Hicham Mouallem - MioDottore.it


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حقن البوتوكس Botox ومدى تأثيرها

البوتوكس Botox هوالمصطلح التجاري لمادة طبية (تكسني بوثولينم) وهي مادة مستخرجة من جرثومة، وحاصلة على موافقة إدارة الأغذية والأدوية FDA على استعمالها لمعالجة مشاكل متعددة في أنحاء الجسم وبشكل خاص في الجراحة التجميلية.
فللبوتوكس القدرة على الحد من العبوس وتقطيب الجبين وظهور الخطوط الجانبية عند زم العينين، ويتم ذلك عن طريق إضعاف عضلات تعابير الوجه، الأمر الذي يريح سطح البشرة ويزيل عنها التجاعيد. وأكثر المناطق التي يتم علاجها هي الجبين، المنطقة حول العينين وبين الحاجبين.
وللبوتوكس استعمالات أخرى حيث تستخدم لمعالجة تشنج الظهر ويستخدم لأوجاع الرأس وللتعرق الزائد في اليدين وتحت الإبط والتأتأة وكذلك للتقلصات غير الإرادية لعضلات الوجه وللرجفة. وتبدو نتيجة البوتوكس واضحة خلال خمسة إلى عشرة أيام وتستمر فعاليتها لفترة تتراوح ما بين أربعة وستة أشهر.
ولا تتسبب حقن البوتوكس بأعراض جانبية أومضاعفات سوى ألم طفيف في الرأس، ونادراً ما يظهر احمرار في مواقع الحقن، ولكنه يختفي عادة حتى قبل مغادرة عيادة الطبيب.
وإذا حقن البوتوكس قرب الحاجبين فإن الضعف الذي يصيب عضلات الجفنين يؤدي إلى هبوط عابر فيهما، إلا أنها حالة عرضية وتستمر فقط لبضعة أسابيع.
إن استعمال البوتوكس باكراً لإزالة التجاعيد يعطي نتائج أفضل، فهو يمنع من أن يستعين بعضلات الوجه العليا لإظهار التعابير وبالتالي يحد كثيراً من ظهور التجاعيد بصورة مبكرة.
ومن المفترض أن يقوم طبيب متمرس بحقن البوتوكس، وذلك لأن التركيب البنيوي للوجه يكون مألوفاً لديه مما يعطي أفضل النتائج وأقربها إلى المظهر الطبيعي، ويحول دون التعرض للمضاعفات والنتائج السلبية الناتجة عن حقن مواقع وكميات خطأ.
ونشأت مؤخراً نزعة حقن البوتوكس في دور التجميل، فالبوتوكس دواء وإن عملية حقنه وإن بدت سهلة فهي إجراء طبي له قواعد صارمة وعواقب وخيمة في حال خطأ استعماله.
وبالنسبة لاستعمال البوتوكس عند الرجال فلا عيب في ذلك ولكن يُستحسن عدم المبالغة في حقنه لدرجة يبدو فيها الوجه ذا تعابير أنثوية.
ويجب الانتظار لمدة ثلاثة أشهر على الأقل قبل تكرار العلاج فإن استعماله أكثر من مرة في الفترة الموصى بها يعرض المريض لتطوير مقاومة ضده، الأمر الذي يفقده تأثيره

الآثار الجانبية
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يعتبر العلاج بحقن البوتوكس آمنا بشكل عام، ولكن قد تظهر بعض الآثار الجانبية وهي مؤقتة مثل الكدمات- الإصابـة بالصـداع- عدم تناسق فـي شكل الوجـه – انتفاض العضـلات – التنميل- استرخاء الجفن العلوي أو الحاجب – ازدواج الرؤية.

هل العلاج بالبوتوكس مؤلم ؟

العلاج بالبوتوكس يكون على شكل إعطاء حقن صغيرة جداً تحت الجلد (شبيهة بإبر الإنسيولين )، وهذا يسبب القليل من الألم بسبب وخذ الأبره وليس مادة البوتوكس ، علماً بأن هذه العملية لا تستغرق أكثر من عشر دقائق يتم إجراؤها في العيادات المتخصصة ويفضل الإستلقاء عدة ساعات بعد الحقن يمكن بعدها مزاولة النشاط المعتاد

الأماكن التي يمكن حقن البوتكس فيها

هنا يجب الإشارة إلى أن هناك حدوداً لما يمكن أن تفعله مادة البوتوكس، يظهر أثر البوتوكس على النحو الأفضل عند استخدامه لمعالجة الخطوط والتجاعيد الواضحة في الوجه ، والتي ترتبط مباشرة مع العضلات المسؤولة عن ظهور تلك التجاعيد. لكن لهذه الحقن فعالية أقل إذا ما استخدمت بغرض علاج التغيرات النسيجية الدقيقة التي تطرأ على سطح البشرة، وتلك التي توجد بصورة طبيعية أثناء سكون العضلات . فالبوتوكس يعمل بشكل مفيد وأفضل على التجاعيد العبيرية الناتجة عن انقباض العضلات تحتها مثل:-

