Plastic Aesthetic Weight Loss Surgery

Androgenetic baldness: causes of alopecia

The most common cause of hair loss in both sexes is androgética baldness. This only occurs in those follicles of the scalp that have a genetic potential of being inhibited by androgen after a period of time.

Both men and women in skin androgen includes: androgenetic baldness, oily skin and acne. Women may also suffer from varying degrees of hirsutism.

Genetic factors

The expression of the gene that determines this baldness depends on the level of circulating androgens, there is no manifestation of baldness where there is no circulating androgens.

The genetic potential is expressed when the appropriate androgen comes into contact with the target cell receptor that is sensitive and androgen that is found in the hair papilla, or matrix, and the interaction with the receptor binding protein is expressed genetic material.

The hair more typically subjected to baldness androgenetic is located in the temporofrontal and in the crown of the scalp.

Baldness is a gradual process in which it becomes ever shorter phase anágena in each cycle.

In women androgenetic baldness is less severe, because there are fewer circulating androgens free and available to inhibit the follicles.

Control receivers and the mediators

With various illnesses alterations in hormonal balance have provided information on the relationship between androgens and alopecia.

Testicular feminization syndrome is caused by a resistance to testosterone (T) and 5-DHT. dehidrostestosterona (DHT), therefore there is no system of receptors for these hormones. Therefore, there is a development of the male reproductive tract, and there are no secondary sexual characteristics, and in addition (and this is what concerns us most) do not have acne, or androgenetic alopecia, or hair sex depends on androgens.

The clinical manifestations and biochemical testicular feminization syndrome and the deficit of 5-DHT receptor and seudohermafroditas type 2 suggest that the DHT is responsible for the gene expression of alopecia in the hair of the scalp.

Androgenetic baldness in normal women and hiperandrogenizadas

Some women with androgenetic baldness have a base of endocrinopathies. In that case there will be a crown or base of hyperandrogenism adrenal and presented signs of virility and / or hirsutism and / or acne depending on the severity of disorderly hormone. In some cases, however, there is no such hyperandrogenism and women presented androgenetic baldness, acne or hirsutism. There are some explanations for this:

a) Special hypersensitivity in the hair follicles and sebaceous glands to normal levels of androgens.

b) Whether it increases the metabolic utilization of the increased production of testosterone DHT at the peripheral level, in the skin and may increase the androgenetic baldness.

e) Also a decline in serum globulin conveyor androgens, an increase in free plasma androgens, which are really acting.

The poor production of this plasma protein in the liver can be settled by a deficient production of estrogen, or thyroid hormone, obesity or failing liver. It must be borne in mind that androgenetic alopecia, hirsutism and acne are exacerbated by Androgenic medications, including oral contraception (which contains progestins have an androgenic effect). There are few foods (peanut oil, wheat germ oil) and some dietary supplements that contain androgens (testosterone or dehidrostestosterona) detected by radioimmunoassay.

Vascularization and baldness androgenetic

There are no determinations of a minor irrigation in areas that are bald, nor a progressive decrease in the vascularization that could lead to hair loss in androgenetic alopecia. The male pattern baldness answered, rather than a loss of follicles at a time dependent gene expression and androgen decline in the growth phase of the hair, and possibly an extension of the phase of rest.

Diet and baldness androgenetic

The diet has a minor impact on the androgenetic baldness. But we can find some deficiencies in the diet that produce the specific and among other changes, disruption of the hair.

List what the main causes:

Food-Androgenic containing substances such as peanut oil and wheat germ (containing testosterone and DHT), can exacerbate the symptoms of androgenetic alopecia in women but not men since they have high levels of endogenous androgens.

- Protein-calorie malnutrition in its extreme form of merasma or Kwashiorkor characterized by anemia, edema, depigmentation of the skin, as well as changes in color and texture of hair (dry, brittle, reddish or black depending on the changing phases Malnutrition). It reduces the diameter of the hair bulb and there is an increase in hair loss.

