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Introduction of departments

Cataract surgery is a procedure to remove the lens of your eye and, in most cases, replace it with an artificial lens. Normally, the lens of your eye is clear. A cataract causes the lens to become cloudy, which eventually affects your vision. Cataract surgery is performed by an eye doctor (ophthalmologist) on an outpatient basis, which means you don't have to stay in the hospital after the surgery. Cataract surgery can be done traditionally using ultrasound energy to remove the cloudy lens or it can be removed with laser-assisted technology. Cataract surgery is very common and is generally a safe procedure.

Blepharoplasty (BLEF-uh-roe-plas-tee) is a type of surgery that repairs droopy eyelids and may involve removing excess skin, muscle and fat. As you age, your eyelids stretch, and the muscles supporting them weaken. As a result, excess fat may gather above and below your eyelids, causing sagging eyebrows, droopy upper lids and bags under your eyes. Besides making you look older, severely sagging skin around your eyes can reduce your side vision (peripheral vision), especially the upper and outer parts of your field of vision. Blepharoplasty can reduce or eliminate these vision problems and make your eyes appear younger and more alert. To help decide if blepharoplasty is right for you, find out what you can realistically expect and explore the benefits and risks of blepharoplasty.

Patient information factsheetDCR (Dacryocystorhinostomy) surgeryWhat is DCR surgery?DCR surgery is done to treat a watery, sticky eye caused by narrowing or blockage of the tear drainage tubes, which run from the inner corner of the eye into the tearsac and then down into the nose. A new passage is made between the tear sac and the nose and this bypasses any blockage below the tear sac and allows tears to drain normally again. The operation is also performed in a modified way to relieve blockages higher in the tear drainage system.Who needs DCR surgery?DCR surgery is worthwhile if the watering is bad enough to really interfere with activities of daily living. It is also recommended if you have had an infection in the tear sac (acute dacryocystitis) as a result of the blocked tear duct,in order to prevent repeated attacks of a red, painful swelling at the corner of the eye.There are two ways of doing the surgery:•Externally -through the skin•Endoscopically -from within the nostril. What isan external DCR?A small cut is made on the side of the nose to access the tear sac. A piece of bone between the tear sac and nose is removed in order to reach the inside of the nose. The tear sac is opened and stitched to the lining of the nose so a direct passage is formed between the sac and the nose. A soft siliconecord(often called tubes) may be put into the tear passage to keep it open during healing. This tube is not usually noticed when in the correct position and is removed in clinic about 6 -12 weeks after the operation. The operation is performed only after examination and possibly X-rays have been done and you have had a chance to discuss the risks and benefits with the doctor in the outpatient clinic. The operation takes about 1-1½ hours so it is not a minor procedure. Sometimes your surgeon will want to take a tiny piece of tissue from the lining of the tear sac or the nose and send it to the pathology laboratory for microscopic checks. It is not generally possible to know whether this will be necessary until during the operation. The results of such tests will be ready after a few weeks. The success rate for this operation at Southampton Eye Unit is 85-90%. Success means that the watering stops completely,or only happens in windy weather. Surgery will help you to enjoy your indoor and outdoor pursuits again and stops you having a watery eye, which needs wiping all the time. For cure of infection (acute dacryocystitis) the success rate is over 95% -you will no longer have painful swelling at the corner of your eye. If you are generally unfit or very overweight, or if it is essential for you to take blood thinning tablets eg Warfarin, surgery may not be advisable.What is an endoscopic DCR?In this operation the tear sac is reachedfrom the inside of the nose, using a small telescopic instrument called an endoscope. The endoscope allows the surgeon to see inside the nose and make an opening between the tear sac and the lining of the nose but without using stitches. There is no cut in the skin for this operation. Silicone tubing is always placed at the time of surgery to keep the new tear passage open.Which surgery will I have?There is no scar with endoscopic DCR although the scar from external DCR is often invisible after a few months. External DCR is better if the tiny tear ducts in the eyelids (canaliculi) are blocked as well as the bigger duct in the nose. Endoscopic surgery may be better if you have polyps or sinus problems, which may be dealt with at the same time as the tearduct operation. Your surgeon will recommend the best type of surgery for you.When will the operation be done?When you are put on the waiting list in the clinic you will be advised about the waiting time for surgery. Before the operation you will be seen in a pre-assessment clinic. You will be weighed and examined and may have blood tests and an ECG. You will be asked to bring your medications with you and will be asked about any illnesses or operations you have had.You will then be sent a date for admission to hospital to the Eye Short Stay Unit (ESSU). You should come prepared to stay in hospital on the night after the operation although it may be possible to go home if your operation is being done in the morning. You should not have any thing to eatafter midnight for surgery in the morning