Botox® is the trade name of Botulinum Toxin Type A, a potent muscular paralyzing agent.

Nowadays it is used with increasing frequency and therefore it is the object of much attention from the press. However, many doubts still persist among lay people, such as: How does it work? What is it used for? Will I lose my facial expression? How long does the effect last? Does it have contraindications?

This short text will try to answer these questions.

Botulinum toxin prevents the transmission of the electrical impulse from the nerves to the muscles (by blocking the release of acetylcholine). Thus, the muscles are paralyzed. The use of Botox® is esthetic therapies derives from the fact that the so-called dynamic facial wrinkles (crow's feet, wrinkles on the forehead or between eyebrows) are due to muscular contraction. Therefore, if the muscles producing such wrinkles are paralyzed, there will be no more wrinkles! It is exactly on these specific muscles that the plastic surgeon applies Botox®, injecting it with a very thin needle.
The procedure is fast (five minutes) and not very painful. Muscle paralysis occurs after 48 hours, remains for six months on average, and does not leave the patient without facial expression.

The return of muscular activity, therefore of wrinkles, occurs due to reinervation of the muscle. When this happens, a new application may be done.

Among the few contraindications are neurological disorders, hypersensitivity to the product, pregnancy and the use of some specific antibiotics.

Due to its fast application, marked effect on dynamic wrinkles and almost immediate results, Botox® became the top hit in today's facial esthetic management.

After marked weight loss or alternating periods of weight gain and loss, very often there is a flaccid bulging on the internal region of the thighs. This is due to the excess skin which forms as a consequence of stretching during the overweight period. As the skin on the internal region of the thigh is relatively thin, it does not retract sufficiently after weight loss, leading to the localized excess skin. Thigh dermolipectomy aims at removing this excess skin, providing a more natural e less flaccid thigh silhouette.

Type of anesthesia:
Anesthesia may be peridural or general.

Length of hospital stay:
Usually between 24 and 48 hours, depending on the speed of recovery and on the doctor's orientation.

Postoperative:
Patients should avoid excessive movement, especially opening the legs apart, since the scar is close to the groin and will be subject to tension if such happens. The natural traction exerted on the scar by walking and by gravity usually leads the scar to some widening over the first months. The lower the tension on the scar, the less it will spread.

Complications: Among the possible, although infrequent, complications, we should mention: hematoma, seroma, infection, necrosis (skin injury), dehiscence (opening of the surgical wound), cheloid, thrombosis, embolism.
Since these complications are more often found in smoking subjects, patients should refrain from smoking during the 30 days before surgery, in order to minimize risks. If the patient makes use of oral or injectable contraceptives, these should be discontinued one month before surgery, and another contraceptive method being used during this period.

Definitive result:
The definitive result of a dermolipectomy is reached 6 months after the surgery, this period being necessary for the accommodation of the tissues and for the maturation of the scar.

Cyberknife, which is available only in a limited number of centers worldwide, is AT YOUR SERVICE only in Anadolu Medical Center in Turkey.

Cyberknife, which is used for the radiotherapy of many types of cancer, removes the tumor precisely as a surgical method while preventing harmful effects of radiation on normal intact tissues. Patients can return to their work soon after the procedures performed with Cyberknife technology, which is the most sophisticated method of radiosurgery. Cyberknife confers additional benefits too!

From 2002 on Cyberknife has been used successfully in thousands of patients in the most respectable cancer institutes mainly in the US and Japan. Many patients from our country have been referred to Stanford University Cyberknife Center, which is accepted as one of the best healthcare centers in the world. Cyberknife is now available in 70 healthcare centers in the world including Anadolu Medical Center in Turkey. Cyberknife, which was approved by FDA for usage in any part of the body, is the latest technology used for the radiotherapy of cancer. It is the most advanced method of radiotherapy, which minimizes exposure of intact peritumoral tissue to radiation Cyberknife is defined as painless non-operative treatment approach. Tumor or affected areas are targeted precisely, and killed with higher radiation doses.

What is Cyberknife ?
Cyberknife is the latest technology used for the radiotherapy of every type of cancer. It works with 6 MV Linac mounted on a robotic arm.
It is the most advanced radiotherapeutic method minimizing exposure of normal intact peritumoral tissues to irradiation.

With a robotic arm that can be rotated, and stopped at every position, focussed radiation beams can be delivered to the patient.
Any body region can be easily irradiated with a robotic arm. This characteristics offers opportunity of treatment to many patients incurable with other radiotherapy equipments.

Cyberknife is defined as a painless, non-operative treatment modality. With Cyberknife, tumor or affected areas in the body are targeted precisely, and destroyed with higher radiation doses.

For which body parts it is used?
Cyberknife is an effective method for brain tumors. Cyberknife may offer an alternative for inoperable patients. After contouring of tumor seen in computerized tomography, CyberKnife system irradiates and destroys tumor meticulously like a surgeon with the help of a robot in a session lasting nearly an hour.

It has a potential widespread usage in many types of tumors. It can irradiate organs having higher incidence of cancer such as brain, brainstem, spinal cord, throat, lungs, liver, pancreas, kidney, adrenals and prostate without any side-effect. This superior technology allows patients return to their homes, or even drive home soon after the therapy.

The probability of treatment errors drops to negligible levels!
Cyberknife is used for cancer radiotherapy. The equipment has a robotic arm that works with an integrated 6 MV Linac, rotates in every direction, and stops at every position. It delivers precisely directed radiation beams to the tumor area within the patient. Thus, any body region can be easily irradiated using this robotic arm. This feature offers a chance of treatment for patients, considered as untreatable with other types of radiotherapy equipments.

Besides, during treatment with Cyberknife, 100% real-time images can be obtained, and these images guide the radiation procedure. Organs, with the exception of brain, can sometimes move. This feature prevents desired dose distribution. With the guidance of the markers placed inside tumor / on the skin surface and Synchrony software program, mobile organs are monitorized continuously during therapy session with Cyberknife, and the organ is irradiated when it is in the desired position. Perfect homogeneity and distribution of doses are obtained with non-isocentric and non-coplanar single or multiple fractionated radiation doses, and radiotherapy can be achieved with minimal deviation (<1 style="font-weight: bold;">

Painless and without adverse effects
It is possible to protect normal tissues from harmful effects of radiation using robotic orientation system with a accuracy rate less than 1 mm. In other words, it removes the tumor precisely as a surgical method while preventing harmful effects of radiation on normal intact tissues. Robot-assisted operations do not carry any adverse effect or risk of traditional surgery, in that it is a bloodless and painless intervention performed without anesthesia. Therefore, it is also known as a radiosurgical equipment. Owing to the monitoring system of organs moving up and down with respiration, it is at least as effective as surgery for the treatment of many types of cancer and their metastases.
Cyberknife in clinical applications.

AVM (Arteriovenous Malformations)
AVM is a vascular disease in brain and spinal cord. It carries a 3-4% risk of bleeding. Besides, it can cause epileptic seizures, pain and neurologic deficits. They can be treated with embolization or other surgical methods. However, these procedures are risky and invasive interventions. Although its effects are seen later than other methods, radiosurgery is a safe treatment modality.

In other methods, a metal frame must be placed around skull to localize and stabilize the target. This apparatus must stay around patient's head for nearly 3-6 hours. However, during treatment with Cyberknife, a metal frame causing pain is avoided. Besides, AVMs in spinal cord of near skull base can not be treated with other radiosurgical methods. However, with Cyberknife, any lesion within the body can be treated easily and precisely.

Brain Tumors
In a majority of tumors arising from brain tissue, Cyberknife treatment is applied as a monotherapy or post-operatively.

In benign tumors of brain, Cyberknife reduces and destroys tumor or stops its growth and allows non-operative management of the patients.
In malign tumors of brain, pre-, and post-operative applications aid in recovery of patients. The greatest advantage of Cyberknife is the avoidance of metal skull frame apart from other radiosurgical methods, and completion of therapy usually within 1-5 sessions instead of 30-40 sessions.

Brain metastases
Cancer cells transport in blood circulation to other organs, settle there and continually damage the tissue. They mostly settle inside brain. In 20-40% of cancer patients, brain metastases are observed. Up to 75% of them metastasize to more than one foci. They can lead to epileptic seizures, headache and neurologic deficits.