التجاعيد بين الحاجبين والناتجة عن قضب الحاجبين المتكرر في حال العبوس . هذه الخطوط تجعلنا نبدو غاضبين طوال الوقت

– التجاعيد ألأفقيه في الجبهة والناتجة عن تعبير الاستغراب

– التجاعيد حول العينين والناتجة عن الضحك أو الانبهار بأشعة الشمس

– التجاعيد الأفقية في الجبهة

– التجاعيد الأفقية في العنـق

ويمنع إستخدامها في منطقة الفم

موانع استخدام البوتوكس

لا ينصح باستخدام هذه الحقن لبعض الحالات مثل :

– مرضى الجهاز العصبي.

– الأشخاص الذين يتناولون مضادات حيوية، وبخاصة “الامينوغلايكوسايدات”، أو “البنسيللامين”.

– الحوامل أو المرضعات.

استخدام البوتوكس مع وسائل أخرى كالليزر او التقشير يمكن استخدامه في نفس الوقت مع حقن مواد تعبئة بالكولاجين أو بالحمض الهيالوريني او الليزر أو مع شد الوجه أو مع التقشير الكيميائي .

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Cosmetic Surgery for Ears

If your ears protrude or are misshapen, or if your child has misshapen or protruding ears, cosmetic surgery may be an option.
The surgery, which doctors call otoplasty, is most commonly done on children ages 4 to 14. It’s never too late, though, to make a change, and adults do undergo this surgery. Otoplasty can correct ear conditions such as protruding ears, abnormally large ear lobes, lop ear (in which the tip folds down and trends forward), and shell ear — a condition in which certain features of a normal ear are missing.
Deciding on Ear Surgery
The first step is to consult a surgeon. At the first meeting, tell the surgeon about your goals as well as your medical history. Ask about risks, benefits, costs, recovery, and whether your expectations for the results are realistic.
You also need to talk to your health insurance company. That way you can find out before the surgery what, if anything, your insurance will cover.
Most health insurance companies only cover ear reshaping surgery if it will solve a functional problem. For instance, you might have it to correct a hearing impairment. Your insurance also may provide coverage if an otoplasty is done to correct a deformity or congenital abnormality. But if it’s being done for cosmetic reasons only, it may not be covered at all. In that case, ask your doctor for full details about the costs and payment options.
How Cosmetic Ear Surgery Is Done
There are several ways the ear can be reshaped. One involves cutting out the cartilage, which is the main structural component of the ear. Another involves folding and stitching the cartilage instead of cutting it away.
In either case, your surgeon will begin by making a small cut at the back of your ear. This will allow access to the cartilage for the necessary procedure. After the surgery is complete, the surgeon will close the cuts with stitches.

What to Expect and How to Prepare for Cosmetic Ear Surgery
The surgery will last about two to three hours, depending on how complex the procedure for your case is. It may take longer than three hours if the procedure you need is very involved. Ask your surgeon for details about what your case requires.
If you are an adult, your surgeon probably will use local anesthesia with a sedative. A child will likely receive general anesthesia (be put to sleep) to ensure that he or she cannot move around during the operation.
People getting general anesthesia cannot eat or drink after midnight the night before surgery or the morning of the surgery. The last meal the night before should be very light.   Untitled-1
Most otoplasties are done in the surgeon’s office or in an outpatient facility. On the day of the surgery, wear loose fitting, comfortable clothing. Avoid wearing a shirt with a collar. It’s also a good idea to wear a shirt with buttons so that you do not have to pull it over your head.
If you are an adult, the surgery will be completed within a few hours and you can go home the same day. Plan for a friend to drive you home and stay with you the first night. Sometimes, in the case of a child, the doctor will prefer that the child stay in the hospital one night. If you are undergoing a more complex procedure as an adult, you also may need to stay in the hospital overnight.

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how is a facelift performed

Nothing can stop the aging process. But for those with the money and motivation, cosmetic surgery can reverse at least some of the ravages of time. A lot of people are willing to pay a high price for a more youthful appearance. More than 150,000 people in the United States had a facelift in 2004, according to The American Society for Aesthetic Plastic Surgery [ref].

In this article, we’ll see how plastic surgeons are offering up the promise of youth in the form of facelift surgery. We’ll learn how the procedure is performed, how dramatic the results can be, and what risks are involved. But before getting into facelifts, let’s look at how the skin on our faces age.

