Proiectul vine in intampinarea nevoilor studentilor la Medicina, prin organizarea de stagii de practica, sub coordonarea unor cadre universitare de renume, dar si prin vizite de studiu in locatii semnificative pentru formarea lor. In plus, proiectul ofera pentru cei 360 de studenti din Bucuresti activitati de orientare si consiliere in cariera, precum si un ghid tiparit de orientare si consiliere in cariera.

In completarea stagiilor de practica, vizitele de studiu vor fi gazduite de unitati precum: o clinica medicala, un laborator de cercetare, o sala de operatie din spital, un centru de radio-diagnostic, un centru de radioterapie oncologie, un laborator de histopatologie, un laborator de analize medicale, o unitate de primiri urgente, o sectie de anestezie si terapie intensiva si o expozitie de produse si echipamente medicale.

Proiectul deserveste scopul final al Axei Prioritare 2, respectiv cresterea ocupabilitatii persoanelor aflate in perioada de educatie si formare profesionala initiala, in contextul societatii bazate pe cunoastere, contribuind la atingerea urmatoarelor obiective specifice aferente AP 2 si DMI 2.1 (conform DCI POSDRU): imbunatatirea serviciilor de orientare si consiliere profesionala si promovarea si dezvoltarea parteneriatelor in randul scolilor, universitatilor, intreprinderilor si altor institutii in vederea facilitarii tranzitiei de la scoala la viata activa.

Prin aspectele punctate mai sus, implementarea proiectului contribuie la realizarea obiectivelor Axei Prioritare 2 – ”Corelarea invatarii pe tot parcursul vietii cu piata muncii”, Domeniului Major de Interventie 2.1. – ”Tranzitia de la scoala la viata activa”, Cerere de propuneri de proiecte Nr. 161 – ”Tranzitia de la scoala la viata activa”.

Dr. Ec. Razvan Daraban, Presedintele Asociatiei Centrul Roman de Initiative

”Credem ca oamenii fac diferenta – prin proiectele noastre, facem tot posibilul sa oferim posibilitati reale de dezvoltare participantilor. Vizam dezvoltarea si excelenta, de aceea incercam, impreuna cu partenerii nostri, sa redefinim modalitatea de realizare a stagiilor de practica din domeniul medical. Studentii mai bine pregatiti azi vor fi specialistii in medicina de maine!”.Prof. Univ. Dr. Ioan Lascar, Presedintele Colegiului Medicilor Bucuresti, sef Clinica Chirurgie Plastica – Microchirurgie reconstructiva – Spitalul Clinic de Urgenta Bucuresti; Prorector stiintific al Universitatii de Medicina si Farmacie “Carol Davila” Bucuresti

„Practica de vara pentru studentii la medicina ofera prigilegiul contactului direct cu pacientul. intr-o prima etapa, respectiv in anul I, studentii sunt indrumati de catre cadrele didactice in vederea dezvoltarii abilitatii de comunicare cu pacientul, adica invata ABC-ul intocmirii unei anamneze corecte, care reprezinta baza informationala pentru stabilirea unui diagnostic clinic initial si constituie fundamentul pentru structurarea strategiei de evaluare paraclinica. In acelasi timp, studentii anului II iau contact direct cu modalitatile de ingrijire a pacientilor cu profil chirurgie plastica, respectiv pregatirile preoperatorii si ingrijirile postoperatorii. Studentii din anii III-IV sunt progresiv implicati in activitatile concrete ce vizeaza ingrijirile specifice specialitatii chirurgie plastica pentru regiunea cranio-faciala. Perioada de practica de vara ofera in acelasi timp si oportunitatea efectuarii unor gesturi si tehnici specifice in laboratorul de microchirurgie al Clinicii, in vederea familiarizarii cu domeniul microchirurgiei reconstructive in etapa experimentala. Anii avansati, respectiv IV, vor avea acces in sala de operatii pentru a asista la desfasurarea interventiilor specifice de diferite grade de complexitate. Scopul final este reprezentat de familiarizarea studentilor cu sfera de preocupare a domeniului chirurgie plastica si microchirurgie reconstructiva in regiunea cranio-faciala precum si confruntarea in etapa experimentala cu exigentele impuse de practicarea acestui domeniu. Este astfel oferita oportunitatea stabilirii concordantei intre dorinta de a practica aceasta specialitate prin dobandirea unor abilitati tehnice strans legate de cultivarea aptitudinilor personale, sub indrumarea unor cadre didactice cu competenta si experienta in domeniu.”As. Univ. Drd. Razvan Nicolae Teodoreanu, Medic primar Chirurgie Plastica, Estetica si Microchirurgie Reconstructiva.

“Practica pentru studenti este continuarea fireasca a activitatii teoretice desfasurate in cursul anului. Ea consolideaza informatiile primite si permite aprofundarea lor pe un model real. Practica europeana pentru studenti ,este un prilej excelent de a face acest stagiu,in conditii foarte bune ,cu acces direct la manevrele medicale si chirugicale si la standarde europene.”

Sef lucrari Dr. Dragos Slavescu, Medic primar chirurgie maxilo-faciala, Medic specialist Chirurgie plastica si reconstructiva si General Manager Dental Profile 2000

”Implicarea Dental Profile in proiectul President provine din necesitatea educarii si formarii tinerei generatii conform dictonului ”Investind in Tineri, Investesti in Viitor”. Dorim ca Dental Profile 2000 sa devina un instrument al coagularii preocuparii specialistilor pe aceasta tema complexa, Estetica Dento-Faciala, putand reprezenta un centru metodologic de referinta pentru reteaua de specialitate si partener de dialog pentru forurile internationale de profil”. As. Univ. Dr. Adrian Frunza, Medic specialist Chirurgie Plastica
„Stagiile de practica pentru studentii la Medicina au un rol foarte important in dezvoltarea lor profesionala. Ne bucuram ca putem face parte din echipa care implementeaza un proiect care vizeaza aceasta dezvoltare a abilitatilor practice si le ofera posibilitatea de a experimenta modalitati de lucru pe care nu le-ar putea incerca altfel.”

