MedTravel Asia https://www.medtravel.asia A better healthcare experience Tue, 28 Jul 2020 09:33:48 +0000 en-US hourly 1 https://wordpress.org/?v=5.4.2 https://www.medtravel.asia/wp-content/uploads/2017/04/MedTravel-Asia-16-march-01-e1521461137553-63x63.jpg MedTravel Asia https://www.medtravel.asia 32 32 Condyloma – HPV and Genital Warts https://www.medtravel.asia/condyloma-hpv-and-genital-warts/ https://www.medtravel.asia/condyloma-hpv-and-genital-warts/#respond Tue, 28 Jul 2020 09:33:20 +0000 https://www.medtravel.asia/?p=2879 Condyloma acuminata, better known as HPV genital warts, are a sexually transmitted disease (STD) caused by the human papillomavirus (HPV). HPV genital warts can affect both women and men and can affect both the genital and the oral area. What are genital warts? Genital warts are small growths on the skin usually having the same […]

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Condyloma acuminata, better known as HPV genital warts, are a sexually transmitted disease (STD) caused by the human papillomavirus (HPV). HPV genital warts can affect both women and men and can affect both the genital and the oral area.

HPV genital warts or condyloma due to human papillomavirus

What are genital warts?

Genital warts are small growths on the skin usually having the same color of the surrounding tissues. These warts are caused by some types of the human papillomavirus: HPV type 6 and 11 are responsible for about 90% of genital warts. Although they rarely develop into cancer, it is always better to have them checked by a medical professional.

Signs and symptoms of genital warts and HPV

The main symptom of HPV genital warts looks like a soft bump on the skin. Sometimes they are very small, other times they are more pronounced with a top shaped like a cauliflower. They have the same color as the surrounding skin but may sometimes be slightly darker. They may occur as a single wart or as a cluster of multiple warts. The growth can be difficult to detect when they are internal such as inside the vagina or anus. Other symptoms include:

  • Itching
  • Burning
  • Bleeding
  • Discomfort
  • Mucus discharge

Genital warts in men

In men, genital warts may affect the following areas:

  • Penis
  • Scrotum
  • Perineum
  • Anus both externally and internally
  • Top inner thighs
  • Groin

Genital warts in women

In women, genital warts may affect the following areas:

  • External genitalia, outside the vagina
  • Inside the vagina
  • The cervix (the part between the vaginal canal and the uterus)
  • Perineum
  • Anus both externally and internally
  • Groin
  • Top inner thighs

In rare cases, they can also develop in the mouth, lips, tongue or throat.

What causes genital warts?

Genital warts are caused by HPV commonly through sexual intercourse. Oral, anal and vaginal sex can spread the virus through direct skin to skin contact, but also hand or fluid contact from an infected partner can cause the infection. Most of genital warts are caused by HPV type 6 and 11, but they may be possible also due to other strains of the virus; different skin manifestations can also be caused by other strains of HPV.

What is HPV?

Human papilloma virus (HPV) is a sexually transmitted viral infection (STI). There are over 200 types of HPV and about 50 of them can be transmitted through sexual intercourse, while others affect other parts of the body such as the hands and feet: 90% of the infections resolve with no treatment and cause no symptoms and different strains are linked to a variety of conditions:

  • HPV type 6 and 11 cause 90% of genital warts.
  • HPV types 1, 2, 3, 4, 27, 57 cause cutaneous warts
  • HPV type 16 and 18 cause 70% of cervical cancer and have a role in the development of cancers in the throat, mouth, anus, rectus, penis, vagina.
  • HPV type 31, 33, 35, 39, 45, 51, 52, 56, 58, 59 are other high-risk strains of the virus that can develop into genital cancer.
  • HPV type 1, 5, 8, 9, 17, 20, 23, 38 are associated with non-melanoma skin cancer

HPV is the most common STD in north America with over 79 million Americans infected and the CDC estimates that at least 50% of sexually active men and women will get genital HPV at some point in their lives. An infected person with no signs and symptoms can still pass the infection and symptoms may develop years after the infection is caught.

Genital warts removal and treatment

There are multiple treatments available for genital warts, but they often resolve without treatment over months to years in healthy patients. To lower the chance of spreading the infection you should seek treatment and abstain from sexual activities or at least have only protected sex if the condom can provide protection from skin to skin contact.

Don’t try to use OTC treatments for skin warts for the treatment of genital warts; they are not intended for use in the genital area. There is no evidence supporting home remedies for the treatment of genital warts.

Among the treatments for genital warts there are:

  • Imiquimod (Aldara, Zyclara), a cream applied 3 times per week for up to 16 weeks.
  • Podophyllin and podofilox (Condylox), a cream applied twice daily for 3 days followed by a four-day rest period, repeated for up to 4 weeks.
  • Trichloroacetic acid, an acid that burns off the wart and is applied once per week for 8-10 weeks.
  • Sinecatechins (Veregen), a cream applied 3 times a day for up to 16 weeks.
  • Cryotherapy, which is the freezing of the wart with liquid nitrogen.
  • Excision, meaning the doctor will cut out the wart with surgical tools.
  • Laser treatment, which uses high energy laser light to treat the wart.
  • Electrocautery, which uses electricity to burn off the wart.

Sometimes, multiple treatments or a combination of treatments may be required.

Always follow the directions of your treating physician. Medications have side effects and may require special precautions or be intended only for external use. Some treatments are only administered by the physician itself.

Genital warts can be treated but cannot be cured. Once you remove the warts you are still infected with HPV for which there is no treatment available. The warts may come back months or years later with a recurrence rate of about 20-30%. HPV infection may also clear from the body without medical treatment.

Genital warts prevention

There are several ways of preventing HPV and genital warts.

Always using condoms when having sexual intercourse can lower the chances of getting HPV. The exposed areas not covered by the condom may still transmit the infection or get infected. Using a dental dam while practicing oral sex is also advised to help prevent the infection. HPV can be transmitted even if no genital warts are visible and if the person carrying it is completely asymptomatic. Other than direct skin to skin contact and oral sex, sharing toys can also transmit the infection.

For women, regular pelvic examinations and a Pap test (aka Pap smear) or a cervical screening test may help detect both the infection and possible changes in the cells that line the inside of the vagina.

Vaccines have been developed to protect against HPV type 6 and 11 which are the major cause of genital warts and against HPV type 16 and 18 which pose at high risk of cancer. The vaccine is now administered to boys and girls aged 9-14, but it is recommended for anyone under the age of 26.


Sources

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Inguinal Hernia – Symptoms and Treatment https://www.medtravel.asia/inguinal-hernia-symptoms-and-treatment/ https://www.medtravel.asia/inguinal-hernia-symptoms-and-treatment/#respond Sat, 25 Jul 2020 08:30:33 +0000 https://www.medtravel.asia/?p=2872 An inguinal hernia is a bulging in the pubic or groin area of the abdomen, near the left or right inguinal canal, which develops due to a weak abdominal wall. The small intestine or fat tissue may push through such weakness and protrude resulting in a bulge and often in groin pain, especially when exercising, […]

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An inguinal hernia is a bulging in the pubic or groin area of the abdomen, near the left or right inguinal canal, which develops due to a weak abdominal wall. The small intestine or fat tissue may push through such weakness and protrude resulting in a bulge and often in groin pain, especially when exercising, lifting something heavy, bending over or coughing.

Under normal conditions the abdominal muscles and the connective tissues of the abdominal wall are strong and tight enough to keep the inside tissues in place, but when a weak spot is present it is possible to develop an inguinal hernia.

The inguinal canal is a small passage in the lower abdominal wall that allows blood vessels and nerves, as well as the spermatic cord in males and the round ligament of the uterus in females, to pass through.

Inguinal hernias are the most common type of abdominal wall hernias and have a lifetime risk of occurrence estimated in 27% for males and 3% for females; they are more common on the right side than the left side. 800,000 inguinal hernia repair surgeries are performed each year in the USA alone.

Groin hernias are divided into inguinal and femoral hernias and inguinal hernias are divided into direct and indirect inguinal hernias, but they are all commonly referred to as “inguinal hernias”.

inguinal hernia image and picture of inguinal bulging

Blausen.com staff (2014). “Medical gallery of Blausen Medical 2014”. WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436. – Own work, CC BY 3.0, https://commons.wikimedia.org/w/index.php?curid=31118600

Direct inguinal hernia

A direct inguinal hernia occurs when there is a weak spot in the abdominal wall close to the inguinal canal. They are more likely to occur later in life due to the physiological weakening of the abdominal wall that comes with aging.

Indirect inguinal hernia

An indirect inguinal hernia occurs when the inguinal canal doesn’t fully close during development. It affects 1-5% of newborns and is generally diagnosed in the first year of life, but sometimes indirect hernias don’t show up until adulthood.

Pantaloon (saddle bag) hernia

A pantaloon hernia is a combination of both a direct and an indirect hernia affecting the same patient. The name originates from the shape of the two hernias together.

Femoral hernia

Femoral hernias are bulging of tissues through the femoral canal, the passage that allows blood vessels to go from the abdomen to the thighs. Bulging is generally seen in the top inner thigh area. Femoral hernias are more common in women than men due to their pelvic anatomy and have a higher risk of strangulation. They are often not diagnosed until acute symptoms such as strangulation or bowel obstruction affect the patient.

Inguinal hernia in females

Females are less likely to develop inguinal hernias than males, but they are more likely to develop a femoral hernia. Most cases of inguinal hernia in females are of the indirect type. In females, hernias can also contain the uterus, ovaries and/or fallopian tubes.

Inguinal hernia in males

Males are about 8 times more likely to develop an inguinal hernia than females and it is estimated that 1 in 2 males will have an inguinal hernia develop in their life. The chance of having one increases with aging. Femoral hernias are the rarest type in males. The protruding tissues in male patients may occasionally descend into the scrotum causing pain and swelling around the testicles.

