Breakthrough Treatment for Decubitus Ulcers

July 27th, 2010
James Woodley asked:




Bed sores, something we all know about, yet dare not think about. All those that saw Clint Eastwood’s film “Million Dollar Baby” definitely winced when they saw the scenes featuring Hillary Duff’s character dealing with these horrid bed sores and the tragic consequences they can bring. Occurrences involving bed sores are normally benign and do not involve such extreme consequences as seen in the film however, but they do range from the completely harmless to the painful and problematic.

Bed sores are known in the clinical world as a decubitus ulcer. The root cause of which is always pressure on a point of the body which isn’t relieved, this causes an ulcer to develop. Bed sores are most prevalent on the bed bound or immobile as they cannot move their body to prevent these sores appearing.

Friction is also another villain that can bring about a decubitus ulcer. In this instance what happens is that a limb may be in a cast and the limb repeatedly rubs against the cast. This can bring about the onset of the ulcers. There are many other things that can cause friction against the body including such seemingly innocuous items such as bed sheets and other common items.

If a patient is bed-ridden or immobile, proper monitoring is essential to prevent bed sores from becoming a real problem. The staff in hospitals, care homes etc. must make sure they are constantly vigilant of the signs that an decubitus ulcer is starting to form and try and relieve the pressure on the patient. This can be done by moving the patient into another comfortable position thus relieving the pressure on the part of the body. This should all be done with the patients comfort in mind, and not be forced upon them. The bed sore can be looked at as a case of negligence if health professionals fail to keep up with their responsibilities of prevention and could lead to being found guilty in a malpractice case.

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Diabetic Foot Infection Control With Ultraviolet Light

July 17th, 2010
Bob G Johnson asked:




Diabetic foot infections arising from ulcerations are the largest non-traumatic cause of lower extremity amputations. Many of the infections are acquired by improper care of the ulcer as well as failure to protect the open wound from contaminants. Contributing factors include peripheral neuropathy and vascular disease, rigid pedal deformities, local trauma and pressure, extensive soft tissue loss, multi-system failure, non-compliance and severe infection. For Podiatrists it is a recurring problem.

The recent Infectious Diseases Society of America (IDSA) Diabetic Foot Infection Guidelines emphasize the following point:

“Aerobic gram positive cocci (especially Staphylococcus aureus) are the predominant pathogens in diabetic foot infections. Patients who have chronic wounds or who have recently received antibiotic therapy may also be infected with gram negative rods, and those with foot ischemia or gangrene may also have obligate anaerobes.”

The guidelines specifically note the dated thinking that all DFIs are mixed infections is not evidence based. There is a difference in microbial flora based on the severity of the infection and the presence of comorbidities. Even in the more complicated infections in which a myriad of other organisms may be isolated, their importance as primary pathogens needing antibiotic coverage is debatable. Many represent colonization only.

MRSA Continues To Be Evolving Problem

While the number and types of true pathogens in the majority of DFIs may be limited to Staphylococcus and Streptococcus, it does not mean that the clinician can rest assured that traditional therapies active against these two organisms will be enough. MRSA as well as VRE are emerging as serious threats to the diabetic patient.

The traditional therapies of systemic antibiotics often compromise the healing of the ulcer itself as well as many of the topical agents that are branded generics of common ingredients such as silver, povidone iodine, and other traditional topicals.

“Wound Healing, Alternatives in Management” by Kloth, McCullouch also point out that many chronic wounds are not chronic in nature but are acute injuries that are consistently reinjured in treatment and appear to be chronic. An example of improper treatment would be the use of sterile gauze as filler yet the gauze is allowed to dry out and the results are the gauze now adheres to the new granulating tissue and each removal destroys the new growth and sets back the healing while exposing newly injured tissue to external contaminants. Eschar develops, which is a wonderful breeding ground for MRSA and other pathogens, because the top cells die from dehydration and the dead tissue becomes the eschar.

In the past five years, there has been a seemingly logarithmic growth in the incidence of methicillin resistant Staphylococcus aureus (MRSA) as a pathogen in the diabetic foot. This organism was once associated only with nosocomial infections but now community-acquired strains of MRSA have become common in DFI cases. While it is outside the scope of this feature to review MRSA in detail, it is important to examine the situation in the diabetic foot.

