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This is my rhinoplasty before and after video

Watch my experience from initial consult to final result as I have an ethnic rhinoplasty procedure performed by Dr. Paul S. Nassif of Spalding Drive Cosmetic Surgery & Dermatology located in Beverly Hills.

The results are incredible! It's like a dream come true. I am so happy that I chose Dr. Nassif as my surgeon. He is truly a gifted and wonderful surgeon.

There where many procedures performed to get the incredible results I received including:
Deep Temporalis Fascia Harvesting
Septoplasty
Turbinoplasty
Open Rhinoplasty
Nasal Smas Excicion
Vestibular Tissue Release
Tip Cartilage Contouring / Cephalic Trim
Columella Strut Placement
Shield Graft
Ear (conchal) Cartilage Harvest
Rim Graft
Osteotomies
Narrowing of Nasal Dorsum
Build up of Radix & Dorsum (cartilage and fascia grafts)
Alar Base Reduction

Rhinoplasty in Los Angeles also specializes in ethnic rhinoplasty for African American, Hispanic and Asian patients. As part of his information campaign on cosmetic surgery in Beverly Hills, those who are interested in rhinoplasty and plastic surgery can get loads of up-to-date information straight from Dr. Nassif through his websites Media Page. This web page contains articles written by Dr. Nassif that have been published in famous plastic surgery journals and books.

The Media Page also contains actual rhinoplasty and revision rhinoplasty surgery captured on video. These videos were aired in Discovery Channel, ET, and other shows. Patients who want to know more about Dr. Paul Nassif can check out his curriculum vitae. Whether you decide to attempt this procedure or not, rhinoplastyspecialist.com can give you an accurate and detailed perspective.

AFRICAN AMERICAN NASAL ANATOMY:
1. Skin: Thick, Abundant Fibrofatty tissue
2. Radix: Deep, Inferiorly-Set & Low
3. Nasal Bridge & Dorsum: Short Nasal Bones, Wide & Flat
4. Tip: Bulbous, Thick-Skinned, Under-Projected, Derotated (Ptotic), Abundant Nasal Soft Tissue, Broad Domes, Minimal Definition
5. Base: Wide, Thick, Horizontal & Flaring Nostrils
6. Nasolabial Junction: Retracted, Under-Developed Nasal Spine
7. Maxilla: Usually Retrusive & Hypoplastic

HISPANIC NASAL ANATOMY:
1. Skin: Thick, Abundant Sebaceous Glands
2. Radix: Low to Normal
3. Nasal Bridge: Wide
4. Dorsum: Convex (Nasal Hump)
5. Tip: Bulbous, Thick-Skinned, Under-Projected, Occasionally Derotated to Normal, Abundant Nasal Soft Tissue, Broad Wide Domes, Minimal Definition
6. Columella: Short to Normal
7. Base: Wide, Thick, Horizontal & Flaring Nostrils
8. Maxilla: Within Normal Limits

ASIAN NASAL ANATOMY:
1. Skin: Heavy, Thick & Sebaceous
2. Radix: Deep & Flat
3. Nasal Bridge & Dorsum: Low, Wide & Flat
4. Tip: Bulbous, Thick-Skinned, Under-Projected, Ptotic, Abundant Fibrofatty Tissue, Broad Domes, Minimal Definition
5. Columella: Short, Minimal Show (Retracted)
6. Base: Wide, Thick, Oblique & Flaring Nostrils
7. Maxilla: Usually Retrusive

DESIRED RHINOPLASTY GOALS:
1. Bridge: Moderately Thinner
2. Dorsum: Higher (Augmented)
3. Tip: Refined, Increased Projection, Increased Rotation
4. Base: Vertical-Oblique Nostrils & Triangular Nasal Base
5. Columella: Increased Columellar Show & Length
6. Maxilla: Less Retrusive
7. Skin-Soft Tissue Envelope: Moderate Thickness that Provides Good Tip Definition African American Rhinoplasty
~NWLN

http://www.rhinoplastyspecialist.com Los Angeles County police officer was shot in the face while on duty, in the surgery to repair his face he was left unable to breathe completely through his nose. Dr. Paul Nassif was the only Rhinoplasty specialist that he would trust to repair his breathing through his nose. Join this officer and his experience through rhinoplasty surgery with rhinoplasty specialist Dr. Paul Nassif. Rhinoplasty, often referred to as a nose job, it is the most commonly performed facial plastic surgery procedure. In the past two years, nearly 600,000 people in the U.S. have undergone rhinoplasty, according to the American Society of Plastic Surgeons. People that have had rhinoplasty usually welcome the subtle enhancement that adds balance and harmony to their faces. Rhinoplasty is generally performed to improve the appearance of the nose, to correct breathing problems, or for reconstructive purposes. 120 S. Spalding Drive Suite 315 Beverly Hills, Ca. 90212 Tel: (310) 275-2467

