[ { "slug": "dental-implants", "name": "Dental Implants", "category": "dental", "description": "A dental implant is a titanium post surgically placed into the jawbone to serve as an artificial tooth root. A crown, bridge, or denture is then attached to the implant. The procedure typically requires two visits spaced several months apart to allow for osseointegration.", "averageRecoveryDays": 7, "typicalSessions": 2, "priceRangeUSD": { "low": 800, "high": 3500 }, "keyConsiderations": [ "Bone volume (assessed by CBCT) determines feasibility — graft if insufficient", "Osseointegration takes 3-6 months before crown placement", "Peri-implantitis risk persists for life — annual hygienist surveillance required", "Implant brand and lot must be documented for any future revision" ], "commonRisks": [ "Infection at the implant site", "Implant failure or rejection", "Nerve damage causing numbness", "Sinus problems (upper jaw implants)", "Bone loss around the implant" ], "questionsToAsk": [ "What implant brand and system do you use?", "What is your implant success rate over 5 years?", "Do you offer a warranty on the implant and crown?", "How many implant procedures do you perform per month?", "What imaging technology do you use for planning?" ], "overview": "Dental implant placement is a two-stage surgical procedure performed under local anaesthesia, often supplemented by sedation. In the first stage, the oral surgeon or implantologist creates a small incision in the gum tissue and drills a precisely sized channel into the jawbone before inserting the titanium or zirconia implant fixture. The site is then sutured and left to heal. During the ensuing osseointegration period — typically three to six months — the implant fuses with the surrounding bone through a process of direct structural bonding, a biological prerequisite for long-term stability.\n\nCandidacy depends on adequate bone volume and density, controlled systemic health (uncontrolled diabetes, bisphosphonate use, and heavy smoking significantly reduce success rates), and sufficient interocclusal space. Patients with insufficient bone may require adjunctive grafting procedures such as a sinus lift or ridge augmentation, which extend the overall treatment timeline by several months. Immediate-load protocols, in which a provisional crown is fitted on the day of implant placement, are available for selected cases with high primary implant stability.\n\nIn the second stage, after osseointegration has been confirmed radiographically, an abutment is connected to the implant and an impression taken for fabrication of the definitive crown. The final restoration is typically fitted one to two weeks later. Post-operative discomfort after each surgical stage is generally manageable with analgesics and resolves within a few days. Outcomes are highly predictable in healthy patients, with published ten-year survival rates exceeding 95% for single-unit implants placed by experienced clinicians.", "costBreakdown": "Quoted prices for dental implants vary considerably and it is essential to establish exactly what is included. Many clinics advertise a per-implant fee that covers only the surgical placement of the fixture itself, excluding the abutment, crown, pre-operative imaging (cone beam CT), and any necessary bone grafting. A single implant with a standard porcelain-fused-to-metal crown will often cost more once these components are itemised. Zirconia crowns, premium implant brands, and immediate-load protocols attract higher fees.\n\nAdditional costs to budget for include the initial consultation and treatment planning appointment, any extraction of the failing tooth if not already performed, bone graft materials and membranes if required, and medications (antibiotics, analgesics, antiseptic mouthwash). Some clinics include a limited number of follow-up visits in the package price, but remote post-operative consultations or complications arising after the patient has returned home may incur further charges. A warranty on the implant body is commonly offered by the manufacturer and should be documented in writing.", "medicalTourismNotes": "Dental implant treatment is one of the most structurally challenging procedures to complete across a single overseas trip because osseointegration requires three to six months between implant placement and crown fitting. Patients should plan for a minimum of two separate visits: the first for surgical placement and any grafting, the second (three to six months later) for abutment connection, impressions, and crown delivery. Attempting to compress both stages into a single trip by requesting an immediate-load crown is only appropriate in carefully selected cases and carries a higher risk of implant failure if bone quality is suboptimal.\n\nBefore travelling, obtain detailed records of the implant brand, batch number, and system used, as these are essential if any complication arises and the patient must seek remedial care at home. Ensure that the clinic provides a written treatment plan and that a local dentist has been briefed on the procedure. Post-operative follow-up — including wound inspection, suture removal, and radiographic review — must be arranged with a dentist in the home country for the intervening months. Travel insurance should be confirmed to cover dental surgical complications abroad.", "recoveryTimeline": "In the first one to three days following implant placement, swelling, bruising, and mild to moderate discomfort are expected and are best managed with prescribed analgesics and ice packs applied externally. Soft foods should be eaten on the opposite side and vigorous rinsing avoided. Sutures are typically removed at seven to ten days, after which the gum tissue heals over several weeks. Patients can generally return to light work within two to three days and resume normal oral hygiene around the implant site by the end of the first fortnight.\n\nOsseointegration — the biological fusion of the implant to the surrounding bone — proceeds silently over three to six months and is confirmed by radiographic assessment at the follow-up visit. No outward signs mark this phase, though the site must be kept clean and free from undue loading. Once osseointegration is confirmed, the abutment is connected and impressions are taken for the crown, which is typically fitted one to two weeks later. The final result is assessable immediately upon crown delivery, though the surrounding soft tissue may continue to mature in appearance for a further few weeks.", "faqs": [ { "question": "How long do dental implants last?", "answer": "With proper oral hygiene and routine dental check-ups, the titanium implant fixture itself can last a lifetime. The crown attached to the implant typically lasts ten to twenty years before requiring replacement due to normal wear." }, { "question": "Can I get dental implants if I smoke?", "answer": "Smoking significantly impairs healing and reduces implant success rates, with studies suggesting failure rates two to three times higher in smokers than non-smokers. Most implantologists will discuss the risks candidly and may require cessation for a period before and after surgery to optimise outcomes." }, { "question": "Am I too old for dental implants?", "answer": "There is no upper age limit for dental implants, provided the patient is in reasonable general health and has adequate bone volume. Many patients in their seventies and eighties receive implants successfully; age alone is not a contraindication." }, { "question": "Can I fly the day after implant surgery?", "answer": "Flying within the first forty-eight to seventy-two hours after implant placement is generally not recommended, as cabin pressure changes and low humidity may exacerbate swelling and discomfort. Most clinics advise a minimum of three to five days before travelling by air." }, { "question": "Is dental implant surgery painful?", "answer": "The procedure itself is performed under local anaesthesia and should not be painful during placement. Post-operative discomfort — typically described as soreness rather than sharp pain — is usual for two to four days and is well managed with standard analgesics." }, { "question": "How do I know if I have enough bone for an implant?", "answer": "A cone beam CT scan is the standard imaging tool for assessing bone volume and density before implant planning. If insufficient bone is present, a bone graft procedure can be performed first, though this extends the overall treatment timeline by several months." }, { "question": "What happens if an implant fails?", "answer": "Implant failure — most commonly due to infection, inadequate osseointegration, or excessive loading — occurs in approximately three to five per cent of cases at experienced centres. A failed implant is removed, the site is allowed to heal, and a new implant is typically placed after several months once bone quality has been restored." }, { "question": "Do implants look and feel natural?", "answer": "Modern implant-supported crowns are fabricated from tooth-coloured materials such as zirconia and are designed to match adjacent natural teeth closely in colour, shape, and translucency. Functionally, patients describe implants as feeling indistinguishable from natural teeth once fully healed." }, { "question": "Are there alternatives to dental implants?", "answer": "The main alternatives to implants are fixed dental bridges, which require preparation of adjacent healthy teeth, and removable partial or full dentures. Implants are generally preferred where feasible as they preserve jawbone, do not involve neighbouring teeth, and provide superior long-term stability." } ], "relatedProcedures": [ "dental-veneers" ], "aliases": [], "eligibility": [ { "criterion": "Adequate bone volume and density at the implant site (assessed by CBCT)", "sourceSlugs": [ "who-surgical-safety-checklist" ] }, { "criterion": "Healthy gum tissue free of active periodontal disease", "sourceSlugs": [ "who-surgical-safety-checklist" ] }, { "criterion": "Skeletal maturity (typically over age 18)", "sourceSlugs": [ "who-surgical-safety-checklist" ] }, { "criterion": "Willingness to commit to long-term oral hygiene and follow-up", "sourceSlugs": [ "who-surgical-safety-checklist" ] } ], "contraindications": [ { "contraindication": "Heavy smoking (significantly reduces osseointegration success)", "sourceSlugs": [ "who-surgical-safety-checklist" ] }, { "contraindication": "Uncontrolled diabetes (HbA1c above local clinical thresholds)", "sourceSlugs": [ "who-surgical-safety-checklist" ] }, { "contraindication": "Recent intravenous bisphosphonate therapy (osteonecrosis risk)", "sourceSlugs": [ "who-surgical-safety-checklist" ] }, { "contraindication": "Active periodontal disease until controlled", "sourceSlugs": [ "who-surgical-safety-checklist" ] } ], "risks": [ { "name": "Implant failure (osseointegration failure)", "severity": "moderate", "rate": { "value": 0.05, "range": [ 0.02, 0.1 ] }, "prevention": "Adequate bone volume confirmed by CBCT imaging; appropriate torque at placement; avoidance of smoking during osseointegration.", "sourceSlugs": [ "who-surgical-safety-checklist" ] }, { "name": "Peri-implantitis (late infection)", "severity": "moderate", "rate": { "value": 0.1, "range": [ 0.05, 0.2 ] }, "prevention": "Strict oral hygiene; quarterly hygienist visits during the first year; smoking cessation.", "sourceSlugs": [ "who-surgical-safety-checklist" ] }, { "name": "Nerve injury (inferior alveolar)", "severity": "severe", "rate": { "value": 0.005 }, "prevention": "Pre-operative CBCT measurement of nerve canal distance; cautious drilling protocol.", "sourceSlugs": [ "who-surgical-safety-checklist" ] }, { "name": "Sinus perforation (upper jaw)", "severity": "moderate", "rate": { "value": 0.02 }, "prevention": "Sinus-lift procedure where bone height under floor is insufficient; CBCT planning.", "sourceSlugs": [ "who-surgical-safety-checklist" ] } ], "subtypes": [], "followUpCadence": [ { "at": "1 week", "type": "Wound check, suture review", "required": true }, { "at": "3 months", "type": "Osseointegration radiograph (panoramic or CBCT)", "required": true }, { "at": "6 months", "type": "Crown placement / final restoration review", "required": true }, { "at": "12 months", "type": "Annual review with hygienist", "required": true } ], "recordsToObtain": [ "Pre-operative CBCT scan files", "Implant manufacturer, batch number, and lot record (implant passport)", "Surgical report including torque values", "Post-operative panoramic or CBCT radiograph" ], "anaesthesia": "local", "operatingTime": { "lowMinutes": 30, "highMinutes": 90, "sourceSlugs": [ "who-surgical-safety-checklist" ] }, "hospitalStay": { "lowNights": 0, "highNights": 0, "sourceSlugs": [ "who-surgical-safety-checklist" ] }, "minimumInCountryDays": { "low": 3, "high": 7, "sourceSlugs": [ "who-surgical-safety-checklist" ] }, "daysToFly": { "low": 1, "high": 2, "explanation": "Single-implant placements under local anaesthesia have minimal flying restriction; multi-implant or sinus-lift cases may benefit from 2-3 days locally for swelling review.", "sourceSlugs": [ "iata-medical-cabin-guidance" ] }, "complicationRate": { "value": 5, "range": [ 2, 10 ], "sourceSlugs": [ "who-surgical-safety-checklist" ] }, "revisionRate": { "value": 5, "range": [ 3, 10 ], "sourceSlugs": [ "who-surgical-safety-checklist" ] }, "numberOfVisits": { "typical": 3, "minimum": 2 }, "recoveryByActivity": { "sedentaryWork": { "days": 1, "sourceSlugs": [ "who-surgical-safety-checklist" ] }, "manualWork": { "days": 3, "sourceSlugs": [ "who-surgical-safety-checklist" ] }, "lightExercise": { "days": 7, "sourceSlugs": [ "who-surgical-safety-checklist" ] }, "vigorousExercise": { "days": 14, "sourceSlugs": [ "who-surgical-safety-checklist" ] }, "flying": { "days": 2, "sourceSlugs": [ "iata-medical-cabin-guidance" ] }, "driving": { "days": 1, "sourceSlugs": [ "who-surgical-safety-checklist" ] }, "swimming": { "days": 7, "sourceSlugs": [ "who-surgical-safety-checklist" ] } }, "literatureLinks": [ { "title": "Systematic review on diabetes mellitus and dental implants: an update.", "journal": "International journal of implant dentistry", "year": 2022, "doi": "10.1186/s40729-021-00399-8", "url": "https://doi.org/10.1186/s40729-021-00399-8" }, { "title": "Effectiveness of the socket shield technique in dental implant: A systematic review.", "journal": "Journal of prosthodontic research", "year": 2022, "doi": "10.2186/jpr.JPR_D_20_00054", "url": "https://doi.org/10.2186/jpr.JPR_D_20_00054" }, { "title": "Medication-related dental implant failure: Systematic review and meta-analysis.", "journal": "Clinical oral implants research", "year": 2018, "doi": "10.1111/clr.13137", "url": "https://doi.org/10.1111/clr.13137" } ], "alternativeTreatments": [ { "name": "Dental bridges", "procedureSlug": "dental-bridges", "rationale": "Adjacent-tooth-supported alternative; cheaper but requires grinding healthy teeth.", "sourceSlugs": [ "who-surgical-safety-checklist" ] }, { "name": "Removable partial denture", "procedureSlug": "dentures", "rationale": "Lowest-cost alternative; less stable and lower patient satisfaction long-term.", "sourceSlugs": [ "who-surgical-safety-checklist" ] }, { "name": "All-on-4 or All-on-6 full-arch restoration", "procedureSlug": "all-on-4", "rationale": "When multiple teeth are missing in the same arch; better cost efficiency than individual implants.", "sourceSlugs": [ "who-surgical-safety-checklist" ] } ], "accreditationsRequired": [ "icoi-fellowship", "national-dental-council" ] }, { "slug": "dental-veneers", "name": "Dental Veneers", "category": "dental", "description": "Dental veneers are thin shells of porcelain or composite resin bonded to the front surface of teeth to improve appearance. They address discolouration, chips, gaps, and minor misalignment. Porcelain veneers typically require two visits: preparation and bonding. The procedure involves removing a thin layer of enamel, which is irreversible.", "averageRecoveryDays": 2, "typicalSessions": 2, "priceRangeUSD": { "low": 250, "high": 1500 }, "keyConsiderations": [ "Porcelain vs composite is the primary aesthetic-durability trade-off", "Preparation depth affects long-term tooth health — preserve enamel where possible", "Bite alignment and bruxism must be evaluated pre-treatment", "Lifetime cost includes likely replacement every 10-15 years for porcelain" ], "commonRisks": [ "Tooth sensitivity after enamel removal", "Veneer chipping or cracking", "Colour mismatch with adjacent teeth", "Irreversible alteration of natural tooth structure", "Gum irritation or inflammation" ], "questionsToAsk": [ "Do you use porcelain or composite veneers?", "What dental laboratory fabricates your veneers?", "How much enamel will be removed?", "What is the expected lifespan of the veneers?", "What happens if a veneer chips or debonds?" ], "overview": "Porcelain veneer placement follows a two-appointment protocol. At the first appointment, the dentist removes a thin layer of enamel from the facial surface of each tooth to be treated — typically 0.3 to 0.7 mm — to create space for the veneer shell and prevent the restoration from appearing bulky. Impressions or intraoral scans are then taken and sent to a dental laboratory, where the veneers are custom-fabricated over approximately one to two weeks. Temporary veneers are usually fitted to protect the prepared teeth in the interim. At the second appointment, the temporary restorations are removed, the permanent veneers are tried in for fit and shade assessment, and then bonded with resin cement following acid etching and surface conditioning.\n\nCandidacy is based on adequate enamel thickness (preparation into dentine is associated with higher sensitivity and lower bond longevity), the absence of active periodontal disease, and realistic patient expectations regarding achievable shade and shape. Significant bite abnormalities or parafunctional habits such as bruxism substantially increase the risk of fracture and are relative contraindications. Composite veneers can be completed in a single appointment and require less or no tooth preparation, but are less durable and more prone to staining than laboratory-fabricated porcelain restorations.\n\nRecovery is minimal; post-operative sensitivity typically resolves within a few days. Porcelain veneers have an average clinical lifespan of ten to fifteen years, after which they will require replacement. Patients should be counselled that the procedure is irreversible: once enamel has been removed, the teeth will always require some form of coverage.", "costBreakdown": "Veneer pricing is almost universally quoted per tooth, and the total cost rises quickly when multiple teeth are treated. A full aesthetic makeover involving eight to ten veneers can represent a substantial expenditure even at clinics offering competitive rates. The quoted per-tooth fee typically covers the preparation appointment, laboratory fabrication, and bonding appointment, but may or may not include temporary veneers, pre-treatment photographs, shade-matching consultations, and any remedial polishing visits.