The picture shown above is of a young gentleman who had a machine injury which resulted in a finger tip amputation. The reconstruction was done using a v-y advancement flap and a fairly acceptable cosmetic result was achieved+
Tuesday, April 9, 2013
Finger tip injury, amputation, machine, plastic surgery India, cosmetic surgery , dr alexander, plastic surgeon, cosmetic surgeon, cochin, kerala, kochi, Before and after , medical tourism+
The picture shown above is of a young gentleman who had a machine injury which resulted in a finger tip amputation. The reconstruction was done using a v-y advancement flap and a fairly acceptable cosmetic result was achieved+
Axillary breast, breast liposuction, breast surgery, plastic surgery India, cosmetic surgery India, Dr Alexander, plastic surgeon, cosmetic surgeon, cochin, kerala, kochi, medical tourism +
Charles Darwin changed the course of our thinking with his revolutionary theory in the 'Descent of man' first published in 1871. That we could have evolved from apes as mutations occurred in the 'evolution of species' and the 'survival of the fittest', was put down as a possibility. Yet all life seems to be connected, though we may not be able to prove it conclusively. The organic molecules that joined together to form the first living structures that were able to multiply must then be considered our original forefathers. We must then believe that inanimate gave way to animate, that life originated from non living... Can we then imagine that one day our tables and chairs, our pots and pans, under unknown conditions may evolve into something living??
It is funny that we consider them non living. Every atom has protons electrons and other particles that are constantly moving and performing some specific functions-- wonder whether we should call them non living or living??? radioactive particles even set of chain reactions ….
On the other hand our understanding of the divine is miniscule, the cosmos remains proof of that. We can hardly fathom the universe we understand, the universes beyond remain a mystery. The big bangs, the black holes and the unending space theories makes us realize that little do we know about anything, including ourselves.
What existed before the big bang????
Because we are unable to see or feel God, we fail to accept him. Yet God has continued to exist only because people are able to experience him. There are things that one cannot explain and must be left at that- till something crops up or an explanation is offered.
Medicine is the same- though we presume to know much, our understanding is naught. Little do we know the micro mechanisms that go on in a cell, nor do we know why our genomes are so long, what mysteries do they code and when will we encode them meaningfully....we make observations and then we make conclusions.... what prompts the DNA to decode, copy and multiply??? who programmed it or does it auto program itself ?? where did it get this ability?? can we presume that the the first DNA blocks that were formed from the soup of organic molecules are part of our DNA codes as well??Why does evolution prefer beauty to ugly...the trees, the leaves, the flowers, the mountains, the rivers, the birds, the bees, the human being, all prove that even evolution favors beauty to ugly... why does mutations not lead to healthy monstrous off springs ??
well- we are diverging from the point- 'axillary breast'
Animals like dogs have multiple breasts along what is referred to as the milk line. This line extends from the axilla to the groin. Going by Darwin's theory, in our evolution we lost many of those breasts and retained the ones over our anterior chest. However sometimes one of these breasts may occur along other positions on the milk line. When it does occur near the axilla or in it, it is referred to as the 'axillary breast'. Sometimes fat deposition at this site may mimic this as well.
Axillary breasts may cause pain, produce milk or discharge or become a cosmetic deformity preventing a lady from even wearing appropriate attires.
Treating an axillary breast will depend on whether it is predominantly fatty or has hard glandular tissue and whether the skin is in excess and overhanging.
When fat is a problem liposuction will help.
When breast tissue is tough and liposuction fails then open surgery may be needed.
When the skin is in excess then the skin also will need to be removed by keeping the incision cosmetically acceptable +
Friday, April 5, 2013
Actor Dileep, star, sound Thoma, bollywood, cleft lip, cleft palate, nose, plastic surgery, India, cosmetic surgery, India, Dr Alexander, cochin, kerala, India, medical tourism, kochi+ +
A lot of people - friends,
patients, relatives and well wishers have been asking me about Dileep's new
movie "Sound Thoma', in which Dileep plays 'Thoma', a gentleman from an
affluent family, who suffers from a cleft lip deformity, with Namitha Pramod
playing the heroine. The movie, produced by Anoop and directed by Vysakh,
promises to be another hit. The picture below is from WWW. kerala9.com
Dileep is a wonderful and
versatile actor who has wooed the audience with his acting skills in movies
like ‘chandupottu’ and ‘kunjikoonan’ besides others. I too am a fan of Dileep
having watched many of his movies and feel that he is now moving slowly into
the class of Mamooty and Mohanlal.
