Surgical procedure to remove a toenail that has curled and grown into the skin, causing pain.

 

Ingrown Nail

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Parts of the Body Involved

Toe and toenail, usually the big toe.

Reasons for Procedure

With this procedure, the entire nail or only the portion of the nail growing into the skin may be removed. It is most often performed for the following reasons:

• To relieve pain
• To relieve swelling (inflammation or infection)
• To remove a deformed nail
• To correct abnormal nail growth

Risk Factors for Complications During the Procedure

• Diabetes
• Problems with blood circulation

What to Expect

 

Prior to Procedure

Your doctor will likely do the following:

• Exam of the area
• Conservative care before surgery

The day of your procedure:

• Wear comfortable clothing and loose-fitting shoes.
• Arrange for a ride to and from the procedure.

 

Anesthesia

Local

 

Description of the Procedure

Local anesthetic is used to numb the area, usually the whole toe. The doctor will pull the nail up and cut along the edge that is growing into the skin. A chemical may be used to prevent the nail from growing back in the same area.

A total nail removal is a more extensive procedure. For a total nail removal, the doctor eliminates the nail, the nail bed, and any adjacent tissue. The tissue may be cut away and stitches used to close the area. Alternatively, a laser will be used to destroy the tissue, or an acidic chemical will be applied to kill the nail’s growth cells.

 

How Long Will It Take?

Less than 1 hour

 

Will It Hurt?

Most patients report no pain during the procedure once the anesthetic has been given. But injection of the local anesthetic can be painful; this discomfort can be reduced by careful administration by your doctor. Anesthetic injection into toes or fingers is usually quite painful due to tight skin and many nerve endings. Spraying with a topical anesthetic spray first before the injection may help. Some anesthetic preparations may be less irritating than others, so the doctor can reduce the discomfort somewhat.

 

Possible Complications

• Infection
• Excessive swelling or bleeding

 

Average Hospital Stay

None

 

Postoperative Care

• Do not put weight on the affected toe.
• If needed, take the pain medication ordered or over-the-counter pain remedy recommended by your doctor.
• Keep your foot elevated for the first day after the procedure.
• Soak your toe in warm, salt, or plain water for 10 to 20 minutes, two or three times each day for one week; soaking decreases pain and swelling.
• Keep a clean, dry dressing over the toe.
• Wash your hands before caring for the nail area or changing the dressing.
• Wear white, cotton socks and loose fitting shoes for about two weeks.
• Do not run or engage in strenuous activities until your doctor says you can, usually after about two weeks.

If your toe is infected:

• You’ll be given an antibiotic cream or ointment to treat the infection; do not touch the antibiotic with your finger, instead put a small dab of the cream on a clean dressing or sterile applicator and use that to touch your toe.
• For severe infections, you may need to take an antibiotic by mouth. If one is ordered, take all of the pills. Do not stop the medication, even if the toe looks better, unless told otherwise by your doctor.

To avoid future ingrown nails:

• Do not wear high heels or shoes that fit poorly.
• Trim your toenails straight across and do not pick or tear at them.
• Foot care is extremely important if you have diabetes, consider letting a podiatrist or other health professional trim your nails and examine your feet routinely.

Outcome

If needed, stitches are usually removed in about 10 days. Complete healing takes about two to three weeks but does not interfere with most daily activities. (Strenuous activities are limited for about two weeks as stated above.)

If the entire nail was removed, your body will generate a hard skin in its place. After the skin has covered the sensitive area, you can resume normal activities.

Call Your Doctor If Any of the Following Occurs

• Signs of infection, including fever and chills
• Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
• Chalky white, bluish, or blackish appearance to skin of toes or foot (Call immediately.)

RESOURCES:

American Academy of Family Physicians
http://familydoctor.org

American College of Foot and Ankle Surgeons
http://www.footphysicians.com

CANADIAN RESOURCES:

Calgary Foot Clinic
http://www.foottalk.com

Nurses Entrepreneurial Foot Care Association of Canada
http://www.nefca.ca/default.asp

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FotoFacial RF

Over time, the aging process and the effects of the sun, wind and pollutants in the air can wreak havoc on our skin. Unfortunately, our highly competitive society places a premium on a youthful look.

