5% of rhinoplasty are made in the aftermath of a broken nose.
A broken nose can be surgically reduced within 10 days after the accident.
In the absence of reduction within 10 days or in the case of an insufficient reduction, nose remain diverted or blocked.
Only a rhinoplasty to repair post traumatic form and function of the nose broken.
Support may be required from the CPAM.
35% of rhinoplasty performed, are in connection with respiratory problems pushing patients to consult.
result before after / deviation of nasal septum
The rhinoplasty may be necessary to improve breathing in the case of a deviation of the nasal septum, for example. It is a rhinoseptoplastie, support will be sought from the CPAM.
Sometimes rhinoplasty is not necessary to improve breathing, but will be increasingly sought in a gesture of septoplastie a partial assumption will be required from the CPAM.
Result 1 month, profile
60% of requests for rhinoplasty are mainly cosmetic applications to reshape the nose in order to make it more natural and harmonious with the rest of the face.
The rhinoplasty is a very practiced, it represents 5% of cosmetic surgery procedures performed in France (15000 intervention / year).
For all the difficulty of rhinoplasty is not misused and asked to be practiced by surgeons specializing in surgery of the face (ENT) because ignoring the function of the nose is sometimes venturing to respiratory problems the origin of occasions procedures (rhinoplasty secondary)
Everyone has a personal image of his nose, sometimes causing a real physical, it is common to observe the surprise of patients do not recognize some photographiques pre operative implications.
The nose surgery can be performed at puberty completed (16/17 years for females, 17/18 years for boys) at that age, the change is quickly integrated as the young teenager did not have time to soak up its image.
The intervention is often carried out later. From 50 years, cosmetic surgery nose brings in addition to the amendment, a rejuvenation indisputable.
Many people are surprised to learn that surgical reduction of breast size is a common plastic surgical procedure. Reduction mammaplasty is not done for cosmetic purposes. This operation has as its goal, a significant reduction in the weight of the breast. Patients who choose this surgical procedure are among the happiest patients the plastic surgeon sees during office follow-up visits.
before and after breast reduction surgery Photos-pics
The patient with very large breasts may suffer from a variety of symptoms . The weight of the breast tissue itself would cause problems; but the woman with large breasts finds that the position of this weight causes back strain and discomfort. The bra ultimately becomes an instrument of pain as the bra straps cut into the shoulders. The pull of gravity is now transferred to the shoulders and neck muscle resulting in more pain and muscle spasm. It is not uncommon in the most severe cases to see permanent grooves in the shoulders where the bra straps have exerted their pull. Some patients may even have scars in this area. Even with the best of bra support there may be some overlap and contact between the breast skin and the lower chest wall skin. Especially in the warmer climates this can create a chronic skin irritation called intertriginous dermatitis.
Patients have often been quite self conscious about their breast size and may have suffered from a variety of unwanted attention . This type of suffering is difficult to quantify but it is present to some degree in many patients with enlarged breasts. Breast size often interferes with the woman’s ability to exercise. There is often direct interference with arm motion in certain sports, and there is the pain many of these women experience during jogging or running inspite of the support of the best bras available.
This degree of breast hypertrophy(enlargement) may occur from shortly after the onset of puberty till old age. The operation of reduction mammaplasty is carried out to relieve the patient’s symptoms and should not be confused with the so called “breast lift” or mastopexy procedure which is done for cosmetic purposes. The majority of insurance policies will cover medically indicated breast reduction but the mastopexy procedure is not covered since it’s purpose is cosmetic
Diagnosis and Planning
At your initial office visit the surgeon will take a medical history and perform an examination to determine whether you might benefit from the procedure. All operations carry some risk and the reduction mammaplasty procedure is no exception. There are risks associated with the anesthetic. These risks are usually quite small in the majority of patients but they should be discussed with you during the preoperative visit by the anesthetist.
There will be some bleeding during the operation but usually this is controlled without great difficulty and it is seldom necessary to transfuse patients under going this procedure. There is a possibility of infection in any surgical procedure and because of this risk most surgeons give some antibiotic medication at the time of the operation. This precaution helps but will not always prevent a wound infection. With any incision through all the layers of skin there will be some scar. Usually the scars fade with time but there is a small risk of developing hypertrophic or even keloid scars and this possibility should be discussed with your surgeon prior to operation.
