Gynecological examination

What is a gynecological exam?

In the various specialties of medicine scans better try to fix the patient and obtain data to guide the diagnosis of their condition, so for example when a person has a sense of fatigue , the doctor listen to the lungs to see the degree of involvement or the main location of your problem.

When a woman goes to the gynecologist for any problems related to their reproductive system, the specialist must submit to an examination which is a recognition of the external genitals, vagina and the cervix or uterus .


To explore the vagina and the cervix, it is necessary to introduce an instrument called a speculum, it is a little gadget on a duck-billed, which when opened in the interior of the vagina reveals the cervix; of Thus it can be seen from a macroscopic point of view and see the possible injury of the vaginal wall.

The second part of the gynecological examination is the introduction of the index and middle fingers inside the vagina of the woman, placing the other hand on the lower abdomen, thus exploring the uterus and ovaries, receiving information about the shape, position and size, as well as its consistency and mobility.

Why is it different this examination to any other?

The main problem with this exploration is the shame and embarrassment that the patient manifests. This sentiment is logical and understandable, given the position you have to take the wife and the intimate nature of exploration. However, the best advice you can give is to make the necessary effort to relax, much less bother you because each of the interventions that we have previously explained.

This, presumably, has its logical explanation, because when a woman contracts the muscles of the pelvis also do, which causes the locking of the speculum into the walls of the vagina, causing more discomfort.

In the case older women, postmenopausal , or not regularly maintained sex, discomfort may be higher due to the lack of elasticity presented, in which case the practitioner uses lubricant on the speculum for better slip into the vagina.

For this reason, the best you can think of the woman who goes to the gynecologist, is subjected to a normal and necessary to scan it, and that the doctor is a valuable exploration. For its part, the physician should not forget what it might mean for the patient.

When should the first gynecological examination?

Every woman should undergo a gynecological examination when you start having sex and, of course, when present any problem of gynecological origin.

A virgin can be explored Gynecology

Yes, but with the following differences: the speculum will be smaller, and as much as the hymen will not allow that, and as for bimanual palpation (with both hands) is performed by inserting a finger in the vagina, while the other is placed in the rectum, to rule out abnormalities of the internal genitalia.

Face lifting

The face is the mirror of the soul, they say. Their delicate skin contains traces of the passing years, the harmful effects of sun exposure , and reflects the ups and downs, problems and sufferings of people, which often manifests as wrinkles, sagging skin folds pronouncement and accumulations or deposits of fat around the neck.

All surgery carries certain risks precesses

The face is, moreover, one of the body areas that people most often ask to be modified and the nose is an organ very prominent in shaping the face. This paper deals with two popular surgical techniques classified as plastic or cosmetic surgery of the face, rhinoplasty and facial skin tightening or lifting .

What is rhinoplasty?

nose surgery or rhinoplasty is one of the most commonly used surgical techniques in cosmetic and plastic surgery. Patients can ask their plastic surgeon to reduce or increase the size of your nose, change the shape of the tip of the nose or nasal bridge, change the degree and form of opening of the nostrils, or even the angle between the nose and upper lip. Some patients with nasal defects of birth, or injury, trauma or even trouble breathing through the nose for a deviated septum often also request this procedure.

What is?

Rhinoplasty is a surgical technique that involves separating the skin from the nose of the underlying structures of bone and nasal cartilage to once sculpted nose as desired and depending on the initial problem, re-attach the skin to the new structure. Most plastic surgeons perform the technique from inside the nose, making incisions in the nostrils inerior to avoid unsightly scars on the skin of the face. Other surgeons prefer what is called the "open surgery", ie, make the incision in the skin of the small wall between the nostrils, especially in more complicated cases.

After the surgery, the surgeon will usually place a small nasal cast or splint to keep the new shape of the nose.

This technique can be done with local or general anesthesia depending on patient preferences and the procedure to be followed.

Indications for rhinoplasty

course, the best candidates for rhinoplasty are suffering a people seeking to improve, but fails to look perfect. The technique can arise, as we have seen, both to achieve aesthetic goals and to correct birth defects or respiratory passages. Many surgeons prefer not to operate on teenagers until they complete their development to avoid problems later.

