w360 - PrudENT Rhinoplasty and Facial Cosmetic Surgery - Page 10
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      Mole Removal

      Skin cancer

      MOLE REMOVAL Moles, also known as nevi, are frequent skin formations that can appear individually or in groups anywhere on the skin or mucous membranes. They typically manifest before one reaches the age of 20.  They come in a variety of shapes, sizes, and colours. While most moles are benign (non-cancerous), it’s essential to be aware of the different types and their characteristics. Here are some of the common types of moles: TYPES OF MOLES COMMON MOLES These are minor skin protrusions with hues varying from your natural skin colour to shades of brown or black, usually with well-defined borders. They are uniform in colour, which can range from pink to brown, and are less than about 5 millimetres in size. They can be flat or raised and are usually round or oval. CONGENITAL MOLES These moles are present at birth and vary in size. They are generally larger than common moles and can range from less than one inch to larger sizes that cover a significant part of the body or face. These are the moles you have from birth and carry a higher risk of evolving into melanomas, a form of skin cancer, compared to moles that develop later in life. ATYPICAL MOLES (DYSPLASTIC NEVI) These are larger than common moles, hereditary moles with irregular shapes and inconsistent coloration—darker at the centre and fading towards the edges. These moles have a higher risk of developing into melanoma, a form of skin cancer. ACQUIRED MOLES These are moles that appear after birth, typically before the age of 30. They are usually a result of sun exposure and are generally harmless, though any new moles should be monitored for changes. SPITZ NEVI These are raised, reddish moles that appear mainly in children but can also be found in adults. They can look alarming because they may resemble melanoma, but they are generally benign. INTRADERMAL NEVI These are flesh-coloured moles that are generally raised and can be found anywhere on the body. They are most common in adults and are usually benign. JUNCTIONAL MOLES These moles are generally flat and can be brown or black. They occur when melanocytes, the cells responsible for skin pigment, accumulate at the junction between the dermis and epidermis layers of the skin. COMPOUND MOLES These are a combination of intradermal and junctional moles. They can be raised, flat, or somewhat raised and have a central raised area. They can be of various colours including brown, tan, or pink. BLUE MOLES These are generally benign and appear as smooth, blue to blue-black spots. They are usually found on the head, neck, or arms. HALO MOLES These moles have a white or light “halo” around them. They are generally benign and can sometimes disappear entirely. It’s essential to have any new or changing moles examined, especially if you notice any signs such as asymmetry, irregular borders, colour changes, or a diameter larger than a pencil eraser. These could be indicators of melanoma or other skin conditions that may require immediate attention. WHAT LEADS TO THE FORMATION OF MOLES? Moles arise when melanocytes, the skin cells responsible for pigmentation, accumulate in specific areas rather than being uniformly spread across the skin. HOW CAN I DETERMINE IF MY MOLE IS MALIGNANT? To assess whether your mole may be cancerous, you can look for certain indicators, such as: A: Asymmetry. A mole that appears uneven or imbalanced could potentially be cancerous. B: Borders. Clear, well-defined edges on a mole are generally a good sign, whereas irregular or blurred borders could indicate cancer. C: Colour Variation. A mole that has multiple colours or is inconsistent in its coloration might be a warning sign of cancer. D: Diameter. A mole larger than 6mm across might be a cause for concern. E: Evolution or Expansion. Growth or change in the size of your mole may suggest it is cancerous. If any of your moles exhibit these characteristics, it’s important to seek medical evaluation. REASONS FOR MOLE REMOVAL Mole removal is typically pursued for either medical reasons, such as testing dysplastic moles for cancer, or for aesthetic purposes when a mole affects personal appearance or self-esteem. MOLE REMOVAL PROCEDURE Mole removal is generally considered a simple outpatient procedure and performed under local anaesthesia. The method chosen for removal will largely depend on the type, size, and location of the mole, as well as whether it appears to be benign or malignant. Here’s an overview of common mole removal procedures: SURGICAL EXCISION Preparation: The area around the mole is cleaned, and a local anaesthetic is applied to numb the area. Excision: Dr Sandeep uses a scalpel to cut out the mole along with a small margin of the surrounding skin. Stitches: The wound is then closed with stitches, which may be dissolvable or may require removal later. SURGICAL SHAVE Preparation: The skin is cleaned, and a local anaesthetic is applied. Shaving: A scalpel is used to shave the mole off, flush or slightly below the level of the surrounding skin. Sometimes a loop cautery may be used instead. Cauterization: The area may be cauterized to stop any bleeding. LASER REMOVAL Preparation: The area is cleaned, and a topical anaesthetic may be applied. Laser Treatment: Pulses of laser light are used to break down the mole cells. Healing: A scab forms over the treated area and falls off over time.   ELECTROCAUTERY Preparation: The area is cleaned, and a local anaesthetic is applied. Burning: An electric current is used to burn away the mole tissue. Healing: The area may scab over and will heal over time. AFTERCARE Regardless of the method, proper aftercare is crucial. You may need to: Keep the area clean and dry. Apply an antibiotic ointment as prescribed. Avoid direct sunlight on the treated area. Follow-up for stitch removal, if needed. DIAGNOSTIC If the mole is suspected to be cancerous, it will be sent for histological examination to confirm the diagnosis to ensure they are benign and take appropriate steps if otherwise.

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      Melanoma: the Stealthy Foe of Skin Health