For the treatment of brain metastases, surgical treatments, whole-brain radiotherapy, and some chemotherapeutic agents have been used. Studies performed have shown that radiosurgery is as effective as surgical treatment. With this modality, patients are freed from a heavy burden as brain surgery. However, as in many radiosurgical methods, for the treatment of AVMs a metal frame must be fixed to the skull to determine the target to be radiated, to plan and apply the treatment. This apparatus must stay on patient's head for nearly 3-6 hours. However, during treatment with Cyberknife, a metal frame causing pain is avoided. In addition, patients will not feel pain since a metal frame is not fixed for planning and application of Cyberknife therapy. Besides, with other radiosurgical methods, only one fraction of radiotherapy is applied, while with Cyberknife, radiosurgical therapy can be instituted in 1-5 fractions.
In addition, with similar reasons, Cyberknife maintains its superiority for glial tumors, acoustic neurinomas and trigeminal neuralgias.

Liver cancers
For primary cancers of liver (hepatocellular carcinoma) and intrahepatic biliary tract, surgical treatment is preferred. Especially patients with small tumors can survive longer after surgery. However, only 30% of the patients are operable. The remaining 70% can not use their chance of surgery, and they do not survive longer despite many systemic treatments. Similarly, in metastatic diseases of liver, surgical approaches are less suitable, and chemotherapy is not sufficiently effective. Conventional radiotherapy can not be applied for these patient groups or only very limited doses can be given to a small number of patients because of mobility of liver and damage incurred on intact liver tissue. Even these doses could not demonstrate the desired effect. Although, with radiosurgery, intact tissues can be protected maximally, technically it can not be performed for tumors outside skull, and a planning can not be done for movable organs. However, with Cyberknife, radiosurgery of mobile organs can be performed with a minimal intervention. Intact tissues can be protected maximally, while higher doses can be applied to cancerous tissues when compared with conventional methods. For inoperable primary or metastatic hepatic cancers, with effective doses of radiosurgery, patients can survive longer.

Lung Cancers
Cancers arising from the lung tissue or those metastasize to the lungs are fatal because of damage incurred on the lungs. Coughing, dyspnea, bleeding, pain, rapid weight loss are usually the most commonly seen symptoms. For the treatment of primary lung cancer, surgical therapy plays an important role. In early stages, with surgical treatment, patients can survive longer. In late stages, radiotherapy and chemotherapy are used. Despite all of these treatment modalities, mostly the disease can not be controlled and the tumor can continue to grow. For these cases, reoperation and / or radiotherapy with conventional methods can not be instituted. Even applicable, the chance of increasing doses to desired levels are very low. For that reason, effective results can not be obtained. However, with Cyberknife, intact tissues are protected maximally, and tumor tissues can be exposed to higher doses that can not be delivered with other conventional methods. In primary lung cancers not amenable to surgical treatments and radiotherapy, effective doses of radiosurgery can control the disease and the patients can survive longer.

In studies performed recently, evidence suggested that the treatment of metastases ( with surgery and / or radiotherapy) provides a better and a longer life span. In these cases, where surgery is inadequate, Cyberknife is preferred as an effective treatment modalities. Sometimes Cyberknife saves patients from serious operations.

Pancreatic Cancer
Every year in the USA, 30,000 individuals are diagnosed as pancreatic cancers, and 30,000 patients are dying from pancreatic cancer. As can be understood from these statements, mortality from pancreatic cancer is relatively higher. They can lead to complaints as jaundice, pain, weakness and indigestion. Surgical treatment is the basic therapy. However, surgery can only be applied only during early stages. Since findings other than jaundice are not specific to the disease, it can not be detected during early stages. In patients who lost their chance of operability, chemotherapy or radiotherapy alone can not provide desired outcomes. Although better outcomes have been achieved with concomitant use of chemotherapy and radiotherapy, the desired levels have not been achieved. Radiotherapy can not be applied with satisfactorily higher levels on small intestines, liver, kidney and spinal cord. Cyberknife will reach the doses not attainable with classical radiotherapy, and offers an opportunity to accomplish outcomes nearly similar to surgery.

Prostate Carcinomas
Studies aiming at achieving definitive treatment outcomes with single sessions of Cyberknife similar to those obtained with classical radiotherapy have reached its last phase. Cyberknife application in prostate cancers has been started in AMC simultaneously with renown international centers.

Cyberknife Available in five centers in Europe, and exclusively in Anadolu Health Center in Turkey, Cyberknife

Advantages of Cyberknife

• Owing to its ability to follow body movements, Cyberknife can be utilized, besides brain tumors, for the treatment of spinal and spinal cord tumors, or tumors in other parts of the body, such as lung, liver, pancreas, and prostate.
• The robotic arm of Cyberknife tolerates patient position modifications, and can be adjusted during therapy.
• It is a painless, non-operative procedure and it does not require anesthesia. Therefore, it allows for outpatient therapy.
• The patients head does not need to be fixated in a metal frame as in other radiosurgery methods.
• There is no convalescence period involved.
• The therapeutic target is reached with a sensitivity of 0.1 millimeter. Thus, minimal radiation is conveyed to surrounding tissues, compared with other radiotherapy methods.
• The treatment target handled with the aid of advanced imaging guidance can be monitored via real-time images.
• It is the only device in the world that can treat medulla spinalis and spine tumors which have a high incidence.
  

For which body parts it is used?
Cyberknife is an effective method for brain tumors. Cyberknife may offer an alternative for inoperable patients. After contouring of tumor seen in computerized tomography, CyberKnife system irradiates and destroys tumor meticulously like a surgeon with the help of a robot in a session lasting nearly an hour.
It has a potential widespread usage in many types of tumors. It can irradiate organs having higher incidence of cancer such as brain, brainstem, spinal cord, throat, lungs, liver, pancreas, kidney, adrenals and prostate without any side-effect. This superior technology allows patients return to their homes, or even drive home soon after the therapy.

The probability of treatment errors drops to negligible levels
Cyberknife is used for cancer radiotherapy. Robotic arm is working with an integrated 6 MV Linac. The equipment has a robotic arm which rotates every direction, and stops at every position. It delivers precisely directed radiation beams to the tumor area within the patient. Thus, any body region can be easily irradiated using this robotic arm. This feature offers a chance of treatment for patients, considered as untreatable with other types of radiotherapy equipments.

Besides, during treatment with Cyberknife, 100% real-time images can be obtained, and these images guide the radiation procedure. Organs, with the exception of brain, can sometimes move. This feature prevents desired dose distribution. With the guidance of the markers placed inside tumor / on the skin surface and Synchrony software program, mobile organs are monitorized continuously during therapy session with Cyberknife, and the organ is irradiated when it is in the desired position. Perfect homogeneity and distribution of doses are obtained with non-isocentric and non-coplanar single or multiple fractionated radiation doses, and radiotherapy can be achieved with minimal deviation (<1>

Painless and without adverse effects
It is possible to protect normal tissues from harmful effects of radiation using robotic orientation system with a accuracy rate less than 1 mm. In other words, it removes the tumor precisely as a surgical method while preventing harmful effects of radiation on normal intact tissues. Robot-assisted operations do not carry any adverse effect or risk of traditional surgery, in that it is a bloodless and painless intervention performed without anesthesia. Therefore, it is also known as a radiosurgical equipment. Owing to the monitoring system of organs moving up and down with respiration, it is at least as effective as surgery for the treatment of many types of cancer and their metastases.

Cyberknife in clinical applications.

AVM (Arteriovenous Malformations)
AVM is a vascular disease in brain and spinal cord. It carries a 3-4% risk of bleeding. Besides, it can cause epileptic seizures, pain and neurologic deficits. They can be treated with embolization or other surgical methods. However, these procedures are risky and invasive interventions. Although its effects are seen later than other methods, radiosurgery is a safe treatment modality.

In other methods, a metal frame must be placed around skull to localize and stabilize the target. This apparatus must stay around patient's head for nearly 3-6 hours. However, during treatment with Cyberknife, a metal frame causing pain is avoided. Besides, AVMs in spinal cord of near skull base can not be treated with other radiosurgical methods. However, with Cyberknife, any lesion within the body can be treated easily and precisely.