\n\nExtras to clarify in advance include the initial consultation and smile design appointment (sometimes charged separately), local anaesthesia for preparation, and the cost of any required pre-treatment (such as teeth whitening of remaining natural teeth for colour matching, or management of gum inflammation). Composite veneers placed directly by the dentist are considerably less expensive than laboratory-fabricated porcelain but have a shorter lifespan, making long-term cost comparisons relevant. Some clinics include a guarantee period covering debonding or chipping within one to two years; confirm whether this applies.", "medicalTourismNotes": "Porcelain veneer treatment requires a minimum of two appointments separated by approximately one to two weeks of laboratory fabrication time, making it well suited to a single overseas visit of seven to ten days. Patients can schedule the preparation appointment at the start of their trip, allow time for sightseeing or other activities, and return for bonding before departure. However, the compressed timeline means there is limited opportunity to make adjustments to shade or shape once the veneers are bonded, so patients should spend adequate time at the try-in stage before consenting to permanent cementation.\n\nPost-bonding sensitivity and minor occlusal adjustments may require a brief follow-up, which is difficult to arrange remotely. Patients should be aware that if a veneer chips, debonds, or causes persistent sensitivity after returning home, repair or replacement will need to be managed by a local dentist who may not use the same laboratory or materials, potentially resulting in a colour mismatch. Before travelling, confirm the veneer material, shade code, and laboratory used so that a home-country dentist has the information needed for repairs. Ensure the clinic provides a written record of the shade selected and the bonding protocol followed.", "recoveryTimeline": "Recovery after veneer bonding is brief. Tooth sensitivity to temperature and pressure is common in the first one to two days, particularly if significant enamel was removed during preparation, and typically resolves without intervention. Most patients find they can eat normally within twenty-four to forty-eight hours, though hard or sticky foods are best avoided in the first few days while the bite settles. A follow-up check at approximately one week allows the dentist to assess the occlusion, polish any high spots, and confirm the gum tissue is not inflamed around the veneer margins.\n\nThere is no extended recovery phase for veneers. The final aesthetic result is visible immediately upon bonding and does not change over time, though minor gum-line refinement may occur over the first few weeks as soft tissue adapts. Patients should report any persistent sensitivity beyond two weeks, as this can occasionally indicate pulpal involvement requiring further assessment. Long-term maintenance involves standard oral hygiene, avoidance of habits such as nail-biting, and wearing a protective night guard if bruxism is present.", "faqs": [ { "question": "How long do porcelain veneers last?", "answer": "Porcelain veneers typically last ten to fifteen years with proper care before needing replacement. Composite resin veneers have a shorter lifespan of five to seven years but are less expensive and easier to repair if chipped." }, { "question": "Is the veneer procedure reversible?", "answer": "No. Because a thin layer of enamel is removed during preparation, the teeth cannot return to their natural state once treatment has begun. Patients should consider this permanent commitment carefully before proceeding." }, { "question": "Do veneers look natural?", "answer": "Modern porcelain veneers are fabricated to mimic the light-reflecting properties and translucency of natural enamel, and skilled ceramists can match colour and shape closely to adjacent teeth. When well made and properly placed, veneers are generally indistinguishable from natural teeth." }, { "question": "Can veneers fix crooked teeth?", "answer": "Veneers can improve the appearance of mildly misaligned or uneven teeth, but they do not straighten teeth in the orthodontic sense. For significant crowding or bite issues, orthodontic treatment is a more appropriate solution." }, { "question": "Will veneers stain like natural teeth?", "answer": "Porcelain veneers are highly resistant to staining and do not discolour with tea, coffee, or wine the way natural enamel can. Composite resin veneers are more susceptible to staining over time and may require polishing or replacement to maintain their appearance." }, { "question": "Is veneer preparation painful?", "answer": "Local anaesthesia is used during enamel preparation, so the procedure itself should be pain-free. Sensitivity to cold and touch is common for one to two days after preparation and after bonding, but this typically resolves without treatment." }, { "question": "How many veneers do I need?", "answer": "The number depends on the extent of the treatment goal. Most full smile makeovers involve six to ten veneers covering the upper teeth visible when smiling. Isolated chips or discolouration may require only one or two veneers." }, { "question": "Can I get veneers if I grind my teeth?", "answer": "Bruxism significantly increases the risk of veneer fracture, as the forces generated during grinding exceed those of normal chewing. Patients who grind should have the habit managed — typically with a night guard — before veneer placement, and must commit to wearing a protective guard long-term." } ], "relatedProcedures": [ "dental-implants" ], "aliases": [], "eligibility": [ { "criterion": "Generally healthy teeth with sufficient enamel for bonding", "sourceSlugs": [ "who-surgical-safety-checklist" ] }, { "criterion": "Stable bite with no untreated TMJ disorder", "sourceSlugs": [ "who-surgical-safety-checklist" ] }, { "criterion": "Realistic aesthetic expectations confirmed in pre-operative consultation", "sourceSlugs": [ "who-surgical-safety-checklist" ] } ], "contraindications": [ { "contraindication": "Active periodontal disease until treated", "sourceSlugs": [ "who-surgical-safety-checklist" ] }, { "contraindication": "Untreated bruxism (high fracture rate)", "sourceSlugs": [ "who-surgical-safety-checklist" ] }, { "contraindication": "Inadequate enamel for bonding", "sourceSlugs": [ "who-surgical-safety-checklist" ] } ], "risks": [ { "name": "Veneer fracture or debonding", "severity": "moderate", "rate": { "value": 0.05, "range": [ 0.02, 0.1 ] }, "prevention": "Avoidance of biting hard objects; bruxism appliance where indicated.", "sourceSlugs": [ "who-surgical-safety-checklist" ] }, { "name": "Tooth sensitivity post-preparation", "severity": "minor", "rate": { "value": 0.2 }, "prevention": "Conservative preparation depth; desensitising agents as needed.", "sourceSlugs": [ "who-surgical-safety-checklist" ] }, { "name": "Pulp damage requiring root canal", "severity": "moderate", "rate": { "value": 0.02 }, "prevention": "Conservative preparation; pre-operative vitality testing.", "sourceSlugs": [ "who-surgical-safety-checklist" ] }, { "name": "Gum recession around veneer margin", "severity": "minor", "rate": { "value": 0.05 }, "prevention": "Sub-gingival margin precision; oral hygiene.", "sourceSlugs": [ "who-surgical-safety-checklist" ] } ], "subtypes": [ "composite-veneers" ], "followUpCadence": [ { "at": "1 week", "type": "Bite check and bonding review", "required": true }, { "at": "6 months", "type": "Margin and gum-health review", "required": true }, { "at": "Annual", "type": "Hygienist review and aesthetic check", "required": true } ], "recordsToObtain": [ "Pre-operative photographs", "Preparation depth records", "Veneer material specification (porcelain composition or composite brand)", "Cement / bonding agent specification", "Final shade record" ], "anaesthesia": "local", "operatingTime": { "lowMinutes": 60, "highMinutes": 180, "sourceSlugs": [ "who-surgical-safety-checklist" ] }, "hospitalStay": { "lowNights": 0, "highNights": 0, "sourceSlugs": [ "who-surgical-safety-checklist" ] }, "minimumInCountryDays": { "low": 5, "high": 10, "sourceSlugs": [ "who-surgical-safety-checklist" ] }, "daysToFly": { "low": 1, "high": 2, "explanation": "Veneer preparation and fitting are outpatient procedures; flying is generally permitted from the next day.", "sourceSlugs": [ "iata-medical-cabin-guidance" ] }, "complicationRate": { "value": 5, "range": [ 2, 10 ], "sourceSlugs": [ "who-surgical-safety-checklist" ] }, "revisionRate": { "value": 10, "range": [ 5, 15 ], "sourceSlugs": [ "who-surgical-safety-checklist" ] }, "numberOfVisits": { "typical": 2, "minimum": 1 }, "recoveryByActivity": { "sedentaryWork": { "days": 1, "sourceSlugs": [ "who-surgical-safety-checklist" ] }, "manualWork": { "days": 1, "sourceSlugs": [ "who-surgical-safety-checklist" ] }, "lightExercise": { "days": 1, "sourceSlugs": [ "who-surgical-safety-checklist" ] }, "vigorousExercise": { "days": 3, "sourceSlugs": [ "who-surgical-safety-checklist" ] }, "flying": { "days": 1, "sourceSlugs": [ "iata-medical-cabin-guidance" ] }, "driving": { "days": 1, "sourceSlugs": [ "who-surgical-safety-checklist" ] }, "swimming": { "days": 1, "sourceSlugs": [ "who-surgical-safety-checklist" ] } }, "literatureLinks": [ { "title": "Survival and Complication Rates of Feldspathic, Leucite-Reinforced, Lithium Disilicate and Zirconia Ceramic Laminate Veneers: A Systematic Review and Meta-Analysis.", "journal": "Journal of esthetic and restorative dentistry : official publication of the American Academy of Esthetic Dentistry ... [et al.]", "year": 2025, "doi": "10.1111/jerd.13351", "url": "https://doi.org/10.1111/jerd.13351" }, { "title": "Long-term survival and reasons for failure in direct anterior composite restorations: A systematic review.", "journal": "Journal of conservative dentistry : JCD", "year": 2021, "doi": "10.4103/jcd.jcd_527_21", "url": "https://doi.org/10.4103/jcd.jcd_527_21" }, { "title": "SURVIVAL AND COMPLICATION RATES OF RESIN COMPOSITE LAMINATE VENEERS: A SYSTEMATIC REVIEW AND META-ANALYSIS.", "journal": "The journal of evidence-based dental practice", "year": 2023, "doi": "10.1016/j.jebdp.2023.101911", "url": "https://doi.org/10.1016/j.jebdp.2023.101911" } ], "alternativeTreatments": [ { "name": "Composite veneers", "procedureSlug": "composite-veneers", "rationale": "Lower-cost, single-visit alternative; less durable and more staining over time.", "sourceSlugs": [ "who-surgical-safety-checklist" ] }, { "name": "Composite bonding", "procedureSlug": "composite-bonding", "rationale": "Minimal or no enamel removal; suitable for chips and small gaps rather than full reshape.", "sourceSlugs": [ "who-surgical-safety-checklist" ] }, { "name": "Tooth whitening + orthodontics", "rationale": "When colour and alignment are the only issues; no enamel removal.", "sourceSlugs": [ "who-surgical-safety-checklist" ] } ], "accreditationsRequired": [ "national-dental-council" ] }, { "slug": "hair-transplant", "name": "Hair Transplant (FUE)", "category": "hair-transplant", "description": "Follicular Unit Extraction (FUE) involves harvesting individual hair follicles from a donor area (typically the back of the head) and transplanting them to areas of thinning or baldness. Results take 9-12 months to fully develop. The procedure is performed under local anaesthesia.", "averageRecoveryDays": 10, "typicalSessions": 1, "priceRangeUSD": { "low": 1500, "high": 8000 }, "keyConsiderations": [ "Stabilised pattern loss is required for predictable results", "Donor area density determines what's achievable", "Combined medical management (minoxidil, finasteride) slows native progression", "Final density visible at 12-18 months post-op" ], "commonRisks": [ "Infection", "Scarring in donor area", "Unnatural-looking results if poorly planned", "Shock loss (temporary shedding of transplanted hair)", "Numbness in donor or recipient area" ], "questionsToAsk": [ "How many grafts do you estimate I need?", "Does the surgeon or a technician place the grafts?", "Can I see before/after photos of patients with similar hair loss patterns?", "What is your graft survival rate?", "What post-operative care protocol do you follow?" ], "overview": "Follicular Unit Extraction is a minimally invasive hair restoration technique performed under local anaesthesia on an outpatient basis. Individual follicular units — naturally occurring groups of one to four hairs — are extracted from the donor area using a specialised punch instrument of 0.6 to 1.0 mm diameter. The extracted grafts are stored in a chilled preservation solution to maintain viability. Recipient sites are then created in the thinning or bald area at angles and densities designed to replicate the natural growth pattern, and each graft is placed individually.\n\nCandidacy is determined primarily by donor density and the extent of hair loss. Patients with insufficient donor density — whether due to advanced loss, fine hair calibre, or previous over-harvesting — may not achieve adequate coverage. The Norwood scale for male pattern baldness and the Ludwig scale for female pattern loss are standard tools for grading severity and planning graft estimates. Underlying conditions causing diffuse hair loss (alopecia areata, telogen effluvium, hormonal disorders) must be excluded or stabilised before surgery is appropriate, as active hair loss will continue regardless of transplanted grafts.\n\nIn the days following surgery, small scabs form around each graft and shed over approximately ten days. A phenomenon termed shock loss — temporary shedding of both transplanted and surrounding native hairs triggered by surgical trauma — is common and resolves over several months. Transplanted hairs typically shed within two to four weeks and begin regrowing at three to four months. Final density and naturalness of result are not assessable until nine to twelve months post-procedure, and a second session may be required for desired coverage.", "costBreakdown": "Hair transplant pricing is typically structured either per graft or as an all-inclusive package for a defined graft range (e.g. up to 3,000 grafts). Per-graft pricing models require an accurate pre-operative graft count, which should be confirmed in writing before travel, as on-the-day revisions to the planned number will affect cost. Package pricing offers more predictability but may limit the surgeon's flexibility to place additional grafts if intraoperative assessment suggests more are needed.\n\nItems typically included in quoted prices are the procedure itself, local anaesthesia, post-operative medications (antibiotics, anti-inflammatory agents, minoxidil for some clinics), and a post-operative care kit. Items commonly excluded include pre-operative blood tests, the initial consultation and trichoscopy assessment, accommodation, airport transfers, and any PRP (platelet-rich plasma) sessions recommended as an adjunct. Patients should verify whether the cost covers a single day's surgery or whether large graft sessions requiring two days are priced differently.", "medicalTourismNotes": "Hair transplant surgery is one of the higher-volume procedures sought abroad, and for straightforward cases it is reasonably well suited to a single trip. Most patients require only one visit, as the procedure is completed in a single session and there is no mandatory return appointment. However, the remote follow-up limitations are significant: post-operative assessment of graft take, early signs of infection, and management of complications such as folliculitis or ingrown hairs typically occur over three to twelve months and cannot meaningfully be conducted via video consultation alone.\n\nA critical concern in major hair transplant destinations — particularly Turkey — is the widespread use of a technician-led model in which the surgeon draws the hairline and creates recipient sites but graft extraction and placement are performed by trained technicians rather than the operating surgeon. Prospective patients should clarify in writing who will perform each stage of the procedure. Results cannot be assessed for nine to twelve months, meaning dissatisfaction will not become apparent until long after the patient has returned home, with limited recourse against an overseas provider. Patients should arrange a dermatology or hair loss clinic review in their home country at the three-, six-, and twelve-month marks.", "recoveryTimeline": "In the three to five days following surgery, small crusts form around each transplanted graft in the recipient area and around each extraction site in the donor zone. These must not be picked or scratched. Gentle washing with diluted shampoo typically begins at forty-eight to seventy-two hours per clinic protocol, and most crusts shed naturally by days ten to fourteen. Redness and minor swelling of the scalp are normal during this period. Most patients feel comfortable returning to office work and light daily activities within ten to fourteen days, once the donor area has healed and crusting has resolved.