BOTOX, πόσο ασφαλές είναι;

Δρ Ιωάννης Γεωργίου

Πλαστικός Χειρούργος

http://www.plasticsurgery4cyprus.com/

Τι είναι η βοτουλινική τοξίνη (Botox);

H βοτουλινική τοξίνη τύπου Α (ΒΤΑ) είναι μία τοξίνη που παράγεται από το αναερόβιο βακτηρίδιο Clostridium Botulinum . Λειτουργεί μπλοκάροντας κάποιες ειδικές  νευρικές απολήξεις που είναι υπεύθυνες για τις κινήσεις των μυών, προκαλώντας έτσι την αδυναμία η παράλυση τους. Το αποτέλεσμα είναι πλήρως αναστρέψιμο μέσο της επανανεύρωσης των μυών εντός 2-6 μηνών.

Ποιές είναι οι ενδείξεις;

Στην πλαστική χειρουργική ενδείκνυται κυρίως για λόγους αισθητικής. Η θεραπεία με το BTA εμποδίζει την σύσπαση των μυών που προκαλούν τις ρυτίδες έκφρασης, και οι ρυτίδες που θα σχηματίζονταν ως αποτέλεσμα της σύσπασης μειώνονται αισθητά. Χρησιμοποιείται κυρίως για τις ρυτίδες στο μέτωπο, στο μεσόφρυδο ,στην εξωτερική γωνία του ματιού και τις χορδές στο λαιμό. Εφαρμογές  γύρω από το στόμα και κάτω από τα μάτια είναι λιγότερο συχνές  καθώς μπορούν  να προκαλέσουν πτώση του κάτω βλεφάρου και παραμόρφωση του στόματος.

Το BTA μπορεί να χρησιμοποιηθεί με επιτυχία σε ασθενείς με υπερίδρωση (υπερβολικός ιδρώτας) στην περιοχή της μασχάλης και στις παλάμες. Μπορεί επίσης να είναι χρήσιμο σε μερικούς ασθενείς που πάσχουν απόημικρανίες. Άλλες ιατρικές ειδικότητες χρησιμοποιούν το BTA για την θεραπεία ορισμένων διαταραχών της κίνησης (δυστονίες), της σπαστικότητας και άλλων διαταραχών των μυών.

Πόσο ασφαλές είναι;

Σε υψηλές δοσολογίες μπορεί να είναι θανατηφόρο, κυρίως λόγω της  παράλυσης των μυών της αναπνοής,  αλλά οι ποσότητες που χρησιμοποιούνται για ιατρικούς λόγους, είναι πολύ χαμηλές, καθιστώντας το ΒΤΑ μια πολύ ασφαλής ουσία.

Υπάρχουν παρενέργειες;

Στις λιγότερο σοβαρές παρενέργειες περιλαμβάνονται αλλεργικές αντιδράσεις, εξανθήματα, κνησμός, πονοκέφαλος και στο σημείο της ένεσης πόνος, ερυθρότητα, πρήξιμο ή ευαισθησία. Σοβαρές αλλεργικές αντιδράσεις που  απαιτούν ιατρική περίθαλψη είναι πολύ σπάνιες.

Οι ενέσεις BTA μπορούν να προκαλέσουν ανεπιθύμητες παρενέργειες σε λειτουργικά σημαντικούς μύες, είτε από λάθος τεχνική, από τοπική διάχυση του φαρμάκου ή υπερβολική δόση. Βλεφαρόπτωση, αδυναμία στα χείλη, πτώση του φρυδιού  και δυσκολίες στην κατάποση είναι μερικές από τις σπάνιες ανεπιθύμητες επιπλοκές. Η κανονική λειτουργία επανέρχεται  σε 2-6 μήνες, όταν θα επιτευχθεί η επανανεύρωση των μυών.

Πού γίνεται το BTA και από ποιούς;

Όλες οι ενέσιμες ιατρικές θεραπείες είναι διαδικασίες που απαιτούν την κατάλληλη εκπαίδευση με στόχο την προστασία και ασφάλεια των ασθενών. Βεβαιωθείτε ότι ο ιατρός (συνήθως πλαστικός χειρούργος ή δερματολόγος)  είναι κατάλληλα εκπαιδευμένος. Μην επιλέξετε μόνο με βάση  την τιμή και αποφεύγεται εκπτώσεις που φαίνονται ακραίες. Είναι πιθανό ότι θα πάρετε  μια πολύ αραιωμένη μορφή του BTA ή ακόμη κάτι που δεν είναι καν πραγματικό BTA. Ρωτάτε πάντοτε για την προέλευση του υλικού.