As recently as 1996, Goldstein reported that 20 percent of the staphylococcal isolates from his diabetic foot population in California were methicillin resistant.4 In 1999, Tentolouris showed 40 percent of the staphylococcal isolates in their diabetic foot clinic in the United Kingdom were methicillin resistant.5 In 2003, the same group published a follow-up study entitled “Methicillin resistant Staphylococcus aureus in the diabetic foot clinic: A worsening problem.”6 Although the absolute percentage of MRSA among their staphylococcal isolates only increased to 42.2 percent, the number of patients that actually presented with MRSA doubled. Fortunately, their study found many of these MRSA isolates could be treated effectively with debridement, topical therapy and isolation.

Unfortunately traditional treatments continue to be used and the population of drug resistant strains of “super germs” continues to develop faster than new antibiotics. This is not necessary.

Ultraviolet C- range ( 254 nm) has consistently shown the ability to not only kill all forms of pathogens, especially bacterial, but no bacteria has ever been capable of mutating or avoiding the lethal effects of UVC. Ultraviolet C range is easy for the patient to self-treat and one of the lamps is FDA approved for dermatological applications such as destroying pathogens on the skin surface thus avoiding new contamination. Total treatment time is less than 90 seconds. Cost once device purchased or rented is only the cost of electricity for a 4 watt bulb for 90 seconds, or less than a penny.

Ultraviolet can be used for not only topical treatment where the bacteria has localized but is also indicated for systemic infections.

Tens and Interferential electrotherapy can be used post Ultraviolet treatment to facilitate faster growth as well as controlling the swelling and increasing blood flow to the foot.

There are many tried and true therapies such as ultraviolet that will stop the necessity of amputation for the patient with a diabetic foot infection or any other foot wound that becomes infected.

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Therapeutic Benefit of Manuka Honey in Wound Care

July 16th, 2010
Frank W. Buonanotte asked:




In comparing the use of Manuka Honey dressings with topical antiseptics on wound infections, it has been found that Manuka Honey dressings significantly reduce the amount of fluid exuding from the wound. This, in part, is a result of the anti-inflammatory properties present in Manuka Honey. In addition, the anti-inflammatory properties in Manuka Honey also help to reduce pain and minimize scaring.

It has also been established that Manuka Honey dressings create a moist wound environment which facilitates the healing process. Manuka Honey draws lymph out of the deeper tissues of the wound by osmosis and continuously cleanses the wound bed. Lymph fluid contains enzymes that degrade protein molecules. The constant reduction of wound fluids remove foreign body contamination, such as dirt or grit.

The most likely explanation for Manuka Honey’s debriding activity involves the conversion of blood to plasmin, which is an enzyme that breaks down the protein in blood coagulation. This conversion minimizes dead tissue and scab formation on the wound. The osmotic action of Manuka honey draws moisture into the skin.

It has also been found that Manuka Honey has the ability to reduce malodor in wounds. Malodorous substances such as ammonia and sulphur compounds are produced when bacteria feeds on the protein in a wound. Because Manuka Honey provides bacteria an alternative source of energy (sugar), these noxious compounds are no longer produced and wound malodor is eliminated.

In clinical observations, Manuka Honey has also been proven to have the ability to manage wound infection in circumstances where antibiotics and other conventional treatments have failed. More specifically, Manuka Honey has been found to be effective against antibiotic-resistant strains of bacteria such as Methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococci (VRE) and other multi-resistant microorganisms. These mutated types of bacteria protect themselves from antimicrobial elements by forming a biofilm. Manuka Honey breaks down these clumpy biofilms as well as preventing the formation of biofilms. These findings are particularly encouraging, considering the growing number of cases involving Staph infections that don’t respond to antibiotics. So far there has been no evidence of any bacterial resistance to Manuka Honey. It is highly unlikely that bacteria will ever be able to develop a resistance to Manuka Honey because bacteria rely on sugar as a source of food.

Manuka Honey’s antibacterial properties are a result of the following:

1. The high sugar content and low water activity provides an osmotic action;

2. Acidic pH inhibits bacterial growth;

3. Glucose oxidase enzyme produces hydrogen peroxide;

4. Plant-derived factors such as UMF and Methylglyoxal.

Manuka Honey’s antibacterial properties have the ability to penetrate below the surface of the skin, making it possible to clear deep-seated infections and boils with unbroken skin. In other words, Manuka Honey diffuses through the skin, getting to deeper tissues.

“The use of Manuka Honey dressings help prevent cross contamination,” says Frank Buonanotte, CEO of Honeymark International which is a manufacturer of advanced wound and skin care products containing Active Manuka Honey as a healing agent. “The sticky nature of Manuka Honey provides a protective barrier that prevents cross contamination.”