A wide variety of medical lasers and light systems are used to rejuvenate the skin. However, every laser is not effective for all skin types. This means patients may have to visit multiple practices to achieve their desired results. Now, all patients who wish to effectively remove these unwanted effects and rejuvenate their skin can benefit from the advanced FotoFacial RF.

The FotoFacial RF uses the AURORA/ELOS™ system developed by SYNERON. It combines optical energy with radio frequency (RF) energy to deliver satisfying, lasting results. Now, patients can enjoy the results they desire regardless of their skin type.

How is the FotoFacial RF different from other laser procedures?

Unlike other lasers, with a FotoFacial RF, the visible light energy is absorbed by the pigment in the skin’s surface, while the RF energy stimulates the production of collagen (which supports the skin) from within. A FotoFacial RF can be used to rejuvenate the skin of the face, neck, chest and arms.

What conditions can be treated with a FotoFacial RF?

Fine lines, rosacea, flushing, pore size, ruddy complexion, broken capillaries and spider veins, hyperpigmentation, melasma, freckles, age and sun spots, a pregnancy mask, as well as non-pitted acne scars can all be diminished in a softer, more gentle way with a FotoFacial RF. All patients see positive results from a FotoFacial RF without any of the potential side effects seen with other laser systems.

What are the benefits of a FotoFacial RF?

• There is no downtime with a FotoFacial RF.

• FotoFacial RF is effective on any area of the body where smoother, younger-looking skin is desired.

• With a FotoFacial RF the results are progressive.

• FotoFacial RF provides lasting results.

What are the treatments like?

First, the area to be treated is cleansed. Then a thin layer of cooling gel is applied to the treatment area. FotoFacial RF treatments are accomplished through a delicate handpiece attached to the AURORA/ELOS system. When placed against the skin you will feel the cold tip. When the pulse of light and low energy radio frequency is administered there is a momentary sensation that is easily tolerated. Treatments take between twenty minutes to a half hour depending on the size of the area being treated.

How many treatments will I need?

Usually, 4-5 treatments are sufficient. FotoFacial RF treatments are administered every three to four weeks. The number of skin rejuvenation treatments depends on the area treated, your expectations and your goals.

What about the results?

With a FotoFacial RF, the results are progressive. With each treatment you will be more pleased. Your skin will look and feel smoother. Your complexion and skin color will begin to look more even. Fine lines and wrinkles will gradually smooth out. Dark spots and broken blood vessels will begin to fade away. Since the aging process continues after your treatment, maintenance treatments may prevent the return of your symptoms.

Following your treatment:

Immediately after your treatment the area is cleansed and you can return to your normal activities. Dark spots and small blood vessels may seem a little more noticeable, but they will begin to fade after several days. Your physician may recommend that you use a specially-formulated skin care product line or prescribe a skin care regime especially formulated for your skin type after your FotoFacial RF treatments. The use of sunscreen is recommended on any treated areas exposed to the sun.

This information is intended to supplement, not replace, a consultation with a board certified physician. To find out if you could be a candidate for one of these procedures or to learn more information about these procedures, we invite you to contact one of our doctors for a private consultation.

Resource : topdocs.com

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Improving Skin Texture with Injectable Facial Fillers

As we age, our faces begin to show the effects of gravity, sun exposure and years of facial muscle movement, such as smiling and chewing. The underlying tissues that keep our skin looking youthful and plumped up begin to break down, often leaving laugh lines, smile lines, and facial creases over the areas where this muscle movement occurs.

Soft-tissue fillers, such as Restylane, Perlane, JUVEDERM™ Injectable Gel or Radiesse can help fill in these lines and creases, temporarily restoring a smoother, more youthful-looking appearance. When injected beneath the skin, these fillers plump up creased and sunken areas of the face. They can also add fullness to the lips and cheeks. Injectable fillers may be used alone or in conjunction with a resurfacing procedure, JUVEDERM™ Injectable Gel or a recontouring procedure, such as a facelift.

Know Your Options

Facial Fillers or Injectable Fillers are primarily used to improve the appearance of the skin’s texture. They can help fill out deep facial wrinkles, creases and furrows, “sunken” cheeks, skin depressions and some types of scars. They can also be used to add a fuller, more sensuous look to the lips and improve “lipstick lines”.