      Facial Scar Refinement

      MELANOMA: THE STEALTHY FOE OF SKIN HEALTH Melanoma is a type of skin cancer that originates in melanocytes—the cells responsible for pigment in the skin. Melanoma is particularly notorious for its ability to metastasize rapidly and aggressively. Understanding Melanoma’s aetiology, risk factors, early signs, diagnostic methods, and treatment options is crucial for effective prevention and management. WHAT IS MELANOMA? Melanoma is the deadliest form of skin cancer. It begins in the melanocytes, which are responsible for producing melanin, the pigment that gives skin its colour. When these cells become cancerous, they can grow uncontrollably and spread to other parts of the body, making early detection and treatment vital. CAUSES Ultraviolet (UV) Radiation: Sunlight and tanning beds are significant risk factors for Melanoma. Sunburn and melanoma are intrinsically linked, with sunburn serving as both an indicator of excessive UV exposure and a risk factor for melanoma. Genetic Factors: Certain genes are known to increase the risk. RISK FACTORS Family History: Those with a family history of Melanoma are at an increased risk. Fair Skin, Hair, and Eyes: Light-coloured skin, hair, and eyes are more susceptible. Age: While it can occur at any age, the risk increases with age. Atypical Moles: The presence of irregular or dysplastic moles can be a warning sign. SYMPTOMS AND EARLY SIGNS Melanoma often manifests as a new, unusual growth or a change in an existing mole. The ABCDE rule is handy for identifying suspicious moles: A: Asymmetry in a mole or spot. B: Border irregularity. C: Colour that is uneven. Multiple colours within a mole. D: Diameter greater than 6mm (size of a pencil eraser). E: Evolution or change in size, shape, or colour. DIAGNOSTIC METHODS Dermoscopy: A specialized tool called a dermoscope is used for a more detailed examination of the skin. Biopsy: The definitive diagnosis of Melanoma is confirmed through a biopsy, where a piece of the suspicious lesion is removed for microscopic examination. Imaging Tests: If there’s a risk of metastasis, imaging tests like MRI, CT scans, or PET scans may be required. TREATMENT OPTIONS Surgical Removal: The primary treatment for early-stage Melanoma is surgical excision of the tumour along with a margin of healthy tissue. Sentinel Lymph Node Biopsy: For deeper lesions, this procedure helps determine if the cancer has spread to nearby lymph nodes. Immunotherapy: Drugs like checkpoint inhibitors can be effective in treating advanced Melanomas. Targeted Therapy: For Melanomas with specific genetic mutations, targeted therapies can be particularly effective. Chemotherapy: While less common for Melanoma, chemotherapy may be used in advanced cases or when other treatments have failed. Radiation Therapy: Used in specific cases, like metastatic Melanoma or to relieve symptoms. PREVENTION STRATEGIES Sun Protection Use a broad-spectrum sunscreen with an SPF of at least 30. Wear protective clothing and sunglasses. Seek shade, especially between 10 a.m. and 4 p.m. Regular Skin Checks Perform monthly self-examinations of your skin to look for new or changing moles or spots. Have an annual skin check-up with a dermatologist, especially if you have a history of sunburns or other risk factors for melanoma. CONCLUSION Melanoma, despite being less common than other skin cancers, poses a significant threat due to its ability to spread rapidly. Early detection, usually by recognizing changes in moles or skin appearance, is crucial for a favourable prognosis. Advances in treatment, particularly in immunotherapy and targeted therapy, have improved outcomes, but the best defence remains prevention and early detection. Therefore, regular skin examinations and protective measures against UV radiation are strongly advised. REVITALIZE YOUR APPEARANCE: FACIAL SKIN CANCER TREATMENT AND RESTORATION WITH DR SANDEEP Dealing with skin cancer on your face? Our specialized service for Facial Skin Cancer Excision and Reconstruction focuses on the complete removal of cancer cells while aiming to conserve and rejuvenate your facial appearance. Our approach is defined by careful precision and a deep understanding of your health and aesthetic concerns. Take the step towards a healthier you. Arrange a consultation with Dr Sandeep. 

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      Mandible Augmentation Surgery

      Mandible Reshaping Surgery

      MANDIBLE AUGMENTATION SURGERY THE PROCEDURE Dr Sandeep and his team are committed to providing a comprehensive and personalized experience. Their meticulous attention to detail and client-centric approach ensures that each mandible augmentation procedure is performed with the utmost care and expertise. Our approach combines medical expertise with a deep understanding of facial aesthetics. Meticulous preoperative planning and postoperative management are the linchpins of a successful mandible augmentation procedure. Such diligence ensures a harmonized understanding between the clinician and the client regarding anticipated outcomes and potential perioperative challenges. INITIAL CONSULTATION Medical History A thorough review of the client’s medical history is taken to assess suitability for surgery and anaesthesia. Dr Sandeep has a thorough discussion with the client to assess their aesthetic goals and makes sure that they have realistic expectations before proceeding with surgery. Facial Analysis Dr Sandeep conducts a comprehensive facial analysis, using advanced imaging techniques like 3D scanning to assess the jawline and overall facial structure. Computer Simulation Client’s photographs are taken, and state of the art software is used for computer image manipulation to educate the client regarding what can be realistically achieved with surgery and for surgical planning. Discussion Dr Sandeep discusses the goals, risks, and expectations with the client. Different implant materials and sizes are considered. PREOPERATIVE INSTRUCTIONS The client receives a set of guidelines to follow before the surgery, which might include discontinuing certain medications or dietary restrictions. ANAESTHESIA After admission to the surgical facility, the client undergoes general anaesthesia, administered by a qualified and experienced anaesthetist who works closely with Dr Sandeep’s team. INCISION Depending on the specific case, an incision is made either inside the mouth to avoid visible scars or under the chin. IMPLANT PLACEMENT A pocket is created along the mandible where the preselected implant will be inserted. If autologous grafts are used, these are harvested and prepared before placement. Adjustment and Assessment: Dr Sandeep meticulously adjusts the implant or graft to achieve the desired augmentation while maintaining facial symmetry. CLOSURE The incision inside the mouth is closed using dissolvable sutures. External incisions are closed with sutures that need to be removed after 7 days. IMMEDIATE POSTOPERATIVE CARE The client is moved to a recovery room where vital signs are closely monitored until full consciousness is regained. RECOVERY PROCESS For a successful mandible augmentation surgery, thorough preparation is key. This ensures that both the medical professional and the client have aligned expectations concerning the results and are aware of potential challenges. Immediate Postoperative Symptoms: After the surgery, it’s typical to experience swelling, bruising, and some pain. These symptoms generally diminish within a couple of weeks. Postoperative Pain Management: Dr Sandeep’s team provides medication to manage any discomfort or pain. Oral Care: Maintaining impeccable oral hygiene is paramount, especially when incisions are made inside the mouth, to ward off infections. Dietary Recommendations: Clients are often advised to stick to a soft food diet in the initial recovery phase. Time Off: It’s prudent to anticipate a break of 2 to 3 weeks from professional commitments or school post-surgery. Recovery Duration: While the primary convalescence phase is estimated to span a couple of weeks, it is noteworthy that residual oedema may persist for an extended period, potentially several months. Support: In the days immediately following the surgery, particularly if general anaesthesia was administered, having someone around for assistance can be beneficial. FOLLOW-UP APPOINTMENTS Scheduled Reviews: It’s essential to pencil in post-operative visits with the surgeon to oversee the healing process and tackle any arising issues with the integration of the implant. Any issues arising are dealt with promptly. Monitoring Progress: Continuous check-ins with Dr Sandeep are vital to track the healing process and ensure the results align with the client’s expectations. Activity Restrictions: Clients are generally advised to avoid strenuous activities for a certain period. Contact sports must be avoided for 3 months after surgery. Long-term Monitoring: Periodic reviews are conducted to ensure the lasting success of the procedure. FINAL ASSESSMENT Once the swelling has fully subsided, Dr Sandeep performs a final evaluation to confirm that the client’s goals have been met. POTENTIAL RISKS AND COMPLICATIONS Mandible augmentation, like any surgical procedure, carries inherent risks. While many clients undergo this procedure without complications and achieve their desired outcomes, it’s essential to be aware of potential risks and discuss them with a qualified surgeon. Here are some of the potential risks associated with mandible augmentation: Infection: Any surgical procedure carries the risk of infection. If an implant is used, there’s a chance that it could become infected and might need to be removed. Hematoma or Seroma: A hematoma is a collection of blood, and a seroma is a collection of clear fluid. Both can develop in the surgical area and may require drainage. Nerve Damage: The surgery could potentially damage the nerves in the area, leading to numbness, tingling, or even muscle weakness. The inferior alveolar nerve, which runs through the mandible, is of particular concern. Implant Issues: If implants are used, they could shift, become exposed, or get infected. There’s also a risk of the body rejecting the implant. Bone Resorption: If bone grafts are used, there’s a chance that the body might reabsorb the bone over time, diminishing the augmentation’s effects. Scarring: While incisions are often made inside the mouth to minimize visible scarring, there’s still a risk of scarring, especially if external incisions are made. Asymmetry: The two sides of the face might not look symmetrical after the procedure, either due to surgical technique or the body’s healing process. Adverse Reaction to Anaesthesia: As with any procedure that requires anaesthesia, there’s a risk of complications such as allergic reactions or breathing difficulties. Prolonged Swelling or Pain: Some clients might experience swelling or pain that lasts longer than expected. Unsatisfactory Results: The final appearance might not meet the client’s expectations, necessitating revision surgery. Unsatisfactory results may be due to implant migration, infection or poor healing and scarring. Difficulty in Opening Mouth or Chewing: The surgery might temporarily or permanently affect the

