Category Archives: Medicines & Sciences

Features medical breakthroughs and the latest in healthcare through informative articles

What Is The Difference Between Food Allergy & Intolerence

Dr Mecherl Lim

An Intuitive Medical Practitioner in Alternative Medicine (MD) (MA), Naturopath (ND), Holistic Kinesiology (HK), and Functional Medicine (FM)


Food Allergy occurs when the body has chemical reaction to eating a particular food & drink. The symptoms for mild to moderate food allergy or intolerance may sometimes be similar, but food intolerance does not involve the immune system and does not cause severe allergic reactions (Anaphylaxis)

A Food Allergy occurs when the immune system reacts to harmless food. Learn to read food labels so you can avoid foods that cause allergic reactions.

Food Allergy & Food Intolerance

Symptoms of food intolerance occasionally resemble those of food allergy so food intolerance is commonly confused with food allergy. Food intolerance does not involve the immune system and does not cause severe allergic reactions (know as anaphylaxis). Food intolerance also does not show on allergy testing. Food intolerance can be a difficult concept to understand and is poorly understood by doctors as well. Sometimes, substances within foods can increase the frequency and severity of migraine, headaches, rashes (such as hives) or stomach upset such as irritable bowel.

Professional diagnosis and confirmation of allergies is important. In Australia, about one in 10 infants, one in 20 children up to 5 years of age, and two in 100 adults have food allergies.

Food Allergies has been Increasing

Allergies in general are on the increase worldwide and food allergies have also become more common, particularly PEANUT ALLERGY in preschool children. About 60 per cent of allergies appear during the first year of life. Cow’s milk allergy is one of the most common in early childhood. Most children grow out of it before they start school.

Inherited Allergy

Children who have one family member with allergy disease (including asthma or eczema) have a 20-40 percent higher risk of developing allergy. If there are two or more family members with allergy disease, the risk increase to 50 to 80 percent.

Most of the time, children with food allergy do not have parents with food allergy. However, if a family has one child with food allergy, their brothers or sisters are at a slightly higher risk of having food allergy themselves, although that risk is still relatively low.

Allergy is an Immune Response

Allergies are an overreaction of the body’s immune system to a protein. These proteins may be from foods, pollens, house dust, animal hair or mould. They are call ALLERGENS. The word allergy means that the immune system has responded to a harmless substance as if it was toxic.

Food Intolerance is a Chemical Reaction

  • Food Intolerance is a chemical reaction that some people have after eating or drinking some foods: It is not an immune response. 
  • Food Intolerance also does not show on allergy testing.
  • Food Intolerance can be a difficult concept for doctors as well. Sometimes substances within foods can increase the frequent severity of migraine headaches, rashes (such as Hives) or stomach upset.
  • Food Intolerance has been associated with Asthma, Chronic Fatigue and Irritable Bowel Syndrome (IBS).
  • Professional diagnosis and confirmation of allergies is important in Australia, about one in 10 infants, or in 20 children up to 5 years of age and two in 100 adults have food allergies.

Therapy

The preferable approach to the nutritional management of immunological food reactions or food hypersensitivities consists of dietary avoidance and the treatment of symptoms resulting  from inadvertent exposure. Nutritional supplements are needed when major food groups are being avoided.  This will ensure the optimum nutritional intakes are maintained. Digestive enzymes example: Dr MH zyame should be taken by individuals who seems to be sensitive to many foods. Bicarbonate of soda , Dr MH Proflora A, taken one hour after meals can improve symptoms. By improving digestion the allergenic load may be destroyed or digested more thoroughly.


Visit : www.drmecherlherbs.com
Email : drmecherherbs@gmail.com
FACEBOOK : drmecherlherbs for further enquiries.

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Intraoperative Radiotherapy (IORT) A New Breast Cancer Treatment Innovation

Dr. Teoh Mei Shi

Consultant Breast, Endocrine & General Surgeon

MBBS (India), MS (USM), Fellowship Breast Oncoplastic Surgery


Screen Shot 2017-11-10 at 1.37.42 PM.pngBreast Cancer is the most common cancer amongst women in the world. Incidence of breast cancer is increasing and the lifetime risk of developing breast cancer in Malaysia is one in 15 women. In developed countries, the lifetime risk of developing breast cancer in women is as high as 1 in 8 women. With more awareness and screening for breast cancer, women are detecting breast cancers earlier, which are smaller and have better survival outcome.

