The Plastic Surgeon for your Rhinoplasty
There are just too many plastic surgeons around, and not all are good. So select the best plastic surgeon for your surgery. One may be able to hide a complication near the buttock area, but any problem around the face is difficult to hide and embarrassing- and it becomes a life long feature for the whole world to see. The following are tips to selecting a surgeon:
1. Make sure that your surgeon is board certified in Plastic surgery. The lure of money has led to many surgeons doing procedures for which they are not trained in.
2. Make sure that the surgeon has a current license to practice and he is up-to-date with his plastic surgery skills. Verify the doctor's credentials and training.
3. Check if the surgeon has had any disciplinary actions and malpractice judgments. Many of the state websites have information on disciplinary actions. A few have information on malpractice judgments. A warning sign is if the surgeon has had more than three malpractice judgments over a period of 5-10 years, seek another surgeon.
4. Ask about the number of rhinoplasty the surgeon has done and his/her complication rates. Any surgeon who claims that he/she has had no complications is a damn liar.
5. Ask where the procedure is going to be done, who is going to administer anesthesia. There have been a number of incidences, esp. among cosmetic surgeons who have tried to cut corners and save money on essential nurses and anesthesiologist. Do not get the procedure in a rinky dinky office. Check out the clinic or the hospital first. You are paying for the surgery, so you will get what you pay for.
6. Most cosmetic surgeons have before and after photos of their patients. Ask to look at some of these illustrations
7. Talk to other patients, family and your personal physician. Always if in doubt, seek a second opinion
8. Ask about anesthesia. - Make sure that your anesthesia is being administered by a properly certified registered nurse anesthetist or a physician anesthesiologist.
Men continue to seek cosmetic procedures, and the trend is definitely on the rise. With the continued development of improved and new minimally invasive procedures and wider male acceptance of plastic surgery, there is every indication that more and more men will seek cosmetic enhancement in the coming years.
Rhinoplasty is strictly an elective procedure and one should never be rushed into the procedure. Always seek a second opinion if one is not happy. You do not want to wear a surgical mask like MJ for the rest of your life
Sunday, June 28, 2009
Men and nose jobs: part 7
Cost of Rhinoplasty
After one is realistic and ready for the surgery, one should select a surgeon based on his skills, reputation and his results. Do not select a surgeon based on the cost. The most expensive is not always the best and vice versa.
Rhinoplasty is an expensive undertaking and is considered a cosmetic procedure; most health plans and Medicare do not cover it. Costs range anywhere from $3,000 - $12,000, depending upon the surgeon and the location. In some cases where the nasal septum is deviated, perforated or one has had a traumatic injury or has difficulty breathing through the nose; part of all of the surgery may be covered by medical insurance.
For the rest of the individuals relying on the medical insurance to pay for the surgery, call the insurance company and be certain that you have proper pre-authorization for your procedure. Find out exactly what will be covered and get it in writing. Medicine is a business (just in case you did know that) and every one wants your money. After consulting with the surgeon, get the total costs which includes the surgeon’s fee, cost of anesthesia, cost of medicines, splints, dressing and other hidden costs (doctors are notorious for these-just like car mechanics).
For those who claim that their rhinoplasty was covered by medical insurance, this is a very rare exception to the rule.
After one is realistic and ready for the surgery, one should select a surgeon based on his skills, reputation and his results. Do not select a surgeon based on the cost. The most expensive is not always the best and vice versa.
Rhinoplasty is an expensive undertaking and is considered a cosmetic procedure; most health plans and Medicare do not cover it. Costs range anywhere from $3,000 - $12,000, depending upon the surgeon and the location. In some cases where the nasal septum is deviated, perforated or one has had a traumatic injury or has difficulty breathing through the nose; part of all of the surgery may be covered by medical insurance.
For the rest of the individuals relying on the medical insurance to pay for the surgery, call the insurance company and be certain that you have proper pre-authorization for your procedure. Find out exactly what will be covered and get it in writing. Medicine is a business (just in case you did know that) and every one wants your money. After consulting with the surgeon, get the total costs which includes the surgeon’s fee, cost of anesthesia, cost of medicines, splints, dressing and other hidden costs (doctors are notorious for these-just like car mechanics).
For those who claim that their rhinoplasty was covered by medical insurance, this is a very rare exception to the rule.
Men and Nose Jobs: Part 6
Complications from rhinoplasty
Like any surgery, rhinoplasty can be associated with some rare complications. These include:
- Some bruising around the nose and face is common.
This is transient and disappears within 7-12 days
- Some individuals may develop skin necrosis or allergy
to tape material
- Difficulty breathing for a few days from swelling in the
nose
- Open rhinoplasty may have a surgical scar but the closed
procedure has no visible scar. With the open technique the
scar is typically just on the underside of the nose.
- Repeat (revision) rhinoplasty maybe required in some cases.
Depending on whom one talks to, this figure ranges from 2-15% of individuals. The revision procedure may be required to correct the remaining deformity. Michael Jackson had numerous revisions and the result was obvious.
It is also possible that the cosmetic results of the surgery will not be what you wanted (there are always some individuals who are not satisfied).
Like any surgery, rhinoplasty can be associated with some rare complications. These include:
- Some bruising around the nose and face is common.
This is transient and disappears within 7-12 days
- Some individuals may develop skin necrosis or allergy
to tape material
- Difficulty breathing for a few days from swelling in the
nose
- Open rhinoplasty may have a surgical scar but the closed
procedure has no visible scar. With the open technique the
scar is typically just on the underside of the nose.
- Repeat (revision) rhinoplasty maybe required in some cases.
Depending on whom one talks to, this figure ranges from 2-15% of individuals. The revision procedure may be required to correct the remaining deformity. Michael Jackson had numerous revisions and the result was obvious.
It is also possible that the cosmetic results of the surgery will not be what you wanted (there are always some individuals who are not satisfied).
Men and Nose Jobs: part 5
After Surgery Results
The surgery is an outpatient procedure. After surgery most patients go home. The patient is not allowed to drive home and someone must pick up the patient. Depending on how the surgery was done, a packing may be placed inside the nose which is usually removed in a few days. A nose guard/splint and a dressing is applied on the nose for about a week. The facial and nose area are always bruised and swollen for a couple of days after surgery. It is recommended that the individual sleep with the head up and place ice compresses-this helps to decrease the facial swelling.
The pain is moderate and controlled with over the counter pain medications. Most individuals stay at home for about 7-10 days. It usually takes at least 2-3 weeks before on can resume all normal activities including sports.
The surgery is an outpatient procedure. After surgery most patients go home. The patient is not allowed to drive home and someone must pick up the patient. Depending on how the surgery was done, a packing may be placed inside the nose which is usually removed in a few days. A nose guard/splint and a dressing is applied on the nose for about a week. The facial and nose area are always bruised and swollen for a couple of days after surgery. It is recommended that the individual sleep with the head up and place ice compresses-this helps to decrease the facial swelling.
The pain is moderate and controlled with over the counter pain medications. Most individuals stay at home for about 7-10 days. It usually takes at least 2-3 weeks before on can resume all normal activities including sports.
Men and Nose Jobs: part 4
The Surgery
Rhinoplasty is a common procedure and thousands of individuals undergo the procedure. However, the surgery is technically demanding and requires a lot of surgical skill and judgment. Most of the surgery is done by a sense of feeling-which is acquired only by experience. There are two main techniques used: closed and open rhinoplasty.
In closed rhinoplasty, the incision is located in the inside of the nose. There is minimal swelling and the post operative course is generally easier. However, the surgeon must be excellent to perform this type of surgery.
In open rhinoplasty, the incision is located just below the nose and provides greater access for surgery. The swelling is more and the post operative course is a little difficult. The recovery period after surgery is also slightly longer. The surgery is either done in a clinic or the hospital. Once anesthesia is induced –either general or local, the surgery is performed. The incisions are usually made on the inside of the nose and are not visible from the outside. Some bone and cartilage is removed and rarely extra tissue is added to reshape the nose. One the surgery is done, a nose guard/splint is placed to support and protect the nose. Some surgeons also place nasal packing inside the nose to support the nasal surgery.
The procedure takes about 2 hrs to complete. With newer versions of rhinoplasty, the post operative course is less troublesome. The pain is significantly less and the nose may not have any packing (it is the nose packing that most individuals hate about the procedure).
The results of the surgery are obvious immediately after surgery.
Rhinoplasty is a common procedure and thousands of individuals undergo the procedure. However, the surgery is technically demanding and requires a lot of surgical skill and judgment. Most of the surgery is done by a sense of feeling-which is acquired only by experience. There are two main techniques used: closed and open rhinoplasty.
In closed rhinoplasty, the incision is located in the inside of the nose. There is minimal swelling and the post operative course is generally easier. However, the surgeon must be excellent to perform this type of surgery.
In open rhinoplasty, the incision is located just below the nose and provides greater access for surgery. The swelling is more and the post operative course is a little difficult. The recovery period after surgery is also slightly longer. The surgery is either done in a clinic or the hospital. Once anesthesia is induced –either general or local, the surgery is performed. The incisions are usually made on the inside of the nose and are not visible from the outside. Some bone and cartilage is removed and rarely extra tissue is added to reshape the nose. One the surgery is done, a nose guard/splint is placed to support and protect the nose. Some surgeons also place nasal packing inside the nose to support the nasal surgery.
The procedure takes about 2 hrs to complete. With newer versions of rhinoplasty, the post operative course is less troublesome. The pain is significantly less and the nose may not have any packing (it is the nose packing that most individuals hate about the procedure).
The results of the surgery are obvious immediately after surgery.
Men and Nose Jobs: part 3
Realistic Expectations
Rhinoplasty is not for everyone. Some individuals are satisfied with their face and some aren’t. Rhinoplasty in most cases brings about a remarkable physical change in the face and this is usually accompanied by a positive outlook. The procedure can reshape, re contour, make the nose bigger or smaller, correct the breathing problem and correct any other associated deformity. Yet, it has limitations. Too many individuals seek plastic surgery to cure their emotional problems and for them rhinoplasty is only a partial cure. In search for vanity can sometimes lead to insanity. So one has to be realistic in their expectations and an honest discussion with the surgeon will go a long ways to help resolve any myths.
Rhinoplasty is not for everyone. Some individuals are satisfied with their face and some aren’t. Rhinoplasty in most cases brings about a remarkable physical change in the face and this is usually accompanied by a positive outlook. The procedure can reshape, re contour, make the nose bigger or smaller, correct the breathing problem and correct any other associated deformity. Yet, it has limitations. Too many individuals seek plastic surgery to cure their emotional problems and for them rhinoplasty is only a partial cure. In search for vanity can sometimes lead to insanity. So one has to be realistic in their expectations and an honest discussion with the surgeon will go a long ways to help resolve any myths.
Men and Nose Jobs: part 2
History of rhinoplasty
Surgery on the nose has been practiced since 3000 BC in Egypt. It was not known as rhinoplasty then, but basically involved cleansing and suturing of the wounds of the face suffered during the battles of those days.
Rhinoplasty as a cosmetic procedure appears to have been developed in the 15th century. However, the nose contouring and shaping did not become a surgical art until the 18th century. Cosmetic surgery on the nose has been practiced for about 120 years to help people cope with their unsightly nose.
With two major wars in the 20th century and the push towards anesthesia and anti sepsis, came better and more improved techniques to deal with injuries to the face. Over the last 3 decades, cosmetic surgery of the nose had been perfected into an Art (Michael Jackson is an exception –either bad surgeon, one too many surgeries on the nose or a lot of bad genes or bad luck). Today, the quality of surgery is excellent and most individuals remain satisfied with the procedure.
Age at rhinoplasty
Rhinoplasty is a permanent procedure and one has to have a firm commitment to the surgery. One cannot reverse the results after the surgery has been done. Generally, rhinoplasty should only be done in individuals who have completed their facial growth. The nose development is generally complete by the ages 17-19. The best time to have surgery is in the 20s. When surgery is done any earlier, the nose continues to grow and reshape, overriding the effects of the surgery- meaning that the surgery was a complete waste-both money and time.
All individuals can have rhinoplasty, as long as they have the ability to consent and are older than 20. Overall, most individuals are satisfied with the surgery and have no complaints, On the other hand, some individuals who tend to have cosmetic surgery are also anal (obsessive compulsive) and never satisfied-even if the surgery has been done well. These individuals should try some Prozac instead of undergoing surgery.
The best candidates for rhinoplasty are healthy men (both physically and mentally) and who have realistic expectations about what the surgery can and cannot do for them.
Surgery on the nose has been practiced since 3000 BC in Egypt. It was not known as rhinoplasty then, but basically involved cleansing and suturing of the wounds of the face suffered during the battles of those days.
Rhinoplasty as a cosmetic procedure appears to have been developed in the 15th century. However, the nose contouring and shaping did not become a surgical art until the 18th century. Cosmetic surgery on the nose has been practiced for about 120 years to help people cope with their unsightly nose.
With two major wars in the 20th century and the push towards anesthesia and anti sepsis, came better and more improved techniques to deal with injuries to the face. Over the last 3 decades, cosmetic surgery of the nose had been perfected into an Art (Michael Jackson is an exception –either bad surgeon, one too many surgeries on the nose or a lot of bad genes or bad luck). Today, the quality of surgery is excellent and most individuals remain satisfied with the procedure.
Age at rhinoplasty
Rhinoplasty is a permanent procedure and one has to have a firm commitment to the surgery. One cannot reverse the results after the surgery has been done. Generally, rhinoplasty should only be done in individuals who have completed their facial growth. The nose development is generally complete by the ages 17-19. The best time to have surgery is in the 20s. When surgery is done any earlier, the nose continues to grow and reshape, overriding the effects of the surgery- meaning that the surgery was a complete waste-both money and time.
All individuals can have rhinoplasty, as long as they have the ability to consent and are older than 20. Overall, most individuals are satisfied with the surgery and have no complaints, On the other hand, some individuals who tend to have cosmetic surgery are also anal (obsessive compulsive) and never satisfied-even if the surgery has been done well. These individuals should try some Prozac instead of undergoing surgery.
The best candidates for rhinoplasty are healthy men (both physically and mentally) and who have realistic expectations about what the surgery can and cannot do for them.
Men and Nose Jobs: part 1
Rhinoplasty is surgery to reshape the nose. The procedure can make the nose larger or smaller; change the nose angle, alter the tip of the nose; or correct bumps, indentations, or any other defects in or around the nose.
Popularity of Rhinoplasty among men has been steadily increasing over the years and gained wider acceptance in North America. Although cosmetic surgery was once the domain of female only, this has changed over the past 2 decades. The number of cosmetic procedures being performed on males is fast catching up. At least 2-3 million males have undergone some type of plastic procedure in the past 2 years- and like their female counterparts- males also undergo very similar procedures.
For men, rhinoplasty is the second most popular plastic surgery procedure, behind liposuction.
Men suddenly want to get plastic surgery for several reasons. They all want to look handsome and appealing. The other reasons include the availability of more minimally invasive methods of surgery- thus less time off work and less prominent incisions. Also, today, there are a lot more cosmetic surgeons and the prices are affordable. No longer is cosmetic surgery only for Hollywood. Other reasons for the rhinoplasty may be due to the number of nasal injuries men suffer- whether from sports or trauma.
Finally, today’s aesthetic Corporate world also demands that men look appealing and successful. Many older men feel that it when it comes to position or promotion in a company, a younger person is always favored. Thus, cosmetic surgery is one way to try and level the playing field.
Rhinoplasty is almost always done to make the nose look better. The surgery can alter the shape, contour and angle of the nose and in most cases; it brings about a pleasing change to the face. The majority of men love looking good.
Popularity of Rhinoplasty among men has been steadily increasing over the years and gained wider acceptance in North America. Although cosmetic surgery was once the domain of female only, this has changed over the past 2 decades. The number of cosmetic procedures being performed on males is fast catching up. At least 2-3 million males have undergone some type of plastic procedure in the past 2 years- and like their female counterparts- males also undergo very similar procedures.
For men, rhinoplasty is the second most popular plastic surgery procedure, behind liposuction.
Men suddenly want to get plastic surgery for several reasons. They all want to look handsome and appealing. The other reasons include the availability of more minimally invasive methods of surgery- thus less time off work and less prominent incisions. Also, today, there are a lot more cosmetic surgeons and the prices are affordable. No longer is cosmetic surgery only for Hollywood. Other reasons for the rhinoplasty may be due to the number of nasal injuries men suffer- whether from sports or trauma.