Ένας εξειδικευμένος ιατρός θα πρέπει να έχει το χρόνο να σας εξηγήσει όλα τα οφέλη και τους κινδύνους κατά τη διάρκεια της ιατρικής εξέτασης, αφού κάθε ιατρική διαδικασία εμπεριέχει κινδύνους.  Θα πρέπει να πάρει ένα πλήρες ιατρικό ιστορικό, να μπορεί να απαντήσει σε όλες τις ερωτήσεις σας και να καταγράψει στον ιατρικό σας φάκελο όλα τα στάδια της θεραπείας.

Όλες οι ιατρικές εταιρίες συνιστούν όπως τέτοιες  ιατρικές διαδικασίες γίνονται σε μέρη που διαθέτουν  τον κατάλληλο ιατρικό εξοπλισμό  και όχι σε εμπορικά κέντρα, ιδιωτικές κατοικίες, σε  γραφεία, σε διάφορες  κοινωνικές εκδηλώσεις σε κομμωτήρια και spa.

Σε γενικές γραμμές όταν το BTA χρησιμοποιείτε από εκπαιδευμένους ιατρούς και κάτω από τις κατάλληλες συνθήκες  είναι πολύ ασφαλές,  μειώνει της ρυτίδες και αναζωογονεί το πρόσωπο.

Botox, how safe is it?

Dr Ioannis Georgiou

Plastic and Reconstructive surgery
http://www.plasticsurgery4cyprus.com/

What is Botulinum Toxin (Botox)?

Botulinum toxin type A (BTA) is a toxin produced by Clostridium botulinum, a gram-positive anaerobic bacterium. It acts by binding specific nerve- endings responsible for muscle movements, thus causing a blocking effect on the muscles. Recovery occurs through the growth of new nerve-endings, thus re-innervate the muscles. The new growth will take between 2 to 6 months.

What are the indications?

In plastic surgery it is used mainly for cosmetic reasons. Treatment with BTA can relax the muscles that cause expression lines, thereby preventing wrinkles from forming and improving the appearance of existing wrinkles caused by facial expressions. It can be used mainly for the frown lines, crow’s feet, forehead wrinkles and skin bands on the neck. Injecting around the mouth and under the eyes is less common, as it can cause dropping of the lower eyelid and deform the mouth.

BTA can be used successfully in patients with hyperhidrosis(excessive sweating) in the underarm and palms. It can also be helpful in some patients suffering from migraine. Other medical specialties use it for the treatment of some movement disorders (dystonias), spasticity and other disorders of the muscles. 

How safe is it?

In high dosages it can be lethal mainly due to paralysation of the breathing muscles but the quantities used for medical reasons are very low, making BTA a very safe substance.

What are the risks and site effects?

Minor side effects include allergic reactions, rash, itching, headache and at the injection site pain, redness, swelling, or tenderness. Severe allergic reactions requiring medical treatment are very rare.

Botox injections can cause unintended side effects to functionally-important muscle fibers, either from improper placement of injections, from localized distribution, or overdose. Eyelid drooping, lip weakness, eyebrow malposition and difficulties in swallowing are some of the rare site effects. Normal function will return in 2-3 months when the new nerve-endings will re-innervated the affected muscles.

Where can you get BTA?

Injectable treatments are medical procedures that require appropriate training and sound judgment in order to help protect patient safety. Make sure that the doctor is credentialed. Don't choose a provider based only on the price and avoid discounts that seem extreme. It’s possible that you are receiving a very diluted form of BTA or perhaps something that is not even real BTA at all. Ask always of what you are being injected with.

A credentialed doctor should have the time to explain you all the benefits and risks during the consultation as every medical procedure has inherent risks and benefits. He should take a medical history, answer all your questions and document in your file all the steps of the procedure. It is recommended by medical societies that all medical procedures should be performed in an appropriate medical facility and not in shopping malls, private homes, office parties, group social gatherings or hair salons and spa.

Overall BTA injected by professionals and well educated physicians in appropriate medical facilities is a very safe treatment to remove wrinkles and rejuvenate the face.  

Neck Rejuvenation

Neck liposuction is performed on patients who have persistent fat deposits below the chin and in the neck area. When fat accumulates around the neck, the youthful shape of the jaw is lost. With this kind of neck plastic surgery, your plastic surgeon sculpts this area and removes fat, to restore the angular qualities of the chin and jaw removing stubborn areas of neck fat that don't respond to traditional weight-loss methods achieving a Neck lift.

Liposuction may be performed in a surgeon's office-based facility, in an outpatient surgery center, or in a hospital. Smaller-volume liposuction is usually done on an outpatient basis for reasons of cost and convenience. However, if a large volume of fat will be removed, or if the liposuction is being performed in conjunction with other procedures, a stay in a hospital or overnight nursing facility may be required.

