Surgery Notes

Posts Tagged ‘Cosmetic surgery’

When cancer is found in the breast of a woman, a relatively common surgical treatment if the cancer is aggressive or is advanced is the mastectomy. Mastectomy is the removal of breast tissue by the presence of a cancerous tissue or pre-cancerous. The amount of tissue removed during mastectomy varies and depends on many factors including: the size and stage of cancer, their anatomy and their personal preferences.
There are 3 types of mastectomy are performed most often by surgical oncologists skilled in Mammary Gland: a modified radical mastectomy, which removes the breast tissue including in these nipple areola tissue and lymph nodes found in the armpit same side. This procedure leaves intact the pectoralis major muscle that lies behind it and over the chest wall. There is also a simple mastectomy in which only removes the breast tissue and lymph nodes occasionally. Finally there is a lumpectomy or partial mastectomy in which only the tumor tissue is excised and local inflammation, leaving as much breast tissue in place.

Women who undergo a mastectomy, most of them are good candidates for breast reconstruction. The reasons for choosing a reconstruction of this type can be many. After a mastectomy, many patients feel a loss of integrity or a deterioration of their femininity that breast reconstruction can restore.

The reconstruction can be performed using a variety of methods:
1. Can be made using the same body’s own tissue of women (flaps)

2. Using medical implants (silicone implants or saline).

3. Using a combination of both methods.

The proper method for you depends on the type of mastectomy that was done, the stage of cancer at the time of discovery, the experience of Surgical Oncologists and if there is a plastic surgeon who has extensive experience in breast reconstruction and finally the type of monitoring and post-surgical care that you have to have under your health and possibilities.

For 40 years, when they started the cosmetic surgery for breast implants with silicone implants, they have evolved in such a way, ensuring a better outcome with fewer complications and long term.

The need for some women and the influence of a new body at rest, have produced a significant increase in the performance of cosmetic breast surgery.

Since the ’80s, gradually volumes of breast implants have been increasing, currently standing prosthesis measures were unthinkable 20 years ago.

The steady progress in the development of breast prostheses, which allow today are composed of a cohesive gel that prevents their migration through the roof and eventually get broken.

Another advance of the beginning of this century has been the different profiles or shapes of breast implants that can be used according to the type of the breast that the patient has and how he’d like.

At high and moderate profile breast implants, it adds the natural and anatomical, which project over the lower pole of the breast by a drop of water, giving a more natural look to it.

The combination of volume and pattern of breast implants, you get the result desired by the patient after undergoing cosmetic breast surgery.

The most commonly used route of entry of these implants are the periareolar and submammary . Both incisions, allows easy access to the space where we put the prosthesis.

According to the anatomical characteristics of the patient, the location of the prosthetic implant silicone can be in front of the pectoral muscle (retroglandular) or behind it (retromuscular) .

In both cases, never break the continuity of the mammary gland and nipple, so it will not be compromised feeding in patients in the future to breastfeed after the surgery.

Plastic surgery according to Dr. Angel Juárez “It’s trying to find a balance between mind and body. Create it when there, and restore it when broken. Ensure that every human being is happy with his image, in relation to perception, and that of others. But not regarded as a panacea, but as an aid to solve certain problems and that makes it infinitely better at the right time. ”

The most frequent interventions and clock
* “From 5-6 years: Otoplasty
Some interventions such as otoplasty (ear correction) can be practiced in very young, five or six years even. This prevents its great and sometimes traumatic complex in the contact group (school, friends etc..). The results obtained are very good and final.

* “From the age of 17: Cheek and chin implants
Lately it has become very fashionable face drawn and angular. They are usually very young people who wish to highlight their features. Cheek Implants and / or chin would be indicated in these cases despite the few years.

* “From 18 years: breast augmentation, liposuction, rhinoplasty
In this age when he terminated the growth. At the end of the physical, it is possible to think of interventions such as breast augmentation, liposuction or a nose under …

* “From 20 to 25 years: Correction of palpebral bags
Blepharoplasty, or eyelid correction can be performed in the operating room from 20, when it comes to constitutional palpebral bags …. There are families in which the bags are very common and inherited from generation to generation …

* “From the age of 35: Lifting
Regarding the lifting, there are different types, depending on what you want to fix. Personally, “says Dr. Juarez,” I favor the patches rather than full one. ” The tail of the eyebrow would be indicated from the thirty-five years. The middle third of face from forty-five. The neck is usually associated to the face, fifty or so.

