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Developments in the cosmetic surgery market: How is the Indian industry keeping pace?

Cosmetic surgery has gained popularity over the years. Today, getting under the knife is not limited to the elite class but the middle class as well is taking the advantage. The latest developments in the Indian cosmetic surgery market vis-à-vis the world are discussed here. 

In India, cosmetic surgery is one of the fastest growing segments among all specialities and over the past 2-3 years there has been tremendous increase in the number of cosmetic surgeries being performed. Today, India has reached the fourth position in the world in terms of number of procedures being conducted in a year. 

According to a global survey conducted by the International Society of Aesthetic Plastic Surgery, India was ranked fourth in the list of top five countries in the world for the number of people going for surgical and non-surgical procedures to enhance their features. The survey included the top 25 countries representing 75 per cent of all procedures performed by board certified plastic surgeons in 2009. Also, continent wise Asia leads with 5,704,277 procedures overall followed by North America at 4,155,955 and Europe at 3,538,319.

Overall the percentage of procedures done in India in 2012 was 1.14 million, which amounted to 6.2 per cent of the world’s cosmetic surgeries. It is a big jump for India who was not even in top 20, 10 years ago. “Due to the availability of information and growing exposure the cosmetic sector has been growing well inspite of being one of the newest branches inIndia. The exposure that India has received due to Internet as well as other forms of media has changed their dressing sense as well as outlook to matters like cosmetic surgery. a procedure that was once looked down upon, has today turned into a huge industry in itself,” expresses Dr Krishan Mohan Kapoor, Director, Anticlock, Age Reversal Clinic and Medispa.

 Factors behind growth

According to the Indian Cosmetic Sector Analysis 2009-2012 report, the cosmetic surgery market in India is anticipated to witness remarkable growth in the coming years. various factors such as increasing consumer awareness, direct marketing and advertising campaigns and technological advances in surgical and non-surgical procedures will lead to a high growth in the cosmetic surgery market inIndia. Owing to growing disposable income of the middle class households and changing lifestyle, it is expected that the Indian cosmetics surgery market will grow at a CAGR of around 31 per cent during 2010-2013. The research also indicates that there will be a gradual shift in people’s choice from getting a more beautiful look to remain young for longer period with the help of cosmetic surgeries and procedures. As a result, anti-ageing surgeries and cosmetic procedures are likely to become more popular in India.

Today, one of the major factors behind the rapid growth of India has been the fact that the concept of beauty and fashion has been gaining ground with beauty pageants and has today gone beyond the elite. “Today, the Internet plays a huge part in increasing awareness as earlier people were not aware of the fashion trends around the world. The ones who were aware and were inclined towards undergoing a cosmetic procedure themselves were under the impression that cosmetic procedures were being conducted only in the the US orUKand not inIndia. It is only after 2002 when Internet became accessible to the middle class that people learnt about the various cosmetic procedures that are available inIndia,” informs Dr Kapoor.

The social acceptability to cosmetic procedures has also been an important change, which has added on to the increase of cosmetic surgery inIndia. Another aspect that has helped increase the cosmetic surgery industry is the fashion trends; earlier most of the people used to wear Indian traditional clothes like saris and suits, which would hide one’s body. however, over the past 4-5 years, the influence of the western countries has increased on the Indian population and people have started wearing western clothes like skirts, jeans etc, which exposes one’s body. Hence, consciousness towards one’s body has increased, which in turn has given rise to a number of cosmetic procedures being performed inIndia.

Today, the medical facility in India is at power with most of the developed countries. India has the necessary technology as well as equipment to provide the best to their patients. “Today, India has majored in invasive, non-invasive as well as procedural developments such as botox, fillers, face lifts, liposuction, and more, and hence the Indian industry has outdone itself from the past,” says Dr Madhu Kumar, Consultant – Cosmetic Plastic Surgeon, Fortis Hospital, Bengaluru. Adding to this Dr Kapoor says, “One factor which has been troubling developed countries is the cost of hospital beds. For instance, in the US and UK the patient is discharged on the same day of the operation/procedure as the cost of a hospital for a night would cost $1000- 1500, whereas in India the average cost is Rs 5000-6000 is a private room. Hence, the risk factor associated with early discharge is taken care of. once the patient is under hospital supervision and care, recovery would be better than what one gets at home.”  Also, as the cost of cosmetic procedures has come down, a number of people want to come to India for cosmetic procedures as the cost of surgery and medical care is cheaper but with high quality – and this is the key factor behind the escalating success ofIndiain the domain of cosmetic surgery.