During the examination the surgeon will assess your general health and will examine and often take some measurements of the breasts. S/he will ask about family history of breast disease and may recommend a mammogram prior to operation. The surgeon will attempt to ensure that there are no other breast diseases present and no general health problems that would prevent safe surgery. Discussion about the amount of tissue which will be removed and the possible complications of breast reduction surgery will help you understand the process. Often the surgeon will have printed materials with illustrations of the surgical procedure. Most insurance companies require submission of a photograph of the breasts.
OPERATION
Prior to operation most plastic surgeons will use a special felt pen to mark the breasts. There are several acceptable surgical techniques depending on patient anatomy and the surgeon’s preference. We are going to illustrate the scars usually associated with the technique we use most commonly.
A variety of circumstances may influence the length of hospital stay following breast reduction surgery. Most of our patients come in the morning of their surgery, are admitted to the hospital after the operation and go home the following day after dressings have been changed. On rare occasion patients may still be experiencing nausea from their anesthetic and may be unable to take normal liquids by mouth . These patients may have to stay an extra day. On some occasions patients may recover very quickly and completely from the effects of the anesthetic and if they live close and have reliable friends or relatives we have on occasion sent patients home the afternoon of their operation.
There is great individual variation in the anatomy and the symptoms experienced by women with large breasts. No single surgical technique or method of management will suit everyone who is a candidate to benefit from the operation. Some operative techniques preserve at least the possibility of breast feeding while other techniques eliminate any such possibility. If this is a major concern it should be discussed in detail with your surgeon. This offering is intended only as a general informational guide. If you are contemplating a breast reduction procedure you should discuss your specific situation and wishes with the plastic surgeon you have chosen. “how to choose a plastic surgeon”
We are interested to know the level of knowledge the public has regarding the training of Plastic Surgeons. If you would be kind enough to answer the questions as you encounter them it will be greatly appreciated. Don’t worry, we aren’t keeping score and there are no wrong answers.
2. Do you think it takes more than four years after completion of medical school to become a board certified plastic surgeon?
Yes NoThe path to becoming a plastic and reconstructive surgeon involves many years of training in a multitude of fields. Four years of undergraduate education followed by four years of medical school are standard presurgical training periods. A number of surgical fields can be chosen for the prerequisite graduate surgical education prior to beginning plastic surgery residency. The following are prerequisite training options for plastic surgery:
1) Completion of a minimum of 3 years of clinical training in an accredited general surgery residency. A large percentage of plastic surgeons completed a general surgery residency (duration of 5-7 years) and have achieved board certification from the American Board of Surgery (certification requires successful completion of the written and oral examinations).
2) Completion of an accredited residency program in Orthopedic Surgery (duration of training is 5 years).
3) Completion of an accredited residency program in Otolaryngology (duration of training is 5-6 years).
3. Is everyone who advertises their practice as “Plastic Surgery” required by law to have completed an approved plastic surgery residency?
Yes”>Yes NoThe resident must then be evaluated by the American Board of Plastic Surgery to ensure that the prerequisite training was satisfactory prior to beginning plastic surgery training. Plastic surgery training is 2-3 years of clinical exposure to the many areas of plastic surgery with graded increases in clinical and surgical responsibilities. The progress of training is evaluated midway through the first and second years with a standardized written examination which all plastic surgery residents take. After satisfactory completion of a Plastic Surgery training program approved by the American Board of Plastic Surgery the resident is eligible for board certification. The American Board of Plastic Surgery administers a written examination at the end of the plastic surgery residency which must be completed satisfactorily. An oral exam is then administered 2 years after completion of the plastic surgery residency, and is based upon the clinical cases collected by the surgeon during the previous 2 years. If this examination is completed satisfactorily, the surgeon will then be board certified in Plastic and Reconstructive Surgery. The entire process of becoming board certified in plastic surgery requires 17-20 years of education/training after high school.
Frequently, surgeons will choose to pursue additional subspecialty fellowship training in one of the following areas; hand surgery, craniofacial surgery, burn/critical care, microvascular surgery, or cosmetic surgery. These fellowships are usually 1 year in length.
4. Prior to reading this were you aware that training in plastic surgery was so lengthy?
Yes No