That brings us to the topic of
cleft lip and the question which everybody is asking me- do all cleft lip
patients have speech abnormalities?
Not really!!
Cleft lip is part of a
congenital (From birth) abnormality that may manifest by itself in its minor
form or may be associated with other defects off the palate, jaw, and nose.
As the child grows in the mother’s
womb the lip and palate start developing in the first 4-6 weeks. The clefting
occurs because of the failure of the tissues to unite from either side as the
face begins to develop.
Depending on the degree of
failure of fusion the baby may have any of these abnormalities
Cleft lip only
Cleft lip and alveolus (the
area where the teeth are attached to the jaw bone)
Cleft lip+ alveolus + nose
deformity
Cleft lip + alveolus + palate +
nose deformity
Cleft lip + alveolus +palate
+nose deformity +premaxillary deformity (Upper jaw)
Cleft lip is more common in
males as compared to females (2:1) and the overall incidence is 1 in every 1000
live births.
Interestingly the ration of
cleft lip and palate deformity to cleft lip is only 2:1
The picture below is of a cleft
lip and palate child.
Why does cleft lip occur?
Sometimes they occur because
the abnormality runs in the family or is carried in the genes. They can be part
of a syndrome where other organs are affected. At other times, they may occur spontaneously
without any family history.
Are there any risk factors that
we can avoid to reduce the occurrence of cleft lip?
Yes during pregnancy avoid the
use of these medications when possible- phenytoin, methyl prednisolone,
steroids, Phenobarbital, diazepam, isotretinoin. Older parents (>30years)
have a higher chance of getting a cleft lip baby. So plan your babies at an
early age. Avoid smoking during pregnancy.
What abnormality does Dileep as
‘Sound thoma’ have?
From the movie still pictures
he seems to have
1. A cleft
lip
2. A nose
deformity
What about a palate deformity
and speech problems?
Well, since ‘Sound thoma’ has a
significant speech defect, he must have a cleft palate or palate deformity. The
whole movie is based on his speech problem and patients with only cleft lip do
not have a significant speech problem as with cleft palate patients, except for
certain alphabets and words. If the palate is clefted, air escapes into the
nose, while we try to speak and a nasal toned speech develops and sounds funny
and difficult to understand.
What can we do for ‘Sound Thoma?’
Well normally a cleft lip is
operated at 3 months and the cleft palate at 6 months. Speech deformity is
evaluated at 2 to 4 years and operated on if necessary if speech therapy fails.
Teeth and alveolar deformity is corrected by 7 to 10 years. Nose deformity is
corrected as it develops. Sometimes even jaw surgery may be needed. ‘Sound
thoma’ has past all these ‘ages’. Still his lip and nose can be cosmetically
corrected to make him more handsome. The palate can be operated and along with
speech therapy the speech can be improved, but a normal speech is unlikely as
speech in a baby develops by 2 years and it is very difficult to correct brain
patterns and habits developed over years.
The secret in treating a cleft
lip/palate baby is timing. By subjecting the child to surgery at the right time
we can try to minimize his defects and problems and make him lead a normal
social life. A child with a cleft lip operated as per the protocol is seen
below.
Dileep has done a great service
to the cleft lip patients by creating awareness through his film.
May this film be a super hit!!
+Am off to watch this movie…………..
Wednesday, April 3, 2013
Earlobe defect, wide hole, repair, ear, plastic surgery India, cosmetic surgery India, cosmetic surgeon, plastic surgeon, Cochin, kerala, Kochi, medical tourism ++
Torn ear lobes or wide ear lobe holes can be a problem as they prevent us from wearing different ear rings. Ear studs tend to fall our while larger ear rings hang down and look unsightly. The picture above shows a wide ear hole with marginal tear. Repairing these defects can help women wear different sized ear rings that match their appearance and styles. Picture below shows a repaired ear lobe after surgery. The ear lobe can now be planned for ear piercing and creation of a new ear hole.
Saturday, March 30, 2013
Tuesday, March 26, 2013
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