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      Mandible Angle Reduction

      Mandible Reshaping Surgery

      MANDIBLE ANGLE REDUCTION Dr Sandeep and his team often consult with clients who are interested in facial contouring procedures, including mandible angle reduction. This specific surgery aims to narrow and soften the jawline, providing a more refined facial appearance. Below is a detailed description of the procedure. PROCEDURE Preparation for a mandible angle reduction surgery is a meticulous process that involves several steps to ensure the safety and success of the procedure. Proper planning is the cornerstone of a successful mandible angle reduction surgery. It ensures that both Dr Sandeep and the client are on the same page regarding the expected outcome and potential risks. Here’s a detailed breakdown of the planning process: INITIAL CONSULTATION Assessment: Dr Sandeep will evaluate the client’s facial anatomy, skin quality, and overall health. This includes understanding the client’s medical history, any previous surgeries, and current medications. Desired Outcome: Dr Sandeep will discuss the desired aesthetic outcome with you in detail. It’s essential for the client to communicate their expectations clearly. Feasibility: Dr Sandeep will determine if the client is a suitable candidate for the procedure based on their anatomy and health status. Imaging: X-rays or CT scans are taken to assess the bone’s anatomy, thickness, and the location of vital structures like the inferior alveolar nerve. 3D Reconstruction: 3D reconstruction software to visualize the expected outcome and plan the exact bone resection is used in some cases. Model Creation: Using the CT scans, a 3D model of the client’s jaw might be created. Trial Surgery: Dr Sandeep might perform a mock surgery on this model to plan the exact amount and location of bone resection. Medications: Clients might be advised to stop certain medications, especially those that can increase bleeding risk, like aspirin or certain supplements like vitamin E, Gingko biloba and Garlic. Smoking and Alcohol: Clients are usually advised to stop smoking and limit alcohol consumption as they can delay healing. Oral Hygiene: Proper oral hygiene is crucial since the incision will be inside the mouth. Dr Sandeep might recommend dental cleaning before the surgery. ANAESTHESIA The procedure is typically performed under general anaesthesia, ensuring the client is comfortable and pain-free throughout the surgery. INCISION The surgery is usually performed intraorally, meaning the incision is made inside the mouth, which avoids visible external scars. This incision is typically made along the mucosa overlying the mandibular ramus (the vertical part of the mandible). EXPOSURE The soft tissues are gently retracted to expose the mandibular angle and the posterior border of the ramus. BONE RESECTION Using surgical instruments like a bone saw or burr, Dr Sandeep will shave or cut off a portion of the mandible’s angle. The amount of bone removed is based on preoperative planning and the desired outcome. SMOOTHING After the desired amount of bone is removed, the edges are smoothed to ensure there are no sharp or rough areas. CLOSURE The incision is sutured closed using absorbable sutures. RECOVERY Immediate Post-Operative Period Hospital Stay: A short hospital stay may be needed for monitoring, based on the surgery’s complexity and Dr Sandeep’s advice. Pain Relief: Prescribed medications are provided to manage post-surgical discomfort. Initial Diet: Soft or liquid foods are advised to minimise stress on surgical areas. Physical Activity: Limitation on strenuous exercises is recommended for 3 weeks, contact sports is prohibited for 3 months. Sleep Position: Elevating the head while sleeping is suggested for quicker recovery. Nasal Care: Nose-blowing and nasal douches may be advised to prevent air accumulation and clear blood clots. First Week Swelling/Bruising: Peaks around day two or three; cold compresses can alleviate symptoms. Oral Care: Antiseptic mouthwash is advised to maintain hygiene and prevent infections. Activity Restrictions: Heavy lifting and strenuous activities should be avoided. First Check-Up: A follow-up appointment is usually scheduled within the week, any non-resorbable sutures are removed. Sleep Position: Head elevation during sleep continues to be advised. Nasal Care: Continued recommendations for nose-blowing and nasal douches. First Month Residual Swelling: Expected to gradually reduce but may persist for up to 8 weeks, the final 10-15% of swelling may take many months to subside. Sensory Changes: Temporary numbness or altered sensations in the cheek area may occur. Diet Transition: Reintroduction of solid foods as comfort permits. Activity Level: Light activities can resume, but high-impact activities and contact sports are prohibited for three months. Long-Term Recovery Bone Recovery: Bone healing is a prolonged process; caution is advised to avoid facial trauma. Final Outcome: Aesthetic results may take several months to fully manifest. Scar Improvement: External scars, if present, will fade gradually over time. General Guidelines Smoking: To be avoided as it hinders the healing process. Adherence to Guidelines: Strictly follow Dr Sandeep’s post-operative instructions. Nutrition and Hydration: Important for aiding the healing process. Sun Protection: Essential to prevent skin discoloration and aid scar healing. Open Communication: Keeping a line of communication with Dr Sandeep and his team is crucial for addressing any concerns or symptoms. ADVANTAGES OF MANDIBLE ANGLE REDUCTION Below are some of the advantages of mandible angle reduction that Dr Sandeep usually discusses with his clients: ENHANCED FACIAL HARMONY The procedure can balance the proportions of the face, creating a harmonious and aesthetically pleasing appearance. AESTHETIC REFINEMENT The procedure refines the jawline, providing a softer, more feminine or balanced look, depending on the client’s aesthetic goals. IMPROVED SIDE PROFILE Mandible angle reduction often results in a more streamlined and less angular side profile, which many clients find attractive. CUSTOMISED RESULTS Dr Sandeep and his team offer a tailored approach, taking into account the client’s unique facial structure and aesthetic goals. The procedure can be tailored to meet the specific needs and preferences of each client, allowing for a highly personalized result. VERSATILITY IN STYLING A less prominent jawline can make it easier for clients to adopt different hairstyles or fashion choices that they may have felt uncomfortable with before the procedure. IMPROVED CONFIDENCE For those who have felt self-conscious about the appearance of their jaw, mandible angle reduction can offer substantial psychological