or after 7am for surgery in the afternoon. What type of anaesthetic is used?The operation may be done under general anaesthetic (you are completely asleep) or under local anaesthetic (you remain awake but haveinjections to numb the operated area and an injection in a vein to make you feel calm and relaxed). Quite a lot of anaesthetic is needed either way, so you need the same kind of preparation for the operation however the anaesthetic is given. We will discuss the best choice of anaesthetic with you before the operation. If you are elderly, have heart or chest problems or are overweight, local anaesthetic is safest.Can I have both tear ducts operated on?Normally we operate on one side at a time otherwise the operation might take too long or require too much anaesthetic. Once you have recovered from one operation, you can go on the list to have the other side done. Endoscopic DCR can sometimes be done on both sides during the same session. What happens after the operation?After a general anaesthetic you may need some time that day to sleep off the anaesthetic before you are ready to resume normal activities. After a local anaesthetic you will be ready to have a drink and a snack fairly soon after the operation.Often there is some bleeding from the nose. Usually there is only a little trickle from the nostril or down the back of the throat. If there is bleeding at the end of the operation the surgeon may pack the nostril. The pack is removed the next day. If you have heavy bleeding after you have left hospital, please contact the Eye Short Stay Unit for advice. Do not blow your nose hard for at least 6 weeks after the operation as this may cause bleeding to occur.After External DCR you will have a dressing on your eye/ side of your nose, which will be removed next day. You may find it difficult to wear your spectacles until the dressing is removed. You will have stitches in the cut on the side of your nose, which will absorb away by themselves. The stitches may also make spectacle wear a little uncomfortable for a short time.After both types of DCR, you will be given eye drops to usefour times a day. You may be given a nasal spray to loosen crusts inside your nose. You should take it easy for the firstweek after the operation, and stay off work until your first clinic visit. Please ask for a certificate for work if you need one.If you have a “tube” put in at the time of the operation, you should be careful not to explore the inner corner of your eye or blow your nose until it has been removed, or it may dislodge. If you do dislodge it by accident, please phone Eye Casualty on 023 81206592 to let them know what has happened. It should be possible to reposition the tube. Ideally the tube should stay in for three months and it can then be removed in the clinic. Tube removal is not painful –your eye is treated with anaesthetic drops and your nose with anaesthetic spray and the tube is then cut and removed.The watering of your eye often stops before the second visit to clinic, but sometimes only when the tube has been removed. Usually no more visits are required unless you still have problems.What are the risks of the operation?•General anaesthetic can carry risks especially if you are unwell or overweight. Usually a local anaesthetic would be advised in this case.•Local anaesthetic injections can very rarely damage the tissues of the eye, but usually prompt treatment would help to resolve any problem. •Bleeding from the nose or into the tissues around the eye. Bleeding is quite common in the first few hours after the operation. Usually it is only slight and settles quickly. Heavy bleeding would need to be stopped by packing the nose or rarely by another operation. •Displacement of the tube. Usually this does not happen, unless you blow your nose hard or fiddle with the tube at the corner of your eye. It is usually possible to replace it.•Infection. This is unusual as antibiotics are given into a vein during the operation and drops are prescribedfor you to use after the operation. If the cut on the side of your nose becomes red, swollen and very sore, please see your GP or Eye Casualty to see whether antibiotic tablets are necessary.•Scarring on the side of the nose after external DCR. Usually the operation cut heals very well and the scar becomes almost invisible after 3 to 6 months. A scar that is unsightly could possibly be helped by plastic surgery.•Failure of the operation to cure the watering. A further operation may be possible and may well be successful.When do I consent for the operation?Before your operation, usually at the pre-assessment visit, you will be asked to sign a consent form. The form is signed by both you and the doctor and is a permanent record to show that your operation and the type of anaesthetic have been discussed with you.When you sign the consent form you are indicating that you want to go ahead with the operation. If you are not happy with anything on the form you should not sign it until you have had your worries discussed and resolved.

A cornea transplant (keratoplasty) is a surgical procedure to replace part of your cornea with corneal tissue from a donor. Your cornea is the transparent, dome-shaped surface of your eye that accounts for a large part of your eye's focusing power. A cornea transplant can restore vision, reduce pain and improve the appearance of a damaged or diseased cornea.

Pterygium is the name given to a degenerative/’wear and tear’ change of the surface of the eye, which results in growth of conjunctival tissue (from the white of the eye) across the cornea (the clear window through which you see). The pterygium is red, fleshy, and thickened in comparison with the normal conjunctiva. Pterygium is NOT a tumour or cancer. It is a growth of normal tissues into the wrong place.