Skin goes through many changes as we get older. Cellsdivide slower. The dermis, or lower layer of skin, gets thinner. It is comprised of several different types of tissue, including elastin andcollagen. Elastin gives the skin its elasticity, and collagen keeps the skin taut. Eventually both of these proteins begin to break down, causing the skin to loosen. The loss of elasticity makes the skin and underlying tissue more susceptible to the effects of gravity. Instead of springing back when pulled, the skin sags. Additionally, themuscle and tissue composition under the skin changes, leading to wrinkles.

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A facelift can’t completely erase the signs of age, and it can’t fix all problems — for example, sagging eyelids, eyebrows, or skin discoloration. To correct these problems, a patient would need to undergo other procedures (such as an eye lift, brow lift, or chemical peel).

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All You Wanted to Know About Rhinoplasty

A rhinoplasty is an operation to improve the appearance of the nose. It can also be used to improve breathing. A successful rhinoplasty requires careful preoperative planning. Each part of the nose, including the dorsum (or “bridge” of the nose), the tip, the nostrils and their relationship and proportions to each other must be carefully analyzed. The effect that a manipulation of one part will have on the appearance of another must be predicted and calculated. Rhinoplasty is truly a combination of art and science.

During a consultation, detailed pictures are taken of the nose from various angles. Computer simulation is used to demonstrate expected results of the procedure. These are reviewed with the patient. The computer simulations are then used as a guide during the actual surgery.

A rhinoplasty can be performed in one of two ways. My preferred approach is the “Closed” approach. Another approach is referred to as the “Open” approach. Both are valuable techniques. Each has its advantages and disadvantages. The choice of which approach to use depends on the findings during an examination. Ultimately, the goal is to create a natural and aesthetically pleasing and balanced result.

Closed Approach

A “Closed” approach refers to a technique of rhinoplasty in which no external incisions are made. All incisions are made within the nose. The advantage of this approach is that no external scars are created. All scars remain hidden with this technique. This is my preferred method of rhinoplasty.

Most people seeking rhinoplasty will be good candidates for the closed approach. This is because most individuals will have great improvement in the appearance of their nose with changes to the dorsum (“bridge”) of the nose, and minor changes to the tip of the nose. The closed approach is successful in treating these areas.

The closed approach can also be used to treat minor breathing difficulties.

If an individual needs major revision of the tip of the nose, more complex maneuvers to the dorsum of the nose, or has major breathing difficulties, the “Open” approach is a better option.

Open Approach

An “Open” approach refers to a technique in which a small incision is made across the “Columella” (which is the small bridge of tissue between the nostrils leading up to the tip of the nose). The incision is designed so that when it heals, it is inconspicuous. Furthermore, when someone is being viewed at eye level, this part of the nose and the scar are generally not visible.

The open approach is preferred when major changes to the tip of the nose are needed. It is also useful when complex work needs to be done to the dorsum, or “bridge” of the nose. In addition, if a patient has major breathing difficulties, the open approach will be a better technique to use.    Untitled-1

The choice of technique will depend on what is found on a careful examination. A thorough discussion of each technique will be conducted during the consultation.

Recovery

The recovery for a rhinoplasty goes through several stages. Patients can go home after the surgery. Surprisingly, there is relatively little pain after rhinoplasty. This is true even if you had to have your nasal bones fractured. There is a lot of swelling and bruising the first 4-5 days after surgery. The bruising begins to improve after about 5 days. Everyone must wear bandages and a splint over the nose during the first week after surgery. The bandages and splint are removed from the nose after 7 days. Most people will look good after about 7 days. However, I always recommend that patients take more time off from work in order to allow the maximum time for the bruising to improve. I tell patients to wait at least 2 weeks after surgery before attending any important social events. Patients look very good after about 3-4 weeks after surgery. This is when patients will begin to see what their final result will be like.

Swelling persists for many weeks after surgery. As already mentioned, most of the swelling is gone after about one month. However, there is still swelling present after 6 months. It takes approximately 12 full months before all of the swelling is finally gone. The final result is seen after 12 months have passed.

Risks

Rhinoplasty is a very safe procedure. The main risk with having a rhinoplasty done is that the patient may not be completely satisfied with the result. Bleeding and infection can happen, as with any surgery, but are very rare. Asymmetry and irregularities can also occur, but again, these are rare. This can be discussed in further detail during the consultation.

Result

A rhinoplasty is one of the most satisfying and rewarding procedures done. A well trained board certified Plastic Surgeon can create the result desired while maintaining a beautiful and natural look. To achieve this, a careful consultation must be completed and careful preoperative planning done. When done properly, a rhinoplasty is very safe and has a relatively easy recovery. A rhinoplasty can create the look and result you have always desired.

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