Cosmetic Laser Surgery Centre

Hi,

I am Dr PK Talwar cosmetic surgeon. I have been doing cosmetic surgery for last 28 years in Delhi. The topic which I would like to speak today is facelift and blepharoplasty, you see with precious of time all because of gravity, pollution and other factors and because of loss of fat, our skin and muscles of the face they become LAX and that is how the signs of aging come. Now to counter that previously we used to do surgical facelift, now what is surgical facelift, a surgical facelift we used to cut the skin in front of the ears and behind the neck open the skin like bonnet of a car, tighten the muscles and then excise the extra skin and pull it up and suture it with that the patient will have nice look. But surgery is now getting less and less preferred by the patients and patient want something which is non-invasive, the reason is that though the scars are very minimal and you hardly find out the scar but because of slight pain, swelling or hospitalization or a day or so, patient did not prefer facelift especially in contemporary time because now there are other techniques are also available but why we are doing surgical facelift I think that it would give you the best possible best result because surgically you can tighten the muscle and the skin. Now the other techniques which came in to help the patient was restarted thread lift now with the thread they used to barbed threads their small barbs you will introduce the barbs from the temporal region below the skin and skin of the face lift of the skin and put it on the barbs with that the skin will be held up by the barbs. They used to be absorbable or non-absorbable different kinds of techniques and with these barbs, the result will not last as long as the surgical facelift but at the same time, it will last for years 2 years or 3 years it depends on how good you are taking care of your facial skin. This thread lift is still very common because it is one of the non-invasive techniques though there are other thread which can you can do it even like cog threads, even you can do in the office but still I prefer that the thread left in a surgical operation theatre will do with longer results and it will definitely give a better results. Now with the precious of time, the skin around your eyes also become black and in that what you can do is, you can always cut the skin here, lift up and then suture it back, it will give you more youthful look. Now again the problem has come with the people who do not want even this surgery, now so there have been other techniques which have come up to improve your eyes which we will be talking in our next lectures. Now with this new technique or thread lifts or the blepharoplasty, you don't need any hospitalization, what you do is come to an operation theatres get it within one hour, get the thread lift in one hour and then you can go back home and there is hardly any swelling. Though we give some antibiotics and mixing for reducing the edema etc. because if there is swelling it will use to heal 5 or 7 days of time and there are certain precautions which we tell the patient that not to wide open the mouth etc and we have seen that lot of patients lot of patients are now coming for work with the non-surgical facelift or thread lift because they really love it that something which doesn't leave any scar at all.

Thank you very much.

Hi,

I am Dr PK Talwar, cosmetic surgeon, I have been doing cosmetic surgery for last 28 years and we were among the first ones who introduced Laser hair removal in India and then Laser for birthmarks in India.

When we talk about the birthmarks, the laser for birthmarks there are basically commonest two kinds of birthmarks one is black birthmark like you seen Nevus of Ota or Becker’s Nevus and second is vascular birthmarks, like port wine stains or then port wine stains that is very common it is also known as hemangioma, hemangioma are different kinds and different kinds of hemangiomas are treated by different laser-like pulsed dye laser, long pulsed ND-YAG etc. Now coming to the first part that is the black birthmarks, so commonest which we are getting is Nevus of Ota in this there is pigment on one side or both side of faces in certain cases and even in the conjunctiva. This can be very disheartening to a patient, when I introduced this laser initially I tried in 2003 I had a young beautiful lady who had the birthmark on the face one side of the face and she has around 30 years of age but by the time she came to me she was already divorced because of the problem of the birthmark. We gave her 10 to 12 sittings and the birthmark Nevus of Ota 95% or you can be gone and she was very happy, only regret she has was Dr. Talwar I should have come to you earlier, but I told her it is not possible because the laser has come recently so even she had come to me earlier we could not her done anything. So that is one of the cases which is still I remember because it was my one of the first cases and I think best possible results the patient is very very grateful and now we have been treating this kind of problem very commonly Nevus of Ota the results have been very good. The same lasers actually this is Q switch laser, the black pigmentation, now the same laser can be used for freckles, for removal of the tattoos and this Becker’s Nevus etc. So the other birthmarks are vascular birthmarks which we call it Port wine stain and the pulsed dye laser is used for that, 2 sittings for black pigments pulsed dye laser is for the vascular or the red birthmarks. Now the difference between these lasers is that the wavelength is different pulsed dye laser is one of the most expensive lasers to buy and the most expensive lasers to maintain, but the results are very rewarding with pulsed dye laser, other modalities are not good as that but pulsed dye laser is the treatment for port wine stain and red birthmarks and we can expect in such cases 70% improvement. We had many patients who have got it done and they are very grateful, we can do Rosacea, Rinofima or facial veins, spider veins etc. we can treat them and patients are really very very happy. So I think the medical science is evolving and the day will come, we will be able to treat 100% of such patients and I suggest strongly that don't go to coeliac because I had a patient with the red birthmark and she went to a coeliac and he applied some sort of acid or what and they burnt the skin. Go to a qualified plastic surgeon or a qualified Dermatologist who is having pulsed dye laser then only you get it done otherwise no and the best wavelength for that is pulsed dye laser is 595 nanometers.

