Bunion

Many foot issues that are not curable dermatologically can be treated by a skilled plastic surgeon. A bunion or as medically called Hallux Abductovalgus develops when the big toe points toward the second toe, forming a bump on the inside edge of the foot. The bump is made of extra bone which the body forms in a defensive mode. The bump is formed because the big toe is not pointing ahead and throws off the alignment of the bones. Bunions do not happen overnight but gradually: as the big toe points toward the second toe, the angle of the bones slowly change throughout the years, causing a bump.

Bunions are so frequent as to afflict 30% of the entire population in the United States. Naturally, your mobility and quality of your life decreases as a bunion worsens, and the big toe pain causes major dissatisfaction with physical, psychological and social appearance.

Certain flawed structures of the foot are inherited. Bunions themselves are not inherited. Wearing shoes that crowd the toes such as narrow shoes or high heels can cause symptoms leading to a bunion. Wearing high heel shoes which place the feet in a more pronatory position will also lead or worsen a bunion. In fact, it is thought that for this very reason women have a higher prevalence of bunions than men. Women are 10 times more likely than men to have bunions. The National American Orthopaedic Foot and Ankle Society conducted a study that should that in the US, 88% percent of women wear shoes that are too small and 55% of women have bunions. Many women with bunions fear wearing open-toe shoes as aside from being uncomfortable, want to hide the appearance of their feet.

At the site of the bunion, the patient may feel pain, a burning sensation, or even numbness. There may be inflammation, as well. Bunions are usually visually apparent. However, x-rays are also taken to fully assess the condition. This can determine to what degree the bones are unaligned. Furthermore, bunions are progressive in that they usually worsen over time without the proper treatment. Individuals who have Rheumatoid Arthritis or some other joint problems will have more odds of getting a bunion.

Treatment is available with or without surgery. After an initial consultation and a review of the patient’s x-rays, the proper route can be determined. Most non-surgical treatments are early therapies for reducing pain, but not to get rid of the bunion. Some of these treatments include changing the type of shoe the patient wears to wider shoes, applying ice to lessen the inflammation, inserting padding in the shoes, avoiding activity that makes the patient stand for long periods of time along with other methods that can be discussed with Dr. Fisher.

There are many, many surgical procedures to fix bunion and most of these are modifications of each other. Some of these procedures involve removing the bump while others involve correcting the structure of the bone where the problem lies. The procedure that Dr. Fisher utilizes is truly revolutionary, because most patients are able to bear weight almost immediately after the procedure. Another benefit that Dr. Fisher provides his patients is that he performs the procedure in such an expert fashion and manner that no-one can tell that the patient had foot surgery.

BDD – Rhinoplasty of the Mind

Dr. Gregory Fisher, FACS, is the expert on body image. Among his numerous publications and articles, he focuses on the correlation of rhinoplasty and decrease of the symptoms of body dysmorphic disorder (BDD). BDD is the result of misperceived proportion among various parts of the body. This can occur with hands and the torso, feet or – the nose.

“The most frequent requests for ‘adjustment’,” says Dr. Fisher, “concern the face. The face is the most obvious, always visible, part of the body, which communicates our feelings and sensations. People with larger noses may appear unnecessarily ‘pushy’ or self-assertive.” This perception is then reflected in their own conduct and they may become what (they thing) corresponds to their appearance.

Many people with BDD have “unrealistic expectations,” says Dr. Fisher. They will never be satisfied and the most perfect result will fall short of the “ideal” they want to achieve. Unfortunately, this “ideal” is just as unreal in the person’s mind as it is in reality. Dr. Fisher suggests pre-operative computer imaging or portrait imposition may assist prior to surgery, in order to realize where to go and what to avoid.

However, Dr. Gregory T. Fisher, M.D., F.A.C.S. is also an expert in psychology and psychiatry. He can help such patients in other ways… “If only the patient will listen,” says Dr. Fisher, “I cannot perform miracles, but my team and I, we come very very close to it.”

A recent study published in Plastic and Reconstructive Surgery® (http://tinyurl.com/c2gqube), the journal of the American Society of Plastic Surgeons® (ASPS), parallels Dr. Fisher’s observations. The study concludes that rhinoplasty patients with BDD may be more likely to be disappointed with their results. People with BDD perceive one or more of their features as a defect. According to the ASPS (http://tinyurl.com/clc3bc8), BDD is “the only psychiatric diagnosis that directly considers body image concerns.”

“As a physician,” says Dr. Fisher, “I must consider primarily the patient’s long-term health. – As a plastic surgeon,” emphasizes Dr. Fisher, “I must always weigh their psychology and mental health. People who approach me for plastic surgery here in Los Angeles will obviously have some aesthetic concerns, but they need to understand what aesthetic medicine can and cannot fix.”