Despre parteneri

Asociatia ”Centrul Roman de Initiative” (CRI) este una dintre cele mai active organizatii non-guvernamentale din Romania, cu o activitate extinsa in domeniul consultantei si implementarii de proiecte europene de dezvoltare a resurselor umane, cat si pentru domeniul antreprenorial. Proiectele derulate de organizatie, atat in calitate de beneficiar, cat si in calitate de partener, au schimbat in bine viata a cateva zeci de mii de oameni, din toate domeniile economice si din toate regiunile tarii, prin activitati de orientare si consiliere profesionala, cursuri de calificare si recalificare in urma carora cursantii au primit certificate recunoscute international dar si stimulente si premii, cursuri de utilizare a calculatorului, stagii de practica pentru elevii scolilor postliceale sanitare, elaborarea si tiparirea de unor lucrari privind segregarea profesionala bazata pe gen in sectorul de sanatate. La acestea se adauga organizarea de campanii de promovare desfasurate la nivel national, in mai multe domenii de activitate.

CRI detine experienta relevanta in derularea de proiecte cu finantare din fonduri structurale, atat la nivel national, cat si transnational, partenerii organizatiei fiind din tari precum Spania, Polonia, Italia, Marea Britanie, Germania.

Universitatea de Medicina si Farmacie ”Carol Davila” (UMF) Bucuresti este cea mai prestigioasa institutie de invatamant superior medical din tara noastra, care a fost intotdeauna un punct de referinta in dezvoltarea invatamantului medico-farmaceutic romanesc si, de asemenea, un deschizator de drumuri in ceea ce priveste progresul cercetarii stiintifice.

UMF este considerata un lider in domeniul stiintelor medicale, continuator al traditiilor primei scoli de medicina din tara si un pion in dezvoltarea invatamantului si a cercetarii stiintifice de specialitate. Numele institutiei se leaga de ilustri profesori si savanti. Toate aceste considerente constituie premisele unui invatamant medical de inalta tinuta caracterizat de tendinta de perfectionare continua ce se impune prin metode moderne de predare – invatare, prin dialogul si implicarea activa a studentilor in procesul instructiv – educative, precum si prin capacitatea institutiei de a forma si indruma studentii pe un parcurs profesional adecvat si individualizat.

Dental Profile 2000 SRL reprezinta o companie al carei domeniu principal de activitate consta in activitati de asistenta medicala ambulatorie si stomatologica, inclusiv radiologie dentara. infiintata in anul 2000, firma a devenit un centru de excelenta in domeniu, dezvoltand un sistem dentar unic in Romania in ceea ce priveste serviciile, tehnologia, logistica si organizarea.

Pe masura ce piata a oferit conditii de implementare a unor tehnici si materiale noi, concomitent cu dezvoltarea activitatilor de implantologie dentara, firma s-a impus prin volumul si calitatea lucrarilor pe acest segment. Serviciie executate in ultimii 3 ani sunt: tratamente stomatologice privind cosmetica dintilor; obturatii compozit de diferite clase; extirpari radiculare; tratament gangrena; implant dentar; sinus lift; aditie de os; extractii dentare; chisectomie; rezectie apicala; refaceri bont; coroane ceramice si metalice; proteze; parodontologie.

Dental Profile 2000 este prezenta in Bucuresti cu doua clinici stomatologice echipate la standarde internationale, clinici infiintate cu scopul de a furniza un set complet de solutii stomatologice, atestate si recunoscute la nivel national si international. Compania este singura firma in Romania ce poate asigura solutii medicale integrate pentru orice problema pe care pacientul o are, fie ca este vorba de dantura sau de organism, dezvoltand un sistem inovator de ingrijire medicala printr-o colaborare continua cu cei mai buni specialisti din toate sectoarele medicale.

De asemenea, Dental Profile 2000 dispune de specialisti pe fiecare disciplina stomatologica: chirurgie, implantologie, parodontologie, protetica, cosmetica dentara, endodontie, ortodontie. Pentru a garanta o perfectionare continua a serviciilor, echipa de specialisti a companiei este angrenata in proiecte de cercetare si dezvoltare a noilor tehnici in domeniul stomatologic, prin colaborari interdisciplinare cu clinici din Bucuresti si din tara si din strainatate.

Asociația ”Centrul Român de Inițiative”, Universitatea de Medicină și Farmacie ”Carol Davila” București și Dental Profile 2000 SRL au lansat recent, proiectul POSDRU/161/2.1/G/ 135696 „PRESMED – Practică Europeană pentru Studenții la Medicină”. Astfel, 360 de studenți vor desfășura activități de orientare și consiliere în carieră. Ei vor efectua stagii practice și vizite de studiu în unități precum: o clinică medicală, un laborator de cercetare, o sală de operație din spital, un centru de radio-diagnostic, un centru de radioterapie oncologie, un laborator de histopatologie, un laborator de analize medicale, o unitate de primiri urgente, o secție de ane¬ste¬zie și terapie intensivă și o expoziție de produse și echipamente medicale. “Practica de vară pentru studenții la Medicină oferă privilegiul contactului direct cu pacientul. Într-o primă etapă, respectiv în anul I, studenții sunt îndrumați de către cadrele didactice în vederea dezvoltării abilității de comunicare cu pacientul, adică învață ABC-ul întocmirii unei anamneze corecte, care reprezintă baza informațională pentru stabilirea unui diagnostic clinic inițial și constituie fundamentul pentru structurarea strategiei de evaluare paraclinică. Studenții anului II iau contact direct cu modalitățile de îngrijire a pacienților cu profil chirurgie plastică, respectiv pregătirile preoperatorii și îngrijirile postoperatorii. Cei din anii III-IV sunt progresiv implicați în activitățile ce vizează îngrijirile specifice specialității chirurgie plastică pentru regiunea cranio-facială”, a spus prof. dr. Ioan Lascăr, prorector științific al Universității de Medicină și Farmacie “Carol Davila” București, la lansarea proiectului.

