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Hyperhidrosis

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What is hyperhidrosis?

Hyperhidrosis is the technical term for excessive sweating. It can start during adolescence and continue until adulthood, if not treated. Primary hyperhidrosis can occur without any triggers. The cause of primary hyperhidrosis is believed to be overactive sweat glands. It is usually genetic and can start as early as childhood in some cases. It tends to occur mainly in the hands, underarms, feet and face.

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Excessive sweating can also be a symptom, or result of another medical condition such as brain or nerve disorders such as stroke, nerve or spinal cord injury, head trauma, or Parkinson’s disease. It can also be caused by anxiety, heart disease, cancer, overactive thyroid, menopause or obesity. It can also be a side effect from medications.

What are the symptoms of Hyperhidrosis?

If you are not sure whether or not you are suffering from hyperhidrosis, you  might want to consider the following symptoms:

  • frequently changing clothes due to excessive sweat stains
  • avoiding handshakes due to excessively sweaty palms
  • avoiding social contact due to extreme sweating
  • skin problems such as acne or rash due to excessive sweat

How is it treated?

If you think you might be suffering from Hyperhidrosis you will want to consult your physician. Your doctor will be able to perform a test to determine if you do in fact suffer from this condition. He may perform a sweat test in which an iodine solution is applied to the affected area. The solution will turn dark blue wherever there is an excessive amount of sweat. The other test is a paper test in which a special type of paper is placed on the suspected area and then weighed. If the paper is heavy, this means that it has absorbed a high amount of sweat.

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There are ways you can self-treat Hyperhidrosis. You can avoid triggers such as spicy foods, alcohol, caffeine and heat. There are over-the-counter antiperspirants you could use, however sometimes these cause severe allergic reactions. It is best to discuss treatment with your physician.

Your doctor may prescribe medications, however, these may have side severe effects and may not work for everyone. There is also a procedure called Iontophoresis, which utilizes electricity to temporarily suspend function of the sweat glands. This is recommended for hyperhidrosis of the hands and feet. Your hands and/or feet are placed into water and a mild electric current is  passed through it and increases until you feel a slight tingling sensation. The procedure usually takes about twenty minutes and you will first need it two to three times a week, then once a month as symptoms decrease. Side effects are blisters and dry skin, but are rare.

You can also try Botox, which works best with severe underarm sweating or even underarm surgery, which is performed under local anesthesia and removes the sweat glands from the armpits. Another method for severe cases of hyperhidrosis is called Endoscopic thoracic sympathectomy (ETS) in which the nerves are cut, which “turns off” the trigger that produces the excessive sweat. This is neither effective or recommended for underarm hyperhidrosis.

You need to discuss your symptoms and forms of treatment with your physician before considering any of the above options. It is crucial to have a proper medical diagnosis before pursuing treatment for hyperhidrosis.

 


Excessive Hand Sweating

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What is palmar hyperhidrosis?

Palmar hyperhidrosis is excessive sweating of the hands or palms. It can cause embarrassment as those who suffer have to deal with sweaty handshakes and ruined schoolwork from oily, sweaty palms. It can cause humiliation and isolation and is the most common form of hyperhidrosis or excessive sweating. If you are among those who suffer from this, you can breathe a little easier, there are treatments available. You should discuss these treatments in detail with a trained and accredited medical professional.

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Treatment Options

Antiperspirant

The most common treatment for palmar hyperhidrosis is antiperspirant, which common to popular opinion, are not just designed for use on underarms only. Antiperspirants range from regular to clinical strength and are available over the counter. If the regular strength does not help, try clinical strength. If this is still not effective, you can ask your doctor for a prescription strength antiperspirant. It is recommended that you apply them at night to completely dry skin and never wrap your hands as this will only irritate the skin further. If you have severe allergic reactions to the stronger antiperspirants as a lot of people do, you will want to look into other forms of treatment for palmar hyperhidrosis.

Iontophoresis

Another method of treatment for excessive hand sweating is Iontophoresis. This is a procedure in which the patient’s hands are immersed in a pan of mineral water in which a very mild electric current will then pass through the water. This is believed to microscopically thicken the outermost layer of skin, which then blocks the sweat from flowing to the surface of the skin. Treatments are usually given a few times a week at first, then once or twice a month and then eventually they will stop if the sweating no is no longer a problem. However, if additional treatment is needed you can either purchase or rent an iontophoresis machine with a doctor’s prescription and do the treatments at home as needed.