Treatment for breast cancer has evolved significantly over the last few decades due to better understanding of the tumor biology and its behavior. This has led to better adjuvant therapy like systemic chemotherapy, radiation therapy, hormonal therapy and targeted therapy. For most of the earlier twentieth century, Halsted radical mastectomy was the standaradised operation for all stages of breast cancer resulting in poor cosmetic outcome. However, over the recent decades, breast conserving surgery (BCS) eg. Lumpectomy has become the popular alternative to mastectomy in the treatment of early breast cancer.

When detected early, the breast conserving surgery involves a lumpectomy followed by 4-6 weeks of external beam radiotherapy to the whole breast and boost to the tumor bed. This combined method has been proven to reduce local recurrence of breast cancer by 60-70%. However, the side effects of whole breast radiotherapy treatment can be detrimental eg. pain and oedema to the breast, skin fibrosis, fatigue and tiredness and in some cases, there can be associated radiation- induced lung injury and cardiac morbidity.

Over the last few years, a new innovative breast cancer therapy known as Intraoperative Radiation therapy (IORT) has become available using the Intrabeam technology. IORT delivers a single dose of radiation directly to the area where the tumor has been removed during surgery.The principle of this approach is to destroy the remaining cancer cells within the lumpectomy cavity where more than 90% of local recurrences usually occur close to the tumor bed.

The Intrabeam IORT is delivered using a miniaturized radiation applicator that is inserted and positioned into the lumpectomy cavity after removal of the tumor. A calculated low energy radiation dose is administered for 20-30mins after which the wound is closed surgically. The operation carries standard risks of bleeding and infection and slightly higher seroma collection comparable to normal breast surgery.

This technology is an excellent option for women having a lumpectomy or breast conserving surgery and is for individuals diagnosed with early-stage breast cancer. The IORT therapy may function as two options ie. as a boost therapy or as a single treatment. Patients are carefully selected and multidisciplinary discussion with breast surgeon and radiation oncologist is carried out to decide the best outcome for the patient.

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IORT offers the following advantages:

  • Reduced radiation treatment time (single session vs 20-25 sessions) in candidates selected for surgery
  • Minimized radiation exposure to surrounding healthy breast tissue, underlying bones, lungs and heart.
  • Reduced daily trips to the radiotherapy centre and convenient for those staying very far away.
  • Same day radiotherapy treatment and no treatment delay for those going for chemotherapy after surgery
  • Provides additional radiotherapy “boost” for high-risk patients who need additional external beam radiation therapy.

The international TARGIT research group has been investigating this new method of delivery radiotherapy for breast cancer after lumpectomy since 1998. The trial compared Intrabeam IORT to standard external beam radiation therapy and found that both treatments were comparable and equally effective with an overall low breast cancer recurrence as well as better breast cancer survival rates. Women who had intraoperative radiotherapy had the advantage of fewer skin side-effects and better cosmetic outcome compared to women who had whole breast external beam radiotherapy.

Conclusion

Intrabeam IORT will be a technology of the future for breast cancer treatment. In properly selected cases, the patients can be offered an alternative option whereby they can receive a shorter dose treatment with lesser side-effects to the breast. It can also be time saving, cost-effective and offers the patient an overall better quality of life.

This treatment will be available at Loh Guan Lye Specialists Centre where a dedicated and trained team of Breast Surgeons and Radiation Oncologists can be consulted to see if you are eligible for the treatment.

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What Is The Difference Between Food Allergy And Food Intolerence

by Dr Mecherl Lim

MD (MA) Naturopath (ND), Holistic Kinesiology


ALLERGY AND FOOD INTOLERANCE :

It is well known that deficient intake of protein, calories, vitamins, or minerals leads to a variety of nutritional disorders.  It is known that food contaminated with toxic materials or bacteria may cause illness if consumed.  It is also known that certain foods contain non-nutrient poisonous substances that may cause illness and in some cases death. Nevertheless, it is not generally realised that the nutrient components of foods, in themselves may be toxic for certain people, causing illness or aggravating pre-existing illness.