Programul a început din data de 1 mai, anul acesta, şi va continua până la 31 octombrie 2015, iar până acum, au fost recrutaţi deja 200 de medicinişti, care vor începe stagiul pe 10 iulie. „Practica de vară pentru studenții la Medicină oferă privilegiul contactului direct cu pacientul. Într-o primă etapă, respectiv în anul I, studenții sunt îndrumați de către cadrele didactice în vederea dezvoltării abilității de comunicare cu pacientul, adică învață ABC-ul întocmirii unei anamneze corecte, care reprezintă baza informațională pentru stabilirea unui diagnostic clinic inițial”, a declarat prof. dr. Ioan Lascăr, președintele Colegiului Medicilor București şi şeful Clinicii de Chirurgie Plastică – Microchirurgie reconstructivă – Spitalul Clinic de Urgență București.

În același timp, studenții din anul al II-lea iau contact direct cu modalitățile de îngrijire a pacienților cu profil chirurgie plastică – pregătirile preoperatorii și îngrijirile postoperatorii. Studenții din anii III-IV sunt implicați în activitățile concrete ce vizează îngrijirile specifice specialității chirurgie plastică pentru regiunea cranio-facială, mai spune Lascăr. Studenţii din anii avansați vor avea acces chiar şi în sala de operații pentru a asista la desfășurarea intervențiilor de diferite grade de complexitate.

Proiectul POSDRU/161/2.1/G/ 135696 „PRESMED – PRactică Europeană pentru Studenții la MEDicină ” este derulat de Asociația ”Centrul Român de Inițiative” (CRI), Universitatea de Medicină și Farmacie ”Carol Davila”(UMF) București şi deservește scopul final al Axei Prioritare 2, respectiv creșterea ocupabilității persoanelor aflate în perioada de educație și formare profesională inițială.

Usually, the breast reconstruction is done in several stages. It may be done at the same time with the mastectomy or may be postponed until the patient is cured and fully recovered after mastectomy and other additional therapies.

What is breast reconstruction?

There are several techniques meant to restore the shape, profile and size of the lost breast:

- procedures based on flaps that reposition muscular, fat or skin segments to create a breast mound or to cover a mammary implant;
- tissue expansion used to stretch the healthy skin in order to cover a breast implant;
- the insertion of a mammary prosthesis to simulate the breast shape;
- the use of skin grafts and other techniques to rebuild the nipple-areolar complex.

The results are very different. A reconstructed breast will never have the same sensibility as the original one. Scars will appear both on the donor sites and on the mammary region.

When only one breast is reconstructed, the other one may need a reduction, a lifting procedure or an augmentation in order to achieve symmetry.

The ideal candidates for breast reconstruction are the patients who are well aware of their medical problem and have completed the oncologic treatment, have no other health problems which would possibly interfere with their healing process; it is also preferable for them to be non-smokers.

Obesity, diabetes or cardiac affections may be a relative counter-indication for using flaps.

Where do I begin?

A plastic surgery consult is the first step. The surgeons’ goal is to make sure you fully understand the reconstruction options , the risks and possible complications and the recommended therapeutic algorithm including the final refinements for symmetry.

The initial evaluation

For safe and best results you are expected to sincerely describe your desired result, to fully disclose your medical history, any ongoing medical treatments, alcohol, recreational drugs or tobacco use.

The reconstruction

Always the reconstruction is a very personalised procedure. The individual anatomic features will lead to the best suited reconstruction method. When we have a small amount of mammary tissue and muscle left after mastectomy we have to use flaps. Their drawbacks are the scars both in the donor and the recipient areas, the risk of flap loss (partially or totally) and the prolonged recovery time.

A TRAM flap (based on the rectus abdominis muscle) may be used as a pedicled flap transposed to the thorax or as a free flap when the vascular pedicle is cut and reattached by microsurgical techniques in the mammary region. The latissimus dorsi flap is comprised of muscle, fat and skin from the back transposed to the anterior thorax and used to rebuilt the breast or to cover a mammary implant.

As previously stated, sometimes after mastectomy we don’t have enough tissue left in place to cover a breast implant. This is why using a breast implant needs adding a flap or tissue expansion.

Tissue expansion implies several steps made over 2-4 months after expander insertion in order to fully inflate it and stretch the skin above it. Sometimes a new surgical procedure is necessary afterwards to replace the expander with a permanent implant.

The final interventions are meant to reconstruct the nipple-areolar complex.

Before the surgery

You will be given instructions concerning any required tests, medication and specific information about the type of anaesthesia to be used.

You will be asked to sign an informed consent in order to assure your surgeon that you fully understand the procedure with all the possible risks and complications.

Among the possible risks are bleeding and developing an infection. Using flaps includes the risk of partial/total flap loss and diminished sensibility both in the donor and recipient area. The use of implants encompasses the risk of capsular contracture (firmness of the reconstructed breast) and the risk of implant rupture. Any surgical procedure comes along with anaesthetic risks.

It is important to understand that mammary reconstruction may yield impressive results but cannot match the original breast. Even after procedures on the contralateral breast the symmetry will not be perfect, but you will have a natural aspect wearing a swimsuit.

What to expect?

All mammary reconstruction procedures require hospitalization for one or two days.

After surgery

After completing the surgery, the incisions are covered with dressings. An elastic bra will help minimize the edema and will support the reconstructed breast. Sometimes drains are inserted to evacuate any fluid or blood collections underneath the skin.

At discharge, you will be instructed about any local wound care, necessary medication to help the healing process or to reduce the risk of infection and also about follow-up visits.

The healing process

In the first days following surgery you will feel some swelling and discomfort at the incisions and donor sites. These can be controlled with medication. An elastic bandage or a support bra is recommended. A return to light activities is possible a few days after surgery.