 India vis-a-vis other nations

As per the survey conducted by the International Society of Aesthetic Plastic Surgery, India was ranked as four in the list of top five countries in the world. The countries that have out done India are US, Brazil and China.

According to the survey, US accounts for almost 18 per cent of the world’s total cosmetic procedures. The reason behind the success of US is high technology and innovation and most importantly the fact that they have been leaders in cosmetic surgery. Innovation has been another plus point for the US over the years, as they spend a huge amount of capital in R&D and they are always a step ahead. Brazil on the other hand stands in the second position as it is a country known for the physical beauty of its people: both men and women.  Surprisingly, the per capita spent on plastic surgery in Brazil is one of the highest in the world. “It is said that in Brazil every women undergoes at least one cosmetic procedure in her life. Hence, 13.6 per cent of world cosmetic procedures are performed in Brazil,” says Dr Kapoor. China on the other hand is relatively new to the cosmetic surgery industry and is marginally ahead of India. India holds its position at number four and performs 6.4 per cent of the world’s total cosmetic procedures. The reason India has outdone itself is due to the increased medical tourism, availability of state-of-the-art technology but at reasonable costs.

 “Today, India is inching ahead, but still has a long way to go. For instance, in India only 1.1 million procedures are conducted, whereas the population is 1.2 billion, so only 1 in 1,000 undergoes a cosmetic procedure, which is a low number. This industry can grow tremendously and has a lot of potential. even if it could reach one per cent in the coming five years the market size would increase by 10 times the current size, which would be great for the Indian market. Hence,India should bank on its strengths and ensure that it makes the most of what is available,” informs Dr Kumar.

 (jasleen.batra@infomedia18.in)

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Developments in the cosmetic surgery market: How is the Indian industry keeping pace?

Plastic Surgery – A Brief Historical View

Since the dawn of time, mankind has constantly striven to find new and more efficient paths with which to improve themselves. because humans, by nature have always sought fulfillment through self-improvement, plastic surgery just may be one of the world oldest arts.

In fact, evidence of these practices for use in treating facial injuries dates back more than 4,000 years ago. Physicians in India have been experimenting with skin grafts relating to reconstructive work as early as 800 B.C.

Like most medicine, the practice of plastic surgery moved forward at a dismal pace, fighting advancement for hundreds of years. it wasn’t until the 19th and 20th centuries that the ideas and techniques that we know today really began to take shape in both the United States and Europe.

The first American physician to make his mark was Dr. John Peter Mettauer, who performed the first cleft palate operation with tools and instruments he designed himself. Though successful, many Americans found the methods used during the early days despicable, and thus the practice was often deemed improper in western society.

In fact, it was war which played a huge role in pushing the evolution of cosmetic surgery forward. World War I presented surgeons with a multitude of facial wounds and burns, creating a large demand for new techniques and procedures almost overnight. some of the world’s greatest medical talent immersed themselves in exploring new techniques and ideas as a way to treat men who had been injured in the war. it was during this time that developments in many aesthetic surgical procedures also began to take shape.

Despite the modern day definition, the word plastic is actually derived from the ancient Greek word, plastikos, meaning to give form or mold. in this context, it’s easy to see why the techniques and treatments were placed in such a category.

As time moved forward, so did cosmetic surgery. new treatments and techniques have steadily evolved to the point where many times, it’s hard to tell if someone has actually undergone treatment at all.

In recent years, physicians have been able to get Congress to support mandatory insurance coverage for breast reconstruction patients. they are also currently working to ensure that treatments related to children’s deformities will also be covered.

While new advancements continue to unfold each day, it’s safe to say that as an industry, plastic surgery is certain to maintain its place among popular culture.

Plastic Surgery – A Brief Historical View

Virtual Plastic Surgery – How Much Is Plastic Surgery?

While the development of state of the art cosmetic surgery keeps arising recently, virtual plastic surgery is among the best programs that a lot of plastic surgeons employed to discuss with their clients. Plastic surgery is considered as one amongst the popular medical operations in the US and in around Europe. Lots of people are taking pleasure in the primary advantages of cosmetic plastic surgery as they can choose to change their appearance on how their nose will look like, just how sexy they want their breast are, or perhaps precisely how flat their tummies are particularly for those that suffer from severe belly fats.