THEORETICAL CONSIDERATIONS :

Food Intolerance may be defined as any illness or biochemical or metabolic abnormality that is causally connected to the ingestion of any food or dietary component. An illness that is causally connected to non-nutritive dietary component may be referred to as food poisoning or food toxicity. The term food intolerance is usually applied to illness resulting from the ingestion of substances that have nutritive value such as carbohydrate, fat, proteins and amino acids, and accessory factors such as purines (purines are responsible for gout in some sensitive individuals).

There may be an obvious connection between food ingestion and the production of acute illness or a less obvious connection so that a patient may fail to recognise

the relationship between his disease and the offending dietary component.

Under special circumstances certain combinations or amounts of food substances may cause illness in otherwise healthy individuals. For example, fasting followed by refeeding may result in stomach and intestinal distress or fluid retention. Another example is in illnesses that cause anorexia where feeding may be associated with nausea and vomiting. This type of Food Intolerance may be considered to be secondary type since the food is non toxic but illness or fasting has so altered the normal physiology that the patient becomes intolerant to many types of food.

REVIEWING SOME COMMON NUTRIENT FOOD INTOLERANCES :

Carbohydrate Induced Food Intolerances

  • Lactose Intolerance is the most common. Most people around the world are deficient in the intestinal enzyme lactase and thus have an inability to digest lactose-containing foods (eg.milk). Symptoms associated with lactase deficiency are bloatedness, wind and diarrhea. Lactose Intolerance may occur of various ages, it may occur at birth or at a latter age to different people. Treatment requires the avoidance of lactose by restricting dietary milk and milk-containing products. Lactose Intolerance should not be confused with milk allergy which is related to milk proteins.
  • High refined carbohydrate diet, in general, may be related to a number of medical problems. For example-low blood sugar (hypoglycaemia) which associated with variety of symptoms including fatigue, weakness, irritability, headaches and sugar craving may classified as diabetic.
  • For the sake of complete example of carbohydrate induced food intolerance are as listed : Glucose-galactose intolerance, sucrose-starch intolerance, sucrose-fruit intolerance, fructose-glycerol intolerance, lactose intolerance, pyruvate dehydrogenase deficiency.
  • All intolerances are due to lack of specific enzymes required for the metabolism of the particular sugar.

Protein Induced Food Intolerance

  • Coeliac disease results from a sensitivity to the protein, gluten, contained in wheat, rye, oats and barley. The disease manifests in most individuals as gastro-intestinal discomfort, wind and diarrhoea. However gastrointestinal symptoms need not be present and the disease may manifest as eczema, or arthritis. Strict avoidance of gluten is necessary in the treatment of this disease.
  • Cow’s milk (casein) allergy or more particular allergy or intolerance to a protein component of milk. It is associated with vomiting, chronic diarrhoea, eczema and failure to thrive. 
  • Other common food sensitivities are to egg protein, soy protein and shell fish. Symptoms may vary from hives to gastrointestinal symptoms, asthma to neurological disturbances (poor concentration, irritability, behaviour disturbances). Avoidance of these food results in remission of symptoms.
  • Individuals suffering from liver failure, cirrhosis of liver, kidney failure or pancreatic insufficiency all show intolerance to most proteins. The intolerance is due to the ailing body’s inability to either digest, metabolise or excrete proteins, amino acids or their waste products. So limiting the intake of protein until the body recovers its health or reduce symptoms.

Lipid Or Fat Induced Food Intolerance

  • Symptoms of diarrhoea (Steatorrhoea) wind, fatty motions occurs whenever fat is malabsorbed.  Steatorrhoe represents an intolerance to dietary fat or lipid. Fat malabsorption occurs in pancreatic insufficiency, various disease of the small bowel (cystic fibrosis, coeliac disease, liver disease, gall bladder disease and diabetes. Obviously a restriction of dietary fats or supplementation with digestive enzymes must be incorporated in the treatment of the above diseases.
  • Very high blood fat concentration due to a deficiency in lipoprotein lipase is associated with severe fasting, pronounced elevation in plasma triglyceride, eruptive xanthomas (fatty nodules in the skin) and recurrent episodes of abdominal pain due to pancreatitis. A low fat diet can control the disease process.
  • High blood cholesterol and altered lipoprotein profile can be viewed as a fat intolerant disease. Treatment in most cases requires the introduction of a low fat diet or supplementation with chromium and essential fatty acids.