Brain Tumors
In a majority of tumors arising from brain tissue, Cyberknife treatment is applied as a monotherapy or post-operatively.
In benign tumors of brain, Cyberknife reduces and destroys tumor or stops its growth and allows non-operative management of the patients.
In malign tumors of brain, pre-, and post-operative applications aid in recovery of patients. The greatest advantage of Cyberknife is the avoidance of metal skull frame apart from other radiosurgical methods, and completion of therapy usually within 1-5 sessions instead of 30-40 sessions.

Brain metastases
Cancer cells transport in blood circulation to other organs, settle there and continually damage the tissue. They mostly settle inside brain. In 20-40% of cancer patients, brain metastases are observed. Up to 75% of them metastasize to more than one foci. They can lead to epileptic seizures, headache and neurologic deficits.

For the treatment of brain metastases, surgical treatments, whole-brain radiotherapy, and some chemotherapeutic agents have been used. Studies performed have shown that radiosurgery is as effective as surgical treatment. With this modality, patients are freed from a heavy burden as brain surgery. However, as in many radiosurgical methods, for the treatment of AVMs a metal frame must be fixed to the skull to determine the target to be radiated, to plan and apply the treatment. This apparatus must stay on patient's head for nearly 3-6 hours. However, during treatment with Cyberknife, a metal frame causing pain is avoided. In addition, patients will not feel pain since a metal frame is not fixed for planning and application of Cyberknife therapy. Besides, with other radiosurgical methods, only one fraction of radiotherapy is applied, while with Cyberknife, radiosurgical therapy can be instituted in 1-5 fractions.
In addition, with similar reasons, Cyberknife maintains its superiority for glial tumors, acoustic neurinomas and trigeminal neuralgias.

Spinal Tumors:
The CyberKnife has the potential to treat most types of spinal tumors. Both benign (non-cancerous) and malignant (cancerous or capable of spreading to other sites in the body) spinal tumors can be treated with the CyberKnife. While some types of lesions develop within the substance of the spinal cord itself, these tumors more commonly develop in and around the vertebral column and disrupt neurologic function by compressing the spinal cord. The following lists detail the tumor pathologies that most commonly affect the spine and which can often be treated with the CyberKnife depending on clinical circumstances:

Benign Lesions:

• meningioma
• schwannoma
• neurofibroma
• hemangioblastoma
• arteriovenous malformations
• chondrosarcoma
• chordoma
• ependymoma
• other: giant cell tumor, aneurysmal bone cyst, epidermoid

Malignant Tumors:

• spinal metastases from many sources
• myeloma
• lymphoma
• Ewing sarcoma

Liver cancers
For primary cancers of liver (hepatocellular carcinoma) and intrahepatic biliary tract, surgical treatment is preferred. Especially patients with small tumors can survive longer after surgery. However, only 30% of the patients are operable. The remaining 70% can not use their chance of surgery, and they do not survive longer despite many systemic treatments. Similarly, in metastatic diseases of liver, surgical approaches are less suitable, and chemotherapy is not sufficiently effective. Conventional radiotherapy can not be applied for these patient groups or only very limited doses can be given to a small number of patients because of mobility of liver and damage incurred on intact liver tissue. Even these doses could not demonstrate the desired effect. Although, with radiosurgery, intact tissues can be protected maximally, technically it can not be performed for tumors outside skull, and a planning can not be done for movable organs. However, with Cyberknife, radiosurgery of mobile organs can be performed with a minimal intervention. Intact tissues can be protected maximally, while higher doses can be applied to cancerous tissues when compared with conventional methods. For inoperable primary or metastatic hepatic cancers, with effective doses of radiosurgery, patients can survive longer.

Lung Cancers
Cancers arising from the lung tissue or those metastasize to the lungs are fatal because of damage incurred on the lungs. Coughing, dyspnea, bleeding, pain, rapid weight loss are usually the most commonly seen symptoms. For the treatment of primary lung cancer, surgical therapy plays an important role. In early stages, with surgical treatment, patients can survive longer. In late stages, radiotherapy and chemotherapy are used. Despite all of these treatment modalities, mostly the disease can not be controlled and the tumor can continue to grow. For these cases, reoperation and / or radiotherapy with conventional methods can not be instituted. Even applicable, the chance of increasing doses to desired levels are very low. For that reason, effective results can not be obtained. However, with Cyberknife, intact tissues are protected maximally, and tumor tissues can be exposed to higher doses that can not be delivered with other conventional methods. In primary lung cancers not amenable to surgical treatments and radiotherapy, effective doses of radiosurgery can control the disease and the patients can survive longer.
In studies performed recently, evidence suggested that the treatment of metastases ( with surgery and / or radiotherapy) provides a better and a longer life span. In these cases, where surgery is inadequate, Cyberknife is preferred as an effective treatment modalities. Sometimes Cyberknife saves patients from serious operations.

Pancreatic Cancer
Every year in the USA, 30,000 individuals are diagnosed as pancreatic cancers, and 30,000 patients are dying from pancreatic cancer. As can be understood from these statements, mortality from pancreatic cancer is relatively higher. They can lead to complaints as jaundice, pain, weakness and indigestion. Surgical treatment is the basic therapy. However, surgery can only be applied only during early stages. Since findings other than jaundice are not specific to the disease, it can not be detected during early stages. In patients who lost their chance of operability, chemotherapy or radiotherapy alone can not provide desired outcomes. Although better outcomes have been achieved with concomitant use of chemotherapy and radiotherapy, the desired levels have not been achieved. Radiotherapy can not be applied with satisfactorily higher levels on small intestines, liver, kidney and spinal cord. Cyberknife will reach the doses not attainable with classical radiotherapy, and offers an opportunity to accomplish outcomes nearly similar to surgery.

Prostate Carcinomas
Studies aiming at achieving definitive treatment outcomes with single sessions of Cyberknife similar to those obtained with classical radiotherapy have reached its last phase. Cyberknife application in prostate cancers has been started in ASM simultaneously with renown international centers.

Breast lift (mastopexy) is usually performed for drooping breasts, which may occur after a woman has had children. Mammograms (breast X-rays) and a routine breast exam are required before surgery.

Breast-revision surgery is performed while you are deep asleep and pain-free (using general anesthesia), in either an outpatient facility or in the hospital. Incisions are made along the natural creases in the breast and around the dark pink skin surrounding the nipple (areola). A keyhole-shaped incision above the areola is also made to define the new location of the nipple. Skin is then removed from the lower section of the breast. The areola, nipple, and underlying breast tissue are moved up to a higher position. The nipple is moved and incisions are closed with stitches (sutures).

After surgery, a bulky gauze dressing is wrapped around the breasts and chest. Sometimes a surgical bra is used. Pain is controlled by medication, and usually subsides in a day or two. Most patients stay in the hospital for two days. The dressing is replaced by a soft bra within the first week, and it must be worn for several weeks. Generally, the swelling and discoloration around the incisions subside within a few days. There may be temporary loss of sensation in the breast skin and nipples after surgery. This condition improves with time. Within two weeks of surgery, stitches (sutures) are removed.

Breast reduction is usually performed for enlarged breasts (macromastia), but may also be indicated by:

• cystic breast infections (polycystic mastitis)
• back pain, neck pain, shoulder pain, breast pain, or headaches
• loss of sensation in the breasts, arms, or fingers
• sleeping problems or poor posture resulting from large breasts
• pigmented bra-strap groove
• striae (scarlike lines) on the breasts

Breast-revision surgery is performed while you are deep asleep and pain-free (using general anesthesia), in either an outpatient facility or in the hospital.

Incisions are made along the natural creases in the breast and around the dark pink skin surrounding the nipple (areola). A keyhole-shaped incision above the areola is also made to define the new location of the nipple. Skin is then removed from the lower section of the breast. The areola, nipple, and underlying breast tissue are moved up to a higher position. The nipple is moved and incisions are closed with stitches (sutures).

Alternative names

Mastopexy; Mammoplasty; Breast size reduction; Breast lift; Breast lift with reduction; Breast lift with augmentation

Definition

Cosmetic breast surgery is a surgical procedure to change the size or shape of the breasts.

Risks

In addition to the general risks of surgery and anesthesia, there are risks of large scars with prolonged healing time, uneven position of the nipples, sensory loss , and inability to nurse a baby after surgery. The emotional risks may include feeling that the breasts look imperfect, or the desired reactions of others are not adequate.