Right here, within this post we will talk over about how much is a plastic surgery, whilst we will add some helpful information from its benefits, and some shopping considerations when selecting for the right plastic surgeon good enough to undertake from any types of virtual cosmetic surgery.

Precisely what is a virtual plastic surgery?

It is a kind of software that assists plastic surgeon about how to discussed future results of a particular cosmetic operation that a patient wants to undergo with. This VPS program is easily used by uploading recent photo of the patient and focus with the specific parts of the body where the patient needs cosmetic surgery operation. When a patient requires a nose job operation, a virtual nose job allows the patient to overlook on how his or her nose will appear like right after his or her preferred cosmetic operation is made.

VPS software will surely do an overall virtual makeover plastic surgery wherein every concern from the patient will certainly be accommodated regardless if they want to undergo a tummy tuck procedure, breast augmentation, or nose lift surgery; this computer software can definitely and easily shows potential results on how the patient will look like just after his or her preferred plastic surgery procedure.

Nearly all professional plastic surgeon is utilizing expensive and high quality VPS software, while the Internet could now possibly give free downloads of this virtual software for plastic surgery. just take into account that the quality of your physician’s preferred VPS will generally show better and accurate outcome on how your particular body part will appear like immediately after the cosmetic operation.

But, just how much does a plastic surgery cost?

In reality, expenses for plastic surgery will differ from one patient to another. as each patient does have different concerns pertaining with their physical appearance – plastic surgeon will also differ their surgery calculation based on how tough a particular cosmetic operation may be. Popularity of your preferred surgeon will matter as well. If you prefer to go through plastic surgery from a highly respected plastic surgery clinic or a dependable plastic surgeon – expect that your total budget will mostly be expensive.

And given that plastic surgery is a critical type of cosmetic operation, it is extremely vital that you prefer a trusted plastic surgeon that utilizes revolutionary equipment from virtual plastic surgery software up to his whole equipment to cover operation whether you opt to undergo high quality liposuction procedure, breast lift or maybe prefer a breast augmentation, chin reduction, tummy tuck, and many others.

Each cosmetic surgery operation is made with particular price rates. Meaning, if you prefer to lessen your breast and undergo a facelift operation – assume that price rate allow you to have two different rates from one plastic surgery operation to another. that is why it is also essential that you ask for a possible quotation first to assure that you have the prepared amount specified by your preferred plastic surgeon.

You can find out more about this and other topics by browsing more pieces by us: virtual plastic surgery

Virtual Plastic Surgery – How Much Is Plastic Surgery?

Heart Surgery Costs – Why You Should Consider India

Any surgery where the chest is opened and surgery is performed on the heart directly is called open-heart surgery and is an operation that understandably worries most patients.

Getting the best Care

It is a traumatic operation and most patients want the best possible treatments they can get above all else.

You can however get heart surgery at an affordable cost as well as enjoying some of the best cardiac care in the world.

Open-heart surgery costs in India are low compared to the west. in fact, in many instances they are only a tenth of the cost for the same treatments at comparable hospitals in Europe and the USA.

Heart surgery can cost as much as 30,000 in the UK and up to $60,000 in the USA, depending on the nature of the operation. in India’s best hospitals however, it could cost between $3,000 and $10,000 for the same surgery.

While cost is a consideration; it is the quality of heart surgery that is the most important factor for most patients.

The success rates in India’s top hospitals for heart surgery are an average of 98.50% – which is on par with the leading cardiac centers of the world.

India – A World Leader for Quality and Cost

As the quality of care and cost is so competitive, more and more people from around the world are choosing India for their heart surgery and a wide variety of other medical treatments.
Below are a few examples of how India is becoming a world leader in heart surgery and cardiac care:

Analysts say that as many as 200,000 medical tourists went to India last year. Some industry analysts actually believe the number is far higher, as 70,000 people came for medical treatment from the Middle East alone.

A study in 2004 by the Confederation of Indian Industry, or CII, and international management consultancy McKinsey & Co. concluded medical tourism could earn India $2 billion a year by 2012.

The Indian government predicts that India’s $17 billion a year health-care industry could grow 13% in each of the next six years, boosted by medical tourism, which industry analysts conclude is growing at 30% annually.

Britain’s National Health Service has large waiting lists of people who need medical procedures. They have been considering increasing the support staff from India, and many industry watchers believe that this will translate into a growing multi-billion pound industry.