\n\nBetween weeks two and eight, the transplanted hairs shed — a normal and expected phase often called the shedding or telogen phase — which can be disconcerting but does not indicate graft failure. New hair growth emerges from three to four months onwards, initially fine and gradually thickening. At six months, meaningful coverage is visible, and the final result — including full density, texture, and naturalness of hairline — is assessable at nine to twelve months post-procedure. A follow-up consultation at twelve months allows the clinic to assess whether a second session is warranted.", "faqs": [ { "question": "How long until I see results from a hair transplant?", "answer": "Transplanted hairs typically shed within two to four weeks of the procedure before regrowing — a normal phase that can be alarming but does not indicate failure. Meaningful new growth is usually visible from three to four months, with the full, final result assessable at nine to twelve months." }, { "question": "Will people be able to tell I had a hair transplant?", "answer": "When performed by an experienced surgeon with careful hairline design and natural graft angulation, FUE results are generally undetectable. The small circular extraction sites in the donor area heal as tiny white dots that are invisible when hair is kept at a normal length." }, { "question": "Can I shave my head after an FUE transplant?", "answer": "Yes — one of the advantages of FUE over older strip techniques is that the donor area can be shaved without revealing a linear scar. The small dot scars from individual punch extractions are not visible at normal shaved lengths for most patients." }, { "question": "How many grafts will I need?", "answer": "The number of grafts required depends on the extent of hair loss and the density goal. A receding hairline may require 1,000 to 2,000 grafts, whilst advanced crown and frontal thinning can require 3,000 to 5,000 grafts or more. An in-person or photo-based assessment is needed for an accurate estimate." }, { "question": "Is a hair transplant permanent?", "answer": "The transplanted follicles are taken from the donor area at the back of the scalp, which is genetically resistant to the hormone DHT responsible for male pattern baldness. These follicles retain their resistance after transplantation, meaning the transplanted hair is permanent. Native hair in other areas may continue to thin over time." }, { "question": "Am I a suitable candidate for a hair transplant?", "answer": "Good candidates have stable hair loss, sufficient donor density at the back and sides of the scalp, and realistic expectations. Patients with diffuse thinning across the entire scalp, active autoimmune conditions causing hair loss, or insufficient donor supply may not achieve satisfactory results." }, { "question": "Is the procedure painful?", "answer": "The procedure is performed under local anaesthesia, and the injections used to numb the scalp are the most uncomfortable part for most patients. The extraction and implantation stages themselves are not painful, though the scalp may feel tender for several days afterwards." }, { "question": "Can women have hair transplants?", "answer": "Yes, women can undergo hair transplant surgery, though the pattern of female hair loss differs from male pattern baldness and requires careful assessment. Women with localised thinning or a receding frontal hairline are generally better candidates than those with diffuse thinning across the whole scalp." } ], "relatedProcedures": [ "rhinoplasty" ], "aliases": [], "eligibility": [ { "criterion": "Stabilised pattern of male or female hair loss (typically Norwood III–VI for men)", "sourceSlugs": [ "ishrs-standards" ] }, { "criterion": "Adequate donor area density", "sourceSlugs": [ "ishrs-standards" ] }, { "criterion": "Realistic expectations about achievable density", "sourceSlugs": [ "ishrs-standards" ] } ], "contraindications": [ { "contraindication": "Active scalp infection or inflammatory scalp condition (psoriasis flare, alopecia areata in active phase)", "sourceSlugs": [ "ishrs-standards" ] }, { "contraindication": "Insufficient donor density to achieve meaningful coverage", "sourceSlugs": [ "ishrs-standards" ] }, { "contraindication": "Body dysmorphic disorder until evaluated by mental-health specialist", "sourceSlugs": [ "ishrs-standards" ] } ], "risks": [ { "name": "Folliculitis (graft infection)", "severity": "minor", "rate": { "value": 0.05 }, "prevention": "Sterile technique; post-operative saline irrigation; antibiotic prophylaxis where indicated.", "sourceSlugs": [ "ishrs-standards" ] }, { "name": "Shock loss of pre-existing native hair", "severity": "moderate", "rate": { "value": 0.1 }, "prevention": "Conservative graft density in transitional zones; minoxidil pre-treatment in selected patients.", "sourceSlugs": [ "ishrs-standards" ] }, { "name": "Visible donor-area scar (FUT) or low-density patches (FUE)", "severity": "moderate", "rate": { "value": 0.1 }, "prevention": "Trichophytic donor closure (FUT); careful FUE extraction pattern.", "sourceSlugs": [ "ishrs-standards" ] }, { "name": "Poor graft survival rate", "severity": "moderate", "rate": { "value": 0.05, "range": [ 0.02, 0.1 ] }, "prevention": "Minimised out-of-body time; appropriate hydration; experienced implantation team.", "sourceSlugs": [ "ishrs-standards" ] } ], "subtypes": [ "hair-transplant-dhi", "hair-transplant-fut" ], "followUpCadence": [ { "at": "10 days", "type": "Crust review and graft inspection", "required": true }, { "at": "3 months", "type": "Shedding-phase reassurance review", "required": true }, { "at": "6 months", "type": "Early growth assessment", "required": true }, { "at": "12 months", "type": "Final density assessment with photography", "required": true } ], "recordsToObtain": [ "Pre-operative donor and recipient photographs", "Number of grafts harvested and placed", "Extraction technique (FUE vs FUT) and instrumentation", "Post-operative care instructions and prescribed medications" ], "anaesthesia": "local", "operatingTime": { "lowMinutes": 360, "highMinutes": 540, "sourceSlugs": [ "ishrs-standards" ] }, "hospitalStay": { "lowNights": 0, "highNights": 0, "sourceSlugs": [ "ishrs-standards" ] }, "minimumInCountryDays": { "low": 3, "high": 5, "sourceSlugs": [ "ishrs-standards" ] }, "daysToFly": { "low": 2, "high": 3, "explanation": "Pressure changes and crusting management argue for 2-3 days locally before flying; airline restrictions are limited.", "sourceSlugs": [ "ishrs-standards", "iata-medical-cabin-guidance" ] }, "complicationRate": { "value": 3, "range": [ 1, 5 ], "sourceSlugs": [ "ishrs-standards" ] }, "revisionRate": { "value": 10, "range": [ 5, 20 ], "sourceSlugs": [ "ishrs-standards" ] }, "numberOfVisits": { "typical": 1, "minimum": 1 }, "recoveryByActivity": { "sedentaryWork": { "days": 3, "sourceSlugs": [ "ishrs-standards" ] }, "manualWork": { "days": 7, "sourceSlugs": [ "ishrs-standards" ] }, "lightExercise": { "days": 14, "sourceSlugs": [ "ishrs-standards" ] }, "vigorousExercise": { "days": 30, "sourceSlugs": [ "ishrs-standards" ] }, "swimming": { "days": 30, "sourceSlugs": [ "ishrs-standards" ] }, "flying": { "days": 2, "sourceSlugs": [ "iata-medical-cabin-guidance" ] }, "driving": { "days": 1, "sourceSlugs": [ "ishrs-standards" ] } }, "literatureLinks": [ { "title": "Complications Following Hair Transplantation: A Systematic Literature Review and Meta-Analysis.", "journal": "Aesthetic plastic surgery", "year": 2025, "doi": "10.1007/s00266-025-05125-y", "url": "https://doi.org/10.1007/s00266-025-05125-y" }, { "title": "Eyebrow and Eyelash Hair Transplantation: A Systematic Review.", "journal": "The Journal of clinical and aesthetic dermatology", "year": 2018, "url": "https://pubmed.ncbi.nlm.nih.gov/29942421/" }, { "title": "Large Skull Metastasis in Follicular Thyroid Carcinoma: A Comprehensive Case Presentation and Systematic Review.", "journal": "Journal of neurological surgery. Part A, Central European neurosurgery", "year": 2025, "doi": "10.1055/s-0044-1785650", "url": "https://doi.org/10.1055/s-0044-1785650" } ], "alternativeTreatments": [ { "name": "FUE (follicular unit extraction)", "procedureSlug": "sapphire-fue", "rationale": "Strip-free harvesting; preferred for short hairstyles and patients with tight scalps.", "sourceSlugs": [ "who-surgical-safety-checklist" ] }, { "name": "DHI (direct hair implantation)", "procedureSlug": "hair-transplant-dhi", "rationale": "Choi-pen implantation; useful for hairline densification.", "sourceSlugs": [ "who-surgical-safety-checklist" ] }, { "name": "FUT (follicular unit transplantation)", "procedureSlug": "hair-transplant-fut", "rationale": "Strip-harvest; higher graft yield per session but leaves a linear scar.", "sourceSlugs": [ "who-surgical-safety-checklist" ] }, { "name": "PRP injections", "procedureSlug": "prp-hair-loss", "rationale": "Non-surgical maintenance; works best in early diffuse thinning, not in established baldness.", "sourceSlugs": [ "who-surgical-safety-checklist" ] }, { "name": "Finasteride or minoxidil", "rationale": "Medical therapy proven to slow androgenetic alopecia progression; lifelong adherence required.", "sourceSlugs": [ "who-surgical-safety-checklist" ] } ] }, { "slug": "rhinoplasty", "name": "Rhinoplasty", "category": "cosmetic-surgery", "description": "Rhinoplasty (nose reshaping surgery) is performed to change the shape, size, or proportions of the nose for aesthetic or functional reasons. It may involve modifying bone, cartilage, and skin. Open and closed approaches exist, each with different recovery profiles and scar visibility.", "averageRecoveryDays": 14, "typicalSessions": 1, "priceRangeUSD": { "low": 2500, "high": 10000 }, "keyConsiderations": [ "Revision rates 10-15% even in experienced hands — surgeon volume matters", "Functional concerns (septum, breathing) often co-exist with aesthetic", "Final tip shape continues refining for up to 12 months post-op", "Pre-operative photography and simulation help align expectations" ], "commonRisks": [ "Infection", "Breathing difficulties", "Unsatisfactory aesthetic result requiring revision", "Numbness or altered sensation", "Septal perforation", "Visible scarring (open approach)" ], "questionsToAsk": [ "How many rhinoplasties do you perform per year?", "What is your revision rate?", "Can you show me 3D simulation of expected results?", "Do you use autologous cartilage or synthetic implants?", "What type of anaesthesia do you recommend?" ], "overview": "Rhinoplasty is performed under general anaesthesia and typically takes two to three hours depending on complexity. In the open approach, a small incision is made across the columella (the strip of tissue between the nostrils), allowing full exposure of the cartilaginous and bony nasal framework. The closed approach uses incisions entirely within the nostrils, leaving no external scar but providing more limited visualisation. The surgeon modifies bone, cartilage, and soft tissue according to the pre-operative plan, which may include hump reduction, tip refinement, base narrowing, or correction of septal deviation.\n\nIdeal candidates are adults who have completed nasal growth (typically eighteen years or older), are in good general health, are non-smokers or have ceased smoking well in advance, and have realistic expectations regarding outcomes. Patients with very thick nasal skin have reduced definition from cartilage work and should be counselled accordingly. Functional concerns such as septal deviation and turbinate hypertrophy may be addressed concurrently with aesthetic rhinoplasty.\n\nA nasal splint is worn for approximately seven to ten days post-operatively. Significant bruising and periorbital oedema typically peaks at two to three days and resolves over two to three weeks. Patients are generally advised to remain near the surgical facility for a minimum of seven to ten days before travelling. The nose continues to refine over twelve to eighteen months as residual oedema subsides, particularly in the nasal tip. Final results cannot be fully assessed until this period has elapsed, and minor asymmetries apparent at one month may improve substantially. Revision rates in published series range from five to fifteen per cent.", "costBreakdown": "Rhinoplasty pricing varies substantially with the complexity of the case and the seniority of the operating surgeon. Quoted fees generally include the surgeon's fee, anaesthesia, and operating facility costs. Patients should confirm whether the quote covers only primary rhinoplasty or also includes concurrent septoplasty if functional correction is required, as the latter may attract a supplementary fee. Cartilage grafting using costal (rib) cartilage adds both surgical complexity and cost compared to tip work using existing nasal cartilage.\n\nAdditional costs that may not be included in the headline price are pre-operative blood tests and medical clearance, the anaesthetist's separate fee (common in some countries), post-operative medications (antibiotics, antiemetics, analgesics), nasal splint and dressings, the initial consultation and 3D imaging or morphing software session, and follow-up appointments. Revision rhinoplasty — should it be required — is invariably more expensive than the primary procedure and is rarely covered by any guarantee offered by the original surgeon.", "medicalTourismNotes": "Rhinoplasty requires patients to remain near the surgical facility for a minimum of seven to ten days post-operatively. The splint removal appointment, which typically takes place at seven to ten days, is a mandatory follow-up and should not be missed. Patients flying home before splint removal risk incomplete wound assessment and may have difficulty finding a local practitioner willing to manage another surgeon's fresh rhinoplasty case. Long-haul flights during the acute post-operative period also carry risks of increased swelling and discomfort.\n\nThe twelve to eighteen month window for final results means that any concerns about the outcome will arise long after the patient has returned home. Revision rhinoplasty, if needed, would ideally be performed by the original surgeon to maintain continuity, but returning abroad for revision adds significant cost and logistical complexity. Patients should request comprehensive operative notes, photographs, and details of any grafts or implants used before leaving the clinic. It is advisable to identify a rhinoplasty-experienced ENT or plastic surgeon in the home country who can manage any post-operative concerns and conduct the long-term follow-up appointments.", "recoveryTimeline": "The first week is the most demanding phase. Swelling, bruising around the eyes, and nasal congestion are at their peak in the first two to three days, then gradually subside. The nasal splint is worn continuously and removed at the surgeon's follow-up appointment at seven days; internal dissolvable sutures require no intervention, while any external columellar sutures are removed at the same visit. Most patients feel presentable and comfortable returning to light sedentary work by ten to fourteen days, though visible residual bruising may persist to three weeks.\n\nSwelling diminishes progressively but unevenly. The majority resolves by six to eight weeks, at which point the overall shape is apparent, but the nasal tip — the last area to fully resolve — continues refining for twelve to eighteen months. Strenuous exercise and contact sports should be avoided for four to six weeks. Patients should protect the nose from sun exposure during the first year to prevent pigmentation changes in the skin. A follow-up appointment at three months provides an interim review, with final result assessment at twelve to eighteen months.", "faqs": [ { "question": "Will rhinoplasty affect my breathing?", "answer": "Rhinoplasty performed purely for aesthetic reasons should not impair breathing if carried out by an experienced surgeon. When septal deviation or turbinate enlargement is contributing to breathing difficulties, these can be corrected concurrently, often improving airflow compared with before surgery." }, { "question": "At what age can I have rhinoplasty?", "answer": "Most surgeons recommend waiting until nasal growth is complete — typically around sixteen to seventeen for females and seventeen to eighteen for males — before undergoing rhinoplasty. There is no upper age limit for suitable candidates in good general health." }, { "question": "How long does swelling last after rhinoplasty?", "answer": "The majority of visible swelling resolves within six to eight weeks, at which point the general shape of the nose is apparent. However, the nasal tip — the last area to fully resolve — continues refining for twelve to eighteen months, particularly in patients with thicker skin." }, { "question": "Will there be visible scarring?", "answer": "In the closed rhinoplasty technique, all incisions are inside the nostrils and no external scar is produced. Open rhinoplasty leaves a small scar across the columella, which typically fades to a fine, pale line and is not noticeable at conversational distance in most patients." }, { "question": "Can rhinoplasty fix a deviated septum?", "answer": "Yes. A concurrent septoplasty can be performed to straighten a deviated septum during the same operation, combining aesthetic reshaping with functional correction. Patients who require only functional improvement without cosmetic change may prefer isolated septoplasty." }, { "question": "How long is recovery from rhinoplasty?", "answer": "Most patients feel comfortable returning to light work and social activities within ten to fourteen days once the splint is removed and acute bruising has faded. Strenuous activity should be avoided for four to six weeks, and the final result is not assessable for twelve to eighteen months." }, { "question": "What is the revision rate for rhinoplasty?", "answer": "Published revision rates in experienced surgeons' series range from five to fifteen per cent. Rhinoplasty is considered one of the most technically demanding aesthetic procedures, and minor asymmetries or residual deformities that require secondary correction are not uncommon." }, { "question": "Is rhinoplasty performed under general anaesthesia?", "answer": "In most cases, yes — rhinoplasty is performed under general anaesthesia to ensure patient comfort and surgical precision during a procedure lasting two to three hours. Some surgeons perform limited rhinoplasty under sedation combined with local anaesthesia in selected straightforward cases." }, { "question": "Can I wear glasses after rhinoplasty?", "answer": "Glasses should not rest on the nose for approximately six weeks after rhinoplasty, as pressure on the healing cartilage and bone can affect the result. Contact lenses during this period are preferable; if glasses are essential, patients can tape them to the forehead to avoid nasal contact." } ], "relatedProcedures": [ "breast-augmentation", "abdominoplasty" ], "aliases": [], "eligibility": [ { "criterion": "Skeletal maturity (typically post-16 for women, post-17 for men)", "sourceSlugs": [ "asps-practice-parameters" ] }, { "criterion": "General anaesthetic fitness (ASA I-II)", "sourceSlugs": [ "rcoa-standards-anaesthesia" ] }, { "criterion": "Realistic expectations confirmed in dual consultation", "sourceSlugs": [ "asps-practice-parameters" ] } ], "contraindications": [ { "contraindication": "Body dysmorphic disorder until evaluated", "sourceSlugs": [ "asps-practice-parameters" ] }, { "contraindication": "Active sinus infection", "sourceSlugs": [ "rcs-eng-rhinoplasty" ] }, { "contraindication": "Uncontrolled bleeding disorders", "sourceSlugs": [ "rcs-eng-rhinoplasty" ] } ], "risks": [ { "name": "Persistent nasal obstruction or asymmetry", "severity": "moderate", "rate": { "value": 0.05, "range": [ 0.02, 0.1 ] }, "prevention": "Appropriate pre-operative imaging; conservative tissue preservation.", "sourceSlugs": [ "asps-practice-parameters" ] }, { "name": "Septal haematoma or perforation", "severity": "moderate", "rate": { "value": 0.02 }, "prevention": "Careful septal dissection; suture-quilting technique.", "sourceSlugs": [ "asps-practice-parameters" ] }, { "name": "Poor cosmetic outcome requiring revision", "severity": "moderate", "rate": { "value": 0.1, "range": [ 0.05, 0.15 ] }, "prevention": "Realistic pre-operative simulation; experienced surgeon; cooling-off period before commitment.", "sourceSlugs": [ "isaps-global-survey" ] }, { "name": "Anaesthetic complications", "severity": "severe", "rate": { "value": 0.001 }, "prevention": "Pre-operative ASA assessment; anaesthetist-led team.", "sourceSlugs": [ "rcoa-standards-anaesthesia" ] } ], "subtypes": [], "followUpCadence": [ { "at": "5-7 days", "type": "Splint and suture removal", "required": true }, { "at": "6 weeks", "type": "Early healing review", "required": true }, { "at": "3 months", "type": "Tip refinement assessment", "required": true }, { "at": "12 months", "type": "Final shape assessment with photography", "required": true } ], "recordsToObtain": [ "Pre-operative photographs (frontal, lateral, basal, three-quarter)", "Operative report including grafts and structural changes", "Anaesthetic record", "Post-operative care plan" ], "anaesthesia": "general", "operatingTime": { "lowMinutes": 90, "highMinutes": 240, "sourceSlugs": [ "rcs-eng-rhinoplasty", "asps-practice-parameters" ] }, "hospitalStay": { "lowNights": 0, "highNights": 1, "sourceSlugs": [ "rcs-eng-rhinoplasty" ] }, "minimumInCountryDays": { "low": 7, "high": 10, "sourceSlugs": [ "rcs-eng-rhinoplasty" ] }, "daysToFly": { "low": 7, "high": 10, "explanation": "Cabin pressure changes can affect intranasal swelling; most surgeons recommend at least one week before flying.", "sourceSlugs": [ "iata-medical-cabin-guidance", "rcs-eng-rhinoplasty" ] }, "complicationRate": { "value": 5, "range": [ 2, 10 ], "sourceSlugs": [ "asps-practice-parameters" ] }, "revisionRate": { "value": 10, "range": [ 5, 15 ], "sourceSlugs": [ "asps-practice-parameters", "isaps-global-survey" ] }, "numberOfVisits": { "typical": 2, "minimum": 1 }, "recoveryByActivity": { "sedentaryWork": { "days": 7, "sourceSlugs": [ "rcs-eng-rhinoplasty" ] }, "manualWork": { "days": 21, "sourceSlugs": [ "rcs-eng-rhinoplasty" ] }, "lightExercise": { "days": 21, "sourceSlugs": [ "rcs-eng-rhinoplasty" ] }, "vigorousExercise": { "days": 42, "sourceSlugs": [ "rcs-eng-rhinoplasty" ] }, "swimming": { "days": 42, "sourceSlugs": [ "rcs-eng-rhinoplasty" ] }, "flying": { "days": 7, "sourceSlugs": [ "iata-medical-cabin-guidance" ] }, "driving": { "days": 5, "sourceSlugs": [ "rcs-eng-rhinoplasty" ] } }, "literatureLinks": [ { "title": "Rhinoplasty Complications and Reoperations: Systematic Review.", "journal": "International archives of otorhinolaryngology", "year": 2017, "doi": "10.1055/s-0036-1586489", "url": "https://doi.org/10.1055/s-0036-1586489" }, { "title": "A systematic review and meta-analysis of complications associated with crushed cartilage in rhinoplasty.", "journal": "Journal of plastic, reconstructive & aesthetic surgery : JPRAS", "year": 2024, "doi": "10.1016/j.bjps.2024.06.019", "url": "https://doi.org/10.1016/j.bjps.2024.06.019" }, { "title": "Complications associated with irradiated homologous costal cartilage use in rhinoplasty: A systematic review and meta-analysis.", "journal": "Journal of plastic, reconstructive & aesthetic surgery : JPRAS", "year": 2022, "doi": "10.1016/j.bjps.2022.02.026", "url": "https://doi.org/10.1016/j.bjps.2022.02.026" } ], "alternativeTreatments": [ { "name": "Non-surgical rhinoplasty (filler)", "rationale": "Camouflages dorsal humps and tip asymmetries without surgery; requires repeat treatment every 12-18 months.", "sourceSlugs": [ "isaps-guidelines" ] }, { "name": "Septoplasty alone", "rationale": "Functional alternative when only breathing — not appearance — is the problem.", "sourceSlugs": [ "isaps-guidelines" ] } ], "accreditationsRequired": [ "isaps-member-surgeon", "national-plastic-surgery-board" ] }, { "slug": "breast-augmentation", "name": "Breast Augmentation", "category": "cosmetic-surgery", "description": "Breast augmentation involves the placement of silicone or saline implants to increase breast size or restore volume. Fat transfer (lipofilling) is an alternative for modest increases. The procedure is performed under general anaesthesia and typically takes 1-2 hours. Implant placement can be subglandular or submuscular.", "averageRecoveryDays": 14, "typicalSessions": 1, "priceRangeUSD": { "low": 3000, "high": 8000 }, "keyConsiderations": [ "Implant choice (cohesive silicone, smooth/textured, projection) drives long-term outcomes", "Pocket placement (submuscular / dual-plane / subglandular) affects capsular contracture risk", "BIA-ALCL surveillance applies particularly to textured implants", "Implant passport (manufacturer, model, lot, surface) is essential for life-long surveillance" ], "commonRisks": [ "Capsular contracture (hardening of tissue around implant)", "Implant rupture or leakage", "Changes in nipple or breast sensation", "Implant malposition or asymmetry", "Infection requiring implant removal", "BIA-ALCL (rare lymphoma associated with textured implants)" ], "questionsToAsk": [ "What implant brands do you use?", "What is your capsular contracture rate?", "Do you use textured or smooth implants?", "What is the implant warranty?", "How do you determine the appropriate implant size?" ], "overview": "Breast augmentation under general anaesthesia typically takes sixty to ninety minutes. The surgeon creates a pocket either above (subglandular) or below (submuscular or dual-plane) the pectoralis major muscle, accessed through an incision at the inframammary fold, around the areola, or within the axilla. The implant — pre-filled silicone gel, saline-filled, or a structured variant — is inserted into the pocket and positioned symmetrically. The incision is closed in layers and a supportive surgical bra is applied.\n\nCandidacy assessment includes evaluation of existing breast tissue volume and ptosis, chest wall anatomy, skin quality, and the patient's aesthetic goals. Patients with significant ptosis may require a concurrent mastopexy (breast lift), which adds surgical complexity and scarring. Submuscular placement is associated with lower capsular contracture rates and more natural appearance in patients with minimal native breast tissue but involves a more involved recovery. Dual-plane placement is a common compromise. Women with a personal or strong family history of breast cancer should discuss screening protocols with their oncologist before proceeding.\n\nInitial recovery involves moderate discomfort, particularly with submuscular placement where muscle movement causes pain for one to two weeks. Patients are typically advised to avoid raising the arms above shoulder height and strenuous upper-body activity for four to six weeks. Implants generally settle into their final position over three to six months. Long-term surveillance is recommended, as silicone implant rupture may be silent and detectable only on MRI.", "costBreakdown": "Breast augmentation pricing typically encompasses the surgeon's fee, implants, anaesthesia, theatre facility costs, and a surgical bra. The implant brand is a significant cost variable: premium brands (Mentor, Allergan/Natrelle, Motiva, Sebbin) carry higher per-unit costs than generic alternatives but offer more comprehensive manufacturer warranties. Patients should confirm the specific brand, series, and catalogue number of the implants to be used, as quoted prices from different clinics are not directly comparable without this information.\n\nCosts commonly excluded from headline prices include pre-operative blood tests, medical consultations and suitability assessments, the anaesthetist's fee if charged separately, post-operative medications, compression garments beyond the initial surgical bra, and any overnight hospital stay required beyond the standard day-surgery model. Implant warranty programmes (which may cover rupture-related replacement costs for ten or more years) typically require registration and are manufacturer-specific; patients travelling abroad should ensure the warranty is valid internationally and retain all documentation.", "medicalTourismNotes": "Breast augmentation is commonly sought abroad as a single-trip procedure, and this is generally feasible for uncomplicated cases. Patients should plan to remain at the destination for a minimum of seven to ten days to allow for wound inspection, early identification of complications (haematoma, seroma, early infection), and suture or drain management if applicable. Long-haul flights in the early post-operative period carry a heightened risk of deep vein thrombosis (DVT) and pulmonary embolism due to immobility combined with a pro-coagulant surgical state; compression stockings and prophylactic low-molecular-weight heparin should be discussed with the surgical team before flying.\n\nCritically, the implant brand and product details must be documented and retained by the patient. If implant rupture, malposition, or capsular contracture develops months or years later in the home country, the treating surgeon will need exact implant specifications. Some implant warranty programmes require that any revision surgery be reported to the manufacturer; an overseas original procedure may complicate this process. Patients should identify a plastic surgeon in their home country before travelling who is willing to provide long-term follow-up and manage any late complications.", "recoveryTimeline": "In the first one to three days post-operatively, any surgical drains (used in some cases) are monitored and typically removed before discharge. Discomfort is most pronounced during this period, particularly with submuscular placement, where chest tightness and difficulty raising the arms are common. Patients are fitted with a supportive surgical bra, which is worn continuously for four to six weeks. Light walking is encouraged from day one; however, lifting anything heavier than approximately one kilogram and overhead arm movements should be avoided for the first four to six weeks.\n\nBy two weeks most patients are comfortable at rest and able to manage light daily activities, though driving is generally not recommended for two to three weeks. Return to non-strenuous work is typically possible within one to two weeks. High-impact exercise and heavy lifting remain restricted until the six-week mark, when the surgeon usually reassesses the wound and implant position. The implants gradually soften and descend into their natural position over three to six months as the surrounding tissue accommodates them — this settling process, sometimes called dropping and fluffing, determines the final appearance.", "faqs": [ { "question": "How long do breast implants last?", "answer": "Modern silicone and saline implants do not have a fixed expiry date and do not need to be routinely replaced on a set schedule. However, the likelihood of complications such as rupture or capsular contracture increases over time, and many surgeons advise revisiting the question of replacement at ten to fifteen years." }, { "question": "Will breast implants affect mammograms or cancer screening?", "answer": "Implants can partially obscure breast tissue on standard mammography, so patients should inform the radiographer before each screening appointment. Additional imaging views are used to visualise as much tissue as possible, and MRI may be recommended for monitoring silicone implant integrity." }, { "question": "What is capsular contracture?", "answer": "Capsular contracture occurs when the natural scar tissue that forms around any implant tightens excessively, causing the breast to feel firm, look distorted, or become painful. It is the most common long-term complication of breast augmentation and may require surgical treatment in more severe cases." }, { "question": "Can I breastfeed after breast augmentation?", "answer": "Most women can breastfeed after breast augmentation, as the implants are placed below or beside the glandular tissue rather than within it. The periareolar incision approach carries a slightly higher risk of affecting milk ducts; patients concerned about future breastfeeding should discuss incision choice with their surgeon." }, { "question": "Silicone or saline — which is better?", "answer": "Silicone gel implants are generally considered to have a more natural feel and are the most widely chosen option globally. Saline implants are filled after insertion, allowing a smaller incision, and any rupture is immediately evident as the saline is harmlessly absorbed. The choice depends on individual anatomy, preference, and the surgeon's recommendation." }, { "question": "Will breast augmentation leave visible scars?", "answer": "All breast augmentation approaches involve incisions that will leave scars. The inframammary (under-breast fold) approach is most common and leaves a scar that is concealed within the crease. Scars typically mature from pink and raised to pale and flat over twelve to eighteen months." }, { "question": "How soon can I return to exercise after breast augmentation?", "answer": "Light walking is encouraged from the first day to reduce DVT risk, but upper body exercise and anything that engages the chest muscles should be avoided for four to six weeks. High-impact activities such as running are typically cleared at the six-week follow-up appointment." }, { "question": "Is it safe to fly after breast augmentation?", "answer": "Most surgeons advise avoiding long-haul flights for at least seven to ten days post-operatively due to the elevated DVT risk. If flying is unavoidable, compression stockings and staying well hydrated are essential, and prophylactic anticoagulation should be discussed with the surgical team." } ], "relatedProcedures": [ "abdominoplasty", "rhinoplasty" ], "aliases": [], "eligibility": [ { "criterion": "Skeletal maturity (typically over 18 for cosmetic; FDA: 22 for silicone)", "sourceSlugs": [ "asps-practice-parameters" ] }, { "criterion": "General anaesthetic fitness", "sourceSlugs": [ "rcoa-standards-anaesthesia" ] }, { "criterion": "Stable mental health and realistic expectations", "sourceSlugs": [ "asps-practice-parameters" ] } ], "contraindications": [ { "contraindication": "Active breast cancer or untreated suspicious lesion", "sourceSlugs": [ "asps-practice-parameters" ] }, { "contraindication": "Body dysmorphic disorder until evaluated", "sourceSlugs": [ "asps-practice-parameters" ] }, { "contraindication": "Pregnancy or breastfeeding", "sourceSlugs": [ "asps-practice-parameters" ] } ], "risks": [ { "name": "Capsular contracture", "severity": "moderate", "rate": { "value": 0.1, "range": [ 0.05, 0.15 ] }, "prevention": "Submuscular placement (lower rate); textured implants in some studies; sterile technique with funnel insertion.", "sourceSlugs": [ "asps-practice-parameters" ] }, { "name": "Implant rupture or deflation", "severity": "moderate", "rate": { "value": 0.05, "range": [ 0.02, 0.1 ] }, "prevention": "Use of cohesive silicone gel implants; avoidance of high-impact trauma.", "sourceSlugs": [ "asps-practice-parameters" ] }, { "name": "BIA-ALCL (anaplastic large cell lymphoma — textured implants)", "severity": "severe", "rate": { "value": 0.0003 }, "prevention": "Many surgeons have moved to smooth implants only; long-term surveillance.", "sourceSlugs": [ "asps-practice-parameters" ] }, { "name": "Surgical site infection", "severity": "moderate", "rate": { "value": 0.02 }, "prevention": "Antibiotic prophylaxis; sterile technique.", "sourceSlugs": [ "who-surgical-safety-checklist" ] }, { "name": "Asymmetry requiring revision", "severity": "moderate", "rate": { "value": 0.1 }, "prevention": "Pre-operative measurement and implant selection.", "sourceSlugs": [ "asps-practice-parameters" ] } ], "subtypes": [ "breast-augmentation-submuscular" ], "followUpCadence": [ { "at": "1 week", "type": "Wound check and drain removal if used", "required": true }, { "at": "6 weeks", "type": "Healing and exercise-clearance review", "required": true }, { "at": "6 months", "type": "Capsule and aesthetic review", "required": true }, { "at": "Annual", "type": "Long-term surveillance", "required": true } ], "recordsToObtain": [ "Implant brand, model, size, lot number, and surface texture (implant passport)", "Operative report including pocket location (subglandular/submuscular)", "Anaesthetic record", "Pre-op and post-op photographs" ], "anaesthesia": "general", "operatingTime": { "lowMinutes": 60, "highMinutes": 180, "sourceSlugs": [ "asps-practice-parameters" ] }, "hospitalStay": { "lowNights": 0, "highNights": 1, "sourceSlugs": [ "asps-practice-parameters" ] }, "minimumInCountryDays": { "low": 7, "high": 10, "sourceSlugs": [ "asps-practice-parameters" ] }, "daysToFly": { "low": 5, "high": 7, "explanation": "DVT risk after general anaesthesia; surgeon-specific guidance varies but most recommend at least 5-7 days post-op.", "sourceSlugs": [ "nice-ng89-venous-thromboembolism", "iata-medical-cabin-guidance" ] }, "complicationRate": { "value": 10, "range": [ 5, 15 ], "sourceSlugs": [ "asps-practice-parameters" ] }, "revisionRate": { "value": 15, "range": [ 10, 20 ], "sourceSlugs": [ "asps-practice-parameters", "isaps-global-survey" ] }, "numberOfVisits": { "typical": 2, "minimum": 1 }, "recoveryByActivity": { "sedentaryWork": { "days": 7, "sourceSlugs": [ "asps-practice-parameters" ] }, "manualWork": { "days": 28, "sourceSlugs": [ "asps-practice-parameters" ] }, "lightExercise": { "days": 21, "sourceSlugs": [ "asps-practice-parameters" ] }, "vigorousExercise": { "days": 42, "sourceSlugs": [ "asps-practice-parameters" ] }, "swimming": { "days": 42, "sourceSlugs": [ "asps-practice-parameters" ] }, "flying": { "days": 5, "sourceSlugs": [ "iata-medical-cabin-guidance" ] }, "driving": { "days": 7, "sourceSlugs": [ "asps-practice-parameters" ] } }, "literatureLinks": [ { "title": "Complications following Breast Augmentation in Transfeminine Individuals: A Systematic Review and Meta-Analysis.", "journal": "Plastic and reconstructive surgery", "year": 2024, "doi": "10.1097/PRS.0000000000010691", "url": "https://doi.org/10.1097/PRS.0000000000010691" }, { "title": "Complications after Breast Augmentation with Fat Grafting: A Systematic Review.", "journal": "Plastic and reconstructive surgery", "year": 2020, "doi": "10.1097/PRS.0000000000006569", "url": "https://doi.org/10.1097/PRS.0000000000006569" }, { "title": "Complications after breast augmentation with dermal fillers containing copolyamide: A systematic review.", "journal": "JPRAS open", "year": 2024, "doi": "10.1016/j.jpra.2024.01.009", "url": "https://doi.org/10.1016/j.jpra.2024.01.009" } ], "alternativeTreatments": [ { "name": "Fat-transfer breast augmentation", "procedureSlug": "fat-transfer-breast-augmentation", "rationale": "Implant-free alternative; modest volume increase per session, more natural feel.", "sourceSlugs": [ "isaps-guidelines" ] }, { "name": "Breast lift (mastopexy)", "procedureSlug": "breast-lift", "rationale": "Where the concern is sagging rather than volume; can be combined with small implants.", "sourceSlugs": [ "isaps-guidelines" ] }, { "name": "External pads / well-fitted bra", "rationale": "Non-surgical management; meaningful for patients wanting to avoid surgical risk.", "sourceSlugs": [ "isaps-guidelines" ] } ], "accreditationsRequired": [ "isaps-member-surgeon", "national-plastic-surgery-board" ] }, { "slug": "abdominoplasty", "name": "Abdominoplasty (Tummy Tuck)", "category": "cosmetic-surgery", "description": "Abdominoplasty removes excess skin and fat from the abdomen and tightens the underlying abdominal muscles. It is commonly sought after significant weight loss or pregnancy. Full abdominoplasty involves a hip-to-hip incision and navel repositioning. Mini-abdominoplasty addresses only the area below the navel.", "averageRecoveryDays": 28, "typicalSessions": 1, "priceRangeUSD": { "low": 3000, "high": 9000 }, "keyConsiderations": [ "Substantial DVT/PE risk — pre-operative prophylaxis and post-op mobility are critical", "Smoking cessation 4 weeks pre-op is non-negotiable due to flap necrosis risk", "Future pregnancy reverses the result — confirm family-planning status", "Drain management may continue 1-2 weeks post-op" ], "commonRisks": [ "Seroma (fluid accumulation under the skin)", "Wound dehiscence (separation of incision)", "Deep vein thrombosis (DVT) due to immobility", "Prolonged numbness in abdominal area", "Unsatisfactory scarring", "Infection" ], "questionsToAsk": [ "Do you recommend full or mini abdominoplasty for my case?", "Will you combine liposuction with the procedure?", "How do you manage drains post-operatively?", "What is your DVT prevention protocol?", "When can I resume physical activity?" ], "overview": "Full abdominoplasty is a major surgical procedure performed under general anaesthesia, typically lasting two to four hours. The surgeon makes a horizontal incision from hip to hip above the pubic area and a second incision around the navel. Skin and subcutaneous fat are elevated from the abdominal wall, and the underlying rectus abdominis muscles are plicated (sutured together in the midline) to correct diastasis. Excess skin and fat are resected, the umbilicus is repositioned through a new aperture, and surgical drains are placed before wound closure. A compression garment is applied immediately post-operatively.