Pushback otoplasty is done for improvement in the appearance of prominent ears. It is usually carried out under general anesthesia in children and local anesthesia in adults. During this procedure, ear cartilage is removed and reshaped so that it lies closer to the head. It is carried out either as a short stay or outpatient procedure. Pain is controlled with the help of oral medications.
After the procedure, a dressing is given in the form of a head wrap with a bandage. The ears are inspected on the first postoperative day for the presence of any collection. The bandages are retained for a week.
At the end of the week, the dressings are removed. Patients can shower once the dressings are out. For two weeks following the procedure, a headband is advised to be worn constantly. After this period, a headband should be worn during the night.
It is common to have swelling of ears following surgery. This gradually subsides over time. Most of the swelling disappears by the end of a month. Pushback otoplasty is a cosmetic procedure. It does not alter the hearing. It helps individuals with prominent ears to obtain a better body image.
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Hair transplant is a surgical procedure for redistribution of hair from areas of relative abundance to those with deficiency. It is most often carried out for male pattern baldness (MPB). In MPB, the hair of the posterior (back) of the scalp is relatively spared when compared to the hair in front of the scalp. The word, 'relatively' is important since the hair in the posterior part of the scalp is not completely unaffected by the changes in MPB. However, this property of relative sparing of the posterior scalp hair in MPB continues even after grafting (transplant).
Hair shafts occur as small groups called follicular units. During a hair transplant, a follicular unit is removed from the donor area (usually the posterior scalp) and implanted at the recipient area (usually the front of the scalp). A follicular unit may contain one, two or three hair shafts. The number of follicular units transplanted in a procedure depends upon the donor and recipient areas. Male pattern baldness usually requires the transfer of a large number of grafts. This is in contrast to the small numbers required for hair loss associated with small scars.
As mentioned previously, the posterior (back) part of the scalp is usually used as a donor area for hair transplants. Less preferred donor areas include beard and body hair. In certain individuals, the posterior scalp hair may be inadequate as a source for donor grafts. This can be due to the progress of MPB. This is observed as reduced density (hair follicles per square cm) and thinning (miniaturization) of hair follicles. It can also be as a result of a previous harvest of hair follicles during a hair transplant. An individual with a poor donor area also tends to have an advanced stage of MPB.
In spite of these challenges, it is possible to improve upon the appearance of those with a poor donor area. In such a situation we try to achieve improvement with the help of fewer grafts. Frontal forelock occupies the portion behind the central part of the forehead. Many individuals with advanced male pattern baldness tend to retain hair in this region. A relatively full forelock does not give an unnatural look in an individual with advanced hair loss. The forelock helps frame the face when an individual is observed from the front. It would be the part of the scalp that would be visible as a person steps out of an elevator. Increasing the density in the forelock region would require lesser grafts when compared to the rest of the scalp.
In patients without donor deficiency, other areas that are addressed include the hairline and mid-scalp. These occupy the area adjoining the forelock. The crown is given lesser importance when compared to the previously mentioned areas because of the lesser aesthetic significance and the requirement of a large number of grafts.
Salvaging the remaining hair follicles is also important in a person with MPB. MPB is usually a progressive condition and left untreated many can progress to more advanced stages of baldness. This is especially true in the case of younger individuals in whom the hair loss has not stabilized. Preservation of remaining hair follicles is achieved by means of medications. These medications include nutritional therapy, topical Minoxidil, and Finasteride. It is important for individuals to make an informed decision about the use of these medications. They should be taken for long periods for adequate results.
Male pattern baldness with poor donor areas offers some challenges for hair restoration. But often it is possible to improve upon the appearance with the help of medications and a limited hair transplant.
For more information on hair transplant please visit, https://www.amicusclinic.in/hair-transplant
Gynecomastia is a commonly seen condition among young men. It presents as fullness near the nipples that give a feminine appearance to the male chest.
A very frequently mentioned symptom among such individuals is the appearance of the nipple and the surrounding pigmented skin (areola). Other than the fullness, the appearance seems to look worse when exposed to warmth and improves when exposed to cold or mechanical stimulation. A certain part of the consultation is usually devoted to an explanation of this phenomenon.
The pigmented skin surrounding the nipple has radially (like spokes of a wheel) oriented smooth muscles in the skin. Exposure to cold and mechanical stimulation leads to a contraction of these smooth muscles and a resulting contraction of the skin (areola). When the smooth muscles are relaxed the areola tends to look globular. The globular appearance of the areola is considered to be less aesthetic.
The presence of smooth muscles in the skin should not be confused with the skeletal muscles situated in a deeper plane. Similar smooth muscles are also found in the scrotum and react in a similar way to variations in temperature and mechanical stimulation. The presence of smooth muscles in the nipple-areola is normal. It is found in everyone.
In individuals with gynecomastia, the presence of glandular tissue makes the nipple-areola region more prominent. It also makes the above-mentioned changes in appearance due to the smooth muscle activity more prominent. But that does not mean that the variations as a result of the smooth muscle activity are abnormal.
Gynecomastia surgery is undertaken for improvement in the appearance of the male chest. With the removal of the excess breast tissue, the prominence of the nipple-areola is reduced. As the areola is no longer stretched out due to the glandular tissue, the changes of the overlying skin are also significantly reduced. As in other cosmetic surgical procedures, this can also lead to a better body image and more self-confidence.
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