Private Medical Treatment in India

India’s medical schools produces a large number of skilled professionals.
There are more than 35,000 specialist doctors of Indian origin in the USA alone, and the UK has a large number of Indian medical staff.

Private Indian hospitals are now at the same technological level as hospitals in Europe and America.

More Indian doctors than ever, who are practicing abroad, are now returning home to cater for the demand.

The combination of the best cardiac care in the world, with the best medical professionals, is an obvious comfort for patients who need such a serious operation as heart surgery.

The savings made on heart surgery costs in India will allow you to take a free holiday to rest and recuperate, in one of the most diverse and beautiful countries on earth.

With a wide variety of wildlife and stunning scenery, India offers the perfect country to recuperate in, after the operation is completed.

Heart Surgery Costs – Why You Should Consider India

Dr. Cortés Interviewed by Revista Hispana

One of the biggest news in the plastic surgery community in the past months has been the association of silicone breast implants with a rare form of cancer in France. the company named Poly Implant Prothesis manufactures the PIP implants. These implants were filled with industrial grade silicone instead of medical grade silicone among other additives that are routinely use to make mattresses.

This composition has resulted in a higher rate of rupture implants as well as inflammatory breast reaction once the implant rupture. Now, different European institutions are currently evaluating the association with breast cancer and their results will be most likely published this year.

Although the association of breast cancer might be dismissed in the future, this situation has brought many questions related to the regulatory system in Europe and South America. this scandal exposes Europe’s weak regulation system – one that allowed PIP to operate for longer than it could have under a more rigorous regimen. Many patients seek to have a plastic surgery in other countries for various reasons. this can expose the patient to devices and products that have not had a strict regulatory regimen to make sure that these are safe to use. for example, the French medical device regulatory authority (AFSSAPS) released the results of their testing on September 29, 2010 and have confirmed there was a higher rate of rupture in PIP breast implants. Now, this was a year or more before the news became public. in their report, AFSSAPS has confirmed that the gel within the PIP implants is not the same as it is described in the manufacturer’s design guide. it was also determined that the gel does not reach the level of quality required before a silicone gel can be used in breast implants and that the gel can lead to inflammatory reactions in some women because of the irritant character of this gel secondary to additives that should have not been used.

Now, these silicone implants are very different from the FDA approved implants in the USA.

Dr. Cortés recently was interviewed by Revista Hispana and was able to discuss the current news related to the PIP implants. You can read about this interview in the following link: http://issuu.com/revistahispana/docs/revistahispana-febrero2012/1

Dr. Cortés Interviewed by Revista Hispana

Switzerland Hikes: Hiking Tours in Switzerland

Switzerland remains a popular destination for mountain enthusiasts the world over, and enjoy hiking around Switzerland

Tourism really started in Switzerland in the early 1800′s when the British were first drawn there to understand more about and climb the high peaks of the Alps. at the end of the 1800s as traveler mark Twain wrote, “There are two how to travel through Switzerland. the first best is afoot.”

Switzerland remains a popular destination for mountain enthusiasts the world over, and it’s no surprise. A majority of the Alp’s peaks over 4,000 rest within her borders and nearly half of Europe’s glaciers blanket her massifs. tiny wood chalet dot the countryside, bell-clad cows graze in peaceful mountain meadows, waterfalls trace their way down glacial valley walls, and stately mountain peaks keep keep an eye on this orderly country that runs like the clocks it’s famous for.

The total distance of hiking trails that have been marked in Switzerland is about 50,000 Km or 30,000 miles. the three various kinds of hiking trails are:

Wanderwege

These routes are marked with yellow signs and they’re meant for everyone. Even though you have no prior connection with walking or climbing these gentle paths shouldn’t pose an issue to a person in normal health having a zest for adventure and comfortable set of walking shoes.

Bergwege

These routes marked with red and white signs, are mountain tracks contributing to higher altitudes. Intended for climbers with some experience these routes will prove tough for any beginner.

Alpine Routen

These Alpine routes aim at experienced climbers who travel with local guides. Marked with blue and white signs, the Alpine routes are thin air paths, that have ropes, pitons and cables fixed at difficult sections to assist climbers.You can also enjoy traveling the cities of Switzerland. Hiking around the historical sites, medieval churches and castles and countryside near major towns are well-liked by tourists who would like to stay near the cities.