Medical students at Johns Hopkins University are getting a real-life birthing experience when a robot goes into labor. Kasey-Dee Gardner reports.

Dilatation and curretage technique.

The products of a surgical abortion.

Surgical abortion using the dilatation and curretage technique.

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One of the most common of all plastic surgery procedures is rhinoplasty, also commonly known as a nose job. Rhinoplasty surgery can serve dual purposes, creating a more aesthetically pleasing look and also helping breathing conditions, such as a deviated septum.. Whether it's because of a genetic defect or some kind of injury, many people have trouble breathing through their nose. A rhinoplasty can counteract this, clearing the airway so you can breathe freely. It can even repair a deviated septum, straightening it and removing any blockages in the airway.
Perfecting surgery with this three-dimensional structure (the nose) takes years to master and continues to improve. Little did we know that rhinoplasty maneuvers that were used three years ago could cause disastrous results today. Rhinoplasty surgery is forever evolving! My fellowship director, J. Regan Thomas, MD, told me something that I’ll never forget – “you haven’t learned anything about rhinoplasty until you’ve performed at least a thousand procedures and followed them for many years”. This statement epitomizes why fellowships are so valuable. Some of the needed experience and potential pitfalls are circumvented by first hand observing and learning the analysis, judgment, techniques, complication management and most importantly, results from a seasoned rhinoplasty surgeon. This is why I super-specialized in rhinoplasty surgery during my fellowship in Facial Plastic & Reconstructive Surgery. The training catapults you years ahead of many other surgeons that aren’t fortunate to have post-graduate training. Many cosmetic surgeons are taught that aggressive cartilage removal is a procedure of the past. Today’s concept is “less is more”. Less cartilage excision, cartilage repositioning, camouflage techniques, structural grafting and suturing techniques are being taught in most rhinoplasty courses and at our national meetings.
http://www.rhinoplastyspecialist.com
120 S. Spalding Drive Suite 315 Beverly Hills, CA 90212 Tel: (310)-275-2467

www.rhinoplastyspecialist.com - (310)275-2467 Join Nadia and her experience first hand as she undergoes a primary rhinoplasty (Nose job) surgery. This surgery was performed by rhinoplasty specialist Dr. Paul Nassif. In Los Angeles rhinoplasty, the majority of incisions are made inside the nose, where they are invisible. In some cases, an incision is made in the area of skin separating the nostrils. Certain amounts of bone and cartilage are then removed or rearranged to provide a newly shaped nose. If the patient has a deviated septum (cartilage and/or bone causing obstruction inside the nose), septal surgery, called septoplasty, is simultaneously performed. The incision is placed entirely inside the nose. The septoplasty removes portions of cartilage and/or bone that are causing the obstruction. The incisions are then closed with fine suture, followed by placement of a splint to the outside of the nose. The splint helps retain the new shape while the nose heals. If packing is placed inside the nose during surgery, it is removed the next morning following Los Angeles surgery. The nasal splint is usually removed seven days after surgery. At that time, tape is applied to the nose for another seven days and then removed. The majority of the bruising and swelling usually resolve two weeks after surgery. Cold compresses are used to help reduce the bruising and discomfort. A short course of post-operative antibiotics and steroids are given to help prevent infection and excess swelling. Although discomfort is minimal, pain medication is available if required. Vigorous activity is avoided for four weeks following surgery. Sun exposure and risk of injury must be avoided. If you wear glasses, tape is used to avoid putting stress on the nose. http://www.rhinoplastyspecialist.com Spalding Drive Cosmetic Surgery and Dermatology 120 S. Spalding Drive Suite 315 Beverly Hills, Ca. 90212 Tel: (310) 275-2467