Finally, today’s aesthetic Corporate world also demands that men look appealing and successful. Many older men feel that it when it comes to position or promotion in a company, a younger person is always favored. Thus, cosmetic surgery is one way to try and level the playing field.
Rhinoplasty is almost always done to make the nose look better. The surgery can alter the shape, contour and angle of the nose and in most cases; it brings about a pleasing change to the face. The majority of men love looking good.
Saturday, June 6, 2009
Does varicocele surgery improve fertility?
There is absolutely no direct correlation between the presence of a varicocele and infertility. There is no doubt that about 40% of individuals who undergo investigation for infertility have been found to have varicoceles. But one has to know that there are many more individuals with varicoceles who go on to have normal sperm and have satisfactory pregnancy with their spouse. There are also many men who undergo varicocele surgery and yet fail to have normal sperm counts.
The questions remains, “what should one do with varicoceles”. There is no question that incidentally discovered varicoceles or varicoceles that produce no symptoms can be safely observed. All the data about testicular atrophy and decline in sperm counts are unproven and hypothetical facts put out by unscrupulous surgeons. Many men live their entire lives with varicoceles and do so without any undue problems.
Varicoceles continue to generate controversy among fertility experts. Despite conflicting evidence from various clinical studies, all the trials still recommend the surgical treatment of clinical varicoceles in men with infertility. However, it is incumbent on the surgeon to discuss the pros and cons of surgery for varicocele. A second opinion is not always a bad idea.
The questions remains, “what should one do with varicoceles”. There is no question that incidentally discovered varicoceles or varicoceles that produce no symptoms can be safely observed. All the data about testicular atrophy and decline in sperm counts are unproven and hypothetical facts put out by unscrupulous surgeons. Many men live their entire lives with varicoceles and do so without any undue problems.
Varicoceles continue to generate controversy among fertility experts. Despite conflicting evidence from various clinical studies, all the trials still recommend the surgical treatment of clinical varicoceles in men with infertility. However, it is incumbent on the surgeon to discuss the pros and cons of surgery for varicocele. A second opinion is not always a bad idea.
What are treatment options for varicoceles?
There is a lot of debate whether varicoceles require any treatment. No medical therapies are available for either treatment or prevention; however analgesics (pain medications) may alleviate associated pain when present. Some doctors claim that no treatment is required. Others claim that treatment may benefit individuals who are infertile and have symptoms. The treatment involves removal of the vein mass which is supposedly causing the enlargement and infertility.
The timing of the varicocele is also debated. Some doctors claim that even though varicoceles may be detected in adolescence, the treatment can wait until the individual has any symptoms or is getting married. Others recommend varicocele repair in adolescence only if there is evidence of pain, testicular atrophy or if the sperm count is altered.
Observation for varicoceles
A varicocele is not of any great danger to health and one should not panic. For the young male in whom the varicocele is discovered incidentally, and there are no symptoms, the varicocele should be left alone.
For those males who are married and have a varicocele but are still able to have children, the varicocele should also be left alone.
For those who have mild pain or an ache and have no problems with sterility, supportive treatment with scrotal support should be tried first for at least 4-12 weeks.
Never go to a surgeon who recommends Varicocele repair without first giving you your options. In any case, in most cases where Varicoceles are treated, fertility is still not restored. If you have no pain and the varicocele does not bother you leave it alone.
The timing of the varicocele is also debated. Some doctors claim that even though varicoceles may be detected in adolescence, the treatment can wait until the individual has any symptoms or is getting married. Others recommend varicocele repair in adolescence only if there is evidence of pain, testicular atrophy or if the sperm count is altered.
Observation for varicoceles
A varicocele is not of any great danger to health and one should not panic. For the young male in whom the varicocele is discovered incidentally, and there are no symptoms, the varicocele should be left alone.
For those males who are married and have a varicocele but are still able to have children, the varicocele should also be left alone.
For those who have mild pain or an ache and have no problems with sterility, supportive treatment with scrotal support should be tried first for at least 4-12 weeks.
Never go to a surgeon who recommends Varicocele repair without first giving you your options. In any case, in most cases where Varicoceles are treated, fertility is still not restored. If you have no pain and the varicocele does not bother you leave it alone.
Thursday, May 21, 2009
Varicoceles FAQs: part 6
What are surgical options for treatment of a varicocele?
There are three options to treat a varicocele and include
- Open surgical varicocele repair
- angiographic embolization- highly recommended
- laparoscopic method
What are results after surgery?
Surgery is hyped up to be the best treatment for Varicocele. It is estimated that in about 40-60 percent of men, sterility can be restored. However, real data are lacking and many men have undergone this surgery, needlessly. There are many men who have had their Varicocele fixed and still cannot conceive.
Do Varicocele recur after treatment?
Sure, recurrence of Varicocele is quite common. These recurrences may occur a few months or may even occur a few years later. In most cases, recurrence is due to poor technical surgery and leaving some small veins intact at first surgery. To obliterate a Varicocele; one has to ligate all small veins.
Who fixes a varicocele?
Urologists are physicians who specialize in the field of male genitals and most are decent surgeons.
What is embolization?
This is perhaps the best treatment for Varicocele. It is an easy procedure done by an interventional radiologist. One side of your groin is numbed with a local anesthetic and a small tube is passed into the vein. Using x rays, the Varicocele is identified in the scrotum and through the tube, glue like substances are injected into the Varicocele. Confirmation that the Varicocele is blocked is done with another x ray study and you are done. There is no general anesthesia, no incisions and the pain is minimal. You go home in the evening. Data on embolization are decent and recurrences are rare. However, the procedure is very expensive and there is still a question of whether the Varicocele should be treated in the first place.
Final Advice
There is a lot of conflicting advice on Varicoceles and how they may affect sterility. Surgery for Varicocele is strictly elective and no one should be rushed into. For best advice, talk to a reputable urologist. Ask questions and if in doubt seek a second opinion. Whilst there are some who say Varicocele affect sterility, there are is also data that show that Varicoceles have no bearing on sterility. The last thing you want is to undergo an unnecessary surgical procedure that has a real risk of damaging your sexual organ. If you have no symptoms- leave the Varicocele alone. If you have symptoms, wear scrotal support panties. Both are reasonable treatments.
One should only undergo Varicocele surgery if there is documentation of abnormal sperm and that one is unable to father a child.
There are three options to treat a varicocele and include
- Open surgical varicocele repair
- angiographic embolization- highly recommended
- laparoscopic method
What are results after surgery?
Surgery is hyped up to be the best treatment for Varicocele. It is estimated that in about 40-60 percent of men, sterility can be restored. However, real data are lacking and many men have undergone this surgery, needlessly. There are many men who have had their Varicocele fixed and still cannot conceive.
Do Varicocele recur after treatment?
Sure, recurrence of Varicocele is quite common. These recurrences may occur a few months or may even occur a few years later. In most cases, recurrence is due to poor technical surgery and leaving some small veins intact at first surgery. To obliterate a Varicocele; one has to ligate all small veins.
Who fixes a varicocele?
Urologists are physicians who specialize in the field of male genitals and most are decent surgeons.
What is embolization?
This is perhaps the best treatment for Varicocele. It is an easy procedure done by an interventional radiologist. One side of your groin is numbed with a local anesthetic and a small tube is passed into the vein. Using x rays, the Varicocele is identified in the scrotum and through the tube, glue like substances are injected into the Varicocele. Confirmation that the Varicocele is blocked is done with another x ray study and you are done. There is no general anesthesia, no incisions and the pain is minimal. You go home in the evening. Data on embolization are decent and recurrences are rare. However, the procedure is very expensive and there is still a question of whether the Varicocele should be treated in the first place.
Final Advice
There is a lot of conflicting advice on Varicoceles and how they may affect sterility. Surgery for Varicocele is strictly elective and no one should be rushed into. For best advice, talk to a reputable urologist. Ask questions and if in doubt seek a second opinion. Whilst there are some who say Varicocele affect sterility, there are is also data that show that Varicoceles have no bearing on sterility. The last thing you want is to undergo an unnecessary surgical procedure that has a real risk of damaging your sexual organ. If you have no symptoms- leave the Varicocele alone. If you have symptoms, wear scrotal support panties. Both are reasonable treatments.
One should only undergo Varicocele surgery if there is documentation of abnormal sperm and that one is unable to father a child.
Varicoceles FAQs: Part 5
Are Varicocele life threatening?
No, varicoceles have no affect on health; they do not rupture nor cause severe pain.
Who should not undergo Varicocele treatment?
Despite what some physicians suggest, the majority of young males with Varicocele should be left alone if there are no symptoms.
Individuals with mild symptoms should wear a scrotal support (special panties should be worn) and this will ease the discomfort.
Married male who have a Varicocele and have no problems with fertility should stay away from surgeons.
Which individual with a Varicocele should be treated?
If one has symptoms, then a scrotal support should be worn. Varicocele is not life threatening nor is it an emergency; one should never be rushed into surgery. Varicocele surgery is purely an elective procedure and should be done after giving it a lot of thought. If the Varicocele is small and one has no symptoms or problems with fertility, just leave it alone.
Repair of a Varicocele is indicated when the couple has documented infertility and abnormal semen has been demonstrated.
Repair should be done when there is a significant discrepancy in size between the two testes.
Just having a Varicocele does not mean that you need surgery. Never go to a surgeon who recommends surgery without documenting that you have problems with semen.
No, varicoceles have no affect on health; they do not rupture nor cause severe pain.
Who should not undergo Varicocele treatment?
Despite what some physicians suggest, the majority of young males with Varicocele should be left alone if there are no symptoms.
Individuals with mild symptoms should wear a scrotal support (special panties should be worn) and this will ease the discomfort.
Married male who have a Varicocele and have no problems with fertility should stay away from surgeons.
Which individual with a Varicocele should be treated?
If one has symptoms, then a scrotal support should be worn. Varicocele is not life threatening nor is it an emergency; one should never be rushed into surgery. Varicocele surgery is purely an elective procedure and should be done after giving it a lot of thought. If the Varicocele is small and one has no symptoms or problems with fertility, just leave it alone.
Repair of a Varicocele is indicated when the couple has documented infertility and abnormal semen has been demonstrated.
Repair should be done when there is a significant discrepancy in size between the two testes.
Just having a Varicocele does not mean that you need surgery. Never go to a surgeon who recommends surgery without documenting that you have problems with semen.
Varicoceles FAQS: part 4
How can Varicocele cause infertility?
Whether Varicoceles actually cause infertility is still in question. Some claim that engorged blood in the veins can lead to high temperatures that damage sperm. Sperms are very fragile and cannot tolerate high temperatures. All this is just speculation. During sexual intercourse, the banging and thrusting of the penis in the vagina leads to even higher temperatures, but sperms do just fine. So all this temperature theory
is a load of bull.
What other problems are associated with a varicocele?
The occasional individual with a Varicocele may have small testes. However, this is not a universal finding and it is meaningless. There is not a single study, which has shown a relationship between Varicoceles and small testes- it is believed to be a coincidental finding.
Why do some individuals develop Varicoceles suddenly?
Sometimes a sudden swelling may appear in the scrotum and this is most common on the left side. Usually sudden appearance of a Varicocele happens in elderly individuals and a cancer or a mass somewhere in the abdomen may be a reason. A CT scan will immediately determine if this is the case
Whether Varicoceles actually cause infertility is still in question. Some claim that engorged blood in the veins can lead to high temperatures that damage sperm. Sperms are very fragile and cannot tolerate high temperatures. All this is just speculation. During sexual intercourse, the banging and thrusting of the penis in the vagina leads to even higher temperatures, but sperms do just fine. So all this temperature theory
is a load of bull.
What other problems are associated with a varicocele?
The occasional individual with a Varicocele may have small testes. However, this is not a universal finding and it is meaningless. There is not a single study, which has shown a relationship between Varicoceles and small testes- it is believed to be a coincidental finding.
Why do some individuals develop Varicoceles suddenly?
Sometimes a sudden swelling may appear in the scrotum and this is most common on the left side. Usually sudden appearance of a Varicocele happens in elderly individuals and a cancer or a mass somewhere in the abdomen may be a reason. A CT scan will immediately determine if this is the case
Varicoceles FAQs: part 3
What are symptoms of Varicocele?
In the majority of individuals, Varicoceles are painless. Most men do not even know they have a Varicocele. Sometimes the Varicocele gets to be very large and some men will feel a dragging or a pulling sensation in the groin. Pain is a rare finding with Varicoceles. Some individuals do feel an odd ache that is relieved when lying down. In almost all cases, Varicoceles become more conspicuous at the end of the day or after standing for long periods. Lying down empties the Varicoceles and hence
decreases the symptoms.
What medical problems are associated with Varicoceles?
There is a belief among physicians that Varicoceles may be the cause of infertility in some men. This association is not very strong. There are many men who have Varicoceles and have no problems fathering children. There are some men who have tiny Varicoceles and have abnormal sperm. There is a slot of debate on Varicoceles and whether they really cause abnormal sperm. There are a few studies showing that having large Varicoceles can cause infertility, but there are just as many studies that show nothing.
Some surgeons always claim that there is a relation between Varicoceles and abnormal sperm- partly because they want to operate on you and make money. To keep facts straight- even after correcting a Varicocele does not always guarantee return of fertility. So all individuals should beware of surgeons who want to book you right away for surgery- these greedy surgeons only want to make money. For all consumers, remember one fact, there are thousands of men with Varicoceles and have no problems fathering children.
In the majority of individuals, Varicoceles are painless. Most men do not even know they have a Varicocele. Sometimes the Varicocele gets to be very large and some men will feel a dragging or a pulling sensation in the groin. Pain is a rare finding with Varicoceles. Some individuals do feel an odd ache that is relieved when lying down. In almost all cases, Varicoceles become more conspicuous at the end of the day or after standing for long periods. Lying down empties the Varicoceles and hence
decreases the symptoms.
What medical problems are associated with Varicoceles?
There is a belief among physicians that Varicoceles may be the cause of infertility in some men. This association is not very strong. There are many men who have Varicoceles and have no problems fathering children. There are some men who have tiny Varicoceles and have abnormal sperm. There is a slot of debate on Varicoceles and whether they really cause abnormal sperm. There are a few studies showing that having large Varicoceles can cause infertility, but there are just as many studies that show nothing.
Some surgeons always claim that there is a relation between Varicoceles and abnormal sperm- partly because they want to operate on you and make money. To keep facts straight- even after correcting a Varicocele does not always guarantee return of fertility. So all individuals should beware of surgeons who want to book you right away for surgery- these greedy surgeons only want to make money. For all consumers, remember one fact, there are thousands of men with Varicoceles and have no problems fathering children.
Varicoceles part 2
At what age are Varicoceles observed?
Varicoceles are common and some studies indicate that nearly 10%-15% of men will develop Varicoceles. Varicoceles are generally seen in males in-between the ages of 16-30.
Are Varicoceles painful?
In most cases Varicocele are not painful. Many individuals may not even be able to see Varicocele but may be able to feel them. One may feel a sensation like a “bag of worms” when the scrotum is examined with fingers. In some cases, Varicocele do become large and may become prominent. The majority of Varicoceles are no longer then 1-2 cm in length
How is diagnosis of Varicocele made?
Diagnosis of a varicocele is not difficult. An astute physician can usually make the diagnosis of a Varicocele based on a physical exam of the scrotum. It is best for the individual to be standing when examination is done. Sometimes the “bag of worms” will disappear when you lie down.
When the Varicocele is small, one may be asked to bear down by taking a deep breathe and pushing out the stomach, this forces the Varicocele to pop out.
Individuals who have long standing Varicoceles may not see any change in size when lying down.
What tests are done to make a diagnosis of a varicocele?
In most cases, an ultrasound is ordered to confirm presence of a Varicocele. Ultrasound is not painful and simply involves placing a small hand held probe on the scrotum. The device can measure location, size, and abnormal blood flow.
Varicoceles are common and some studies indicate that nearly 10%-15% of men will develop Varicoceles. Varicoceles are generally seen in males in-between the ages of 16-30.
Are Varicoceles painful?
In most cases Varicocele are not painful. Many individuals may not even be able to see Varicocele but may be able to feel them. One may feel a sensation like a “bag of worms” when the scrotum is examined with fingers. In some cases, Varicocele do become large and may become prominent. The majority of Varicoceles are no longer then 1-2 cm in length
How is diagnosis of Varicocele made?