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Botox injections

The next level of treatment for palmar hyperhidrosis is Botox injections. In order to eliminate the pain that is normally associated with Botox injections, some medical professionals will use a icing or vibration technique. Botox injections have little to no side effects and can last from six months to a year. They will need to be repeated when the symptoms return.

ETS Surgery

For the most severe cases of palmar hyperhidrosis, your doctor may recommend endoscopic thoracic sympathectomy surgery, or ETS, in which tiny incisions are made in the palms to cut the nerves that activate the sweat glands. It is a highly effective procedure when used for hyperhidrosis of the hands, face and feet, but there are some side effects such as  scarring and compensatory sweating. Compensatory sweating is when your body adapts by sweating in another area other than the one treated. Suppose you had surgery for your palms, you might start to sweat more from your face or back. Another deterrent of ETS is that is not reversible and can be quite costly.

 


Tummy Tuck

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What is a tummy tuck?

Tummy tucks surgery, or abdominoplasty, is a surgical procedure which removes excess fat and skin from the belly area. It also can repair or restore weakened or damaged muscles resulting in a flatter firmer stomach.

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The most common reasons for an abdominoplasty include: aging, previous surgeries, significant fluctuations with weight and genetic issues. You should not get a tummy tuck as an alternative to weight loss or exercise. Tummy tucks will not reduce or reverse the appearance of stretch marks.

Ideal candidates for abdominoplasty:

  • must be in good health
  • have excess weight in the midsection
  • loose or drooping skin in the abdominal region
  • have a realistic expectation of the outcome of the procedure
  • are willing to make a serious commitment to a health diet and regular exercise routine
  • already be close to your ideal body weight

 

You should not consider a tummy tuck if you are a smoker, plan to have children, are getting the procedure simply out of pressure from someone else or have a medical condition that may be compromised by this type of surgery.

Meeting with your plastic surgeon

If you are considering a tummy tuck you need to meet with a plastic surgeon to discuss how to prepare for the procedure, what to expect, which type of surgery you will need, and how to recover from the surgery.

There are several types of tummy tuck surgeries, but the most common are a complete abdominoplasty in which the surgeon will make an incision across your abdomen from hipbone to hipbone and then contour the muscle, tissue and skin. A partial, or mini, abdominoplasty, usually performed on those with fatty deposits located below their navel, is less invasive and will not be as time consuming.

Your doctor will advise you to eat a well-balanced, healthy diet before your procedure as this might aid the healing process. You need to disclose any medical history or issues to your doctor as well as any drugs you are taking, prescription, over the counter or recreational, as you may need to stop taking some of these before surgery as well as during your recovery.

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Possible complications

You will experience pain and swelling after the surgery. Your doctor will help with pain management, including any prescription pain meds. The soreness could continue for months after the procedure and you may experience fatigue, bruising and numbness as you are recovering. There will be scarring, which will fade over time, but never disappear completely.
The following complications are rare, but as with any surgery, there are risks such as infection, blood clots and bleeding. You are at a higher risk for these if you suffer from diabetes, circulatory problems or liver, lung or heart disease.

Recovery time will be at least six to eight weeks and you will need to limit strenuous activity. You might need to take off from work during this time to allow for proper recovery. It will take some time to recover, but you will be pleased with the results once you are fully healed.

 


Tummy Tuck Without Surgery

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For those who may be hesitant to go under the knife for a tummy tuck there are other options available. They might not be as effective as abdominoplasty (tummy tuck surgery), but many are opting for these less invasive options as they leave less scarring as well as forgo the other risks of a surgical procedure.

Before considering any of these procedures, you should discuss the risks, benefits and any health concerns with your physician.

CoolSculpting

CoolSculpting  is a non surgical method that uses patented cooling technology to safely get rid of fat cells and is approved by the FDA. The procedure takes an hour per area and often multiple areas can be done at one appointment.
As the fat takes several weeks to shrink, you will need see immediate results. Also this is not a weight loss procedure, but rather a “sculpting” technique used to shrink stubborn areas. Ideal candidates for CoolSculpting are those who are already within 20-30 lbs of their goal weight.