Risks, Complications and side effects

As with any surgical procedure, rhinoplasty involves always the possibility of occurrence of risks, complications and side effects. The most common complications are infection, nosebleed , or reactions to anesthesia .

After surgery the patient may experience headache , swollen face and pain in the nose. The swelling and bruising around the eyes are prominent at the beginning and gradually increase during the first 2-3 days, then fades away in a couple of weeks. You can reduce the inflammation by applying cold compresses, so the patient will feel better.

In the early days it is common to produce a small amount of bleeding from the nose and nasal stuffiness feeling for several weeks. Chances are that the patient can not blow your nose until several days or weeks to let the tissues heal and recover.

The facelift, or skin tightening facial

Surgery of facial skin tightening, technically known as rhytidectomy, it obviously can not stop the natural aging process, but it can improve the most visible signs of it through removal of excess fat in joining the underlying muscles and re-attach the sagging of the face and neck. Often this procedure arises simultaneously with others, such as stretching of the skin of the forehead, eyelid surgery or nose surgery or rhinoplasty, described above.

It is important to note that a facelift is a very individualized. The plastic surgeon will evaluate your face, including skin and bone structures, and advise the best procedure for each case.

What is?

It is difficult to establish exactly how to make a facial skin tightening because each surgeon has their own method for the procedure. The exact location of the incisions and the sequence of events depends on the patient's facial structure and technique, and surgeon preference.

But in general the skin incisions are made ​​initially by the hairline of the scalp over the temples, extend in a natural line in front of the ear (or just inside the front of the ear cartilage) and continues behind the lobe of the same to the lower scalp area. If you must work on the neck, you can also make a small incision under the chin.

In general, the surgeon separates the skin from underlying fat and muscle. Fat may be trimmed or suctioned from the neck area or the chin to improve contour. Then reinforces the underlying muscle and membrane, pulls the skin back and remove the excess of it. Stitches secure the layers of tissue and close the incisions can be used metal staples to the scalp. Commonly used local anesthetic and a sedative.

Who is subjected to this intervention?

generally undergo a facelift some people whose face and neck have begun to present sagging, but whose skin still retains some elasticity and whose bone structure is strong and well defined. Most of these patients are between 40 and 60 years, although this technique can also be performed in patients 70 to 80 years.

Risks, Complications and side effects

As with any surgical procedure, also stretching the facial skin and involves certain risks, although infrequent and mild, complications. The most common complications include hematoma, injury to the nerves that innervate the facial muscles (usually temporary and reversible), infection and adverse reactions to anesthesia.

Most of the scars are hidden within the hair and skin folds, therefore generally not be a problem.

During the early days operated patients experience a swelling of the face that prevents them from proper mobilization of the facial muscles, so feel stiff. As a curiosity, men who have surgery now find they need to shave in new places behind the neck and ears as they have been repositioned skin areas that generate facial hair in these new locations.

Many times, due to the passage of the years , which does not pass in vain, new interventions will be needed within 5 to 10 years to maintain the desired effect.

Investing in health is investing in our work

Did you know that for more than 45 years, community health centers have provided a primary health services, comprehensive prevention and high quality patient care regardless of ability to pay? For many Americans, community health centers are the main source of their health care. Everyone, from prevention to treatment. Currently, there are more than 8,100 centers around the country that provide high quality health care to 20 million people.
In addition to keeping our families healthy, community health centers contribute to the prosperity of the local economy by creating well-paying jobs. That's why we have announced today that thanks to the Health Care Act we Affordable $ 700 billion in new financing to pay for the renovation and construction of community health centers.
Since the beginning of 2009, health centers have added more than 18.600 new jobs full time in many communities with the nation's economic difficulties. And these new funding announced today will help continue this trend and generate thousands of jobs nationwide. Here are some details. In 2010, community health centers provided employment for more than 131,000 people, including:

• Medical 9.600
• 11.400 nurses
• 9.500 dentists and oral health professionals
• 6.400 nurse practitioners, physician assistants and certified nurse-midwives
• 4.200 professional mental health care
• And more than 12,000 case managers and staff for health education, outreach and transportation

All this is part of ongoing investments to the health of Americans of the Obama administration. By improving health care and create jobs, strengthen our communities.