Diagnosis of a varicocele is not difficult. An astute physician can usually make the diagnosis of a Varicocele based on a physical exam of the scrotum. It is best for the individual to be standing when examination is done. Sometimes the “bag of worms” will disappear when you lie down.
When the Varicocele is small, one may be asked to bear down by taking a deep breathe and pushing out the stomach, this forces the Varicocele to pop out.
Individuals who have long standing Varicoceles may not see any change in size when lying down.
What tests are done to make a diagnosis of a varicocele?
In most cases, an ultrasound is ordered to confirm presence of a Varicocele. Ultrasound is not painful and simply involves placing a small hand held probe on the scrotum. The device can measure location, size, and abnormal blood flow.
Varicoceles 101: FAQs
What is a varicocele?
A varicocele is a medical disorder that describes a collection of dilated or enlarged veins in the scrotum. There are many small veins that drain blood away from the scrotum into the blood circulation. Sometimes these veins get blocked and congestion of blood results. Over time, these veins become engorged and are known as Varicoceles. Varicoceles are the same thing as varicose veins on the legs. When Varicoceles become large, one may be able to feel them – this sensation is often described as a “bag of worms”
Which scrotum is most affected with Varicoceles?
Varicoceles can occur in both scrotums. but generally are more common on the left side.
Why does a varicocele develop?
Blood flow in veins occurs only in one direction. To prevent back flow, veins have tiny valves. When these valves become defective or fail to close properly, blood starts to pool and collect downstream. This leads to congestion of veins leading to Varicoceles. It is believed that defective valves are the most common cause of Varicocele in young males.
The small veins from the scrotum drain into larger veins of the body. Often, if there is a cancer or a mass, which compresses the large veins, this can lead to engorgement of small veins downstream. In the left scrotum, cancers of kidney can often cause development of Varicoceles. This is more common in middle-aged males.
A varicocele is a medical disorder that describes a collection of dilated or enlarged veins in the scrotum. There are many small veins that drain blood away from the scrotum into the blood circulation. Sometimes these veins get blocked and congestion of blood results. Over time, these veins become engorged and are known as Varicoceles. Varicoceles are the same thing as varicose veins on the legs. When Varicoceles become large, one may be able to feel them – this sensation is often described as a “bag of worms”
Which scrotum is most affected with Varicoceles?
Varicoceles can occur in both scrotums. but generally are more common on the left side.
Why does a varicocele develop?
Blood flow in veins occurs only in one direction. To prevent back flow, veins have tiny valves. When these valves become defective or fail to close properly, blood starts to pool and collect downstream. This leads to congestion of veins leading to Varicoceles. It is believed that defective valves are the most common cause of Varicocele in young males.
The small veins from the scrotum drain into larger veins of the body. Often, if there is a cancer or a mass, which compresses the large veins, this can lead to engorgement of small veins downstream. In the left scrotum, cancers of kidney can often cause development of Varicoceles. This is more common in middle-aged males.
Monday, April 20, 2009
Penile enlargement surgery – historical perspective part 2
In North America, our educated folks were not very impressed with the old methods of penile enlargement and we had to wait until the early 1980s until adequate surgical techniques were developed. The first penile enlargement surgery was performed in China but like everything else in life- we in America have always wanted to be the biggest and best- and so the technique of penile enlargement was perfected here.
Today, penile enlargement surgery is a flourishing business for cosmetic surgeons all over the world. Men globally think that a big penis is good for sex,
Even though penile enlargement surgery has been performed for about 2 decades, it is still not recognized by the various Surgical Organizations. In fact, many traditional surgeons are against it. Currently there are no guidelines, rules or quality control measures for this type of surgery.
Many surgeons consider penile enlargement surgery to be experimental, risky and not indicated. While a few individuals have obtained the desired result, there are just as many who have developed severe and irreversible complications. Like the beginnings of any surgery, technical problems still do occur and the side effects are unpredictable. For most surgeons this is unchartered territory and fraught with hazards. Penile enlargement is still only done by a few surgeons and the procedure remains unrecognized by the formal Surgical Organizations.
There is a strong belief among health care professionals that men who remain dis-satisfied with their penis size should be careful about undergoing what is considered experimental surgery. Perhaps a psychological evaluation may be a better option. For those who do seek surgery, heed the adage, Buyer Beware. Surgery may give you bigger penis, but whether it will improve your sex life is another story.
Today, penile enlargement surgery is a flourishing business for cosmetic surgeons all over the world. Men globally think that a big penis is good for sex,
Even though penile enlargement surgery has been performed for about 2 decades, it is still not recognized by the various Surgical Organizations. In fact, many traditional surgeons are against it. Currently there are no guidelines, rules or quality control measures for this type of surgery.
Many surgeons consider penile enlargement surgery to be experimental, risky and not indicated. While a few individuals have obtained the desired result, there are just as many who have developed severe and irreversible complications. Like the beginnings of any surgery, technical problems still do occur and the side effects are unpredictable. For most surgeons this is unchartered territory and fraught with hazards. Penile enlargement is still only done by a few surgeons and the procedure remains unrecognized by the formal Surgical Organizations.
There is a strong belief among health care professionals that men who remain dis-satisfied with their penis size should be careful about undergoing what is considered experimental surgery. Perhaps a psychological evaluation may be a better option. For those who do seek surgery, heed the adage, Buyer Beware. Surgery may give you bigger penis, but whether it will improve your sex life is another story.
Penile enlargement surgery – historical perspective
Enlargement of the penis by surgery is not a novel procedure. Ever since mankind came to know about pleasure derived from genitals, almost every culture started to muck around with the genitals. The great American myth “bigger is better” was known even to the cavemen.
There are countless anecdotal reports on penile enlargement techniques used by different cultures during different eras. The crudest method of penile enlargement has been the use of a traction device. While this may sound ancient and foolhardy, it is still a widely used technique and advocated by many non health care professionals. Other cultures have inserted safety pins and needles in the penis to promote inflammation and engorgement of the penis with blood (trust me, this technique did not work and most individuals ended up with a deformed penis). And still others used weighted devices to elongate the penis.
While these techniques may sound stupid and moronic, the most insane has been the methods used by ancient civilizations in South America- the courageous Incas let snakes bite their penis- the end result in each of these scenarios was painful penis which was severely deformed.
So where do we stand today with penile surgery?
There are countless anecdotal reports on penile enlargement techniques used by different cultures during different eras. The crudest method of penile enlargement has been the use of a traction device. While this may sound ancient and foolhardy, it is still a widely used technique and advocated by many non health care professionals. Other cultures have inserted safety pins and needles in the penis to promote inflammation and engorgement of the penis with blood (trust me, this technique did not work and most individuals ended up with a deformed penis). And still others used weighted devices to elongate the penis.
While these techniques may sound stupid and moronic, the most insane has been the methods used by ancient civilizations in South America- the courageous Incas let snakes bite their penis- the end result in each of these scenarios was painful penis which was severely deformed.
So where do we stand today with penile surgery?
Penile enlargement - a phallus side of life part 2
Data from hospitals indicate that at least a quarter of a million men have some type of penile enlargement procedure each year. Surgery for penile enlargement is based on two principles- the first is to increase penile length by making an incision at base of penis. This releases the ligament that normally holds the penis to the pubic bone. This simple procedure allows for elongation of the penis by 2-4 cms. The surgery creates an illusion of a longer penis but just removing the attachment of the penis. One thing to note- the penis may be elongated but the rigidity may be compromised with this procedure.
Once the penis is enlarged, the second part of surgery involves widening the penis girth. This is very similar to a dermal filler used for a face lift. Some type of filler is injected in between muscles of the penis and the girth can be increased by 20-30%. This is not a fun procedure and the results vary from poor to extremely crap. Just imagine, taking some collagen and injecting it in between the muscles of the penis. If you want to know if this is painful, take a pin and jab your dick- this is exactly how it feels.
While there are anecdotal reports of success of such procedures, the procedures are also associated with a fair number of complications.
Whether surgery, herbs, lotions, rubber bands or drinking a bear’s urine can enlarge the penis is not really known. In any case, for any men who has a perception that his penis is small, rather than seeking an unproven therapy the first step should be to seek psychological counseling. This therapy may not lengthen your penis, but it will hopefully provide you with a better perception of life.
Once the penis is enlarged, the second part of surgery involves widening the penis girth. This is very similar to a dermal filler used for a face lift. Some type of filler is injected in between muscles of the penis and the girth can be increased by 20-30%. This is not a fun procedure and the results vary from poor to extremely crap. Just imagine, taking some collagen and injecting it in between the muscles of the penis. If you want to know if this is painful, take a pin and jab your dick- this is exactly how it feels.
While there are anecdotal reports of success of such procedures, the procedures are also associated with a fair number of complications.
Whether surgery, herbs, lotions, rubber bands or drinking a bear’s urine can enlarge the penis is not really known. In any case, for any men who has a perception that his penis is small, rather than seeking an unproven therapy the first step should be to seek psychological counseling. This therapy may not lengthen your penis, but it will hopefully provide you with a better perception of life.
Penile enlargement - a phallus side of life
When men are not thinking about money, they are thinking of sex. If a man was to be asked what is one thing that could improve his sex life or image- the most common answer across all cultures and races is – a bigger penis. And this is not accidental. Everyday, there are hundreds of come-on ads offering a larger penis. Such ads are commonly found on billboards, cyberspace, newspapers and magazines.
Everything under the sun has at one time been claimed to increase size of the penis. Drugs, herbs, lotions, potions, spices, pills, solutions and surgery are increasingly advertised to increase penile size. The sellers of such services make it sound that having a big penis is the magic pill and a panacea to all of man’s troubles.
The question asked since mankind evolved, “is there a satisfactory way to enlarge the penis?” And the answer to this question is debatable. Most men are so gullible and easily fall prey to claims made by charlatans. It was the same thing with hair loss. Does anyone really believe that female breasts can be augmented by eating a pill or applying a cream or lotion? If you do, then you need to see a psychiatrist as soon as possible. If you do not, then read on.
When it comes to sex, men have two strong delusional beliefs. One is that they have a small penis and the second is that some pill/herb can make the penis bigger. And for those men who fail to get their penis enlarged by these pills or lotions, nirvana can be attained via surgery. Over the years, several surgical procedures have been devised to enlarge the penis.
Everything under the sun has at one time been claimed to increase size of the penis. Drugs, herbs, lotions, potions, spices, pills, solutions and surgery are increasingly advertised to increase penile size. The sellers of such services make it sound that having a big penis is the magic pill and a panacea to all of man’s troubles.
The question asked since mankind evolved, “is there a satisfactory way to enlarge the penis?” And the answer to this question is debatable. Most men are so gullible and easily fall prey to claims made by charlatans. It was the same thing with hair loss. Does anyone really believe that female breasts can be augmented by eating a pill or applying a cream or lotion? If you do, then you need to see a psychiatrist as soon as possible. If you do not, then read on.
When it comes to sex, men have two strong delusional beliefs. One is that they have a small penis and the second is that some pill/herb can make the penis bigger. And for those men who fail to get their penis enlarged by these pills or lotions, nirvana can be attained via surgery. Over the years, several surgical procedures have been devised to enlarge the penis.
Wednesday, April 8, 2009
Men who cannot get it up- Treatment options for Erectile Dysfunction Part 2
While there is no ideal treatment for everyone with erectile failure, the majority of men can be helped. Viagra has been a great help in treating men with erectile dysfunction but some men do not respond to it. Further, Viagra also fails to work in some men after repeated use. In some men who have had surgery on the penis, mechanical devices may help. There are a variety of mechanical devices and most are easy to implant, are safe and work well.
All consumers should understand that mechanical implants are never the first choice for erectile dysfunction. In simple these devices function like a “dildo”. The first treatment of erectile dysfunction is always drugs or some type of behavior therapy.
Mechanical penile implants have been used for more than 2 decades and are the best treatment for men who simply cannot get an erection.
Penile implants are available in two basic designs- inflatable (hydraulic) implants that can be manually pumped to create an erection and semi rigid (these remain firm all the time).
The vendors of these devices claim that more than 90% of men go on to have a great sex life. The reality is that these devices only work in 50-60 percent of men and they are not problem free. Anything mechanical is always prone to some type of mishap.
Even though penile devices can be easily implanted, things can go wrong. The problems that can occur with penile implants include technical problems, device malfunction, infection, bleeding, pain, or abnormal contour of the penis. Some of these complications means removal of the implant. So before all you men cue up for your implant, talk to someone who has had an implant. Do not always listen to the first physician and get ready for surgery. Be realistic and ask questions. The most important treatment for erectile dysfunction is to get a good doctor.
All consumers should understand that mechanical implants are never the first choice for erectile dysfunction. In simple these devices function like a “dildo”. The first treatment of erectile dysfunction is always drugs or some type of behavior therapy.
Mechanical penile implants have been used for more than 2 decades and are the best treatment for men who simply cannot get an erection.
Penile implants are available in two basic designs- inflatable (hydraulic) implants that can be manually pumped to create an erection and semi rigid (these remain firm all the time).
The vendors of these devices claim that more than 90% of men go on to have a great sex life. The reality is that these devices only work in 50-60 percent of men and they are not problem free. Anything mechanical is always prone to some type of mishap.
Even though penile devices can be easily implanted, things can go wrong. The problems that can occur with penile implants include technical problems, device malfunction, infection, bleeding, pain, or abnormal contour of the penis. Some of these complications means removal of the implant. So before all you men cue up for your implant, talk to someone who has had an implant. Do not always listen to the first physician and get ready for surgery. Be realistic and ask questions. The most important treatment for erectile dysfunction is to get a good doctor.
Men who cannot get it up- Treatment options for Erectile Dysfunction
Many men have problems achieving an erection. For some, the problem is that they simply can’t get an erection and in others the erection is not sustained or is quite limp. The actual number of men who have problems with erection is not really known partly because men do not go around bragging about this problem to their doctors. In any case, the numbers are quite high. Men would like to seek help but the condition is too embarrassing for them to talk about it.
In recent years, some physicians have taken a proactive approach and have been asking men if they have any problems with their sex life. This has often led to a more relaxed atmosphere and it appears that many men are now coming out of the closet to discuss this issue.
Fact- all men at some point in their lives go through a period when they fail to achieve an erection. While this is not an issue when it occurs once, twice or three times, but if it is persistent and occurs on a regular basis, then a diagnosis of erectile dysfunction is made. Sex therapists indicate that at least 25 percent of men have this problem and it is not only the old people. Erectile dysfunction affects men of all ages.
In simple, the cause of erectile function can be divided into two groups- organic meaning that there is something physical causing the penis not to become erect. This may be an illness, trauma, or surgery on the penis. The other group is psychological or emotional. Some data indicate that the organic causes account for the majority of cases of erectile failure. About 10-25 percent have an emotional problem and cannot get an erection. In about 5 percent of men, no cause is ever found.
What is tragic is that many men do not seek help because of embarrassment and this makes sex life for their loved ones miserable. In fact, the majority of men who do seek treatment is because the spouse insists on it.
In recent years, some physicians have taken a proactive approach and have been asking men if they have any problems with their sex life. This has often led to a more relaxed atmosphere and it appears that many men are now coming out of the closet to discuss this issue.
Fact- all men at some point in their lives go through a period when they fail to achieve an erection. While this is not an issue when it occurs once, twice or three times, but if it is persistent and occurs on a regular basis, then a diagnosis of erectile dysfunction is made. Sex therapists indicate that at least 25 percent of men have this problem and it is not only the old people. Erectile dysfunction affects men of all ages.
In simple, the cause of erectile function can be divided into two groups- organic meaning that there is something physical causing the penis not to become erect. This may be an illness, trauma, or surgery on the penis. The other group is psychological or emotional. Some data indicate that the organic causes account for the majority of cases of erectile failure. About 10-25 percent have an emotional problem and cannot get an erection. In about 5 percent of men, no cause is ever found.
What is tragic is that many men do not seek help because of embarrassment and this makes sex life for their loved ones miserable. In fact, the majority of men who do seek treatment is because the spouse insists on it.
Saturday, April 4, 2009
Tattoo Removal- the best treatment Part 7
What is the cost for tattoo removal with laser?