Best Regions for Hiking Tours in SwitzerlandBernese Oberland

The best region for hiking in Switzerland is certainly the Bernese Oberland. This scenic region abounds in the hills, lakes, glaciers, forested slopes and incredible scenic beauty with the towering Alps along the horizon. the Jungfrau region around Interlaken, the Stockhorn Nature Path and the Alpine Botanical trail are a few of the popular trails here. the cable cars, caogwheel trains and funicular railways offer picturesque methods for reaching the summits of peaks and viewpoints in this region, where you can enjoy a pleasing hike downhill.

Appenzell

The Alpenzell region is a beautiful area for any gentle hike over rolling meadows and nature trails which extend for 1200 Km or 750 miles. the greenery and scenic beauty need to be seen to become truly appreciated. Attractions of the region include miniature cattle – tiny cows that appear to be like toy version of the larger bovine relatives.

Eastern Switzerland

The prefect spot to visit in Switzerland if walking is the passion, the picturesque valleys and gentle hills of Eastern Switzerland create a pleasant spot for a walking tour in Switzerland. the mountain goats and miniature cows create a pleasant diversion when you are walking along beside their lush fields.

St. Gallen

Noted for its picturesque nature trails, St Galen has paved pathways that meander through the beautiful countryside where dairy farms, herds of cows and flower-filled meadows enchant the eye while you step out on the walking tour of Switzerland .other regions in Switzerland recognized for their scenic hiking trials are Ticino, south of the Alps and the Uetliberg, a mountain near Zurich where hiking trails offer spectacular views of the countryside. enjoy walking through Switzerland on Walking Tours with Switzerland Flexi Tours.

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Switzerland Hikes: Hiking Tours in Switzerland

Victims just like Hitler Youth, says mass killer

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OSLO: the teenagers he killed were not innocent non-political children but people guilty of upholding multicultural positions, the mass killer Anders Behring Breivik told a court yesterday.

He said the youth wing of the Norwegian Labour Party that he attacked was akin to the Hitler Youth movement, indoctrinating young people into hatred of Norway’s cultural heritage.

”I have carried out the most sophisticated and spectacular political attack committed in Europe since the second World War,” he bragged.

Breivik is being tried on terrorism charges after killing 77 people last July in a bomb attack and a shooting massacre in what he claims was a defence of Norway and Europe against the spread of Islam.

Maintaining he acted out of “goodness, not evil” to prevent a wider civil war, Breivik vowed, “I would have done it again.”

He said his actions were based on good, not evil: ”People who have called me vicious have missed the difference between brutality and evil.”

He could no more be called evil than US commanders in World War II who dropped the atomic bomb to save lives, killing 300,000 people but with noble motives, he said.

If conservatives such as himself could change policies to prevent immigration ”by executing 70 people, that will contribute to upholding our values and culture and will help prevent civil war in Norway in the future and prevent further people from dying”.

Breivik said he had been demonised in the media as possessing a low IQ, being a loser, having a longing for his father and an incestuous relationship with his mother because ”cultural Marxists” feared his views.

He said the European leaders Nicolas Sarkozy, Angela Merkel and David Cameron had all admitted that multiculturalism in Europe had failed and that mass immigration had led to economic loss and social problems.

Breivik likened the ”cultural deconstruction” of the Norwegian people to ”ethnic cleansing”.

He compared himself to the Native American chief Sitting Bull, saying that he and others like him had fought off foreign invaders and tried to preserve the culture of their peoples: ”were they terrorists or were they heroes? … Militant nationalists are characterised as terrorists because they are fighting for the same ideals.” MORE  thank you Brian

OSLO (Reuters) – Norwegian anti-Islamic fanatic Anders Behring Breivik told a court on Thursday that he used computer games to prepare for his attacks, once spending an entire year isolated from society playing a game for hours on end.

Breivik, on trial for massacring 77 people last July, said he spent “lots of time” playing Modern Warfare, a first-person shooting game, and also took an entire year off to play World of Warcraft, a multi-player role-playing game with more than 10 million subscribers.

“I don’t really like those games but it is good if you want to simulate for training purposes,” Breivik said as he discussed Modern Warfare, smiling when asked about the aiming system.

Breivik killed eight people with a car bomb in Oslo on July 22 and then killed 69, mostly teenagers, at a Labour Party summer youth camp on Utoeya island, in a gun massacre.