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Scientific Jobs are not for Scientists Alone

July 14th, 2010
Stefan Kyriakides asked:




Scientific jobs usually involve some research. The jobholder would have specialized training and experience in a field, and the ability to draw on it to conduct field or laboratory research. For example, a clinical research assistant working for a clinical research organization can be required to go out into the field and record the findings of clinical trials for medical devices or medication.

In such cases, in addition to knowledge in the field of science, the job holder will also have to be familiar with research methodology to ensure adherence to quality research practices, so that the research findings will be acceptable to practitioners in the relevant field.

Furthermore, the jobholder might also be required to keep track of the costs of the research, which require some administrative experience. Scientific jobs could thus involve much more than doing theoretical research in a laboratory.

Roles of Career Scientists

We saw in the previous section that even when research is involved, scientific jobs could involve administrative and quality control roles. Many scientific jobs might not involve research as such. Instead, it might involve applying the jobholder’s knowledge to do practical work. For example, physicians apply their knowledge of healing science primarily to cure sick patients rather do research with medication.

Another example is the clinical psychologist engaged in providing clinical and forensic psychology service to patients, and advice and consultation to non-psychologist colleagues in the medical profession.

A forensic toxicology expert might be primarily involved in providing testimony in courts about the effect of alcohol on human body and driving skills, and explaining the significance of the results of a defendant’s breath and blood tests. Such a function requires the application of professional knowledge and experience in the relevant scientific field.

Environmental health practitioners might have to be community workers and change agents in addition to their roles of identifying and preventing environmental health problems. Possessing knowledge alone might not help them provide valuable services in their field. They will have to work with an environmental health team to create awareness about environmental health issues among the community, and show how the locality can be made a better place to live and work.

Scientific jobs can also involve working in areas other than the primary scientific field of the jobholder. For example, a healthcare specialist with Information Technology experience might be employed to develop clinical information models. They might have to do requirements studies to develop the kind of clinical information models that clinicians need. The requirements study in this case is more IT work than clinical work.

Another example is a specialist who works in the sales and marketing department helping the department explain product benefits and other technical aspects to prospective clients, or for creating product literature. Many specialists might be attracted by commercial work, and can use their specialist know-how, say in wound care, in marketing wound care products effectively.

Then there is the science teacher who is engaged in developing the scientists of tomorrow. The teacher must be able to create an enthusiasm for the field among students in addition to teaching them science.

Scientific jobs thus involve being more than just scientists. In fact few scientific jobs require you to be a scientist these days.



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Foot Ulcer – Types and Treatment

July 1st, 2010
peterhutch asked:




A skin ulcer is where an area of skin has broken down and you can see the underlying tissue. Most skin ulcers occur on the lower legs or feet. The skin normally heals quickly if it is cut. However, in some people with diabetes the skin on the feet does not heal so well and is prone to develop an ulcer. This can be even after a mild injury such as stepping on a small stone in your bare feet.

Types of Foot Ulcer

Venous ulcers are located below the knee and are primarily found on the inner part of the leg, just above the ankle.

The borders of a venous ulcer are usually irregularly shaped and the surrounding skin is often discolored and swollen. It may even feel warm or hot.

The skin may appear shiny and tight, depending on the amount of edema (swelling). The skin may also have brown or purple discoloration about the lower leg, known as “stasis skin changes.”

Neurotrophic (diabetic)

Neurotrophic ulcers are usually located at increased pressure points on the bottom of the feet. However, neurotrophic ulcers related to trauma can occur anywhere on the foot. They occur primarily in people with diabetes although they can affect anyone who has an impaired sensation of the feet.

Diabetes can cause damage to the nerve and vascular supply in the feet and legs. Patients with neuropathy have reduced or no sensation and, therefore, might be unaware of any trauma to their feet caused by ill-fitting footwear or an object in their shoes, such as a piece of glass, a stone or a drawing pin.

Continued walking on an injured foot will damage it further and minor lesions can become more serious. A simple examination of the feet, feeling inside the shoes before wearing them and not walking barefoot can help to prevent minor injuries. Many of the patients attending the diabetes clinic are older and some cannot see, feel or reach their feet, which means that they are often unaware of any injuries

Diabetic foot ulcers are caused by neuropathic (nerve) and vascular (blood vessel) complications of the disease.