Inguinal hernia in children and babies

Inguinal hernia in babies are most commonly due to a congenital defect (present from birth) affecting 1-5% of newborns and about 10% of premature babies, which causes an indirect hernia. Direct hernias rarely occur in babies or children.

Reducible and irreducible hernia

When the lump can be pushed back through the abdominal wall, it is called reducible hernia. It is also called uncomplicated hernia, meaning it does not constitute an immediate threat. Later on, a reducible hernia may evolve into an irreducible hernia.

Irreducible or incarcerated hernia

An incarcerated hernia or incarceration occurs when the hernia cannot be pushed back into the abdomen by applying manual pressure. In this case, the bulging in the groin area is permanent and requires surgery to fix it.

Strangulated hernia

A strangulated hernia or strangulation occurs when a hernia has its blood flow cut off due to incarceration. This is a serious medical condition requiring emergency surgery and can be fatal. The bulging tissues without blood supply become ischemic and die, causing great pain and release of toxins.

Causes and risk factors of inguinal hernia

The causes of inguinal hernia are multifactorial, meaning there isn’t a single cause, but many factors contribute to the development of the condition. A weakened abdominal wall or a congenital defect of the inguinal canal are major contributors to inguinal hernias.

The risk factors identified to increase the chance of developing an inguinal hernia are:

  • Connective tissue disorders that cause it to be weaker than normal. These can be both genetic and acquired.
  • Family history. Having other family members affected by inguinal hernia increases the chance of developing one.
  • Being male. Males are more likely to be affected by this condition.
  • Being older. The abdominal wall weakens as we age.
  • Premature birth.
  • History of inguinal hernia.
  • Previous abdominal surgery, such as an appendectomy.
  • Chronic cough.
  • Chronic constipation.

The role of heavy lifting as risk factor, whether due to a single strenuous episode, or due to a physical demanding job, or to exercising, is still controversial and studies have been inconclusive.

Symptoms of inguinal hernia

About one third of patients don’t experience any symptom at all and the hernia is detected by a physician during a physical examination.

The main symptom of an inguinal hernia is a bulge on either side of the pubic bone; in males, the bulge can be in the scrotum. The bulge may appear all of a sudden or develop over several weeks.

Other symptoms include:

  • Discomfort or pain in the groin area. Pain can increase when coughing, exercising or bending over.
  • Burning, heaviness or pressure in the groin.

Inguinal pain and other emergency warning signs

Sudden or severe inguinal pain and inability to push the hernia back through the abdominal wall are possible signs of strangulation. Other symptoms include:

  • Nausea and/or vomiting
  • Fever
  • Intestinal obstruction. Inability to pass gas, bloating, or inability to defecate.
  • Bulge changing color and becoming red or dark.

Diagnosis and exams

Diagnosis of an inguinal hernia usually requires just a physical examination.

When symptoms are present, but no bulge is found, or to exclude other conditions with similar symptoms, imaging studies may be prescribed. These include:

  • Abdominal ultrasound
  • Computed Tomography (CT Scan)
  • Magnetic Resonance (MRI)
  • Also known as peritoneography, herniography requires an injection of a contrast fluid into the peritoneal space and the execution of radiographs of the abdomen.

Overview of surgical techniques for hernia repair

For asymptomatic hernia, your doctor may just advise to wait. Hernias won’t get better on their own, so you will have to monitor the evolution of the symptoms which is known as watchful waiting.

When symptoms are present, surgery is generally recommended. There are 3 types of surgical procedures available for treating inguinal hernias and the choice may depend on many different factors such as the patient’s age and medical history, the size of the hernia, the surgeon’s experience and the availability of surgical equipment at the hospital (ie. Surgical Robot), as well as if it is an elective surgery or an emergency surgery.

Open inguinal hernia repair surgery (Open Herniorrhaphy and Open Hernioplasty)

Open hernia surgery requires either a local anesthesia plus sedation or general anesthesia. The surgeon then will perform an incision in the groin area to push back the hernia into the abdomen. When stitches are used to sew the weak spot and prevent the hernia from bulging again it is called herniorrhaphy; when a synthetic mesh is used to reinforce the abdominal wall, it is called hernioplasty.

Laparoscopic Inguinal Hernia Repair Surgery

Laparoscopic (keyhole) surgery is a minimally invasive procedure where several small cuts are made instead of a single large incision. It is typically performed under general anesthesia. A camera will be inserted through one of the incisions to visualize the inside of the abdomen which will be inflated by introducing gas to better visualize the organs. The instruments will be inserted through the other small cuts to perform the surgery. After reducing the hernia, the surgeon inserts a piece of synthetic mesh to strengthen the abdominal wall.

Laparoscopic surgery allows for a quicker recovery with less pain and fewer complications, but there is risk of a recurring hernia if the surgeon is not highly experienced in this specific operation.

Robotic inguinal hernia repair surgery

With the increased use and availability of surgical robots, robotic inguinal hernia repair became available. It is performed similarly to laparoscopic surgery, but the instruments are handled by the surgeon by using a console. It allows for greater precision and better visualization when compared to traditional laparoscopic surgery.

Is Inguinal Hernia treatable without surgery?

Surgical treatment is the only available option for inguinal hernia. Watchful waiting is an option for uncomplicated and asymptomatic hernia. Delaying surgery when recommended will make the symptoms grow worse with time and will allow the bulge to grow bigger, requiring a more invasive surgery for repair. You will also pose yourself at risk for strangulation, which can be fatal and requires emergency surgical treatment.

Supports, trusses and strapping which apply pressure on the hernia to keep it in place may sometimes alleviate some of the symptoms, but will not cure the underlying condition and it is generally not recommended as it won’t prevent incarceration or strangulation.


Sources
  • Groin Hernias in Adults.
    RJ Fitzgibbons, RA Forse – The New England Journal of Medicine, Feb 2015
  • Risk and prognosis of inguinal hernia in relation to occupational mechanical exposures–a systematic review of the epidemiologic evidence.
    SW Svendsen, P Frost – Scandinavian Journal of Work, Environment & Health, Jan 2013
  • Risk factors for inguinal hernia among adults in the US population.
    CE Ruhl, JE Everhart – American Journal of Epidemiology, May 2007
  • Textbook of Hernia
    WW Hope, WS COBB, GL Adrales – Springer, 2017
  • Society of American Gastrointestinal and Endoscopic Surgeons (SAGES)
  • U.S. National Institutes of Health (NIH)

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Hand foot and mouth disease (HFMD) – Symptoms and Treatment https://www.medtravel.asia/hand-foot-and-mouth-disease-hfmd-symptoms-and-treatment/ https://www.medtravel.asia/hand-foot-and-mouth-disease-hfmd-symptoms-and-treatment/#respond Thu, 23 Jul 2020 08:56:45 +0000 https://www.medtravel.asia/?p=2863 Hand foot and mouth disease (HFMD) is a generally mild but highly contagious disease caused by a virus. It usually affects children below 10 and in particular those below 5, however it is also possible for adults to get the disease. Hand foot and mouth disease is commonly caused by a coxsackievirus, but other types […]

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Hand foot and mouth disease (HFMD) is a generally mild but highly contagious disease caused by a virus. It usually affects children below 10 and in particular those below 5, however it is also possible for adults to get the disease. Hand foot and mouth disease is commonly caused by a coxsackievirus, but other types of enteroviruses can cause it too; the signs and symptoms of HFMD are the same even if the infection is caused by a different virus.

Hand foot and mouth disease (HFMD) signs and symptoms

hand foot and mouth disease skin rash and red  spots sores and blisters in a child

By MidgleyDJ at en.wikipedia, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=4000344

After an incubation period of 3 to 6 days, the first symptoms to show up are generic and common with other illnesses like the common cold or the flu:

  • Fever
  • Sore throat
  • Loss of appetite
  • Irritability
  • Malaise

One or two days after the fever begins, the other characteristic signs of hand foot and mouth disease become evident:

  • Mouth sores. They usually start as small red spots on the gums, sides of the tongue, palate or inner cheeks; they then develop into painful blisters
  • A skin rash on the hands and feet that looks like flat red spots. Sometimes the rash may show up also on the elbows, knees and buttocks area. The red spots are itchy and may turn into blisters.

Hand, foot and mouth disease is usually a mild illness most commonly seen in summer and fall; symptoms are worst in the first few days and resolve without treatment in 7 to 10 days. Blisters generally leave no permanent mark.

Mouth sores may make it painful to drink, eat and swallow. Refusing to eat or drink, with a fever, can sometimes be the only sign of hand foot and mouth disease in young babies. Cold water may be helpful by keeping the child hydrated and providing some relief from the discomfort or pain in their mouth.

In rare cases, the virus may cause serious complications such as, myocarditis, meningitis, encephalitis, polio-like syndromes and is potentially fatal. In the past two decades, several outbreaks and epidemics of a particularly severe form of hand foot and mouth disease caused by enterovirus-71 were reported around Asia accounting for most of the serious complications and deaths due to the disease.

Adults often don’t show any sign of the disease when infected.

hand foot and mouth disease skin rash and red  spots sores and blisters in a child

By Ngufra at English Wikipedia, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=34704405

When to see a doctor

The youngest are those at higher risk for serious complications from hand foot and mouth disease. It is advised to see your doctor if any of the following signs are present:

  • Persistent fever (with HFMD it should only last a couple of days)
  • Dehydration or inability to keep the child hydrated due to painful mouth sores
  • Abnormal movements
  • Rapid breathing
  • Drowsiness

Other reasons to seek your doctor’s attention are if:

  • The symptoms are severe
  • The child is very young, especially if under 6-12 months
  • The patient is immunocompromised
  • Worsening of the symptoms after a few days or no improvement after 7-10 days

Hand foot and mouth disease (HFMD) transmission and contagious period

The virus is highly contagious and can spread easily. HFMD transmits through contact with an infected person’s:

  • Saliva
  • Mucus from nose or lungs
  • Fluid from blisters
  • Feces

Contact with infected surfaces or airborne infection through saliva droplets is possible as well.