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      Is Undergoing Facial Plastic Surgery Safe?

      Dr Sandeep's Surgical Philosophy

      IS UNDERGOING FACIAL PLASTIC SURGERY SAFE? ENHANCING AESTHETICS WITH SAFETY: DR SANDEEP’S COMMITMENT TO MINIMIZING RISKS IN FACIAL PLASTIC SURGERY Facial plastic surgery, like all medical interventions, comes with its set of potential risks. However, Dr Sandeep and his team take every measure to minimize these risks and ensure client safety. The clinic boasts a team of highly skilled and dedicated medical professionals committed to delivering optimal results. CLIENT COMPLIANCE: THE KEY TO SUCCESSFUL OUTCOMES IN DR SANDEEP’S FACIAL PLASTIC SURGERY To further enhance the safety and success of the procedure, it’s imperative for clients to adhere strictly to Dr Sandeep’s directives. This includes diligently following both pre-operative and post-operative instructions. CRITICAL DIALOGUES: THE IMPORTANCE OF TRANSPARENCY AND OPEN COMMUNICATION IN FACIAL PLASTIC SURGERY WITH DR SANDEEP Equally crucial is the open communication between the client and the surgeon. Being forthright about your entire medical history, your physical and emotional state, and any other factors you believe might influence the surgery or its outcomes is essential. PROACTIVE WELL-BEING: OPTIMIZING SAFETY AND EFFICACY IN FACIAL PLASTIC SURGERY WITH DR SANDEEP Moreover, a proactive approach to your well-being plays a significant role in ensuring a safe surgical experience. This means adequately preparing your body before the surgery and dedicating time to its recovery afterward. By taking these precautions and collaborating closely with Dr Sandeep and his team, you can significantly enhance the safety and efficacy of your facial plastic surgery journey

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      Facial Scar Refinement