In the vast majority of cases surgeons use absorbable sutures; however, if some stitches are to be removed, this is performed 14 days postoperative; at this time you may return to your normal activity, but you are not allowed to lift heavy objects.
The healing process will continue over a few weeks along with dissipation of the edema.

Results

The final aspect of breast reconstruction can help you feel emotionally and physically complete. With time, breast sensibility will improve and the scars will look better.

Your surgeon, your choice

The decision to have cosmetic or reconstructive surgery is important, as well as choosing the right surgeon. Not all the doctors performing these procedures are plastic surgeons. Make sure your doctor is a board- certified plastic surgeon, member of the Romanian Plastic Surgeons Association.

The solution destined to restore the shape of your breasts may be the breast lift (mastopexy). This implies removing the excess skin and remodelling local tissue. Sometimes is necessary to reduce the areola in order to restore the original dimensions. The result is a breast with a firm and youthful contour.

What is the breast lift?

The breast lift (also called mastopexy) is the surgical procedure meant to lift and improve the shape for breasts which : are sagging, but proportionate with the general body aspect; have lost their consistency; have a flatter, elongated shape; have a nipple fallen below the breast crease; have an enlarged areola.

The mastopexy is designated for women desiring breasts with better form and shape. If they want also a volume increase, breast implants can be used along with the breast lift.

It is recommended to inform your plastic surgeon if you have scheduled a pregnancy in the near future. A breast lift will not affect the lactating function, but the body changes related to pregnancy may counteract the effects of this surgical procedure. An important weight loss must be also discussed. For these reasons, good candidates for mastopexy are women with normal weight, with completely developed breasts and who have completed their family. The breast lift is performed in younger women with asymmetric breasts (one of them is positioned lower than the other). The patients must be healthy and preferably non-smokers (smoking slows healing).

Where do I begin?

A consultation with your plastic surgeon is the first step to discover how a breast lift may improve your breasts. You will be fully informed about the surgical options, possible risks, complications and results; according to your wishes, your doctor will recommend you the most appropriate treatment.

Evaluation

Your overall health and general aspect may greatly influence the outcome of your surgery. For best results it is necessary to sincerely share your expectations, fully disclose your medical history, any previous treatments, the use of alcohol, recreational drugs or tobacco; it is important to tell if you have any family history of breast cancer.

My breast lift

Mastopexy is a highly-individualized procedure with a wide variety of surgical techniques. The one best suited to your case will be chosen based on: size and shape of the breasts, size and position of the areola, the degree of mammary ptosis, quality and elasticity of skin as well as skin excess.

The most commonly used pattern for breast lift uses three incisions:

- around the areola;
- vertically down from the areola to the breast crease;
- horizontally along the breast crease.

Using these incisions the mammary tissue is lifted and remodelled. The nipple and areola are repositioned to a more youthful height. If it is necessary, the areolar diameter is reduced. The excess skin is excised to compensate loss of elasticity.

The alternative techniques eliminate either the horizontal incision at the breast crease, the vertical one or both. In every case the incisions are made in such fashion that they may be hidden under a bathing suit.

Preparing for surgery

The plastic surgeon will inform you about every aspect of the operation. You will be instructed about any necessary lab tests, any recommended medicines and the chosen type of anaesthesia.

You will be asked to sign an informed consent in order to assure your surgeon that you fully understand the procedure with all the possible risks and complications. Among the possible risks are bleeding, developing an infection, alterations in nipple sensibility. Any surgical procedure comes along with anaesthetic risks.

What to expect?

The breast lifting procedures require hospitalization for 2 days.

After surgery

After completing the surgery, the incisions are covered with dressings. An elastic bra will help minimize the edema and will support the lifted breast. Sometimes drains are inserted to evacuate any fluid or blood collections underneath the skin.

At discharge, you will be instructed about any local wound care, necessary medication to help the healing process or to reduce the risk of infection and also about follow-up visits.

The healing process

In the first days following surgery you will feel some swelling and discomfort at the incisions and donor sites. These can be controlled with medication. An elastic bandage or a support bra is recommended. A return to light activities is possible a few days after surgery.

Results

The final aspect of your mastopexy will be seen in a few months. Over time your breasts will change their aspect due to aging and gravity. The breast profile is maintained by having a constant weight, a healthy lifestyle and a good support (elastic bra).

Your surgeon, your choice

The decision to have cosmetic or reconstructive surgery is important, as well as choosing the right surgeon. Not all the doctors performing these procedures are plastic surgeons. Make sure your doctor is a board- certified plastic surgeon, member of the Romanian Plastic Surgeons Association.

If weight loss and exercise haven’t help you to get a better proportioned and youthful body, a thigh lift may be the solution you are looking for. This kind of surgery reshapes the thighs by removing excess skin and fat; these changes may improve your body image and will give you more self-confidence.

What is the thigh lift?

The thigh lift is a surgical procedure meant to improve the contour of the thighs. Usually this surgery modifies the inner thighs, the outer thighs or both by repositioning the supportive structures and excising the skin excess. The result is a more youthful, smoother skin.

Among the possible causes contributing to thigh contour irregularities and localized skin excess we include:

- weight fluctuations caused by pregnancy;
- weight loss following bariatric surgery;
- genetic factors influencing skin elasticity including dimpled, irregular skin, commonly known as cellulite;
- aging;
- sun damage and other environmental factors that induce skin aging;
- childhood and adolescence obesity that cause a premature skin tone loss.

The thigh lift may be appropriate to those with a constant weight, suited to their height.

This procedure can be performed on adults of any age that have realistic purposes related to their body image.

The best candidates are healthy, non-smokers individuals who have a soft tissue excess at their inner thighs, outer thighs or both.

Where do I begin?

A consultation with your plastic surgeon is the first step to discover how a thigh lift may improve your body image. You will be fully informed about the surgical options, possible risks, complications and results; according to your wishes, your doctor will recommend you the most appropriate treatment.