The virus is most contagious during the first week from the onset of symptoms, but a person with hand foot and mouth disease may be contagious for several weeks following the infection and those who don’t experience any symptom at all, like it often happens in adults, are still carriers and can spread the virus.

It is advised for children to stay at home until the symptoms disappear to avoid spreading the disease.

Persons who had hand foot and mouth disease develop an immunity to it, but the immunity is limited to the specific virus which caused the illness. It is still possible to get HFMD again from a different virus.

Hand foot and mouth disease treatment and care

There is no available treatment for hand foot and mouth disease. A vaccine and antiviral drugs are under development and are not available yet. Being a viral infection, antibiotics have no effect on it and won’t help.

Fever tends to last 1-2 days only. The other symptoms clear on their own in 7 to 10 days from the onset of the disease, without leaving any trace.

It is still possible to treat the symptoms of hand foot and mouth disease as well as to ease them with the following:

  • You can treat fever and pain with ibuprofen or acetaminophen. Numbing sprays are available OTC and they may provide relief for mouth sores. Never give aspirin to children as it is linked to the development of Reye Syndrome when fighting off a viral infection. Adults can take aspirin. Consult your physician first.
  • Avoid hot, spicy, salty or acidic foods and drinks. These can make the sores inside the mouth more painful.
  • Drinking cold liquids may ease the discomfort and help avoiding dehydration.
  • Ice-creams, yogurts, smoothies and popsicles may be a good choice to provide relief and some energy.
  • Soft foods like soups may be easier to eat.
  • Other gels, sprays, mouthwashes and creams are available OTC for treating the pain or discomfort from the rashes and blisters or sores. Ask your GP and/or your pharmacist for an advice.

Prevention strategies for HFMD

To prevent the spread of hand foot and mouth disease and to lower the chances of catching it you should follow these simple steps:

  1. Wash your hands with soap and water frequently. This is important not only for the prevention of hand foot and mouth disease, but for many more diseases as well. Teach your kids how to wash their hands and instruct them to do so before eating and after going to the toilet.
  2. Teach your children not to put their hands or objects like toys in their mouth.
  3. Teach your kids to cover their mouth when they cough or sneeze with a disposable tissue or with the sleeve of their shirt.
  4. If sick, stay home from school or work until symptoms resolve to avoid spreading the disease. After 7-10 days you may have no symptoms but still be contagious. You can go back to work or your child can go back to school, but you should be extra careful not to share forks, spoons, drinking bottles or glasses, with others. You should also be careful not to rub your nose, mouth and eyes, and wash your hands frequently.
  5. If you have multiple siblings and one is sick, keep them separated until resolution of the symptoms. Disinfect any surface that is touched frequently, toys included. Avoid kissing and hugging.

Sources

 

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What is Allergic Cough? Symptoms and remedies https://www.medtravel.asia/what-is-allergic-cough-symptoms-and-remedies/ https://www.medtravel.asia/what-is-allergic-cough-symptoms-and-remedies/#respond Tue, 21 Jul 2020 11:36:44 +0000 https://www.medtravel.asia/?p=2856 Allergic cough is defined as cough caused by allergy rather than an infection. Cough is one of the most common signs and symptoms of diseases both in adults and children, from a common and transient respiratory tract infection as the common cold to more serious and chronic illnesses which can even be life-threatening. In this […]

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Allergy cough and coughing due to allergies

Allergic cough is defined as cough caused by allergy rather than an infection. Cough is one of the most common signs and symptoms of diseases both in adults and children, from a common and transient respiratory tract infection as the common cold to more serious and chronic illnesses which can even be life-threatening.

In this article, we will discuss cough developing due to allergic disease such as allergic rhinitis, commonly known as hay fever.

Symptoms of Allergic Cough and differences with a common cold

Allergic cough is caused by an excessive response from the immune system to some substances, such as dust and pollen, known as allergens; being mistakenly recognized by the organism as germs, the immune systems attacks such allergens and releases chemical substances like histamine which cause the classic allergy symptoms.

Symptoms associated with allergies are:

  • Sneezing
  • Red, itchy and watery eyes
  • Runny or stuffy nose
  • Coughing

Other possible symptoms are fatigue, headache and sore throat.

These symptoms are similar to those experienced with a common cold, but their characteristics are very different.

Allergic symptoms last from days to months depending on how long you are exposed to the allergen. If you are allergic to cats and are briefly in contact with one, those symptoms may last just a couple of hours. If you are allergic to pollen, your symptoms may last for several months from the onset of symptoms to when the plants stop releasing their pollen. Allergic symptoms can happen any time of the year and in some cases, like pollen allergy, they are seasonal and happen around the same time every year. Another characteristic of allergy symptoms is that the onset of such symptoms is very rapid after contact with the allergen.

Symptoms from a viral infection tend to last between 3 and 14 days and are more likely to be experienced in winter although they are possible any time of the year. After catching a virus, it usually takes a couple of days for the symptoms to appear and the onset is more gradual. With a cold or other viral infection, you may also experience fever and aches which are not a symptom of allergies.

Persistent cough: is it CoViD-19 or allergy?

Due to the current pandemic, some may wonder whether their cough is simply a seasonal allergy or a symptom of coronavirus disease 2019 (CoViD-19). According to the CDC, the following are the symptoms of coronavirus which appear 2-14 days after exposure:

  • Fever or chills
  • Cough
  • Shortness of breath or difficulty breathing
  • Fatigue
  • Muscle or body aches
  • Headache
  • New loss of taste or smell
  • Sore throat
  • Congestion or runny nose
  • Nausea or vomiting
  • Diarrhea

Some of these symptoms clearly differentiate between COVID and allergies, such as fever which is the main symptom, loss of taste and smell, nausea and vomiting, and diarrhea. These symptoms may range from mild to severe and you may only experience some of those.

COVID-19 does not respond to allergy medications, so if you feel better after taking your usual allergy treatment you likely don’t have an infection.

If you have some of the above symptoms don’t panic, it could also be another type of infection unrelated to the outbreak.

Difficulty breathing and/or shortness of breath are also common with asthma that can worsen during allergy season.

Symptoms should always be looked at critically, logically and as a whole, so calling your GP for a consult is always a good choice.

Trouble breathing, persistent pain or pressure to the chest, confusion, inability to wake or stay awake, bluish lips or face, are all emergency warning signs according to the CDC so if you or someone you know is experiencing such symptoms call the medical emergency number. The list does not cover all possible symptoms so for any severe or concerning symptom you should call your medical provider.

Allergic bronchitis vs acute bronchitis

Bronchitis may be caused by allergies or by an infection and its main symptom is coughing. Germs are the of cause acute bronchitis, which usually lasts from a few days to a few weeks; conversely, chronic allergic bronchitis may last several weeks or months.

With bronchitis there is also mucus production, which is clear or whitish when it’s chronic or due to allergies, while it is green or yellow when it is due to an infection. Moreover, acute bronchitis generally causes fever too, which is not present in chronic or allergic bronchitis.

Chronic allergic bronchitis may be caused by the exposure to allergens like pollen and dust, and may worsen with pollution; chronic cough may also have other causes.

Other possible causes of chronic cough

A chronic cough may be a sign of a wide range of illnesses and diseases. Some of the most common are:

  • Allergic rhinitis
  • Chronic rhinosinusitis
  • Asthma
  • Acid reflux
  • Some medications such as ACE-inhibitors for blood pressure
  • Primary lung disease
  • Other causes

You should refer to your GP for a proper evaluation and differential diagnosis of your chronic cough.

Why do allergies cause coughing – Throat itching and cough

Allergic cough is usually caused by swelling or irritation of the airways. Irritation if often caused by what is known as postnasal drip: nasal secretions due to the allergy drip down the throat causing irritation of both the throat and the larynx and a tickling feeling which in turn causes the cough. Although allergies are usually worse during the day when it is more likely to be in contact with allergens, postnasal drip may be worse at night due to the position of the body: by lying down, due to gravity and the anatomy of the nose, it’s easier for liquids to drip into the throat and cause the itching.

Allergic cough in children

Cough as a symptom accounts for roughly 10% of all medical appointments in patients younger than 15 years old, with most cases being self-resolving and classified as acute cough due to upper respiratory tract viral infection. If a cough lasts more than 3 weeks or if episodes of cough are recurring over several months, it is advised to seek a proper evaluation by a medical professional.

Allergic cough in children is caused by post-nasal drip and upper airways irritation by the allergens.

Allergies tend to run in families: If both parents have allergies, the children have a 60-70% chance of being allergic too, while if only one parent has allergies, the chance is lower, around 30%. The exception to this is allergies to medications, insect venom and latex.

Allergic cough treatments and remedies

There are several remedies as well as treatments available OTC for allergic cough.

The first thing to do is to understand what substance is causing the allergy. Seasonal allergies are commonly triggered by grass pollen, ragweed pollen, spores from molds and fungi, and tree pollen. Year-round allergies are commonly triggered by dust, mites, pet hair or dander, and mold. Your doctor may order a Skin Prick Test (SPT) or a Specific IgE Blood Test to find out what you’re allergic to.

Once the allergen is known, you should avoid it. You may want to keep the windows closed during allergy season both at home and in your car, take a shower and change your clothes after spending time outdoor, and get an air purifier or making sure your air conditioning system has a clean filter. Face masks with filters are also an option when being outdoors. You can also check your local pollen counts online and avoid going out during peaks.

