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METHODS:
Previously existing methods are characterized by unpleasant scars that, despite surgeons promises, remain for life.
Incisions are:
- around the areola (Round block) leading to a flat areola, often unpleasant hypertophic skars, skin rippling.
- inverted T (around the areola, vertically down and in the fold under the breast).
- Vertical (around the areola and vertically down). Due to the extess skin, incisions often turn into inverted L or T. Rearrangement of glandular tissue and skin changes the shape of the breasts and may be different from expectations. Scars worry patients and sometimes cause disturbances in the relationship with their partner.
- No scars. The "Serdev Suture" lifting technique for breast lifting without scars (only points - needle perforations in the skin) is created by the Bulgarian cosmetic surgeon Prof. Dr. Nikolay Serdev. It is a novelty that had changed the cosmetic surgery world in the last 10-14 years for young patients. The technique is especially important in Asia and Latin America, for Asians, African-Americans, Indians, and others who form keloids and lumpy scars after operations.
The Serdev suture method can achieve lift upto and over 14 centimeters and is most suitable for the following types of breasts:
- not very heavy full breasts.
- in the presence of subpectoral implants with subsequent drooping of the breasts after childbirth and lactation.
- empty and loose breasts after childbirth and breastfeeding. In such cases this technique is combined with subpectoral implants. In sagging breasts implants should not be placed in the skin over the pectoral muscles, because thus will lead to even more drooping. Therefore, breast lift requires breast fixation to the level of the pectoral muscle (the normal position in young women), and then placement of appropriate implants under the muscle, to hold them in the appropriated position.
- in drooping breasts after subglandular augmentation (over the muscle). In such cases, patients should not wait until the skin elongation becomes visible. The implants should be removed, the capsule removed - a difficult but a necessary operation, preventing postop seromas and infection. Implants should be placed under the pectoralis muscle to wear them. Patients should orient the cosmetic surgeon at what level they want the nipples - in the middle of the implant, higher or lower.
Implants should be generally replaced - below the muscle implants should be smooth, move naturally without hurting the muscle.
Because of modern anesthetics and new methods without trauma, pain and swelling after surgery are not significant. In 3-4 days, patients can return to social life, even the next day, but it is preferable to rest for 2-3 days.
Exercises with the arms and weight lifting is prohibited for a month and a half.
Due to lack of scars, the breast lift using the Serdev sutures can be repeated to maintain the aesthetic appearence of the breasts even in advanced age.
Gigantomastia i.e. very large, very heavy and drooping breasts can not be operated in this manner, because of gravity and overskin.
Early mastopexy using Serdev sutures is recommended before too much changes in the tissues. If late, more and more complex interventions are required.
"A lot of people are opting for various breast procedures and one of the most common among them is “mastopexy”. This is the surgery that involved uplifting of sagging breasts and, in certain cases, repositioning of the nipple and areola in order to restore normality and beauty. The excess skin is removed and firmness is provided to the breasts. Though mastopexy can be done as a stand alone surgery, many people combine it with breast augmentation which involves inserting implants inside the b
Endotracheal intubation is a medical procedure in which a tube is placed into the windpipe (trachea) through the mouth or nose. In most emergency situations it is placed through the mouth. Whether you are awake (conscious) or not awake (unconscious), you will be given medicine to make it easier to insert the tube. After endotracheal intubation, you will likely be placed on a breathing machine. If you are awake after the procedure, your health care provider may give you medicine to reduce your anxiety or discomfort.
Tension pneumothorax develops when a lung or chest wall injury is such that it allows air into the pleural space but not out of it (a one-way valve). As a result, air accumulates and compresses the lung, eventually shifting the mediastinum, compressing the contralateral lung, and increasing intrathoracic pressure enough to decrease venous return to the heart, causing shock. These effects can develop rapidly, particularly in patients undergoing positive pressure ventilation.
Neck Examination - Cervical Spine Assessment - Clinical Skills - Dr Gill
Compose a new pain within athletes is cervical spine discomfort, thankfully in the vast majority of cases when the neck is examined the cause of the neck pain is found to be muscular.
However, pain can also refer from the neck to the arm, in which case it is important to be able to assess for cervical radiculopathy prior to gaining more information which may indicate an MRI is needed
We assess for radiculopathy by doing Spurling's test, an often overlooked part of the neck examination, but it should be included for completeness and reassurance of the patient - not forgetting the athlete or not, neck pain can be a considerable source of distress, so it's vital to be able to get information from the neck examination which allows you to safely reassure a patient when appropriate, or comment that neck exam found evidence that needs further investigation
#DRGill #neck #asmr
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Although techniques of vascular anastomosis after trauma are numerous in type and form, most surgeons will default to the one associated with the greatest comfort and ease. This report offers a rapid and reliable repair using a conceptually and operationally simple technique. Its methodology is appropriate for all repairs, including cases mandating the insertion of vascular conduit. We have employed this technique for the past 15 years in nearly all patients with vascular injuries, regardless of the site and size of the vessel. This has included vessels of the neck, torso, upper and lower extremities. There have been no obvious complications associated with its use. Major advantages include: 1) the operating system is always oriented towards the surgeon, 2) the posterior row of sutures is placed as both ends are readily visualized, avoiding the need for potentially obscuring traction stitches, and 3) flushing is easily performed prior to completing the anterior suture row.