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There is little risk involved as this procedure has been performed quite often, especially as an alternative to a tummy tuck surgery. You may experience some temporary side effects such as mild bruising, soreness or numbness. Rare side effects include severe bruising and pain. Most patients who received this procedure said they experienced little to no pain and required no recovery time.

Laser Tummy Tightening

There are several types of laser tummy tightening and the main difference is the type of laser used in the procedure. Ablative lasers are used mainly to resurface the skin by removing a portion of the skin. The most popular type are the non-ablative lasers which pass light straight into the deep fat tissue thru the skin. Another alternative is called Titan, which is a laser treatment that uses heating and cooling to stimulate collagen production in the dermis (middle layer of the skin) This procedure will not require anesthesia and results generally last for about two  years.

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ReFit

Refit treats the skin around the abdomen by enhancing the skin’s elasticity and firmness by restoring collagen flexibility.  This procedure provides instant results as it contracts tissue fibers, thus strengthening the collagen fibers for longer results. It is also a good alternative for those looking to get rid of stretch marks.

Lipodissolve

Lipodissolve is a common procedure most often used by women to lose weight after pregnancy. It involves injecting mild enzymes along with other medications to the abdomen to melt the unwanted fat.

Thermage

This procedure is designed for those who do not have an excessive amount of loose skin. It uses radiofrequency energy to firm the collagen in the skin of the abdomen and stimulates collagen production. Patients may require several sessions to achieve the desired results.

Ultrasound Cavitation

This non-invasive procedure melts the fat without affecting the fat cells through the use of ultrasound energy by eliminating the fatty deposits from the lymphatic system.

VelaSmooth

VelaSmooth is a quick and painless procedure which incorporates the use of massage rollers, radio frequency, suctioning and infra red energy to break down the fat cells.

 

 


Tummy Tuck Surgery

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What are the reasons for a tummy tuck?

A tummy tuck, or abdominoplasty, is performed on those who have excess skin or fat in their abdomen which does not seem to go away despite a healthy diet and exercise. Women might consider a tummy tuck after birth. People might opt for a tummy tuck procedure after extreme weight loss once they have reached their ideal weight.

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Tummy tuck surgery can also help reduce the appearance of scars from previous surgeries, boost self esteem and increase cosmetic appeal. There are also medical reasons for a tummy tuck. Abdominoplasty can also help reduce urinary incontinence and improve abdominal tone which helps improve posture as well as correcting hernias.

Types of tummy tuck surgery

Your plastic surgeon will discuss your specific needs and desires and then will determine which type of surgery you will need. All of the procedures do require some recovery time, so plan to take some time off from work and follow your doctor’s orders pre and post surgery to guarantee a successful surgery and recovery. You will have to severely limit physical activity and the recovery process may take several months.

You will be sore for several months following the surgery. Your doctor will prescribe the proper pain medications. You may also experience numbness, bruising and extreme fatigue. Average recovery time is usually between six and eight weeks.

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Complete abdominoplasty

This type of surgery is performed on those who need the most work. Your surgeon will make an incision in your lower abdomen which runs from hipbone to hopone. They will then contour and manipulate the skin and muscle until they have the desired result. The doctor will have to make an incision in your belly button to free it from the tissue surrounding it during the procedure. You may have to have drainage tubes under your skin for a few days after your surgery.

Partial or mini abdominoplasty

This procedure is usually performed on those whose fat deposits are located below the belly button. You will most not likely need an incision in your navel during a partial or mini abdominoplasty. The surgery could be performed via an endoscope. or small camera, and may take up to two hours. Again, you  may need drainage tubes under your skin for a few days after the operation.

Circumferential abdominoplasty

This procedure is more those who have an excess of fat in the back as well as the abdomen and removes the fat and skin from both the hoop and back region. This will improve the overall contour of  your body.

Risks of Tummy Tuck Surgery

As with any surgery, there are risks involved. Some of the risks of tummy tuck surgery include scarring, bleeding, infection, skin loss, blood clots, numbness, changes in skin color, swelling, and accumulation of fluid. These risks are higher in those who have a history of heart disease, liver disease, lung disease, poor circulation, diabetes or are a smoker.