“Moreover,” adds Dr. Fisher, “one cannot consider a bodypart-at-a-time so to speak. For instance rhinoplasty is as much about the rest of the face as it is about the nose. I can change the shape of your nose to best balance with the chin and cheekbones, but balance is an uneasy concept for anyone with BDD, because BDD is all about balance and the inability to balance.”

Chocolate News

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Researchers at University of Warwick have come up with a new way through which they can cut down the fat content in chocolates by as much as half without changing how it feels in your mouth.

Presenting their study at an American Chemical Society meeting, the researchers revealed that one can create tiny ‘sponges’ in chocolate with the help of gelling agent agar, which can displace fat.

The researchers added that these sponges could be filled up with anything from water, juice or even alcohol.

Lead researcher Stefan Bon said that while their findings can be used to create ‘unhealthy’ chocolates by filling them up with alcohol, it can also be used to create chocolates with significantly lower fat content. “You can stick to your fruit juice if you want, but you can also make a vodka-based chocolate bar, which is exciting – obviously not very healthy, but exciting. It opens the route to different types of confectionery candy that can be placed on the shelf next to everything else that’s out there already”, he said.

 

 

Corrective Breast Surgery

 

Corrective breast surgery refers to several types of cosmetic breast correction, such as breast implant revision and inverted nipple correction. Dr. Gregory Thomas Fisher performs these procedures with utmost kill, specifically tailored to your conditions. It is therefore impossible to inform you in particular.

Generally speaking, however, there are many types of complaints patients come to us with desire to revise their previous breast augmentation. Breast augmentation is a very popular procedure. Among the many women who undergo breast augmentation, a relatively small number of them do not achieve their desired outcome. If you have undergone breast augmentation surgery and are not satisfied with the result, you can choose to have a breast implant revision at the Cosmetic Surgery and Laser Center in Cerritos Towne Center.

 

What Does Breast Implant Revision Correct?

Even if Dr. Fisher did not perform your original breast augmentation, he can help you improve your results through breast implant revision. Dr. Fisher performs breast implant revision in order to:

  • Change the size of your implants,
  • Improve breast symmetry
  • Replace a ruptured implant
  • Correct symmastia or treat capsular contracture.

In most cases, patients only undergo a revision procedure if they have completely healed from breast augmentation.

 

How Is Breast Implant Revision Performed?

Implant revision surgery is similar to your original augmentation surgery. Dr. Fisher will make incisions, typically in the same location as the first operation. These allow Dr. Fisher to reposition your implants or replace a ruptured implant. Your recovery will be very similar to your original breast augmentation recovery. You should rest, wear your supportive bra, and avoid lifting heavy objects. Dr. Fisher and his staff will provide specific instructions after the surgery. IT IS IMPERATIVE THAT YOU FOLLOW DR.FISHER’S POST OPERATIVE INSTRUCTIONS, because any complications caused by your negligence in not following Dr.Fisher’s instructions will result in another corrective surgery, which is not a part of your first or second procedure.

 

Inverted Nipple Correction (For Inverted or Prominent Nipples)

Nipples may be naturally flat or indented, and not project to the desired position. You may choose to undergo an inverted nipple correction procedure in order to improve the appearance of your breasts.

Pregnancy and breast-feeding can create prominent nipples and make nipples long, wide, and droopy. Prominent nipples can overshadow the youthful look of a breast enhancement. Correction of the nipple can complement breast augmentation or breast lift.

You can undergo inverted nipple correction in order to gain:

  • a more beautiful and proportioned contour,
  • an improved breast appearance,
  • breasts that appear more youthful.

How Is Inverted Nipple Correction Performed?

To correct an inverted nipple, small incisions are made near the nipple to allow access to the underlying structure. Tissues in the nipple are spread (inverted nipples) or contracted (prominent nipples), and dissolvable sutures are placed in the nipple.

A special stent may be placed for 1-3 days to ensure that your nipple is held in the correct position as it heals. The sutures in your nipple dissolve in several weeks. Inverted nipples are corrected with great care to preserve the milk ducts.

If you are interested in a corrective breast procedure, such as implant revision or inverted nipple correction, contact Dr. Fisher’s office at 562 865 9600 for a confidential consultation.

 

Tumescent Liposuction

The tumescent technique of liposuction consist of the following: Dr. Fisher distends the fat and soft tissues with local anesthesia, adrenaline, and salt water. In so doing, the blood loss has decreased to levels that are acceptable in an outpatient surgery setting without the need for post-operative transfusion. Further, more fat tissue may be safely aspirated at one sitting, frequently without the necessity of hospitalization or even general anesthesia. Currently, experimental procedures involving ultrasound and liposuction are being perfected which will hopefully improve techniques further. However, there is no substitute for the gentle hands of a skilled surgeon, who like a sculptor approaches the body to accomplish the perfection machinery can never master.

Regardless of the technique, liposuction is still not a treatment for generalized obesity, but rather for treatment of localized fat excess and disproportion.