Expectations after surgery

The likely outcome from reduction surgery is very good. The appearance and lifestyle activities are significantly enhanced. Also, the pain or skin symptoms (such as striation) disappear. A special supporting bra may be required for a few months to reshape the breasts.

After a breast lift, a bulky gauze dressing is wrapped around the breasts and chest following surgery, or a surgical bra may be used. Pain is controlled by medication and will subside in 2 to 4 days. An overnight stay for breast reduction usually is needed to control pain and nausea. The dressing will be replaced by a soft bra within the first week, which must be worn for several weeks.

Generally within a few days the swelling and discoloration around the incisions will subside. There may be temporary loss of sensation in the breast skin and nipples after surgery. This condition will improve with time. Within 2 weeks of surgery, sutures will be removed.

Convalescence

During convalescence, limit physical activities in order to prevent stretching of the scars. Some activity may be allowed in a day or two following surgery. The plastic surgeon will recommend a schedule for resuming your usual routine (usually about 8 weeks). To permit proper healing, avoid overhead lifting for 3 to 4 weeks.

Scars are permanent and often remain highly visible for a year following surgery, then fade to some degree. Every effort is made to place the incisions so that scars are as inconspicuous as possible, and the scars should not be noticeable even in low-cut clothing (incisions are usually made on the underside of the breast).

What is breast reduction surgery?
Large breasts can dominate a woman's appearance and make you look unbalanced and make exercise difficult or even impossible to do. Breast reduction is a procedure for reshaping exceptionally large breasts surgically to increase your comfort and satisfaction. Overly large breasts frequently have a considerable affect on self-confidence and can even affect personal relationships. The aim of surgery is to give you smaller, shapelier breasts that are in proportion to the rest of your body.

What does breast reduction surgery involve?
The most common procedure involves an anchor-shaped incision that circles the areola and extends down in a vertical line it will then follow the natural curve of the crease beneath the breast. Excess breast tissue, fat and skin are then removed and the nipples and remaining underlying tissues are then moved to a new higher location. The skin from both sides of the breast is then brought down and around the areola shaping the new contour of the breast and sutured.

How long does the breast reduction surgery take?
Breast reduction is performed under general anaesthesia and usually takes about 2 to 3.5 hours depending on each individual patient and the extent of surgery. The length of stay in hospital will be mainly determined by you, many patients are able to go home on the day of the surgery but some remain in the hospital for 1-2 days.

What will happen in the recovery period?
The breast will be bandage for support and can be removed a day or two after surgery but you will have to continue wearing a surgical bra 24 hrs a day for 1-2 weeks while the swelling and bruising subside. There will be considerable swelling and bruising of the breasts which usually lasts 2-3 weeks. Almost all the stitches used will simply dissolve but if there are any clips they will be removed after 5 days of surgery. The scars are quite lengthy and may take many months or years to settle. You will have follow-up visits in the months after surgery to check on your progress.

What is breast reduction surgery recovery time?
Depending on the individual patient recovery times will vary. You should be up and about in a day or two but your breasts may still ache occasionally for a couple of weeks. Most patients will return to work with 14 days but this is down to the individual. Avoid any strenuous activity for at least 6 weeks and limit your exercises to stretching and swimming.

What can I expect from breast reduction surgery?
Your expectations need to be realistic. Most patients are pleased with the outcome and find they have smaller, lighter, and firmer breasts. You will be freed from the physical discomfort of large breasts and your body will be better proportioned therefore in most cases giving a new-found confidence.

Introduction
Breast augmentation is a surgical procedure to enhance the size and shape of a woman's breast using implants. Breast augmentation is performed for a number of reasons varying from patient to patient, some cosmetic and some medical. The implants used are either a silicone rubber shell filled with either medical grade silicone gel or a salt-water solution known as saline.

What does the breast augmentation surgery involve?
The method of inserting and positioning your implant will depend on your preferences, anatomy and your surgeon's recommendation. However the implant is normally inserted through an incision made in the natural crease beneath the breast. It is also possible to make the incision in the armpit or around the edge of the areola. The incisions are then close by using fine, dissolving sutures which will also be taped for better support.

How long does the breast augmentation surgery take?
Breast augmentation is an operation that usually takes 1.5 hours to complete using a general anaesthetic and normally includes an overnight stay at the hospital. In certain circumstances it can be performed as a day case.

What will happen in the recovery period?
You will feel tired and sore for a few days and will have slight swelling and bruising which is only natural. Most of your discomfort will be subsided with prescription medication. Following the operation you will have a light dressing in place which will need to be kept dry for 2 weeks. After 2 weeks your dressing will be removed and the wound inspected and lightly cleaned. The scars will be firm and pink for at least six weeks and may remain the same size for several months and it is important to keep in mind that they may take up to 2 years to fade. You will have follow-up visits in the months after surgery to check on your progress.

What is the recovery time?
This will depend on the individual patient however most patients are able to go back to work after a couple of days. Although you can walk about and do very light activities from the next day it is advisable not to do anything strenuous for 7-10 days. The average recovery time is between 1-2 weeks.

What can I expect from the breast augmentation surgery?
Your expectations need to be realistic. Most patients are pleased with the outcome and find they gain a feeling of increased self-confidence especially when wearing can those more revealing clothes. The overall achievement will be having a completely natural look that compliments your figure.

In today's world, looking and feeling good mean having a fit, well-proportioned body. However, for many people, this may seem like an unreachable goal. Sometimes even a strict diet or a disciplined exercise program can't conquer stubborn areas of excess fat. For those who seek a smoother or better-proportioned body contour, liposuction may be the answer.

Liposuction, also called lipoplasty, is a surgical procedure that removes deposits of excess fat from specific areas of the body, face or neck. Liposuction can be used to slim the hips and thighs, flatten the abdomen, shape the calves and ankles or eliminate a double chin.

You'll find basic information about liposuction in this brochure. However, the best way to get complete answers to specific questions that relate to your individual needs is to have a personal consultation with a plastic surgeon certified by the Board of Plastic Surgery.

LIPOPLASTY, LIPOSCULPTURE, LIPOSHAPING, BODY SHAPING, BODY SCULPTURING

Is liposuction right for me?

Liposuction is most commonly recommended for men and women of normal weight who simply want to improve their body contour. The procedure can produce excellent results for people who have deposits of excess fat that make certain body areas appear disproportionately large. Although liposuction is not a treatment for obesity, it can permanently alter body proportion and is sometimes the only way to eliminate fat deposits that do not respond to diet and exercise.

People of almost any age may undergo liposuction; however, patients with good skin elasticity will achieve the smoothest contour after fat is removed. You may be a good candidate for liposuction if you desire fat removal or contouring in any of the following areas:

• Cheeks chin and neck
• Upper arms
• Breast or chest area
• Back
• Abdomen and waist
• Hips and buttocks
• Thighs
• Inner knee
• Calves and ankles

It's important to be clear, about a few "can’s and cant’s" related to liposuction.

Liposuction can . . .

be performed on several areas of the body at the same time or be done in conjunction with other cosmetic surgery procedures, as long as you understand that there is increased risk and your surgeon feels that having multiple procedures is a safe option for you.

• be used to treat some cases of gynecomastia, or male breast enlargement, which occurs in both teenagers and adult men.

Liposuction can't. . .

• serve as a substitute for dieting and exercise
• Effectively treat cellulite (a condition that gives the skin a dimpled appearance).

a) Liposuction can slim the hips and thighs and provide a more shapely contour for the inner knee, calves and ankles.

b) Liposuction can flatten the abdomen, remove fat from the under-arms, eliminate a double chin and contour the face or neck

Also, certain medical conditions may complicate liposuction. They include: diabetes, high blood pressure or heart disease and previous surgery near the area to be contoured. It's important to let your plastic surgeon know if you have any of these medical conditions or if you have had surgery in the past.

What should I expect from the consultation?

A personal consultation is the first step for every patient considering liposuction. During this meeting, your surgeon will assess your physical and emotional health and discuss your specific cosmetic goals for the procedure.
c) "Love handles" and a large abdomen, typical problems for men, respond well to liposuction. Liposuction can also be used to treat gynecomastia (male breast enlargement

d) After liposuction, you will see a noticeable difference. After swelling and fluid retention have subsided, your results will be even more apparent.

