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Nose forms the central part of the face. A beautiful shaped nose can do wonders to the appearance of an individual. Sometimes as a result of trauma or otherwise a person may have a too flat, too wide, too big, or crooked nose. Sometimes nose may have a bulky tip or unpleasing tip. Sometimes along with appearance, there may be problems with breathing through one or both nostrils due to a crooked nasal septum. All these can cause distress to an individual.

Rhinoplasty or a ‘nose job’ is a surgical procedure to achieve the desired form and shape of the nose. It can be combined with septoplasty- which is the correction of the crooked septum. So rhinoplasty can achieve desired form and function.

The Procedure

Depending on how much the nasal shape needs to be corrected to achieve the desired result rhinoplasty can be done under General or local anaesthesia. Tip plasty is the correction of only the tip of the nose. This is done under local anaesthesia wherein only the tip of the nose is numbed and necessary corrections are done to a boxy tip, bulky tip, narrow tip. This is done as a daycare. If there is too small a nose, this may need some extra cartilage and proper shaping. This is done under General Anaesthesia. Cartilage may be taken from the ear or chest. Too broad or crooked noses need osteotomies and septoplasty, which needs to be done under general anaesthesia.

All these procedures require technical, surgical finesse which can be achieved when rhinoplasty is done by a qualified plastic surgeon. If the function is also an issue then an ENT surgeon will also be a part of the team.

Post-operative recovery:

Post the procedure there will be the nasal pack for 2 days and a nasal splint for 7-10 days. There will be swelling of the nose that will last around 3-6months. The result will be well appreciated once the swelling subsides at the end of 6 months.

Thus the desired shape and function of the nose can be achieved by individualising the type of rhinoplasty for each patient after proper consultation.

Deciding on getting a Rhinoplasty:

If you are not satisfied with your nose then you may decide on getting rhinoplasty surgery. However, bear in mind that there is nothing like a perfect nose. Once you decide to get a rhinoplasty you should consult an expert Plastic Surgeon. Dr Eulalia D’Souza is an expert Plastic Surgeon with 10+ years of experience who can consult and explain to you what can be done to achieve the desired shape of the nose and what will suit you best taking your facial features into consideration. Once you are satisfied with the consultation you may go ahead with the procedure.

Results:

A well done rhinoplasty has several benefits like improved self- confidence, improvement in body image, alleviation of breathing problems. So if you think you need to improve the shape of your nose or you have breathing problems book your consultation today.

In this day and age of the internet and social media, all of us want to look our very best. In a quest for the same, the number of persons undergoing cosmetic surgeries has increased in recent years. Cosmetic surgery is well known not only amongst celebrities but also common people. Liposuction – a procedure where the excess fat lying beneath the skin is removed – is the most common cosmetic surgery performed. Botox and fillers are the most common office procedures performed. Cosmetic Procedures definitely give a boost to one’s self confidence along with improving the appearance.

It is not surprising if you have been considering going under the surgeon’s knife to look better and feel better about yourself. However, there might be a few questions in your mind, ie. ‘Am I the right Candidate’ or ‘should I undergo this procedure?’ This blog tries to address the same.

Below are a few points that one should consider before planning for a Cosmetic procedure:

Are you medically, emotionally and mentally fit to undergo the procedure?

Good general health is a prerequisite for any procedure. One should not be suffering from any acute illness or inadequately managed chronic illness. Diabetes and hypertension are not a contraindication to undergo a cosmetic procedure provided you are taking your medications regularly and the condition is well controlled. Before planning any procedure, the doctor will run some basic tests to ascertain your fitness for surgery. It is crucial to inform your doctor if you are on any long-term medication or blood thinners, so that the doctor can do the indicated tests and the preparation for the surgery can be done accordingly.

One should also be emotionally well balanced to undergo cosmetic surgery and be of sound mind to be able to make the decisions with regards to the same. If you are undergoing a period of acute stress, then allow the stress to subside before undergoing any procedure. Mental illnesses like schizophrenia are a relative contraindication for a cosmetic procedure. Appropriate clearance will be required to be obtained from the psychiatrist or psychologist before any surgery is planned.

Are you adequately motivated enough to undergo the procedure?