Tattoo removal is considered cosmetic and is a big business. No insurance company covers the cost of applying or removing a tattoo. Tattoo removal is much more expensive undertaking than tattoo placement. Laser tattoo removal usually starts at several hundred dollars per session and the entire treatment can cost many thousands of dollars, depending upon size, type and location of tattoo and the number of visits required. The fees may vary but usually start at $ 300-400 per session. However, this is a very conservative estimate. So before you embark on this therapy, sit down and get the cost. In some cases the costs may be quite prohibitive, you may be better off wearing suitable clothing to hide your tattoo. For those who do not have suitable clothes, paint it over with another dye or learn to like your tattoo.
How many laser sessions are required?
Most simple tattoos are removed in 2 - 4 treatments scheduled about 4-8 weeks apart. Removing complex and deep tattoos requires a series of treatments spaced approximately 8 weeks apart or longer. Professional tattoos usually require 6-10 treatments for complete clearing. A large, professional tattoo in color can cost thousands of dollars to remove, and the success of the procedure still can not be guaranteed. The more superficial the tattoo pigment and the less the total volume of pigment, the fewer the number of treatments necessary to remove the pigment.
Cream Removals
The best advice on cream removers is they do not work. Numerous dermatologists and cosmetic parlors sell creams for everything and some even claim that they remove tattoos. The only thing they remove is your finances. Avoid them and go and see a reputable physician (and if he recommends a cream-run). It will save you a lot more money in the long run.
Final Advice
Because laser surgery is a medical procedure inherent with all the possible complications and costly, it is recommended that one go and see a professional physician who is experienced and understands the procedure. Avoid going to back street tattoo removal parlors because tattoo removal is a complex procedure which is best done by professionals. Find a reputable dermatologist or cosmetic surgery center to ensure proper treatment and care. If possible, you should obtain a recommendation from your family physician for a physician who specializes in tattoo removal.
Tattoo removal is considered cosmetic and is a big business. No insurance company covers the cost of applying or removing a tattoo. Tattoo removal is much more expensive undertaking than tattoo placement. Laser tattoo removal usually starts at several hundred dollars per session and the entire treatment can cost many thousands of dollars, depending upon size, type and location of tattoo and the number of visits required. The fees may vary but usually start at $ 300-400 per session. However, this is a very conservative estimate. So before you embark on this therapy, sit down and get the cost. In some cases the costs may be quite prohibitive, you may be better off wearing suitable clothing to hide your tattoo. For those who do not have suitable clothes, paint it over with another dye or learn to like your tattoo.
How many laser sessions are required?
Most simple tattoos are removed in 2 - 4 treatments scheduled about 4-8 weeks apart. Removing complex and deep tattoos requires a series of treatments spaced approximately 8 weeks apart or longer. Professional tattoos usually require 6-10 treatments for complete clearing. A large, professional tattoo in color can cost thousands of dollars to remove, and the success of the procedure still can not be guaranteed. The more superficial the tattoo pigment and the less the total volume of pigment, the fewer the number of treatments necessary to remove the pigment.
Cream Removals
The best advice on cream removers is they do not work. Numerous dermatologists and cosmetic parlors sell creams for everything and some even claim that they remove tattoos. The only thing they remove is your finances. Avoid them and go and see a reputable physician (and if he recommends a cream-run). It will save you a lot more money in the long run.
Final Advice
Because laser surgery is a medical procedure inherent with all the possible complications and costly, it is recommended that one go and see a professional physician who is experienced and understands the procedure. Avoid going to back street tattoo removal parlors because tattoo removal is a complex procedure which is best done by professionals. Find a reputable dermatologist or cosmetic surgery center to ensure proper treatment and care. If possible, you should obtain a recommendation from your family physician for a physician who specializes in tattoo removal.
Tattoo Removal- the best treatment Part 6
Miscellaneous: Many of the dyes are supplied by a variety of sources, some unlicensed. Fortunately, complications are rare. Some complications may include localized swellings underneath the skin (granuloma), loss of hair and even permanent scarring. The area may appear like a sun burn for a few months and ultimately the skin will become normal.
Can lasers remove all colors equally well?
No, different lasers may remove different colors. In general, blue, black, green and red colors fade way the fastest. Yellow is the most difficulty color to remove. Most lasers are only capable of putting out one wavelength, which significantly limits their ability to treat colors selectively without causing scarring or pigment changes. Some colors may require more treatments, but they can be usually removed.
Can the pigmentation changes seen during pregnancy be removed with laser?
Yes, but melasma is a physiological change of pregnancy and will disappear after birth. There is absolutely no need for a pregnant female to undergo an expensive laser procedure during this time period. Plus, one can’t tell what may happen to the fetus
What care is required of the laser treated area?
There may be some pinpoint bleeding but one should keep the area clean and dry. One can take a shower the next day but not scrub the treated area.
Can laser remove permanent make up?
The majority of permanent makeups have metallic bases and when they come into contact with laser, the make up is usually darkened. Once this darkening occurs it is not possible to remove the discoloration
In addition, most physicians do not like to use the laser near the eye. You never know what can happen.
Can lasers remove all colors equally well?
No, different lasers may remove different colors. In general, blue, black, green and red colors fade way the fastest. Yellow is the most difficulty color to remove. Most lasers are only capable of putting out one wavelength, which significantly limits their ability to treat colors selectively without causing scarring or pigment changes. Some colors may require more treatments, but they can be usually removed.
Can the pigmentation changes seen during pregnancy be removed with laser?
Yes, but melasma is a physiological change of pregnancy and will disappear after birth. There is absolutely no need for a pregnant female to undergo an expensive laser procedure during this time period. Plus, one can’t tell what may happen to the fetus
What care is required of the laser treated area?
There may be some pinpoint bleeding but one should keep the area clean and dry. One can take a shower the next day but not scrub the treated area.
Can laser remove permanent make up?
The majority of permanent makeups have metallic bases and when they come into contact with laser, the make up is usually darkened. Once this darkening occurs it is not possible to remove the discoloration
In addition, most physicians do not like to use the laser near the eye. You never know what can happen.
Tattoo Removal- the best treatment Part 5
How long does each Laser procedure take?
Laser treatment usually does not take more than a few minutes. However, multiple sessions are required to remove most tattoos. The multiple sessions are split over 4-8 weeks, depending on the size and complexity of the tattoo
What happens at the physician’s office?
Once you arrive, your eyes will be covered by eye shields to protect against the laser rays. The doctor will test your skin’s reaction to the laser to set the right amount of energy. A pen like laser device is then activated and the laser is fired along the tattoo. Each burst of laser feels like a needle sting. Depending on the size of the tattoo, 10-30 pulses of the laser may be required in one session. For those who hate needle stings, this is real fun.
What happens after each laser treatment?
Once the treatment is completed, ice is applied immediately on the treated tattoo to minimize the swelling. After about 30 minutes, a topical antibiotic ointment is placed on the tattoo followed by a sterile dressing. The skin site should be left dry for a few days. It should be treated just like sunburn.
How long is each session?
On average, each laser treatment takes from ten to twenty minutes. Most individuals require at least several treatments for the best result
What are side effects of laser treatment?
Side effects of laser procedures are generally few but may include:
Depigmentation: Some individuals may develop fading of the skin (hypopigmentation). This hypopigmentation may resolve in 2-3 months, but in some cases it is permanent. Others may develop darkening of the skin. However, these dark spots are difficult to resolve and require some of bleaching agent
Texture change: Often an individual will feel changes in texture of skin. The skin will appear rough and scratchy. These textural changes usually resolve in a few months. However, in some cases the changes may be permanent. Skin textural changes resolve over 6-8 weeks in most cases. Tattoos of face and neck respond faster but are also more sensitive to tissue damage.
Allergic reactions: Some individuals may develop a localized allergic response to some of the tattoo pigments after laser treatment. However, these allergic responses are more common with some lasers only. The allergic response can be treated with steroids.
Ink darkening: Sometimes cosmetic tattoos with red or flesh colored tattoos can darken with laser treatment. This is usually a chemical reaction from the heat generated from the laser. Therefore, a test will be conducted by the physician to determine how things will work out. Some individuals may use this ability of the laser to darken the eyeliner tattoos. This is a permanent reaction.
Laser treatment usually does not take more than a few minutes. However, multiple sessions are required to remove most tattoos. The multiple sessions are split over 4-8 weeks, depending on the size and complexity of the tattoo
What happens at the physician’s office?
Once you arrive, your eyes will be covered by eye shields to protect against the laser rays. The doctor will test your skin’s reaction to the laser to set the right amount of energy. A pen like laser device is then activated and the laser is fired along the tattoo. Each burst of laser feels like a needle sting. Depending on the size of the tattoo, 10-30 pulses of the laser may be required in one session. For those who hate needle stings, this is real fun.
What happens after each laser treatment?
Once the treatment is completed, ice is applied immediately on the treated tattoo to minimize the swelling. After about 30 minutes, a topical antibiotic ointment is placed on the tattoo followed by a sterile dressing. The skin site should be left dry for a few days. It should be treated just like sunburn.
How long is each session?
On average, each laser treatment takes from ten to twenty minutes. Most individuals require at least several treatments for the best result
What are side effects of laser treatment?
Side effects of laser procedures are generally few but may include:
Depigmentation: Some individuals may develop fading of the skin (hypopigmentation). This hypopigmentation may resolve in 2-3 months, but in some cases it is permanent. Others may develop darkening of the skin. However, these dark spots are difficult to resolve and require some of bleaching agent
Texture change: Often an individual will feel changes in texture of skin. The skin will appear rough and scratchy. These textural changes usually resolve in a few months. However, in some cases the changes may be permanent. Skin textural changes resolve over 6-8 weeks in most cases. Tattoos of face and neck respond faster but are also more sensitive to tissue damage.
Allergic reactions: Some individuals may develop a localized allergic response to some of the tattoo pigments after laser treatment. However, these allergic responses are more common with some lasers only. The allergic response can be treated with steroids.
Ink darkening: Sometimes cosmetic tattoos with red or flesh colored tattoos can darken with laser treatment. This is usually a chemical reaction from the heat generated from the laser. Therefore, a test will be conducted by the physician to determine how things will work out. Some individuals may use this ability of the laser to darken the eyeliner tattoos. This is a permanent reaction.
Tattoo Removal- the best treatment Part 4
How do Lasers Remove tattoos?
Lasers work by generating concentrated beams of light energy. The heat generated from the laser breaks up the ink particles- which are later cleared by the body’s normal scavenging system. Different lasers have different ability to penetrate the skin. Depending on size and complexity of the tattoo, several sessions may be required to remove the tattoo. The laser is selective for the tattoo and does not harm the normal skin or tissues. In general, superficial tattoo are easily removed and deeper tattoos may take some time. The laser does generate heat and there is some pain and blistering in some cases. Despite all the bragging about Lasers and their potential uses, the chance of scarring is always present.
Who is a Candidate for laser tattoo removal?
Those individuals with fair skin and superficially placed tattoos on the arms, chest, buttocks or legs are the best candidates. Dark skinned individuals with tattoos placed on the ears, ankles or the fingers are some of the most difficult to treat. Results of tattoo removal in dark skinned people, in general, is difficult and the results are mediocre at best.
What determines the success of tattoo removal?
The size, location and how deep the tattoo is placed affects the results. Because of better ink technology and improved skills of tattooer, the newer tattoos are more difficult to remove compared to the older ones.
Does Tattoo Removal Hurt?
Yes, nothing in life is painless and the same goes for tattoo removal. If you thought that it was painful applying a tattoo, then you will feel the same or slightly more pain when the tattoo is removed. The laser is basically a heating source and stings when it touches the skin. The pain is like a needle jab, but many times over. To decrease the pain, the physician will recommend taking a few over the counter pain medications before the procedure. Aspirin like products are not recommended because they have a tendency to increase the bruising.
To further decrease the pain, the physician may apply a local anesthetic ointment on the tattoo 30 minutes before the procedure. In some cases, the physician may inject a local anesthetic into the tattoo before the procedure. One can only imagine how much pain there may be if one goes to a tattoo parlor which does not have access to any of these pain medications.
Lasers work by generating concentrated beams of light energy. The heat generated from the laser breaks up the ink particles- which are later cleared by the body’s normal scavenging system. Different lasers have different ability to penetrate the skin. Depending on size and complexity of the tattoo, several sessions may be required to remove the tattoo. The laser is selective for the tattoo and does not harm the normal skin or tissues. In general, superficial tattoo are easily removed and deeper tattoos may take some time. The laser does generate heat and there is some pain and blistering in some cases. Despite all the bragging about Lasers and their potential uses, the chance of scarring is always present.
Who is a Candidate for laser tattoo removal?
Those individuals with fair skin and superficially placed tattoos on the arms, chest, buttocks or legs are the best candidates. Dark skinned individuals with tattoos placed on the ears, ankles or the fingers are some of the most difficult to treat. Results of tattoo removal in dark skinned people, in general, is difficult and the results are mediocre at best.
What determines the success of tattoo removal?
The size, location and how deep the tattoo is placed affects the results. Because of better ink technology and improved skills of tattooer, the newer tattoos are more difficult to remove compared to the older ones.
Does Tattoo Removal Hurt?
Yes, nothing in life is painless and the same goes for tattoo removal. If you thought that it was painful applying a tattoo, then you will feel the same or slightly more pain when the tattoo is removed. The laser is basically a heating source and stings when it touches the skin. The pain is like a needle jab, but many times over. To decrease the pain, the physician will recommend taking a few over the counter pain medications before the procedure. Aspirin like products are not recommended because they have a tendency to increase the bruising.
To further decrease the pain, the physician may apply a local anesthetic ointment on the tattoo 30 minutes before the procedure. In some cases, the physician may inject a local anesthetic into the tattoo before the procedure. One can only imagine how much pain there may be if one goes to a tattoo parlor which does not have access to any of these pain medications.
Tattoo Removal- the best treatment Part 3
Surgery: In the old days, tattoos were simply excised together with the skin. This is sometimes done for difficult tattoos which are deep and located in unusual places. Areas of the body with lax skin are best suited for excision as the incision can be closed without any tension. However, surgery for removal of tattoos is very rare and the last modality of choice.
Chemical tissue destruction: Various caustic chemicals (tannic acid and silver nitrate) have been used to treat numerous skin conditions including tattoo removal. The chemicals are applied on skin and often combined with superficial dermabrasion. Sometimes the chemicals are injected superficially underneath the skin. The chemical method of treating any skin lesion is now relegated to the history books. The procedure always results in scarring, deformity, and pain and skin discoloration. Many individuals have had to undergo skin grafting other plastic surgery procedures to correct the defects caused by the chemicals. This was a technique used when there was nothing available in the past. Unfortunately, some of these chemicals are available and still used for home use. If you come across any cosmetic clinic or tattoo parlor which still uses chemicals to treat tattoos- just run away.
Liquid nitrogen: In dermatology, liquid nitrogen (-196 °C) is commonly used to treat numerous skin lesions and once was attempted to remove tattoos. There have been a few reports of successful removal of tattoos, but in general, the technique is not effective and can destroy surrounding normal tissue. It can only be used for the very superficial and very small tattoos. Liquid nitrogen is best left to treat anal warts and not tattoos.
Thermal tissue destruction: Tattoo removal has even been attempted with heat. Thermal injury via fire, hot coal and metals and cigarettes has been applied on the skin for centuries to try to remove unwanted tattoos. As one can imagine, the results were obvious and anyone who has ever been burnt with a cigarette, will known exactly how great it feels. Electrocautery and electrodessication were widely used in the past and caused significant scarring. Most thermal products to remove tattoos are not used today. However, technology in the use of thermal products has led to the best methods of tattoo removal- the laser.
Chemical tissue destruction: Various caustic chemicals (tannic acid and silver nitrate) have been used to treat numerous skin conditions including tattoo removal. The chemicals are applied on skin and often combined with superficial dermabrasion. Sometimes the chemicals are injected superficially underneath the skin. The chemical method of treating any skin lesion is now relegated to the history books. The procedure always results in scarring, deformity, and pain and skin discoloration. Many individuals have had to undergo skin grafting other plastic surgery procedures to correct the defects caused by the chemicals. This was a technique used when there was nothing available in the past. Unfortunately, some of these chemicals are available and still used for home use. If you come across any cosmetic clinic or tattoo parlor which still uses chemicals to treat tattoos- just run away.
Liquid nitrogen: In dermatology, liquid nitrogen (-196 °C) is commonly used to treat numerous skin lesions and once was attempted to remove tattoos. There have been a few reports of successful removal of tattoos, but in general, the technique is not effective and can destroy surrounding normal tissue. It can only be used for the very superficial and very small tattoos. Liquid nitrogen is best left to treat anal warts and not tattoos.