Thank you very much.

I am Dr. Talwar, a cosmetic surgeon from New Delhi.

Today I will be speaking about the Rhinoplasty. Rhinoplasty is actually the beautification of the nose and this is usually done after the age of puberty. People bring children of 10-11 years old age and ask if their nose can be corrected or not. But we feel that once the growth of the nose is complete, which is around the puberty time 14-15 years,  then we can do the rhinoplasty or the beautification of the nose.

Now in rhinoplasty, there are many techniques which are performed or many problems which can be solved. Suppose you have got a hump on the nose, then that naturally can be corrected. We can shave it off and then fracture the nose from the side and make it narrower. If your nose is flat, then we can raise the height of the nose. It can be done either by an implant, or you can take local tissues like cartilage from septum or year or the chest and with this, the height of the nose can be raised.

Then there are tip deformities. Tip deformity is like - suppose the height is less, or it is more round then we can correct that by trimming the lower cartilages. If the nose is broad, then we can narrow it down by cutting the extra tissues. So there are different problems which can be rectified by different techniques.

The question the patient asks is whether there will be any skin mark or not? So there are two techniques- either we can make a cut from inside the nose and then go inside and correct the nose, then another is the open approach which is also getting more and more popular in which we just make a small cut in the base and lift up the whole skin like a bonnet of the car and correct whatever is to be done and then put down the skin back. So this is an open approach. Open and close both the approaches are being followed and scars are hardly visible. The second thing which they ask for is - whether it is to be done under local anesthesia or general anesthesia.

So most of the cases are done under local anesthesia, in which we do not make the patient unconscious but yes if the bone has to be reduced or the bone has to be cut or fractured and narrowed so in that case we generally prefer to give a general anesthesia because the patient mind gets some pain. After rhinoplasty, usually the dressing nose is packed for 2 days and packing of the nose is removed but the plaster or the tape is kept for 7-10 days time for total healing. The results in certain cases are immediate, if you raise the nose it is immediate but if you do the tip work then the result will be apparent after 3 months onwards and the final shape might come after 9-12 months time.

So you need to have patience when you go for a rhinoplasty and otherwise, it's a 1-day job. In morning we do the surgery, if it is a local anesthesia in the patient can go on the same day. If it is under general anesthesia then the by evening also we can send them back. So practically no admission or maybe 8-12 hours admission is required maximum and the dressing is required for 7-10 days time. The results are very rewarding in this case. Male and female both are coming forward for this surgery because the nose is one of the most prominent part of your face. Thank you very much!

How Breast surgery is performed?

Hi, I am Dr PK Talwar. I am a cosmetic surgeon previously at Apollo Hospital, Max Hospital. And currently, I am working in Fortis Hospital, Nehru Place, New Delhi.

Today's topic is Hair transplant. I would like to inform you that for hair loss we have got 2 types of treatment.