-Diets to lose weight, a decrease of 10 to 25 kg. can lead to an increase in hairs on the scalp telógena phase and an increase in hair loss which will forward a few months. Being the parent of hair which has the highest turnover of cells of the body, is therefore not surprising that any protein or calorie restriction produces a decrease in their mitotic activity,

- Changes in the reserves or the contribution of various vitamins (A, B12, D, Biotin) can induce alterations in the hair as dryness, color change or collapse.

- The zinc and iron are essential for good health of your hair can cause a deficiency of diffuse hair loss

It is important individualise the choice of treatment for each patient that this baldness.

Can be carried out:

- Reductions tonsúrales as the only treatment sessions spaced between four and six months.

- In patients with complete baldness.

- In patients who do not have a good donor site of follicular units. 

 * Combination of reduction - Session of follicular units at one time or during surgery

    Alternate:

     - In patients with intermediate and complete baldness that has affected the crown.

     - By reducing the general area of baldness, can be more densely filled with follicular units sessions, the rest of the area of baldness that is.

When the two techniques are combined in a single surgical time, it starts by reducing crown, finishing the session follicular units.

On the reduction means the surgical removal of a piece of scalp with hair loss, the coronal part.

Selecting the patient

   Good condition.

   Studying the degree of baldness well.

   Check the laxity and elasticity of the scalp.

   Psychological predisposition of the patient.

   Patient age.

Different patterns of reduced crown 

  No employer is optimal for all patients, but the main ones are:

1 .- Pattern half ellipse - sagittal.

2 .- Pattern Y - T.

3 .- Pattern side (on the periphery of the area of alopecia).

4 .- Pattern in U.

5 .- Measuring and combining patterns .- In I, or horizontal cross, in an ellipse and crescent.

      Combination of patterns. 
 
The choice of the appropriate standard depends on each individual case. 

The degree of elasticity and laxity of the scalp is important when assessing the number of reductions that can be practiced in one patient. The ideal patient is the one with a good laxity. It may be appropriate to recommend treatments cosmetological prior to the intervention, to increase the maximum moisture and elasticity of the scalp in the area to treat. 

  The patient age is a factor taken into account in planning for the treatment of alopecia. In younger patients who perhaps do not require hair transplants, with incipient baldness, it must be borne in mind that in the future, will likely increase their problem. 

  In people over 40 years it is easier to calculate the number of reductions that are required, since it is likely that his baldness did not advance much more. The patient who decides to undergo treatment consisting of a reduction in the area of alopecia should be fully informed. Should be aware and accept the fact that bear a scar on the coronal region.

Wrinkles that appear on the skin of the face are of different origins and this is dependent on the processing or treatment. In assessing the patient must differentiate wrinkles caused by sun damage, those which are caused by the operation of the muscles of facial expression and those that are much more coarse, visible and permanent, such as those caused by the process of aging and action of gravity.

A. - The wrinkles caused by solar photodamage are preventable by avoiding direct exposure to the sun and if it were inevitable exposure, then we recommend the compulsory use of sunscreen and a half-day morning along with moisturizing creams. The sun’s rays are the cause of microscopic changes in the skin that causes thickening and atipias his cell in the dermis and changes in its architecture. Photodamage of the wrinkles are fine and remain on the face and the patient is serious, the pielluce dry acartonada thick. Their treatment is the elimination or evaporización of the surface layers of the skin or with any of the following methods: laser rejuvenation, the dermabrasión surgical or chemical peeling.

B. The other class-wrinkle product are those that appear in the functioning of the muscles of facial expression. These are characterized by appearing from the middle-aged, are obvious and laughed while we admire, or are we angry, disappear when we are serious, but as the years pass and if not treated they leave marks on the skin. Hence the most important treatment is prevention.

The use of Botulinum toxin is helping us with this objective (read article Botulinum Toxin). But if you want a more radical and permanent then recommended the selective surgical removal of specific muscle fibers (read article Surgical treatment of facial rejuvenation). Another method that does not cure the cause but a camouflage would be filling those wrinkles. Any of these techniques result would be the disappearance of wrinkles in the forehead, the entrecejo, and the so-called “crow’s feet.” Circumoral wrinkles and deep nasogenian folds may be dealing with the use of botulinum toxin (botulinum toxin type A - BOTOX ®
) Or with stuffing.