Common Questions From Couples Desiring IVF Programme

Mr. Sim Seng Keat

Obstetrician & Gynaecologist / Fertility Specialist


1. Do you really need IVF programme to get pregnant?

Though it is also equally important that IVF should not be attempted without good justification, it should not be delayed very long either. Unfortunately the public’s idea that IVF to be tried as the last resort has delayed the decision making of many couples and hence most of them have reached their late thirties and even late forties before trying for IVF- assisted pregnancy.

Attempting to try for IVF must be a timely decision by the couples. Incorporating fertility status into annual checkup early in your married life will give a perspective idea about your fertility status. Then it will be more realistic to decide on when to enlist for fertility assistance and /or when to have a timely attempt for IVF amidst your busy daily routine. 

The following time proven approaches still stand true:

  • It is better to have the first child early
  • Couple should decide to go for a checkup with Fertility specialist when there is failure of pregnancy after actively attempting for one year in women less than 35 years old and half a year of active attempt in women more than 35 years old.
  • It is strongly recommended to have early fertility consultation in couple with preexisting gynecological or male fertility related disorders.

2. How long is the duration of IVF injections and is it easy to self-administer injections?

Though earlier IVF injection schedules were longer & lasted for 4-5 weeks, with the advent of recent methodologies, newer injection schedules are shorter lasting which is less than two weeks. It has been proven that the chance of having successful IVF pregnancy has been equally good even in couple adopting shorter injection schedule!

This has not only reduced the stress and time spent in keeping to the schedule but also the number of injections. Moreover, the shorter injection schedules tend to be equally flexible to plan for egg-retrieval procedures and better in reducing the risk of ovarian hyper stimulation.

With the development of newer user friendly injection pens, self-administration of injections deliver dosages precisely and are also easier to use reducing the likelihood of errors and mistakes. 

3. Is it possible to plan / prefix earlier for all appointment dates for couples adopting to go for attempt of IVF pregnancy?

Yes, all the appointment dates from the first day of the injection to the end of IVF procedure including the dates of blood tests could be planned and fixed much in advance and can be made known to the couple even during their first day of consultation. This usually helps the couple to plan their leave or allocate time and be available for all appointments in the midst of their busy work commitments, holiday plans and family obligations.

Treatment plan includes 6 appointments, first three are for collection of medications after pelvic ultrasound examinations. Fourth appointment is for semen collection from husband and day case admission for wife for egg retrieval. Fifth appointment is for admission as day case for wife to have the embryo transfer and sixth appointment is for wife to have the blood test to detect pregnancy status. 

Hence husband must be present for the fourth appointment unless he has already preserved frozen sperms to be used for IVF procedures. It is needless to say wife must be present for all appointments. It is highly recommended to have the presence of an accompanying adult with the wife for day-care admissions for fourth and fifth appointments since these admissions are for the wife to undergo minor procedures.

Schedule of appointments depend on the day of onset of menstruation and hence for women with regular menstrual cycles, appointment dates are very much predictable and easier to fix. 

Women with irregular menstrual cycles require oral contraceptives or progesterone-only pills to induce menstruation to get the date of onset of menstruation to plan for all future appointments.

4. How is the egg retrieval procedure performed? How true are hear-says about pain during and after undergoing egg retrieval procedures?

From the feedback from many patients, egg retrieval procedures are relatively painless though very few of them might experience minor lower abdominal discomfort for a shorter duration after the procedure.

Most egg retrieval procedures are performed easily with minor sedation though some of them might need light general anaesthesia or spinal anaesthesia.

