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.

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?

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.

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.

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.

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.

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- 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.

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.

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.

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.

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.

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.