BOTOX® Cosmetic is used to help smooth creases caused by overactive muscles (such as forehead wrinkles, crow’s feet and frown lines). When excess facial or neck skin is present, this type of aging is more appropriately treated by face and neck lifts or forehead lifts.

What to Expect From Treatment

The most important fact to remember about injectable fillers is that the results are not permanent. Injected material is eventually metabolized by the body. You should not expect the same long-lasting results that may be gained from cosmetic surgery.

Depending on the type of facial filler used, the results may last anywhere from a few months to a year or more. Researchers believe that age, genetic background, skin quality and lifestyle as well as the injected body site may all play a role in the injected material’s “staying power.”

Risk Related to Injectables

When injectables are administered by a qualified plastic surgeon, complications are infrequent and usually minor in nature. Still, individuals vary greatly in their anatomy, their physical reactions and their healing abilities. The outcome of treatment with injectables is never completely predictable.

Redness and swelling are common for 2-5 days after treatment. Early lumpiness can be treated with finger pressure, later lumpiness generally resolves by itself. Nodules may require office treatment.

In contrast to collagen, prior testing is not required for Restylane, Perlane, JUVEDERM™ Injectable Gel or Radiesse. Risks not necessarily related to allergies include infection, abscesses, open sores, skin peeling, scarring and lumpiness, which may persist over the treated area. Reports of these problems are very rare.

Planning for Treatment

Facial rejuvenation is very individualized. That’s why it’s important to discuss your hopes and expectations during your consultation. In your initial consultation, we will evaluate your face — the skin, the muscles and the underlying bone — and discuss your goals for the surgery. We will help you select a treatment option based on your goals and concerns, your anatomy and your lifestyle.

We will ask you about your medical history, drug allergies, and check for conditions that could cause problems, such as active skin infections or non-healed sores from injuries. Facial fillers are generally off limits for pregnant women, patients who suffer from autoimmune diseases, and those who are allergic to the local anesthetic.

The Treatments

Injectables are administered in our office. After the areas are marked, the patient ices the area. Local anesthesia (Lidocaine) is injected followed by the facial filler. A treatment takes approximately 20-30 minutes. Lips take longer.

Icing is continued after the treatment. After the local wears off, you may notice some minor discomfort, stinging or throbbing in the injected area. Occasionally some bruising will occur, but it is usually minor. Swelling and redness in the injected site is common and usually disappears in 2-5 days. In some individuals, particularly fair-skinned patients, this redness may persist for a week or more. Tiny scabs may also form over the needle-stick areas; these generally heal quickly.

No bandaging is needed and you are free to eat, drink, and wear makeup with sunblock protection shortly thereafter.

It is best to be seen for a follow-up appointment and possible “touch-up” about 3-4 weeks after treatment.

Your New Look

If you’re like most of our patients, you’ll be satisfied with the results of your injectable treatments. You may be surprised at the pleasing results that can be gained from this procedure.

Fees for Injectables:

Facial Fillers:

Restylane®: $500 per 1 cc syringe (Includes local anesthesia)
Perlane®: $550 per 1 cc syringe (Includes local anesthesia)
JUVEDERM™ Injectable Gel: Ultra $500 per 0.8 cc syringe (Includes local anesthesia)
Ultra Plus $550 per 0.8 cc syringe (Includes local anesthesia)
Radiesse®: $800 per 1.3 cc syringe (Includes local anesthesia)
$400 per 0.3 cc syringe for touch-ups (Includes local anesthesia)
Fat Grafting: Varies, needs to be determined at time of consultation.

BOTOX® Cosmetic :

Forehead: About 8 to 10 injections at $35.00 per injection ($14 per unit — 2.5 units per .05cc injection)
Frown Lines: About 4 to 10 injections at $35.00 per injection ($14 per unit — 2.5 units per .05cc injection)
Crow’s Feet: About 3 to 4 injections per side at $35.00 per injection ($14 per unit — 2.5 units per .05cc injection)
Armpits (for sweating): About 10-12 injections per side at $35.00 per injection ($14 per unit — 2.5 units per .05cc injection).

Source: plasticsurgerypa.com

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