdomen and lower body.

 

FAQs on Liposuction

At my practice here at Cocoona Dubai, I frequently come across patients pre-occupied by misleading information. Our duty as plastic surgeons lies in not just performing the surgery, but also to educate people about the procedure and its intricacies. I have listed some of the most common questions we as plastic surgeons encounter during our consult regarding high definition liposuction.

Who is the right candidate for high definition liposuction?

Any individual (male/female) who meets the following criteria is a good candidate:

  • Low visceral fat
  • Good skin elasticity
  • Minimal to no excess skin
  • Motivated patient committed to working on lifestyle change in terms of diet and exercise

Do I need to be muscular to get better results out from a High Definition Liposuction surgery?

I classify my patients into three categories :

  1. Poorly muscular: These patients need to work-out on their abdominal muscles to get the best shape after the surgery. Also need to make sure they don’t gain fat in the same area by focusing on their diet and cardio (HIIT). They typically see their 6-pack result after a longer duration. Could take 5-6 months or even more.
  2. Slightly muscular: Need to work-out on a regular basis and keep their diet in check. However, they tend to see the results faster and its less difficult for them to maintain their results.
  3. Very Muscular : These patients usually are athletes or bodybuilders, who are usually extremely cautious about their diet and exercise. They see the results the fastest and maintain them very well for a very long period. Needless to say, these patients have the best results and are a treat for any plastic surgeon.

How do I do Liposuction or What technique do I use?

I infiltrate tumescent fluid in the fatty layer to numb the area. This helps in post-operative pain control. The fluid also helps in vasoconstriction which reduces the amount of blood loss during the procedure.

I use vaser to help me in emulsification of fat and skin retraction which in the end translates to a well sculpted slimmer look of the body.

Ref. Click here

This can also be done using laser, J plasma or other energy-based devices. No single device has been shown to be more superior than the other for this purpose.

However, worldwide Vaser is the commonest tool used for high definition liposuction.

Once liposuction is done and the patient is slimmed down in an aesthetic way, etching is done using special cannulas.

The end result is a combination of various factors like surgeon’s skills, technology that’s used, post-operative protocol and a healthy lifestyle on the part of patient.

Is the liposuction technique different for males and females?

Muscle definition (or Etching) is commonly done in the midline above the belly button (Linea alba) and by the sides of the two rectus muscles (Linea semilunaris) in females.

Most females don’t prefer the six-pack look. They like a softer look.

Males usually prefer the six-pack look. I have had few female clients in my practice requesting the same. Hence etching in them besides Linea alba and Linea semilunaris is also done in the transverse lines to create the packs. (Transverse inscriptions)

How do I make the results of the liposuction long lasting (or sustainable)?

I do not prefer leaving fat over the muscles to create Abs as this fat has the potential to grow in later life leading to an abnormal bulge.

Remember ‘Abs are muscles not fat’.

Leaving fat or injecting fat under the muscle to make it look like abs only creates “Fat packs” or “Fake packs”.

Also, the patient is strictly advised to adopt a heathy lifestyle with clean diet and regular exercise to make the rectus muscle grow bigger (Ab muscle hypertrophy).

What is the post-operative care after getting liposuction?

Patient is advised to go for manual lymphatic drainage massages from day 2 or 3, after the surgery to help swelling go off faster and also to aid in skin retraction.

Pressure garment is given on the second day after surgery while Foam dressing is given to be placed along with the garment from day 3 or 4, which helps in avoiding swelling in the etched areas and preserves the etching that was created during the surgery. This is typically given for about 2-3 weeks.

Pressure garment is advised for 1.5-2 months following the surgery. This duration could be shorter or longer depending on how the patient is healing.

Follow ups are recommended at 1 week, 2 weeks, 1 month, 2 months, 3 months, 6 months and 1 year after the surgery.

I am strict with my follow ups to ensure high patient satisfaction and long-lasting good results.

When do my patients see results after liposuction?

Typically, patients see good results between 2-3 months.

Different patients swell and heal differently, but most of them see a good result by 3 months and that keeps improving till about 5-6 months.

Results also depend on patient compliance in terms of diet and exercise.

When can a patient start exercising after the liposuction surgery?

My patients start light exercises from 2nd week after the liposuction surgery and progressively increase the intensity every week.

Patients usually begin their routine exercises (workout, dance, Zumba, Pilates, etc.) in a month’s time.

What exercises do I recommend after the liposuction surgery?

I usually customize an exercise plan for each client considering their goals, the area that I have worked on (abs, glutes, shoulders, chest, back, etc.) and looking at how much time and effort they are ready to put in.

I have been trained by some finest bodybuilders in the world and my experience in bodybuilding helps me shape up my clients post operatively.

Sample exercise plan

At 1 week – Long distance walking, walking on a treadmill

At 2 weeks – Running on a treadmill, Mild intensity exercises on uninvolved areas (like exercise for arms and legs when only tummy liposuction is done)

At 3 weeks – Moderate intensity exercises on uninvolved areas, Passive exercises for operated areas (like Planks for abdomen, stretch and hold for arms, buttocks)

At 4 weeks – Moderate to severe intensity exercises for all parts

More about Myself

I am a Board-certified plastic surgeon with a 7 years’ experience in plastic surgery. I perform both aesthetic surgical and non-surgical procedures.

I like to scribble, sketch, sculpt, inject, cut and stitch.

My hands are my biggest asset and I try my best to create something beautiful with them, at or out of work.

KEY INTERESTS

Surgical Procedures

Body Contouring

  • Vaser / Laser Liposuction
  • Slim Down Liposuction
  • 3D / 4D liposuction (6 packs liposuction)
  • Tummy tuck
  • Brazilian Butt Lift
  • Arm Lift / Thigh Lift

Facial Surgeries

  • Blepharoplasty
  • Buccal fat pad removal (Bichectomy)
  • Face Liposuction
  • Face fat grafting

Breast Surgeries

  • Breast Augmentation (Implants/Fat transfer)
  • Breast Lift / Breast Reduction

Genital Surgeries

  • Labiaplasty
  • Labia Majora Fat grafting
  • Vaginoplasty

Non Surgical Procedures

  • Botox
  • Fillers (face/hands/buttocks)
  • Platelet Rich Plasma (PRP)
  • Microneedling
  • Fractional CO2 Laser
  • Mesotherapy

 

 

Dr. Sanjay Parashar

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