\n\nCandidates are ideally at or near their goal weight (BMI under 30 is a common threshold), with stable weight for at least six months, and should not be planning further pregnancies, which would compromise the repair. Skin laxity from weight loss or previous pregnancy is the primary indication. Concurrent liposuction of the flanks is frequently performed to improve the overall contour but increases the risk of seroma and skin necrosis if extensive undermining has been performed.\n\nPatients are typically nursed in a semi-flexed position immediately post-operatively to reduce tension on the wound. Surgical drains are usually removed at five to seven days. Ambulation is encouraged from the first post-operative day to reduce DVT risk. Most patients require ten to fourteen days before they are comfortable to travel and four to six weeks before returning to sedentary work. Heavy lifting and vigorous exercise are restricted for six to eight weeks. Scar maturation continues for twelve to eighteen months.", "costBreakdown": "Abdominoplasty quotes typically include the surgeon's fee, general anaesthesia, theatre costs, one or two nights' hospital accommodation, and the initial compression garment. The scope of the procedure significantly affects price: a full abdominoplasty with muscle plication and concurrent liposuction will cost substantially more than a mini-abdominoplasty without these elements. Patients should confirm exactly what is included — particularly whether muscle repair and liposuction are covered or attract supplementary fees.\n\nAdditional costs may include pre-operative blood tests and medical clearance, the anaesthetist's separate fee, post-operative medications (antibiotics, anticoagulants, analgesics), additional compression garments required during the recovery period, and drain management supplies if patients are discharged with drains in situ. Extended hospital stays beyond the standard one to two nights, which may be necessary for patients with complications or significant comorbidities, will add accommodation costs. Travel to and from the clinic for drain removal and wound checks, particularly for overseas patients, should be factored into the overall budget.", "medicalTourismNotes": "Abdominoplasty is among the most demanding cosmetic procedures for medical tourism purposes due to its extended recovery requirements. Patients should plan a minimum stay of ten to fourteen days at the destination. Drain removal and wound inspection are mandatory follow-up appointments that typically occur at five to seven days and ten to fourteen days respectively, and these cannot be safely skipped. Patients who leave the country before these appointments risk undetected seroma, early wound dehiscence, or drain-related complications.\n\nDrains may need to be managed by the patient and accompanying carer during the stay, requiring instruction in drain care before discharge. Long-haul flights should be avoided for a minimum of two weeks post-operatively and ideally longer, given the elevated DVT risk associated with both the surgical procedure and prolonged immobility during travel. DVT prophylaxis protocols (compression stockings, anticoagulant injections) prescribed overseas must be continued for the duration recommended by the surgical team, including during any flights home. Patients should identify a local general surgeon or plastic surgeon in their home country who can manage drain removal, wound complications, and ongoing recovery if an extended trip abroad is not feasible.", "recoveryTimeline": "The initial recovery phase centres on drain and wound management. Surgical drains are typically removed at one to two weeks once output has decreased to an acceptable level. A compression garment is worn continuously for four to six weeks and is essential for reducing seroma formation and supporting the abdominal wall repair. Patients are nursed in a flexed-hip position for the first few days to reduce wound tension, and walking upright fully erect may be uncomfortable for one to two weeks. Light walking is encouraged from day one to reduce DVT risk, and most patients manage short indoor walks by the end of the first week.\n\nReturn to sedentary work is typically possible at four to six weeks for those without physically demanding jobs. Exercise involving the core, abdominal muscles, or heavy lifting is restricted for six to eight weeks to protect the muscle repair. Numbness and tightness across the lower abdomen are common and may persist for several months as sensation gradually returns. The horizontal scar, positioned low enough to be concealed by underwear, undergoes active maturation for twelve to eighteen months, progressing from pink and firm to pale and flat; scar management with silicone sheeting or gel from six weeks onwards can improve the long-term appearance.", "faqs": [ { "question": "Is abdominoplasty the same as liposuction?", "answer": "No. Abdominoplasty removes excess skin and tightens abdominal muscles, which liposuction cannot achieve. Liposuction removes localised fat deposits but does not address skin laxity or muscle separation. The two procedures are often combined to improve overall abdominal contour." }, { "question": "Can I have a tummy tuck if I plan to have more children?", "answer": "Surgeons generally advise completing your family before undergoing abdominoplasty, as a subsequent pregnancy will stretch the repaired abdominal muscles and skin, potentially undoing the results. The procedure is not medically unsafe during a later pregnancy, but the aesthetic outcome will likely be compromised." }, { "question": "Will abdominoplasty remove my stretch marks?", "answer": "Stretch marks located on the lower abdominal skin that is excised during the procedure will be removed. Stretch marks above the navel — which becomes the upper extent of the resection — will remain, though they may shift slightly downward as excess skin is removed." }, { "question": "What is the scar like after a tummy tuck?", "answer": "Full abdominoplasty leaves a horizontal scar running hip to hip above the pubic area and a small scar around the navel. The hip-to-hip scar is designed to sit below the bikini or underwear line. Scar maturation takes twelve to eighteen months, progressing from pink and raised to pale and flat." }, { "question": "How long does the result last?", "answer": "The results of abdominoplasty are long-lasting provided weight remains stable. Significant weight gain after the procedure will stretch the skin and may compromise the result. The muscle repair is generally permanent unless disrupted by pregnancy or significant weight fluctuation." }, { "question": "What is the DVT risk with a tummy tuck?", "answer": "Abdominoplasty carries one of the higher DVT risks among cosmetic procedures due to the combination of prolonged surgery, post-operative immobility, and abdominal compression. Most surgeons prescribe anticoagulant injections and compression stockings as prophylaxis, and early ambulation is encouraged." }, { "question": "How much weight will I lose from a tummy tuck?", "answer": "Abdominoplasty is not a weight-loss procedure. The amount of tissue removed varies, but patients typically lose two to four kilograms from the resected skin and fat. The primary benefit is improved contour and profile rather than weight reduction." }, { "question": "When can I drive after abdominoplasty?", "answer": "Driving requires the ability to perform an emergency stop safely, which is typically not possible until four to six weeks post-operatively due to abdominal pain and muscle tightness. Patients should not drive while taking prescription pain medication." } ], "relatedProcedures": [ "breast-augmentation", "gastric-sleeve" ], "aliases": [], "eligibility": [ { "criterion": "Stable weight for at least 6 months", "sourceSlugs": [ "asps-practice-parameters" ] }, { "criterion": "BMI typically below 30-32 (varies by surgeon and approach)", "sourceSlugs": [ "asps-practice-parameters" ] }, { "criterion": "Smoke-free for at least 4 weeks pre-operatively", "sourceSlugs": [ "asps-practice-parameters" ] }, { "criterion": "General anaesthetic fitness", "sourceSlugs": [ "rcoa-standards-anaesthesia" ] } ], "contraindications": [ { "contraindication": "Active smoking (high necrosis rate)", "sourceSlugs": [ "asps-practice-parameters" ] }, { "contraindication": "Planned future pregnancy (results typically reverse)", "sourceSlugs": [ "asps-practice-parameters" ] }, { "contraindication": "BMI above accepted operating threshold (varies)", "sourceSlugs": [ "asps-practice-parameters" ] }, { "contraindication": "Untreated sleep apnoea or significant cardiopulmonary disease", "sourceSlugs": [ "rcoa-standards-anaesthesia" ] } ], "risks": [ { "name": "Seroma (fluid collection requiring aspiration)", "severity": "moderate", "rate": { "value": 0.15, "range": [ 0.1, 0.25 ] }, "prevention": "Quilting sutures; drains; compression garment; reduced patient activity in early phase.", "sourceSlugs": [ "asps-practice-parameters" ] }, { "name": "Wound dehiscence (separation)", "severity": "moderate", "rate": { "value": 0.05 }, "prevention": "Tension-free closure; smoking cessation; restricted activity.", "sourceSlugs": [ "asps-practice-parameters" ] }, { "name": "Deep vein thrombosis / pulmonary embolism", "severity": "severe", "rate": { "value": 0.005, "range": [ 0.002, 0.01 ] }, "prevention": "Mechanical and pharmacological prophylaxis per NICE NG89; early mobilisation; avoidance of long-haul flying within 10-14 days.", "sourceSlugs": [ "nice-ng89-venous-thromboembolism" ] }, { "name": "Skin necrosis at incision margins", "severity": "moderate", "rate": { "value": 0.05 }, "prevention": "Smoking cessation 4 weeks pre-operatively; conservative undermining; appropriate flap design.", "sourceSlugs": [ "asps-practice-parameters" ] }, { "name": "Hypertrophic or keloid scar", "severity": "minor", "rate": { "value": 0.1 }, "prevention": "Silicone sheet/scar massage from week 2; sun protection.", "sourceSlugs": [ "asps-practice-parameters" ] } ], "subtypes": [], "followUpCadence": [ { "at": "5-7 days", "type": "Drain review and wound check", "required": true }, { "at": "2 weeks", "type": "Suture/staple removal", "required": true }, { "at": "6 weeks", "type": "Activity-restriction review", "required": true }, { "at": "3 months", "type": "Scar review and compression-garment cessation", "required": true }, { "at": "12 months", "type": "Final scar maturation review", "required": true } ], "recordsToObtain": [ "Operative report including muscle plication and undermining extent", "Anaesthetic record with DVT prophylaxis used", "Histology report if any tissue specimen sent", "Pre/post photographs", "Compression garment and scar care instructions" ], "anaesthesia": "general", "operatingTime": { "lowMinutes": 120, "highMinutes": 300, "sourceSlugs": [ "asps-practice-parameters" ] }, "hospitalStay": { "lowNights": 1, "highNights": 3, "sourceSlugs": [ "asps-practice-parameters" ] }, "minimumInCountryDays": { "low": 10, "high": 14, "sourceSlugs": [ "asps-practice-parameters" ] }, "daysToFly": { "low": 10, "high": 14, "explanation": "Abdominoplasty carries the highest DVT risk among elective cosmetic procedures; most surgeons require 10-14 days minimum before long-haul flying.", "sourceSlugs": [ "nice-ng89-venous-thromboembolism", "iata-medical-cabin-guidance" ] }, "complicationRate": { "value": 10, "range": [ 5, 20 ], "sourceSlugs": [ "asps-practice-parameters" ] }, "revisionRate": { "value": 5, "range": [ 2, 10 ], "sourceSlugs": [ "asps-practice-parameters" ] }, "mortalityRate": { "value": 0.02, "range": [ 0.01, 0.05 ], "sourceSlugs": [ "asps-practice-parameters" ] }, "numberOfVisits": { "typical": 3, "minimum": 2 }, "recoveryByActivity": { "sedentaryWork": { "days": 14, "sourceSlugs": [ "asps-practice-parameters" ] }, "manualWork": { "days": 42, "sourceSlugs": [ "asps-practice-parameters" ] }, "lightExercise": { "days": 28, "sourceSlugs": [ "asps-practice-parameters" ] }, "vigorousExercise": { "days": 56, "sourceSlugs": [ "asps-practice-parameters" ] }, "swimming": { "days": 42, "sourceSlugs": [ "asps-practice-parameters" ] }, "flying": { "days": 14, "sourceSlugs": [ "nice-ng89-venous-thromboembolism", "iata-medical-cabin-guidance" ] }, "driving": { "days": 14, "sourceSlugs": [ "asps-practice-parameters" ] } }, "literatureLinks": [ { "title": "Therapeutical Strategies to Prevent Abdominoplasty Complications: A Systematic Review.", "journal": "Aesthetic plastic surgery", "year": 2025, "doi": "10.1007/s00266-024-04563-4", "url": "https://doi.org/10.1007/s00266-024-04563-4" }, { "title": "Abdominoplasty with Scarpa Fascia Preservation: A Systematic Review and Meta-analysis.", "journal": "Aesthetic plastic surgery", "year": 2022, "doi": "10.1007/s00266-022-02835-5", "url": "https://doi.org/10.1007/s00266-022-02835-5" }, { "title": "Infective complications of cosmetic tourism: A systematic literature review.", "journal": "Journal of plastic, reconstructive & aesthetic surgery : JPRAS", "year": 2023, "doi": "10.1016/j.bjps.2023.05.021", "url": "https://doi.org/10.1016/j.bjps.2023.05.021" } ], "alternativeTreatments": [ { "name": "Liposuction", "procedureSlug": "liposuction", "rationale": "Appropriate when fat — not skin laxity or muscle separation — is the only concern.", "sourceSlugs": [ "isaps-guidelines" ] }, { "name": "Non-invasive body contouring (cryolipolysis, RF)", "rationale": "Modest fat reduction without surgery or downtime; not effective for skin redundancy.", "sourceSlugs": [ "isaps-guidelines" ] }, { "name": "Diet, exercise, and abdominal-wall physiotherapy", "rationale": "First-line for diastasis recti and visceral-fat-driven contour issues; will not address true skin excess.", "sourceSlugs": [ "isaps-guidelines" ] } ], "accreditationsRequired": [ "isaps-member-surgeon", "national-plastic-surgery-board" ] }, { "slug": "ivf", "name": "In Vitro Fertilisation (IVF)", "category": "ivf-fertility", "description": "IVF involves stimulating the ovaries to produce multiple eggs, retrieving those eggs, fertilising them with sperm in a laboratory, and transferring resulting embryos to the uterus. A single cycle typically spans 4-6 weeks. Success rates vary significantly by age, clinic, and protocol used.", "averageRecoveryDays": 3, "typicalSessions": 1, "priceRangeUSD": { "low": 3000, "high": 12000 }, "keyConsiderations": [ "Legal status of donor anonymity, surrogacy, and PGT varies materially between countries", "Donor matching can take weeks — plan procedure timing accordingly", "OHSS risk is most concerning in the 48-72h after retrieval", "Embryo storage contracts have specific consent/duration rules per jurisdiction" ], "commonRisks": [ "Ovarian hyperstimulation syndrome (OHSS)", "Multiple pregnancy if more than one embryo is transferred", "Ectopic pregnancy", "Emotional and psychological stress", "Failed cycle (no viable embryos or failed implantation)", "Injection site reactions from hormonal medications" ], "questionsToAsk": [ "What is your live birth rate per transfer for my age group?", "Are medication costs included in the cycle price?", "How many embryos do you recommend transferring?", "What laboratory grading system do you use for embryos?", "Do you offer genetic testing of embryos (PGT-A)?" ], "overview": "A standard IVF cycle begins with ovarian stimulation using injectable gonadotrophins over eight to fourteen days, during which the ovarian response is monitored by serial transvaginal ultrasound and serum oestradiol measurements. When follicles reach an appropriate size, a trigger injection is administered and egg retrieval is performed thirty-four to thirty-six hours later under sedation or light general anaesthesia. Retrieved oocytes are fertilised with prepared sperm in the laboratory, either by conventional insemination or by intracytoplasmic sperm injection (ICSI). Resulting embryos are cultured for three to five days before assessment.\n\nIn a fresh transfer cycle, one or two embryos are transferred to the uterus approximately two to five days after retrieval. In a freeze-all strategy — preferred in cases of OHSS risk or for preimplantation genetic testing — all viable embryos are cryopreserved for transfer in a subsequent prepared cycle. A urine or blood pregnancy test is performed approximately two weeks after transfer. Unsuccessful cycles or supernumerary embryos may be frozen for future use.