• First is through medication. To take medicines whatever are prescribed by a dermatologist and try to delay the process. Suppose after taking all the medications, PRP therapy, you lost your hair significantly, then the treatment is Hair transplant.
• Hair transplant is the second procedure for hair growth. In this treatment, we take the hair from behind the neck and put them on the balded area. In hair transplant also there are two techniques.

1) One is the strip technique in which the strip of hair is taken from the back of the head and then the follicles are put inside the balded area. In this technique, the scars are left.

2) Second is the Follicle unit extraction which is the latest technique all over the world. In this technique, each single graft is plucked by using the motorised equipment. Each graft consists of 1-2-3-4 follicles. The grafts are plucked from behind and the small holes type are created in the balded area where the same grafts are implanted. The process usually takes 8-10 hours. And the hair which we implant starts to grow after 3-4 months after the procedure. And the full growth may take around 8-9 months. But within 6 months you will find your head full of hair and you will be able to see the drastic changes in your hair growth. The full hair length will some time.

The next question which is frequently asked by the patients is that this implanted hair may also fall. So I would like to answer that this hair usually does not fall. As this is a male pattern baldness which is hormone dependent. The male pattern baldness is the hair loss from the crown area. But we transplant the hair from the back of the head or any other body area where occurs minimum hair loss. If the hair from the back of the head is not available then we take the grafts from the beared, chest, back or anywhere from the body. As the hair from these body parts is not dependent on hormones. So we have not seen any such case of hair loss after this transplantation. It will not last a lifetime but it will last for a quite long time. Throughout the youth, there should not be any problem.

Secondary thing is that usually, patients ask if there is any need to take a medication during the period. The medications are not required to be taken throughout the life but take antibiotics for few days and some medications like mentop or any such things which are usually taken for a year or 2 years. And after that, your hair will be as normal as they were before and you will forget everything. And you will live a normal life as you have overcome from the problem.

If you need any solution or suggestion for such problems, you can contact me through Lybarte for online consultation or book an appointment. Or you can take a direct appointment at my clinic which is in E34, Greater Kailash, New Delhi.

Thank you very much.

Hi, I am Dr PK Talwar, a cosmetic surgeon previously at Apollo Hospital and Max group of Hospital, New Delhi. And presently I am attached to Fortis Hospital, Nehru Place, New Delhi. 

Today I will speak about the laser Cosmetic Surgery. We take pride that we are the 1st in India to start Laser Hair removal treatment in the year of 2000. That time, none of the beauty clinics were in existence. Since then, after starting laser hair removal, we have started laser for pigmentation, laser for red birth marks and there are other laser treatment also like fractional carbon dioxide laser. Recently we added Hypho also, the system for skin tightening without any surgery. So these things are basically non-surgical things.

Now, laser hair removal which I started in 1999-2000. Perhaps I and one of my other friend have started this laser hair removal which gave an excellent response. And now it has become a gold standard treatment. 

Most of the population, especially the females are blessed to have this treatment to get rid of hairs permanently. Other laser treatments are Pulsed dye laser. I get to see many patients with red birth marks on their face and till now there is no treatment for this, whether in America or any other country. The only treatment available is Pulse Dye laser.

Even I feel very good, we are blessed to have very good machines from Cynosure i.e, Cynosure photogenica v-star which gives excellent results. We can assure that the results are very good after 10 sittings.

The only problem with the Laer treatment is multiple sittings. Every month you have to come, and usually, 8-10 sittings are required.

Now the pigmentation laser, I would like to mention one case here as an example. A few years back when I got this laser, one young lady came to me. Her age was about 30 years and very beautiful but she has a big black patch on one side of her face due to which she was divorced. So I told her that I have a new treatment for you which might help. After 10 sittings, the patch was almost cleared, it was 95% faded. The only regret she has was that if she could get this treatment earlier then the divorce procedure might not have done. That patient is still in touch with me for other cosmetic treatments. 

So the thing is that if you want to get rid of any acne scar or pigmentation or any blemishes, you consult your doctor or you can consult me as well through Lybrate for the online consultation, appointments etc. Also you can come to my clinic directly which is in E34, Greater Kailash, Delhi.

Thank you so much.