http://www.rhinoplastyspecialist.com This video will take you through Donna’s experience with Revision Rhinoplasty Specialist Dr. Paul Nassif. Follow Donna as she goes through the process before, during and after surgery. Listen to what Donna has to say about Dr. Paul Nassif and his staff in regards to the overall operation. Patients seeking revision rhinoplasty have a number of concerns. The foremost is a poor aesthetic and functional result. Second is often the loss of trust in their first surgeon, and the third: will surgery help improve them or just cause more deformity. Dr. Nassif and his staff are well trained in helping patients overcome these fears. They are sensitive to the reluctance patients have over considering more surgery. The staff will help you feel at ease from the beginning; recognizing your courage to address the need for revision surgery and consider improving upon what was your less than ideal surgical result. Together we can work towards achieving our mutual goals of looking and breathing better. By choosing the right specialist for surgery, the goal is to improve the functional and aesthetic results from prior treatment. Dr. Nassif often states that revision rhinoplasty follows the architectural theme "form follows function." Noses that look pinched typically don't work well and vice versa. Improving nasal airflow usually has the consequence of also enhancing the appearance of the nose. Revision surgery is about restoring structure and strength. Finally, I will use the computer image as a goal in surgery. Often times, patients will bring photos (models, movie stars, etc.) of what they feel their nose should look like. My goal is to take what you have and make a moderate, and sometimes, significant difference in the appearance and function of your nose, creating an aesthetically pleasing, natural nose. Following surgery, the majority of patients have minimal pain. I will ask you to clean your incisions and the inside of your nose approximately twice a day. You will be instructed to spray salt water (saline) into your nose with a spray bottle and a baby bulb syringe. Your cast and the stitches will be removed in one week (assuming that you are having an open revision rhinoplasty). For the second week, your nose will be taped. Following the second week, if needed, I will instruct you on how to tape your nose nightly to help reduce the swelling. The most important attribute that you, the patient, can possess following revision nasal surgery is PATIENCE. It may well take one year for the swelling to completely resolve. I can promise you that I will do the best job possible to improve the health of your nose and your spirit. http://www.rhinoplastyspecialist.com 120 S. Spalding Drive Suite 315 Beverly Hills, CA 90212 Tel: (310)-275-2467

avara plastic surgery center in Cairo Egypt where you can have amazing excellent surgery with very competitive price and at the same time spend your marvelous vacation in charming red sea
مركز افارا لجراحات التجميل في مصر هو مركز متخصص في جراحة التجميل بكافة فروعها تصغير المؤخرة تصغير الارداف تنسيق القوام شد المؤخرة و جراحة الثدي تكبير الثدي تكبير الصدر تجميل الثدي تجميل الصدر شد الثدي شد الصدر تصغير الثدي تصغير الصدر رفع الثدي رفع الصدر شد الترهلات شد الجسم شد البطن شد الارداف شد المؤخرة رفع المؤخرة تجميل الانف تصغير الانف زراعة الشعر شد الجفون تجميل الجفن تجميل العين شد الوجة تجميل الاذن شفط الدهون شفط الشحوم بالليزر تصغير الساق نحت الجسم ازالة الشعر بالليزر علاج الهالات السوداء تجميل الوجة تجميل البشرة تجميل الجسم بدون جراحة حقن الدهون نفخ الوجة حقن السيايكون جقن الفيليرز حقن البوتكس علاج تجاعيد الوجة تقوية الشعر تكبير الخدود تكبير الشفايف