You should arrive at the consultation ready to provide complete information about:

• Previous surgical procedures
• Past and present medical conditions
• Medications you are taking, including herbal remedies or nutritional supplements
  

Depending on the parts of your body that you would like to be treated with liposuction, you may be asked to undress. Your surgeon will fully assess the extent of correction needed. You'll also be asked to point out the exact areas where you would like to see improvement. Your surgeon will check the elasticity of your skin and may feel certain areas to assess the thickness of the underlying layer of fat. Your surgeon will also check your blood pressure and weight, and ask you if you are planning to lose or gain weight in the future.

How is liposuction performed?

To perform liposuction, one or more small incisions are made near the area to be suctioned. Whenever possible, incisions are placed within the natural folds or contour lines of the skin so that they are inconspicuous. The surgeon then places a slim, hollow tube called a cannula through the incision so that its tip penetrates the underlying fat. After the cannula is connected by flexible tubing to a suction pump, the surgeon moves the cannula back and forth through the fat, which is vacuumed into the tube. Several variations to the basic liposuction technique have been introduced.

The fat-removal technique that best meets your needs depends on a number of individual factors that your surgeon will discuss with you.

• Your surgeon may use the tumescent technique, in which the fat is pre-injected with a salt-water solution containing small amounts of adrenaline and sometimes local anesthetic.
• Your surgeon may also use ultrasound-assisted lipoplasty or UAL, a two-step technique that uses the energy from sound waves to liquefy the fat before it is suctioned.
• The type of instrumentation used may also vary. For some areas, a hand-held syringe may be used to provide the vacuum instead of a suction pump.
  

How will I learn about the safety of liposuction?

Each year thousands of people undergo liposuction and experience no major complications. However, you must fully understand the risks as well as the benefits of the procedure.

One of the most important parts of your consultation is the discussion that you and your surgeon will have about the possible complications of liposuction. In addition to listening carefully to what your surgeon tells you, be sure to raise any questions or concerns that you may have about the safety of the procedure. By carefully following your surgeon's advice and instructions - both before and after surgery - you can do your part to minimize some of the risks.

What can I do to prepare for my surgery?

When the date for your surgery has been set, your plastic surgeon will provide you "with specific instructions for the days immediately before and after your surgery. A number of points may be covered, including:

• avoiding certain medications that may complicate surgery or recovery
• stopping smoking for a period of time before and after surgery
• arranging for help or special care following surgery

How will I be cared for on the day of my surgery?

Liposuction may be performed in a hospital, an outpatient surgery center or an office-based surgical suite.

Various types of anesthesia can be used for liposuction. Your surgeon will select the type of anesthesia that provides the safest and most effective level of comfort for your procedure. For some patients, local anesthesia is used (usually with sedation) which numbs only the affected areas. For others, regional anesthesia, such as an epidural block (the kind of anesthesia commonly used in childbirth) or general anesthesia may be the best choice.

Your physical status will be closely monitored throughout the procedure and during your recovery.

How will I look and feel after surgery?

When the procedure is complete, you will be taken to a recovery area. For some patients, small drainage tubes will have been placed beneath the skin. Any discomfort you may feel can be controlled with medication prescribed by your plastic surgeon. An elastic bandage or specially designed compression garment may have been applied over the treated areas to control swelling and assist healing. Your plastic surgeon will tell you how long you must wear the garment and how you can remove it to bathe.

If only a small amount of liposuction has been done, you will be encouraged to get out of bed very shortly after the surgery. If multiple areas have been treated, you will probably remain in bed for a day or two, getting up to go to the bathroom and for meals.

Keep in mind that the speed of your recovery depends largely on the extent of your surgery. Although everyone heals at a different rate, you can expect that your recovery will follow this general time line:

Within the first week

• The swelling will reach its peak and then begin to subside.
• Your stitches will be removed.
• You may return to nonstrenuous work.

After several weeks

• Bruises will fade and eventually disappear.
• Areas that felt numb will regain normal sensation.
• You may resume most of your normal exercise and activities.
• Swelling will continue to subside

e) You may notice that clothes fit more comfortably and you feel more confident about your new, slimmer appearance.

What should I know about my results?

Quite soon after surgery you will see a noticeable difference in the shape of your body. However, improvement will become even more apparent after a couple of months, when fluid retention and swelling have subsided. For most patients, the final result is evident after about three months.

After your liposuction surgery, you may notice that clothes fit more comfortably and you feel more confident about your appearance. As long as you maintain your postoperative weight, your new, slimmer contour will be permanent. Many patients who gain a few pounds after surgery find that the weight distributes itself more evenly and does not settle in the same "problem areas."

What should I do after my liposuction surgery?

1. You should drink at least 2 lts of water or various kind of fluids. (tea, soup, juice etc.)

2. You are advised to be checked on 1st week, 3rd week and 3rd month, 6th month on regular basis.

3. Take an appointment from physiotheraphy specialist after 5th day of your surgery.

4. In physiotherapy, in addition to ultrasound therapy you will be instructed how to perform physical exercises. It will be useful for you to do these exercises 20 minutes a day. You must do these exercises at least 6 months after your surgery.

5. LPG Endermologie : Using this high-tech instrument following liposuction surgery will hasten subsiding the edema, soften the lumps increase healing and tighten the skin via its increased nourishment.

6. SLIM-UP: This instrument increases healing via exercises muscles and tightens the skin tone as well as aids lymphatic drainage. It also helps to diminish edema and healthy sliming of the body.

How long will I continue to see my plastic surgeon?

After the initial healing period, you will return to your plastic surgeon's office for a postoperative follow-up visit so that your progress can be evaluated. In the following months, your surgeon may ask you to return for periodic checkups. It's important to keep these appointments so that your surgeon can assess your long-term results and address any questions or concerns you may have.

CHOOSING A QUALIFIED SURGEON

No matter what type of plastic surgery you're considering, one of the most important factors in its success is the surgeon you choose. Although it may seem hard to believe, some of the physicians who are performing cosmetic surgery today have had no formal surgical training at all.

It's advisable to consider the following points before scheduling a consultation:

Find out if he or she is certified by the Board of Plastic Surgery. Surgeons with this certification have completed a minimum of six years of surgical training following medical school, including a plastic surgery residency program. During this intensive program, surgeons learn to perform surgical procedures for the entire body and face. At the same time, they develop their technical skill and aesthetic judgment. After training, a surgeon must pass comprehensive oral and written exams before being granted certification. It is also very important to find out the postgraduate education, experience, competency for specific procedures and scientific status of Plastic Surgeon.

Some of the most visible signs of aging first appear on the face. Although the changes appear gradually, there may come a day when you look in the mirror and decide that the face you see doesn't reflect the way you feel about yourself. If you'd like to look as good as you feel, a facelift can help. Also known as rhytidectomy, a facelift smooths the loose skin on your face and neck, tightens underlying tissues and removes excess fat. As a result, your face will appear firmer and fresher.

You'll find basic information about a facelift in this brochure. However, the best way to get complete answers to sprecific questions that relate to your individual needs to have a personal consultation with a plastic surgeon certified by the Board of Plastic Surgery.

Is a facelift right for me?

Facelifts are most commonly performed on patients in the 40-60 age range. However, the procedure can produce good results for people in their 60s, 70s and 80s as well. You may be a good candidate for a facelift if you have any of the following types of conditions :

• A deep line that runs from the corner
• Loss of a well-defined jawline
• Deep wrinkles in the cheeks and sagging skin near the cheekbones
• Loose skin, wrinkles or excess fatty tissue in the neck.

Facelift surgery needs to be approached with extra caution if you have any of the following medical conditions:

• Uncontrolled high blood pressure
• Blood-clotting problems
• The tendency to form excessive scars.

Be sure to alert your plastic surgeon if you are affected be any of these conditions.a) A facelift can improve the deep cheek folds, jowls, and loose, sagging skin arround the neck that come with age. What should I expect from the consultation?

A personal consultation is the first step for every patient considering a facelift. During this meting, your surgeon will assess your physical and emotional health and discuss your specific cosmetic goals for surgery.

You should arrive at the consultation prepared to providee complete information about:

• Previous surgeries
• Past and present medical conditions
• Treatments you have received
• Medications that you are taking, including nutritional supplements and herbal remedies.

If you are overweight and have a realistic desire to lose more than 15 pounds, your weight loss could affect your results. It's important to discuss these plans with your surgeon.