Rhinoplasty: Rhinoplasty (RIE-no- Plas -tee) is surgery that changes the shape of the nose. The motivation for rhinoplasty may be to change the appearance of the nose, improve breathing or both The upper portion of the structure of the nose is bone, and the lower portion is cartilage. Rhinoplasty can change bone, cartilage, skin or all three. Talk with your surgeon about whether rhinoplasty is appropriate for you and what it can achieve When planning rhinoplasty, your surgeon will consider your other facial features, the skin on your nose and what you would like to change. If you're a candidate for surgery, your surgeon will develop a customized plan for you Sometimes part or all of a rhinoplasty is covered by insurance During the surgery: Rhinoplasty requires local anesthesia with sedation or general anesthesia, depending on how complex your surgery is and what your surgeon prefers. Discuss with your doctor before surgery which type of anesthesia is most appropriate for you.

Local anesthesia with sedation. This type of anesthesia is usually used in an outpatient setting. It's limited to a specific area of your body. Your doctor injects a pain-numbing medication into your nasal tissues and sedates you with medication injected through an intravenous (IV) line. This makes you groggy but not fully asleep.
General anesthesia. You receive the drug (anesthetic) by inhaling it or through a small tube (IV line) placed in a vein in your hand, neck or chest. General anesthesia affects your entire body and causes you to be unconscious during surgery. General anesthesia requires a breathing tube.

Rhinoplasty may be done inside your nose or through a small external cut (incision) at the base of your nose, between your nostrils. Your surgeon will likely readjust the bone and cartilage underneath your skin Your surgeon can change the shape of your nasal bones or cartilage in several ways, depending on how much needs to be removed or added, your nose's structure, and available materials. For small changes, the surgeon may use cartilage taken from deeper inside your nose or from your ear. For larger changes, the surgeon can use cartilage from your rib, implants or bone from other parts of your body. After these changes are made, the surgeon places the nose's skin and tissue back and stitches the incisions in your nose If the wall between the two sides of the nose (septum) is bent or crooked (deviated), the surgeon can also correct it to improve breathing After the surgery, you'll be in a recovery room, where the staff monitors your return to wakefulness. You might leave later that day or, if you have other health issues, you might stay overnight After the surgery: After the surgery you need to rest in bed with your head raised higher than your chest, to reduce bleeding and swelling. Your nose may be congested because of swelling or from the splints placed inside your nose during surgery In most cases, the internal dressings remain in place for one to seven days after surgery. Your doctor also tapes a splint to your nose for protection and support. It's usually in place for about one week Slight bleeding and drainage of mucus and old blood are common for a few d ays after the surgery or after removing the dressing. Your doctor may place a "drip pad" — a small piece of gauze held in place with tape — under your nose to absorb drainage. Change the gauze as directed by your doctor. Don't place the drip pad tight against your nose To further lower the chances of bleeding and swelling, your doctor may ask that you follow precautions for several weeks after surgery. Your doctor may ask you to:
Avoid strenuous activities such as aerobics and jogging.
Take baths instead of showers while you have bandages on your nose.
Not blow your nose.
Eat high-fiber foods, such as fruits and vegetables, to avoid constipation. Constipation can cause you to strain, putting pressure on the surgery site.
Avoid extreme facial expressions, such as smiling or laughing.
Brush your teeth gently to limit movement of your upper lip.
Wear clothes that fasten in the front. Don't pull clothing, such as shirts or sweaters, over your head.
In addition, don't rest eyeglasses or sunglasses on your nose for at least four weeks after the surgery, to prevent pressure on your nose. You can use cheek rests, or tape the glasses to your forehead until your nose has healed Use SPF 30 sunscreen when you're outside, especially on your nose. Too much sun may cause permanent irregular discoloration in your nose's skin Some temporary swelling or black-and-blue discoloration of your eyelids can occur for two to three weeks after nasal surgery. Swelling of the nose takes longer to resolve. Limiting your dietary sodium will help the swelling go away faster. Don't put anything such as ice or cold packs on your nose after surgery.Your nose changes throughout your life whether you have surgery or not. For this reason, it's difficult to say when you have obtained your "final result." However, most of the swelling is gone within a year.