Newer well designed needle tips are very small in diameter with finer needles causing lesser trauma and as such these procedures are relatively painless. Hence most of them do not even require paracetamol for pain relief though very few patients require paracetamol for a day or two.

5.  Are these dreadful stories of Ovarian Hyper Stimulation (OHSS) true?

5 to 20% of women undergoing IVF procedures with longer injection schedules develop OHSS while chances of developing OHSS is much lesser in women with shorter injection schedules. OHSS developing after egg retrieval in women produces a bloated abdomen, poor oral intake, shortness of breath, abdominal pain, reduced urine output, nausea and vomiting.

Occurrence of  OHSS can be reduced to less than 1% by the introduction of deliberate efforts such as use of agonist medications  as triggers and with the approach of new technique of freeze-all embryos.

With the advent of well researched methodologies the incidence of OHSS has reduced significantly while the success rate of IVF pregnancy has increased satisfactorily.

6. What are the factors to be considered before deciding the chances for getting successful pregnancy after IVF procedures?

Everyone would like to know the chances of getting pregnant through IVF procedures though there are many factors that decide the success after such procedures.

Basically in sub fertile women of less than 35 years, transfer of two good quality embryos in fresh IVF attempt confers more than half the chance of getting pregnant. In established IVF centre with good “Freezing and Thawing Program”, transfer of 2 good quality thawed embryos also provides good outcome.

80% of fertile couple conceive naturally through active attempts within a period of 12 months.

Direct comparison of chances of getting pregnant of sub fertile and fertile couple might not be appropriate. It is very encouraging and overwhelming to note the uptrend in the increasing pregnancy rates after fertility techniques, with the advent of research proven technologies and procedures.

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Knee Osteoarthritis

Dr. Tan Boon Cheong

MBBS (MU), MS Ortho (MU)


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One of the most common causes of knee pain, especially when oneself is approaching middle age, is usually links to degenerative joint disease (age as risk factor), but it is more complex as some young people have it too and for some it may be hereditary.

By definition knee osteoarthritis is defined as chronic joint disorder in which there is progressive softening and disintegration of joint cartilage, accompanied by new growth of cartilage and bone at the joint margins and capsular fibrosis. The prevalence of knee osteoarthritis increase with age (>45 years) and females have a higher incidence compare to male.

Knee pain is one of the most common chief complaints for knee osteoarthritis. The knee pain usually takes place with prolonged walking or standing. Resting the joint will relieve the pain. Stiffness is another common complaint. The stiffness happens after prolonged immobilization especially when getting up from a sitting position or early morning when oneself tries to get out from the bed to walk. The patient will need to stand for a brief second before he/she can start to walk. After a few steps, the patient will feel easier to walk.  Frequently, the patient may have episodic attack of knee swelling due to inflammatory process that takes place. When the knee osteoarthritis become more advance, the patient will have deformity, which most of the time the leg appear to curve inward, and if the patient’s both knees are involved, then the deformity would appear like an ‘O’ shape (in most of the patients). Knee osteoarthritis has no immediate threat to one’s life, but it reduces the quality of life due to persistent pain and immobility.

The management of knee osteoarthritis starts with the establishment of its diagnosis. Beside a good history given above, an examination by a doctor will help to come to this diagnosis and exclude other causes of knee pain. A plain X-ray of the knee with the patient standing will be good enough to tell the grading of the knee osteoarthritis. Kellgren and Lawrence classification system (Grade 0 to 4) are usually in use.

The treatment of knee osteoarthritis will depends on the severity of it and how much the symptoms affect the patient’s on daily basis. Joint supplements such as glucosamine sulphate and chondroitin have been used widely for knee osteoarthritis. Analgesia (pain killer) can be used but will give grieve side effects if abused. Intra-articular injection of hyaluronic acid (gel), PRP (blood) and stem cells have been widely introduced but their effectiveness and cost should always  be taken into consideration. Surgical intervention such as total knee replacement surgery will be the last resort when everything fails and the pain is tremendously affecting the quality of life. Beside all the above medical treatment, the lifestyle of the patient should also be modified such as exercising and weight management.

Leaky Gut Syndrome

by Dr Mecherl Lim

MD (MA) Naturopath (ND),  Holistic Kinesiology


Lets us understand WHAT CAUSES LEAKY GUT SYNDROME?