Although many techniques can be used, the tumescent technique seems to be the safest and the most effective technique. The tumescent technique for local anesthesia involves the injection of large volumes of very dilute lidocaine (local anesthetic) and epinephrine (drug that shrinks capillaries) into subcutaneous fat. The local anesthetic lidocaine in the tumescent solution provides such complete local anesthesia, that it eliminates the need for general anesthesia, or IV sedation.

Then a thin hollow tube, or cannula, is inserted through 3 small incisions (under the chin and under each ear) to loosen excess fat using a controlled back and forth motion. The dislodged fat is then suctioned out of the body using a syringe. As this fat is removed, the layer of fat left behind is sculpted into aesthetically pleasing curves.

Once your procedure is completed, a compression garment will cover the Neck for 24-48 hours. These help to control swelling after liposuction and compress the skin to your new Neck contour.You will see a noticeable difference in the shape of your body quite soon after surgery. However, improvement will become even more apparent after about four to six weeks, when most of the swelling has subsided. After about four to six months, any persistent mild swelling usually disappears and as the skin contracts the final contour and the neck lift will be visible.

www.plasticsurgery4cyprus.com

Dr Ioannis Georgiou

Plastic Surgeon Cyprus

Myths about Breast Implants

As breast enlargement surgery has become more popular, the number of myths surrounding this procedure has risen as well. These rumors have caused many women to become confused trying to separate fact from fiction. What follows is a list of facts and myths about breast implants. Understanding the truth will help you make a better informed decision about your breast enlargement surgery.

Breast Implants Rupture EasilyThis simply isn't true. While there have been cases of breast implants rupturing, this is a highly rare occurrence. Breast implants are tested regularly in strenuous conditions to ensure they withstand daily activities.

You Can't Breastfeed with ImplantsThis myth is a case of sensationalism. It's true that some women have experienced problems with breastfeeding due to their implants. However, this is the exception, not the rule. The vast majority of women who receive breast implants are able to breastfeed with no complications.

Silicone Implants are DangerousSilicone implants were out of favor with the FDA for a long period of time. However, today’s silicone implants are not like those of the past. They are much safer and far more effective. In 2006, the FDA approved silicone breast implants as perfectly safe for women to use.

Breast Implant Surgery is ComplicatedMany women make the unfortunate mistake of assuming any surgeon can handle their breast enlargement. This is a crucial error. You must find a surgeon with ample experience and all the proper certifications. This gives you the best chance of receiving a successful surgery.

Implants must be replaced every 5 to 10 yearsImplants do not need to be replaced unless a problem occurs. Many patients have had implants for 20+ years which continue to be soft and natural looking. Interestingly, the most common cause for implant removal and exchange, is the desire on the patient's part to have larger implants!

Dr Ioannis Georgiou Plastic and Cosmetic Surgery, Cyprus

Plastic Surgery in Cyprus

Plastic surgery is a medical specialty concerned with the correction or restoration of form and function. Though cosmetic or aesthetic surgery is the best-known kind of plastic surgery, most plastic surgery is not cosmetic: plastic surgery includes many types of reconstructive surgery, hand surgery, microsurgery, and the treatment of burns.

In the term plastic surgery, the adjective plastic denotes sculpting, and derives from the Greek πλαστική (τέχνη), plastikē (tekhnē), “the art of modelling” of malleable flesh.

Reconstructive plastic surgery is performed to correct functional impairments caused by burns; traumatic injuries, such as facial bone fractures and breaks; congenital abnormalities, such as cleft palates or cleft lips; developmental abnormalities; infection and disease; and cancer or tumors. Reconstructive plastic surgery is usually performed to improve function, but it may be done to approximate a normal appearance.

Aesthetic plastic surgery can also be called as cosmetic surgery involves techniques intended for the "enhancement" of appearance through surgical and medical techniques, and is specifically concerned with maintaining normal appearance, restoring it, or enhancing it beyond the average level toward some aesthetic ideal. Allover in the world including Cyprus , the number of patients that undergo  cosmetic surgery is rising.

As the costs of surgery rise in many countries, more and more people are becoming "medical tourists" and travelling abroad for treatment. Cyprus is a popular medical tourism destination offering low cost cosmetic and reconstructive plastic surgery and enabling people to combine treatment with a holiday in Cyprus with its idyllic sandy beaches.

www.plasticsurgery4cyprus.com

Breast Lift (Mastopexy)

Plastic Surgery Cyrprus

Commonly referred to as a breast lift or boob lift, mastopexy surgery raises and firms the breasts by removing excess skin and tightening the surrounding tissue to reshape and support the new breast contour. A woman's breasts often change over time, losing their youthful shape and firmness. These changes and loss of skin elasticity can result from:

Pregnancy
Breastfeeding
Weight fluctuations
Aging
Gravity
Heredity

Sometimes the areola becomes enlarged over time, and a breast lift will reduce this as well. A breast lift can rejuvenate your figure with a breast profile that is youthful and uplifted. Breast lift surgery does not significantly change the size of your breasts or round out the upper part of your breast. If you want your breasts to look fuller, consider breast lift and augmentation surgery. If you want smaller breasts, consider combining breast lift and reduction surgery.

