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Submitted by Admin on Wed, 11/27/2013 - 08:11

cocaine for nose jobs

Does Dr. Shah use topical Cocaine as an anesthetic in rhinoplasty?

Cocaine is one of the traditional agents used in rhinoplasty and septoplasty to both anesthetize the nose and cause vasocontriction*. The main issue with the use of cocaine is the potential for cardiac arrhythmia*. So do the pros of its use outweigh the cons?

Dr. Shah does not use cocaine as a topical anesthetic in septorhinoplasty. There are several reasons behind this. First, although studies have shown that cocaine is safe in the nose, there is still a small chance of cardiac arrhythmia. In addition, a recent study in the European Archives of Otorhinolaryngology from Queens Hospital found no benefit in the use of cocaine versus epinephrine. Modern inhalational gas anesthetic agents also cause less vasodilation than agents in the past. This makes a topical agent like cocaine unnecessary.

So what does Dr. Shah uses instead of topical cocaine?

Dr. Shah uses liodcaine with epinephrine in combination with Afrin nasal spray for vasoconstriction in rhinoplasty in concert with modern inhalation gas agents. This combination works well for both short and long nasal cases.

*Vasoconstriction - Narrowing of blood vessels. When blood vessels constrict, blood flood is slowed or blocked.

*Arrhythmia - An irregular heartbeat.

Tags: Rhinoplasty

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Submitted by Admin on Mon, 11/25/2013 - 17:10

The Magnificent Seven

Much has been stated about trying to define beauty using objective measures. While I do not adhere to these and think that what defines a beautiful face is as much an artistic interpretation, one author has attempted to do so in what is termed the Magnificent Seven. The Magnificent Seven, not to be confused with a 1960 movie starring Steve McQueen and Yul Brenner, consists of defining facial beauty based on the following features (as defined by Swift A et al. Clin Plast Surg 2011):

1. Facial Shape (cheeks and chin)

2. Forehead height

3. Eyebrow shape

4. Eye size and intercanthal distance

5. Nose shape

6. Lips

7. Skin clarity/color/texture

So how can changes be made to these seven criteria if desired. 

1. Facial shape (cheeks and chin)- can be changed with facial fillers, neuromodulators, diet, exercise, facial implants

2. Forehead height- Change in hairstyle, hair lowering procedure, hair transplantation

3. Eyebrow shape- Eyebrow grooming techniques, neuromodulators, facial fillers, browlift

4. Eye size and intercanthal distance- Makeup techniques, rhinoplasty (upper 1/3), blepharoplasty, neuromodulators

5. Nose shape- Makeup techniques, Rhinoplasty

6. Lips- Makeup techniques, lip plumpers, facial fillers

7. Skin clarity/color/ texture- lifestyle changes (avoidance of sun/smoking, diet, exercise), skin care products, resurfacing techniques (chemical peels, LASER)

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Submitted by Admin on Fri, 11/22/2013 - 16:47

Many of us know that sleep apnea, which is pauses in our sleep, is dangerous and can lead to daytime somnolence, premature death and even cardiovascular disease.  But can patients who snore and do not have sleep apnea have increased risks as well?  Most physicians have viewed snoring as a loud disruptive sound, but not deadly if there wasn't any associated apneas.  However, more recent evidence has found that snoring may indeed have health risks including carotid vascular disease.  This area which is currently being studied, may have us look at snoring in a different perspective than before.

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