Evaluation

Your overall health and general aspect may greatly influence the outcome of your surgery. For best results it is necessary to sincerely share your expectations, fully disclose your medical history, any previous treatments, the use of alcohol, recreational drugs or tobacco; it is important to follow exactly your doctors’ advices.

Make sure your surgeon is a board-certified member of the Romanian Association of Plastic Surgeons.

My thigh lift

The surgical procedure will be individualized to your condition. Your surgeon will treat the following aspects:

- areas of skin laxity;
- localized fat deposits;
- contour irregularities, dimpled skin (cellulite).

The lift may address the inner, outer thigh or both.

A thigh lift is the only body contouring method that may restore shape and skin tone. The length and incision pattern depend on the amount and location of skin excess to be removed but also on surgeon’s personal preferences and judgement. To treat the inner thighs the incisions are made in the inguinal region and extended downward on the inside of the thigh to the knee. To treat the outer thigh it is necessary to extend the incision from the groin (inguinal) area towards the hip and buttock in a bikini pattern.

Using these incisions your plastic surgeon will reshape your thighs. Excess fat can be excised or liposuctioned. The underlying support structures will be tightened, the excess skin will be removed or redraped for a better contour.

The thigh lift may be associated with other procedures performed simultaneously or separately like liposuction, buttock lift, abdominoplasty, breast lift, reduction mammoplasty. Not every patient is a good candidate for a combined procedure.

The results of your thigh lift are visible immediately, although initially are obscured by bruises and edema. It will be necessary that you wear a compression garment for a few weeks after surgery to minimize swelling and support the tissues as they heal.

Preparing for surgery

The plastic surgeon will inform you about every aspect of the operation. You will be instructed about any necessary lab tests, any recommended medicines and the chosen type of anaesthesia.

You will be asked to sign an informed consent in order to assure your surgeon that you fully understand the procedure with all the possible risks and complications. Among the possible risks are bleeding, developing an infection, alterations in local skin sensibility. Any surgical procedure comes along with anaesthetic risks.

What to expect?

The thigh lifting procedures require hospitalization for 2 or 3 days. Usually is performed under general anaesthesia, but it can be done also using local anaesthesia and sedation.

After surgery

After completing the surgery, the incisions are covered with dressings. An elastic garment will help minimize the edema and will support the new shape as you heal. Sometimes drains are inserted to evacuate any fluid or blood collections underneath the skin.
At discharge, you will be instructed about any local wound care, necessary medication to help the healing process or to reduce the risk of infection and also about follow-up visits.

The healing process

In the first days following surgery you will feel some swelling and discomfort at the incisions. These can be controlled with medication. You will be advised to return to walking as soon as possible to minimise the risk of developing blood clots or other complications.

You have to avoid physical effort; otherwise, you will strain the internal sutures. It is also recommended for you to sleep with your knees elevated on pillows. You should be able to return to light activity in 2 or 3 weeks after surgery.

The incisions heal in 14 days; sutures will be removed, if necessary. Numbness in certain thigh areas will get better in time. It is necessary to avoid sun exposure or to use sun screen for 6 months following surgery, otherwise you may develop hyperpigmented scars. It may take up to one year until your scars refine.

Results

The result of your thigh lift is immediately visible but it may take up to one year to reach the final aspect. The scars, although permanent, can be hidden by a swimsuit. If you’ll maintain your weight and general fitness, your body image improvement will be long-lasting.

Your surgeon, your choice

The decision to have cosmetic or reconstructive surgery is important, as well as choosing the right surgeon. Not all the doctors performing these procedures are plastic surgeons. Make sure your doctor is a board- certified plastic surgeon, member of the Romanian Plastic Surgeons Association.

If you have sagging skin in the inner side of your arms, an arm lift could be the right solution. An arm lift removes the excess skin and fat restoring the natural contour. The result is a more youthful, more toned appearance, improving your self-confidence.

The tribute paid to a better image is the scar on the inside of your arm.

What is the arm lift?

The arm lift (brachioplasty) is a surgical procedure meant to reshape the arms, from the axilla to the elbow.

The brachioplasty is performed to:

- remove sagging skin from the inside of the arms;
- tighten and smooth the underlying support structures that define the shape of the arm;
- remove any localised fat deposits.

The body contour changes treated by brachioplasty may develop both in men and women; usually they are a consequence of loss of elasticity in the skin and the supportive tissues. They may appear after massive weight loss (stretched skin with lost elasticity), they may be due to aging and heredity.

An arm lift cannot improve lost tone of upper arm muscles; in fact, those who choose to have a brachioplasty are people with a good physical condition.

The perfect candidates for this procedure are:

- adults of any age with a normal, stable weight;
- healthy, non-smokers individuals;
- patients with a positive attitude and realistic goals.

Where do I begin?

A consultation with your plastic surgeon is the first step to discover how an arm lift may improve your body image. You will be fully informed about the surgical options, possible risks, complications and results; according to your wishes, your doctor will recommend you the most appropriate treatment.

Evaluation

Your overall health and general aspect may greatly influence the outcome of your surgery. For best results it is necessary to sincerely share your expectations, fully disclose your medical history, any previous treatments, the use of alcohol, recreational drugs or tobacco; it is important to follow exactly your doctors’ advices.

Make sure your surgeon is a board-certified member of the Romanian Association of Plastic Surgeons.

My arm lift

Brachioplasty is a safe procedure that can significantly improve the appearance of your upper arms. It begins with an incision made on the inside of the upper arm. This incision can be extended from the axilla to the elbow or may be shorter. The length and pattern of the incision depend on the amount and location of the excess skin to be removed, as well as on the surgeon’s preference and technique. If it is necessary to remove some fat, this is either excised either treated by liposuction.

The underlying supportive tissue is tightened and remodelled using sutures. Subsequently the excess skin is excised. The incisions are closed using absorbable sutures; sometimes non-absorbable sutures are also used; these need to be removed after two weeks.