Botox: Botulinum toxin cosmetic treatment

In recent years a new treatment has made deep inroads into the world of cosmetic and plastic surgery and in the cosmetics: the vistabel, Botox, or botulinum toxin.

Must be a qualified doctor who injected botulinum toxin

The search for eternal youth makes women especially, but increasingly men, are able to use all kinds of treatments, including this new one, in which a toxin or poison is injected under the skin to remove wrinkles on the face. More popular than breast augmentation surgery, this new treatment is seen by some as the ultimate fountain of youth.

What is botulinum toxin?

botulinum toxin type A is a protein produced by a bacterium called Clostridium botulinum , which contains the same toxin that causes severe and often fatal disease called botulism food poisoning.

Its use in the treatment of diseases (blepharospasm and strabismus or uncontrollable blinking of the eyes) was adopted 15 years ago. Later expanded the spectrum of diseases eligible for this type of treatment of cervical dystonia, a neurological disease that causes severe contractions of the shoulders and neck, and more recently also used for hyperhidrosis or excessive sweating of underarms and hands .

As an extraordinary finding as unusual side effects or unusual treatment of eye disorders, doctors saw that the drug eliminated the vertical lines of the skin between the eyebrows, those wrinkles between the eyebrows that make us look tired, angry or unsatisfied.

How does this substance?

Basically, small doses of botulinum toxin used in medicine act by blocking the release of a chemical produced in nerve endings called acetylcholine that is responsible for muscle contractions. When thus the ability to selectively interfere contraction of the muscles of the desired areas, the lines of the skin and soften frown, in most cases disappear within a week.

In what situations is used in the world of plastic and cosmetic surgery?

botulinum toxin injections are a cosmetic procedure that is growing fastest in the industry.

The current indications approved a couple of years by the U.S. Agency for Medicines and Food (FDA, its acronym in English) are the temporary improvement in the appearance of skin lines of moderate to severe frown on people aged 18 to 65 years. It is considered a minimally invasive treatment.

However, despite its approval only as outlined above, is currently being used by many doctors, surgeons and clinics for the treatment of facial wrinkles, so that users of this technique should be advised that Safety and efficacy of these injections in other regions or areas of the face and neck, alone or in combination with skin lines between the eyebrows, have not been clinically evaluated.

When Botox is contraindicated?

The injection of botulinum toxin is contraindicated when there is an infection in the area where treatment will be applied and in individuals with known hypersensitivity to any of the preparations of the product.

The laboratory which markets have warned that a high risk of side effects in people who suffer major neurological diseases such as:

• amyotrophic lateral sclerosis
  
  
• la miastenia gravis
  
  
• the Eaton-Lambert syndrome, a rare disease of the nerves and muscles.
  
  

What are the most common side effects?

The most common side effects are headache , pain and redness of the face, respiratory infections, flu syndrome , temporary eyelid drop, muscle weakness and nausea. Have been described, however, more serious adverse effects, ranging from pneumonia , swallowing disorders and generalized muscle weakness even some deaths. Other findings have been rare cardiovascular disorders, including arrhythmias and myocardial infarction , seizures , facial paralysis and others. Most of these problems occur within the first week after treatment application, and although some reverse soon, others may last for months or years.

It is important to note that there is no chance of contracting botulism toxin injections administered botulinum.

It is noted that this treatment may involve multiple risks from improper use and lends itself to abuse (have detected such treatments in health clubs, hotels, lounges and other places have even proposed the so-called parties of botulinum toxin in which many patients are treated at once, usually in clinics). Therefore, experts advise strongly that this type of treatment is administered by a qualified physician in a medical clinic with adequate means. Patients should be in good hands if complications arise.

The FDA recommends that Botox injections are administered at a rate not less than once every 3 months.

The trade name of this product in the U.S. is Botox , and in Europe , Vistabel .

Before injecting ...