      Facial Scar Refinement, Scar Revision

      FACIAL SCAR REFINEMENT WHY ARE SOME SCARS MORE VISIBLE? Here are some of the key reasons why facial scars may be more noticeable: LOCATION Centre of Attention: The face is the focal point of most social interactions, so any scarring is likely to be noticed. Mobile Area: Facial skin is constantly moving due to talking, eating, and expressions, which might affect how a scar heals and make it more visible. Relaxed Skin Tension Lines: Incisions or wounds that are not aligned along RSTL’s tend to heal poorly because there is more tension pulling the wound edges apart. This usually results in a wider and more noticeable scar. SIZE OF THE SCAR The eye can easily catch a long and straight scar, making them more noticeable. SKIN COLOUR AND TEXTURE Hyperpigmentation: Darkening of the scar tissue can make it stand out against lighter skin. Hypopigmentation: Scars may lose pigment and appear lighter than the surrounding skin, making them more noticeable. Texture Differences: Raised (keloids, hypertrophic), depressed or indented (atrophic) scars have a texture different from normal skin, making them easier to spot. HEALING FACTORS Blood Supply: The face has an extensive blood supply, which can aid in better healing. However, any disruption to the blood supply may contribute to more noticeable scarring. Inflammation: Prolonged inflammation during the healing process can lead to more visible scars. Sun Exposure: UV rays can darken the healing tissue and make scars more noticeable. Environmental Factors: Exposure to wind, cold, and dry air can affect the healing process and the scar’s final appearance. Skin Type: The oiliness or dryness of your skin can influence how a scar heals and its eventual appearance. Genetic Predisposition: Some individuals are genetically more prone to form noticeable scars, such as keloids. PSYCHOLOGICAL FACTORS Self-Perception: How one perceives their own scars can magnify their apparent visibility. SCAR REVISION Scar revision techniques aim to improve the appearance, texture, and function of scars. The appropriate treatment may vary depending on the type, size, and location of the scar, as well as the individual’s skin type, age, and overall health. Here’s a detailed look at some of the common scar revision options: SURGICAL TREATMENTS EXCISIONAL SURGERY Dr Sandeep removes the scar tissue and closes the incision, aiming for a less noticeable scar. Z-PLASTY This technique reorients the scar so that it aligns more closely with natural skin lines, making it less visible. It may also be used to treat a contracted scar. W-PLASTY Similar to Z-Plasty but involves multiple small incisions for a zig-zag pattern to break up the linear appearance of the scar. GEOMETRIC BROKEN LINE CLOSURE Scars that are oriented perpendicular to the relaxed skin tension lines of the face are often treated with this technique which converts a linear scar into an irregularly irregular scar, thus making it less noticeable. SKIN FLAPS A flap of healthy skin is lifted from an adjacent area and used to cover the scarred region. SKIN GRAFTS Skin is harvested from another part of the body (usually a hidden area) and transplanted to the scar area. MINIMALLY INVASIVE PROCEDURES LASER THERAPY High-energy light is used to resurface the skin, which can improve the appearance and texture of scars. This therapy is often used to help in achieving better scars after all kinds of surgery at our centre. DERMABRASION A rotating instrument like a diamond burr is used to remove the upper layers of skin to make the scar less visible. MICRODERMABRASION Similar to dermabrasion but less invasive, this technique removes only a very superficial layer of skin. MICRO NEEDLING Fine needles are used to puncture the skin, stimulating collagen production. CHEMICAL PEELS Chemicals are used to remove the upper layer of skin, which can help reduce the appearance of superficial scars. FILLER INJECTIONS For atrophic or indented scars, injectable fillers can be used to elevate the scar to the level of surrounding skin. TOPICAL TREATMENTS SILICONE GEL AND SHEETS These are applied to the scar to hydrate the skin, which may help in reducing the scar’s appearance. STEROID CREAMS These can help to soften and flatten hypertrophic and keloid scars and reduce pigmentation caused by inflammation. BLEACHING AGENTS For scars that have hyperpigmentation, bleaching agents like hydroquinone can be applied. STEROID INJECTIONS Intralesional steroid injections can be effective for hypertrophic and keloid scars, helping to reduce redness, itching, and elevation. SCAR REVISION PROCEDURE Scar revision is a surgical procedure aimed at improving the appearance, texture, or function of a scar. The specific method employed can vary depending on the type, size, and location of the scar, as well as the client’s age, health, and personal preferences. Here is a general outline of what a scar revision procedure may involve: PRELIMINARY CONSULTATION Initial Assessment: Dr Sandeep will evaluate the scar’s type, size, and location, along with your skin type and overall health. Photographs will be taken for documentation. Treatment Plan: Different options for scar revision will be discussed, including surgical and non-surgical methods, to determine the most appropriate treatment for you. PRE-TREATMENT PREPARATIONS Medical Tests: Blood tests and other preoperative evaluations may be conducted. Avoid Certain Medications: Stop taking medications or supplements that can affect bleeding, such as aspirin, ibuprofen, and certain herbal supplements. No Smoking: Smoking can impair wound healing, so it’s advised to quit several weeks before the procedure. Hydration and Nutrition: Maintain good hydration and nutrition to aid in the healing process. DAY OF PROCEDURE Anaesthesia: Depending on the complexity of the procedure, local, regional, or general anaesthesia may be administered. Incision and Revision: Various techniques may be used, including excision, skin grafts, or flap surgery, to improve the appearance of the scar. Closure: The incision is closed with sutures, staples, or adhesive, depending on the specific procedure. Dressings: Sterile dressings are applied to the treated area. AFTERCARE FOLLOWING THE PROCEDURE Immediate Aftercare Pain Management: Follow the prescribed pain medication regimen to manage post-operative discomfort. Dressings: Keep the surgical site clean and protected with the dressings as advised by your healthcare provider. Instructions

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      Facial Reconstruction After Skin Cancer Excision