After an arm lift you will have a scar on the inside of the upper arm. Sometimes the skin elasticity is so week that a new lifting procedure is necessary.

Preparing for surgery

The plastic surgeon will inform you about every aspect of the operation. You will be instructed about any necessary lab tests, any recommended medicines and the chosen type of anaesthesia.

You will be asked to sign an informed consent in order to assure your surgeon that you fully understand the procedure with all the possible risks and complications. Among the possible risks are bleeding, developing an infection, alterations in local skin sensibility. Any surgical procedure comes along with anaesthetic risks.

What to expect?

The arm lifting procedures require hospitalization for 2 or 3 days. Usually is performed under general anaesthesia, but it can be done also using local anaesthesia and sedation.

After surgery

After completing the surgery, the incisions are covered with dressings. An elastic garment will help minimize the edema and will support the new shape as you heal. Sometimes drains are inserted to evacuate any fluid or blood collections underneath the skin.

At discharge, you will be instructed about any local wound care, necessary medication to help the healing process or to reduce the risk of infection and also about follow-up visits.

The healing process

In the first days following surgery you will feel some swelling and discomfort at the incisions. These can be controlled with medication. You will be advised to keep your arms elevated in the first days following surgery and to return to light walking to avoid the development of blood clots or other complications. You should also avoid heavy lifting, but you may return to work in a few days.
The incisions heal in 14 days; sutures will be removed, if necessary. Numbness in certain thigh areas will get better in time. It is necessary to avoid sun exposure or to use sun screen for 6 months following surgery, otherwise you may develop hyperpigmented scars. It may take up to one year until your scars refine.

Results

The result of your arm lift is immediately visible but it may take up to one year to reach the final aspect. The scars, although permanent, will improve in time. If you’ll maintain your weight and general fitness, your body image improvement will be long-lasting.

Your surgeon, your choice

The decision to have cosmetic or reconstructive surgery is important, as well as choosing the right surgeon. Not all the doctors performing these procedures are plastic surgeons. Make sure your doctor is a board- certified plastic surgeon, member of the Romanian Plastic Surgeons Association.

If you have gynecomastia breast reduction surgery may be a solution. Excess skin, glandular tissue and fat are removed. This leads to a more masculine, a better proportioned torso.

What is gynecomastia?

Gynecomastia’s main feature is the presence of enlarged breasts, disproportioned to a masculine body. The surgery designed to correct this anomaly is reduction mammoplasty; the result is a flattened and improved contour of anterior thorax. In severe cases, the weight of excess mammary tissue may cause the aspect of sagging breasts, with enlarged areolas. In this situation, areolar size and position may be improved and the excess skin surgically removed.

Gynecomastia may develop following the hormonal changes in adolescence; it may be the result of heredity, certain medicines, excessive alcohol consumption and smoking, use of marijuana or anabolic steroids. Enlarged breasts in obese males are not categorized as gynecomastia; they are just the consequence of being overweight.

In gynecomastia cases we encounter three types of modifications:

- localized excess fat;
- overdeveloped glandular tissue;
- o combination of the previous conditions.

Gynecomastia may affect just one or both breasts. In some cases, correcting gynecomastia may be considered a reconstructive procedure, not an aesthetic one. The surgery may be performed at any age, but the best results ensue if the natural growth process is complete. Therefore, if the patient is an adolescent, new surgery may be required in the future should breast development continue.

The ideal candidate for this surgery is the normal weight man whose breast development is complete. Before surgery is mandatory to obtain a full medical history, to perform a physical exam associated with diagnostic endocrine lab tests in order to uncover any possible cause.

Where do I begin?

A consultation with your plastic surgeon is the first step to understand how a reduction mammoplasty can correct the torso profile, giving you a more masculine appearance. Your doctor will discuss with you the available options according to your wishes. You will be informed about the possible results and the associated risks. The success of your surgery needs that you honestly share your expectations, any ongoing medical treatments, the use of alcohol, tobacco and recreational drugs (marijuana).

Make sure your surgeon is a board-certified member of the Romanian Association of Plastic Surgeons.

Correction of the gynecomastia

Choosing the right technique for correcting gynecomastia depends on several factors:

- the underlying cause;
- the excess of mammary tissue and particular composition (fat, glandular tissue or skin);
- age and overall health.

If it’s just an excess of adipose tissue, liposuction techniques only will be used. These require that a cannula (a hollow metal tube with multiple holes) is inserted through several small incisions. The cannula is connected to a surgical aspirator which helps to remove the excess fat.

The surgical excision is recommended when we have to excise excess skin or glandular tissue. Sometimes a reduction of the areolar diameter or nipple repositioning may be necessary . The incisions may vary according to necessities and surgeon’s preferences. Most of the incisions are made around the areola or in the breast crease.

Preparing for surgery

The plastic surgeon will inform you about every aspect of the operation. You will be instructed about any necessary lab tests, any recommended medicines and the chosen type of anaesthesia.

You will be asked to sign an informed consent in order to assure your surgeon that you fully understand the procedure with all the possible risks and complications. Among the possible risks are bleeding, developing an infection, alterations in nipple sensibility. Any surgical procedure comes along with anaesthetic risks.

What to expect?

The surgical procedures to correct gynecomastia require hospitalization for 2-3 days.

After surgery

After completing the surgery, the incisions are covered with dressings. An elastic bandage will help minimize the edema and will support the new breast contour. Sometimes drains are inserted to evacuate any fluid or blood collections underneath the skin.

At discharge, you will be instructed about any local wound care, necessary medication to help the healing process or to reduce the risk of infection and also about follow-up visits.

The healing process

In the first days following surgery you will feel some swelling and discomfort at the incisions. These can be controlled with medication. An elastic bandage is recommended. A return to light activities is possible a few days after surgery. If non-absorbable sutures were used, they have to be removed at 10-14 days. You will be able to return to work in 10 days if you don’t have to do any heavy lifting.