Thermal tissue destruction: Tattoo removal has even been attempted with heat. Thermal injury via fire, hot coal and metals and cigarettes has been applied on the skin for centuries to try to remove unwanted tattoos. As one can imagine, the results were obvious and anyone who has ever been burnt with a cigarette, will known exactly how great it feels. Electrocautery and electrodessication were widely used in the past and caused significant scarring. Most thermal products to remove tattoos are not used today. However, technology in the use of thermal products has led to the best methods of tattoo removal- the laser.
Tattoo Removal- the best treatment Part 2
Can All Tattoos Be Removed?
Not all tattoos can be removed completely, but the majority can be partially removed. Tattoos are meant to be permanent and with recent improvements in ink technology and professional tattoo artists improving their skills, tattoos imprinted on in the last decade are very difficult to remove. Even with the best technique, some residual scarring remains in a few cases.
What are other methods of tattoo removal?
There are other methods of tattoo removal, but most of them are painful and ineffective. Today laser therapy has replaced most of them. The other methods include dermabrasion, camouflage and excision of the tattoo. These methods cause a lot more damage to skin and also result in scarring. These techniques are only used when laser is not an option.
Salabrasion: this technique involves physical destruction of the superficial skin with some chemicals, like salt, or a piece of gauze or tissue. This is a poor’s man version of tattoo removal. Very painful and sucks.
Dermabrasion: Dermabrasion is the primary method of mechanical tissue destruction. The skin is scrubbed with various devices ranging from a rapidly spinning diamond fraise wheel, a wire brush or even a metal scrapper. The skin is usually frozen with a coolant to make it rigid prior to the procedure. As the name suggests, the procedure can be bloody and unsightly even painful. Rarely pieces of skin tissues break off and will result in a scar. Not a recommended method for tattoo removal as it causes severe scarring. Today, the technique is refined with novel methods of skin abrasion, but nevertheless, the results are poor at best.
What are disadvantage of Mechanical tissue destruction?
The main disadvantages with mechanical destructive methods are the high risk of scarring; hypertrophic scars and even infection. For those who have deep tattoos, the risk of scarring is even higher with the above techniques. Often, the technique causes the tattoo pigments to imbed even deeper into the tissues. These methods are only used for very small areas of the skin with very superficial tattoos.
Not all tattoos can be removed completely, but the majority can be partially removed. Tattoos are meant to be permanent and with recent improvements in ink technology and professional tattoo artists improving their skills, tattoos imprinted on in the last decade are very difficult to remove. Even with the best technique, some residual scarring remains in a few cases.
What are other methods of tattoo removal?
There are other methods of tattoo removal, but most of them are painful and ineffective. Today laser therapy has replaced most of them. The other methods include dermabrasion, camouflage and excision of the tattoo. These methods cause a lot more damage to skin and also result in scarring. These techniques are only used when laser is not an option.
Salabrasion: this technique involves physical destruction of the superficial skin with some chemicals, like salt, or a piece of gauze or tissue. This is a poor’s man version of tattoo removal. Very painful and sucks.
Dermabrasion: Dermabrasion is the primary method of mechanical tissue destruction. The skin is scrubbed with various devices ranging from a rapidly spinning diamond fraise wheel, a wire brush or even a metal scrapper. The skin is usually frozen with a coolant to make it rigid prior to the procedure. As the name suggests, the procedure can be bloody and unsightly even painful. Rarely pieces of skin tissues break off and will result in a scar. Not a recommended method for tattoo removal as it causes severe scarring. Today, the technique is refined with novel methods of skin abrasion, but nevertheless, the results are poor at best.
What are disadvantage of Mechanical tissue destruction?
The main disadvantages with mechanical destructive methods are the high risk of scarring; hypertrophic scars and even infection. For those who have deep tattoos, the risk of scarring is even higher with the above techniques. Often, the technique causes the tattoo pigments to imbed even deeper into the tissues. These methods are only used for very small areas of the skin with very superficial tattoos.
Tattoo Removal- the best treatment
It is estimated that close to 10% of the U.S. population has some type of tattoo on their body and the numbers are increasing exponentially. After a few years, close to 50% of then want to have laser tattoo removal. There is some good news for those who have a bad tattoo or are not pleased with what they have. Newer laser tattoo removal techniques are now available which can eliminate your tattoo with minimal side effects. however, even with the best laser techniques tattoo removal is not always a guarantee.
There are numerous types of lasers- but they all work by breaking up pigment colors of the tattoo with a high-intensity light beam. Black tattoo pigment absorbs all laser wavelengths, making these tattoos the easiest to remove. Other colors, such as red, selectively absorb green laser light. Various colors can only be treated by selected lasers based upon the pigment color.
Tattoo removal is an old age problem and various methods have been described in the past. The majority of past tattoo removal methods were many times worse than the tattoo itself- the majority cause scars or do not work. For the past 3 decades, tattoo removal was done using unsophisticated surgery techniques, all of which left individuals with a lot of scarring and empty pockets. From ripping the skin, scrubbing the skin with sand paper, we now have evolved through a century of chemical, mechanical, light, cold and thermal methods of tattoo removal- and today the gold standard for tattoo removal is LASER.
With recent advances in medical technology, laser therapy has become the gold standard for removal of tattoos. If you have a tattoo that you wish to have partially or completely removed, you should first consider your options and decide which method might be best for you.
There are numerous types of lasers- but they all work by breaking up pigment colors of the tattoo with a high-intensity light beam. Black tattoo pigment absorbs all laser wavelengths, making these tattoos the easiest to remove. Other colors, such as red, selectively absorb green laser light. Various colors can only be treated by selected lasers based upon the pigment color.
Tattoo removal is an old age problem and various methods have been described in the past. The majority of past tattoo removal methods were many times worse than the tattoo itself- the majority cause scars or do not work. For the past 3 decades, tattoo removal was done using unsophisticated surgery techniques, all of which left individuals with a lot of scarring and empty pockets. From ripping the skin, scrubbing the skin with sand paper, we now have evolved through a century of chemical, mechanical, light, cold and thermal methods of tattoo removal- and today the gold standard for tattoo removal is LASER.
With recent advances in medical technology, laser therapy has become the gold standard for removal of tattoos. If you have a tattoo that you wish to have partially or completely removed, you should first consider your options and decide which method might be best for you.
Thursday, March 26, 2009
Premature Ejaculation” Prevalent but Poorly understood- Part 10
Conclusion
Premature ejaculation is one of the most common sexual problems in men. The condition is most often described as being an inability to delay ejaculation to a point when it is mutually desirable for both partners. The definition of when ejaculation is premature is subjective. While some men have difficulty controlling their orgasm before entry, females think 1-5 minutes of copulation is too little time (women like to have the time increased to at least 15-30 minutes). How long a man is able to last is not the important factor in diagnosing premature ejaculation. The crucial issue is if both partners are satisfied with the length of coitus.
In some cases, premature ejaculation may be caused by poor communication between partners and unrealistic expectations. Many men and women have little knowledge of their partner’s sexual needs and what satisfies them. Women typically require more foreplay and prolonged stimulation than men do to reach orgasm, and this lack of understanding causes tension and undue stress. For many men, feeling anxiety and the pressure to perform frequently leads to premature ejaculation. Drug treatment is not always the answer, and a visit to a psychologist or sex therapist may help resolve the problem.
Premature ejaculation is one of the most common sexual problems in men. The condition is most often described as being an inability to delay ejaculation to a point when it is mutually desirable for both partners. The definition of when ejaculation is premature is subjective. While some men have difficulty controlling their orgasm before entry, females think 1-5 minutes of copulation is too little time (women like to have the time increased to at least 15-30 minutes). How long a man is able to last is not the important factor in diagnosing premature ejaculation. The crucial issue is if both partners are satisfied with the length of coitus.
In some cases, premature ejaculation may be caused by poor communication between partners and unrealistic expectations. Many men and women have little knowledge of their partner’s sexual needs and what satisfies them. Women typically require more foreplay and prolonged stimulation than men do to reach orgasm, and this lack of understanding causes tension and undue stress. For many men, feeling anxiety and the pressure to perform frequently leads to premature ejaculation. Drug treatment is not always the answer, and a visit to a psychologist or sex therapist may help resolve the problem.
Premature Ejaculation” Prevalent but Poorly understood- Part 9
Prostate massage
Of all therapies, this takes the piece of cake for being the most stupid idiotic idea. Based on the technique of squeezing the tip of the penis prior to ejaculation, some even recommend squeezing the prostate or pulling the testis downwards. The testis and prostate gland do play a very important role in sexual arousal. The glands do get engorged and become sensitive during intercourse. The advocates of prostate squeezing claim that the prostate should be massaged just prior to ejaculation. The squeezing of the prostate is done to decrease the pleasurable sensations and prevent the ejaculation. This completely fool hardy idea should not be propagated. Prostate squeezing and testicle pulling is not safe and can cause serious injuries to internal organs and be very painful. The advocates for this technique, have obviously, never had their prostate/testes squeezed.
Nutrition supplements
Today, in all of medicine and general life, people seem to think that health supplements are the answer. Everyday on the internet and glossy magazines, there are ads about nutrition supplements to treat premature ejaculation. The majority of these supplements are based on the science of quackery and do not work. Further, many of these health supplements come from China and other countries where the quality and quantity is never known. With these unknown supplements, you may temporarily cure your premature ejaculation if you are lucky but chances are you may end up having no libido or sexual desire.
If one is interested in getting adequately treated, the best advice is to avoid this hodgepodge of non tested chemicals and see a physician. Not only are these supplements expensive but a large percentage of them are fake pills. Like most things in America- buyer beware.
Of all therapies, this takes the piece of cake for being the most stupid idiotic idea. Based on the technique of squeezing the tip of the penis prior to ejaculation, some even recommend squeezing the prostate or pulling the testis downwards. The testis and prostate gland do play a very important role in sexual arousal. The glands do get engorged and become sensitive during intercourse. The advocates of prostate squeezing claim that the prostate should be massaged just prior to ejaculation. The squeezing of the prostate is done to decrease the pleasurable sensations and prevent the ejaculation. This completely fool hardy idea should not be propagated. Prostate squeezing and testicle pulling is not safe and can cause serious injuries to internal organs and be very painful. The advocates for this technique, have obviously, never had their prostate/testes squeezed.
Nutrition supplements
Today, in all of medicine and general life, people seem to think that health supplements are the answer. Everyday on the internet and glossy magazines, there are ads about nutrition supplements to treat premature ejaculation. The majority of these supplements are based on the science of quackery and do not work. Further, many of these health supplements come from China and other countries where the quality and quantity is never known. With these unknown supplements, you may temporarily cure your premature ejaculation if you are lucky but chances are you may end up having no libido or sexual desire.
If one is interested in getting adequately treated, the best advice is to avoid this hodgepodge of non tested chemicals and see a physician. Not only are these supplements expensive but a large percentage of them are fake pills. Like most things in America- buyer beware.
Premature Ejaculation” Prevalent but Poorly understood- Part 8
Condoms
Wearing ultra thick condoms has also been suggested as a remedy for premature ejaculation. The condom reduces the sensitivity of the penis and prevents rapid arousal. Some claim that wearing two condoms may be required at times to decrease the penile sensitivity. Condom use also protects against STDs. However, many individuals do claim that frequently they ejaculate while trying to get the condom on.
Sexual positions
Some sexologists maintain that the entire problem can be solved by changing the position for sex. It is said that the "missionary" position (man on top of the female) is not the best position while attempting to control ejaculation. One should reverse the position by letting the female be on top. Everyone agrees that ejaculation is delayed in this position, but females claim that they have a difficult reaching orgasm in this position. So alternating the position and squeezing the tip of the penis may be part of the answer.
Hypnosis
Some individuals indicate that hypnosis has been helpful in the treatment of premature ejaculation. However all these data are anecdotal and have no scientific basis. As to how hypnosis prevents premature ejaculation remains a mystery. Some claim that in the lethargic or sedated state they are no longer able to have an erection nor have any sexual desire. I always believed hypnosis was to induce sleep and not stimulate sex! In any case, hypnosis is not a recommended therapy today.
Wearing ultra thick condoms has also been suggested as a remedy for premature ejaculation. The condom reduces the sensitivity of the penis and prevents rapid arousal. Some claim that wearing two condoms may be required at times to decrease the penile sensitivity. Condom use also protects against STDs. However, many individuals do claim that frequently they ejaculate while trying to get the condom on.
Sexual positions
Some sexologists maintain that the entire problem can be solved by changing the position for sex. It is said that the "missionary" position (man on top of the female) is not the best position while attempting to control ejaculation. One should reverse the position by letting the female be on top. Everyone agrees that ejaculation is delayed in this position, but females claim that they have a difficult reaching orgasm in this position. So alternating the position and squeezing the tip of the penis may be part of the answer.
Hypnosis
Some individuals indicate that hypnosis has been helpful in the treatment of premature ejaculation. However all these data are anecdotal and have no scientific basis. As to how hypnosis prevents premature ejaculation remains a mystery. Some claim that in the lethargic or sedated state they are no longer able to have an erection nor have any sexual desire. I always believed hypnosis was to induce sleep and not stimulate sex! In any case, hypnosis is not a recommended therapy today.
Premature Ejaculation” Prevalent but Poorly understood- Part 7
Psychotherapy
Psychotherapy or counseling, with the partner is an essential component of treatment. With understanding and emotional support, the male is likely to obtain the level of relaxation required for sexual satisfaction. Both the male and partner are encouraged to communicate freely and with sensitivity. While the premature ejaculation is being treated, the male is encouraged to satisfy the partner orally, or if the partner wants, anally.
By increasing knowledge of both partners about their sexual responses and responsibilities, the sexual tension can greatly be reduced. All sexual activity should be done without any pressure or tension and performed in a private relaxed environment.
Latex sheaths
Today, various types of external latex rigid sheathes are available. Basically these devices are worn over the penis and fastened around the pelvis with a belt. The penis is placed inside a plastic dildo and it is the actual sheath which is placed inside the vagina. The sheath prevents the penis from getting stimulated from the vagina walls and helps regain control of their ejaculation. This technique has not been useful as many women claim that they would rather use a “dildo” instead- and millions do.
Psychotherapy or counseling, with the partner is an essential component of treatment. With understanding and emotional support, the male is likely to obtain the level of relaxation required for sexual satisfaction. Both the male and partner are encouraged to communicate freely and with sensitivity. While the premature ejaculation is being treated, the male is encouraged to satisfy the partner orally, or if the partner wants, anally.
By increasing knowledge of both partners about their sexual responses and responsibilities, the sexual tension can greatly be reduced. All sexual activity should be done without any pressure or tension and performed in a private relaxed environment.
Latex sheaths
Today, various types of external latex rigid sheathes are available. Basically these devices are worn over the penis and fastened around the pelvis with a belt. The penis is placed inside a plastic dildo and it is the actual sheath which is placed inside the vagina. The sheath prevents the penis from getting stimulated from the vagina walls and helps regain control of their ejaculation. This technique has not been useful as many women claim that they would rather use a “dildo” instead- and millions do.
Premature Ejaculation” Prevalent but Poorly understood- Part 6
Medications
Numerous antidepressant drugs have been shown to delay ejaculation in men treated for various psychiatry disorders. The SSRIs class are considered the most effective treatment for premature ejaculation. The drugs include paroxetine, fluoxetine and sertraline. The prolonged use of these drugs is only limited by their side effects. Recently a new SSRI (dapoxetine) that can be taken only when needed is undergoing going clinical trials.
Other medical agents known to delay ejaculation are opioids, cocaine, and marijuana. However, this may not be appropriate as the drugs are addictive and have legal implications.
The majority of these medications do not have to be taken on a daily basis to prevent premature ejaculation. One takes the medication an hour before planning to have sexual intercourse. For those who initially do not respond to these drugs, the dose may be adjusted or another medication can be tried.
Topical creams
Various topical anesthetic creams are available that may help improve premature ejaculation. The local anesthetic work by decreasing the sensation in the penis. One usually applies the local anesthetic 30-45 minutes before sex. The local anesthetic causes the penis to loose sensation. One has to wipe the anesthetic off before intercourse. Using the anesthetic cream as a lubricant will also cause numbness of the female vagina and cervix. This is a poor man’s version of drug treatment. The effect of the local anesthetic is very short lived and it often fails to work. Most women hate these creams because it numbs their genitalia and takes away the pleasurable sensations. Best to leave these topical anesthetic creams to numb the painful hemorrhoids.