Nerve damage due to diabetes causes altered or complete loss of feeling in the foot and/or leg. This is known as peripheral neuropathy. Pressure from shoes, cuts, bruises, or any injury to the foot may go unnoticed. The loss of protective sensation stops the patient from being warned that the skin is being injured and may result in skin loss, blisters and ulcers.

Treatment options for all ulcers may include:

Antibiotics, if an infection is present

Anti-platelet or anti-clotting medications to prevent a blood clot

Topical wound care therapies

Compression garments

As a rule, the better the control of your diabetes, the less likely you are to develop complications such as foot ulcers. Also, where appropriate, treatment of high blood pressure, high cholesterol level, and reducing any other risk factors will reduce your risk of diabetes complications. In particular, you are strongly advised to stop smoking if you smoke.

Our feet keep us balanced and carry our weight. In a lifetime they walk as much as going five times around the earth. We should look after our feet before any of these problems creep in. Some of the serious foot problems may need the attention of a doctor. So, prevention is always better than cure.



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Oral Health and Dental Care

June 6th, 2010
Rolf Joho asked:




Dental care is integral part of general health, and good oral health gives the sense of overall well-being. Tooth decay is the most common health problem in many countries, and it shows the poor emphasis on the dental care by the general public. Unbalanced diet, poor brushing habits and negligence to daily oral care leads to various dental problems calling for dental treatments, which can be time consuming, expensive, painful and complex. Most of the dental problems can be avoided by paying attention to the daily oral hygiene.

Important Dental Care Tips

It is advisable to use the soft bristled brush with synthetic rounded bristles. When buying a brush, look for the seal of approval from American Dental Association. The toothbrush must be replaced every 2-3 months, or when the bristles are bent or worn. For good dental care, replace your toothbrush after you have suffered from cold.

Proper brushing technique is important for dental care, and brush outside, inside and inside surface of lower and upper jaws. Brush your tongue to freshen up your breath as bacteria and debris on the tongue cause bad breath.

The ideal dental care involves brushing the teeth at least once everyday, preferably at bed time. Brushing after the breakfast helps in thorough removal of plague daily. To clean each tooth properly, change the position of the brush after few strokes. Good dental care does not require too much of paste, and pea-sized fluoridated toothpaste is sufficient. It is essential to avoid brushing teeth too vigorously as it can wear down the tooth structure. It can also cause the gums to recede, exposing the root surface.

For good dental care, good flossing techniques must be used. But, many people do not enjoy flossing, as they are not aware of the proper technique, and hence hurt the soft tissues of the mouth during the attempt. A safe and effective alternative to flossing includes use of brush picks, floss picks, tooth picks and special plague removers.

Some dental specialists and dentists advise using the plague removers instead of regular flossing for dental care. The picks can reach the nooks of the mouth that are left unavailable for floss and toothbrush. Toothpicks are great for dental care, but they are not able to reach all the desired places such as behind the last wisdom tooth.

For good dental care, you can also make the toothpaste at home by mixing baking soda, salt, glycerin and peppermint. But, never swallow the toothpaste, as it may cause the fluoride toxicity. Brush mildly for 2-3 minutes as brushing vigorously for longer time does more harm than good.

Many studies have indicated a strong correlation between oral health and general health. Not paying attention to the dental care can lead to many health problems such as osteoporosis, heart disease, diabetes, respiratory disease and pregnancy problems. The bacteria causing the periodontal infection can enter the blood stream carrying the infection to many major body organs, leading to various health problems. Consider a periodontal evaluation if you have diabetes, osteoporosis, heart disease, respiratory disease or if planning to conceive a baby.

As a good dental care program, smoking must be avoided as it can cause tooth discoloration, bad breath, tooth decay and gum disease. Some of the other ill-effects of smoking include mouth bores, hairy tongue, shifting teeth, delayed wound healing, altered sense of smell and taste and jaw bone loss.

For good dental care, mouthwashes such as Chorohexidine or Listernine have effective antiseptic properties that kill the bacterial plague. It is also important to maintain a well-balanced diet, and minimize the consumption of sugary and starchy foods that are known to cause tooth decay. To maintain proper dental care, avoid eating between meals as it makes teeth more prone to decay.

It also helps to visit your dentist once in 3-4 months so that any oral concern can be diagnosed early. There are no symptoms associated with most of oral health problems till the disease has progressed to the advanced stage.

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Do You Currently Have a Wound?