Stomach cancer usually begins in the mucus-producing cells that line the stomach. This type of cancer is called adenocarcinoma.For the past several decades, rates of cancer in the main part of the stomach (stomach body) have been falling worldwide. During the same period, cancer in the area where the top part of the stomach (cardia) meets the lower end of the swallowing tube (esophagus) has become much more common. This area of the stomach is called the gastroesophageal junction.Gastroesophageal junction cancer that has not spread requires surgery to remove the part of the esophagus or stomach where the tumor is located. The goal of surgery is to remove all of the cancer and a margin of healthy tissue, when possible. Nearby lymph nodes are typically removed as well.The goal of surgery for cancer in the body of the stomach is also to remove all of the stomach cancer and a margin of healthy tissue, when possible. Options include: • Removing early-stage tumors from the stomach lining. Very small cancers limited to the inside lining of the stomach may be removed using endoscopy in a procedure called endoscopic mucosal resection. The endoscope is a lighted tube with a camera that's passed down your throat into your stomach. The doctor uses special tools to remove the cancer and a margin of healthy tissue from the stomach lining. • Removing a portion of the stomach (subtotal gastrectomy). During subtotal gastrectomy, the surgeon removes only the portion of the stomach affected by cancer. • Removing the entire stomach (total gastrectomy). Total gastrectomy involves removing the entire stomach and some surrounding tissue. The esophagus is then connected directly to the small intestine to allow food to move through your digestive system. • Removing lymph nodes to look for cancer. The surgeon examines and removes lymph nodes in your abdomen to look for cancer cells. • Surgery to relieve signs and symptoms. Removing part of the stomach may relieve signs and symptoms of a growing tumor in people with advanced stomach cancer. In this case, surgery can't cure advanced stomach cancer, but it can make you more comfortable. Surgery carries a risk of bleeding and infection. If all or part of your stomach is removed, you may experience digestive problems.

The rectum is the last several inches of the large intestine. It starts at the end of the final segment of your colon and ends when it reaches the short, narrow passage leading to the anus. Cancer inside the rectum (rectal cancer) and cancer inside the colon (colon cancer) are often referred to together as "colorectal cancer." While rectal and colon cancers are similar in many ways, their treatments are quite different. This is mainly because the rectum sits in a tight space, barely separated from other organs and structures in the pelvic cavity. As a result, complete surgical removal of rectal cancer is challenging and highly complex. Additional treatment is often needed before or after surgery — or both — to reduce the chance that the cancer will return. In the past, long-term survival was uncommon for people with rectal cancer, even after extensive treatment. Thanks to treatment advances over the past 30 years, rectal cancer can now, in many cases, be cured. Rectal cancer is often diagnosed when a doctor orders tests to find the cause of rectal bleeding or iron deficiency anemia. A colonoscopy is the most accurate of these tests. In a colonoscopy, a doctor uses a thin, flexible, lighted tube with a video camera at its tip (a colonoscope) to view the inside of your colon and rectum. Sometimes rectal cancer has no noticeable symptoms. People without symptoms may learn they have rectal cancer when they have a screening colonoscopy — that is, a colonoscopy recommended at age 50 for everyone with an average risk of colorectal cancer. It's usually possible to remove small tissue samples (biopsies) from suspicious-looking areas during a colonoscopy. Laboratory analysis of this tissue helps pin down the diagnosis. Mayo Clinic's Division of Colorectal Surgery has been accredited by the American College of Surgeons Commission on Cancer since 1970. The Division of Radiation Oncology at Mayo Clinic is accredited by the American College of Radiology. Experts across Mayo Clinic's three campuses treat about 2,000 patients each year for cancers of the anus, anal canal and rectum.

Once you are diagnosed with rectal cancer, the next step is to determine the cancer's extent (stage). Staging helps guide decisions about the most appropriate treatments for you. The following blood tests and imaging studies are involved in staging rectal cancer: • Complete blood count (CBC). This test reports the numbers of different types of cells in your blood. A CBC shows whether your red blood cell count is low (anemia), which suggests that a tumor is causing blood loss. A high level of white blood cells is a sign of infection, which is a risk if a rectal tumor grows through the wall of the rectum. • Carcinoembryonic antigen (CEA). Cancers sometimes produce substances called tumor markers that can be detected in blood. One such marker, carcinoembryonic antigen (CEA), may be higher than normal in people with colorectal cancer. CEA testing is particularly useful in monitoring your response to treatment. • Chemistry panel. This test measures a number of chemicals in the blood. Abnormal levels of some of these chemicals may suggest that cancer has spread to the liver. High levels of other chemicals may indicate problems with other organs, such as the kidneys. • CT (computed tomography) scan of the chest. This imaging test helps determine whether rectal cancer has spread to other organs, such as the liver and lungs. • MRI (magnetic resonance imaging) of the pelvis. An MRI provides a detailed image of the muscles, organs and other tissues surrounding a tumor in the rectum. An MRI also shows the lymph nodes near the rectum and different layers of tissue in the rectal wall.
Rectal cancers fall into one of five possible stages (stage 0 through stage 4). The stages, in simplified form, are:
•Stage 0. Cancer cells on the surface of the rectal lining (mucosa), sometimes within a polyp.
•Stage I. Tumor extending below the rectal mucosa, sometimes penetrating into the rectal wall
•Stage II. Tumor extending into or through the rectal wall, sometimes reaching and growing on or sticking to tissues next to the rectum
•Stage III. Tumor invading lymph nodes next to the rectum, as well as structures and tissues outside the rectal wall
•Stage IV. Tumor spread to a distant organ or lymph nodes distant from the rectum
Staging also involves examining a sample of tissue taken from the tumor (a biopsy) to determine the tumor's grade. Low-grade tumors tend to grow and spread slowly. In contrast, high-grade tumors grow and spread quickly, so they may need more-aggressive treatment.

