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Breast reduction can relieve strain from shoulder straps, neck, back, and upper arms.
It can provide an uplift to help clothes fit and look better. Traditionally, insurance companies would provide benefits for a broad range of breast sizes and gram weight of tissue to be removed from each breast. At present most insurance companies limit authorization when the doctor plans to remove less than 500gm weight per breast. Since many patients present with symptoms in a D cup to DD cup, often, the very removal of over 500 grams weight may reduce the breasts too much. This amount of reduction may not be in harmony with body shape. Newer methods of breast assembly after reduction, will tighten things using internal brassiere techniques that also compact and reduce breast volume. Therefore, a gram weight reduction of 500gms in some patients combined with internal tightening efforts, could pose an over-reduction. With the unreliability of insurance support in some cases, it is best not to look solely at gram weight in the surgical planning of breast reduction. When excess skin and weight is removed, the improved location of the breasts on the chest will give marked relief of symptoms.
Surgery takes from 2 to 5 hours and can be done as an outpatient or with a brief overnight stay. When possible, no scarring other than around the areola can be planned which follows the Brazilian and French methods (Goes and Benelli). For very large reductions, a vertical method, or T pattern approach is offered. Recovery is a few days, with special care to avoid strain for 4 to 6 weeks. Some soreness may persist for a few weeks. The breasts can appear tight, swollen, and bruised at first, but will usually settle to their near final look by 6 weeks. There may be sutures to be removed in some cases. Costs relate to the severity of the sag, and weight of the breasts.
The operation can make a stunning change in body image, relief of upper body symptoms, and offer a cosmetic lift to naturally sloping breasts.
plantar fasciitis and calcaneal spur can be treated by EPFR with calcanean drilling - endoscopic plantar fascia release علاج الشوكة العظمية للكعب بالمنظار د. أسامة الشاذلي مدرس جراحة العظام واستشاري جراحات و مناظير القدم والكاحل كلية الطب جامعة عين شمس
Kendall Lee, M.D., describes deep brain stimulation surgery, and how it is is typically done with patients who remain awake, so neurological functions can be measured and maintained. For more information on deep brain stimulation, visit http://mayocl.in/2A09T80.
The pelvic floor or pelvic diaphragm is composed of muscle fibers of the levator ani, the coccygeus, and associated connective tissue which span the area underneath the pelvis. The pelvic diaphragm is a muscular partition formed by the levatores ani and coccygei, with which may be included the parietal pelvic fascia on their upper and lower aspects. The pelvic floor separates the pelvic cavity above from the perineal region (including perineum) below.
The right and left levator ani lie almost horizontally in the floor of the pelvis, separated by a narrow gap that transmits the urethra, vagina, and anal canal. The levator ani is usually considered in three parts: pubococcygeus, puborectalis, and iliococcygeus. The pubococcygeus, the main part of the levator, runs backward from the body of the pubis toward the coccyx and may be damaged during parturition. Some fibers are inserted into the prostate, urethra, and vagina. The right and left puborectalis unite behind the anorectal junction to form a muscular sling . Some regard them as a part of the sphincter ani externus. The iliococcygeus, the most posterior part of the levator ani, is often poorly developed.
The coccygeus, situated behind the levator ani and frequently tendinous as much as muscular, extends from the ischial spine to the lateral margin of the sacrum and coccyx.
The pelvic cavity of the true pelvis has the pelvic floor as its inferior border (and the pelvic brim as its superior border.) The perineum has the pelvic floor as its superior border.
Some sources do not consider “pelvic floor” and “pelvic diaphragm” to be identical, with the “diaphragm” consisting of only the levator ani and coccygeus, while the “floor” also includes the perineal membrane and deep perineal pouch. However, other sources include the fascia as part of the diaphragm. In practice, the two terms are often used interchangeably.
Inferiorly, the pelvic floor extends into the anal triangle.
Microcalcifications in the breast can be the first sign of cancer. They are, as the name says, very small and clustered. A precise biopsy without pain under stereotactic guidance is the standard procedure. What makes this Spirotome different from the vacuum assisted biopsies is that only a few biopsies are needed and that the approach of the needle towards the microcalcifications is direct and frontal. There is no damage to the surrounding tissues making this procedure rather painfree and with minimal bleeding.