May 14th, 2010
Uchenna Ani-Okoye asked:




Addressing the wounds of casualties, betrayal, and the lack of love, Kidd shows the power of women uniting together to treat those wounds, to care about each other and themselves, and to create a community of true family and home. Lieutenant Inouye was transferred back to the United States to receive treatment and rehabilitation for his wounds. There is nothing wrong in it, you cannot imagine how venting-out bitter and harmful emotions like anger, pain, frustration, hopelessness can heal inner wounds.

Honey has been used as a dressing and first aid treatment for wounds, burns and cuts as it is able to absorb moisture from the air and promote healing. I went away from that experience licking my wounds, but absolutely convinced there was an underlying and identifiable pattern or rhythm in the markets. After the dissection, the surgeon will then puncture the sites for the receiving grafts, implanting them in a predetermined density and pattern angling the wounds in a consistent pattern to promote a realistic hair pattern.

Also it is said that chopping onion helps the eyes, and during World War II, Russian soldiers applied Onions to battle wounds as an antiseptic. It can be used on all organs as well as for viruses, herpes, low level infections, sinus conditions, allergies, wounds, pain and for muscle relaxation. Honey prevents ageing of the skin and it also helps in easy healing of wounds.

We relate to the world from the wounds of apathy, grief, fear, lust, anger, and pride. You’ve forced me to look into my raw wounds with an unflinching eye and take a massive inventory of my mind and my soul. Active blood circulation also means efficient transport of nutrients which attributes to prompt healing of wounds, delayed ageing, a boost in stamina, improved digestion, and dodging disability, enhanced breathing, rejuvenation of skin and radiation of confidence.

You have magical tools to alter your appearance, fragrant soaps and shampoos, potions to ease your body’s discomforts, items for dressing your wounds, each made from materials gathered from all over the globe and brought to you through the labour of thousands of workers. Secrets were revealed, wounds were healed, fears were relieved, hopes were supported, faith was renewed and we all discovered a new level of love and caring. Topical application of colloidal silver made on blistered or open wounds prevents risk of infection.

Moreover, zinc’s antioxidant properties help remove free radicals and bacterial from wounds to expedite healing. Lord your word says in 1 Peter 2:24 “and He Himself bore our sins in His body on the cross, so that we might die to sin and live to righteousness; for by His wounds you were healed. Ascorbic acid promotes healthy cell development, proper calcium absorption, normal tissue growth and repair – such as healing of wounds and burns.

This nutrient is vital in aiding your body heal wounds faster and build new tissues. This chronic disease is caused by the normal response of your body to infections, injury, wounds, or foreign objects. Some studies have shown that, while the aloe vera does relieve pain, wounds treated with aloe vera can take longer to heal than usual, making it an undesirable treatment in many situations.

As with other “action” films, the blood leaking from gun or knife wounds may be too much at times, some things that have been reported by patients and dermatological surgeons which affect the appearance on aging skin, making it look younger, are: reducing light wrinkles and fine lines, lightening sun spots, reducing the appearance of some scars, and healing of wounds.



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Studies Show That Honey Promotes Healing

May 7th, 2010
Ken Petersen asked:




Bacteria protect themselves from antibiotics by forming slimy clumps as a protective layer. However, scientists have now discovered that honey is effective in breaking down this protective barrier. Bacteria is the main cause for wounds not healing fast enough and with the recent outbreaks of antibiotic-resistant strains of bacteria, this is becoming more of a problem.

If bacteria multiply enough to form a slimy mass or bio-film, they are much less sensitive to antibiotics and antiseptics. Doctors treating infected wounds need to remove this bio-film so that they can prevent the spread of bacteria. Bio-films prevent healing in wounds and may lead to chronic ulcers.

Laboratory studies indicate that wounds treated with a special type of honey known as “Manuka Honey” are able to heal more rapidly and the bio-film is disrupted. This suggests that Manuka Honey could be a viable solution to treating infected wounds, more so than antibiotics. With the increase in MRSA cases and other hospital infections from antibiotic-resistant bacteria, doctors need more effective treatments.

A company called Honeymark International has developed an over-the-counter wound dressing containing Manuka Honey that is effective against tough bio-films and bacteria. This First Aid Antiseptic Lotion with Manuka Honey is effective in treating staph infections and other hard to heal wounds. It’s also effective in treating burns and skin ulcers. “The reason why Manuka Honey is more effective in destroying bacteria is because Manuka Honey has the ability to draw water out of the bacteria, making it impossible for the bacteria to survive,” says Frank Buonanotte, CEO of Honeymark International. “As a result Manuka Honey is the most important ingredient to consider for wound care products as nothing else has proven to be as effective.”