Skin cancer — the abnormal growth of skin cells — most often develops on skin exposed to the sun. But this common form of cancer can also occur on areas of your skin not ordinarily exposed to sunlight. There are three major types of skin cancer — basal cell carcinoma, squamous cell carcinoma and melanoma. You can reduce your risk of skin cancer by limiting or avoiding exposure to ultraviolet (UV) radiation. Checking your skin for suspicious changes can help detect skin cancer at its earliest stages. Early detection of skin cancer gives you the greatest chance for successful skin cancer treatment.
Determining the extent of the skin cancer
If your doctor determines you have skin cancer, you may have additional tests to determine the extent (stage) of the skin cancer. Because superficial skin cancers such as basal cell carcinoma rarely spread, a biopsy that removes the entire growth often is the only test needed to determine the cancer stage. But if you have a large squamous cell carcinoma, Merkel cell carcinoma or melanoma, your doctor may recommend further tests to determine the extent of the cancer. Additional tests might include imaging tests to examine the nearby lymph nodes for signs of cancer or a procedure to remove a nearby lymph node and test it for signs of cancer (sentinel lymph node biopsy). Doctors use the Roman numerals I through IV to indicate a cancer's stage. Stage I cancers are small and limited to the area where they began. Stage IV indicates advanced cancer that has spread to other areas of the body. The skin cancer's stage helps determine which treatment options will be most effective.

Neuroendocrine tumors are cancers that begin in specialized cells called neuroendocrine cells. Neuroendocrine cells have traits similar to those of nerve cells and hormone-producing cells. Neuroendocrine tumors are rare and can occur anywhere in the body. Most neuroendocrine tumors occur in the lungs, appendix, small intestine, rectum and pancreas. There are many types of neuroendocrine tumors. Some grow slowly and some grow very quickly. Some neuroendocrine tumors produce excess hormones (functional neuroendocrine tumors). Others don't release hormones or don't release enough to cause symptoms (nonfunctional neuroendocrine tumors). Diagnosis and treatment of neuroendocrine tumors depend on the type of tumor, its location, whether it produces excess hormones, how aggressive it is and whether it has spread to other parts of the body.
•Surgery. Surgery is used to remove the tumor. When possible, surgeons work to remove the entire tumor and some of the healthy tissue that surrounds it. If the tumor can't be removed completely, it might help to remove as much of it as possible.
•Chemotherapy. Chemotherapy uses strong drugs to kill tumor cells. It can be given through a vein in your arm or taken as a pill. Chemotherapy might be recommended if there's a risk that your neuroendocrine tumor might recur after surgery. It might also be used for advanced tumors that can't be removed with surgery.
•Targeted drug therapy. Targeted drug treatments focus on specific abnormalities present within tumor cells. By blocking these abnormalities, targeted drug treatments can cause tumor cells to die. Targeted drug therapy is usually combined with chemotherapy for advanced neuroendocrine tumors.
•Peptide receptor radionuclide therapy (PRRT). PRRT combines a drug that targets cancer cells with a small amount of a radioactive substance. It allows radiation to be delivered directly to the cancer cells. One PRRT drug, lutetium Lu 177 dotatate (Lutathera), is used to treat advanced neuroendocrine tumors.
•Medications to control excess hormones. If your neuroendocrine tumor releases excess hormones, your doctor might recommend medications to control your signs and symptoms.
•Radiation therapy. Radiation therapy uses powerful energy beams, such as X-rays and protons, to kill tumor cells. Some types of neuroendocrine tumors may respond to radiation therapy. It might be recommended if surgery isn't an option.

Head and neck cancers are a broad category of cancers that occur in the head and neck region. Head and neck cancer treatment depends on the type, location and size of your cancer. Treatment for head and neck cancers often involves surgery, radiation therapy and chemotherapy. Treatments may be combined. After treatment, recovery from head and neck cancers may involve working with rehabilitation specialists and other experts to cope with side effects, such as hearing loss, difficulty eating, dental problems, thyroid issues, difficulty breathing or difficulty speaking.