      Facial Scar Refinement

      FACIAL RECONSTRUCION AFTER SKIN CANCER EXCISION The surgical removal of skin cancer often leaves behind wounds, scars, or cosmetic irregularities that may require reconstructive procedures to restore both function and appearance. The choice of reconstructive option depends on various factors, such as the size and location of the excised area, the type of skin cancer, and the client’s overall health. This guide aims to outline the range of reconstructive techniques commonly used after skin cancer excision. LOCAL FLAPS Advancement Flaps: Suitable for small to medium-sized defects, especially on the face. Adjacent skin is stretched or advanced to cover the defect and stitched into place. Rotation Flaps: Commonly used for larger defects. A flap of skin is rotated from an adjacent area to cover the defect. Transposition Flaps: Useful for irregularly shaped defects. A flap is cut from skin near the surgical defect, moved into the defect and stitched into place over the defect. SKIN GRAFTS Full-thickness Grafts: Ideal for smaller, less conspicuous areas. A full layer of skin is taken from a donor site (usually the behind the ear, neck, abdomen, or inner arm) and sutured to reconstruct the wound. Split-thickness Grafts: Used for larger defects or areas where the graft can be secured tightly. A partial thickness thinner layer of skin is harvested from a larger area (usually the thigh) and transferred to the defect. Free Flaps: Used for large, complex defects, especially where significant tissue loss has occurred. Skin and sometimes muscle or bone are transferred from one part of the body to another, along with the blood vessels that supply them. Microsurgical techniques are used to connect the blood vessels to those in the recipient site. Tissue Expansion: Best for areas adjacent to the defect where similar skin texture and colour are desirable. A balloon-like device is inserted under the skin and gradually inflated to stretch the skin, which can then be used to cover the nearby defect. Secondary Intention Healing: Suitable for small, shallow defects, often in areas with good blood supply. The wound is left open and allowed to heal naturally, filling in with new tissue over time. CONCLUSION Reconstruction after skin cancer excision is a tailored approach that depends on various factors like the type of skin cancer, its location, and the extent of tissue removed. Dr Sandeep has trained under world renowned facial plastic and reconstructive surgeons Prof Shan R Baker, Prof Hade Vuyk, and Prof Nick Stafford, to name a few. He has gained extensive experience in excision of facial skin cancer and lesions, and oncologic reconstruction of resultant tissue defect for achieving the best aesthetic and functional outcome. POSTOPERATIVE CARE AFTER SKIN CANCER EXCISION: A COMPREHENSIVE GUIDE Postoperative care is a critical component of successful skin cancer treatment, complementing the surgical removal of the tumour. Proper care can help prevent complications such as infection, promote optimal wound healing, and reduce the risk of scarring. This guide outlines the key steps involved in postoperative care following skin cancer excision. IMMEDIATE POSTOPERATIVE PERIOD Wound Cleansing: Cleansing agent like hydrogen peroxide may be prescribed to clean the wound twice a day to prevent crusting and aid healing. Antibiotic Ointment: To aid wound healing and prevent infection. Dressing and Wound Care: The surgical site may typically be dressed with sterile bandages or adhesive strips. The frequency of dressing changes will depend on the type of dressing and Dr Sandeep’s guidelines. Pain Management: Mild to moderate pain is normal and can be managed with prescribed pain relievers or over-the-counter medications, as recommended by our team. Antibiotics: Antibiotics may be prescribed to prevent bacterial infection at the surgical site. Activity Restrictions: Strenuous activities may need to be avoided, especially for specific areas like the face. FIRST WEEK Monitoring for Signs of Infection: Keep an eye out for redness, increased pain, pus, or elevated temperature, as these may indicate infection. Hydration and Moisturization: Keep the area hydrated with recommended ointments, usually antibiotic or antiseptic creams, to facilitate healing. Suture Care: If you have non-dissolvable sutures, Dr Sandeep will provide instructions on suture care and when they should be removed. ONGOING CARE Scar Care: Once the wound has fully closed, scar creams or silicone gel sheets can be used to minimize scarring. Triluma may be prescribed to reduce scar pigmentation. Sun Protection: Protect the healing and surrounding skin from sun exposure by using high SPF sunscreen, hats, or clothing, as ultraviolet rays can affect wound healing and increase the risk of new skin cancers. Regular Check-ups: Scheduled follow-up appointments are crucial for monitoring the healing process, checking for complications, and discussing next steps for surveillance or additional treatment if necessary. Follow up scans may be needed for certain kinds of skin cancers. Sentinel Lymph Node Biopsy or Lymph Node Dissection: Additional care may be needed if you have undergone these procedures, such as managing lymphatic drainage or specialized wound care. Large or Complex Reconstructions: For grafts, flaps, or complex reconstructions, additional or specialized care may be necessary, including more frequent follow-up appointments. Emotional Wellbeing: The emotional aspect of skin cancer treatment shouldn’t be overlooked. Support from friends and family, as well as mental health professionals, can help you cope with stress or anxiety. CONCLUSION Postoperative care after skin cancer excision is essential for optimal outcomes. Following your healthcare provider’s guidelines can help prevent complications and speed up the healing process. Regular follow-up appointments will help monitor your progress and ensure that you are on the right track for both healing and cancer surveillance. RENEW YOUR CONTOURS: POST SKIN CANCER EXCISION RECONSTRUCTION WITH DR SANDEEP Have you undergone skin cancer excision? Our comprehensive reconstruction options are designed to restore the form and function of the affected area. With a blend of advanced techniques and compassionate care, we focus on achieving the most natural-looking results. Chart your course back to wholeness. Explore your reconstruction options following skin cancer excision with Dr Sandeep. 