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Victims just like Hitler Youth, says mass killer

Impatience to Get Thin Sends Some to Canada

Jeffrey Sauger for The new York TimesTammy Kwarciak, center, a nurse from Michigan., traveled to Canada for the intragastric-balloon procedure, which is not approved for use in the United States.

Tammy Kwarciak, a 44-year-old nurse whose weight had been creeping up for years, was determined to lose 50 pounds. so in February, she drove from her home in Port Huron, Mich., across the border into Canada and had a small balloonlike device inserted into her stomach.

The intragastric balloon, filled with liquid and left in the stomach for up to six months, is not approved for use in the United States, though it’s available in Europe, South America and other parts of the world. Clinical trials required to win federal Food and Drug Administration approval are being initiated, but many Americans aren’t waiting.

Since the balloon’s introduction in Canada in 2006, people like mrs. Kwarciak have been streaming north in growing numbers. Drawn by the relative ease of balloon placement, Americans account for nearly a third of patients undergoing the procedures in Canadian clinics just over the border.

“The nice thing about the balloon is that you have such a sense of satiety,” said mrs. Kwarciak, who has lost 25 pounds since she had the procedure. “I feel full all the time. I have to remind myself at times to eat.”

But the balloon is a temporary measure, and once it is removed in a few months, she said, “I’m on my own.”

The intragastric balloon appeals to people like mrs. Kwarciak who have a significant amount of weight to lose but are not heavy enough to qualify for bariatric surgery like gastric bypass surgery and adjustable gastric band surgery. The patient is anesthetized, and the balloon is inserted through the esophagus — a relatively noninvasive procedure. it is removed after six months or so.

The balloon may also be an option for extremely obese people who need to lose enough weight to be considered for more invasive procedures.

But just because the placement doesn’t involve surgery doesn’t mean it’s risk-free. Patients can suffer severe nausea and vomiting during the first few days or week after placement. On rare occasions, it can deflate and obstruct the intestines, or it can perforate the abdomen, which can be life-threatening.

Perhaps as significant, the weight loss that patients can expect is modest at best.

“That’s the most common complication — not losing as much weight as the patient would like,” said Dr. Sanjeev Kaila, the plastic surgeon who pioneered the intragastric balloon program in Canada. some return for a second balloon after taking a short break, he added.

Though mrs. Kwarciak said she lost 25 pounds in the first two months, studies say most patients experience the bulk of their weight loss during the first three to four months after the balloon’s insertion.

Studies of the balloon have reported weight loss ranging from 13 to 34 pounds on average, with some individuals losing up to 50 pounds. Patients often gain weight again after the device is removed, though long-term studies are limited.

But a scathing review by The Cochrane Collaboration in 2007 noted the possibility of serious complications and concluded that “compared with conventional management, intragastric balloon did not show convincing evidence of greater weight loss.” Another review suggested the device was a waste of money, saying that its use “only to reduce weight has no medical and economic justification.”

The combination of potential risks and little benefit is the main reason there is no intragastric balloon on the market in the United States. An earlier version called the Garren-Edwards Gastric Bubble was approved in 1985. but officials at the Food and Drug Administration soon became concerned about the severe and frequent complications associated with the device, an agency spokeswoman said.

By 1988, the manufacturer, American Edwards Laboratories, stopped selling it, voluntarily withdrawing the balloon from the market entirely in 1992. In the interim, randomized clinical trials comparing the bubble with a sham or placebo device found that diet and exercise were equally effective for weight loss.

Getting the new intragastric balloon is not cheap: In Canada, an outpatient procedure that takes less than an hour costs $8,000. The fee includes removal of the device after six months, as well as physician follow-up and support services from a nutritionist and dietitian, usually provided over the phone and online.

F.D.a. officials would not comment on the current balloons, which are made of new, sophisticated materials, but said generally that the agency “reviews medical devices to assure American patients that they are safe and effective. many countries will approve medical devices without first having to demonstrate that the technology is effective.”

Dr. Robin Blackstone, a bariatric surgeon in Scottsdale, Ariz., and president of the American Society for Metabolic and Bariatric Surgery, who is involved in a clinical trial of a balloon in the United States, said that people who need to lose a modest amount of weight may do just as well with a more conventional approach, given the risk of complications.

“Patients who are obese are very vulnerable,” she said. “They’re desperate to find something that works, and it’s important for people not to offer things that aren’t well established.”

For those who insist on trying the procedure despite its lackluster record, some cautions are in order.