 

 


Tummy Tuck Price

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Tummy Tucks are becoming more popular as there are now many different types of procedures available. Thus. the cost may vary greatly, depending on type of surgery. Plastic surgery in general is not covered by the majority of health insurance programs, but these days, quite a large amount of plastic surgeons offer payment plans. It is critical that you carefully consider the cost of a tummy tuck should be you considering the surgery.

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There are instances in which medical insurance could cover, or help with the cost of a tummy tuck. These usually involve situations in which a physician recommends an abdominoplasty following extreme weight loss after bariatric surgery. And in those rare occasions where it would be required for a health issues, such as a hernia.

The average price of a tummy tuck ranges from $3, 000 to $12,000 with the average rate being somewhere in the $8,000 range. This normally entails a facility fee of $700 to $1000, anesthesia fees ranging from $500 to $800 and the surgeon’s fee, which is an average of $5,232. These numbers go up if an overnight stay is required. Rates tend to be slightly higher in the northeastern region of the US and lower in the southern central region.

Since Abdominoplasty can consist of a combination of different procedures there is no way to quote an exact price as they also vary by specialist, region and the procedure itself. Most procedures involve tightening of the muscles, removal of excess skin and some form of liposuction. You also have to factor in pain and other medications, anesthesia, hospital stay if required and other costs. You will also need to take into account that you may be losing time from work due to extended recovery time. Unless you have vacation or personal time, you could also be losing money as well.

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List of costs for tummy tuck surgery

  • initial consultation
  • hospital or surgical facility costs
  • pretesting and procedures prior to surgery
  • pain medications and other prescriptions
  • plastic surgeon’s fee
  • post-surgery costs such as clothing, gauze, creams, etc

 

Research before making a final decision

You should definitely do extensive research before you consider tummy tuck surgery. Discuss all  options with your physician and if possible, get more than one opinion. It is important to make certain that you are in fact a good candidate for this procedure. Those who are ideal candidates are those who have realistic expectations of the outcome of the procedure, are in good physical health, close to their ideal weight and non-smokers. You should also determine if you require a full or partial abdominoplasty, as this could greatly affect your overall cost and you should examine some of the non-surgical methods as well. Make sure to discuss the possibility of payment plans and also investigate to see if your insurance can help cover some of the costs if it is in fact, a medically required procedure. And most importantly, be sure to shop for a plastic surgeon who is both experienced and board certified.

 


Treatment of Sweating

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Excessive sweating

Sweat can be an embarrassing problem, especially for someone who is struggling with hyperhidrosis, or excessive sweating. It can make you feel uncomfortable and awkward. Excessive sweating, or hyperhidrosis affects up to 3% of the population and can start as early as childhood or adolescence. But have no fear, there are effective treatment methods to help ease the embarrassment.

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Try a stronger antiperspirant

Some of the less severe cases may be treated with an over the counter antiperspirant. Antiperspirants differ from deodorant in that deodorant simply covers up any order from perspiration and does not prevent sweat, while antiperspirants are designed to prevent the body from sweating by using aluminum salts to block the sweat. There are some stronger clinical antiperspirants available over the counter, but if these do not do the trick, your doctor may be able to write a prescription for you.

Contrary to popular belief, antiperspirants are not only designed for use on the underarms. They can be applied to other problem areas as well such as hands, feet and even the hairline. You can apply antiperspirants  both in the morning and  before you go to bed at night, to help keep you drier while you sleep. A lot of people suffer from heavy night sweats and applying antiperspirant to the problem areas at night can greatly reduce night sweats in most cases.  However, a lot of people develop an allergic reaction or sensitivity to antiperspirants, so there are other treatment options available.

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Medical Treatments for Excessive Sweating

Iontophoresis

Iontophoresis is a treatment in which you emerge your hands and/or feet in a shallow pool of water for 20-30 minutes several times a week while a low powered electrical current is passed through the water. This is believed to aid in blocking the sweat glands from producing perspiration. Depending on the severity of your condition, you may only need a few weeks of treatment. If you still have an issue and need additional treatment, you can purchase or rent an Iontophoresis machine and do the treatment at home. Most patients have seen a drastic improvement in just a few months.

Botox

Botox injections are another option for hyperhidrosis. Botox has been approved by the FDA for underarm hyperhidrosis, but is also used to treat excessive sweating of the hands and feet. Botox injections at the site of the problem release a chemical that prevents the sweat glands from perspiring. Several injections may be needed initially, but the effects of Botox have been proven to last for close to a year.