During your physical evaluation, your plastic surgeon will assess your bone structure and the underlying tissues of the face. The thickness, texture and elasticity of your skin and the severity of the wrinkles and folds will also be considered. Your hairline will be examined to determine where incisions can be conisdered in developing your surgical plan.

Your plastic surgeon may explain additional procedures that can be performed along with a facelift to meet your appearance goals. For example, a facelift is frequently combined wih:

• Forehead lift, to correct lines or furrows in the brow
• Eyelid surgery, to eliminate drooping upper eyelids or bags beneath the eyes.
• Nose reshaping
• Skin treatments, such as a chemical peel or laser resurfacing, to minimize fine wrinkles.
• Face contouring with micro fat or tissue cocktail injection.

How is a facelift performed?

The technique chosen for your surgery depends on your features, your surgeons's perferences and your desired results. There are many variations to the facelift procedure. However, the incision is typically hidden in the natural contour of your ear, and then extends around the earlobe and back into the hairline. Following surgery, the incisions are easily concealed by your hair or with makeup. There also may be a small incision hidden beneath your chin.

Working through these incisions, your plastic surgeon frees the facial skin from its underlying tissues and pulls it upward and back. The excess skin is then removed. In some cases, the deeper tissues may also be repositioned to restore a more youthful contour to your face. If necessary, an incision under the chin allows your surgeon to remove fatty tissue in that area and smooth the cord-like structures of the underlying muscle in the neck.

How will I learn about the safety of facelift surgery?

Each year, thousands of people have facelifts and experience no major complications. However, it is important for you to be informed of the risks as well as benefits.

One of the most important parts of your consultation is the discussion that you and your surgeon will have about the possible complications of facelift surgey. In addition yo listening carefully to what your surgeon tells you, be sure to raise any questions you may have about the safety of the procedure.

By carefully following your surgeon's advice and instructions – both before and after surgery – you can do your part to minimize some of the risks.

b) Incisions usually begin above the hairline at the temples follow the natural line in front of the ear, curve behind the earlobe into the crease behind the ear, and into or along the lower scalp.

c) Facial, neck tissue and muscle may be separated; fat may be trimmed or suctioned and underlying muscle may be tightened.

d) After deep tissues are tightened, the excess skin is pulled up and back, trimmed and sutured into place.

e) Most of the scars will be hidden within your hair and normal creases of your skin What can I do to prepare for my surgery?

When the date for your procedure has been set, your plastic surgeon will provide you with specific instructions for the days immediately before and after surgery. A number of points may be covered, including:

• Avoiding certain medications that may complicate surgery or recovery.
• Stopping smoking for a period of time before and after surgery
• Arranging for help and special care following surgery
• Letting your hair grow long enough so that it will cover your incisions while they heal
• Hair coloring before surgery if you do usally.

How will I be cared for on the day of my surgery?

Your facelift may be performed in a hospital, an outpatient surgery center or an office-based surgicak suite. If you are admitted to a hospital or surgery center, your stay will be a short one, perhaps just one or two nights. We have arrenged a three days package programme in the hospital that you may benefit.

Medications are administered to keep you comfortable during the surgical procedure. Your plastic surgeon may use local anesthesia and intravenous sedation for your facelift. However, for some patients, general anesthesia may be the best choice. Your surgeon will monitor your physical status throughout the operation and during your recovery.

How will I look and feel right after surgery?

When surgery is complete, you'll be taken to a recovery area. A bandage may have been wrapped around your face to help control swelling. Sometimes, small drainage tubes are placed beneath the skin to drain away fluids that might otherwise accumulate. Discomfort is usually minimal, but any pain you feel can ce controlled with medication prescribed by your surgeon. Although everyone heals at a different rate, you can expect that your recovery will follow this general time line:

The first day

• In this early stage of healing, you should rest with your head elevated to help minimize bruising and swelling

Within the first week

• Swelling reaches its peak, and then begins to subside.
• Bandages will ve removed and you may shower.
• Stitches will dissolve or be removed.
• You may return to light activity, but continue to sleep with your head elevated.
• You can wear makeup to conceal any discoloration.

Within two weeks

• Most of the bruising will disappear
• You may resume many of your normal activities, including non-strenuous.

After several weeks

• You may resume exercise.
• Swelling and puffiness will continue to subside.
• Numbness in the facial area will diminish; however, some numbness may persist for several months.

Throughout the healing period, you should avoid exposure to direct sunlight and, for the long term, be conscientious about using sun block preparations to protect your skin.

After surgery, you'll present a fresher, more youthful face to the world.

What should I know about my results?

If you are like most people who have the procedure, you'll be very pleased with your refreshed and rejuvenated appearance. Although the healing may take some time, you can expect the end result to be woth the wait.

A number of factors, including your heredity and your lifestyle, play a role in how long the results of your facelift will last. Even though the aging process continues, patients are usually happy with their apperance for many years following a facelift. Some patients find that they want to make additional improvements at a later time.

How long will I continue to see my plastic surgeon?

After the initial healing period, you will return to your plastic surgeon's office for a postoperative foollow-up visit so that your healing and progress can be evaluated. In the following months, your surgeon may ask you to return for periodic checkups. It's important to keep these appointments so that your surgeon can assess your long-term results and address any questions or concerns you may have.

No matter what type of plastic surgery you're considering, one of the most important factors in its success is the surgeon you choose. Although it may seen hard to believe, some of the physicians who are performing cosmetic surgery today have had no formal surgical training at all.

It's advisible to consider the following points before scheduling a consultation:

Find out if he or she is certified by the Board of Plastic Surgery. Surgeons with this certification have completed a minimum of six years of surgical training following medical school, including a plastic surgery residency program. During this intensive program, surgeons learn to perform surgical procedures for the entire body and face. At the same time, they develop their technical skill and aesthetic judgement. After tarining, a surgeon must pass comprehensive oral and written examsbefore being granted certification. It is also very important to find out the post graduate education, experience, competency for specific procedures and scientific status of Plastic Surgeon.

What is an attractive nose? Quite simply, it is a nose that fits your face. It is a natural-looking nose achieves a harmonious balance with your other facial features. If you feel that your nose is not a good fit, you may benefit from cosmetic surgery of the nose, also called rhinoplasty. Rhinoplasty can enhance the shape, size and general appearance of your nose.

You'll find basic information about rhinoplasty in this brochure. However, the best way to get complete answers to specific questions that relate to your individual needs is to have a personal consultation with a plastic surgeon certified by the Board of Plastic Surgery.

Is rhinoplasty right for me?

Rhinoplasty can be performed on men and women of almost any age. However, it's usually recommended that young people wait until facial growth is complete - about age 16 or 17. If you are a teenager, having the procedure should be your own idea.

You may be a good candidate for rhinoplasty if you have any of the following conditions:

• your nose appears too large for your face
• there is a bump or depression on the nasal bridge when viewed in profile
• the nose seems too wide when viewed from the front
• the nasal tip droops or plunges
• the tip is thickened or enlarged
• the nostrils are excessively flared
• your nose is off-center or crooked
• a previous injury has made your nose asymmetrical

What should I expect from the consultation?

A personal consultation is the first step for every patient considering rhinoplasty. During this meeting, your surgeon will assess your physical and emotional health and discuss your specific cosmetic goals for surgery.

You should arrive at the consultation prepared to provide complete information about:

• previous surgeries
• past and present medical conditions
• medical treatments you have received
• medications that you take, including nutritional supplements and herbal remedies
• any allergies that cause congestion or conditions that cause breathing difficulties
• how often you use nasal sprays to relieve congestion.

a) If you feel your nose is not a good fit for your face, rhinoplasty can enhance the shape, size and general appearance of your nose.

b) after surgery, the patient has a straighter bridge, a well defined nasal tip and an improved angle between the nose and upper lip

During your physical evaluation, your plastic surgeon will examine the structures inside your nose and the quality of your skin, as well as the size and shape of your nose and its relationship to your other facial features.

Your plastic surgeon may recommend other treatments that can be performed along with the rhinoplasty to better meet your appearance goals or to improve breathing.

To enhance your appearance:

• Chin surgery can help improve facial balance by making the chin more or less prominent.