INTESTINAL PERMEABILITY

A possible cause of LEAKY GUT is increased Intestinal Permeability or Intestinal Hyperpemeability.

That could happen when tight junction in the gut, which control what passes through the lining of the small intestine, don’t work properly. That could let substance leak in the bloodstream.

People with Celiac Disease & Crohns disease experience this. Example,  Toxins in form of Medications, like Steriods, Antibiotics, Advil, Acid reducing drugs and environment toxins like Mecury, Pesticides & BPA from plastic. Stress and Age might also contributes to a Leaky Gut.

Digestive issues include Bloating, Gas, Diarrhea, Irritable Bowel Syndrome (IBS), Cramp, Food Sensitivities, Aches & Pains.

Leaky Gut Sydrome aren’t unique. They are shared by other problem too. Leaky Gut often overlooked as a condition when under disgestive stress, and almost completely ignored if you have been diagnosed with another disease.

However, it is often a root cause of many health concerns,when the gut cannot properly digest nutrients.

WHAT ARE THE SYMPTOMS OF A LEAKY GUT SYNDROME?

A number of symptoms can arise from Neurological, Endocrine and Metabolic eg: Mood Changes, Memory Lapses, Irritable Bowel, Cancer, Loss of Energy, reduced

in Immune Response, Arthritis, Malnutrition, Bloatedness,

Chronic Fatigue, general Seasonal Allergies, Food Allergies, Intolerences, Skin Rashes (related to inflammation), Nutritional deficiencies, (improper absorption),

weakend immune system (from overexertion), Candida Over Growth, Constipation, ongoing Diarrhea, Atopy, Chronic Uticaria, Ulcerative Colitis, Acute Gastroenterities, Cystic Fibrosis, Exocrine Pancreatic Defects, Poor Digestion, Iron Deficiency, Bowel Cancer, Rheumatoid Arthritis, Ankylosing Spondylitis and Maldigestion.

When your immune system attacks particles that escape into the blood stream, regardless of whether they are harmful or not, the killer cells inadvertenly attack healthy cells in the process creating more inflammation thoughtout the body.

Symptoms may spread body wide, but still be attributed to other lifestyle factors. Gaps from intestinal lining widen from inflammation.

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MANY WAYS OF MANAGING LEAKY GUT AND REDUCING SYMPTOMS

  • We could support Liver Function to improve Detoxification such as 1st Phase MHT 5 Days Detoxification programme and followed by 2nd Phase MHT Detoxification as we need to check yeast infections and parasites as the person may be suffering from Achlorhydria, Lactose Intolerance and Pancreatic Insufficiency (refer http://www.drmecherlherbs.com)
  • Reinoculating the bowel with beneficial colonic bacteria, by supplementing with good bacteria count such as Proflora A.
  • Restabilising the gut epithelium to normal function.
  • Eliminate or reduce the insult to the gut barrier from xenobiotic or food allergies.
  • Follow an elimination diet or eliminate substances that produce toxic insult to the gut. 80% of individuals who have food allergens or intolerences have LEAKY GUT SYDROME.
  • Limit the uses of Alcohol, Antibiotics, Aspirin, and NSAIDS as they damage the gut barrier.
  • Reduce exposure to exogenous xenobiotics eg: pesticide, insecticides, and irritant chemicals, by eating more organically grown vegetables.
  • Increase the intake of high fibre foods, slippery elm, bananas and cabbage.
  • Increase intake of fish, cod, tuna, salmon or their oil.
  • Support the liver with supplements on phase II as above mentioned.
  • Glucosamine and Glutamine improve the bowel wall integrity and reduce bowel leakiness.
  • Improve digestion by supplementing with digestive enzymes

Plastic And Aesthetic Surgery In Today’s World

Dr. Lee Kim Siea

Consultant Plastic and Aesthetic Surgeon


Plastic Surgery is a sub-speciality of general surgery, it deals mainly with forms and functions of the whole body. The word plastic is derived from the Greek word ‘plastikos’ which means ‘fit for molding’, it has nothing to do with the plastic wares that we know about, plastic materials are certainly not used in the surgery.