The balloon is an option only for those who have less than 50 pounds to lose — Canadian clinics may accept patients with a body mass index as low as 27, if they also have weight-related health problems — or for extremely obese people who need to lose weight to be accepted for bariatric surgery.

Potential patients should consult with a primary-care physician. The metabolic and bariatric surgery organization recommends establishing a relationship with a local gastroenterologist able to remove the balloon endoscopically should a complication occur.

The balloon, usually filled with blue liquid, can rupture. The liquid will turn patients’ urine green, which is how they are alerted to the problem. a ruptured balloon may pass through the intestines on its own or require endoscopic or surgical removal if it obstructs the intestines. The most serious complication is a rupture in the abdomen, which can be life-threatening. other complications include infections and ulcers.

Patients should not have the balloon implanted if they are pregnant or planning a pregnancy, have a hiatus hernia or history of gastric ulcers, other gastrointestinal disease or previous abdominal surgery.

Successful weight loss with the intragastric balloon depends on lifestyle changes, including a better diet and increased physical activity, and maintaining those changes is critical to maintaining the weight loss after the balloon is removed. many balloon programs have a team of providers, often a gastroenterologist, endocrinologist, nutritionist or dietitian, personal trainer and psychologist involved in weekly follow-up with patients.

Impatience to Get Thin Sends Some to Canada

Plastic and Cosmetic Surgery Differences

More and more men and women worldwide are committing to surgery to enhance their looks, whether it is to hold back the signs of aging or to correct a facial or body feature that they believe could be made more attractive. Knowing what to look for in a cosmetic surgeon will be the first and most important step that should be taken by anybody considering committing themselves to enhancement surgery.

It should be understood that plastic surgery, which includes the practise of cosmetic surgery, is so called from the Greek plastikos to shape or mould, and does not have any association with the use of plastic material. Plastic surgery is said to date back 4000 years when records show reconstructive surgery was carried out in India. The Romans and later the Arabs also practised simple surgical techniques and by the 15th century the skills began to develop in Europe.

Although the techniques and surgical skills began developing beyond recognition in the twentieth century with the mainly facial reconstruction of badly wounded or burned servicemen and civilians resulting from the two world wars, the basis of plastic surgery has not significantly changed. either by grafting skin or other tissue such as fat or muscle from either another part of the patient’s body or from a donor or by removing surplus fat, bone, skin etc. remain the principal basic techniques.

Probably the two most important benefits to plastic surgery has been the development of sterile procedures and anaesthetics, thus dramatically reducing the occurrence of infection and enabling control of post operative pain. The worldwide boom in cosmetic surgery shows no sign of slowing down despite the recession. because of the big bucks that can be made the temptation to cash in by ill trained and under qualified fringe medical practitioners has never been greater.

Some countries have strict controls, the UK for example will only allow members of The British Association of Aesthetic Plastic Surgeons who are on the specialist register of the General Medical Council to hang out their shingle advertising that they have qualified and are approved to practise cosmetic surgery.

In the United States any licensed Medical Practitioner can call him or herself a cosmetic surgeon without any training or practical experience. Checking out the credentials of the surgeon and satisfying yourself that he or she is up to the job is an absolute must. even the most highly qualified, experienced and expensive cosmetic surgeons can make mistakes.

Just think of some of the celebrities that have gone through the procedure and have ended up caricatures of their former selves with disfigurements that can sometimes never be corrected.

Plastic and Cosmetic Surgery Differences

Ultrasonic Assisted Liposuction (UAL): The Well-Kept Secret of Plastic Surgery

Liposuction is one of the most common invasive procedures performed in plastic surgery. Statistics published by the American Society of Plastic Surgery indicate that over 300,000 liposuction procedures were performed by board certified or eligible plastic surgeons last year.

Despite a growing demand for the procedure, liposuction continues to be one of the most controversial procedures in plastic surgery. Severe complications, and even reports of deaths, have appeared in the mainstream media, creating questions regarding the safety of liposuction. Early reports of complications stemmed from an underestimated blood volume loss associated with subcutaneous aspiration.

Liposuction was first described in Europe in the early 1970′s. Several surgeons contributed to the new technology. however, French gynecologist Dr. Yves Ilouz, is largely credited with popularizing the innovative body contouring procedure. Liposuction, or more accurately, suction assisted lipectomy (S.A.L.) quickly gained popularity in the United States.