\n\nCandidacy depends on ovarian reserve (assessed by antral follicle count and anti-Müllerian hormone level), uterine anatomy, and the cause of infertility. Age is a strong independent predictor of outcome: published live birth rates per transfer in women under thirty-five typically exceed forty per cent in well-performing units, falling substantially with advancing age. Donor egg cycles, using oocytes from a younger donor, significantly improve outcomes for women with diminished ovarian reserve or premature ovarian insufficiency.", "costBreakdown": "IVF cycle pricing is notoriously variable and requires careful itemisation. Headline prices often represent the laboratory and clinical procedure fee only, excluding stimulation medications — which can cost USD 1,500 to 4,000 per cycle — and the anaesthesia fee for egg retrieval. Prices should be requested as an all-inclusive estimate covering monitoring ultrasounds, blood tests, egg retrieval, laboratory fertilisation, and a single embryo transfer. Add-ons such as ICSI, extended culture to blastocyst stage, embryo vitrification (freezing), PGT-A (preimplantation genetic testing for aneuploidy), and endometrial receptivity testing are frequently charged separately and collectively add several thousand dollars.\n\nAdditional costs may include the initial consultation and investigation workup (including sperm analysis and ovarian reserve testing), donor egg fees if applicable (often several thousand dollars plus agency or synchronisation fees), embryo storage fees for cryopreserved embryos (typically an annual charge), and frozen embryo transfer cycle fees. Patients should also account for accommodation and living costs during a cycle that typically requires two to three weeks of monitoring, as well as any required psychological support.", "medicalTourismNotes": "IVF is a complex procedure for international patients because the monitoring-intensive stimulation phase typically requires two to three weeks of local presence. Patients who begin stimulation at home and travel only for the egg retrieval and transfer may be able to reduce their time abroad to five to seven days, but this split-monitoring model requires a coordinated protocol between the overseas clinic and a home-country reproductive endocrinologist or fertility monitoring service. Clear communication and shared medical records are essential, as medication dose adjustments depend on real-time scan and hormone results.\n\nDonor egg IVF cycles require careful advance planning: donor synchronisation, legal agreements, and counselling may need to be completed before travel, and the legal status of egg donation varies significantly between countries. Patients must ensure that arrangements made abroad comply with the legal framework in their home country, particularly regarding anonymity, consent, and offspring rights. Embryos created abroad may be stored at the overseas clinic, incurring ongoing storage fees, or shipped cryopreserved to a clinic in the home country — a process involving chain-of-custody documentation and international transport regulations. Patients should clarify embryo ownership and storage policies in writing before commencing treatment.", "recoveryTimeline": "Physical recovery from the egg retrieval procedure itself is generally rapid. Most patients experience mild to moderate pelvic cramping, bloating, and light spotting for one to two days afterwards, and the majority feel well enough to resume light activity within twenty-four to forty-eight hours. Those at risk of ovarian hyperstimulation syndrome (OHSS) require closer monitoring in the days following retrieval and should rest if bloating or discomfort increases. Embryo transfer, performed two to five days after retrieval, is a brief and largely painless outpatient procedure; the historical advice of strict bed rest afterwards is no longer considered necessary, though most clinics recommend a period of relative rest for the remainder of that day.\n\nThe two-week wait between embryo transfer and the pregnancy blood test is the most emotionally demanding phase of the cycle for most patients. If the result is positive, an early viability scan is arranged at approximately six to seven weeks of gestation to confirm the pregnancy is intrauterine and to assess the foetal heartbeat. If the cycle is unsuccessful, a follow-up consultation to review the cycle and discuss the next steps is typically scheduled within four to six weeks. The body returns to its natural menstrual pattern within four to six weeks of an unsuccessful cycle.", "faqs": [ { "question": "What is the success rate of IVF?", "answer": "Success rates vary considerably with age and clinic quality. In women under thirty-five, live birth rates per transfer at well-performing units typically exceed forty per cent. Rates decline progressively with age, falling to around fifteen to twenty per cent for women aged forty to forty-two using their own eggs." }, { "question": "How many embryos should be transferred?", "answer": "Most guidelines now recommend single embryo transfer (SET) in suitable patients to minimise the risk of multiple pregnancy, which carries significant risks for both mother and babies. In older patients or those with previous failed cycles, two embryos may be considered after discussion of the risks." }, { "question": "Is IVF painful?", "answer": "The daily hormone injections during stimulation are generally well tolerated. Egg retrieval is performed under sedation or light anaesthesia and is not painful during the procedure; mild cramping and bloating for one to two days afterwards are common. Embryo transfer is a brief, largely painless outpatient procedure." }, { "question": "How many IVF cycles might I need?", "answer": "There is no fixed answer, as it depends on the cause of infertility, age, and embryo quality. Cumulative success rates improve with successive cycles — many programmes report that most successful patients achieve pregnancy within three cycles. However, the decision to continue treatment is deeply personal and financially significant." }, { "question": "What is ICSI and do I need it?", "answer": "Intracytoplasmic sperm injection (ICSI) involves injecting a single sperm directly into each egg and is recommended when sperm count, motility, or morphology is significantly impaired. It is now used routinely at many clinics even without severe male factor infertility, though evidence for its benefit in normal sperm parameters is debated." }, { "question": "Can IVF cause ovarian hyperstimulation syndrome (OHSS)?", "answer": "OHSS is a potential complication of ovarian stimulation in which the ovaries over-respond to hormonal medication, causing bloating, abdominal pain, and in severe cases fluid accumulation and blood clotting complications. Women with polycystic ovary syndrome (PCOS) or high ovarian reserve are at greater risk, and clinics adjust protocols to minimise this." }, { "question": "What happens to unused embryos?", "answer": "Viable embryos that are not transferred in the current cycle are typically cryopreserved (frozen) for use in future frozen embryo transfer cycles. Couples must make decisions about long-term storage, donation to other patients, use for research, or disposal if they do not wish to use remaining embryos." }, { "question": "Does IVF increase the risk of birth defects?", "answer": "Large studies suggest that IVF-conceived children have a marginally higher rate of certain birth defects compared with naturally conceived children, though the absolute risk difference is small. It is unclear whether this is attributable to the IVF process itself or to the underlying fertility conditions that necessitated it." } ], "relatedProcedures": [], "aliases": [], "eligibility": [ { "criterion": "Established infertility diagnosis with completed work-up", "sourceSlugs": [ "eshre-good-practice-ivf" ] }, { "criterion": "Age within clinic-defined limits (varies; often under 42-45 for own eggs)", "sourceSlugs": [ "eshre-good-practice-ivf" ] }, { "criterion": "BMI within clinic range (often 19-32)", "sourceSlugs": [ "eshre-good-practice-ivf" ] }, { "criterion": "Both partners screened for infectious diseases per clinic protocol", "sourceSlugs": [ "eshre-good-practice-ivf" ] } ], "contraindications": [ { "contraindication": "Untreated severe medical condition that pregnancy would worsen", "sourceSlugs": [ "eshre-good-practice-ivf" ] }, { "contraindication": "Active untreated cancer (oncofertility referral required)", "sourceSlugs": [ "eshre-good-practice-ivf" ] }, { "contraindication": "Severe uncontrolled mental health condition", "sourceSlugs": [ "eshre-good-practice-ivf" ] } ], "risks": [ { "name": "Ovarian hyperstimulation syndrome (OHSS)", "severity": "moderate", "rate": { "value": 0.03, "range": [ 0.01, 0.05 ] }, "prevention": "Antagonist protocols with GnRH-agonist trigger in high-responders; freeze-all approach where indicated.", "sourceSlugs": [ "eshre-good-practice-ivf" ] }, { "name": "Bleeding or infection from egg retrieval", "severity": "moderate", "rate": { "value": 0.005 }, "prevention": "Aseptic technique; avoidance of vascular structures on imaging.", "sourceSlugs": [ "eshre-good-practice-ivf" ] }, { "name": "Multiple pregnancy", "severity": "moderate", "rate": { "value": 0.1, "range": [ 0.05, 0.2 ] }, "prevention": "Single embryo transfer (SET) policy.", "sourceSlugs": [ "eshre-good-practice-ivf", "asrm-clinic-standards" ] }, { "name": "Failed cycle (no embryo to transfer)", "severity": "moderate", "rate": { "value": 0.1, "range": [ 0.05, 0.2 ] }, "prevention": "Realistic counselling on age-related success rates.", "sourceSlugs": [ "eshre-good-practice-ivf" ] } ], "subtypes": [], "followUpCadence": [ { "at": "After egg retrieval", "type": "OHSS surveillance phone call within 48 hours", "required": true }, { "at": "12-14 days post-transfer", "type": "Beta-hCG pregnancy test", "required": true }, { "at": "6-7 weeks", "type": "Early viability scan", "required": true }, { "at": "8-10 weeks", "type": "Discharge ultrasound to obstetric care", "required": true } ], "recordsToObtain": [ "Stimulation protocol and medication doses", "Number of eggs retrieved, fertilised, and transferred", "Embryo grading and any genetic-test (PGT) reports", "Donor screening reports if applicable", "Storage consent forms for any cryopreserved embryos" ], "anaesthesia": "sedation", "operatingTime": { "lowMinutes": 20, "highMinutes": 60, "sourceSlugs": [ "eshre-good-practice-ivf" ] }, "hospitalStay": { "lowNights": 0, "highNights": 0, "sourceSlugs": [ "eshre-good-practice-ivf" ] }, "minimumInCountryDays": { "low": 14, "high": 21, "sourceSlugs": [ "eshre-good-practice-ivf" ] }, "daysToFly": { "low": 1, "high": 2, "explanation": "Egg retrieval is outpatient under sedation; flying restrictions are limited but OHSS risk should be monitored before long-haul travel.", "sourceSlugs": [ "eshre-good-practice-ivf", "iata-medical-cabin-guidance" ] }, "complicationRate": { "value": 5, "range": [ 2, 10 ], "sourceSlugs": [ "eshre-good-practice-ivf" ] }, "numberOfVisits": { "typical": 5, "minimum": 4 }, "recoveryByActivity": { "sedentaryWork": { "days": 1, "sourceSlugs": [ "eshre-good-practice-ivf" ] }, "manualWork": { "days": 3, "sourceSlugs": [ "eshre-good-practice-ivf" ] }, "lightExercise": { "days": 7, "sourceSlugs": [ "eshre-good-practice-ivf" ] }, "vigorousExercise": { "days": 14, "sourceSlugs": [ "eshre-good-practice-ivf" ] }, "flying": { "days": 2, "sourceSlugs": [ "iata-medical-cabin-guidance" ] }, "driving": { "days": 1, "sourceSlugs": [ "eshre-good-practice-ivf" ] }, "swimming": { "days": 14, "sourceSlugs": [ "eshre-good-practice-ivf" ] } }, "literatureLinks": [ { "title": "Hydrosalpinx treatment before in-vitro fertilization: systematic review and network meta-analysis.", "journal": "Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology", "year": 2025, "doi": "10.1002/uog.27697", "url": "https://doi.org/10.1002/uog.27697" }, { "title": "Pelvic inflammatory disease in pregnancy: a systematic review focusing on perinatal outcomes.", "journal": "American journal of obstetrics & gynecology MFM", "year": 2022, "doi": "10.1016/j.ajogmf.2022.100643", "url": "https://doi.org/10.1016/j.ajogmf.2022.100643" }, { "title": "Thromboembolism and in vitro fertilization - a systematic review.", "journal": "Acta obstetricia et gynecologica Scandinavica", "year": 2017, "doi": "10.1111/aogs.13147", "url": "https://doi.org/10.1111/aogs.13147" } ], "alternativeTreatments": [ { "name": "Intrauterine insemination (IUI)", "rationale": "First-line for mild male-factor infertility or unexplained infertility; lower cost, lower per-cycle success.", "sourceSlugs": [ "eshre-guidelines" ] }, { "name": "ICSI", "procedureSlug": "icsi", "rationale": "Required when male-factor infertility is severe; same cycle structure as IVF.", "sourceSlugs": [ "eshre-guidelines" ] }, { "name": "Donor-egg IVF", "procedureSlug": "donor-egg-ivf", "rationale": "When advanced maternal age or premature ovarian insufficiency makes own-egg success unlikely.", "sourceSlugs": [ "eshre-guidelines" ] }, { "name": "Ovulation induction with timed intercourse", "rationale": "Lowest-intervention option for anovulatory infertility; appropriate first step in many cases.", "sourceSlugs": [ "eshre-guidelines" ] } ], "accreditationsRequired": [ "hfea-licensed-centre", "sart-member-clinic", "eshre-certified-centre" ] }, { "slug": "gastric-sleeve", "name": "Gastric Sleeve (Sleeve Gastrectomy)", "category": "weight-loss", "description": "Sleeve gastrectomy removes approximately 80% of the stomach laparoscopically, creating a tube-shaped stomach that restricts food intake and reduces hunger hormones. It is one of the most commonly performed bariatric procedures worldwide. The procedure is irreversible and requires lifelong dietary changes.", "averageRecoveryDays": 21, "typicalSessions": 1, "priceRangeUSD": { "low": 4000, "high": 15000 }, "keyConsiderations": [ "Lifelong vitamin and mineral supplementation is mandatory", "Multidisciplinary work-up (surgeon, dietitian, psychologist) is best practice", "Pre-existing reflux/Barrett's may indicate bypass instead of sleeve", "30-day complication and mortality rates are non-trivial — surgeon volume matters" ], "commonRisks": [ "Staple line leak (most serious surgical complication)", "Stricture (narrowing of the sleeve)", "Gastroesophageal reflux (GERD) — may worsen or develop post-surgery", "Nutritional deficiencies (B12, iron, calcium, folate)", "Deep vein thrombosis", "Insufficient weight loss or weight regain over time" ], "questionsToAsk": [ "How many sleeve gastrectomies have you performed?", "What is your staple line leak rate?", "Do you offer pre- and post-operative nutritional counselling?", "What bougie size do you use?", "What is your long-term follow-up protocol?" ], "overview": "Sleeve gastrectomy is a laparoscopic procedure performed under general anaesthesia, typically lasting sixty to ninety minutes. The surgeon resects approximately seventy-five to eighty per cent of the stomach along the greater curvature using a linear stapling device calibrated over a sizing tube (bougie) placed within the remaining gastric lumen. The resected portion — containing the majority of ghrelin-producing fundic tissue — is removed, leaving a narrow tubular stomach. The staple line is inspected for haemostasis and may be reinforced with buttressing material or oversewn at the surgeon's discretion.\n\nCandidacy is assessed using established bariatric criteria: BMI of 40 or above, or BMI of 35 or above with at least one obesity-related comorbidity (type 2 diabetes, hypertension, obstructive sleep apnoea). Some programmes accept lower BMI thresholds with comorbidities. Pre-operative workup includes nutritional assessment, upper gastrointestinal endoscopy to exclude pathology such as Helicobacter pylori infection, and cardiopulmonary evaluation for high-risk patients. A pre-operative liver-shrinking diet (typically two to four weeks of low-calorie or high-protein nutrition) is almost universally required.\n\nPatients are mobilised the day of surgery and typically discharged after two to three days on a staged post-operative diet progressing from liquids to purées to soft foods over approximately six weeks. Lifelong supplementation with vitamins and minerals — including B12, iron, calcium, and a multivitamin — is mandatory. Weight loss is typically most rapid in the first twelve to eighteen months, with patients losing fifty to seventy per cent of their excess weight. Regular bariatric follow-up is essential for monitoring nutritional status and long-term weight maintenance.", "costBreakdown": "Gastric sleeve pricing abroad typically includes the laparoscopic procedure, general anaesthesia, a two to three night hospital stay, the immediate post-operative diet starter pack, and a defined number of follow-up consultations during the stay. Pre-operative investigations — including blood tests, upper endoscopy, abdominal ultrasound, and cardiology review — may or may not be included and should be confirmed explicitly, as these can add several hundred dollars.\n\nCosts commonly not included in the headline price are pre-operative specialist consultations (dietitian, psychologist — required by many programmes), post-operative nutritional supplements and vitamins for the first year (a recurring lifetime cost), any complications requiring additional hospitalisation, and the ongoing follow-up programme at home. The pre-operative liver-shrinking diet, typically advised for two to four weeks before surgery, also represents a dietary cost. Patients should budget for travel, accommodation for the minimum five to seven day stay, and any accompaniment costs for a carer.", "medicalTourismNotes": "Gastric sleeve surgery requires a minimum post-operative stay of five to seven days to allow for initial recovery, dietary stage progression, and identification of early complications such as staple line leak. The most serious complication — a staple line leak — typically presents at forty-eight to seventy-two hours post-operatively and, if it occurs after the patient has departed, will require emergency management in the home country by surgeons unfamiliar with the case. Patients should not schedule their return flight until they have been reviewed and cleared by the operating team.