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There are two main division of plastic surgery, reconstructive surgery and aesthetic or cosmetic surgery.  Reconstructive surgery deals mainly with repair and restoration of the loss or damaged tissues. Tissues such as bone, flesh and skin can lost or damaged in trauma, burns or surgeries to remove cancers, the resultant defects can be repaired and restored using various type of tissues from nearby or other parts of the body with various surgical techniques. The restoration of the defects give back the form and functions to the patients, allowing them to live more normally. Imagine the loss of lower jaw from surgical removal of a cancer without reconstruction…. Hand and microsurgery is an integral part of plastic surgery.

Aesthetic / cosmetic surgery concerns with improving the physical forms of the person. Patients are usually well physically, however, they are driven by dissatisfaction of the physical appearance of certain part(s) of their body.  In severe cases, they can be totally unhappy with their whole body. This dissatisfaction can result in minor or severe psychological disturbance affecting self-esteem to the extent of affecting their life. Improving the appearance thus restores their self- confidence resulting in improvement of their life. As society becomes more affluent, people are looking to more than just basic needs, money is spent to make themselves more beautiful; clothing, hairdo, accessories are made more and more expensive and attractive. Some will venture into changing or improving their appearance with aesthetic/cosmetic procedures.

Plastic surgery is not new, the history can be dated back to 15th century when there was an epidemic of syphilis resulting in many disfigured people. Plastic surgery was performed to restore the appearance of these people. The most notable procedure was the nose reconstruction which was recorded in many parts of the world including Europe and India. Procedures than were painful with many complications, even death, results were unsatisfactory by today’s standards, it has evolved through many advances in techniques, better understanding of the processes and importantly availability of more advanced materials and tools.

Aesthetic procedures can be surgical or nonsurgical. Surgeries are what plastic surgery is well known for, this involves operations to improve the appearance of the patients who are otherwise healthy; facelifts, nose operations, eyelids operations, body contouring operations, breast augmentations and fat grafting are some of the well- known examples.

Nonsurgical procedures are done without or with minimum incisions. Among the well- known ones are laser/light and energy based devices, injectables like BOTOX and fillers, thread lifts, medical skin cares and recently stem cell treatment. The aim is to beautify and rejuvenate without using the scapel.  This is the field that is growing rapidly; the affordability, the fear of surgery and minimum down time have made these procedures extremely popular. However, they are not without problems and complications, it is important to look for a qualified doctor like plastic surgeon to perform these procedures.

Beauty is a concept, it has no universal criteria. Beauty is in the eyes of the beholder. It is influenced by many factors including media. There are, however, a number of parameters that make a person’s appearance pleasing to the eyes- symmetry, proportions and harmony are important. Everyone has his/her own unique appearance and attractiveness, it is up to a plastic surgeon to enhance the attractive features and minimize the short comings in order to bring out the best in the person. The plastic surgeon must have an eye for beauty, ability to appreciate beauty and be able to visualize the results before even doing the procedure. It is both art and medicine. My philosophy is to enhance the natural beauty and not to change the person’s appearance. Although the concept of extreme makeover is being  promoted, I see it being too dramatic and too risky as the complication rate is too high; besides, it is too costly.

Plastic surgery/aesthetic procedures are not just for women. There is an increasing number of men looking for plastic/aesthetic procedures, a man with big eyebags, frown furrows, saggy face and a pot belly would not make as good an impression to clinch that crucial deal against a younger looking, more energetic appearing competitor.

Plastic surgery is simply not just for the rich and famous or the vain selected few. We seek improvement in all areas of our life, for example our physical health and mental well- being; many of us spend hours in the gym, even a manicure/pedicure takes hours; we spend lots of money on our dressing and accessories. Plastic surgery or aesthetic procedures are just an extension of this to improve our appearance, it gives a tremendous boost to our self- confidence. A lady beautifully dressed with expensive clothing and accessories would not have the same impact if her face looks old and haggard. Plastic surgery/aesthetic procedures in today’s modern world enhance our life style, it is more and more accepted as a way to enable us to look our best at whatever age.