When planning a cosmetic surgery your motivation to undergo the same should be clear. You need to ask yourself if you are undergoing the procedure to improve your self-confidence rather than doing it to look better for others. Being adequately motivated also means understanding that there will be some post-operative discomfort, also there will be some time lag in order to get the final result. Some procedures like liposuction need a commitment to maintain the result obtained which is possible only when you are adequately motivated.

Are your expectations realistic?

It is important to have a detailed consultation with your Plastic Surgeon. This will help in knowing your expectations from the procedure you wish to undergo and the surgeon can explain to you in detail what can be achieved so that your final expectations from the procedure are realistic. You may be desirous of certain change in your body, but you have to understand that the final result achieved will be what is most suitable, anatomically feasible and safe for you. For e.g., you need to understand that liposuction is a body contouring surgery and not a weight loss surgery. Liposuction will definitely give you a better shape, but may not necessarily help with weight loss. If your expectations are realistic, you will definitely be satisfied after the cosmetic surgery.

Is this cosmetic procedure right for you?

After due consideration when you plan to undergo cosmetic surgery, it is necessary to understand which procedure is right for you. For eg. you want a flat tummy post childbirth, only liposuction is not the ideal procedure for you as the skin post child birth is lax and not elastic. Liposuction needs the skin to be elastic enough to retract to get the desired result. You will need a tummy tuck along with liposuction to achieve a flat tummy.

Will this procedure improve my self-image and self-confidence?

Improving one’s appearance and body shape helps boost one’s self image and confidence. If you think this is what undergoing cosmetic surgery is going to do for you, then you should consider the same.

For undergoing any cosmetic procedure, you should have a detailed consultation with a qualified Plastic Surgeon. Dr Eulalia is a qualified Plastic Surgeon with almost 10 years of experience in her field. During the consultation, discuss your concerns, expectations and medical history in detail so an appropriate treatment plan can be drawn out for you.

The size, shape and proportion of the breasts have a profound impact on how a woman perceives her femineity and also self-confidence. Overtly large breasts can cause great physical as well as emotional distress. Disproportionately large breasts can lead to strained neck, altered posture, pain due to bra straps, irritation and rashes to the skin fold beneath the breasts and social embarrassment among others. If a woman has large breasts that cause such discomfort and it interferes with her day-to-day life, she should consider a breast reduction surgery also known as reduction mammaplasty.

Breast reduction is the surgical procedure to remove excess fat and glandular tissue from the breast while reshaping and lifting them while maintaining the aesthetic proportions. Most women who undergo breast reduction for the right reasons are generally satisfied with the ultimate outcome. However, it is a major surgery and all factors must be taken into consideration before you choose to undergo this procedure. It should be done only by a board-certified Plastic Surgeon.

Benefits of Breast Reduction Surgery

More proportional and aesthetically shaped breasts- Large breasts tend to hang and look disproportionate to the rest of the body. Breast reduction is a plastic surgery procedure that achieves breasts that are more aesthetic, proportional and attractive.

Decreased neck and back strain, improvement in irritation and rashes beneath the breast folds- After breast reduction the breasts are smaller, lighter and more comfortable. This definitely causes an improvement in the discomfort associated with large breasts leading to a great deal of satisfaction post breast reduction surgery.

Better comfort while performing physical activities- Without heavy breasts hanging from the chest it becomes much more comfortable to perform several physical activities like running, cycling, playing outdoor games. This leads to a sense of general wellbeing.

Improved self-confidence- More aesthetic and proportional breasts means you can wear clothes of your choice; social embarrassment is decreased leading to an improved self-confidence.

When to Plan / Timing of the breast reduction

Breast reduction can be planned at any age once the breasts are fully developed. If pregnancy is planned in the near future, it is advisable to undergo breast reduction after cessation of breast feeding as post pregnancy changes to the breast could affect the ultimate result.

Preparing for the procedure/ consultation

Once you have decided to undergo breast reduction surgery fix up an appointment for consultation with a Plastic Surgeon. Discuss in detail what are the problems faced by you due to the large breasts and what are your expectations and concerns regarding the procedure.