Numerous antidepressant drugs have been shown to delay ejaculation in men treated for various psychiatry disorders. The SSRIs class are considered the most effective treatment for premature ejaculation. The drugs include paroxetine, fluoxetine and sertraline. The prolonged use of these drugs is only limited by their side effects. Recently a new SSRI (dapoxetine) that can be taken only when needed is undergoing going clinical trials.
Other medical agents known to delay ejaculation are opioids, cocaine, and marijuana. However, this may not be appropriate as the drugs are addictive and have legal implications.
The majority of these medications do not have to be taken on a daily basis to prevent premature ejaculation. One takes the medication an hour before planning to have sexual intercourse. For those who initially do not respond to these drugs, the dose may be adjusted or another medication can be tried.
Topical creams
Various topical anesthetic creams are available that may help improve premature ejaculation. The local anesthetic work by decreasing the sensation in the penis. One usually applies the local anesthetic 30-45 minutes before sex. The local anesthetic causes the penis to loose sensation. One has to wipe the anesthetic off before intercourse. Using the anesthetic cream as a lubricant will also cause numbness of the female vagina and cervix. This is a poor man’s version of drug treatment. The effect of the local anesthetic is very short lived and it often fails to work. Most women hate these creams because it numbs their genitalia and takes away the pleasurable sensations. Best to leave these topical anesthetic creams to numb the painful hemorrhoids.
Wednesday, March 25, 2009
Premature Ejaculation” Prevalent but Poorly understood- Part 5
Treatment
There are varied treatments for this condition and like everything in medicine- one treatment may not be helpful for all individuals. Occasionally a combination of treatments is used. The essence of all treatments is to combine sexual therapy, medications and psychotherapy for the best results.
Sex therapy
Some sexologists recommend that individuals masturbate an hour or two before the sexual intercourse. This enables one to delay the ejaculation during sex. Other sexual activities such as foreplay are encouraged to relieve the anxiety of the actual process of sexual intercourse. Masturbation is in fact, used by normal men to prolong their sexual activity. It is believed that masturbation before sexual activity decreases the amount of desire/intensity the individual feels, thereby giving him more control over the penis. However, the results in men with premature ejaculation are variable. Some claim that there is no benefit and others claim that after masturbation, they lose the desire to have sex.
Squeezing techniques
Various squeezing techniques have been developed to prevent premature ejaculation and some have helped. It is recommended that the partner can squeeze the end of the penis when the male is just about to ejaculate. The partner has to maintain the squeeze for a few seconds until the urge to ejaculate diminishes. After the urge is over, the individual can resume the sexual activity and repeat the process. The theory is that by repeating this maneuver numerous times, the male will finally be able to have sexual intercourse without ejaculation. This technique is believed to train the penis to delay ejaculation.
However, follow-up of patients who have used this technique claim that is a poor method to manage premature ejaculation. In short, it sucks.
There are varied treatments for this condition and like everything in medicine- one treatment may not be helpful for all individuals. Occasionally a combination of treatments is used. The essence of all treatments is to combine sexual therapy, medications and psychotherapy for the best results.
Sex therapy
Some sexologists recommend that individuals masturbate an hour or two before the sexual intercourse. This enables one to delay the ejaculation during sex. Other sexual activities such as foreplay are encouraged to relieve the anxiety of the actual process of sexual intercourse. Masturbation is in fact, used by normal men to prolong their sexual activity. It is believed that masturbation before sexual activity decreases the amount of desire/intensity the individual feels, thereby giving him more control over the penis. However, the results in men with premature ejaculation are variable. Some claim that there is no benefit and others claim that after masturbation, they lose the desire to have sex.
Squeezing techniques
Various squeezing techniques have been developed to prevent premature ejaculation and some have helped. It is recommended that the partner can squeeze the end of the penis when the male is just about to ejaculate. The partner has to maintain the squeeze for a few seconds until the urge to ejaculate diminishes. After the urge is over, the individual can resume the sexual activity and repeat the process. The theory is that by repeating this maneuver numerous times, the male will finally be able to have sexual intercourse without ejaculation. This technique is believed to train the penis to delay ejaculation.
However, follow-up of patients who have used this technique claim that is a poor method to manage premature ejaculation. In short, it sucks.
Premature Ejaculation” Prevalent but Poorly understood- Part 4
When to seek medical advice
The major problem with premature ejaculation and treatment is that many males never seek treatment or see a doctor. For whatever reason, the treatment and diagnosis of premature ejaculation is always delayed. Treatment is much easier in the early stages of the disorder and pretty complex when a male presents at much older age.
Screening and diagnosis
The diagnosis of premature ejaculation is based on the individual’s history. The history and the initial interview are the most difficult part of the entire process as intimate sexual details are obtained. However, frank details about the problem, can lead to the most effective treatment. In order to diagnose the cause, sexually intimate questions may involve your:
• religious upbringing
• early sexual experiences
• past and present sexual relationships
• when premature ejaculation started
• conflicts or concerns within your current relationship
• feelings of guilt, anxiety as related to performance
• use of medications
• illicit drug use
Complications
Premature ejaculation is not a life threatening disorder. However, the disorder can have severe repercussions in one‘s personal life and relationship. Sometimes, premature ejaculation can make conceiving difficult if one continues to spurt sperm on the bed or the floor instead of the vagina.
The major problem with premature ejaculation and treatment is that many males never seek treatment or see a doctor. For whatever reason, the treatment and diagnosis of premature ejaculation is always delayed. Treatment is much easier in the early stages of the disorder and pretty complex when a male presents at much older age.
Screening and diagnosis
The diagnosis of premature ejaculation is based on the individual’s history. The history and the initial interview are the most difficult part of the entire process as intimate sexual details are obtained. However, frank details about the problem, can lead to the most effective treatment. In order to diagnose the cause, sexually intimate questions may involve your:
• religious upbringing
• early sexual experiences
• past and present sexual relationships
• when premature ejaculation started
• conflicts or concerns within your current relationship
• feelings of guilt, anxiety as related to performance
• use of medications
• illicit drug use
Complications
Premature ejaculation is not a life threatening disorder. However, the disorder can have severe repercussions in one‘s personal life and relationship. Sometimes, premature ejaculation can make conceiving difficult if one continues to spurt sperm on the bed or the floor instead of the vagina.
Premature Ejaculation” Prevalent but Poorly understood- Part 3
Signs and symptoms
There are no set guidelines to determine what early ejaculation is. The question remains: “Is the man having an orgasm at his regular time or is the female taking too long to have an orgasm”? The primary sign of the disorder is that ejaculation occurs before either the male or the female can reach orgasm, causing anxiety/distress in one or both the partners. Premature ejaculation is not always a problem associated with sexual intercourse, but may also occur during foreplay, masturbation and even simply fondling or cuddling and may not even involve a partner.
Causes
The majority of causes of premature ejaculation are thought to be psychological. Early sexual experiences, family upbringing, rigid family social life an upbringing where sex is always thought of as dirty, taboo or evil, leads to guilty feelings which eventually may express as premature ejaculation.
Premature ejaculation can be caused by temporary depression, financial stress, unrealistic performance anxiety, history of sexual repression and an overall lack of confidence. Conflicts in interpersonal relationship, emotional torment, unresolved conflicts and dynamics strongly contribute to sexual dysfunction such as premature ejaculation.
Others have claimed that perhaps the genitalia of some men are ultra sensitive to the touch of the female genitalia and perhaps there may be altered levels of hormones. No scientific data supports such theories. Finally, some individuals may be taking some certain medications (anti psychotics) which may cause premature ejaculation.
There are no set guidelines to determine what early ejaculation is. The question remains: “Is the man having an orgasm at his regular time or is the female taking too long to have an orgasm”? The primary sign of the disorder is that ejaculation occurs before either the male or the female can reach orgasm, causing anxiety/distress in one or both the partners. Premature ejaculation is not always a problem associated with sexual intercourse, but may also occur during foreplay, masturbation and even simply fondling or cuddling and may not even involve a partner.
Causes
The majority of causes of premature ejaculation are thought to be psychological. Early sexual experiences, family upbringing, rigid family social life an upbringing where sex is always thought of as dirty, taboo or evil, leads to guilty feelings which eventually may express as premature ejaculation.
Premature ejaculation can be caused by temporary depression, financial stress, unrealistic performance anxiety, history of sexual repression and an overall lack of confidence. Conflicts in interpersonal relationship, emotional torment, unresolved conflicts and dynamics strongly contribute to sexual dysfunction such as premature ejaculation.
Others have claimed that perhaps the genitalia of some men are ultra sensitive to the touch of the female genitalia and perhaps there may be altered levels of hormones. No scientific data supports such theories. Finally, some individuals may be taking some certain medications (anti psychotics) which may cause premature ejaculation.
Premature Ejaculation” Prevalent but Poorly understood- Part 2
The Pathology
The majority of men have experienced premature ejaculation at least once in their lives. Frequently, adolescent teenagers and young men experience "premature" ejaculation during their initial sexual encounters. The vast majority learn how to control the problem and a few start experimental home based therapies.
One episode of premature ejaculation is never a problem, however, if it occurs on a very regularly basis than one wishes (usually before intercourse or orgasm), then one has a disorder known as premature ejaculation. Premature ejaculation is the most common male sexual disorder. In the United States, premature ejaculation affects nearly 20% of males between the ages of 18-60. The major cause of premature ejaculation is believed to be psychological, but occasionally some organic causes are also responsible.
In a number of cases, premature ejaculation is secondary –mainly due to anxiety, mental stress, preoccupation with satisfying a female and fears about maintaining an erection during sex. Over the years numerous treatments have been postulated to help treat this condition. Some of these are outright based on quack medicine whereas others may help to some extent.
The majority of men have experienced premature ejaculation at least once in their lives. Frequently, adolescent teenagers and young men experience "premature" ejaculation during their initial sexual encounters. The vast majority learn how to control the problem and a few start experimental home based therapies.
One episode of premature ejaculation is never a problem, however, if it occurs on a very regularly basis than one wishes (usually before intercourse or orgasm), then one has a disorder known as premature ejaculation. Premature ejaculation is the most common male sexual disorder. In the United States, premature ejaculation affects nearly 20% of males between the ages of 18-60. The major cause of premature ejaculation is believed to be psychological, but occasionally some organic causes are also responsible.
In a number of cases, premature ejaculation is secondary –mainly due to anxiety, mental stress, preoccupation with satisfying a female and fears about maintaining an erection during sex. Over the years numerous treatments have been postulated to help treat this condition. Some of these are outright based on quack medicine whereas others may help to some extent.
Premature Ejaculation” Prevalent but Poorly understood- The facts
Premature ejaculation is a common disorder in men of all ages. Because the condition is often not reported, surveys of premature ejaculation reveal a low prevalence. Almost all males report of having had an episode(s) of premature ejaculation at some point in their lives. Generally, these premature ejaculation occur more often in the teens and early 20s and subside.
Unfortunately, for some men the problem is long lasting. The sensitive nature of the disorder means all data are underestimates as most men are unlikely to brag about this ailment.
Most data falsely indicate that the disorder is common only in Caucasians. However, because of cultural values, social taboos and lack of medical access, Blacks, Hispanics and Asians are underrepresented in most studies.
Anecdotal reports indicate that premature ejaculation is present in all cultures and communities. As men start to come out of their closets, it is becoming realized that premature ejaculation is much more common than previous estimates.
Unfortunately, for some men the problem is long lasting. The sensitive nature of the disorder means all data are underestimates as most men are unlikely to brag about this ailment.
Most data falsely indicate that the disorder is common only in Caucasians. However, because of cultural values, social taboos and lack of medical access, Blacks, Hispanics and Asians are underrepresented in most studies.
Anecdotal reports indicate that premature ejaculation is present in all cultures and communities. As men start to come out of their closets, it is becoming realized that premature ejaculation is much more common than previous estimates.
Monday, March 16, 2009
Legal implications of testes torsion
Legal implications
Law suits are quite common when it comes to the testes. No one is happy to lose their testes. Any evidence of a missed or delayed diagnosis is a sure bet that a law suit may result. There may be a risk of litigation even if the patient has delayed seeking medical attention. Any time there is a poor outcome, the probability of a lawsuit is real.
Summary
The most significant and feared complication of testicular torsion is loss of the testis, which may lead to permanent infertility. Common causes of testicular loss after torsion are a delay in seeking medical attention, incorrect initial diagnosis and delay in treatment of the condition.
Testicular torsion is one of the few emergencies in urologic practice. Any delay in the diagnosis by more than 4-8 hours severely reduces the chances of salvaging the testes. Some surgeons claim that there is a direct correlation between the duration of torsion and abnormal semen findings.
Some authorities even suggest that retention of an injured testis can induce pathologic changes to the contralateral testis. This creates a major dilemma when evaluating patients who present to the surgeon late. Removing one testis is fine; removing two testes is a nightmare-for both the surgeon and the patient.
Law suits are quite common when it comes to the testes. No one is happy to lose their testes. Any evidence of a missed or delayed diagnosis is a sure bet that a law suit may result. There may be a risk of litigation even if the patient has delayed seeking medical attention. Any time there is a poor outcome, the probability of a lawsuit is real.
Summary
The most significant and feared complication of testicular torsion is loss of the testis, which may lead to permanent infertility. Common causes of testicular loss after torsion are a delay in seeking medical attention, incorrect initial diagnosis and delay in treatment of the condition.
Testicular torsion is one of the few emergencies in urologic practice. Any delay in the diagnosis by more than 4-8 hours severely reduces the chances of salvaging the testes. Some surgeons claim that there is a direct correlation between the duration of torsion and abnormal semen findings.
Some authorities even suggest that retention of an injured testis can induce pathologic changes to the contralateral testis. This creates a major dilemma when evaluating patients who present to the surgeon late. Removing one testis is fine; removing two testes is a nightmare-for both the surgeon and the patient.
Treatment of Testicular Torsion
Treatment
The treatment of testicular torsion is surgery and thus as soon as the diagnosis is confirmed the patient must be referred to a urologist for prompt surgery. Time is of essence and viability of the testes is highly dependent on prompt detorsion.
Manual detorsion
Manual detorsion is sometimes used to treat testicular torsion. However, this must only be done by the surgeon. The patient usually requires some form of IV sedation and also injection of a local anesthetic in the scrotum near the spermatic cord. The physician will manipulate the testes and try to rotate the testes into its original position. This is easier said than done. Frequently there is more than 360 degree of torsion and it is impossible to know how many turns to make for detorsion. After every manual detorsion, return of blood flow must be documented by ultrasound. Even if the detorsion is successful, elective surgery must be done to permanently repair the defect so that torsion does not recur.
A number of times this manual detorsion attempt fail and frequently the situation worsens. Most urologists prefer to take the patient straight to the operating room instead of mucking around blindly with a serious condition. When successful, manual detorsion results in immediate relief of pain. Data from some series reveal a success rate of only 20% and in some cases there has been an 80% success rate (more based on luck than any technical skill).
The surgeon should never persist and be obsessive about manual detorsion. If it fails, the patient should be hurried to surgery. Only surgery can provide the definite treatment.
In addition, given the risks of a missed diagnosis, scrotal exploration may be needed if a definitive diagnosis cannot be made. If the testicle is not viable, it must be removed. In many cases, when torsion of the testes occurs on one side, it is very likely that the same anatomical defect occurs on the other side and thus, most urologists will also fix the other testes to prevent future torsion.
Postoperative surgery
In individuals who required complete removal of the testis because of non viability, a testicular prosthesis is available. This can be placed in the scrotum at around 3-6 months, once healing is complete.
The treatment of testicular torsion is surgery and thus as soon as the diagnosis is confirmed the patient must be referred to a urologist for prompt surgery. Time is of essence and viability of the testes is highly dependent on prompt detorsion.
Manual detorsion
Manual detorsion is sometimes used to treat testicular torsion. However, this must only be done by the surgeon. The patient usually requires some form of IV sedation and also injection of a local anesthetic in the scrotum near the spermatic cord. The physician will manipulate the testes and try to rotate the testes into its original position. This is easier said than done. Frequently there is more than 360 degree of torsion and it is impossible to know how many turns to make for detorsion. After every manual detorsion, return of blood flow must be documented by ultrasound. Even if the detorsion is successful, elective surgery must be done to permanently repair the defect so that torsion does not recur.