The healing will continue over the next few weeks as the edema subsides and the new chest contour settles. The scars will improve in time.

Results

The aspect obtained by breast reduction is permanent in the majority of cases. If your gynecomastia was a consequence of using certain medicines, steroids or marijuana you have to renounce them completely. All scars are permanent, but are easily concealed in the natural anatomic contours. They are the tribute paid to restore a male chest profile; you will have a better self-image and confidence.

Your surgeon, your choice

The decision to have cosmetic or reconstructive surgery is important, as well as choosing the right surgeon. Not all the doctors performing these procedures are plastic surgeons. Make sure your doctor is a board- certified plastic surgeon, member of the Romanian Plastic Surgeons Association.

What are injectable fillers?

Injectable fillers are substances used to increase the volume of soft tissues, especially in the face. These fillers can be used singularly or in combination with other procedures such as botulinum toxin. Some fillers are based on natural compounds of the human body; others are synthetic products containing several biocompatible substances. The differences among fillers are not only related to their composition but also to the preferred areas for injection and the duration of their effect.

Collagen is a natural protein included in the support structure of the skin. The products based on human dermis-derived collagen are used to contour the lips, inject the rhytides and scars. There are products containing bovine collagen which need prior allergy testing. The results of collagen injections will begin to fade after three or four months.

Hyaluronic acid is a natural substance found in the human body. Synthetic hyaluronic acid is a gel with various density degrees. The different types of hyaluronic acid are used to fill fine and deep wrinkles. Hyaluronic acid is also used to restore facial prominences and to thicken (augment) the lips. Because is colourless, hyaluronic acid is suited to all skin types, regardless the complexion . The effect of hyaluronic acid treatment will diminish after 6-12 months.

Semi-permanent fillers are recommended for deep facial creases; they can be used to restore facial volume or to correct lipoatrophy (the loss of facial fat). Their effect lasts a year or more.

Among these semi-permanent fillers, calcium hydroxylapatite is a mineral component of bones; it is used as a gel. Poly L-lactic acid is a synthetic biocompatible , biodegradable product, commonly used as absorbable suture. As a filler is injected in one or more stages several weeks apart until the desired volume is obtained.

Polymethylmethacrylate microscopic spheres are suspended in a collagen solution and injected to fill facial creases. These are considered permanent filler.

You should know that semi-permanent and permanent fillers are not recommended for very mobile areas (such as lips) or regions with fine structure (the lids). These fillers can be efficiently used to contour and augment the chin, cheeks and nose.

Human fat obtained from your own body can be also used as injectable filler. The fat must be harvested from the abdomen, hips or buttocks using liposuction techniques. Once injected into soft tissues, the fat must get a proper blood supply in order to survive and to confer a long term correction, although some of the component cells will be absorbed. The remaining fat and its volumetric effect are permanent, but will diminish with aging. Extracted fat can be frozen and saved for future treatments but the results obtained using this type of fat are not as good as ones using fresh fat.

Where do I begin?

A consultation with your plastic surgeon is the first step to find out how injectable fillers may be used to rejuvenate the face by restoring lost volume, filling the rhytides and improving contour. You will be informed about the available options for facial rejuvenation and the recommended treatment according to your wishes, the expected outcomes, duration of results and potential risks.

Evaluation

The success of your treatment requires that you honestly share your expectations, disclose your fully medical history and any previous treatments with fillers or other rejuvenation methods, use of alcohol, tobacco, recreational drugs. You should follow precisely your doctor’s recommendations.

You have to tell your doctor if you have the Herpes virus; it is necessary in this case to follow a specific treatment to avoid developing herpetic lesions at the injection site.

Not everyone injecting fillers is a plastic surgeon. For your own safety, make sure your doctor is a board-certified plastic surgeon.

The procedure

Your plastic surgeon will evaluate carefully your skin tone and overall facial aspect. For your comfort, in the areas to be injected the doctor will apply ice and a local anaesthetic. Many types of filler already contain some local anaesthetic. The injection points will be marked and disinfected. In most cases, treatment takes about 20-30 minutes. After completing the procedure, ice will be applied to prevent any minor pain. Make-up may be reapplied but avoiding to exert any pressure on the treated areas.

The effects of injectable fillers are immediately visible; the injected areas though may develop slight edema, bruises and temporary numbness. All these resolve within a few days.

Hyaluronic acid fillers are the only ones whose effect can be reversed by injecting hyaluronidase; this will accelerate filler’s resorption in a few days comparing with the expected duration of six to twelve months.

Poly-L-lactic Acid treatment requires several stages to obtain the desired results. Furthermore, you will have to massage the injected zone for one to two weeks.

If your own fat was used you will notice at the injection site some swelling and bruising for a few days to several weeks.
Preparing for injection

The treatment is performed in a plastic surgeon’s office. Previous to inject, your doctor will describe carefully the recommended treatment, type and brand of the selected filler, expected results and how long they are going to last. You will be asked to sign an informed consent in order to certify that you have fully understood the procedure, including possible risks and complications.
The risks associated with using injectable fillers vary depending on every product type. An infection may develop at the injection site. Some fillers obtained from animal tissue require prior testing to exclude possible allergies. The component particles of semi-permanent fillers may form granulomas which can be felt beneath the skin. In rare cases, these granulomas may need to be surgically removed.

After treatment

Once the procedure is finished you will be instructed how to care for the treated areas. You will be reminded the duration of the effect, the necessary precautions in the first days, the scheduled follow-up visits.

As your filler is resorbed you will need another injection. If you choose not to continue the treatment you will return to your original aspect. The wrinkles will reappear; the injected zones will lose their volume.

Results

You will be surprised by the effects of this rapid procedure. For safety reasons, using these substances require serious anatomy knowledge. Therefore choosing a plastic surgeon to inject these fillers warrants that your treatment is performed by somebody experienced not only in injection therapy, but also in all types of facial rejuvenation, surgical or non-surgical.