The doctor will take a detailed medical history, examine the breasts and axilla for any lumps, measurements will be taken to determine the exact cup size. Some pre-op photos will be taken to exactly plan the course of the surgery and for a post-op comparison. The surgery, post op recovery, scars will be discussed in the consultation.

Investigations will be done to determine the fitness for surgery. Ultrasound or Mammography of the breast will be done to rule out any undetected lumps. Diabetes and hypertension will need to be well controlled pre procedure. Smoking will have to be stopped at least 2 weeks prior to the procedure. Certain blood thinners will need to be stopped pre-op.

Types of Surgery

Depending on the size of your breasts one of these three procedures will be planned.

  • Liposuction: If the size of the breast is moderately large and a significant reduction is not desired only liposuction can be planned. Significant reduction cannot be achieved with liposuction. The post-operative recovery is much faster and return to work is earlier. There will be only a few 5mm incisions used to suction out the excess fat from the breast, so scars are also hardly visible.
  • Vertical Reduction: This is the most common type of breast reduction for moderately large to large breasts. Breast tissue is retained on a medial, superior or inferior pedicle and all the excess is excised. The wound is closed in a vertical scar and stiches are also there around the areola. There is no scar in the breast crease, only a vertical scar from areola to just the crease. There is no scar above the areola. With the vertical reduction a good amount of reduction can be achieved along with uplifting the breasts and making them much more youthful.
  • Inverted T shaped Reduction: For very large breasts, vertical reduction cannot achieve adequate reduction, hence a reduction with an inverted T scar is preferred. Breast tissue is retained on a medial or superior pedicle. All inferior and lateral excess is excised along with skin excess. Final wound closure is like an inverted T with a scar form areola to crease and a horizontal scar along the crease. There is no scar above the areola. Good uplifting and good reduction can be obtained with this procedure.

Liposuction may be used in combination with the other procedures to achieve a better and symmetrical result.

The procedure

Once you decide to undergo a breast reduction procedure after the detailed consultation, all tests needed for fitness will be carried out after which a suitable date will be decided for surgery. You will need to be admitted and requisite fasting will be advised before the procedure is carried out. Pre-operatively the surgeon will also do the markings so that all the incisions and excisions are precise and the desired result is obtained. The procedure is done under General Anaesthesia. Post operatively there will be bandages and there will be some pain for which appropriate medication will be administered. You will be mobilised the next day. Discharge is usually on the 2nd day once you are comfortable. Dressings are changed on either the 2nd or 3rd day and specialised supportive garments are given.

Recovery/Getting back to routine life

In about 7-8 days the pain, swelling settles and you will start to feel more comfortable with the new and renewed you. The doctor will advise you when you can start showering. If you are comfortable, you can join back to work in 7-10 days. Heavy exercises should be avoided up to 1 month post-operatively. Doctor will call you for follow up till the wound settles.

As the post-operative discomfort settles you will start noticing decreased neck and back strain. Confidence will improve gradually as you embrace the new shape. Most women are very satisfied with the decision to undergo breast reduction surgery.

Problems/Complications

Some of the problems or complications that are associated with breast reduction surgery are:

  • Swelling and bruising: some swelling and bruising is common after this procedure, but sometimes it may be troublesome and take more time to settle.
  • Infection: Wound infection may happen in a few instances. Sometimes it is localised and settles with antibiotics and dressing. Very rarely infection may be more and may need minor procedures to allow it to settle. If you notice some redness and pain more than expected then contact your doctor to rule out infection.
  • Delayed wound healing: Sometimes a part of the wound may gape and take longer to heal and need dressings longer. With proper management this usually settles.
  • Scars: There will be scarring post the procedure. They may be more visible earlier but they fade over a period of time. In case the scar becomes hypertrophic or thick, take the advice of your doctor to help improve the scar.
  • Asymmetry: if the procedure is properly planned and proper pre-op markings are done this rarely ever occurs. If there is some asymmetry that you are bothered by, consult your doctor to get it corrected

Breast reduction is a blend of surgical skills with art to achieve proportionate, aesthetically shaped breasts that add to the feminine appeal. Dr Eulalia D’Souza is a Board-Certified Plastic Surgeon who has an eye for the art and can help you with achieving what you desire with a breast reduction surgery.