Breast cancer is cancer that forms in the cells of the breasts. After skin cancer, breast cancer is the most common cancer diagnosed in women in the United States. Breast cancer can occur in both men and women, but it's far more common in women. Substantial support for breast cancer awareness and research funding has helped created advances in the diagnosis and treatment of breast cancer. Breast cancer survival rates have increased, and the number of deaths associated with this disease is steadily declining, largely due to factors such as earlier detection, a new personalized approach to treatment and a better understanding of the disease. Making changes in your daily life may help reduce your risk of breast cancer. Try to: • Ask your doctor about breast cancer screening. Discuss with your doctor when to begin breast cancer screening exams and tests, such as clinical breast exams and mammograms. Talk to your doctor about the benefits and risks of screening. Together, you can decide what breast cancer screening strategies are right for you. • Become familiar with your breasts through breast self-exam for breast awareness. Women may choose to become familiar with their breasts by occasionally inspecting their breasts during a breast self-exam for breast awareness. If there is a new change, lumps or other unusual signs in your breasts, talk to your doctor promptly. Breast awareness can't prevent breast cancer, but it may help you to better understand the normal changes that your breasts undergo and identify any unusual signs and symptoms. • Drink alcohol in moderation, if at all. Limit the amount of alcohol you drink to no more than one drink a day, if you choose to drink. • Exercise most days of the week. Aim for at least 30 minutes of exercise on most days of the week. If you haven't been active lately, ask your doctor whether it's OK and start slowly. • Limit postmenopausal hormone therapy. Combination hormone therapy may increase the risk of breast cancer. Talk with your doctor about the benefits and risks of hormone therapy. Some women experience bothersome signs and symptoms during menopause and, for these women, the increased risk of breast cancer may be acceptable in order to relieve menopause signs and symptoms. To reduce the risk of breast cancer, use the lowest dose of hormone therapy possible for the shortest amount of time. • Maintain a healthy weight. If your weight is healthy, work to maintain that weight. If you need to lose weight, ask your doctor about healthy strategies to accomplish this. Reduce the number of calories you eat each day and slowly increase the amount of exercise. • Choose a healthy diet. Women who eat a Mediterranean diet supplemented with extra-virgin olive oil and mixed nuts may have a reduced risk of breast cancer. The Mediterranean diet focuses mostly on plant-based foods, such as fruits and vegetables, whole grains, legumes, and nuts. People who follow the Mediterranean diet choose healthy fats, such as olive oil, over butter and fish instead of red meat. Breast cancer risk reduction for women with a high risk If your doctor has assessed your family history and determined that you have other factors, such as a precancerous breast condition, that increase your risk of breast cancer, you may discuss options to reduce your risk, such as: • Preventive medications (chemoprevention). Estrogen-blocking medications, such as selective estrogen receptor modulators and aromatase inhibitors, reduce the risk of breast cancer in women with a high risk of the disease. These medications carry a risk of side effects, so doctors reserve these medications for women who have a very high risk of breast cancer. Discuss the benefits and risks with your doctor. • Preventive surgery. Women with a very high risk of breast cancer may choose to have their healthy breasts surgically removed (prophylactic mastectomy). They may also choose to have their healthy ovaries removed (prophylactic oophorectomy) to reduce the risk of both breast cancer and ovarian cancer. Doctors know that breast cancer occurs when some breast cells begin to grow abnormally. These cells divide more rapidly than healthy cells do and continue to accumulate, forming a lump or mass. Cells may spread (metastasize) through your breast to your lymph nodes or to other parts of your body. Breast cancer most often begins with cells in the milk-producing ducts (invasive ductal carcinoma). Breast cancer may also begin in the glandular tissue called lobules (invasive lobular carcinoma) or in other cells or tissue within the breast. Researchers have identified hormonal, lifestyle and environmental factors that may increase your risk of breast cancer. But it's not clear why some people who have no risk factors develop cancer, yet other people with risk factors never do. It's likely that breast cancer is caused by a complex interaction of your genetic makeup and your environment. Inherited breast cancer Doctors estimate that about 5 to 10 percent of breast cancers are linked to gene mutations passed through generations of a family. A number of inherited mutated genes that can increase the likelihood of breast cancer have been identified. The most well-known are breast cancer gene 1 (BRCA1) and breast cancer gene 2 (BRCA2), both of which significantly increase the risk of both breast and ovarian cancer. If you have a strong family history of breast cancer or other cancers, your doctor may recommend a blood test to help identify specific mutations in BRCA or other genes that are being passed through your family. Consider asking your doctor for a referral to a genetic counselor, who can review your family health history. A genetic counselor can also discuss the benefits, risks and limitations of genetic testing to assist you with shared decision-making. Risk factors A breast cancer risk factor is anything that makes it more likely you'll get breast cancer. But having one or even several breast cancer risk factors doesn't necessarily mean you'll develop breast cancer. Many women who develop breast cancer have no known risk factors other than simply being women. Factors that are associated with an increased risk of breast cancer include: • Being female. Women are much more likely than men are to develop breast cancer. • Increasing age. Your risk of breast cancer increases as you age. • A personal history of breast conditions. If you've had a breast biopsy that found lobular carcinoma in situ (LCIS) or atypical hyperplasia of the breast, you have an increased risk of breast cancer. • A personal history of breast cancer. If you've had breast cancer in one breast, you have an increased risk of developing cancer in the other breast. • A family history of breast cancer. If your mother, sister or daughter was diagnosed with breast cancer, particularly at a young age, your risk of breast cancer is increased. Still, the majority of people diagnosed with breast cancer have no family history of the disease. • Inherited genes that increase cancer risk. Certain gene mutations that increase the risk of breast cancer can be passed from parents to children. The most well-known gene mutations are referred to as BRCA1 and BRCA2. These genes can greatly increase your risk of breast cancer and other cancers, but they don't make cancer inevitable. • Radiation exposure. If you received radiation treatments to your chest as a child or young adult, your risk of breast cancer is increased. • Obesity. Being obese increases your risk of breast cancer. • Beginning your period at a younger age. Beginning your period before age 12 increases your risk of breast cancer. • Beginning menopause at an older age. If you began menopause at an older age, you're more likely to develop breast cancer. • Having your first child at an older age. Women who give birth to their first child after age 30 may have an increased risk of breast cancer. • Having never been pregnant. Women who have never been pregnant have a greater risk of breast cancer than do women who have had one or more pregnancies. • Postmenopausal hormone therapy. Women who take hormone therapy medications that combine estrogen and progesterone to treat the signs and symptoms of menopause have an increased risk of breast cancer. The risk of breast cancer decreases when women stop taking these medications. • Drinking alcohol. Drinking alcohol increases the risk of breast cancer.