In the 1980′s, in response to excessive blood volume loss, several authors described a pre-suction treatment stage using wetting solutions. the term tumescent infiltration describes the use of such a stage. the process involves subcutaneous infiltration of varying combinations including saline (or lactated Ringer’s solution), epinephrine, and a local anesthetic. the effect of tumescent infiltration is to provide vasoconstriction in the subcutaneous layer and create increased adipocyte fragility. the clinical effect is a diminished blood loss compared to the original dry technique. Tumescent S.A.L. has been the conventional method used in the U.S. since the late 1980′s.

The mechanism of traditional S.A.L. is conceptually simple. A rigid, hollow cannula, connected to a suction machine, is inserted into the subcutaneous space. Rapid, coarse strokes by the surgeon create a series of tunnels, eventually becoming confluent, diminishing the fat pannus. the underlying problem with the technique is that there is no tissue selectivity. the suction energy evacuates or destroys all elements of the subcutaneous tissue plane, including valuable structures such as blood vessels, nerves and fibrous tissue.

Critics of the procedure describe it as rough and traumatic, translating clinically into a painful, bloody process with a prolonged recovery. In addition, loss of essential connective tissue leads to rippling of the skin, the most common complaint following traditional liposuction. One study reported an 80 % incidence of skin irregularities following S.A.L.

Ultrasonic assisted Lipoplasty (U.A.L.)

In the late 1980′s plastic surgeons in Europe and Latin America began experimenting with the use of ultrasound to achieve subcutaneous lipolysis. the use of ultrasonic energy was not new. our colleagues in radiology, ophthalmology, obstetrics, gynecology, urology, neurosurgery and other specialties were already familiar with the use of ultrasound in both a diagnostic, as well as therapeutic, capacity. the application of this energy to plastic surgery was appealing however, for two reasons. first, ultrasound has an established history of safety. Secondly, the vibratory frequency of the ultrasonic energy can be made specific to the adipocyte. It is this tissue specificity that underlies the mechanism and benefit of ultrasonic lipoplasty.

The procedure is performed using a device made up of three component parts. Electrical energy is converted into ultrasonic energy using an ultrasonic generator attached to a handpiece containing a piezoelectric crystal. A hollow titanium cannula attached to the handpiece delivers the energy to the tip at a frequency specific to adipocytes of 22,000 cycles per second. the process is similar to phacoemulsification used in ophthalmology.

The cellular effect is membrane fragility and cell implosion, a process known as cavitation. more importantly, the energy at a frequency of 22K Hz. is not absorbed by the other elements in the subcutaneous tissue, thus largely sparing the blood vessels, nerves and fibrous tissue. At a clinical level this translates into less bleeding, less pain, fewer skin irregularities and a faster recovery.

The procedure is performed in a manner similar to traditional liposuction. A small incision is made in the skin followed by tumescent infiltration. however, since it is the ultrasonic energy that does the work and not the forceful suction, the cannula strokes with U.A.L. are slow and smooth instead of rapid and coarse. the technique has been described as a violin or air brush type movement.

U.A.L. in the U.S.A.

The introduction of tumescent U.A.L. into the U.S. mainstream occurred in the late 1990′s. Although early machines originated in Italy and France, two American manufacturers, produced devices for the international market. Great enthusiasm, fueled by media attention touting U.A.L. as the magic wand of liposuction, created an eager anticipation of the emerging technology.

Anecdotal reports soon surfaced describing limitations and complications related to the procedure. among the concerns expressed were the risk of burns and post-operative seroma formation. Some authors recommended limiting the amount of energy time per site and even avoiding U.A.L. completely in certain body areas.

Data collected in 350 consecutive tumescent U.A.L. cases, revealed no burns and few, minor complications and minimal blood loss. moreover, there was no correlation between U.A.L. energy time and complications. the main disadvantages of U.A.L. are largely related to cost and training. As with any new technology, a learning curve also exists with U.A.L. In addition, the slower stroke movements require additional time. A typical U.A.L. procedure takes approximately 25% longer than the same procedure using S.A.L. Proponents of U.A.L. feel the benefits of the procedure make the extra time worthwhile.

In summary, ultrasonic lipoplasty is an innovation available to plastic surgeons for body contouring procedures which offers greater tissue selectivity and less connective tissue trauma. the procedure is safe with a high degree of patient satisfaction and can be performed safely by qualified, trained surgeons.

Ultrasonic Assisted Liposuction (UAL): The Well-Kept Secret of Plastic Surgery