If you are interested in receiving this type of treatment, finally, point out some tips from the American Society for Dermatologic Surgery:

• Make sure it is a qualified doctor who performed the procedure of injecting botulinum toxin.
  
  
• Make sure the doctor is trained and experienced in cosmetic skin surgery of the face.
  
  
• Ask for all the information you need about the benefits and risks of this technique.
  
  
• Avoid alcohol and remain on your back for several hours after the procedure.
  
  
• Choose a medical clinic that provides guaranteed sterile technique and appropriate equipment if a problem occurs.

Cosmetic surgery

Is socially acceptable to have a skin care, smooth and flawless is an attribute of physical attractiveness. However, we are often hard to accept that as we age, keeping the skin healthy, radiant light and becomes increasingly difficult. The face is the "calling card" of the people and so we want to take care of both, yet is the most exposed body area and therefore more vulnerable to the harmful rays of the sun .

Cosmetic surgery has developed rapidly in recent years

The search for a perfect body and eternal youth by many people has led to a rapid development of aesthetic and cosmetic surgery in recent years throughout the world. It is said, not without irony, that in countries like Brazil, where they live with other developed areas very poor, there are many more cosmetic surgery clinics that basic health centers. In many other countries, the high demand for cosmetic surgery procedures by citizens has also led to an extraordinary proliferation of these clinics or centers that provide technical and surgical care for a thousand and one problems of beauty and health.

In Here we review very briefly the most popular techniques and procedures, beyond those already described in previous articles.

It is important to know that most of the techniques we describe, like many other surgical procedures involving or involve certain risks and uncertainties such as infection, bleeding or bleeding, problems with blood clotting and adverse reactions to anesthesia. It is therefore important to choose a plastic surgeon or a specialist in the field highly qualified and accredited clinic or center that provides basic guarantees of hygiene and equipment to reduce or avoid such risks and complications.

have been described more than thirty procedures and treatment techniques for aesthetic and cosmetic problems from which this article will discuss the most important and frequently requested. The treatment referred to breasts as well as facial cosmetic surgery , are skipped in this article because they are treated separately in other articles.

Tummy Tuck

is basically a procedure different from liposuction , which involves flattening or leveling of abdomen by removing fat from the belly and the strengthening of the skin and abdominal wall muscles. It is usually done with anesthesia or local with sedation generally does not last more than 2-3 hours and allowed to return to the patient's normal activity within 2-4 weeks.

"Peeling" or "peeling"

The peeling or "bare" chemical in the skin of the face is a chemical process in which substances are used as phenol or trichloroacetic acid in order to restore the skin of the face, eliminating wrinkles and pigmented lesions or spots or patches of skin caused by sun exposure, using a face mask that produces a bare, ie, an irritation of the upper layers of the skin of the face with subsequent desquamation. This technique works best on smooth thin skin with superficial wrinkles. Takes 1 to 2 hours and requires no anesthesia. Produces or causes little local discomfort, such as redness of the skin or warmth, which disappear in a few days.

Local injections of fat or collagen

These injections are given in the skin of the face, lips, cheeks, chin or, ultimately, the body area to be modified. It is a very simple procedure that usually requires no anesthesia, short duration and only involves the risk of occurrence of an allergic reaction to collagen (a test usually performed prior to injection of the substance to verify whether or not allergies ).

Dermabrasion or skin abrasion

consists of a mechanical scraping of the surface layers of the skin through a small high-speed rotary wheel. Often this technique is used to smooth the skin surface irregularities, including acne and other small facial scars, marks or fine wrinkles, especially around the mouth.

Surgery of the ear and eyelid

techniques exist to treat the ears separate or "jug" (otoplasty), closer to the head or techniques for reducing the size of large ears. They are usually made ​​in children with certain complexes.

Other techniques, such as blepharoplasty, corrects the fall of the upper eyelids and eliminate pockets of fat from the lower eyelids.

Facial implants

basically change the shape and pursue the basic balance of the face, using small facial implants to build a retracted chin, cheekbones, or redraw emphasize the jaw line.

Finally, many other techniques are used to correct problems of the forehead, remove facial wrinkles and scars by laser or by reinstating the hair grafts hair in bald areas, we address further in this article