To correct breathing difficulties:

• A turbinectomy can open the nasal air passages by reducing the turbinates, the internal projections that warm and moisturize the air that passes through the nose.
• A septoplasty can correct a deviated septum, a condition in which the dividing wall within the nose shifts from the middle to block the air passages.

c) Rhinoplasty can correct a nasal tip that droops, a bump on the nasal bridge, and other attributes that may make someone feel their nose is unattractive.

d) The results of rhinoplasty enhance the balance between the nose and other facial features.

e) Small wedges of skin at the base of the nostrils may be removed through incisions that are hidden in the nose's natural creases.

How is rhinoplasty performed?

The technique used for your surgery depends not only on your surgeon's preferences, but also on your desired results. Alterations may be made to increase or decrease the nasal bridge, reduce the size or width of the nose, narrow the nostrils, reshape the tip, or change the angle between the nose and the upper lip.

Plastic surgeons may perform rhinoplasty from within the nose, making the incision inside the nostrils. This is called a "closed rhinoplasty." Other times, a surgeon prefers an "open" procedure, in which a small incision is made across the columella, the vertical strip of tissue separating the nostrils, as well as within the nose.

Working through these incisions, the nose's framework of bone and cartilage is sculpted to the desired shape. Your surgeon may reshape or reposition the bones in your nose, or build up certain areas, using either nasal cartilage or bones and cartilage from another body site, or other materials. The skin and soft tissues are then redraped over the reshaped framework. If the lower part of the nose is being narrowed or the nostrils are being reduced, small wedges of skin at the base of the nostrils may be removed through incisions that are hidden in the nose's natural creases.

Turkish Delight

A new era has been opened in aesthetic rhinoplasty operations after a new technique, known as “ Turkish Delight” in the world literature, which was described by Onur Erol in 1989. In this technique, excised cartilage remnants are not devastated but prepared in order to use to re-shape the nasal dorsum and the tip of the nose. The aim of the technique is not only to minimize the errors that can be seen after an ordinary rhinoplasty operation but also leads to construct a new nose with a non-operated look.

How will I learn about the safety of nasal surgery?

Each year, thousands of people undergo cosmetic surgery of the nose and experience no major complications. However, it is important for you to be informed of the risks as well as the benefits. One of the most important parts of your consultation is the discussion that you and your surgeon will have about the possible complications of nasal surgery. In addition to listening carefully to what your surgeon tells you, be sure to raise any questions that you may have about the safety of the procedure.

By following your surgeon's advice and instructions carefully - both before and after surgery - you can do your part to minimize some of the risks.

What can I do to prepare for my surgery?

When the date for your procedure has been set, your plastic surgeon will provide you with specific instructions for the days immediately before and after surgery. A number of points may be covered, including:

• avoiding certain medications that may complicate surgery or recovery
• stopping smoking for a period of time before and after surgery
• arranging for help and care following surgery.

How will I be cared for on the day of my surgery?

Rhinoplasty surgery may be performed in an outpatient surgery center, an office-based surgical suite or a hospital. If you are admitted to a hospital or surgery center, your stay will be a short one, perhaps just one night.

Medications are administered to keep you comfortable during the surgical procedure. Local anesthesia and intravenous sedation may be used for patients undergoing rhinoplasty, although general anesthesia may be desirable in some instances. Your plastic surgeon will monitor your physical status throughout the operation and during your recovery.

How will I look and feel right after surgery?

When the surgery is completed, you'll be taken to a recovery area. Any discomfort that you feel will be controlled with medication prescribed by your surgeon. A splint may be applied to the bridge of your nose to protect the nose and hold the tissues in place until they have stabilized. You may also have a small, triangular bandage beneath the tip of your nose and packing inside the nostrils, especially if work has been done to improve your breathing.

Although everyone heals at a different rate, you can expect that your recovery will follow this general time line:

The first day:

• In this early stage of healing, you should rest with your head elevated to help minimize swelling
• Activity must be kept to a minimum
• You may experience a small amount of bleeding and stuffiness.

Within 10 days:

• Swelling reaches its peak and then begins to subside
• Bruising will begin to diminish
• You can safely use makeup to conceal any discoloration
• Stitches and packing will dissolve or be removed
• You may discontinue wearing the splint (near the week's end)
• You may return to school or a nonstrenuous job.

After several weeks:

• You may resume exercise and most of your normal activities
• Most of the swelling will subside.

CHOOSING A QUALIFIED SURGEON

No matter what type of plastic surgery you're considering, one of the most important factors in its success is the surgeon you choose. Although it may seem hard to believe, some of the physicians who are performing cosmetic surgery today have had no formal surgical training at all.

It's advisable to consider the following points before scheduling a consultation:

Find out if he or she is certified by the Board of Plastic Surgery. Surgeons with this certification have completed a minimum of six years of surgical training following medical school, including a plastic surgery residency program. During this intensive program, surgeons learn to perform surgical procedures for the entire body and face. At the same time, they develop their technical skill and aesthetic judgment. After training, a surgeon must pass comprehensive oral and written exams before being granted certification. It is also very important to find out the postgraduate education, experience, competency for specific procedures and scientific status of Plastic Surgeon.

Blepharoplasty is used to correct drooping upper lids that make the patient look older or tired or that interfere with vision. Blepharoplasty is sometimes done alone or with other facial surgery such as a browlift or facelift. Eyelid surgery will not remove wrinkles around the eyes, lift sagging eyebrows, or eliminate dark circles under the eyes.

Eyelid surgery (blepharoplasty) is used to correct "puffy bags" below the eyes and drooping upper lids that make the patient look older and tired or that interferes with vision. Eyelid surgery will not remove wrinkles around the eyes, lift sagging eyebrows, or eliminate dark circles under the eyes.

Incisions are made in the natural creases or folds of the eyelids. Underlying fat may be removed, excess skin is trimmed along the natural fold in the eyelid.

Introduction
Blepharoplasty is one of the most popular surgical procedures. Eyelid surgery is a procedure to remove fat-usually along with excess skin and muscle from the upper and lower eyelids. Eyelid surgery can lift drooping upper lids and reduce the puffy bags that form below your eyes. This procedure can be done alone or in conjunction with other facial surgery procedures such as a facelift.

What does the blepharoplasty surgery involve?
For the upper eyelids the incision is made in the natural crease line that occurs 1 cm above the eyelashes. The incisions might extend into the crow's feet or laughter lines at the outer corners of your eyes. Working through the incisions your surgeon will separate the skin from the subcutaneous layers and remove excess fat and trim sagging muscle and skin. The incisions will then be closed with very fine sutures.

For the lower eyelids the incision starts underneath the eyelashes and extends out 1 cm or so outwards into the crow's feet area, the skin is then lifted upwards and outwards, gently tensioning the area and overlapping skin removed. Again the incisions will then be closed with very fine sutures.

What will happen in the recovery period?
After surgery the surgeon will probably lubricate your eyes with ointment and may apply a bandage. Some bruising and swelling will be experienced during the first and second weeks, however the majority of the swelling usually subsides after the first 10 days. Your eyelids may feel dry at first but eye drops can help with this. Any sutures are usually removed after 5 days. Scars will form as a result of the surgery. Overall these scars heal relatively well but will differ in each individual patient.

What is the recovery time?
Recovery varies from patient to patient and it is advisable to take it easy for the first week after surgery. Most people are ready to go out and return to work after a week to 10 days. You should keep your activities to a minimum for three to five days and avoid more strenuous activities for about three weeks.

What can I expect from the blepharoplasty surgery?
Your expectations need to be realistic. The positive results of your refreshing eyes and reduced tired appearance will benefit your self-esteem and confidence and should last for years.

ONEP Aesthetics, Plastic and Reconstructive Center, Turkey’s first fully equipped “Ambulatory Treatment Center”, was established under the leadership of Prof. Dr. Onur Erol, who had its name recorded in the World medical literature with the techniques he developed, on an area of 1200 square meters in Levent, Istanbul in 1996.

Having made it its principle to provide the services of the highest quality for the patients, the clinic is equipped with the most state-of-the-art anesthesia equipment, endoscopic surgery instruments, 2 operating rooms, and 4 post-operation care units. Thanks to the computer network, surgical operations at ONEP can be programmed and discussed with the patients through visual computer software. Thus, it is ensured that the expectations of the patients and the planning of the physicians are harmonized.