* “From 40: Increase of cheekbones. Blepharoplasty
When completed because of the years produced a reabsorption of the fat and bones, appears with some frequency that is called “witch’s chin.” Surgery can increase the size of the cheeks and chin defatted by a tiny liposuction. Another case is that of the eyelids, which also cause an aged appearance. This is all operating out of the thirty-five to forty years. Both approaches, ie the technique used will be different if the patient has more or less years.

Time results
Generally in the lifting, the results remain about twelve years. And now, thanks to new techniques, it also acts in depth on the muscle and this allows more lasting end results. However, absolutely nothing happens if you want to “stretch” later, but has not been more than five or six years after the last intervention. Thanks to its action away some wrinkles such as the neck and the nasolabial folds … but mostly avoid sagging.

At present it is accepted that the field of action is for plastic surgery:

- Burns and their sequelae

- Surgical treatment of tumors in all those areas where reconstruction is required by plasty or grafting

- Surgical treatment of external congenital malformations of the cranio-cervical-facial and other regions requiring plasty or grafting

- Surgical treatment of those regions which require soft tissue reconstruction

- Hand Surgery

- Cosmetic Surgery

It is a specialty “unique” in that it covers the entire body and has no defined anatomic area. Therefore includes many “subspecialties,” with each service a portfolio of specific services is marked by:

care needs of the population

the existence of other hospital services to treat the disease that overlaps with areas that handle plastic surgeons (ENT, COT, Maxillofacial, etc.).

or treatment of serious burns.
The be a specialty as broad contours involves two essential characteristics:

on one hand the high degree of synergy or areas of increased interaction with other specialties, services or levels of care where a good cooperation scheme leads to a greater benefit for the patient,

On the other hand the development, either internally or in collaboration with other specialties, a range of activities, process lines and units super-clinics (formally recognized or not).

Various global, European and Spanish define the specialty of Plastic Surgery. These include the IPRAS (International Confederation for Plastic Reconstructive and Aesthetic Surgery) as an association of 88 national societies worldwide promotes the advancement and scientific exchange, sponsors meetings and works to improve the standards of the specialty, and FILACP (Federation Ibero-Latin) which includes Spain and Portugal and all Spanish-speaking countries in the Americas Lusa.

In Europe highlights the EURAPS (European Association of Plastic Súrgenos). In addition, Plastic Surgery is one of 24 specialties members of the European Union of Medical Specialists (UEMS).

In Spain, the Spanish Society of Plastic, Reconstructive and Aesthetic Surgery (SECPRE) is to contribute with all means available to scientific and practical knowledge of Plastic Surgery. This mission is accomplished by holding scientific meetings, publication and periodic publication of the magazine “Ibero-Latin American Plastic Surgery” and untimely publications and organization of courses, conferences, meetings, exhibitions.

Plastic Surgery in the Modern Era

In the second half of the twentieth century grows extremely Plastic Surgery developing new reconstructive procedures as well as aesthetics. Reconstructive Surgery.

In one of the most important advances has been the birth and development of microsurgery. With the creation of micro-instruments, ultra fine suture materials and manufacture of surgical binocular microscope in the 50’s, microsurgery has revolutionized the field of reconstructive surgery.

Microsurgery has dramatically expanded the possibilities of reconstruction with all kinds of flaps, the replantation of amputees or devitalized members revascularization.

In 1965, he made the first experminetacion Krizek with a free transplant the same year, in Japan, Tamai and Susumi described the first successful replantation of a digit amputee. In 1972, Harii and Ohmori Japanese also made the first free flaps in humans.

In 1969 the American Harry Buncke (father of microsurgery) held its first free microvascular omentum transplantation to repair a large scalp defect.

In this period of Cosmetic Surgery experience an explosion even more. Anesthetic and surgical safety, improved living standards and the growing importance of image in our society have contributed to the flowering of this branch. Currently the technique is the most common cosmetic liposuction, described by the Italian dermatologist Arpad early 70’s.