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      Facial Fractures

      Facial Injury

      FACIAL FRACTURES: UNDERSTANDING YOUR INJURY WHEN TO SEEK MEDICAL ATTENTION FOR FACIAL FRACTURES? If you or someone you know is exhibiting any of the symptoms or signs associated with facial fractures detailed below, immediate medical attention is highly recommended. Delaying evaluation and treatment can result in long-term functional deficits and cosmetic deformities. Understanding the symptoms and physical signs of facial fractures is vital for early diagnosis and effective treatment. We specialize in diagnosing and treating a wide range of facial fractures. Here are the types of fractures we commonly treat: NASAL FRACTURES The most common facial fracture, typically resulting from blunt force trauma. The injury may involve the nasal bones and/or cartilage. X-Ray showing nasal bone fracture IMMEDIATE SYMPTOMS Pain: The most immediate and noticeable symptom is localized pain at the site of injury. Nosebleeds: A fracture is often accompanied by bleeding from one or both nostrils. Swelling: Almost all nasal fractures will show some degree of swelling around the nose and possibly extending into the facial area. Sometimes surgery to treat nasal bone fracture may have to be delayed by a few days till the swelling settles. Breathing Difficulties: The swelling or deformity may cause problems breathing through the nose. Bruising: Over the course of a few hours or days, you may notice bruising around the nose or eyes. Altered Smell: In some instances, your ability to smell might be compromised. PHYSICAL SIGNS Deformity: A visible change in the shape of the nose, either subtle or pronounced, may be evident. Crepitus: A grating sound or sensation can be felt when touching the nose, indicative of fractured bone moving against each other. Tenderness: Touching the area even lightly may elicit pain, indicating underlying trauma. Septal Hematoma: In some cases, a blood clot may form inside the nose, which requires immediate medical attention. Deviated Septum: The partition of the nose may buckle, bend, get dislocated or fractured leading to narrowing of the nasal passage and nasal obstruction. Read more about Nasal bone fractures and their management >> MANDIBULAR (LOWER JAW) FRACTURES Lower jaw fractures can be categorized into: Angle: Occurs near the molars. Body: Involves the horizontal portion of the lower jaw. Condylar: Near the joint connecting the lower jaw to the skull. Symphyseal and Parasmphyseal: Located at the front of the lower jaw, near the chin. Multiple sites: Fractures may involve two or more of the above sites. IMMEDIATE SYMPTOMS Pain: Intense, localized pain often at the site of impact. Swelling: Prominent swelling at the site of fracture. Bruising and Swelling: Visible bruising and/or swelling around the jawline or along the floor of the mouth. Open Wound: In cases of compound fractures, there may be an open wound. Haemorrhage: Bleeding within the oral cavity may be observed during a clinical examination. Ear Pain: Referred pain may extend up to the ear. Speech Impediments: Difficulties in articulating certain sounds or words. Chewing Difficulties: Experiencing difficulty or discomfort while chewing. PHYSICAL SIGNS Facial Asymmetry: Obvious or subtle changes in the shape of the lower face. Jaw Stiffness: A feeling of stiffness or restriction in the jaw. Crepitus: Crunching or grinding sounds during jaw movement due to bone fragments. Numbness: Loss of sensation along the lower lip or chin due to nerve damage. Malocclusion: Improper alignment of the teeth. Bite Disruption: An uncomfortable or shifted bite, particularly near the back molars. ZYGOMATIC (CHEEKBONE) FRACTURES 3-D reconstructed CT scan showing cheek bone fracture. Cheekbone fractures can disrupt the alignment of the eye and cheek and lead to difficulty in mouth opening. These may require surgical intervention for repair. PRIMARY SYMPTOMS Facial Pain: Sharp or throbbing pain localized to the cheek area, especially when attempting to open the mouth or move the face. Swelling: Significant swelling is usually observed over the cheekbone area, extending towards the lower eye rim and side of the face. Numbness: You may experience numbness or reduced sensation over the cheek and upper lip due to nerve damage. SECONDARY SYMPTOMS Visual Disturbances: Difficulty moving the eye, double vision, or blurring may occur due to muscle entrapment or swelling. Difficulty in Mouth Opening: Discomfort or resistance when opening the mouth is common due to muscle attachment to the zygomatic bone. Altered Facial Appearance: There might be an obvious or subtle change in the facial contour, leading to asymmetry. PHYSICAL SIGNS Step-Off Deformity: A physical indent or “step” can be felt along the bone’s edge, often near the lateral eye rim or below the zygoma. Bruising: Bruising may develop below the eye or around the cheek, sometimes extending to the neck or chest due to gravity. Ecchymosis: ‘Raccoon eyes’ or periorbital ecchymosis may be apparent in severe cases. Trismus: Limited mouth opening due to muscle spasm or mechanical blockage by displaced bone fragments. MAXILLARY (UPPER JAW) FRACTURES 3-D reconstructed CT scan showing upper jaw fracture. Affecting the upper jaw, these fractures can also impact the alignment of the teeth and the position of the palate. Types include: Le Fort I: Horizontal fracture above the upper teeth Le Fort II: Pyramidal fracture affecting the nose and upper jaw Le Fort III: Transverse fracture that separates the facial skeleton from the cranial base Palatal Fractures: These fractures affect the roof of the mouth, involving both the hard palate. Maxillary fractures, involving the upper jaw, are complex and can significantly affect facial function and appearance. Quick identification and intervention are essential for the best possible outcomes. Here, we provide an in-depth guide to the symptoms and signs of maxillary fractures. PRIMARY SYMPTOMS Pain and Tenderness: Acute pain in the upper jaw, often intensifying when speaking, chewing, or moving the face. Swelling: Swelling often extends from the upper jaw to the surrounding facial areas, including the cheeks and lower eye regions. Malocclusion: A noticeable change in dental alignment or bite, which may affect eating and speech. Bleeding: Blood may be visible in the nose, mouth, or even in the throat, potentially causing difficulty in swallowing. SECONDARY SYMPTOMS Numbness: A loss of sensation in the upper lip,

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      Ear Lobe Surgery

      Ear lobe surgery

      EAR LOBE SURGERY (LOBULOPLASTY) PROCEDURE Earlobe surgery (earlobe repair or earlobe reduction) is a cosmetic procedure that can help address issues with ear lobes such as: Sagging of ear lobes due to age Stretching of ear lobes Tearing of earlobes due to wearing heavy earrings The surgery can improve the appearance of large earlobes that result from ageing, making them more proportional to the rest of the ear and face. Aesthetic Goals might differ for older clients; while some might seek subtle changes, others might want a more dramatic youthful appearance. DETAILED PROCEDURE STEPS PREOPERATIVE ASSESSMENT A comprehensive medical history and physical examination are performed by Dr Sandeep and his team. This includes discussing any existing medical conditions, medications, and previous surgeries. Dr Sandeep’s team also take photographs of the ears for “before and after” comparisons and hold a detailed discussion with the client regarding their aesthetic goals. INFORMED CONSENT Risks, benefits, and alternatives are discussed in detail with the client, and written informed consent is obtained. ANESTHESIA Local anaesthesia, usually in the form of lidocaine injections, is applied to numb the earlobe area. Sometimes, a mild sedative may be given to help you relax. SURGICAL TECHNIQUES There are several techniques depending on the type of correction needed: Simple Repair: A small wedge of skin may be removed and then the two edges sutured together. Z-Plasty or W-Plasty: These more complex flap techniques may be used for significant elongation or deformation. Lobuloplasty: This involves sculpting the earlobe for a more aesthetic look. Suturing: Fine sutures, either dissolvable or non-dissolvable, are used to minimize scarring. Sometimes a combination is used—dissolvable for internal sutures and non-dissolvable for skin closure. DRESSING Sterile dressings are applied to protect the incisions and minimize infection risk. POSTOPERATIVE CARE Initial Hours: A friend or family member should drive you home. Mild pain and swelling are expected but generally manageable with over-the-counter pain medication. Follow-up Visits: Scheduled to check wound healing, remove sutures (if they are not dissolvable), and monitor for complications. Activity Restrictions: Avoid strenuous activities for 3 weeks. If a torn earlobe has been repaired ear piercing should be performed only after 6 months. Avoid wearing heavy earrings in the future. Long-term Care: Sun protection and gentle care are advised to minimize scarring. Silicone gel is prescribed to help achieve a better scar and avoid keloid or hypertrophic scar formation. POTENTIAL RISKS AND COMPLICATIONS Bleeding: Rare. Usually this is minimal and stops with application of pressure. Infection: Antibiotics may be prescribed to minimize this risk. Poor Scarring: This includes hypertrophic scarring or keloid formation, more common in people with a history of such issues. Nerve Damage: Though rare, nerve damage can lead to numbness or changes in sensation. Asymmetry: No two ears are completely symmetrical, but significant asymmetry can be bothersome. Anesthesia Complications: Although rare, some people have allergic reactions to local anaesthesia. ENHANCE YOUR ELEGANCE: SCHEDULE YOUR LOBULOPLASTY CONSULTATION TODAY! Transform your look with Lobuloplasty. Dealing with elongated, drooping, or split earlobes due to the natural aging process or the weight of decorative earrings can be a thing of the past. Dr Sandeep offers individualized consultations to revitalize your earlobes. Our specialized Lobuloplasty service is designed not only to rectify these issues but also to bring a harmonious balance to your earlobes and facial aesthetics, giving you a subtly refreshed and younger-looking profile. Discover how Lobuloplasty can restore balance and beauty to your earlobes. Book your consultation today and take the first step towards a more sophisticated and polished you. Organize your Lobuloplasty consultation here. For convenience, connect with us on WhatsApp or book an appointment through our appointment booking page.