Other remedies for allergic cough are:

  • Nasal sinus irrigations (nasal rinse) with saline solution, which can wash out any irritant stuck in the nose and curb nasal drip.
  • Drinking warm water mixed with honey and lemon may help soothe the throat and reduce the need of coughing. Honey by itself (1-2 teaspoons) may also help relieve your cough.
  • Nasal corticosteroids
  • Eye drops for red, itchy, watery eyes. This is because tears are drained through the tear duct to your nose and may contribute to postnasal drip.
  • Oral and nasal antihistamines
  • Nasal decongestants
  • Leukotriene inhibitors are another class of medications that block chemicals produced by the body in response to allergens. They require a prescription.
  • Known as allergy shots, immunotherapy can provide long-lasting symptom relief. It consists of a series of shots with progressively increasing amounts of the allergen to desensitize your organism to it.

Ask your physician for a proper recommendation on the right treatment for your allergic cough.


Sources

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Round vs Teardrop Implants for breast augmentation https://www.medtravel.asia/round-vs-teardrop-implants-for-breast-augmentation/ https://www.medtravel.asia/round-vs-teardrop-implants-for-breast-augmentation/#respond Wed, 15 Jul 2020 04:38:47 +0000 https://www.medtravel.asia/?p=2826 Breast implants for breast augmentation surgery come in many different ways and one of the most common questions among patients is whether you should get a round implant or an anatomical teardrop implant. Aside from shape then you’ll have to find an answer to many more questions such as: What size? From 80cc to over […]

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breast implant selection

Breast implants for breast augmentation surgery come in many different ways and one of the most common questions among patients is whether you should get a round implant or an anatomical teardrop implant. Aside from shape then you’ll have to find an answer to many more questions such as:

  • What size? From 80cc to over 800cc.
  • Which surface? Textured vs smooth surface implants.
  • Which filling material? Saline vs cohesive silicone gel vs highly cohesive silicone gel (gummy bear) vs structured saline implants.
  • Which incision? Transaxillary, periareolar, inframammary or transumbilical?
  • Which profile? Low, moderate, high or extra high?
  • Which placement? Under the muscle vs over the muscle vs dual plane.
  • What surgeon? This will be your most critical decision as it will both influence the answer to the above questions and the results of the procedure.

Don’t worry, your chosen surgeon will help you to go through the many different options and make an informed decision, but it is always best to be prepared to better understand your surgeon’s recommendation.

How to choose breast implant shape? Teardrop vs Round

When it comes to shape, the decision is between two options: teardrop vs round.

Implant shape will depend on many factors:

  • Your unique expectations and aesthetic goal
  • Your preferred incision site
  • The implant placement
  • Your own individual anatomy, which includes your body type, sternum width, chest-wall contour, existing breast tissue, nipple position, degree of ptosis (sagging), and other anatomic measurements that will be taken during your consultation.
  • Your surgeon’s experience

Teardrop Implants

Teardrop breast implants are also known as anatomical or shaped implants. Like a teardrop, anatomical implants are smaller at the top and larger at the bottom, mimicking the slope and silhouette of a natural breast. Their maximum projection point, the point further away from your chest, is off-center below the nipple. They are often chosen to provide not only a breast augmentation, but also correction of a mild ptosis (sagging of the breast) thanks to their shape. They will not be able to address higher degrees of ptosis or be a substitute of mastopexy surgery (breast lift) if that is needed. They are also chosen by those who feel that round implants tend to look artificial and look for an alternative more natural look.

Teardrop implants are filled with silicone gel or with highly cohesive silicone gel (gummy bear implants) for the most natural feel to the touch; they are not filled with saline. They have a textured surface to prevent them from rotating within the chest as that would compromise the aesthetic result.

The downside of having a teardrop shape and being able to maintain it is that when lying down their volume will not spread out evenly as natural breast or round implants would. If placed and sized properly though, most plastic surgeons agree that even when lying on your back such as at the beach they won’t look more fake than round ones.

Anatomical implants focus more on shape than size, so for people looking for a dramatic increase in size round implant may be better.

Round Implants

Round implants were the first type of implant introduced in the market and are the most commonly used breast implant for cosmetic breast augmentation surgery. As the name suggests, they are round and symmetric in shape: for this reason, they give more fullness to the upper pole, the upper region of the breast, when compared to teardrop implants as well as they provide more cleavage. The fluid within the implant flows freely, following the movements and position of the body such as when lying on your back or when running; this also means that while standing the fluid inside the implant will tend to settle in the lower portion of the implant providing, to some extent, the teardrop effect like the anatomical ones.

The downside of having a round implant is that if you’re petite and/or with little natural breast tissue the round implants will tend to look more unnatural than the teardrop ones.

Teardrop vs Round Implant for Cosmetic Breast Augmentation

  • Teardrop implants have an overall more natural look and feel. Keep in mind though, that natural look and feel depends also greatly on other variables such as size, filling material, placement and patient’s anatomy. You may be able to achieve a natural look also with a round implant.
  • Teardrop implants are more customizable to your unique anatomical features than round implants. Teardrop implants don’t just have different volumes and profiles like round ones, but also different width, height and prominence of the slope as well as different customizable volumes in the upper and lower part of the implant.
  • Price. Anatomical teardrop implants are generally more pricey than round ones.
  • Size and Volume. Round implants are best for those who want to substantially increase the size of their breast.
  • Teardrop implants fill the lower part of the breast more, while round implants tend to provide more upper pole fullness, lift and cleavage.
  • Teardrop implants carry the risk of rotation, while the rotation of a round implant would not compromise the aesthetic result. The textured surface and proper placement by the surgeon are able to prevent this. Nevertheless, this is a possible complication requiring corrective surgery.
  • Teardrop implants have a shaped shell, so it usually requires a larger incision for placement when compared to a similarly sized round implant.
  • Capsular contracture. From studies, the risk of capsular contracture is lower with textured implants, so choosing a smooth round implant may carry a higher risk of this complication.
  • Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL). BIA-ALCL is a rare and highly treatable type of lymphoma that can develop around breast implants and it occurs in patients who have breast implants with textured surfaces, with currently no reported cases in women who have smooth surface implants. Current lifetime risk of developing BIA-ALCL is estimated to be between 1 in 2,207 patients and 1 in 86,029 patients. When caught early it is usually curable.

Best natural looking breast implant: round vs teardrop

If you’re looking for a natural looking result following cosmetic breast augmentation surgery the best advice would not be to choose teardrop implants or round implants, but to choose the right surgeon. There are many factors to take into account when looking for a natural result and this can be achieved with both type of implants when choosing a skilled surgeon.

There have been studies were plastic surgeons, nurses or lay individuals were shown pictures of before and after breast augmentation. Not knowing whether round or teardrop implant were used, they were neither able to recognize the type of implant nor they were able to agree on the aesthetic superiority of one over the other.


Sources
  • U.S. Food & Drug Administration
  • American Society of Plastic Surgeons (ASPS)
  • Capsular Contracture after Breast Augmentation: An Update for Clinical Practice.
    H Headon, A Kasem, K Mokbel – Archives of Plastic Surgery, Sep 2015
  • Intraoperative Comparison of Anatomical versus Round Implants in Breast Augmentation: A Randomized Controlled Trial.
    DA Hidalgo, AL Weinstein – Plastic and Reconstructive Surgery, Mar 2017
  • Round versus Anatomical Implants in Primary Cosmetic Breast Augmentation: A Meta-Analysis and Systematic Review.
    F Cheng, Y Cen, C Liu – Plastic and Reconstructive Surgery, Mar 2019
  • Essentials of Aesthetic Surgery.
    JE Janis – Thieme, 2018

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Dissolvable stitches: how long do they last? (complete guide) https://www.medtravel.asia/dissolvable-stitches-how-long-do-they-last-complete-guide/ https://www.medtravel.asia/dissolvable-stitches-how-long-do-they-last-complete-guide/#respond Mon, 13 Jul 2020 06:33:42 +0000 https://www.medtravel.asia/?p=2819 Dissolvable stitches are also known as dissolvable sutures or absorbable sutures and are one of the ways to hold a wound, cut or surgical incision closed so that it can heal properly, minimizing scars, bleeding and the risk of infections. The main types of surgical sutures are: Dissolvable (absorbable) stitches, which are resorbed by the […]

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Dissolvable stitches are also known as dissolvable sutures or absorbable sutures and are one of the ways to hold a wound, cut or surgical incision closed so that it can heal properly, minimizing scars, bleeding and the risk of infections.

The main types of surgical sutures are:

  1. Dissolvable (absorbable) stitches, which are resorbed by the body over time
  2. Regular (non-absorbable) stitches, which need to be removed by a medical professional
  3. Metal staples
  4. Adhesive stitches (steri-strips)
  5. Cyanoacrilate glue, a special non-toxic glue suitable for the skin

Dissolvable stitches are mainly used for deep tissues and tissues that heal rapidly such as the skin, the subcutaneous tissues and the muscles.

What are dissolvable stitches made of?

Dissolvable sutures can be made of many different materials. Nowadays most stitches are made of synthetic polymer materials such as polyglycolic acid or as polylactic acid, which is also used as biodegradable dermal and facial filler (Sculptra®) for cosmetic applications.

All materials used to manufacture dissolvable stitches are biocompatible and safe to use although in rare cases they may be rejected by the organism causing an inflammatory response.

dissolvable stitches or absorbable sutures wound closure

Wikip2011 / CC BY-SA (https://creativecommons.org/licenses/by-sa/3.0)

How long does it take for stitches to dissolve?

The time it takes for sutures to dissolve varies depending on multiple factors:

  • The material the dissolvable suture is made of
  • The size of the dissolvable stitches used
  • The location of the body and the type of tissue where the dissolvable sutures have been used
  • The patient’s unique metabolism and characteristics

Dissolvable stitches are engineered to hold the wound for a set amount of time before losing their strength because of the dissolution process. This time varies between few days and over 8 weeks.