Our clinic was established to enable you to feel yourself safe as you regain your health and assumes it as its duty to provide health services at your own environment without tiring you and always acts with that principle. All plastic surgery patients are operated with the most state-of-the-art technologies without a requirement for hospitalization at our clinic and are taken to 5-star hotels by a limousine with the accompaniment of a nurse only a few hours after the operation.

Onep, Turkey's biggest aesthetics and plastic surgery center, is the first to apply the 'beauty without surgery' concept with years of experience under the name M-Onep Aesthetics and Beauty Center in 2003 at Etiler Maya Residences in Istanbul by Prof. Dr. Onur Erol. With a branch to be opened in Caddebostan on the Asian side of Istanbul in 2006, the center that offers the widest range of applications is equipped with the CE certified state-of-the-art laser equipment and instruments, etc. approved by the FDA, and employs the latest technology in the field of beauty without surgery with specialist staff under the management of a dermatologist. The Onep Plastic Surgery specialists provide consultancy services, and the expert dieticians give healthy life and diet programs.

In addition to beauty without surgery, the center provides treatment for removal of surgical scars, capillary and skin stain treatments, skin tightening and rejuvenation treatment without surgery, elimination of post-surgical edema, as well as local slimming and firming applications. Among other services are laser epilation, exotic Far Eastern massages, permanent make-up, and Dior skin and body care.

Diagnosis and Treatment Units

Thermage: Skin tightening treatment without surgery in 1 session.
Quantum: Surgical scar, staining, and capillary treatment, skin rejuvenation treatment
N-Lite: Acne treatment, skin rejuvenation treatment
Botox: Wrinkle and perspiration treatment
Restylane: Filling treatment
Micro peeling: Treatment aimed at decreasing the disorders on the skin.
Slim-Up: Slimming, firming, local fat reduction
Slim-Drainage: Edema elimination treatment
LPG : Cellulite cure
Slimming with Radio Frequency: Local slimming, firming and cellulite cure
Permanent Make-up: Applied to lip edges, eyelash bottoms, and eyebrows
Oxygen Therapy: Treatment aimed at skin rejuvenation.
Diode Laser , Lyra-i Laser : Treatment aimed at reduction in unwanted hair.
Far East Massages: Massages for relaxing
Dior skin and body care

Kent Hospital is a huge health complex located on the northern peninsula of the Izmir, the most modern city in Turkey. The hospital that was built as a “hospital building” right from the foundation has a covered area of 28 thousand square meters and is equipped with all technologies and standards that should exist in an international “world hospital”. Aiming to provide diagnostic and treatment services that meet the world standards to both domestic and foreign patients with the state-of-the-art technology, the Kent Hospital has assumed a leading role in contributing to the number of health institutions that provide services with high quality and technology in the region and the country. Kent Hospital has become one of the important health institutions in the world by obtaining accreditation from the Joint Commission International in June 2006. With this accreditation, the hospital has become an important national reference center in the field of superior quality health services.

Our mission:
• The primary business of Kent Hospital is to provide quality health services and absolute customer satisfaction.

Our Vision:
• To become a preferred hospital thanks to our efforts to achieve absolute customer satisfaction.

Diagnosis and Treatment Units

MEDICAL DEPARTMENTS
Emergency Service and Ambulance Services
Anesthesia and Reanimation
Intensive Care Units
General Intensive Care
Cardiovascular Surgical Intensive Care
Coronary Intensive Care

INTERNAL SERVICES
Cardiology
Gastroenterology
Endocrinology, Diabetes, and
Metabolism Diseases
Allergy and Immunology
Pediatric Diseases
Neonatal Intensive Care
Pediatric Cardiology
Neurology
Physical Therapy and Rehabilitation
Dermatology
Pulmonary and Chest Diseases
Psychiatry
Psychological Counseling

SURGICAL SERVICES
Cardiovascular Surgery
General Surgery
Brain, Spinal Cord and Peripheral Nerve Surgery (Neurosurgery)
Ophthalmology
Orthopedics and Traumatology
Obstetrics and Gynecology
Otorhinolaryngology and
Head and Neck Surgery
Aesthetics and Reconstructive Surgery
Urology
Pediatric Urology
Pediatric Surgery

SPECIAL CLINICS AND CENTERS
In Vitro Fertilization and Reproductive Health Center
Transplantation Center
Cerebrovascular Diseases and Stroke Center
Sleep Disorders Center
Oncology Center
Nephrology and Dialysis Center
Check-up Center
Oral and Dental Health Center
Nutrition and Diet Center
Diabetics and Obesity Center
Reflux Center

Technical Details
An open area of 30.000 m2 and covered area of 28,000 m2, hospital building designed and built in accordance with the AIA (American Institute of Architects) Hospital Design Guidelines, Laminar-flow air current based on the double corridor (sterile, semi sterile) system, complete sterilization under positive pressure and with Hepa filtration, 2 operating rooms of 55 m2 each for cardiovascular operations and 4 more operating rooms of 48 m2 each for other surgical operations, 2 maternity wards, 1 Jacuzzi for relief from labor pains, 2 special Labor/Delivery/Recovery/Post-Partum (LDRP) rooms where all delivery services are provided in a comfortable environment, 4 newborn intensive care units and transport incubators, patient rooms equipped with nurse calling system for direct communication with nurses, central medical gas system, microprocessor controlled patient beds.

Professional health service with traditional Turkish hospitality!

Anadolu Health Center provides the highest quality services in the field of health with the strategic partnership established with Johns Hopkins Medicine!

New Reference Center
Oncological Science, Heart Health, Neurological Sciences, Women’s Health, IVF, Orthopedics, Plastic and Reconstructive Surgery, and Personal Health Programs.

Expert Opinion
Expert staff with 35% having received specialist training in the USA, 40% holding academic title, and all capable of providing services in foreign languages.

State-of-the-art Technology
The latest diagnosis and treatment methods: Cyberknife, Lineer Accelerators with the IMRT system, PET-CT, Straton CT, TIM-MR
State-of-the-art technological infrastructure: PYXIS, PACS, Tele-Medicine, Electronic Patient Records.

Multi-Discipline Approach
Definite diagnosis and effective treatment of waist, paralysis, diabetes, arrhythmia, and pulmonary diseases at special clinics.

International Patient Services
Expert team planning the visits of the international patients in all aspects.

Assistance Companies
Contracts with international insurance companies such as Ipa/Axa Assistance, Euro Center, Europe, Remed Assistance, Roland Assistance, Coris, Turquie Assistance, Adac, Euro Alarm, Group 4 Falck, Turasist-Mapfre Assistance, Global Voyager Assistance, Mercur Assistance, Voyager Assistance, Gis, Winterhur, Nordic, Aide, Asitur, Voyager, Specialty, Huk Coburg, Call-Us, as well as special packages and opportunities for establishments and organizations.

In illness and in health...

Diagnosis and Treatment Units

ONCOLOGY
Medical Oncology
Hematologic Oncology
Radiation Oncology
Cyberknife Radiosurgery
Psychological Counseling / Psychotherapic
Attempts

CARDIAC CARE
Cardiovascular Surgery
Cariıovascular Anestheiıology
Cariıovascular Intensive Care
Throcic Surgery
Cardiology
Invasive Cardiology
Non-Invasive Cardiology
Coronary Care Unit
Electrophysiology
Pediatric Cardiology

WOMEN’S HEALTH
Gynecology
Obstetrics
Perinatology
IVF
Gynecological Oncology
Urogynecology

SURGICAL SPECIALTIES
Opthalmology
ENT
Pediatric Surgery
Urology
General Surgery
Orthopedics
Anesthesiology
Plastic & Reconstructive Surgery
Hand Surgery
Sports Medicine
Pain Management
Dental Care
Er
Surgical Intensive Care

LABORATORY AND IMAGING
Radiology
Nuclear Medicine

LABORATORY
Clinic Lab
Pathology
Microbiology
Genetics

MEDICAL SPECIALTIES
Endocrinology
Allergy And Immunology
Pulmonology
Physical Therapy & Rehabilitation
Hematology
Pediatrics
General Pediatrics
Nicu
Pediatric Intensive Care Unit
Gastroenterology
Rheumatology
Nephrology
Dermatology
Infectious Diseases
Diet & Nutrition
Check-Up
Internal Medicine
Medical Intensive Care

NEUROLOGICAL SCIENCES
Neurosurgery
Neurology
Psychiatry
Neurological Intensive Care Unıt