C. - Those wrinkles that appear on the aging process and effect of gravity as the drop in the skin of the face, neck, flaccid muscles of facial and neck, was the only corrects the stretch with facial surgery or facial or Lifting Ritidectmonia facial. Neither the Botulinum toxin, or dermabrasión, or peeling, or creams, massage or cure these features so dramatically (read article Surgery for facial rejuvenation) as the Face Lift.

It is important that we make an assessment of the patient to make the results of their total satisfaction, depending on the diagnosis is the same as the treatment can be alone or in combination. The use of cosmetic creams tensioning, moisturizer, sunscreen, massage and give the skin a feeling of softness and smoothness that slows the effects imminently come with time and life.

WHAT IS THE LIPOSCULPTURE?: It is the art surgical patient to return to the lines and curves to them to the body and face after his kind, at the expense of dealing with this is that fat cells are removed by suction in case of excesses or inject (lipoinyección) in the event of a deficit.

I AM A CANDIDATE FOR LIPOSCULPTURE?

If you are a man or woman who holds deposits of fat that desarmonizan forms of your body or face, with normal weight and elastic skin, then it is an ideal candidate for liposculpture. Obviously recourse to surgery so upset if these areas have not disappeared despite the physical exercise and diets low in calories. 

  AREAS THAT CAN CHANGE WITH THE LIPOSCULPTURE: You can modify face, neck, arms, back, chest, abdomen, buttocks, thighs and calves. 

  WHAT ARE THE METHODS TO BE USED TO MAKE THE LIPOSCULPTURE?: If there is accumulation of fat they can deal with the Tumescent Assisted Suction (Liposuction) or with Ultrasound Assisted Tumescent or combination of the two methods. 

  if there is shortfall in volume then the treatment is the infusion of liposuction and fat in the treated areas in need of greater volume and buttocks, and hips, among others. 

The best approach would be to indicate their plastic surgeon, hence the importance of preoperative evaluation. 

ME IF I decide BY THE SURGERY THAT WOULD HAVE Preoperative: Every surgeon will give indications that the case warranted, and this will depend on the medical history. In general, avoid alcohol, drugs, snuff, certain medications that cause disorders and stay healthy for the surgery. Blood tests and cardiac evaluation (variable) will be part of the routine preparation for surgery. 

  ANESTHESIA METHOD TO USE ME: It depends on the amount of fat to suck and the layout, age and degree of apprehension of the patient. The types of anesthesia that can be used are local, sedation, blocking epidural or general anesthesia. The indications are specific and your surgeon will explain in more detail what method is suitable for you. 

  Before   After  liposculpture photos
  

WHAT long SURGERY AND WHAT IF I NEED CARE POSTOPERATIVE? The duration of the surgery will depend on the amount of fat to treat and whether or not there are other additional surgeries to be performed. After surgery to wear belts to the areas liposuction is not swell and the skin will adhere to the deep planes and give the desired shape. Depending on the amount of fat liposuction surgery will be outpatient or hospitalization, however, can walk as soon as you can, any way you take antibiotics and medicines that do not feel pain during a timely fashion. 

  WHEN MY return to business as usual?: Depending on the amount of fat liposuction you can re-integrate its activities as soon as possible and in all cases wearing the belt prescribed by your doctor. Always remember to rest and restart your exercise routine physical a month after the surgery. 

  WHY SOME PATIENTS AFTER THE ENGORDAN LIPOSCULPTURE?: It is important to note that the liposculture is not a quick way to lose weight, but is a surgical option to define or soften the picture instantly. But it is wise to think that the patient who has aspirations is so ambitious because it has decided to change their lifestyle to a healthier which includes a plan of physical exercise and maintaining a diet low in calories even when he decides to maintain the good results surgery. This means that while you do not have the habit of being and feeling good, do not opt for liposculpture, because the results will last a very short time and predictably fattening.