Redefining Asian nose using implants an art in itself Written by Leslie Sabbagh
Newport beach, Calif. - Rhinoplasty for Asian patients brings with it a variety of challenges, not least of which is lack of agreement among surgeons on how to achieve best results, along with a paucity of good reports in literature. Nazih Haddad, M.D., who has extensive experience in treating Asian noses, explained his techniques for achieving consistent outcomes and happy patients. A clear recognition of challenges with Asian nose is necessary, he advised, to develop a good surgical plan. "Asian skin is thicker and less elastic than Caucasian skin, making it less easy to remodel," he said. What's more, cartilage is softer and thinner compared with Caucasian noses, so it is somewhat less reliable. Attempts to sculpt cartilage fail because "it does not take shape you want due to its softness, in addition to warping and possible absorption," said Dr. Haddad, aesthetic plastic surgeon in Newport Beach, Calif. To further complicate matters, bony framework, in general, is tiny. This means that patient's bone structure itself does not help surgeon to reshape nose. Building bridge The Asian nose is often saddle-shaped: bony structure is disproportionately small with a wide tip. If patient wants a Caucasian nose, then surgeon must build upper and middle portion of nose and reduce lower part of nose (the tip and alae). The latter techzique sometimes requires making an incision in skin, and this can be challenging, warned Dr. Haddad, who is also a clinical associate professor of facial plastic surgery at Uiversity of California, Irvine. Asians, Dr.Haddad said, prefer to have a strong nasal profile. A quick and easy way to achieve this - at least as a first-line treatment - is by using Silastic implants. "I suggest using larger rather than smaller implants because I have found my patients prefer this look. They also want a more narrow ala." Dr. Haddad also uses implants to achieve narrow alae. This he noted, can be somewhat controversial because conventional wisdom holds that implants have a high likelihood for eventual extrusion. "The incidence of extrusion is about 5 percent, but I believe benefits far outweigh this risk. The good news is that thickness of Asian skin better protects and hides implant."
| | Enhancing the Quality of Life for People with Alzheimer's and Their FamiliesWritten by William Hammond, J.D.
Learning how to communicate with loved ones who have Alzheimer's Disease is often a difficult task for families. It can be heartbreaking and confusing to witness a loved one exhibit behavior that is far from their usual temperament. In order to sustain relationships and enhance coping abilities, family members and caregivers must learn how to communicate with their loved ones in ways that can enhance quality of life for individual. Techniques for Communication Learning how to successfully communicate with your loved one can help to keep undesired behaviors like agitation and wandering to a minimum as well as improve their quality of life. There are a few basic techniques caregivers and family members should keep in mind when communicating with their loved one. First, approaching a person from front can be helpful in reducing potential of surprise. The element of surprise can be fear-producing and disorienting for someone with Alzheimer's. Second, face person as you talk with them, and avoid spending time in a setting with a lot of sensory stimulation. Too much surrounding noise or movement can be confusing and affect your loved one's ability to communicate. Third, if a situation looks like it might get out of hand, distraction can be helpful to diffuse situation. For example, introducing another activity such as a walk or drive can help to redirect their attention. Lastly, speaking slowly in a low-pitch and remembering to ask only one question at a time can help your loved one understand and minimize confusion. The above are a few basic keys to communicating with someone who has Alzheimer's. More information regarding communication can be found at ElderCare Online (www.ec-online.net). Helpful Interventions Sometimes prescription medications are appropriate for those with Alzheimer's to alleviate psychotic symptoms or enhance memory and cognitive functions. However, there are other interventions that caregivers and family members can take in order enhance their relationships and quality of life for individual.
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