Your surgeon, your choice

The decision to have cosmetic or reconstructive surgery is important, as well as choosing the right surgeon. Not all the doctors performing these procedures are plastic surgeons. Make sure your doctor is a board- certified plastic surgeon, member of the Romanian Plastic Surgeons Association.

If you were diagnosed with skin cancer or you have a suspicious skin lesion, a consultation with a plastic surgeon may help you understand the available therapeutic options. It’s only natural for you to be concerned that a surgical procedure may affect your physical appearance. The plastic surgeon can remove the neoplastic lesions using the right techniques to restore both your health and your physical aspect. Any surgery comes with a scar, but your surgeon will do everything possible to treat your skin cancer without damaging your appearance.

Before going to a doctor, make sure the one you have chosen is a board-certified plastic surgeon.

What is skin cancer?

The skin is the largest organ of the body, protecting all internal organs. Like every other organ the skin is composed by multiplying cells. Along this process the skin may develop lesions of various colours, forms and sizes. Many of these lesions, such as nevi (moles) are benign; they grow slowly and do not spread. When the cellular multiplying process is abnormal the result is a malignant lesion (skin cancer) that may spread to other areas of the body.

From the superficial skin layer, the epidermis, may develop squamous cell carcinomas (usually scaly lesions) and basal cell carcinomas (the most frequent type, with a round-pearly appearance). Melanoma is the most aggressive skin cancer. It presents as a black or brown lesion with irregular, ill-defined borders; it develops in the deepest portion of the epidermis, having the biggest tendency to spread throughout the body.

There are some others rare types of skin cancer.

In order to diagnose skin cancer and its type a tissue sample must be microscopically evaluated.  According to size and location of the skin lesion, there are multiple ways to excise the skin cancer and to perform the subsequent reconstruction.

A small lesion may be removed by excision. This is a simple surgical procedure done by cutting away the suspicious lesion along with a border of normal skin. There are cases resembling with an iceberg: what we see is actually just a small part of the problem. In this situation your surgeon may request a “frozen section”. This means that the excised lesion is microscopically examined before closing the wound to make sure that every cancerous cell was removed. Once the skin cancer was removed the plastic surgeon’s goal is to close the skin in such manner that your appearance is minimally affected.

The excision of small cancerous lesions is usually closed by direct suture. Removing larger lesions leads to a bigger defect requiring reconstruction with a skin graft or a flap. If the post -excisional defect is very deep or has a large surface the local flaps are not suited and we have to use free tissue transfer. This is a microsurgical procedure allowing coverage of complex defects with skin, fat, muscle, sometimes bone and cartilage, taken away along with the nutrient blood vessels and connected to the  local vascular network.

Where do I begin?

A consultation with a plastic surgeon is the first step to find out how  a skin cancer can be surgically removed and if a reconstruction will be necessary. You will be fully informed about the different types of skin cancer, the therapeutic options according to your case and the expected results, including your physical appearance.

Evaluation

Your overall health will greatly influence the end result of the surgery. It is very important that you honestly share your expectations, use of medicines, alcohol, tobacco or recreational drugs.

Your case

The simple mentioning of the word “cancer” is hard to accept. Understanding that treating this cancer can get you scars or disfigurement is troublesome. Your surgeon understands your concern and will explain every therapeutic method and its effect on your appearance. In certain situations, the reconstruction may need multiple stages. All these may restore an almost natural aspect, but there is no such thing like the perfect reconstruction. There will be scars. Sometimes the reconstructed zones may differ in colour and texture comparing to unaffected areas. Although every effort will be made to get a result as natural as possible the most important thing is that the cancer is completely removed.

Preparing for surgery

The plastic surgeon will inform you about every aspect of the operation. You will be instructed about any necessary lab tests, any recommended medicines and the chosen type of anaesthesia.

You will be asked to sign an informed consent in order to assure your surgeon that you fully understand the procedure with all the possible risks and complications. Among possible risks we encounter infection or the development of fluid or blood collections underneath the skin. If a skin graft is used it is possible that your graft will not “take” and therefore additional surgery will be necessary to close the wound. There may be changes in skin colour, texture and local sensation.

Many times skin cancer surgery is done under local anaesthesia; some procedures require sedation or general anaesthesia.

What to expect?

Most skin cancer surgery is performed on an outpatient basis. If your surgery requires general anaesthesia or the lesion is a large one, hospitalization will be necessary for a few days.

After surgery

After completing the surgery, the incisions are covered with dressings.Sometimes drains are inserted to evacuate any fluid or blood collections underneath the skin.

At discharge, you will be instructed about any local wound care, necessary medication to help the healing process or to reduce the risk of infection and also about follow-up visits.

The healing process

In the first days following surgery you will feel some swelling and discomfort at the incisions. These can be controlled with medication.A return to light activities is possible a few days after surgery. If non-absorbable sutures were used, they have to be removed at 10-14 days. Any local numbness will resolve in time. In certain cases additional procedures are necessary to complete or refine the reconstruction.

A particular attention must be given to sun protection for life.  Sun exposure may lead to pigmentation anomalies; new skin lesions may appear in the same place or on another region of your body.

Results

The plastic surgeon will help you heal by excising the skin cancer and performing the reconstruction as natural as it can be. Simple excision may cure you; there are cancer types necessitating additional radiotherapy or chemotherapy. It is important to follow all the treatment recommendations.

Once you were diagnosed with skin cancer you have a greater risk of developing a new skin cancer. Skin cancer may reoccur. It is important to self-examine your skin periodically to detect and follow any suspicious lesion. Use sun blockers and try to give up smoking.

 Your surgeon, your choice

The decision to have excisional and reconstructive surgery is important, as well as choosing the right surgeon. Not all the doctors performing these   procedures are plastic surgeons. Make sure your doctor is a board- certified plastic surgeon, member of the Romanian Plastic Surgeons Association.