Sarcoma is a type of cancer that can occur in various locations in your body. Sarcoma is the general term for a broad group of cancers that begin in the bones and in the soft (also called connective) tissues (soft tissue sarcoma). Soft tissue sarcoma forms in the tissues that connect, support and surround other body structures. This includes muscle, fat, blood vessels, nerves, tendons and the lining of your joints. There are more than 70 types of sarcoma. Treatment for sarcoma varies depending on sarcoma type, location and other factors.
•Surgery. The goal of surgery for sarcoma is to remove all of the cancer cells. Sometimes it's necessary to amputate an arm or leg to remove all of the cancer, but surgeons try to preserve limb function when possible. Sometimes all of the cancer can't be removed without hurting important structures, such as nerves or organs. In these situations, the surgeons work to remove as much of the sarcoma as possible. What to expect from your doctor Your doctor is likely to ask you several questions, such as:
•When did your symptoms begin?
•Have your symptoms been continuous or occasional?
•How severe are your symptoms?
•What, if anything, seems to improve your symptoms?
•What, if anything, appears to worsen your symptoms?

Liposuction is a surgical procedure that uses a suction technique to remove fat from specific areas of the body, such as the abdomen, hips, thighs, buttocks, arms or neck. Liposuction also shapes (contours) these areas. Other names for liposuction include lipoplasty and body contouring. Liposuction isn't typically considered an overall weight-loss method or a weight-loss alternative. If you're overweight, you're likely to lose more weight through diet and exercise or through bariatric procedures — such as gastric bypass surgery — than you would with liposuction. You may be a candidate for liposuction if you have too much body fat in specific spots but otherwise have a stable body weight. Before your liposuction procedure, the surgeon may mark circles and lines on the areas of your body to be treated. Photos also may be taken so that before and after images can be compared. How your liposuction procedure is done depends on the specific technique that's used. Your surgeon will select the appropriate technique based on your treatment goals, the area of your body to be treated, and whether you have had other liposuction procedures in the past.
•Tumescent liposuction. This is the most common type of liposuction. The surgeon injects a sterile solution — a mixture of salt water, which aids fat removal, an anesthetic (lidocaine) to relieve pain and a drug (epinephrine) that causes the blood vessels to constrict — into the area that's being treated. The fluid mixture causes the affected area to swell and stiffen. The surgeon then makes small cuts into your skin and inserts a thin tube called a cannula under your skin. The cannula is connected to a vacuum that suctions fat and fluids from your body. Your body fluid may be replenished through an intravenous (IV) line.
•Ultrasound-assisted liposuction (UAL). This type of liposuction is sometimes used in conjunction with traditional liposuction. During UAL, the surgeon inserts a metal rod that emits ultrasonic energy under your skin. This ruptures the fat-cell walls and breaks down the fat for easier removal. A new generation of UAL called VASER-assisted liposuction uses a device that may improve skin contouring and reduce the chance of skin injuries.
•Laser-assisted liposuction (LAL). This technique uses high-intensity laser light to break down fat for removal. During LAL, the surgeon inserts a laser fiber through a small incision in the skin and emulsifies fat deposits. The fat is then removed via a cannula.
•Power-assisted liposuction (PAL). This type of liposuction uses a cannula that moves in a rapid back-and-forth motion. This vibration allows the surgeon to pull out tough fat more easily and faster. PAL may sometimes cause less pain and swelling and can allow the surgeon to remove fat with more precision. Your surgeon may select this technique if large volumes of fat need to be removed or if you've had a previous liposuction procedure.
During the procedure