A number of times this manual detorsion attempt fail and frequently the situation worsens. Most urologists prefer to take the patient straight to the operating room instead of mucking around blindly with a serious condition. When successful, manual detorsion results in immediate relief of pain. Data from some series reveal a success rate of only 20% and in some cases there has been an 80% success rate (more based on luck than any technical skill).
The surgeon should never persist and be obsessive about manual detorsion. If it fails, the patient should be hurried to surgery. Only surgery can provide the definite treatment.
In addition, given the risks of a missed diagnosis, scrotal exploration may be needed if a definitive diagnosis cannot be made. If the testicle is not viable, it must be removed. In many cases, when torsion of the testes occurs on one side, it is very likely that the same anatomical defect occurs on the other side and thus, most urologists will also fix the other testes to prevent future torsion.
Postoperative surgery
In individuals who required complete removal of the testis because of non viability, a testicular prosthesis is available. This can be placed in the scrotum at around 3-6 months, once healing is complete.
Diagnosis of testicular torsion
Diagnostic tests
Despite all the physical signs and clinical acumen of the physician, most doctors order some type of radiological test to confirm the diagnosis of testicular torsion. Only in the rare exceptional cases, where the diagnosis is unequivocal is surgery done without further studies. In all cases where the diagnosis is in doubt, diagnostic testing is highly recommended.
The most commonly used radiological tests to asses the scrotum are Doppler ultrasonography, radionuclide imaging, and surgical exploration.
Ultrasound
Blood flow in the testes can easily be evaluated by ultrasound. In patients with testicular torsion, the blood flow in the affected testis is decreased or absent compared with the asymptomatic testis. In addition, the affected testicle appears to be enlarged. Initially, the testicle may also reveal increased echogenicity once the testes is twisted and starts to die.
Doppler ultrasonography also can differentiate between ischemia of the testes and inflammation of the epididymis. Ultrasound also can reveal the presence of other testicular disease (e.g., torsion, tumor, hydrocele, hematoma, and varicocele).
In some cases, the Doppler ultrasound can miss the diagnosis of testicular torsion, especially when the torsion is only partial. In addition, the technique can also show falsely suggest testicular torsion, when none is present. This is particularly so in younger teenagers and children with smaller prepubescent testicle. Doppler ultrasonography is not 100% sensitive for testicular torsion.
Radionuclide study
Radionuclide studies are 100% sensitive for the diagnosis of testicular torsion. Individuals with suspected torsion are injected with a small amount of a radioactive chemical which flows into the blood vessels. When the blood flow to the testes is obstructed, the radionuclide will not show up in the testes. In cases of inflammation or infection, there is more flow of the tracer to the testis.
Radionuclide study is the gold standard and 100% sensitive for the diagnosis of torsion. However, the test is not always readily available and does take a few hours to perform. In contrast, ultrasonography is faster and more readily available. This is important to know when dealing with testicular torsion- a condition that depends on rapid diagnosis for a positive outcome.
Despite all the physical signs and clinical acumen of the physician, most doctors order some type of radiological test to confirm the diagnosis of testicular torsion. Only in the rare exceptional cases, where the diagnosis is unequivocal is surgery done without further studies. In all cases where the diagnosis is in doubt, diagnostic testing is highly recommended.
The most commonly used radiological tests to asses the scrotum are Doppler ultrasonography, radionuclide imaging, and surgical exploration.
Ultrasound
Blood flow in the testes can easily be evaluated by ultrasound. In patients with testicular torsion, the blood flow in the affected testis is decreased or absent compared with the asymptomatic testis. In addition, the affected testicle appears to be enlarged. Initially, the testicle may also reveal increased echogenicity once the testes is twisted and starts to die.
Doppler ultrasonography also can differentiate between ischemia of the testes and inflammation of the epididymis. Ultrasound also can reveal the presence of other testicular disease (e.g., torsion, tumor, hydrocele, hematoma, and varicocele).
In some cases, the Doppler ultrasound can miss the diagnosis of testicular torsion, especially when the torsion is only partial. In addition, the technique can also show falsely suggest testicular torsion, when none is present. This is particularly so in younger teenagers and children with smaller prepubescent testicle. Doppler ultrasonography is not 100% sensitive for testicular torsion.
Radionuclide study
Radionuclide studies are 100% sensitive for the diagnosis of testicular torsion. Individuals with suspected torsion are injected with a small amount of a radioactive chemical which flows into the blood vessels. When the blood flow to the testes is obstructed, the radionuclide will not show up in the testes. In cases of inflammation or infection, there is more flow of the tracer to the testis.
Radionuclide study is the gold standard and 100% sensitive for the diagnosis of torsion. However, the test is not always readily available and does take a few hours to perform. In contrast, ultrasonography is faster and more readily available. This is important to know when dealing with testicular torsion- a condition that depends on rapid diagnosis for a positive outcome.
How does Testicular Torsion Present?
Signs and Symptoms
Symptoms of testicular torsion include:
- Blood in semen
- Pain in the groin and lower abdomen
- Hard testicle and redden testicle
- Swelling of the testicle
- Nausea and vomiting
- Sudden, severe testicular pain
Clinical Examination
When an individual presents with testicular torsion, pain is a common feature. The patient may not allow the examiner to touch the testes because of the pain. The spermatic cord is shortened because it is twisted and the testes may be higher compared to the unaffected testes. This finding of an elevated testes is quite specific and provides strong evidence for testicular torsion. The affected testes will also appear swollen and engorged.
Another important finding which may provide a clue to the diagnosis of testicular torsion is the absence of what is called the cremasteric reflex. This reflex is elicited by stroking or pinching the skin on the medial thigh, causing contraction of the cremasteric muscle, which elevates the testis. The cremasteric reflex is considered positive if the testicle moves at least 5 mm. This reflex is almost always present in healthy young males and the loss of the cremasteric reflex is at least 99% sensitive for testicular torsion.
Symptoms of testicular torsion include:
- Blood in semen
- Pain in the groin and lower abdomen
- Hard testicle and redden testicle
- Swelling of the testicle
- Nausea and vomiting
- Sudden, severe testicular pain
Clinical Examination
When an individual presents with testicular torsion, pain is a common feature. The patient may not allow the examiner to touch the testes because of the pain. The spermatic cord is shortened because it is twisted and the testes may be higher compared to the unaffected testes. This finding of an elevated testes is quite specific and provides strong evidence for testicular torsion. The affected testes will also appear swollen and engorged.
Another important finding which may provide a clue to the diagnosis of testicular torsion is the absence of what is called the cremasteric reflex. This reflex is elicited by stroking or pinching the skin on the medial thigh, causing contraction of the cremasteric muscle, which elevates the testis. The cremasteric reflex is considered positive if the testicle moves at least 5 mm. This reflex is almost always present in healthy young males and the loss of the cremasteric reflex is at least 99% sensitive for testicular torsion.
What happens during testicular torsion?
When torsion occurs the testes rotates along the spermatic cord. During the rotation, it obstructs the blood flow. The stoppage in blood flow results in ischemia and no oxygen supply to the testes. The degree of damage to the testes depends on the duration of the torsion and the degree of twisting of the spermatic cord. Changes are evident in the testes soon after torsion and are reversible up to 4 hours. However, after 24 hours of torsion, the testes is almost always non functional and salvage is impossible.
Differential Diagnosis
Testicular torsion is a surgical emergency and if there is going to be any hope of salvage; it must be rapidly diagnosed and treated. Any delay in the diagnosis almost always leads to loss in the testes. Over diagnosis of the condition leads to unnecessary surgery. Data from hospital records indicate that testicular pain is quite frequent in teenagers and young adults. At least 20-40% of young males complain of some type of testicular pain at some point.
- Conditions which can mimic testicular torsion include
- trauma to the scrotum
- epididymitis (infection of the spermatic cord)
- orchitis (infection of the testis)
- incarcerated hernia
- varicocele
- idiopathic scrotal edema
- torsion of the appendix testis
Whenever there is trauma to the groin area, there is a general tendency to always attribute the scrotal pain entirely to trauma and become oblivious to the presence of testicular torsion. However, if the pain lasts more than one hour after the trauma, the testicle should always be evaluated for possible trauma-induced torsion.
Differential Diagnosis
Testicular torsion is a surgical emergency and if there is going to be any hope of salvage; it must be rapidly diagnosed and treated. Any delay in the diagnosis almost always leads to loss in the testes. Over diagnosis of the condition leads to unnecessary surgery. Data from hospital records indicate that testicular pain is quite frequent in teenagers and young adults. At least 20-40% of young males complain of some type of testicular pain at some point.
- Conditions which can mimic testicular torsion include
- trauma to the scrotum
- epididymitis (infection of the spermatic cord)
- orchitis (infection of the testis)
- incarcerated hernia
- varicocele
- idiopathic scrotal edema
- torsion of the appendix testis
Whenever there is trauma to the groin area, there is a general tendency to always attribute the scrotal pain entirely to trauma and become oblivious to the presence of testicular torsion. However, if the pain lasts more than one hour after the trauma, the testicle should always be evaluated for possible trauma-induced torsion.
Twisting of the Testes- painful!
In the USA, the annual incidence of testicular torsion affects about one in 4,000 males younger than 25 years. In testicular torsion, the testes twist (rotate) around the spermatic cord. The spermatic cord is the life line of the testes and carries with it important blood vessels and duct that carries sperm.
When the testis twists around the spermatic cord, the blood supply to the testes is cut off. Within a few hours, the testes can be severely damaged and infertility is a common end result if there is any delay in treatment. Surgery is the mainstay of treatment.
Testicular torsion primarily affects teenagers and young adults in the 2nd decade of life, but it can also occur at any age. Males with one or both testicles which have not descended into scrotum (cryptorchidism) develop testicular torsion more often than the general population.
Torsion may occur spontaneously. In about 5-10% of males, it may result from direct trauma to the groin. Other factors that may increase the risk of torsion include an increase in testicular size (volume), presence of a testicular tumor, testis which lies along a horizontal plane, a history of failure of the testes to descend into the groin and a long spermatic cord. Torsion often occurs during sleep.
When the testis twists around the spermatic cord, the blood supply to the testes is cut off. Within a few hours, the testes can be severely damaged and infertility is a common end result if there is any delay in treatment. Surgery is the mainstay of treatment.
Testicular torsion primarily affects teenagers and young adults in the 2nd decade of life, but it can also occur at any age. Males with one or both testicles which have not descended into scrotum (cryptorchidism) develop testicular torsion more often than the general population.
Torsion may occur spontaneously. In about 5-10% of males, it may result from direct trauma to the groin. Other factors that may increase the risk of torsion include an increase in testicular size (volume), presence of a testicular tumor, testis which lies along a horizontal plane, a history of failure of the testes to descend into the groin and a long spermatic cord. Torsion often occurs during sleep.
Friday, March 13, 2009
Male Boobs: Embarrassing but harmless Part 6
Diagnosis
In the majority of cases, the diagnosis of gynecomastia is made by the physician by just simple observation and the presenting history. The breast is always palpated (felt with hands) to ensure there are no hard masses present. Infection of the male breast is almost unheard of, except in those males who pierce their nipples.
However, the physical examination should also be done to ensure that the scrotum does not have any abnormal mass that may be responsible for the gynecomastia. There are a few testicular cancers that can make female sex hormones and Gynecomastia may be initial presenting feature.
In some cases, there is no real breast tissue and the breast is infiltrated with a fatty tissue. In these cases a diagnosis of pseudo-gynecomastia is made. This is a common finding in obese individuals. Breast cancer in males does occur but is seen in the older males and typically presents as a hard mass in a single breast. Both breasts having a cancer is very unusual.
The majority of the younger individual do not require any tests, either radiological or blood tests.
Mammogram has no role in the evaluation of breast mass in males. Unless the male has undergone a sex change and undergone a size 44 C breast enlargement, it is impossible to place a male breast on a mammogram machine. A mammogram requires fairly decent sized breasts to be placed between two metal plates.
A chest x ray of an ultrasound of the scrotum may be obtained in the rare individual with Gynecomastia.
Biopsy of the breast is very unusual and is only done if there is a great suspicion of a breast cancer, or if the physician is clueless
In the majority of cases, the diagnosis of gynecomastia is made by the physician by just simple observation and the presenting history. The breast is always palpated (felt with hands) to ensure there are no hard masses present. Infection of the male breast is almost unheard of, except in those males who pierce their nipples.
However, the physical examination should also be done to ensure that the scrotum does not have any abnormal mass that may be responsible for the gynecomastia. There are a few testicular cancers that can make female sex hormones and Gynecomastia may be initial presenting feature.
In some cases, there is no real breast tissue and the breast is infiltrated with a fatty tissue. In these cases a diagnosis of pseudo-gynecomastia is made. This is a common finding in obese individuals. Breast cancer in males does occur but is seen in the older males and typically presents as a hard mass in a single breast. Both breasts having a cancer is very unusual.
The majority of the younger individual do not require any tests, either radiological or blood tests.
Mammogram has no role in the evaluation of breast mass in males. Unless the male has undergone a sex change and undergone a size 44 C breast enlargement, it is impossible to place a male breast on a mammogram machine. A mammogram requires fairly decent sized breasts to be placed between two metal plates.
A chest x ray of an ultrasound of the scrotum may be obtained in the rare individual with Gynecomastia.
Biopsy of the breast is very unusual and is only done if there is a great suspicion of a breast cancer, or if the physician is clueless
Male Boobs: Embarrassing but harmless Part 6
Complications
Gynecomastia has no medical or physiological consequences. The major problem is cosmetic and may create emotional stress due to embarrassment. Despite claims by some that gynecomastia is a risk factor for breast cancer, there is no scientific data to prove such a claim. In fact, if this was true, there would be thousands of cases of male breast cancer each year, and this is not true. Male breast cancer is a rare condition.
Could the breast lump be cancer?
When both breasts are enlarged in a young male, the chances of breast cancer are almost nil. Breast cancer does occur in males. When it does occur, it occurs in one breast and the cancer is seen in older males. In the majority of cases of gynecomastia, there is no cancer associated. However, any male over the age of 50 with a sudden increase in a single breast, should definitely be seen by a doctor for further work up.
Breast cancer in males presents just like in females. A mass is identified in a single breast but there is generally no pain or nipple discharge but the mass may be hard to touch. The only way to tell if it is a cancer, is by a biopsy.
Symptoms
The male individual generally present with an increase in breast tissue which he has identified himself. Most of the individuals present late to the doctor, mainly due to embarrassment. The diagnosis of gynecomastia is in most cases made on physical examination. The breasts are enlarged on both sides. In most cases, the breast enlargement is mild to modest. There is no “Pamela Anderson –like Breast growth”- in males the breast enlargement is more a source of embarrassment-unlike a female who tends to have a sex appeal and in fact is willing to show off her boobs.
In the majority of cases, the enlargement is bilateral and in about 10-20%, only one breast is enlarged. The breasts are soft and the nipples and the areola area also well developed. A few males, especially, the younger ones will also complain of nipple sensitiveness. There is no real pain but an odd ache is a typical complaint. The breast enlargement is symmetrical in most cases. Nipple discharge is almost never seen. There is nothing specific about the breast examination.
There are several classifications of gynecomastia based on either size or the tissue component found in the breast. In simple, if the breasts are large, surgery may require not only removal of the breast tissue but also the excess redundant skin left over.
Gynecomastia has no medical or physiological consequences. The major problem is cosmetic and may create emotional stress due to embarrassment. Despite claims by some that gynecomastia is a risk factor for breast cancer, there is no scientific data to prove such a claim. In fact, if this was true, there would be thousands of cases of male breast cancer each year, and this is not true. Male breast cancer is a rare condition.
Could the breast lump be cancer?
When both breasts are enlarged in a young male, the chances of breast cancer are almost nil. Breast cancer does occur in males. When it does occur, it occurs in one breast and the cancer is seen in older males. In the majority of cases of gynecomastia, there is no cancer associated. However, any male over the age of 50 with a sudden increase in a single breast, should definitely be seen by a doctor for further work up.
Breast cancer in males presents just like in females. A mass is identified in a single breast but there is generally no pain or nipple discharge but the mass may be hard to touch. The only way to tell if it is a cancer, is by a biopsy.
Symptoms
The male individual generally present with an increase in breast tissue which he has identified himself. Most of the individuals present late to the doctor, mainly due to embarrassment. The diagnosis of gynecomastia is in most cases made on physical examination. The breasts are enlarged on both sides. In most cases, the breast enlargement is mild to modest. There is no “Pamela Anderson –like Breast growth”- in males the breast enlargement is more a source of embarrassment-unlike a female who tends to have a sex appeal and in fact is willing to show off her boobs.