Complete absorption times vary between 40 days and 200 days, after which the material used for suturing is completely metabolized by the body and replaced by connective tissue.

My internal dissolvable stitches are sticking out of the wound (“spitting silks”)

In some cases, internal dissolvable stitches can be pushed to the surface and break through the skin. These are known as spitting silks, spitting stitches or spitting sutures.

Sometimes after starting to dissolve small parts of the stitches are pushed out of the body by the organism. Other times there is an inflammatory response to the stitches recognized as foreign object by the body: this leads to a fluid buildup and to the pushing of the stitches to the skin surface; in this case you may see something that looks like a pimple or small wound. There may be some blood or fluid discharge that can range in color from brown to green and yellow.

If this happens there is nothing to worry about:

  1. Disinfect the wound
  2. Keep the wound clean and dry
  3. Go see your surgeon or GP and have it removed.

The removal of a spitting stitch is an easy, quick and painless procedure. Sometimes more experienced patients just remove them by themselves with a pair of tweezers and a gentle pull. Once the stitch is removed the pimple-like small wound will heal rapidly and disappear.

Spitting stitches have no effect on the outcome of the procedure.

Dissolvable stitches inside the mouth

Dissolvable stitches inside the mouth are the same that can be used in any other body part. They are sometimes called dental stitches or oral stitches and are often used in dental and oral surgery such as after wisdom tooth extraction or other tooth removal or gum surgery.

Because of the materials and thickness chosen for such stitches and due to the characteristic of the tissues, dissolvable stitches when placed in the mouth often fall within 2-7 days following surgery and generally don’t last more than 14 days.

How to remove dissolvable stitches

As a general rule, there is no need to remove dissolvable stitches as they are made to disappear on their own. If the wound healed and the stitches are bothering you, you may consider removing them after getting your doctor’s approval. Never remove stitches without consulting you physician first.

To remove the sutures, you’ll need a set of two hands so if you can’t reach the stitches with both hands due to the location of the closed wound you will need some help from another person. You will also need a pair of tweezers and one pair of surgical scissors. If you don’t have surgical scissors, other types of small sharp scissors or a nail clipper should do the work too. To sterilize the equipment put it in boiling water for 10 minutes, then dry it with a clean paper towel. Find a location with good lighting where you can rest in a comfortable position while removing the stitches.

  1. Wash your hands thoroughly.
  2. Sterilize the area where the stitches are located, not just the closed wound, but also the surrounding area.
  3. Pull the knot with the tweezers and cut right below it.
  4. Gently pull out the thread from the skin.
  5. Repeat the process for each knot.
  6. Wipe again the area with a disinfectant.

You may feel the skin being pulled, but removing stitches is generally not painful. If there is minor bleeding, cover the wound with a bandage after finishing. If you have doubts or complications arise ask your doctor for directions.

How do I know if my stitches are infected?

The signs of infection for any wound are the following:

  1. Redness around the stitches
  2. The area is warm to the touch
  3. The area is swollen
  4. Increasing pain.

Keep in mind the pink-reddish skin is normal around the stitches while the wound heals, as well as minor pain or discomfort.

The presence of pus or colored and foul-smelling discharge, fever and/or swollen glands are other signs of infection.

If you think your wound is infected, call your doctor for directions and a proper evaluation.

How do you treat infected stitches? (Stitch abscess)

You should always consult your physician if you suspect your wound or stitches have become infected.

Your doctor may prescribe warm compresses, a wound culture, topical antibiotic ointment, a course of oral antibiotics or other medications. Minor infections may be treated by simply wiping the wound twice a day with a disinfectant and keeping it clean, dry and covered. More serious infections may require additional surgery or procedures to treat it.

How do I stop my stitches from bleeding?

Some oozing or minor bleeding may be normal and expected depending on the wound. If there is minor bleeding, replace the bandage with a clean, dry new one and apply pressure on it for a couple of minutes to stop the bleeding. If it doesn’t stop or if it keeps happening, consult your doctor.


Sources

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Non-surgical fat reduction to get rid of stubborn belly fat https://www.medtravel.asia/non-surgical-fat-reduction-to-get-rid-of-stubborn-belly-fat/ https://www.medtravel.asia/non-surgical-fat-reduction-to-get-rid-of-stubborn-belly-fat/#respond Thu, 09 Jul 2020 04:40:34 +0000 https://www.medtravel.asia/?p=2795 There are several options to get rid of stubborn belly fat that do not involve surgery, inpatient hospital stays, scars, pain and downtime. These nonsurgical fat reduction technologies use heat, cold, ultrasounds or an injected medication to remove stubborn fat deposits. They are also known as non-invasive body contouring procedures, a broad category that comprises […]

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stubborn belly and lower belly fat deposits

There are several options to get rid of stubborn belly fat that do not involve surgery, inpatient hospital stays, scars, pain and downtime. These nonsurgical fat reduction technologies use heat, cold, ultrasounds or an injected medication to remove stubborn fat deposits.

They are also known as non-invasive body contouring procedures, a broad category that comprises also skin tightening procedures and muscle tightening and enhancement treatments.

What is stubborn fat?

Stubborn fat refers to the localized fat deposits that do not respond to diet and exercise.

Due to genetics, stress with risen cortisol levels or adaptation to the hypocaloric diet and exercise regimen, it may be difficult to lose the last few pounds that separate our current shape to our desired shape or, for fitter individuals, to their dream beach body ready for summer.

Indications for nonsurgical fat reduction

Noninvasive body contouring is indicated to target the stubborn fat deposit in most areas of the body such as the belly, flanks (love handles), thighs, chin (double chin), neck, back, upper arms, and knees.

These treatments are effective in reducing a localized fat bulge, but they are not a substitute to diet and exercise or to other medical procedures such as gastric bypass surgery or abdominoplasty when the goal is overall weight loss or the removal of a great amount of fat tissue.

Options for noninvasive fat reduction

All nonsurgical options for fat reduction rely on handheld devices that are placed in contact with the skin in the target area, or just above the skin, to target and permanently destroy the adipocytes (fat cells) without causing harm to the skin, nerves, muscles or any other tissue. Injection lipolysis does the same, but instead of a handheld device it consists of a drug being injected directly into the subcutaneous fat layer.

Cryolipolysis – CoolSculpting®

Cryolipolysis is most commonly known by patients as “fat freezing” or as CoolSculpting, the name of the patented device used to perform the treatment. A hollow applicator of the appropriate size is placed on the fat bulge to be treated. The applicator creates a vacuum, suctioning the fat bulge into its hollow opening. Cooling panels make the temperature drop inside the applicator, cooling the target area. You may feel cold, tingling and slight discomfort during the first few minutes of treatment, but this resolves quickly as the cold has also an anesthetic effect numbing the area.

A treatment session lasts up to 1 hour during which the patient can read, use the smartphone or watch tv.

Cryolipolysis works by cooling the adipocytes (fat cells) between 0-4 °C. Fat cells are susceptible to cold temperatures unlike other cells and tissues like the skin. The cold injures the fat cells causing their death and an inflammatory response that results in a gradual reduction of the fat layer over the course of several weeks.

Injection Lipolysis – Kybella®, Lipostabil®, LipoDissolve®

Injection lipolysis is also known as intralipotherapy and is commonly referred to as fat dissolving injections. The treatment is performed by injecting a medication in a grid pattern in the target area. The medication used is deoxycholic acid as in the case of Kybella and Belkyra, phosphatidylcholine as in the case of Lipostabil or a combination of the two as in the case of LipoDissolve. These substances cause the disruption of the fat cell membrane and its death, causing it to be metabolized and permanently eliminated from the body.

Radiofrequency Lipolysis – Vanquish®

Radiofrequency lipolysis is also known as Vanquish, the name of one of the patented devices used to deliver this treatment. Adjustable panels are placed around the target area without touching the body. The device emits radiofrequency, an electromagnetic wave capable of heating the deeper skin layers without causing harm to the skin. The energy emitted heats the subcutaneous fat layer causing the death of the adipocytes resulting in permanent fat loss. The patient feels a gentle heating without discomfort during the 30 minutes long treatment. Treatment causes no damage to the skin, nerves, muscles or the internal organs.

Laser Lipolysis – SculpSure®, Zerona®

Laser lipolysis commonly known by the name of the patented devices used to perform the treatment such as SculpSure and Zerona, is another heat-based treatment. In this case, heat is generated by a laser. The energy emitted by the laser is absorbed by the adipocytes, leaving other cells and tissues unharmed, and causing them to heat up during the 25 minutes long treatment. Heating results in the death of the fat cells, which will be then eliminated by the body over the course of several weeks.

Ultrasound Lipolysis – Ultrashape®, Liposonix®

Ultrasound lipolysis uses another type of electromagnetic waves: Ultrashape uses pulsed ultrasound technology while Liposonix uses high intensity focused ultrasound. The energy emitted by these devices on the target area cause the fat cells to vibrate and heat up. The heat causes the death of the adipocytes resulting in permanent fat loss.

Are non-invasive fat reduction results permanent?

cryolipolysis fat freezing coolsculpting procedure

Scientific Animations [CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0)]

All of the above treatments lead to permanent results.

Fat is not stored freely in tissues. It is stored within the cell membrane of specialized cells known as adipocytes. The number of adipocytes in adults doesn’t normally change. When we gain or lose weight, what changes is the volume of each cell which gets larger or smaller. By resulting in the death of the fat cells in the target area, the above treatments decrease the ability of that area to store fat resulting in permanent fat loss in the target area. This doesn’t mean it is impossible to regain fat in the treated area: not all the adipocytes are killed by the treatment and the surviving ones still retain the ability to store fat so in case of a significant gain of bodyweight and fat mass you may see the fat come back.

How long before I can see the results of targeted fat reduction?