Dr.Prof Abdelsalam AL Howni

Amyotrophic lateral sclerosis The disorder causes muscle weakness and atrophy throughout the body caused by degeneration of the upper and lower motor neurons. Unable to function, the muscles weaken and atrophy. Affected individuals may ultimately lose the ability to initiate and control all voluntary movement, although bladder and bowel sphincters and the muscles responsible for eye movement are usually, but not always, spared. Cognitive function is generally spared for most patients although some (~5%) also have frontotemporal dementia.A higher proportion of patients (~30-50%) also have more subtle cognitive changes which may go unnoticed but are revealed by detailed neuropsychological testing. Sensory nerves and the autonomic nervous system, which controls functions like sweating, are generally unaffected but may be involved for some patients. The earliest symptoms of ALS are typically obvious weakness and/or muscle atrophy. Other presenting symptoms include muscle fasciculation (twitching), cramping, or stiffness of affected muscles; muscle weakness affecting an arm or a leg; and/or slurred and nasal speech. The parts of the body affected by early symptoms of ALS depend on which motor neurons in the body are damaged first. About 75% of people contracting the disease experience "limb onset" ALS i.e. first symptoms in the arms ("upper limb", not to be confused with "upper motor neuron") or legs ("lower limb", not to be confused with "lower motor neuron"). Patients with the leg onset form may experience awkwardness when walking or running or notice that they are tripping or stumbling, often with a "dropped foot" which drags along the ground. Arm-onset patients may experience difficulty with tasks requiring manual dexterity such as buttoning a shirt, writing, or turning a key in a lock. Occasionally, the symptoms remain confined to one limb for a long period of time or for the whole course of the illness; this is known as monomelic amyotrophy. About 25% of cases are "bulbar onset" ALS. These patients first notice difficulty speaking clearly or swallowing. Speech may become slurred, nasal in character, or quieter. Other symptoms include difficulty swallowing, and loss of tongue mobility. A smaller proportion of patients experience "respiratory onset" ALS where the intercostal muscles that support breathing are affected first. Regardless of the part of the body first affected by the disease, muscle weakness and atrophy spread to other parts of the body as the disease progresses. Patients experience increasing difficulty moving, swallowing (dysphagia), and speaking or forming words (dysarthria). Symptoms of upper motor neuron involvement include tight and stiff muscles (spasticity) and exaggerated reflexes (hyperreflexia) including an overactive gag reflex. An abnormal reflex commonly called Babinski's sign (the big toe extends upward and other toes spread out) also indicates upper motor neuron damage. Symptoms of lower motor neuron degeneration include muscle weakness and atrophy, muscle cramps, and fleeting twitches of muscles that can be seen under the skin (fasciculations). Around 15–45% of patients experience pseudobulbar affect, also known as "emotional lability", which consists of uncontrollable laughter, crying or smiling, attributable to degeneration of bulbar upper motor neurons resulting in exaggeration of motor expressions of emotion.

Most intact aortic aneurysms do not produce symptoms. As they enlarge, symptoms such as abdominal pain and back pain may develop. Compression of nerve roots may cause leg pain or numbness. Untreated, aneurysms tend to become progressively larger, although the rate of enlargement is unpredictable for any individual. Rarely, clotted blood which lines most aortic aneurysms can break off and result in an embolus. They may be found on physical examination. Medical imaging is necessary to confirm the diagnosis. Symptoms may include: anxiety or feeling of stress; nausea and vomiting; clammy skin; rapid heart rate. In patients presenting with aneurysm of the arch of the aorta, a common symptom is a hoarse voice as the left recurrent laryngeal nerve (a branch of the vagus nerve) is stretched. This is due to the recurrent laryngeal nerve winding around the arch of the aorta. If an aneurysm occurs in this location, the arch of the aorta will swell, hence stretching the left recurrent laryngeal nerve. The patient therefore has a hoarse voice as the recurrent laryngeal nerve allows function and sensation in the voicebox. Abdominal aortic aneurysms, hereafter referred to as AAAs, are the most common type of aortic aneurysm. One reason for this is that elastin, the principal load-bearing protein present in the wall of the aorta, is reduced in the abdominal aorta as compared to the thoracic aorta (nearer the heart). Another is that the abdominal aorta does not possess vasa vasorum, hindering repair. Most are true aneurysms that involve all three layers (tunica intima, tunica media and tunica adventitia), and are generally asymptomatic before rupture. The most common sign for the aortic aneuysm is the Erythema nodosum also known as leg lesions typically found near the ankle area. The prevalence of AAAs increases with age, with an average age of 65–70 at the time of diagnosis. AAAs have been attributed to atherosclerosis, though other factors are involved in their formation. An AAA may remain asymptomatic indefinitely. There is a large risk of rupture once the size has reached 5 cm, though some AAAs may swell to over 15 cm in diameter before rupturing. Before rupture, an AAA may present as a large, pulsatile mass above the umbilicus. A bruit may be heard from the turbulent flow in a severe atherosclerotic aneurysm or if thrombosis occurs. Unfortunately, however, rupture is usually the first hint of AAA. Once an aneurysm has ruptured, it presents with a classic pain-hypotension-mass triad. The pain is classically reported in the abdomen, back or flank. It is usually acute, severe and constant, and may radiate through the abdomen to the back. The diagnosis of an abdominal aortic aneurysm can be confirmed at the bedside by the use of ultrasound. Rupture could be indicated by the presence of free fluid in potential abdominal spaces, such as Morison's pouch, the splenorenal space (between the spleen and left kidney), subdiaphragmatic spaces (underneath the diaphragm) and peri-vesical spaces. A contrast-enhanced abdominal CT scan is needed for confirmation. Only 10–25% of patients survive rupture due to large pre- and post-operative mortality. Annual mortality from ruptured abdominal aneurysms in the United States alone is about 15,000. Another important complication of AAA is formation of a thrombus in the aneurysm.