In the majority of cases, the enlargement is bilateral and in about 10-20%, only one breast is enlarged. The breasts are soft and the nipples and the areola area also well developed. A few males, especially, the younger ones will also complain of nipple sensitiveness. There is no real pain but an odd ache is a typical complaint. The breast enlargement is symmetrical in most cases. Nipple discharge is almost never seen. There is nothing specific about the breast examination.
There are several classifications of gynecomastia based on either size or the tissue component found in the breast. In simple, if the breasts are large, surgery may require not only removal of the breast tissue but also the excess redundant skin left over.
Male Boobs: Embarrassing but harmless Part 5
Medical conditions which have been associated with Gynecomastia include:
- In children the most common condition known to cause gynecomastia is
kleinfelter’s. This is a genetically acquired condition which is
diagnosed in early childhood. The breast enlargement unfortunately
is persistent and does not always resolve.
- Pituitary failure: In some cases, the pituitary gland may fail and
there is failure to make hormones. This leads to a lack of the male
hormones. The condition is rare but can be treated with hormonal
supplements
- Obesity. In obese individual there is a lot of excess fat. The excess
fat contains a lot of cholesterol which is a precursor chemical for
the female sex hormones- and it is for this reason that many obese
individuals develop female characteristics
- Some cancers are known to generate precursors for the synthesis of
the female sex hormones. These cancers are generally lung, testes and
adrenal.
- Liver and Kidney Failure- when the liver fails, there is an accumulation
of the female sex hormone. This is due to the liver’s inability to
breakdown this hormone. So the excess hormone is known to cause
Gynecomastia
- In some individuals, an excess of the thyroid hormone may be responsible
for the condition
- Starvation is a common cause of gynecomastia in children. This condition
is typically seen in Africa where poverty is endemic.
- In children the most common condition known to cause gynecomastia is
kleinfelter’s. This is a genetically acquired condition which is
diagnosed in early childhood. The breast enlargement unfortunately
is persistent and does not always resolve.
- Pituitary failure: In some cases, the pituitary gland may fail and
there is failure to make hormones. This leads to a lack of the male
hormones. The condition is rare but can be treated with hormonal
supplements
- Obesity. In obese individual there is a lot of excess fat. The excess
fat contains a lot of cholesterol which is a precursor chemical for
the female sex hormones- and it is for this reason that many obese
individuals develop female characteristics
- Some cancers are known to generate precursors for the synthesis of
the female sex hormones. These cancers are generally lung, testes and
adrenal.
- Liver and Kidney Failure- when the liver fails, there is an accumulation
of the female sex hormone. This is due to the liver’s inability to
breakdown this hormone. So the excess hormone is known to cause
Gynecomastia
- In some individuals, an excess of the thyroid hormone may be responsible
for the condition
- Starvation is a common cause of gynecomastia in children. This condition
is typically seen in Africa where poverty is endemic.
Male Boobs: Embarrassing but harmless Part 4
Medications causing gynecomastia
A number of medications have been associated with gynecomastia and include:
- There are some drugs used to treat prostate cancer and these are
anti androgenic medications. By blocking the male hormones, these
drugs stimulate the actions of female sex hormones. The most commonly
used anti androgenic medications are flutamide and Finasteride.
- There are some medications used to treat AIDS that can also cause
gynecomastia. These medications are efavirenz or didanosine.
Unfortunately, these medications are life saving and the individual
just can’t stop them. There are some alternative HIV medications
available which do not cause gynecomastia.
- Anti-anxiety medications such as diazepam (Valium) also been linked
to gynecomastia. However, this is not a reproducible finding in all
patients who take valium.
- Tricyclic antidepressants have also been associated with gynecomastia.
- The most common medication known to cause gynecomastia is cimetidine.
However, this is not seen in all patients. There are other anti ulcer
medications which have been reported to cause gynecomastia. However,
this is not a universal finding.
- Cancer drugs are also known to cause gynecomastia.
- Heart medications such as digitalis and spironolactone are also
known to cause gynecomastia.
Illicit drugs and alcohol
Illicit drug use and alcohol appears to be a common cause of gynecomastia among adolescents and older individuals. The majority of these individuals develop gynecomastia after prolonged use of these agents. Other illicit drugs that have also been known to cause this disorder are heroin and use of anabolic steroids.
Alcohol is postulated to cause gynecomastia after the liver is destroyed. A cirrhotic liver is no longer able to breakdown the normal circulating female sex hormone- and this eventually accumulates and causes gynecomastia. Steroids and other excess androgens are sometimes converted by the body into estrogens and consequently cause gynecomastia.
A number of medications have been associated with gynecomastia and include:
- There are some drugs used to treat prostate cancer and these are
anti androgenic medications. By blocking the male hormones, these
drugs stimulate the actions of female sex hormones. The most commonly
used anti androgenic medications are flutamide and Finasteride.
- There are some medications used to treat AIDS that can also cause
gynecomastia. These medications are efavirenz or didanosine.
Unfortunately, these medications are life saving and the individual
just can’t stop them. There are some alternative HIV medications
available which do not cause gynecomastia.
- Anti-anxiety medications such as diazepam (Valium) also been linked
to gynecomastia. However, this is not a reproducible finding in all
patients who take valium.
- Tricyclic antidepressants have also been associated with gynecomastia.
- The most common medication known to cause gynecomastia is cimetidine.
However, this is not seen in all patients. There are other anti ulcer
medications which have been reported to cause gynecomastia. However,
this is not a universal finding.
- Cancer drugs are also known to cause gynecomastia.
- Heart medications such as digitalis and spironolactone are also
known to cause gynecomastia.
Illicit drugs and alcohol
Illicit drug use and alcohol appears to be a common cause of gynecomastia among adolescents and older individuals. The majority of these individuals develop gynecomastia after prolonged use of these agents. Other illicit drugs that have also been known to cause this disorder are heroin and use of anabolic steroids.
Alcohol is postulated to cause gynecomastia after the liver is destroyed. A cirrhotic liver is no longer able to breakdown the normal circulating female sex hormone- and this eventually accumulates and causes gynecomastia. Steroids and other excess androgens are sometimes converted by the body into estrogens and consequently cause gynecomastia.
Male Boobs: Embarrassing but harmless Part 3
Causes of Gynecomastia
There are many causes of bilateral breast enlargement. In most cases it is due to an abnormal or altered ratio between the male and female sex hormones. In simple, any one of the following changes in sex hormones can cause Gynecomastia:
- Decrease in production of male sex hormone androgen
- Increase in estrogen formation
- Decrease in sensitivity of breast tissue to androgens
Gynecomastia in infants
More than 60% of infant males have Gynecomastia at birth. This physiological condition is due to the female sex hormone which has crossed from the placenta. The condition is short lived and almost all cases resolve within a few weeks.
Gynecomastia during puberty
Gynecomastia that occurs around the time of puberty is very common. The exact numbers are unknown as many young males are too shy to tell anyone about their condition. However, hospital data reveal that at least 40-60% of males may develop some form of Gynecomastia at around puberty. The cause of this gynecomastia is due an excess of sex hormones. The condition is also more common in tall or overweight males. The condition is completely benign and resolves in 2-3 years.
There are many causes of bilateral breast enlargement. In most cases it is due to an abnormal or altered ratio between the male and female sex hormones. In simple, any one of the following changes in sex hormones can cause Gynecomastia:
- Decrease in production of male sex hormone androgen
- Increase in estrogen formation
- Decrease in sensitivity of breast tissue to androgens
Gynecomastia in infants
More than 60% of infant males have Gynecomastia at birth. This physiological condition is due to the female sex hormone which has crossed from the placenta. The condition is short lived and almost all cases resolve within a few weeks.
Gynecomastia during puberty
Gynecomastia that occurs around the time of puberty is very common. The exact numbers are unknown as many young males are too shy to tell anyone about their condition. However, hospital data reveal that at least 40-60% of males may develop some form of Gynecomastia at around puberty. The cause of this gynecomastia is due an excess of sex hormones. The condition is also more common in tall or overweight males. The condition is completely benign and resolves in 2-3 years.
Male Boobs: Embarrassing but harmless Part 2
Frequency
Breast growth in males is more common than what one is led to believe. Many male children develop breast enlargement during puberty. From available data, this phenomenon is seen in about 35-60% of males and is considered physiological. The exact numbers remain unknown because not many males brag about the disorder. The condition is most commonly seen in males between the ages of 12-16.
The prevalence increases again in males in the 6-7th decade of life. The condition is typically identified by the individual himself. In the majority of cases, there is no milk production from the breast and unlike the female; breast enlargement in males is not deemed erotic or sexy.
Breast enlargement in the younger age group of males is almost always physiological and generally resolves with time. In males who are older, the cause may be linked to various factors (see below) and may not always resolve.
Pseudo-gynecomastia is a condition which looks very similar in size and shape to Gynecomastia. However, unlike glandular tissue which is found in Gynecomastia, only fat is found in pseudo-gynecomastia. The condition is more common in obese males.
Breast growth in males is more common than what one is led to believe. Many male children develop breast enlargement during puberty. From available data, this phenomenon is seen in about 35-60% of males and is considered physiological. The exact numbers remain unknown because not many males brag about the disorder. The condition is most commonly seen in males between the ages of 12-16.
The prevalence increases again in males in the 6-7th decade of life. The condition is typically identified by the individual himself. In the majority of cases, there is no milk production from the breast and unlike the female; breast enlargement in males is not deemed erotic or sexy.
Breast enlargement in the younger age group of males is almost always physiological and generally resolves with time. In males who are older, the cause may be linked to various factors (see below) and may not always resolve.
Pseudo-gynecomastia is a condition which looks very similar in size and shape to Gynecomastia. However, unlike glandular tissue which is found in Gynecomastia, only fat is found in pseudo-gynecomastia. The condition is more common in obese males.
Male Boobs: Embarrassing but harmless
Gynecomastia (male boobs) is defined as the growth of breast glandular tissue in males. The term gynecomastia is derived from the Greek terminology meaning female like breast. The disorder is completely benign and is frequently seen in prepubertal children and young teenagers. Another very similar condition to Gynecomastia is pseudo-gynecomastia- which looks and resembles Gynecomastia but the breast tissue is composed of fat only.
Gynecomastia is a disorder which occurs in both breasts, only rarely is it seen in only one breast. Unlike Pamela Anderson you will never grow 44 cup size breasts: the breast enlargement is more similar to breast growth seen in pubertal and young teenage females. In almost all cases, the breast growth is symmetrical and painless. The majority of the cases of breast enlargement subside on their own which may take about 1-2 years to completely disappear.
Gynecomastia by definition is enlargement of both breasts in a male. The condition is almost always bilateral but in some cases may be one sided. The condition most commonly is seen at puberty and in older age males. The majority of individuals have no symptoms, except for the obvious enlargement.
The condition is linked to an imbalance between the male and female sex hormones. In other cases, gynecomastia may be caused by certain medications, alcohol, marijuana and liver failure. Surgery is only done for cosmetic reasons and only after some time period has elapsed since the condition started.
Gynecomastia is a disorder which occurs in both breasts, only rarely is it seen in only one breast. Unlike Pamela Anderson you will never grow 44 cup size breasts: the breast enlargement is more similar to breast growth seen in pubertal and young teenage females. In almost all cases, the breast growth is symmetrical and painless. The majority of the cases of breast enlargement subside on their own which may take about 1-2 years to completely disappear.
Gynecomastia by definition is enlargement of both breasts in a male. The condition is almost always bilateral but in some cases may be one sided. The condition most commonly is seen at puberty and in older age males. The majority of individuals have no symptoms, except for the obvious enlargement.
The condition is linked to an imbalance between the male and female sex hormones. In other cases, gynecomastia may be caused by certain medications, alcohol, marijuana and liver failure. Surgery is only done for cosmetic reasons and only after some time period has elapsed since the condition started.
Acne Part 12
Patient Education
To avoid the disfiguring effects of acne, it is essential to educate the patient about acne. Patients need to know the facts and dispel the myths about the disorder. The acne is not related to hygiene and extensive scrubbing and use of strong alcohol based acids only worsen the disorder.
Patients should know that simple washing with warm water and soap is sufficient. Individuals with acne have to know that acne is not caused by stress but in fact acne can worsen the stress. The role of cosmetic products in the etiology of acne is overstated. Cosmetics do not cause acne but may worsen the redness and skin irritation. Oil based cosmetics generally worsen the acne.
Prognosis
Most teenagers and young adults with acne grow out of this stage by the mid to late 20s. The best treatment for acne is the combination of drugs in which a retinoid is a part of the treatment regimen.
Depending on the physician and his/her experience, the combination therapy may be variable. One needs to go to a dermatologist who has experience in treating acne. All patients with acne should be given realistic expectations about their treatment plan, along with good follow-up. These measures can contribute to the ultimate success of treatment.
The majority of individuals who get treated early for acne have excellent results. For those who have delayed their treatment, some scarring and facial disfiguring may be evident. In such cases, a visit to a cosmetic or plastic surgeon may be necessary. Today, advances in lasers can help smooth the skin and remove the facial scars. Before going to any plastic surgeon for scar removal, be informed about the various skin peeling procedures. They are not only expensive and the results are not always guaranteed.
To avoid the disfiguring effects of acne, it is essential to educate the patient about acne. Patients need to know the facts and dispel the myths about the disorder. The acne is not related to hygiene and extensive scrubbing and use of strong alcohol based acids only worsen the disorder.
Patients should know that simple washing with warm water and soap is sufficient. Individuals with acne have to know that acne is not caused by stress but in fact acne can worsen the stress. The role of cosmetic products in the etiology of acne is overstated. Cosmetics do not cause acne but may worsen the redness and skin irritation. Oil based cosmetics generally worsen the acne.
Prognosis
Most teenagers and young adults with acne grow out of this stage by the mid to late 20s. The best treatment for acne is the combination of drugs in which a retinoid is a part of the treatment regimen.
Depending on the physician and his/her experience, the combination therapy may be variable. One needs to go to a dermatologist who has experience in treating acne. All patients with acne should be given realistic expectations about their treatment plan, along with good follow-up. These measures can contribute to the ultimate success of treatment.
The majority of individuals who get treated early for acne have excellent results. For those who have delayed their treatment, some scarring and facial disfiguring may be evident. In such cases, a visit to a cosmetic or plastic surgeon may be necessary. Today, advances in lasers can help smooth the skin and remove the facial scars. Before going to any plastic surgeon for scar removal, be informed about the various skin peeling procedures. They are not only expensive and the results are not always guaranteed.
Acne Part 11
Miscellaneous medications
With a large lucrative market and millions of individuals seeking to look younger and more beautiful, there are daily reports of newer products, herbs, spices, mineral and nutrients claiming to cure acne. The majority of these substances are worthless.
A few chemicals that may have the potential to treat acne include zinc and use of lasers. However, there are no scientific data to back the claims made by these individuals who sell or offer these products.
Surgery
Surgery for acne is a last resort treatment. When all therapies have failed and the comedomes are large, surgery may be of some benefit. The surgery is a very minor procedure and involves extraction of the blackheads with a special instrument (comedo extractor). In rare cases, corticosteroids may be injected into the lesion to help reduce the redness and soften up the comedone. Steroids may also help to reduce the scarring.
Surgery may cause skin scarring and dermabrasion may be required in future. Be careful about whom you choose as your surgeon. Results after acne treatment are not always great and in cosmetic surgery, there are no refunds.
With a large lucrative market and millions of individuals seeking to look younger and more beautiful, there are daily reports of newer products, herbs, spices, mineral and nutrients claiming to cure acne. The majority of these substances are worthless.
A few chemicals that may have the potential to treat acne include zinc and use of lasers. However, there are no scientific data to back the claims made by these individuals who sell or offer these products.
Surgery
Surgery for acne is a last resort treatment. When all therapies have failed and the comedomes are large, surgery may be of some benefit. The surgery is a very minor procedure and involves extraction of the blackheads with a special instrument (comedo extractor). In rare cases, corticosteroids may be injected into the lesion to help reduce the redness and soften up the comedone. Steroids may also help to reduce the scarring.
Surgery may cause skin scarring and dermabrasion may be required in future. Be careful about whom you choose as your surgeon. Results after acne treatment are not always great and in cosmetic surgery, there are no refunds.
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