ETS Surgery

Endoscopic thoracic sympathectomy, or ETS surgery, is a procedure used in severe cases of hyperhidrosis, but does not always work in the case of severe underarm sweating. Rather it is most often performed on those with excessive sweating of the face and hands.  During the procedure the surgeon will make tiny incisions and cut the nerves that activate the sweat glands. It is a highly effective treatment but can leave some residual scarring.

If you suffer from excessive sweating, you should make an appointment with your doctor to discuss your options. Do not attempt any of the aforementioned treatments without first seeking professional medical advice.

 

 

 

 


Scrubs

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 Brief History of Medical Scrubs

Scrubs are the universal uniform worn by doctors and nurses in medical settings. They come in a variety of colors and designs and are worn for both comfort and sanitary purposes. They are generally a blend of cotton and polyester to provide a wrinkle free professional look that is both comfortable and practical. The name originates from the fact that they were first worn by surgeons in a sterile environment in the operating room where they “scrubbed” in for surgery.

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Nurses have always traditionally worn uniforms. Originally they were fashioned after nun’s habit and then evolved to white stretched dresses, white tights, nursing shoes and a white hat. Doctors, however, just wore regular clothes until the Spanish influenza epidemic in 1918 when awareness of infection become widespread and surgeons. However, it wasn’t until the 1940’s that aseptic techniques became a standard in an effort to prevent infections.

The original uniform was white, but with the bright lights in the operating room as well as the surroundings, surgical green became the standard color by 1970 to reduce eye fatigue, as well as to make the blood stains on the scrubs less obvious.

Originally the uniform was the standard surgical green for all medical personnel as guidelines did not allow for differentiation between departments and positions, but over the years exceptions have been made to distinguish between departments such as labor and delivery, emergency, etc as well as different positions such as nurses, physical therapists, office staff, etc. Eventually they became the norm for other healthcare positions. In most cases, except for surgeons, doctors still wear their own clothing under their white coat.

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Scrubs quickly became the norm for other health care professions as well from outpatient care to labs to dentists offices. They are now available in a wide variety of colors, prints and styles. They can be ordered online from a medical site,purchased directly at a uniform store or and most retail clothing stores.

Some facilities employ a strict uniform code with different colors for varying departments and staff positions, while others allow for individuality. Hospitals tend to adhere to the strict guidelines, while other facilities such as private practices are for more  lax with the style of scrubs required for office attire. Some facilities even provide scrubs for their employees and will launder them, especially for surgical and other departments where there is contact with bodily fluids.

Benefits of Scrubs

In addition to providing a sterile wardrobe and helping distinguish medical staff, there several other benefits of medical scrubs. They also help medical professionals easily identify bodily waste such as urine, blood, vomit, etc as well as other contaminants.

In facilities that provide laundering services for their staff, the scrubs are cleaning using high temperature machines along with special detergents and chemicals to remove stains. This ensures that the scrubs are clean and free of any fluids or contaminants. Scrubs are more practical to wear than regular clothing, which would be ruined if subject to such harsh conditions.  Scrubs are also more sterile and inexpensive than regular clothing so therefore they are a practical alternative to street clothing for anyone in the medical field.

 

 

 

 


Plastic Surgery

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What is plastic surgery?

Plastic surgery is the surgical process of reconstructing or repairing parts of the body, via tissue transfer. This may be done either for injury, genetic defects or other aesthetic reasons.

Most common types of plastic surgery

  • breast reduction or augmentation
  • reduce the size of ears
  • reset protruding ears
  • correct droopy eyelids
  • remove bags from under eyes
  • repair and remove facial wrinkles, creases or scars
  • change the shape and appearance of the nose
  • tummy tuck to flatten the abdomen

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Know the risks

Before considering plastic surgery you need to be aware of the risks involved. These include but are not limited to:

  • complications related to anesthesia such as blood clots
  • infection at the site
  • fluid build up
  • bleeding which may result in follow up surgery or a transfusion
  • scarring
  • nerve damage which may lead to excessive numbness or tingling
  • deep vein thrombosis
  • pulmonary embolism
  • organ damage
  • anemia
  • rejection of skin grafts or tissue implants

Initial Consultation with a plastic surgeon

You should have a consultation with a plastic surgeon to discuss your options. Make sure you choose a surgeon that specializes the specific type of procedure in which you are interested. Also do your research and make certain that they have the proper certifications from either an accredited association. Your doctor will ask for your full medical history including any previous surgeries, health issues and any and all medications you may be taken.