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Piercing Care

April 27th, 2010
Liopased Ioaspa asked:




In order to prevent an inflammation, your fresh piercing demands for constant ongoing care. During at least two weeks, twice a day minimum, you will have to clean your wound with special liquid disinfectant, up to complete healing will be achieved. Please use only oil-free antiseptic creams, forget about the sauna, pool and solarium, swimming in natural water basins and especially in sea water, because sea water slows the healing process.

Should any complications (such as severe redness, pain, etc.) occur, rush to the dermatologist immediately. Could happen, the doctor will have to remove your ring.

If you have managed without an inflammation, wear first adornment until the wound heals completely. Otherwise, it might easy catch dirt, and this time an inflammation will develop for sure.

No other care products are allowed, except recommended ones, and no other creams should be used but oil-free.

Please refer to the description of the professionally done piercing after-effects provided below:

1) Stable redness, which is expected to go down in 3-4 days;

2) Bleeding can last over some two-three days;

3) Extra sensitivity will bother you for approximately 2 weeks;

4) There will be some discharge of white-yellowish liquid for nearly 2 weeks, which is just normal and good for healing;

5) It could slightly decrease in size.

See below for all the stuff you would need for your aftercare procedures:

- Special solution, broad spectrum antiseptic. This liquid they will recommend you in the piercing saloon.

- You have to rinse piercing twice a day – in the morning and in the night – for the entire healing period. To do this, soak cosmetic swabs or tissue in your special liquid and clean the area of puncture from discharged blood plasma and lymph. Don’t even think about scratching off this bloody scab from around the ring with your nails! To remove it, moist the ring with the soaked little cotton pad, pressing it against the area for half an hour. Do not turn your ring over!

- There is no need to clean your piercing for too often, and it is not recommended. You don’t want to irritate your wound and thus prolong the healing. On the other hand, it is not advisable to rinse the puncture less than 2 times a day, as it may allow an infection to develop.



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The Skinny on Tummy Tucks

March 30th, 2010
Nick Messe asked:




Abdominoplasty, otherwise known as the tummy tuck, is a plastic surgery procedure designed to rid you of the excess fat and skin around your midsection. As well it helps tighten the middle and lower abdominal muscles with the ultimate goal of giving you a firmer leaner waistline.

During an abdominoplasty, an incision is made across the abdomen, just above the pubic area. The doctor makes a second incision to free the belly button from the belly button stalk. The skin is then pulled up along the rib cage, separating it from the abdominal wall. Excess fat is removed from the abdominal area. Next the surgeon tightens the underlying tissue and muscle by suturing it together, revealing a tighter, more toned waistline.

The surgeon then pulls the skin back down, removing any excess, and makes a new incision for the belly button. Sometimes at this point the surgeon performs liposuction to sculpt the abdomen. A compete abdominoplasty takes about two to five hours. A partial, or mini-tummy tuck, is a less invasive procedure that focuses just on removing excess skin and fat from the lower abdominal area and takes about one to two hours to perform.

Ideal candidates for this procedure include individuals who retain extra fat and skin around their midsections even when they adhere to a diet and exercise program, especially people who have loose skin after weight loss or multiple pregnancies.

If you decide to consult a cosmetic surgeon about abdominoplasty, expect the doctor to begin by taking a detailed family and personal medical history that he will use to evaluate whether you are a suitable candidate for cosmetic surgery. He will then examine your abdominal area to measure fat deposits, their distribution, and your general skin tone.

The plastic surgeon will also explain the surgical process to you, including informing you of any anesthetic that will be used, and discuss risks associated with the surgery. The surgeon will then explain the recovery process to you and estimate how long it’s likely to take, and give you an honest assessment of what results you should ultimately expect from your surgery.

If you decide to proceed with the plastic surgery, your doctor will give you detailed instructions before surgery, including a warning to refrain from smoking during the two week period prior to the procedure and the two weeks after surgery, as smoking inhibits wound healing.

Swelling and pain are common and to be expected afterward. Your physician can give you medications to ease the pain, and you can expect to have your sutures taken out approximately a week after surgery. Recovery times depends upon the individual, but many people are able to return to work after only one to two weeks, even though they may not fully recover for several months. Scars will take a little longer to fade.

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