Some liposuction procedures may require only local or regional anesthesia — anesthesia limited to a specific area of your body. Other procedures may require general anesthesia, which induces a temporary state of unconsciousness. You may be given a sedative, typically through an IV injection, to help you remain calm and relaxed. The surgical team will monitor your heart rate, blood pressure and blood oxygen level throughout the procedure. If you are given local anesthesia and feel pain during the procedure, tell your surgeon. The medication or motions may need adjustment. The procedure may last up to several hours, depending on the extent of fat removal. If you've had general anesthesia, you'll wake in a recovery room. You'll typically spend at least a few hours in the hospital or clinic so that medical personnel can monitor your recovery. If you're in a hospital, you may stay overnight to make sure that you're not dehydrated or in shock from fluid loss.
After the procedure
Expect some pain, swelling and bruising after the procedure. Your surgeon may prescribe medication to help control the pain and antibiotics to reduce the risk of infection. After the procedure, the surgeon may leave your incisions open and place temporary drains to promote fluid drainage. You usually need to wear tight compression garments, which help reduce swelling, for a few weeks. You may need to wait a few days before returning to work and a few weeks before resuming your normal activities — including exercise. During this time, expect some contour irregularities as the remaining fat settles into position.
After liposuction, swelling typically subsides within a few weeks. By this time, the treated area should look less bulky. Within several months, expect the treated area to have a leaner appearance. It's natural for skin to lose some firmness with aging, but liposuction results are generally long lasting as long as you maintain your weight. If you gain weight after liposuction, your fat distribution may change. For example, you may accumulate fat around your abdomen regardless of what areas were originally treated.

Dental Clinic

The center has the most up-to-date facilities in its dental clinic


Get your medicine from the pharmacy center


CT Scan, Radiology


Perform medical tests using modern devices

Doctors who work with us

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Dr.Alireza Nemati Motehavaer
General Surgery Specialist - Cancer Surgery Fellowship

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Dr.Amir Hossein Jenabi
Ear, nose and throat specialist

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Dr.HamidReza Rozi Talab
Ear, Nose & Throat Specialist - Nasal & Sinus Surgery Fellowship

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Dr.MohammadReza Famil Tokhmeh Chi
Surgeon and Ophthalmologist - Retina Specialist Fellowship

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Dr.Davood Hayati
Surgeon and ophthalmologist

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Dr.Mehdi Alizadeh
Surgeon and Ophthalmologist - Specialized Corneal Fellowship

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Dr.Hasan Roghani
Surgeon and ENT specialist (head and neck)

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Dr.Hasan Jalalvand
Anesthesiologist and Intensive Care Specialist

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Dr.Hossein Moradi
Anesthesiologist and Intensive Care Specialist

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Dr.Mehdi Zandiyan
Surgeon and Ophthalmologist - Specialized Corneal Fellowship

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Dr.Masoud JanAhmad
Surgeon and ophthalmologist

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Dr.Ali Bakhtar
Surgeon and ophthalmologist

About Center

The Healing Limited Surgery Center was opened and launched in year 6 to improve the quality of care for dear clients. In this center, using the most experienced medical staff and personnel, we try to maximize client satisfaction and retain the dignity and human dignity of patients and their companions. At this center, specialized and specialized areas of cosmetic, ear surgery, pharyngeal surgery, ophthalmology, maxillofacial surgery and general surgery are offered to clients at their highest level. The strengths of this center are the utilization of the proper space of well-equipped operating rooms and patient rooms of high quality.

Contact Us


Shafa Limited Surgery Center, Koolab ave, Hamedan, Hamedan, Iranا