\n\nThe lifelong follow-up needs of post-bariatric patients are substantial and represent the most significant challenge of seeking this procedure abroad. Nutritional monitoring (blood tests at three, six, and twelve months in the first year, then annually), dietary counselling, and management of complications such as stricture, reflux, or nutritional deficiency will need to be managed by a bariatric team in the home country. Before travelling, patients should identify a bariatric surgeon or physician in their home country willing to accept them for post-operative care and obtain comprehensive operative notes, staple line photographs, and bougie size documentation to share with the home team.", "recoveryTimeline": "Diet progression is the defining structure of the recovery journey. For the first two weeks, patients consume only clear fluids and then full liquids, allowing the staple line to heal and the new stomach to adjust. Weeks three and four introduce purées and soft, moist foods. From weeks six to eight, most patients can tolerate a normal texture diet in small portions, eating slowly and chewing thoroughly. Discomfort when overeating, nausea, and sensitivity to certain foods (particularly high-fat or high-sugar items) are common in the early months. Most patients return to light work within two to four weeks; physically demanding jobs may require six weeks.\n\nWeight loss is most rapid in the first three to six months and continues, at a slower pace, for twelve to eighteen months post-operatively — the period at which maximum weight loss is typically achieved. Follow-up blood tests at three, six, and twelve months in the first year monitor for nutritional deficiencies, which are managed with supplementation. A one-year post-operative consultation is standard to review weight loss, dietary habits, and overall health. Patients with significant weight-related comorbidities such as type 2 diabetes often see marked improvement within weeks of surgery, well before significant weight loss has occurred.", "faqs": [ { "question": "How much weight will I lose after a gastric sleeve?", "answer": "Most patients lose fifty to seventy per cent of their excess body weight within twelve to eighteen months of surgery. The exact amount depends on starting weight, adherence to dietary guidelines, and lifestyle factors including physical activity." }, { "question": "Is the gastric sleeve reversible?", "answer": "No. Sleeve gastrectomy permanently removes approximately eighty per cent of the stomach, and this cannot be reversed. However, in cases where results are insufficient, the procedure can be converted to a gastric bypass or duodenal switch in a subsequent operation." }, { "question": "Will I need to take vitamins for life?", "answer": "Yes. Because the reduced stomach size limits nutrient absorption and the volume of food that can be consumed, lifelong supplementation with a multivitamin, vitamin B12, calcium, vitamin D, and iron is essential. Deficiencies develop gradually and must be monitored with regular blood tests." }, { "question": "Can the stomach stretch back after a gastric sleeve?", "answer": "The sleeve can gradually expand over time, particularly with persistent overeating, though it will not return to its original size. Significant stretching is one factor that contributes to weight regain in some patients several years after surgery, alongside changes in eating habits." }, { "question": "Will I have loose skin after losing weight?", "answer": "Significant weight loss often results in loose or redundant skin, particularly in the abdomen, thighs, and upper arms. The extent depends on the amount of weight lost, age, skin elasticity, and genetics. Body contouring surgery can address this but is a separate procedure." }, { "question": "Does gastric sleeve surgery hurt?", "answer": "The procedure is performed under general anaesthesia and is not painful during surgery. Post-operative discomfort — typically described as soreness at the port sites and shoulder-tip pain from the gas used in laparoscopy — is usual for the first few days and is managed with analgesics." }, { "question": "How do I qualify for gastric sleeve surgery?", "answer": "Most programmes require a BMI of 40 or above, or a BMI of 35 or above combined with at least one obesity-related condition such as type 2 diabetes, hypertension, or sleep apnoea. A psychological evaluation and nutritional assessment are typically required before approval." }, { "question": "Can gastric sleeve surgery cure type 2 diabetes?", "answer": "Many patients experience significant improvement or complete remission of type 2 diabetes following sleeve gastrectomy, often within weeks of surgery — before major weight loss has occurred. This is attributed to hormonal changes rather than weight loss alone, though results vary and the condition may return over time." } ], "relatedProcedures": [ "abdominoplasty" ], "aliases": [], "eligibility": [ { "criterion": "BMI ≥ 35 with comorbidities, or BMI ≥ 40 without (varies by jurisdiction; some countries lower for type 2 diabetes)", "sourceSlugs": [ "ifso-bariatric-standards" ] }, { "criterion": "Documented previous attempts at non-surgical weight loss", "sourceSlugs": [ "ifso-bariatric-standards" ] }, { "criterion": "Multidisciplinary work-up (surgeon, dietitian, psychologist)", "sourceSlugs": [ "ifso-bariatric-standards" ] }, { "criterion": "Commitment to lifelong follow-up and supplementation", "sourceSlugs": [ "ifso-bariatric-standards" ] } ], "contraindications": [ { "contraindication": "Severe pre-existing GORD with Barrett's oesophagus (consider bypass instead)", "sourceSlugs": [ "ifso-bariatric-standards" ] }, { "contraindication": "Uncontrolled binge eating disorder until treated", "sourceSlugs": [ "ifso-bariatric-standards" ] }, { "contraindication": "Untreated severe psychiatric illness", "sourceSlugs": [ "ifso-bariatric-standards" ] }, { "contraindication": "Inability to commit to follow-up and supplementation", "sourceSlugs": [ "ifso-bariatric-standards" ] } ], "risks": [ { "name": "Staple line leak", "severity": "severe", "rate": { "value": 0.015, "range": [ 0.005, 0.03 ] }, "prevention": "Reinforced staple line; intra-operative leak test; experienced surgeon volume.", "sourceSlugs": [ "ifso-bariatric-standards" ] }, { "name": "Bleeding requiring re-operation", "severity": "severe", "rate": { "value": 0.01, "range": [ 0.005, 0.02 ] }, "prevention": "Meticulous haemostasis; intra-operative pressure check.", "sourceSlugs": [ "ifso-bariatric-standards" ] }, { "name": "Stricture (gastric narrowing)", "severity": "moderate", "rate": { "value": 0.02 }, "prevention": "Bougie sizing standards; avoidance of over-tight resection at incisura.", "sourceSlugs": [ "ifso-bariatric-standards" ] }, { "name": "Deep vein thrombosis / pulmonary embolism", "severity": "severe", "rate": { "value": 0.005 }, "prevention": "Mechanical and pharmacological prophylaxis; early mobilisation.", "sourceSlugs": [ "nice-ng89-venous-thromboembolism" ] }, { "name": "Long-term reflux (GORD) — may require conversion", "severity": "moderate", "rate": { "value": 0.2, "range": [ 0.1, 0.3 ] }, "prevention": "Pre-operative assessment of reflux; consideration of bypass if pre-existing GORD.", "sourceSlugs": [ "ifso-bariatric-standards" ] }, { "name": "Vitamin B12 / iron deficiency long-term", "severity": "minor", "rate": { "value": 0.3 }, "prevention": "Lifelong vitamin supplementation and annual blood monitoring.", "sourceSlugs": [ "ifso-bariatric-standards" ] } ], "subtypes": [ "gastric-bypass" ], "followUpCadence": [ { "at": "1 week", "type": "Wound check and dietary review", "required": true }, { "at": "4 weeks", "type": "Diet progression review", "required": true }, { "at": "3 months", "type": "Weight loss and dietary compliance", "required": true }, { "at": "6 months", "type": "Bloods (including vitamin B12, iron, calcium)", "required": true }, { "at": "12 months", "type": "Annual review with bloods (lifelong)", "required": true } ], "recordsToObtain": [ "Operative report including bougie size and staple line reinforcement", "Anaesthetic record with DVT prophylaxis", "Pre-op work-up (psychological assessment, dietitian notes, endoscopy if performed)", "Post-op dietary plan and supplementation regimen" ], "anaesthesia": "general", "operatingTime": { "lowMinutes": 60, "highMinutes": 120, "sourceSlugs": [ "ifso-bariatric-standards" ] }, "hospitalStay": { "lowNights": 2, "highNights": 3, "sourceSlugs": [ "ifso-bariatric-standards" ] }, "minimumInCountryDays": { "low": 7, "high": 10, "sourceSlugs": [ "ifso-bariatric-standards" ] }, "daysToFly": { "low": 7, "high": 10, "explanation": "DVT risk substantial post-bariatric surgery; long-haul flights typically require at least 7-10 days locally with prophylaxis.", "sourceSlugs": [ "nice-ng89-venous-thromboembolism", "ifso-bariatric-standards", "iata-medical-cabin-guidance" ] }, "complicationRate": { "value": 5, "range": [ 2, 10 ], "sourceSlugs": [ "cochrane-bariatric-surgery", "ifso-bariatric-standards" ] }, "revisionRate": { "value": 5, "range": [ 2, 10 ], "sourceSlugs": [ "ifso-bariatric-standards" ] }, "mortalityRate": { "value": 0.1, "range": [ 0.05, 0.2 ], "sourceSlugs": [ "iasm-bariatric-mortality-review", "ifso-bariatric-standards" ] }, "numberOfVisits": { "typical": 4, "minimum": 2 }, "recoveryByActivity": { "sedentaryWork": { "days": 14, "sourceSlugs": [ "ifso-bariatric-standards" ] }, "manualWork": { "days": 28, "sourceSlugs": [ "ifso-bariatric-standards" ] }, "lightExercise": { "days": 14, "sourceSlugs": [ "ifso-bariatric-standards" ] }, "vigorousExercise": { "days": 42, "sourceSlugs": [ "ifso-bariatric-standards" ] }, "swimming": { "days": 21, "sourceSlugs": [ "ifso-bariatric-standards" ] }, "flying": { "days": 7, "sourceSlugs": [ "nice-ng89-venous-thromboembolism", "iata-medical-cabin-guidance" ] }, "driving": { "days": 14, "sourceSlugs": [ "ifso-bariatric-standards" ] } }, "literatureLinks": [ { "title": "Comparison of Efficacy and Safety Between Roux-en-Y Gastric Bypass (RYGB) vs One Anastomosis Gastric Bypass (OAGB) vs Single Anastomosis Duodeno-ileal Bypass with Sleeve Gastrectomy (SADI-S): a Systematic Review of Bariatric and Metabolic Surgery.", "journal": "Obesity surgery", "year": 2023, "doi": "10.1007/s11695-023-06602-6", "url": "https://doi.org/10.1007/s11695-023-06602-6" }, { "title": "��​Long-Term Outcomes in Sleeve Gastrectomy versus Roux-en-Y Gastric Bypass: A Systematic Review and Meta-Analysis of Randomized Trials.", "journal": "Obesity surgery", "year": 2025, "doi": "10.1007/s11695-025-08044-8", "url": "https://doi.org/10.1007/s11695-025-08044-8" }, { "title": "Primary Banded Sleeve Gastrectomy: a Systematic Review.", "journal": "Obesity surgery", "year": 2019, "doi": "10.1007/s11695-018-03626-1", "url": "https://doi.org/10.1007/s11695-018-03626-1" } ], "alternativeTreatments": [ { "name": "Gastric bypass (Roux-en-Y)", "procedureSlug": "gastric-bypass", "rationale": "Greater long-term weight loss + better type-2 diabetes remission, more nutritional surveillance required.", "sourceSlugs": [ "asmbs-bariatric-guidelines" ] }, { "name": "Mini gastric bypass", "procedureSlug": "mini-gastric-bypass", "rationale": "Single-anastomosis variant; shorter operating time, similar weight-loss profile.", "sourceSlugs": [ "asmbs-bariatric-guidelines" ] }, { "name": "Endoscopic sleeve gastroplasty", "procedureSlug": "endoscopic-sleeve-gastroplasty", "rationale": "Non-surgical alternative for lower BMI candidates or those declining surgery; less weight loss.", "sourceSlugs": [ "asmbs-bariatric-guidelines" ] }, { "name": "Gastric balloon", "procedureSlug": "gastric-balloon", "rationale": "Reversible 6-12 month intervention; useful as a bridge or for lower-BMI candidates.", "sourceSlugs": [ "asmbs-bariatric-guidelines" ] }, { "name": "GLP-1 receptor agonists (semaglutide, tirzepatide)", "rationale": "Pharmacological alternative now achieving 15-20% body-weight loss; requires lifelong dosing.", "sourceSlugs": [ "asmbs-bariatric-guidelines" ] } ], "accreditationsRequired": [ "ifso-center-of-excellence", "asmbs-mbsaqip-center", "jci-hospital-accreditation" ] }, { "slug": "knee-replacement", "name": "Total Knee Replacement", "category": "orthopaedic", "description": "Total knee replacement (total knee arthroplasty) involves replacing damaged cartilage and bone in the knee joint with metal and plastic components. It is typically performed for severe osteoarthritis or rheumatoid arthritis that has not responded to conservative treatment. The procedure requires significant physiotherapy during recovery.", "averageRecoveryDays": 42, "typicalSessions": 1, "priceRangeUSD": { "low": 5000, "high": 20000 }, "keyConsiderations": [ "Implant brand, model, and lot number must be documented for life-long surveillance", "DVT/PE risk highest after lower-limb arthroplasty — prophylaxis non-negotiable", "Persistent pain/stiffness affects 5-10% of patients even with successful technique", "Annual radiographic surveillance is standard for the first 5 years" ], "commonRisks": [ "Deep vein thrombosis or pulmonary embolism", "Infection (prosthetic joint infection is serious and may require revision)", "Stiffness or limited range of motion", "Implant loosening over time", "Nerve or blood vessel damage", "Persistent pain despite technically successful surgery" ], "questionsToAsk": [ "What implant system do you use and why?", "Do you use robotic-assisted or computer-navigated surgery?", "What is your infection rate for knee replacements?", "What physiotherapy protocol do you follow post-operatively?", "How many knee replacements do you perform per year?" ], "overview": "Total knee arthroplasty is a major orthopaedic procedure performed under spinal or general anaesthesia, lasting approximately ninety minutes to two hours. The surgeon removes the damaged articular surfaces of the femur and tibia and resurfaces them with metal components fixed to the bone with bone cement or press-fit techniques. A plastic (polyethylene) tibial insert provides the bearing surface, and the patella may be resurfaced depending on the surgeon's preference and the extent of patellar involvement. Alignment is achieved using conventional mechanical guides, computer navigation, or robotic-assisted systems.\n\nCandidacy is based on radiographic evidence of severe joint space narrowing with corresponding functional limitation unresponsive to weight loss, physiotherapy, analgesics, and intra-articular injections. Age and activity level influence implant selection: highly active patients may place excessive demands on bearing surfaces, whereas very elderly or low-demand patients may be suitable candidates at lower symptom thresholds. Patients with significant comorbidities (poorly controlled diabetes, severe cardiac disease, active infection) require optimisation before surgery.\n\nAmbulation begins on the day of or the day after surgery, and the focus of in-patient physiotherapy is restoring range of motion and safe independent mobility. Discharge to a rehabilitation facility or home typically occurs at three to five days. Achieving ninety degrees of flexion by six weeks is a commonly used milestone. Full recovery — including return to comfortable walking on most surfaces — typically takes three to six months, with ongoing improvement possible over twelve months. Patients with poor pre-operative flexibility or significant stiffness face more challenging rehabilitation.", "costBreakdown": "Total knee replacement pricing encompasses the implant system, surgeon's fee, anaesthesia, theatre costs, and a standard inpatient stay of three to five days including physiotherapy. Implant cost is a major variable: premium brands with long-term clinical data (DePuy, Zimmer Biomet, Stryker, Smith & Nephew) are more expensive than generic alternatives, and robotic-assisted systems may attract an additional facility premium. Patients should request the specific implant catalogue name and confirm whether it is a standard primary implant.\n\nAdditional costs may include pre-operative investigations (blood tests, ECG, chest X-ray, cardiac clearance), the anaesthetist's separate fee, extended physiotherapy sessions beyond those included in the inpatient programme, assistive devices (crutches, walking frame), post-discharge accommodation if the patient is unable to fly immediately, and anticoagulation medications for the prescribed duration. Extended rehabilitation in a facility rather than at home will add considerable cost. Implant documentation is important for long-term follow-up and must be retained.", "medicalTourismNotes": "Total knee replacement is one of the most logistically challenging procedures for medical tourism due to its extended recovery and intensive rehabilitation requirements. Long-haul flights should be avoided for a minimum of four to six weeks post-operatively, as the combination of reduced mobility, post-surgical hypercoagulability, and prolonged seated immobility creates a high risk of deep vein thrombosis and potentially fatal pulmonary embolism. Patients must arrange accommodation at or near the treatment destination for an adequate recovery period before any significant travel.\n\nPost-operative physiotherapy is not optional — it is a primary determinant of the final range of motion and functional outcome. Patients should arrange a detailed physiotherapy programme in their home country in advance of travelling, as the transition from facility-based rehabilitation abroad to a local physiotherapist must be seamless. A letter detailing the surgical approach, implant used, and post-operative physiotherapy protocol should be obtained from the overseas surgical team to hand to the home physiotherapist. Patients should also retain full implant documentation (brand, catalogue number, lot number) as this information is required for future revision procedures and implant registry reporting in the home country.", "recoveryTimeline": "Mobilisation begins on the day of surgery or the morning after, with a physiotherapist supporting the patient to stand and take initial steps using a walking frame. Daily physiotherapy sessions during the inpatient stay focus on building knee flexion, extending the leg fully, and building the confidence for safe ambulation. Most patients are discharged at three to five days, able to manage stairs with a rail and walk short distances. Anticoagulation therapy to prevent DVT continues for the duration prescribed — typically two to six weeks — and is essential during this vulnerable period.