The second intervention is often breast augmentation with an estimated 25,000 procedures per year. From the first silicone gel implants by Cronin (1963) breast prostheses have evolved greatly and now has a wide variety of volumes, sizes and shapes. Also have been describing and harmonization and improved techniques of facial rejuvenation and body.

History, Evolution and Current

Plastic surgery is a specialized branch of surgery dedicated to the repair of deformities and correction of functional defects.

Etymologically, the name derives from two Greek words: “Girurguiki” (surgery, labor, work) and “Plastikos” (mold). Already in 1798 Desault used the term “Plastique.” Von Graefe subsequently incorporated it in their monograph “Rhinoplastik” (Berlin, 1818), but it was a German surgeon, Edmund Zeis who popularized by publishing in 1838 his treatise “Plastiche Handbuch der Chirurgie”, named this branch surgery, she experienced a great development from the First World War.

The origins

The bases of Plastic Surgery can be found in the ancient history and represent man’s effort to treat wounds and defects inflicted by nature or by other human beings. The Ebers Papyrus (1500 BC) shows that the transplantation of tissues was practiced by the Egyptians in 3500 BC The Vedas, the sacred books of the same age, have both flaps (1) as grafting (2) were known in India. In the seventh century B.C. Susruta describes some techniques for reconstruction of the nose, ears and lips that were made in India 2500 years BC It was customary to punish prisoners of war, adulterers and criminals with the mutilation of the nose. The frequency of the procedure was that developed an ingenious method of repairing such loss, with some modifications, still used today. In Roman times, Celso (25 aJ) used in their classic designs to mobilize Demedicina writings we now call tissue advancement flaps.

Even the royal physician Byzantine Orbasio, picked her medical encyclopedia Synagogue Medicae 2 volumes devoted to the reconstruction of facial defects, especially of the nose. In addition, many procedures have been described after treatment of facial fractures to interventions urinary tract malformations such as hypospadias.

At that time, those engaged in such activity were the Kooma skilled or potters, who possessed the secret of living tissue manipulation. With the skin of the forehead flap performed, spinning and incorporated the rest of the existing nose. When the distal end was “stuck” to the recipient bed, sectioning the pedicle and the surplus was returned to its place of origin. In India this knowledge is passed on to Persia and Arabia and later to Greece and the Arab Italia.Posteriormente work Sushruta brought to the West.

In the Middle Ages, and despite the continued use of established methods, the fall of the Roman Empire in the V century and the subsequent extension of the barbarian tribes desafrotunadamente caused a stop in the development of reconstructive surgery. Christianity is not allowed to continue progress in this field. In the thirteenth century Pope Innocent III specifically prohibited surgical procedures.
By then the practice of medicine became an ethereal experience that should not come into contact with the patient. Manual labor required for operations was considered dishonorable and showed baseness. This accompanied the beginning of the era of barber surgeons still worse reputation
surgery.

Renaissance, Resurgence of Surgery

In the fourteenth century revived Sciences and with them the surgery, this time with important contributions from both East and West. The Turk was who described techniques for the treatment of gynecomastia (breast development in men), considered the first signs of glandular breast tissue removed for cosmetic reasons, and based on current techniques of breast reduction.

Branca brothers were in Sicily (s. XV), who reintroduced the Hindu practice of nasal reconstruction and modified using a skin flap of the arm. Tagliacozzi Gaspar (1545) is considered a key figure in the development of plastic surgery for his detailed work on pedicle flaps, especially for nasal reconstruction. But at the end of XVI century Europe enters a new stage of cultural decadence, superstition and ignorance of science.

In the nineteenth century, however, was followed by a resurgence of this surgery, probably related to advances in anesthesia (the century of the surgeon). Von Graefe uses the techniques of nasal reconstruction during the Napoleonic Wars; Dupuytren palmar fibromatosis describes and classifies burns according to depth, von Langenbeck develop treatment of cleft palate, Sir Astley Cooper performed the first skin graft … important contributions have come until today. It is also the time when the term “Plastic Surgery” became popular and appears as such in various treaties.