All of the above procedures require multiple sessions and the results become evident weeks or months after the treatment due to the long time the body needs to metabolize and remove the dead and damaged fat cells from the body.

  • Cryolipolysis – CoolSculpting®: this treatment generally requires between 1 and 3 sessions for each area. Each session lasts up to 1 hour and initial results may be seen as early as 3 weeks after the treatment. After 4 to 6 months you can see the final results with an average fat reduction of about 20%.
  • Injection Lipolysis – Kybella®, Lipostabil®, LipoDissolve®: this treatment usually requires 2-4 sessions for each area in order to have satisfactory results. It takes 4-8 weeks for the results to be visible with further improvements up to 3 months after the treatment.
  • Radiofrequency Lipolysis – Vanquish®: this treatment usually requires 4 to 6 sessions for each area, spaced 1 week apart. Initial results are visible after 6 weeks and as little as 2-3 treatments, while full results may be seen 2-4 months after the last treatment session. From studies, after 6 sessions patients lost on average 5 cm (2 inches) around the abdomen.
  • Laser Lipolysis – SculpSure®, Zerona®: this treatment usually requires 1-4 sessions with 2 sessions minimum usually recommended by physicians for better results. Each session lasts about 25 minutes and the results may be visible after 6 weeks with further improvements up to 3-4 months after the last treatment session.
  • Ultrasound Lipolysis – Ultrashape®, Liposonix®: this treatment is usually recommended for a minimum of 3 sessions, each one 30 to 60 minutes long. Results are visible about 2 weeks after the treatment with further improvements up to 6-8 weeks after each session.

What is the cost of non-invasive body contouring?

Price varies greatly depending on the chosen clinic and doctor, the type of treatment, the device used for the treatment, the number of sessions required and the country where you’re being treated. Here are the average costs:

  • Cryolipolysis costs between 2,000 and 4,000 USD per area.
  • Injection Lipolysis costs between 1,200 and 2,000 USD per area.
  • Radiofrequency Lipolysis costs between 2,000 and 4,000 USD per area.
  • Laser Lipolysis costs between 1,200-2,200 USD per area.
  • Ultrasound Lipolysis costs between 2,000-4,200 USD per area.

You should expect to save about 30-70% on the overall costs by undergoing treatment at a plastic surgery clinic in Thailand.

For more information on each specific treatment check out the dedicated articles. 


Sources

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IVF Gender selection for a baby boy in Bangkok, Thailand https://www.medtravel.asia/ivf-gender-selection-for-a-baby-boy-in-bangkok-thailand/ https://www.medtravel.asia/ivf-gender-selection-for-a-baby-boy-in-bangkok-thailand/#respond Wed, 01 Jul 2020 04:07:46 +0000 https://www.medtravel.asia/?p=2762 Gender selection or sex selection is the process of choosing the sex of a child in order to conceive a baby of the desired gender. Gender selection is achieved with in-vitro fertilization (IVF) and pre-genetic diagnosis (PGD) and is a medical procedure which is available in Bangkok, Thailand. Why parents want to choose the sex […]

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sex gender selection

Gender selection or sex selection is the process of choosing the sex of a child in order to conceive a baby of the desired gender. Gender selection is achieved with in-vitro fertilization (IVF) and pre-genetic diagnosis (PGD) and is a medical procedure which is available in Bangkok, Thailand.

Why parents want to choose the sex of their child?

Gender selection to control the sex of a baby has been marketed worldwide as family balancing. As the term suggests, it can be done to balance the number of male and female members of a family. Sometimes parents might have two children of the same gender, for example two males, and would conceive another one only if they knew they could have one of the opposed gender or in this example a female.

There are also other socio-economic reasons as well as religious factors for parents to choose the gender of their offspring in which case family balancing is not an appropriate term anymore and gender or sex selection is used instead:

  1. In some cultures, there is a disparity of treatment between male and females and parents wants their child to enjoy the best social and economic positions available in their life.
  2. In other cultures, the male is the one that provides support to the family, therefore a son would guarantee a better outlook on the future of the parents.
  3. In some cultures, a female child constitutes an expense, such as in India with the dowry system, while a male child ensures economic security.
  4. Some parents tragically experienced the loss of one child and may want another child of the same gender.
  5. Some parents simply desperately want to have a male or female child and due to age or economic factors can only afford to conceive once, so they resort to gender selection.

Gender selection is particularly sought after and desired in China and India, but in both countries it is illegal.

Is gender selection legal in Bangkok, Thailand?

Sex selection in Thailand is legal and many couples from all over the world fly to Bangkok to choose the gender of their child. Thailand also has some of the best medical infrastructures and top trained doctors, reason why it is a popular medical tourism destination with Bangkok known as the world’s medical tourism hub for all medical and surgical specialties.

How much does gender selection cost in Bangkok?

Gender selection is achieved with in-vitro fertilization (IVF) and pre-implantation genetic diagnosis (PGD).

The cost of these two procedures is about 8,000-15,000 USD on average.

Best clinics for gender selection in Bangkok

Here are the best fertility clinics in Bangkok that also offer PGD and sex selection:


Sources

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Injection lipolysis: fat dissolving injections https://www.medtravel.asia/injection-lipolysis-fat-dissolving-injections/ https://www.medtravel.asia/injection-lipolysis-fat-dissolving-injections/#respond Sun, 14 Jun 2020 09:13:38 +0000 https://www.medtravel.asia/?p=2756 Injection lipolysis, also known as intralipotherapy, is a minimally invasive medical procedure for targeted fat reduction. Commonly referred to as fat dissolving injections, intralipotherapy is a form of mesotherapy and one of the nonsurgical fat reduction options available in cosmetic medicine. What is injection lipolysis? Intralipotherapy refers to the injection of a broad range of […]

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face injection

Injection lipolysis, also known as intralipotherapy, is a minimally invasive medical procedure for targeted fat reduction. Commonly referred to as fat dissolving injections, intralipotherapy is a form of mesotherapy and one of the nonsurgical fat reduction options available in cosmetic medicine.

What is injection lipolysis?

Intralipotherapy refers to the injection of a broad range of different substances directly in the fat layer below the skin known as the hypodermis; after the injection, the fat cells are destroyed and are unable to store or accumulate fat anymore, consequently their debris are metabolized and eliminated permanently from the body.

Indications of fat dissolving injections

In the US and in Canada the only FDA-approved fat dissolving injection is deoxycholic acid and it is indicated only for the treatment of submental fat known as the double chin. This drug is marketed as Kybella® in the US and Belkyra® in Canada and in Europe.

This and other substances are also used on-label or off-label, depending on each country’s approval, for the treatment of other localized fat deposits. You should ask your treating physician for information specific to the country where you are receiving treatment. Common treatment areas are:

  • Submental fat a.k.a. double chin
  • Infraorbital fat pads a.k.a. eye bags
  • Jowls
  • Other facial fat deposits such as cheeks and jaw fat
  • Axillary fat pads a.k.a. armpit fat
  • Male gynecomastia
  • Upper back fat rolls
  • Bra fat rolls
  • Upper arm fat
  • Waistline fat
  • Abs and six pack definition
  • Male and female abdominal fat
  • Male and female flanks
  • Buttock fat and cellulite
  • Thighs fat and cellulite
  • Knee fat
  • Upper calf fat
  • Lipoma (benign fat tumor)

Types of fat dissolving injections

The main substances used for injection lipolysis are the following:

  • Deoxycholic acid – Kybella®, Belkyra®, GeoLysis®
  • Phosphatidylcholine – Lipostabil®

The main combinations of substances used for injection lipolysis are the following:

  • LipoDissolve®, Dermastabilon®, Aqualyx®

How does injection lipolysis work?

Deoxycholic acid – Kybella®, Belkyra®, GeoLysis®

Deoxycholic acid is a component of human bile, which is a fluid secreted by the liver and stored in the gallbladder to digest the lipids transiting in the small intestine. Deoxycholic acid disrupts the fat cell membrane causing the death of the fat cell which is then metabolized and eliminated from the body. 

Phosphatidylcholine – Lipostabil®

Phosphatidylcholine mechanism of action as fat dissolving injection is not yet well understood. Phosphatidylcholine is naturally found in the human body where it is involved in different body functions, such as being a component of the cellular membrane or metabolizing cholesterol. It is thought to cause the lysis of fat cell membranes. Phosphatidylcholine is extracted from soybean where it is abundant.

LipoDissolve®, Dermastabilon®, Aqualyx®

There are many mixes of substances, some of which have been registered as trademark, that are used for injection lipolysis.

LipoDissolve®, Dermastabilon®, Aqualyx® all contain a mix of two active ingredients: sodium deoxycholate (DC) and phosphatidylcholine (PC). Sodium deoxycholate is the sodium salt of deoxycholic acid and works similarly by disrupting the fat cell membrane causing its death. They are thought to work well in combination with DC breaking the fat cells and PC helping to metabolize them.

Other substances for injection lipolysis

Some clinics promote mesotherapy for facial rejuvenation, skin tightening, improving the tone and color of the skin and also for localized fat reduction. Mesotherapy is the injection of substances into the hypodermis, which is the layer of fat and connective tissue under the skin. There is scarce if not nonexistent evidence on both the efficacy and the safety of such treatments. Although most of the substances are FDA approved, they are used in mesotherapy for non-approved indications.

Many physicians and physician’s organizations such as the American Society of Plastic Surgeons (ASPS) advise against mesotherapy employing substances that have not been studied with safety and efficacy still not proven; they encourage further testing and research before recommending these treatments. Among the many substances advertised in mesotherapy for fat reduction there are:

  • L-Carnitine
  • Lecithin
  • Choline
  • Aminophyline
  • Isoproterenol
  • Vitamins
  • Collagenase
  • Hyaluronidase
  • And many more…

How long do fat dissolving injections last?