The Procedure:

What happens during breast lift surgery? Your mastopexy surgery can be achieved through a variety of incision patterns and techniques. The appropriate technique for you will be determined based on:

Breast size and shape
The size and position of your areolas
The degree of breast sagging
Skin quality and elasticity as well as the amount of extra skin

There are three common incision patterns:

Around the areola


Around the areola and vertically down from the areola to the breast crease


Around the areola, vertically down from the breast crease and horizontally along the breast crease



After the incisions, the underlying breast tissue is lifted and reshaped to improve breast contour and firmness. The nipple and areola are repositioned to a natural, more youthful height. If necessary, enlarged areolas are reduced by excising skin at the perimeter. Excess breast skin is removed to compensate for a loss of elasticity. After your breasts are reshaped and excess skin is removed, the remaining skin is tightened as the incisions are closed.

Some incision lines resulting from breast lifts are concealed in the natural breast contours; however, others are visible on the breast surface. Incision lines are permanent, but in most cases will fade and significantly improve over time. Sutures are layered deep within the breast tissue to create and support the newly shaped breasts. Sutures, skin adhesives and/or surgical tape may be used to close the skin.

After your breast lift procedure is completed, dressings or bandages will be applied to the incisions. You’ll need to wear an elastic bandage or support bra to minimize swelling and support your breasts as they heal. A small, thin tube may be temporarily placed under the skin to drain any excess blood or fluid that may collect after breast lift surgery.

The results of your breast lift surgery are immediately visible. Over time, post-surgical swelling will resolve and incision lines will fade. Satisfaction with your new image should continue to grow as you recover and realize the fulfillment of your goal for breasts which have been restored to a more youthful and uplifted position.The final results of your breast lift will appear over the next few months as breast shape and position continue to settle. Incision lines are permanent, but will continue to fade over time. Your mastopexy results will be long-lasting. Over time, your breasts can continue to change due to aging and gravity. But, you’ll be able to retain your new look longer if you:

Maintain your weight
Keep a healthy lifestyle

Dr Georgiou Ioannis

Plastic Surgery Cyprus

Click here for more Information

Fillers- Hyaluronic Acid

Plastic Surgery Cyprus

If you want to reduce facial wrinkles and lines, hyaluronic acid may be a good choice as a dermal filler because of its compatibility with the human body. In fact, this substance is found in almost every single living thing. In humans, it acts as a network that transfers essential nutrients from the bloodstream to skin cells. High concentrations are found in soft connective tissues and in the fluid surrounding your eyes. It's also in some cartilage and joint fluids, as well as skin tissue. It is extracted and reformulated and now has become one of the most popular kinds of injectable fillers.

When this gel is injected, it acts like an inflated cushion to support facial structures and tissues that may have lost volume or elasticity due to normal aging. It also brings water to the surface of skin to keep it looking fresh and supple.

The Procedure:
Tiny amounts of hyaluronic acid are injected into your face through very fine needles. The treatments typically take less than 30 minutes, depending how many lines are treated. You can expect very little discomfort. First, your surgeon will listen to your desired results and then evaluate your facial appearance and skin tone, examining the areas of your face to be augmented with hyaluronic acid as a filler.

Your injection sites will be cleansed with an antibacterial agent. Then a topical anesthetic will be used to numb the area, particularly if you are sensitive to injections. The actual injections will take just a few minutes total, and just seconds per site. An ice pack to reduce any minor and temporary discomfort. At this point you may apply makeup, but be careful not to apply pressure to the treated areas, as doing so may result in movement of the hyaluronic acid.

A special note about scars and deep lines.
These areas will often require multiple injections to achieve your desired results. If a deeper injection is required, you'll be offered a local anesthetic to remain comfortable. Common sites for deeper tissue fillers are the nasolabial folds and marionette lines, or to enhance fullness in the cheeks.

You can resume most activities immediately following injection with hyaluronic acid wrinkle treatment. Just be careful not to rub the area. Most people tolerate injectable hyaluronic acid therapy without irritation or complications. Right after your treatment, the area may be red, swollen and bruised. This tenderness should go away within a few days.

Before you consider having hyaluronic acid treatment, be aware that you might not achieve the results you want with just one treatment. Depending on how your body reacts to the injections, you might need additional injections

Contact us for more information

Dr Georgiou Ioannis

Plastic Surgery Cyprus