Toxin is a protein produced by the bacterium Clostridium botulinum, and is extremely neurotoxic.

Neurotransmitter 3D Animation
on Tuesday, December 21, 2010




Neurotransmitters are endogenous chemicals which transmit signals from a neuron to a target cell across a synapse. Neurotransmitters are packaged into synaptic vesicles clustered beneath the membrane on the presynaptic side of a synapse, and are released into the synaptic cleft, where they bind to receptors in the membrane on the postsynaptic side of the synapse. Release of neurotransmitters usually follows arrival of an action potential at the synapse, but may also follow graded electrical potentials. Low level "baseline" release also occurs without electrical stimulation. Neurotransmitters are synthesized from plentiful and simple precursors, such as amino acids, which are readily available from the diet and which require only a small number of biosynthetic steps to convert. The chemical identity of neurotransmitters is often difficult to determine experimentally. For example, it is easy using an electron microscope to recognize vesicles on the presynaptic side of a synapse, but it may not be easy to determine directly what chemical is packed into them. The difficulties led to many historical controversies over whether a given chemical was or was not clearly established as a transmitter. In an effort to give some structure to the arguments, neurochemists worked out a set of experimentally tractable rules. According to the prevailing beliefs of the 1960s, a chemical can be classified as a neurotransmitter if it meets the following conditions: * There are precursors and/or synthesis enzymes located in the presynaptic side of the synapse. * The chemical is present in the presynaptic element. * It is available in sufficient quantity in the presynaptic neuron to affect the postsynaptic neuron; * There are postsynaptic receptors and the chemical is able to bind to them. * A biochemical mechanism for inactivation is present. There are many different ways to classify neurotransmitters. Dividing them into amino acids, peptides, and monoamines is sufficient for some classification purposes. Major neurotransmitters: * Amino acids: glutamate, aspartate, D-serine, γ-aminobutyric acid (GABA), glycine * Monoamines and other biogenic amines: dopamine (DA), norepinephrine (noradrenaline; NE, NA), epinephrine (adrenaline), histamine, serotonin (SE, 5-HT), melatonin * Others: acetylcholine (ACh), adenosine, anandamide, nitric oxide, etc. In addition, over 50 neuroactive peptides have been found, and new ones are discovered regularly. Many of these are "co-released" along with a small-molecule transmitter, but in some cases a peptide is the primary transmitter at a synapse. β-endorphin is a relatively well known example of a peptide neurotransmitter; it engages in highly specific interactions with opioid receptors in the central nervous system. Single ions, such as synaptically released zinc, are also considered neurotransmitters by some[by whom?], as are some gaseous molecules such as nitric oxide (NO) and carbon monoxide (CO). These are not classical neurotransmitters by the strictest definition, however, because although they have all been shown experimentally to be released by presynaptic terminals in an activity-dependent way, they are not packaged into vesicles. By far the most prevalent transmitter is glutamate, which is excitatory at well over 90% of the synapses in the human brain. The next most prevalent is GABA, which is inhibitory at more than 90% of the synapses that do not use glutamate. Even though other transmitters are used in far fewer synapses, they may be very important functionally—the great majority of psychoactive drugs exert their effects by altering the actions of some neurotransmitter systems, often acting through transmitters other than glutamate or GABA. Addictive drugs such as cocaine and amphetamine exert their effects primarily on the dop

Describe pre-procedure considerations for administering a subcutaneous injection.