Fat is not stored in the body freely as a fat molecule in tissues. Fat is stored within specialized cells known as adipocytes which absorb triglycerides from the bloodstream and store them within their cell membrane. When fat is needed for energy or other body functions, fat cells can release their content back into the bloodstream.

As adults, when we gain weight, we don’t increase the number of fat cells, we just increase their size as they get bigger by storing more triglycerides. In the same way, when we lose weight, we don’t reduce the number of adipocytes, we just reduce their volume.

Fat dissolving injections break down fat cells. The destroyed fat cells will not grow back and will be gone forever. Only the remaining adipocytes in the treated area will still be able to store fat and increase in size, but this will happen only if you gain weight which will anyway be redistributed among all fat cells in the body (depending also on genetics and other factors some areas are privileged for fat storage). The treated area will have less capacity for fat storage which will result in long-term efficacy of the treatment.

This means that once you reach the desired results, treatment is expected to last indefinitely unless there is a great increase in bodyweight and fat mass.

How much does injection lipolysis cost?

Depending on the country where you receive treatment, the chosen clinic and doctor administering the treatment, the area to be treated and the number of sessions required to achieve the desired result, the cost of injection lipolysis varies greatly.

  • Kybella® and Belkyra® on average costs about 600-750 USD per vial.
  • LipoDissolve®, Dermastabilon®, Aqualyx® and Lipostabil® on average are cheaper treatments starting from 150 USD.

You should expect to save about 30-70% on the overall costs by undergoing treatment in a plastic surgery clinic in Thailand.

Risks and side effects of intralipotherapy

Fat dissolving injections are a minimally invasive and non-surgical option for targeted fat reduction. As any other medical or surgical procedure, injections lipolysis carries some risks and has possible side effects.

The most common side effects concern the treated area:

  • Swelling
  • Bruising
  • Pain or discomfort
  • Numbness
  • Redness
  • Hardness

These side effects last from a couple of hours to a couple of weeks.

The possible serious complications reported are:

  • Marginal mandibular nerve injury (with asymmetric smile or facial muscle weakness)
  • Dysphagia (trouble swallowing)

Both these complications resolved spontaneously, without medical treatment, in clinical trials.

Other serious but rare complications are:

  • Injection-site infection
  • Injection-site ulceration
  • Tissue necrosis
  • Alopecia

An expert and knowledgeable physician can minimize all the risks by following protocols such as using the proper injection technique, targeting the right areas, injecting the right amount of product, observing aseptic techniques, etc.

Ask your treating doctor for the specific risks, side effects and contraindications of the specific product you are interested in.

How long after treatment with fat dissolving injections to see results?

It takes about 4-8 weeks for results to be fully visible and sometimes further improvement is possible up to 12 weeks post-treatment.

On average, at least 2-4 treatment sessions are needed for satisfactory results, spaced at least 4 weeks apart.


Sources
  • Metabolic and Structural Effects of Phosphatidylcholine and Deoxycholate Injections on Subcutaneous Fat: A Randomized, Controlled Trial.
    DN Reeds, BS Mohammed, S Klein – Aesthetic Surgery Journal, Mar 2013
  • Injectable Treatments for Adipose Tissue: Terminology, Mechanism, and Tissue Interaction.
    AM Rotunda – Lasers in Surgery and Medicine, 2009
  • Injection Adipolysis: Mechanisms, Agents, and Future Directions.
    S Kamalpour, K Leblanc – Journal of Clinical and Aesthetic Dermatology, Dec 2016
  • Mesotherapy – The french connection
    G Sivagnanam – Journal of Pharmacology and Pharmacotherapeutics, 2010
  • Lipodissolve for Subcutaneous Fat Reduction and Skin Retraction.
    DI Duncan – Aesthetic Surgery Journal, Sep 2005
  • International Textbook of Aesthetic Surgery.
    N Scuderi, BA Toth – Springer 2016
  • Detergent Effects of Sodium Deoxycholate Are a Major Feature of an Injectable Phosphatidylcholine Formulation Used for Localized Fat Dissolution.
    AM Rotunda, H Suzuki, RL Moy – Dermatologic Surgery, Jul 2004
  • Injection Lipolysis: A Systematic Review of Literature and Our Experience with a Combination of Phosphatidylcholine and Deoxycholate over a Period of 14 Years in 1269 Patients of Indian and South East Asian Origin.
    MK Thomas, JA D’Silva, AJ Borole – Journal of Cutaneous and Aesthetic Surgery, Oct 2018
  • Lipostabil: The Effect of Phosphatidylcholine on Subcutaneous Fat.
    VL Young – Aesthetic Surgery Journal, Sep 2003
    K Mahmud, CE Crutchfield – The Journal of Clinical and Aesthetic Dermatology, Oct 2012
  • Effectiveness of Local Fat-Dissolving Solution Injection
    GS Jung – Aesthetic Surgery Journal, Mar 2019
  • Efficacy of mesotherapy in facial rejuvenation: a histological and immunohistochemical evaluation.
    M El-Domyati, TS El-Ammawi, O Moawad – International Journal of Dermatology, Aug 2012
  • Dynamics of Fat Cell Turnover in Humans.
    KL Spalding, E Arner PO Westermark – Nature, Jun 2008
  • Evaluation of the Efficacy of Injection Lipolysis using Phosphatidylcholine/Deoxycholate Versus Deoxycholate Alone in Treatment of Localized Fat Deposits.
    A El Kamshoushy, RA Maksoud, N El Mahdy – Journal of Clinical & Experimental Dermatology Research, 2012
  • American Society of Plastic Surgeons (ASPS)

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Facial dermal filler injections guide https://www.medtravel.asia/facial-dermal-filler-injections-guide/ https://www.medtravel.asia/facial-dermal-filler-injections-guide/#respond Tue, 09 Jun 2020 04:38:57 +0000 https://www.medtravel.asia/?p=2746 Dermal fillers, also known as injectable soft tissue fillers, are the second most popular minimally invasive procedure in the field of cosmetic medicine and surgery, the first one being botulinum toxin injections (Botox). Dermal fillers are mainly used for facial rejuvenating purposes to fight the signs of aging, such as lines and wrinkles, but are […]

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hyaluronic acid treatment areas

Dermal fillers, also known as injectable soft tissue fillers, are the second most popular minimally invasive procedure in the field of cosmetic medicine and surgery, the first one being botulinum toxin injections (Botox). Dermal fillers are mainly used for facial rejuvenating purposes to fight the signs of aging, such as lines and wrinkles, but are also often used to enhance facial features, to replace lost volume both in the face and in the hands and to overall restore a youthful appearance.

What are dermal fillers?

Dermal filler is a broad term that includes many different substances used to achieve the same goal. These substances can be natural, such as hyaluronic acid, derived from our own bodies such as PRP and autologous fat, or synthetic like PLLA and PMMA. They can be temporary treatment, long lasting biodegradable treatments or permanent non-biodegradable substances. They work in different ways and not all of them are right for each indication and injection area; for this reason, a plastic surgeon may prefer using one over another to provide the results that meet the expectations of the patient. 

Indications of dermal fillers

Injectable soft tissue fillers have many different cosmetic indications and are used to improve the look and appearance in several different ways. Dermal fillers can:

  • Smooth fine lines on the face, like crow’s feet and vertical lip lines (smoker’s lines).
  • Fill wrinkles, like the horizontal forehead lines and the frown lines.
  • Soften creases and skin folds on the face, like the nasolabial fold and marionette lines.
  • Fill hollows, such as the under-eye hollows that cause black circles and a tired appearance or the submalar hollow when cheek volume is loss due to aging.
  • Reshape features, such as the chin and the nose
  • Augment features, such as lips and cheeks
  • Restore lost volume, in many facial areas but also in the aging hands
  • Improve the look of scars, such as acne scars and other depressed scars

Types of dermal fillers

The main types of dermal fillers are:

  1. Hyaluronic acid fillers (HA)
  2. Collagen fillers
  3. Autologous Fat
  4. Platelet-rich plasma (PRP)
  5. Poly-L-lactic acid fillers (PLLA)
  6. Calcium Hydroxylapatite (CaHA)
  7. Polymethylmethacrylate (PMMA)
  8. Polycaprolactone (PCL)

Beware of black-market substances, unlicensed providers and non-FDA approved products.

There are reports of patients who received all kind of dangerous injections for cosmetic purposes: from silicone, to animal fat, glycerin, non-medical-grade products to even cement and motor oil.

How do dermal fillers work?

Depending on the specific substance injected, dermal fillers work in different ways.

Hyaluronic acid fillers

Hyaluronic acid (HA) is a natural occurring molecule in the human body. It is also found in the skin where it keeps it plump and hydrated. HA has the ability to bind 1000 times its weight in water, helping to retain it in the skin. Photodamaged and aging skin in general see a decrease in concentration of hyaluronic acid due to its degradation and reduced synthesis resulting in loss of volume, wrinkling and altered elasticity. Hyaluronic acid as an injectable filler may be chemically modified (crosslinked) to make it last longer in the body.