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      Dimple Creation Surgery

      Dimple Creation

      DIMPLE CREATION SURGERY If you’re considering undergoing this procedure, it’s crucial to consult with a qualified surgeon like Dr Sandeep and his team for a comprehensive assessment and personalized advice. Here is a detailed explanation of the procedure. PROCEDURE CONSULTATION During your consultation Dr Sandeep will take a detailed medical history, conduct a facial analysis, and discuss your aesthetic objectives. Pre-operative photographs will be taken for documentation. It is helpful to bring a few photographs of other people with the kind of dimple you wish to have to help in pre-operative discussion and surgical planning. ARRIVAL AT CLINIC Usually, you would arrive at our surgical facility a few hours before the scheduled time. You’ll undergo an examination to ensure you are fit for local anaesthesia. PREPARATION The area to be treated will be marked and cleansed. Anaesthesia is then administered. INCISION AND MUSCLE WORK A small incision is made in the inner side of your cheek. Dr Sandeep will then create a small defect in the buccinator muscle. SUTURING A dissolvable suture is threaded through the muscle defect and anchored to the skin to create a dimple. CLOSING INCISION The incision inside your mouth will be closed with dissolvable sutures. IMMEDIATE AFTERCARE You’ll be observed for a short period to ensure there are no immediate complications from the anaesthesia or surgery. DISCHARGE Usually, you can go home the same day, unless complications arise. PAIN MANAGEMENT Mild pain and swelling are common but usually managed with over-the-counter pain medication. DIETARY RESTRICTIONS Soft diet or liquid diet might be recommended for the first few days to avoid stressing the sutured area. ANTIBIOTICS  May be prescribed to reduce the risk of infection. FOLLOW-UP APPOINTMENTS These are vital, our team arrange the appropriate follow-up appointments for monitoring healing, checking for infection, and assessing the results. ADVANTAGES OF DIMPLE CREATION Minimally Invasive: No general anaesthesia or hospital stay is usually required. Short Procedure Time: Typically takes between 30 minutes to an hour. Fast Recovery: You can usually return to most daily activities within a day or two. Concealed Scarring: Since the incision is inside the mouth, there’s no visible scarring. Immediate Results: Dimples are visible right after the procedure, although they’ll be most natural-looking after the healing process is complete. Tailored Results: The position and size of the dimples can often be tailored to your preference. Reversible: In some cases, if you’re not satisfied with the results, the process can be reversed or modified, although this is more challenging. Reversal of the procedure is more likely to succeed if it is performed early after surgery but may not always be successful. DISADVANTAGES AND LIMIATIONS Dimple is designed to offer a more youthful or pleasing appearance to those who desire dimples. However, like all surgical procedures, dimpleplasty comes with its own set of disadvantages and limitations. Here are some to consider: COST Dimple creation surgery is not covered by health insurance since it’s considered a cosmetic procedure. PERMANENT RESULT Dimple creation surgery is not covered by health insurance since it’s considered a cosmetic procedure. HEALING TIME Like any surgical procedure, dimple creation requires time for the incision to heal, which can mean days to weeks of downtime. SCARRING RISK Although the incisions are usually made inside the mouth to minimize visible scarring, there is still a risk, especially if the wound becomes infected or heals poorly. NATURAL APPEARANCE Achieving a natural-looking dimple can be challenging, and there’s a risk that the result may look artificial. AESTHETIC OUTCOME The desired look may not be achieved due to individual healing processes or surgical technique, leading to dissatisfaction. TEMPORARY DIMPLES In some cases, the created dimples may not be permanent and could fade away over time, requiring another procedure for maintenance. UNPREDICTABLE RESULTS Factors like individual skin elasticity, healing response, and other biological variables can affect the end result, making it somewhat unpredictable. LIMITED CANDIDACY Not everyone is a good candidate for the procedure. Factors like skin type, age, and medical history can affect suitability. POTENTIAL RISKS AND COMPLICATIONS Dimple creation surgery is generally considered a safe and straightforward cosmetic procedure. However, as with any surgical procedure, there are potential risks and complications to consider. Below are some general potential risks and complications: Bleeding: This may rarely occur despite meticulous haemostasis. Hematoma or Bruising: Accumulation of blood in the surgical area could occur, requiring additional intervention like drainage. Nerve Damage: Though rare, there is a slight chance that facial nerves could be affected during the procedure. Numbness at the surgical site may persist for a few months. Foreign Body Reaction: Since a suture is placed inside the tissue, there’s a slight possibility that your body may reject or react to the material. Body Image: How you perceive your new dimples might take time, and psychological adjustment is often necessary. Expectation vs Reality: It’s important to note that while dimples can enhance your facial features, they are not a ‘magic bullet’ for self-esteem or attractiveness. Asymmetry: Dimples may not be perfectly symmetrical, depending on how the sutures hold and the healing process. Over or Under-Correction: The depth and appearance of the dimples might not meet your expectations. Usually, the dimples are deep and static during the initial phase after surgery but become less pronounced and more dynamic with time. Temporary Results: In some cases, the sutures may not hold as expected, leading to the fading of the dimples over time. If you are considering dimple creation, please consult with Dr Sandeep for personalized medical advice and to find out if dimple creation is suitable for you. CRAFT YOUR UNIQUE SMILE WITH DR SANDEEP’S DIMPLE DESIGN Enter the delightful realm of smiles adorned with dimples, precisely crafted by Dr Sandeep. In your personalized consultation, he will tailor a dimple creation plan that complements your facial aesthetics, ensuring a natural and charismatic result. Dr Sandeep’s approach is to sculpt dimples that resonate with your personal style, adding an irresistible depth to your smile. Book your bespoke consultation with Dr Sandeep and

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