Describe and demonstrate the preparation for administering a subcutaneous injection.

Describe and demonstrate needle and blood safety.

Describe and demonstrate suitable injection sites for subcutaneous injections.

Discuss the appropriate needle and syringe sizes for subcutaneous injection.

Describe and demonstrate the preparation of the substance to be injected.

Describe and demonstrate safe and correct administration of a subcutaneous injection.

Understand and apply Occupational Safety and Health Administration (OSHA) guidelines.

Understand and apply drug administration safety guidelines (seven rights).

Understand correct post-procedure considerations.

Describe and demonstrate correct documentation.

Define and demonstrate correct recording and reporting procedures.

Define and use related medical terminology.

Explain the Patient Privacy Rule (HIPAA), Patient Safety Act, and Patients' Bill of Rights.

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A Bone scan or bone scintigraphy is a nuclear scanning test to find certain abnormalities in bone which are triggering the bone's attempts to heal. It is primarily used to help diagnose a number of conditions relating to bones, including: cancer of the bone or cancers that have spread (metastasized) to the bone, locating some sources of bone inflammation (e.g. bone pain such as lower back pain due to a fracture), the diagnosis of fractures that may not be visible in traditional X-ray images, and the detection of damage to bones due to certain infections and other problems.

Nuclear medicine bone scans are one of a number of methods of bone imaging, all of which are used to visually detect bone abnormalities. Such imaging studies include magnetic resonance imaging (MRI), X-ray computed tomography (CT) and in the case of 'bone scans' nuclear medicine. However, a nuclear bone scan is a functional test, which means it measures an aspect of bone metabolism, which most other imaging techniques cannot. The nuclear bone scan competes with the FDG-PET scan in seeing abnormal metabolism in bones, but it is considerably less expensive.

Nuclear bone scans are not to be confused with the completely different test often termed a "bone density scan," DEXA or DXA, which is a low exposure X-ray test measuring bone density to look for osteoporosis and other diseases where bones lose mass, without any bone re-building activity. The nuclear medicine scan technique is sensitive to areas of unusual bone re-building activity because the radiopharmaceutical is taken up by osteoblast cells which build bone. The technique therefore is sensitive to fractures and bone reaction to infections and bone tumors, including tumor metastases to bones, because all these pathologies trigger bone osteoblast activity. The bone scan is not sensitive to osteoporosis or multiple myeloma in bones, and therefore other techniques must be used to assess bone abnormalities from these diseases.

A breech birth is the birth of a baby from a breech presentation. In the breech presentation the baby enters the birth canal with the buttocks or feet first as opposed to the normal head first presentation.

There are either three or four main categories of breech births, depending upon the source:

* Frank breech - the baby's bottom comes first, and his or her legs are flexed at the hip and extended at the knees (with feet near the ears). 65-70% of breech babies are in the frank breech position.

* Complete breech - the baby's hips and knees are flexed so that the baby is sitting crosslegged, with feet beside the bottom.

* Footling breech - one or both feet come first, with the bottom at a higher position. This is rare at term but relatively common with premature fetuses.

* Kneeling breech - the baby is in a kneeling position, with one or both legs extended at the hips and flexed at the knees. This is extremely rare, and is excluded from many classifications.

As in labour with a baby in a normal head-down position, uterine contractions typically occur at regular intervals and gradually cause the cervix to become thinner and to open. In the more common breech presentations, the baby’s bottom (rather than feet or knees) is what is first to descend through the maternal pelvis and emerge from the vagina.

At the beginning of labour, the baby is generally in an oblique position, facing either the right or left side of the mother's back. As the baby's bottom is the same size in the term baby as the baby's head. Descent is thus as for the presenting fetal head and delay in descent is a cardinal sign of possible problems with the delivery of the head.

In order to begin the birth, internal rotation needs to occur. This happens when the mother's pelvic floor muscles cause the baby to turn so that it can be born with one hip directly in front of the other. At this point the baby is facing one of the mother's inner thighs. Then, the shoulders follow the same path as the hips did. At this time the baby usually turns to face the mother's back. Next occurs external rotation, which is when the shoulders emerge as the baby’s head enters the maternal pelvis. The combination of maternal muscle tone and uterine contractions cause the baby’s head to flex, chin to chest. Then the back of the baby's head emerges and finally the face.