There are several different brands marketing different hyaluronic acid products each with its own slightly different formulation, characteristics and applications. The main ones are:

  • Belotero®: Balance.
  • Captique®
  • Esthélis®
  • Elevess®
  • Hylaform®
  • Juvederm®: Ultra, Ultra Plus, XC, Ultra XC, Volbella XC, Vollure XC, Voluma XC
  • Perlane®
  • Prevelle®: Silk
  • Puragen®
  • Restylane®: L, Lyft, Silk, Refyne, Defyne
  • Teoxane Teosyal®: RH1, RH2, RH3, RH4, Kiss

Collagen fillers

Collagen is a naturally occurring and most abundant protein found in the human body. Collagen is a major component of the skin giving it strength and support. Collagen deteriorates over time and is easily damaged and degrades when hit by UV rays. There are different collagen products on the market, some are derived from animal sources (bovine and porcine) and other are derived from human sources (cadaveric skin or lab cell cultures). The main ones are:

  • Alloderm®
  • Cosmoderm®
  • Cosmoplast®
  • Cymetra®
  • Evolence®
  • Fibrel®
  • Zyderm®
  • Zyplast®

Autologous Fat Graft

Fat grafting is a procedure that utilizes autologous fat as filling material. Fat grafting is also known as fat transfer, fat transplant or lipofilling. Fat is another component of the subcutaneous tissue that is loss due to the aging process and its loss contributes to sagging and wrinkling skin as we age; this loss happens in the face and hands mainly while fat storage is increased in other areas of the body such as the waist in women and the abdomen in men. Fat is usually obtained through liposuction of the lower abdomen and after centrifugation and processing it is ready for reinjection. Not all transplanted fat cells will survive, and the survival rate varies greatly depending on the surgical techniques used and the ability of the surgeon. The damaged cells and those that can’t receive blood and nutrient supply in the recipient area will be resorbed with time. The survival rate ranges 10-90% and the use of PRP in conjunction with fat grafting seems to be promising in guaranteeing a higher survival rate of the fat cells.

Platelet-rich plasma (PRP)

PRP injections to the face are also known as “vampire lift”. Blood is drawn from the arm and after centrifugation and processing the PRP is separated from the other blood components and is ready for reinjection. PRP is rich in growth factors which increase fibroblast proliferation; fibroblasts are cells that synthetize the extracellular matrix (ECM) which is composed by proteins such as collagen and elastin, and by other molecules such as hyaluronic acid, all of which are lost due to the aging process. By increasing fibroblast and their production of ECM components, PRP effectively rejuvenates the skin, decreasing the signs of aging and increasing elasticity and volume.

Poly-L-lactic acid (PLLA)

Polylactic acid is a synthetic but resorbable dermal filler used for many years in the medical field such as in dissolvable stitches. PLLA works by stimulating the tissue to synthetize new collagen over several weeks while slowly being resorbed. It is marketed under the following brand names:

  • Sculptra®
  • Sculptra Aesthetics®

Calcium Hydroxylapatite (CaHA)

Calcium hydroxylapatite is a biodegradable substance naturally found in human bones and teeth. As a filler, CaHA is made in the lab as microspheres suspended in a soluble gel which is resorbed and helps in the dispersion of the microspheres. Calcium hydroxylapatite stimulates collagen production, increasing volume over several months in the areas where it was injected, and it is eventually resorbed. It is marketed under the following brand name:

  • Radiesse®

Polymethylmethacrylate (PMMA)

PMMA is a biocompatible but permanent filler. Microspheres of PMMA are suspended in a collagen gel which helps for an even distribution of the product. While collagen is quickly resorbed, PMMA microspheres stimulate our own collagen production providing volume in the treated areas. It is marketed under the following brand names:

  • Artefill®
  • Bellafill®

Polycaprolactone (PCL)

PCL is a biocompatible and biodegradable polymer. Microspheres of PCL are suspended in an aqueous gel and injected in the desired area. The aqueous gel provides immediate volume restoration and is then resorbed over 2 to 3 months. The PCL microspheres stimulate collagen production overtime providing a longer lasting effect. It is marketed under the following brand name:

  • Ellansé®

How long do dermal filler lasts?

Different classes of fillers have different duration of the effects. Different formulations of the same class of fillers also have different duration. Duration is also affected by the site of injection, technique used for the injection, amount of product injected, patient’s metabolism and individual characteristics, and if it is the first treatment or a follow-up treatment.

This is how long, on average, dermal filler last:

  • Hyaluronic acid fillers HA (Juvederm®, Restylane®, …): effects lasting 6-18 months
  • Collagen fillers (Cosmoderm®, Zyplast®, …): effects lasting 1-4 months
  • Autologous Fat: some fat cells will be resorbed during the first few months, after about 6 months the effects should be stable and last several years (5-15 years).
  • Platelet-rich plasma (PRP): full effects visible in 2-3 months and lasting up to 12-18 months
  • Poly-L-lactic acid fillers PLLA (Sculptra®): full effects visible in 2-3 months and lasting about 2 years.
  • Calcium Hydroxylapatite CaHA (Radiesse®): effects lasting 12-18 months
  • Polymethylmethacrylate PMMA (Bellafill®): full effects seen after 3-6 months and lasting over 5 years.
  • Polycaprolactone PCL (Ellansé®): Effects from the water gel carrier are immediate and fade in 6-12 weeks, while full effects of PCL are seen after about 12 weeks and last 12-48 months depending on the formulation used.

Facial dermal fillers cost

As per the duration, there are many variables influencing the cost of dermal fillers: it will depend on the surgeon and clinic where the treatment is performed, the country, the formulation, the brand, …

On average, the cost of face dermal filler treatment is:

  • Hyaluronic acid fillers HA (Juvederm®, Restylane®, …): 500-1,500 USD per syringe
  • Collagen fillers (Cosmoderm®, Zyplast®, …): 300-450 USD per syringe
  • Autologous Fat: 2,500-8,000 USD per treatment
  • Platelet-rich plasma (PRP): 500-2,500 USD per treatment
  • Poly-L-lactic acid fillers PLLA (Sculptra®): 800-1,000 USD per syringe
  • Calcium Hydroxylapatite CaHA (Radiesse®): 800-1,000 USD per syringe
  • Polymethylmethacrylate PMMA (Bellafill®): 1,000 USD per syringe
  • Polycaprolactone PCL (Ellansé®): 450-650 USD per syringe

You may expect to save about 30-70% by undergoing treatment in plastic and cosmetic surgery clinics in Bangkok, Thailand.

Risks and side effects of dermal fillers

Dermal filler injections are generally a safe treatment but do carry some risks, like any other medical or surgical procedure.

To minimize such risks, it is of utmost importance to have the procedure carried out in a medical setting by a qualified and experienced professional using products purchased from a reputable source.

The face has a great number of blood vessels and nerves and if a filler is injected in the wrong spot or in the wrong amount or with the wrong technique it can cause complications, sometimes irreversible and potentially even death.

Over the years, due to dermal fillers being a very remunerative industry, doctors from all specialties and background started providing dermal filler injections. While a plastic surgeon, or dermatologist, or cranio-facial surgeon has extensive knowledge of the facial and soft tissues anatomy, a dentist, a GP, or a nurse are not as trained as them. Sometimes doctors qualify themselves as aesthetic doctors. Aesthetic medicine is not a recognized medical specialty and it is a title often awarded after attending a 1-2 days course on how to perform injections or how to use a medical (cosmetic) device such as lasers.

Moreover, cosmetic surgery is also an art. To achieve a harmonious, pleasing, natural looking result doesn’t just require medical knowledge but also artistic sense.

Each filler has a different risk profile, which also depends on the area treated and on the characteristics of the patient. Your provider will inform you of the specific risks related to the procedure you want performed.

In general, these are the potential risks and side effects of dermal filler treatment to the face

Common risks of dermal fillers include

  • Bruising
  • Swelling
  • Minor bleeding
  • Redness
  • Itching
  • Discomfort or pain for a few days

Uncommon risks of dermal fillers include

  • Asymmetry of the face
  • Infection at the injection site
  • Scarring
  • Lumps
  • Redness of the skin and itching
  • Skin discoloration
  • Numbness
  • Allergic reactions
  • Systemic infection
  • Blisters
  • Migration of the filler to another area
  • Skin necrosis
  • Blindness and cardiovascular complications if injected into a blood vessel

It is generally better to start with hyaluronic acid injections before committing to a long-lasting or permanent filler injection. Hyaluronic acid is also the only type of filler than can be reversed by injecting an enzyme known as hyaluronidase which dissolves the filler if you are unhappy with the results.

We advise against the use of permanent PMMA fillers (Bellafill®) and Polyacrylamide fillers (Aquamid®).

Best Bangkok Clinics for dermal filler injections to the face


Sources
  • Skin ageing and its treatment.
    L Baumann – Journal of Pathology, 2007
  • “Saving Face”: An Online Study of the Injecting Use of DIY Botox and Dermal Filler Kits.
    R Brennan, JSG Wells, M Van Hout – Plastic Surgery, 2018
  • A Review of Dermal Fillers in Facial Plastic Surgery.
    D Bray, C Hopkins, DN Roberts – Current Opinion in Otolaryngology & Head and Neck Surgery, Aug 2010
  • Fat, Stem Cells, and Platelet-Rich Plasma.
    IB James, SR Coleman, JP Rubin – Clinics in Plastic Surgery, 2016
  • Update in minimally invasive periorbital rejuvenation with a focus on platelet-rich plasma: A narrative review.
    M Kassir, G Kroumpouzos, P Puja – Journal of Cosmetic Dermatology, Mar 2020
  • ArteFill® Permanent Injectable for Soft Tissue Augmentation: I. Mechanism of Action and Injection Techniques.
    G Lemperle, TR KNAPP, NS Sadick – Aesthetic Plastic Surgery, Jun 2010
  • Polycaprolactone: How a Well-Known and Futuristic Polymer Has Become an Innovative Collagen-Stimulator in Esthetics.
    MO Christen, F Vercesi – Clinical Cosmetic and Investigational Dermatology, Jan 2020
  • Managing Complications of Fillers: Rare and Not-So-Rare.
    E Haneke – Journal of Cutaneous and Aesthetic Surgery, Oct 2015
  • Overview of Deep Dermal Fillers.
    MH Liu, DP Beynet, NM Gharavi – Facial Plastic Surgery, Jun 2019
  • U.S. Food & Drug Administration (FDA)
  • American Society of Plastic Surgeons (ASPS)
  • American Academy of Dermatology (AAD)

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