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There are some factors you need to take into consideration before getting plastic surgery. You might want to discuss these with your plastic surgeon at your initial consultation.

  • What are your expectations? Don’t expect perfection, just improvement.
  • What is the expense? Most insurance plans do not cover plastic surgery so be prepared for the cost, as well as the cost of follow up care and/or procedures.
  • What risks are involved with your particular procedure? Discuss the possible risks, complications and side effects of the operation.
  • What is the recovery time? Recovery time can vary from days to weeks to even months depending on the procedure. Take into consideration how it may affect both your professional and personal life.
  • What are the psychological effects? Although your self esteem might drastically improve after the surgery, plastic surgery is not a long term cure for depression or anxiety.

If you have any of the following conditions you may not be an ideal candidate for plastic surgery

  • heart disease
  • severe infections
  • infectious hepatitis or HIV
  • certain types of cancer
  • extreme obesity
  • blood clotting disorders
  • liver disease
  • lung disease
  • diabetes

Types of Procedures

General Plastic Surgery

This encompasses a number of different procedures usually involving the skin and include tummy tucks, dermabrasion and otoplasty.

Cosmetic Surgery

Cosmetic surgery is usually performed on the facial region and is intended to correct or enhance facial features. These include rhinoplasty, blepharoplasty, face lifts and breast augmentation or mammoplasty.

Reconstructive Surgery

This type of surgery is most often performed on burn or accident victims and may involve rebuilding bones that have been severely damaged as well as skin grafting. It also includes reattaching severed limbs.

 

 

 

 

 

 

 

 

 

 

 

 

 


Peeling

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Peeling, or chemical peels, are a type of skin treatment in which doctors apply an acidic solution to remove damaged layers of skin. They are usually done as a facial peel to smooth and enhance the overall texture of the skin as a treatment for wrinkles, blemishes and uneven skin tone. The outer layer of skin is exfoliated to reveal a new layer with improved color, texture and tone. Other types of skin peels are used as a way to reduce stretch marks or repair damaged skin on other areas of the body.

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Candidates for Chemical Peels

Those with fair hair and skin are the best candidates for chemical peels. although others can also get good results. An ideal candidate for a facial peel should be of good physical health and have a realistic expectation of the outcome of the procedure. If your goal is to rid the appearance of wrinkles and age spots, reduce the effects of weather damaged, eliminate acne and improve the overall texture of your skin, then you are a likely candidate for a chemical peel. A chemical peel is not a face lift so if you are thinking something along those lines, you should not opt for a facial peel.

Different Types of Chemical Peels

There are different levels of chemical peels according to the different PH levels as well as the active ingredients. Light chemical peels are those with a PH of 2.5 or lower and can be performed by a licensed beautician or dermatologist. Anything other than a light chemical peel should be done by a licensed physician. You should discuss what type of chemical peel is best for your specific needs with your doctor before undergoing any procedure.

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Light/Superficial Chemical Peels

In a light chemical peel, your dermatologist or cosmetologist will use a specific chemical peel designed based on your skin’s characteristics and your desired outcome. Superficial and light chemical peels are designed to treat dry skin, uneven skin tone, light to moderate acne and wrinkles.  The solution used in light chemical peels in a combination of alpha hydroxy acids such as glycolic or fruit acids.  Light chemical peels are usually performed on those individuals who do not wish to invest in the recovery time and cost of a deep peel. There is no recovery time, but there may be some minor skin irritation after the procedure.

Medium Chemical Peels

Medium chemical peels are recommended for those with a darker skin tone. In this procedure, doctors will use trichloroacetic acid to treat surface wrinkles, pigmentation issues  and blemishes.  Medium chemical peels have a minimum recovery time of about two weeks.

Deep Chemical Peels

These are the strongest variation of chemical peels and use phenol acid to treat deep wrinkles, sun damaged skin, age spots and pre-cancerous growths. The procedure takes much longer than the other types of chemical peels, possibly as long as two hours. Deep chemical peels require more recovery time which can be up to two months. Most candidates for deep chemical peels will take a week off to allow for recovery.