Due to the increased pressure during labour and birth, it is normal for the baby's leading hip to be bruised and genitalia to be swollen. Babies who assumed the frank breech position in utero may continue to hold their legs in this position for some days after birth.

Breast reconstruction 3D Animation
on Friday, December 17, 2010




The primary part of the procedure can often be carried out immediately following the mastectomy. As with many other surgeries, patients with significant medical comorbidities (high blood pressure, obesity, diabetes) and smokers are higher-risk candidates. Surgeons may choose to perform delayed reconstruction to decrease this risk. Patients expected to receive external beam radiation as part of their adjuvant treatment are also commonly considered for delayed autologous reconstruction due to significantly higher complication rates with tissue expander-implant techniques in those patients. Breast reconstruction is a large undertaking that usually takes multiple operations. Sometimes these follow-up surgeries are spread out over weeks or months. If an implant is used, the individual runs the same risks and complications as those who use them for breast augmentation but has higher rates of capsular contracture (tightening or hardening of the scar tissue around the implant) and revisional surgeries. Outcomes based research on quality of life improvements and psychosocial benefits associated with breast reconstruction served as the stimulus in the United States for the 1998 Women's Health and Cancer Rights Act which mandated health care payer coverage for breast and nipple reconstruction, contralateral procedures to achieve symmetry, and treatment for the sequelae of mastectomy. This was followed in 2001 by additional legislation imposing penalties on noncompliant insurers. Similar provisions for coverage exist in most countries worldwide through national health care programs. There are many methods for breast reconstruction. The two most common are: * Tissue Expander - Breast implants This is the most common technique used in worldwide. The surgeon inserts a tissue expander, a temporary silastic implant, beneath a pocket under the pectoralis major muscle of the chest wall. The pectoral muscles may be released along its inferior edge to allow a larger, more supple pocket for the expander at the expense of thinner lower pole soft tissue coverage. The use of acellular human or animal dermal grafts have been described as an onlay patch to increase coverage of the implant when the pectoral muscle is released, which purports to improve both functional and aesthtic outcomes of implant-expander breast reconstruction. o In a process that can take weeks or months, saline solution is percutaneously injected to progressively expand the overlaying tissue. Once the expander has reached an acceptable size, it may be removed and replaced with a more permanent implant. Reconstruction of the areola and nipple are usually performed in a separate operation after the skin has stretched to its final size. * Flap reconstruction The second most common procedure uses tissue from other parts of the patient's body, such as the back, buttocks, thigh or abdomen. This procedure may be performed by leaving the donor tissue connected to the original site to retain its blood supply (the vessels are tunnelled beneath the skin surface to the new site) or it may be cut off and new blood supply may be connected. o The latissimus dorsi muscle flap is the donor tissue available on the back. It is a large flat muscle which can be employed without significant loss of function. It can be moved into the breast defect still attached to its blood supply under the arm pit (axilla). A latissimus flap is usually used to recruit soft-tissue coverage over an underlying implant. Enough volume can be recruited occasionally to reconstruct small breasts without an implant. o Abdominal flaps The abdominal flap for breast reconstruction is the TRAM flap or its technically distinct variants of microvascular "perforator flaps" like the DIEP/SIEP flaps. Both use the abdominal tissue between the umbilicus and the

Visit http://www.nasalcleanse.com/index.php after watching our video on NasalCare nasal irrigation versus sinus sprays for sinusitis & sinus congestion relief. Learn how & why this natural sinus remedy really works! Unlike the temporary relief offered by chemical-laden nasal sprays, our patented NasalCare® Nasal Rinse System ensures comfortable and effective delivery throughout the nasal passages, preventing sinus infection, allergy and post nasal drip. A soothing mix of sea salt and Aloe Vera extract washes away nasal irritants and the common causes of colds and flu without the potential addiction that comes with nasal spray use. NasalCare also acts as a sinus wash for allergy treatment. Used for centuries in the Orient as a preventative measure for all sinus conditions, nasal irrigation is just catching on here. Catch us now and stop catching colds and the flu – the natural way! Order online at: http://www.nasalcleanse.com/index.php.