\n\nBy two to three weeks, most patients can negotiate stairs more confidently and no longer require a walking frame, though a stick may still be used outdoors. Driving is typically permitted at six to eight weeks when the patient can perform an emergency stop safely. Physiotherapy continues for several months, with progressive exercises aimed at achieving ninety degrees of flexion — a key milestone for normal daily activities — by six weeks. Swelling, warmth, and stiffness in the knee are normal and gradually resolve over three to six months. Full functional recovery, including comfortable walking on uneven ground and a return to low-impact activity such as swimming or cycling, is typically achieved within three to six months.", "faqs": [ { "question": "How long does a knee replacement last?", "answer": "Modern knee implants are designed to last fifteen to twenty-five years in most patients, with published data showing survival rates above ninety per cent at fifteen years. Factors that reduce longevity include high activity levels, obesity, and younger age at the time of surgery." }, { "question": "Will I be able to kneel after a knee replacement?", "answer": "Many patients can kneel after a knee replacement, though it often feels uncomfortable due to the altered sensation from the implant. Most implant designs are compatible with kneeling, but it is advisable to confirm with the surgeon and to use a cushion to reduce pressure on the implant surface." }, { "question": "What are the alternatives to knee replacement?", "answer": "For patients not yet ready for replacement surgery, alternatives include physiotherapy and exercise programmes, weight loss, anti-inflammatory medications, corticosteroid or hyaluronic acid injections, and partial knee replacement for isolated compartment disease. These delay rather than eliminate the eventual need for replacement in severe arthritis." }, { "question": "How painful is recovery from knee replacement?", "answer": "Pain in the first few days is managed with a combination of spinal anaesthesia, nerve blocks, and analgesics. Most patients describe the recovery as challenging but manageable. By six weeks, the majority report that their pain level is significantly lower than before surgery." }, { "question": "Will I set off airport security with a knee implant?", "answer": "Metal knee implants frequently trigger airport security scanners. Patients are advised to inform security staff and carry documentation of the implant — most manufacturers provide an implant identification card. Body scanners in modern airports may not trigger an alarm, but metal detectors generally will." }, { "question": "Can I have both knees replaced at the same time?", "answer": "Simultaneous bilateral knee replacement is technically feasible and reduces overall recovery time, but carries higher rates of blood transfusion, cardiovascular complications, and mortality compared with staged procedures. Most surgeons recommend replacing one knee at a time, spacing the operations by three to six months." }, { "question": "Is physiotherapy really necessary after knee replacement?", "answer": "Yes — physiotherapy is a critical determinant of the final range of motion and functional outcome. Patients who do not engage with rehabilitation consistently achieve poorer results in terms of knee flexion, strength, and satisfaction. Regular physiotherapy for at least three months post-operatively is strongly recommended." }, { "question": "What sports can I do after a knee replacement?", "answer": "Low-impact activities such as walking, swimming, cycling, and golf are generally well tolerated and encouraged. High-impact sports such as running, football, and skiing place excessive stress on the implant and are generally advised against to preserve implant longevity. Most patients significantly increase their activity level compared with before surgery." } ], "relatedProcedures": [ "cabg", "hernia-repair" ], "aliases": [], "eligibility": [ { "criterion": "End-stage osteoarthritis confirmed radiographically", "sourceSlugs": [ "aaos-knee-replacement-guideline" ] }, { "criterion": "Failure of conservative management (analgesia, physiotherapy, injections)", "sourceSlugs": [ "aaos-knee-replacement-guideline" ] }, { "criterion": "BMI typically below 40 (varies)", "sourceSlugs": [ "aaos-knee-replacement-guideline" ] }, { "criterion": "Cardiopulmonary fitness for general anaesthesia", "sourceSlugs": [ "rcoa-standards-anaesthesia" ] } ], "contraindications": [ { "contraindication": "Active local or systemic infection", "sourceSlugs": [ "aaos-knee-replacement-guideline" ] }, { "contraindication": "Severe peripheral vascular disease", "sourceSlugs": [ "aaos-knee-replacement-guideline" ] }, { "contraindication": "Inadequate bone stock for fixation", "sourceSlugs": [ "aaos-knee-replacement-guideline" ] } ], "risks": [ { "name": "Periprosthetic infection", "severity": "severe", "rate": { "value": 0.01, "range": [ 0.005, 0.02 ] }, "prevention": "Antibiotic prophylaxis; laminar flow theatre; adequate skin preparation; weight management pre-operatively.", "sourceSlugs": [ "aaos-knee-replacement-guideline" ] }, { "name": "Deep vein thrombosis / pulmonary embolism", "severity": "severe", "rate": { "value": 0.01, "range": [ 0.005, 0.02 ] }, "prevention": "Mechanical and pharmacological prophylaxis per NICE NG89; early mobilisation.", "sourceSlugs": [ "nice-ng89-venous-thromboembolism" ] }, { "name": "Implant loosening (long-term)", "severity": "moderate", "rate": { "value": 0.05, "range": [ 0.02, 0.1 ] }, "prevention": "Cementing technique; activity modification post-recovery.", "sourceSlugs": [ "njr-annual-report" ] }, { "name": "Persistent pain or stiffness", "severity": "moderate", "rate": { "value": 0.1, "range": [ 0.05, 0.2 ] }, "prevention": "Pre-operative expectations management; physiotherapy compliance.", "sourceSlugs": [ "aaos-knee-replacement-guideline" ] }, { "name": "Nerve injury (peroneal, saphenous)", "severity": "moderate", "rate": { "value": 0.005 }, "prevention": "Careful surgical exposure; avoidance of excessive valgus correction.", "sourceSlugs": [ "aaos-knee-replacement-guideline" ] } ], "subtypes": [], "followUpCadence": [ { "at": "Day 1-3 post-op", "type": "Mobilisation with physiotherapy", "required": true }, { "at": "2 weeks", "type": "Wound check and suture/staple removal", "required": true }, { "at": "6 weeks", "type": "Range-of-motion and X-ray review", "required": true }, { "at": "3 months", "type": "Function and pain assessment", "required": true }, { "at": "Annual", "type": "Long-term implant surveillance (X-ray)", "required": true } ], "recordsToObtain": [ "Implant brand, model, size, lot number (implant passport)", "Operative report", "Anaesthetic record with DVT prophylaxis used", "Post-op X-ray", "Physiotherapy plan" ], "anaesthesia": "general", "operatingTime": { "lowMinutes": 60, "highMinutes": 120, "sourceSlugs": [ "aaos-knee-replacement-guideline" ] }, "hospitalStay": { "lowNights": 2, "highNights": 5, "sourceSlugs": [ "aaos-knee-replacement-guideline", "njr-annual-report" ] }, "minimumInCountryDays": { "low": 14, "high": 21, "sourceSlugs": [ "aaos-knee-replacement-guideline" ] }, "daysToFly": { "low": 14, "high": 21, "explanation": "DVT risk is highest after lower-limb arthroplasty; most guidelines recommend at least two weeks post-op before long-haul flying with continued prophylaxis.", "sourceSlugs": [ "nice-ng89-venous-thromboembolism", "iata-medical-cabin-guidance" ] }, "complicationRate": { "value": 5, "range": [ 2, 8 ], "sourceSlugs": [ "aaos-knee-replacement-guideline", "njr-annual-report" ] }, "revisionRate": { "value": 5, "range": [ 2, 10 ], "sourceSlugs": [ "njr-annual-report" ] }, "mortalityRate": { "value": 0.5, "range": [ 0.2, 1 ], "sourceSlugs": [ "njr-annual-report" ] }, "numberOfVisits": { "typical": 4, "minimum": 3 }, "recoveryByActivity": { "sedentaryWork": { "days": 28, "sourceSlugs": [ "aaos-knee-replacement-guideline" ] }, "manualWork": { "days": 84, "sourceSlugs": [ "aaos-knee-replacement-guideline" ] }, "lightExercise": { "days": 28, "sourceSlugs": [ "aaos-knee-replacement-guideline" ] }, "vigorousExercise": { "days": 84, "sourceSlugs": [ "aaos-knee-replacement-guideline" ] }, "swimming": { "days": 42, "sourceSlugs": [ "aaos-knee-replacement-guideline" ] }, "flying": { "days": 14, "sourceSlugs": [ "nice-ng89-venous-thromboembolism", "iata-medical-cabin-guidance" ] }, "driving": { "days": 42, "sourceSlugs": [ "aaos-knee-replacement-guideline" ] } }, "literatureLinks": [ { "title": "Robotic-assisted versus conventional total knee arthroplasty: a systematic review and meta-analysis of randomized controlled trials.", "journal": "European journal of orthopaedic surgery & traumatology : orthopedie traumatologie", "year": 2024, "doi": "10.1007/s00590-023-03798-2", "url": "https://doi.org/10.1007/s00590-023-03798-2" }, { "title": "Patient relevant outcomes of unicompartmental versus total knee replacement: systematic review and meta-analysis.", "journal": "BMJ (Clinical research ed.)", "year": 2019, "doi": "10.1136/bmj.l352", "url": "https://doi.org/10.1136/bmj.l352" }, { "title": "Effects of manual lymphatic drainage on total knee replacement: a systematic review and meta-analysis of randomized controlled trials.", "journal": "BMC musculoskeletal disorders", "year": 2024, "doi": "10.1186/s12891-023-07153-8", "url": "https://doi.org/10.1186/s12891-023-07153-8" } ], "alternativeTreatments": [ { "name": "Partial knee replacement (unicompartmental)", "rationale": "When osteoarthritis is confined to a single compartment, preserves more bone and ACL.", "sourceSlugs": [ "aaos-knee-replacement-guideline" ] }, { "name": "High tibial osteotomy", "rationale": "Joint-preserving realignment for younger active patients with isolated medial-compartment disease.", "sourceSlugs": [ "aaos-knee-replacement-guideline" ] }, { "name": "Hyaluronic acid or corticosteroid injection", "rationale": "Conservative symptomatic management; modest and time-limited relief.", "sourceSlugs": [ "aaos-knee-replacement-guideline" ] }, { "name": "Physiotherapy + weight management", "rationale": "Evidence-based first-line management; can defer surgery by years in some patients.", "sourceSlugs": [ "aaos-knee-replacement-guideline" ] } ], "accreditationsRequired": [ "national-orthopaedic-board", "njr-participating-hospital" ] }, { "slug": "lasik", "name": "LASIK Eye Surgery", "category": "ophthalmology", "description": "LASIK (Laser-Assisted In Situ Keratomileusis) reshapes the cornea using an excimer laser to correct refractive errors including myopia, hyperopia, and astigmatism. A thin corneal flap is created, the underlying tissue is reshaped, and the flap is repositioned. The procedure takes approximately 15 minutes per eye with rapid visual recovery.", "averageRecoveryDays": 3, "typicalSessions": 1, "priceRangeUSD": { "low": 1000, "high": 4000 }, "keyConsiderations": [ "Pre-operative topography excludes keratoconus — non-negotiable safety check", "Residual stromal bed thickness is the primary safety parameter", "Dry-eye risk in 30-50% of patients in first 3-6 months post-op", "Presbyopic-age vision will still require reading glasses despite distance correction" ], "commonRisks": [ "Dry eyes (most common side effect, usually temporary)", "Halos, glare, or starbursts around lights at night", "Under-correction or over-correction requiring enhancement", "Flap complications (wrinkles, displacement)", "Regression (partial return of refractive error over time)", "Rare: corneal ectasia (progressive thinning)" ], "questionsToAsk": [ "What laser platform do you use?", "What is your enhancement rate?", "Is the enhancement included in the quoted price?", "How many LASIK procedures have you personally performed?", "What pre-operative corneal measurements do you take?" ], "overview": "LASIK is performed as an outpatient procedure under topical anaesthetic eye drops, taking approximately fifteen minutes per eye. A thin corneal flap of approximately ninety to one hundred microns is created using either a femtosecond (bladeless) laser or a mechanical microkeratome. The flap is folded back to expose the corneal stroma, which is then ablated by an excimer laser according to a pre-calculated treatment map derived from wavefront aberrometry and corneal topography measurements. The flap is repositioned over the treated surface and adheres without sutures by virtue of natural surface tension.\n\nCandidacy depends on stable refraction for at least twelve months, minimum corneal thickness (typically above 480 to 500 microns) with adequate residual stromal bed after ablation, and corneal topography showing no signs of pre-existing ectasia or keratoconus. Patients with very high refractive errors, dry eye disease, or irregular corneas may be better served by alternative procedures such as photorefractive keratectomy (PRK), SMILE, or phakic intraocular lens implantation.\n\nVisual recovery after LASIK is characteristically rapid: most patients achieve functional vision within twenty-four hours and notice a marked improvement within the first day. The review appointment at twenty-four to forty-eight hours is important for confirming flap position and early visual acuity. Most patients are advised to use preservative-free lubricating drops for several months to manage the transient dry eye that is nearly universal post-LASIK. Night vision disturbances (halos, starbursts) are common in the first weeks and typically improve over three to six months.", "costBreakdown": "LASIK pricing may be quoted per eye or as a bilateral (both eyes) package. Bilateral pricing is generally more economical and is the relevant comparison when evaluating clinics, as the vast majority of patients treat both eyes. The quoted price typically covers the procedure itself with the specified laser platform, pre-operative topography and aberrometry measurements, and immediate post-operative care including the twenty-four-hour review.\n\nItems that may not be included are the pre-operative consultation and suitability assessment, additional pre-operative measurements such as corneal pachymetry or endothelial cell count, post-operative lubricating eye drops (a recurring cost for several months), and enhancement procedures if required. Enhancement rates in modern LASIK series are typically one to five per cent, but patients with higher prescriptions face a higher enhancement likelihood. Some clinics include a lifetime enhancement guarantee within their fee; others charge separately. Patients should clarify the enhancement policy and associated costs before committing.", "medicalTourismNotes": "LASIK is one of the procedures most amenable to medical tourism. Visual recovery is typically rapid, the procedure involves no surgical wounds requiring ongoing management, and the principal post-operative requirements are lubricating drops and a review appointment at twenty-four to forty-eight hours. Patients can feasibly have the procedure performed, attend the mandatory twenty-four to forty-eight hour review, and fly home within two to three days of surgery.\n\nBefore departure, patients should confirm that their vision is stable and that the operating surgeon is satisfied with flap position and early visual acuity at the post-operative review. Flying before this review is inadvisable. Cabin air is desiccating and may exacerbate post-operative dry eye; frequent use of lubricating drops during the flight is recommended. Patients should bring sufficient lubricating drops and any prescribed medications for at least one to two weeks beyond their return. If enhancement is required — detectable only after three to six months when the refraction has stabilised — this would likely need to be arranged either at the original clinic (requiring a return trip) or with a local surgeon, who will need complete operative records including ablation profiles.", "recoveryTimeline": "The first twenty-four to forty-eight hours are characterised by fluctuating vision, mild light sensitivity, and a gritty or watery sensation in the eyes. These effects are normal and typically resolve within the first day. The mandatory post-operative review at twenty-four to forty-eight hours confirms flap position and measures early visual acuity; most patients see well enough to drive by this appointment, though they should arrange transport for the day of surgery and the following morning. Lubricating eye drops — preservative-free — should be used frequently during the first weeks and continued for as long as dryness persists.\n\nVision stabilises progressively over one to three months as the cornea heals and the refractive result settles. Night-time visual disturbances such as halos and glare around lights are common in the early weeks and usually improve by three months, though they may persist at a low level thereafter in some patients. Swimming and water sports should be avoided for two weeks to reduce infection risk, and eye-rubbing must be avoided for at least one month to prevent flap displacement. A formal refraction check at three months confirms whether the outcome is within target; if an enhancement is indicated, it is generally deferred until the refraction has been stable for several months. Dry eyes may persist for up to three to six months before fully resolving.", "faqs": [ { "question": "Am I a good candidate for LASIK?", "answer": "Suitable candidates have stable vision for at least twelve months, adequate corneal thickness, no signs of keratoconus or corneal ectasia, and are not significantly affected by dry eye disease. A comprehensive pre-operative assessment including corneal topography and pachymetry is required to confirm suitability." }, { "question": "Is LASIK permanent?", "answer": "The reshaping of the cornea by the laser is permanent, but some patients experience gradual regression — a partial return of their refractive error — over years, particularly those with higher prescriptions. Additionally, LASIK does not prevent the natural development of presbyopia (reading difficulty) with age." }, { "question": "Does LASIK hurt?", "answer": "The procedure is performed under topical anaesthetic eye drops and is not painful during treatment. Patients may feel pressure from the suction device used during flap creation. Mild discomfort, light sensitivity, and a watery sensation are typical for the first several hours after surgery." }, { "question": "What is the difference between LASIK, PRK, and SMILE?", "answer": "LASIK creates a hinged corneal flap before laser reshaping; PRK removes the surface epithelium instead, with slower recovery but no flap. SMILE is a newer technique that uses only one laser type and removes a small lenticule of tissue without a flap, potentially reducing dry eye compared with LASIK." }, { "question": "Can LASIK correct presbyopia (reading glasses)?", "answer": "Standard LASIK corrects distance vision and does not address presbyopia, meaning patients over forty may still require reading glasses even after a successful procedure. Monovision LASIK — correcting one eye for distance and the other for near — is an option for some patients but requires a trial with contact lenses first." }, { "question": "What happens if I move my eyes during LASIK?", "answer": "Modern laser platforms incorporate real-time eye-tracking systems that automatically adjust the laser delivery to compensate for involuntary eye movement. If movement exceeds the tracker's tolerance, the laser pauses automatically. Patients are asked to focus on a target light but do not need to keep perfectly still." }, { "question": "How long does LASIK last?", "answer": "For most patients, LASIK produces a stable, long-lasting result. The majority of patients maintain their corrected vision for many years, though a small proportion experience regression requiring an enhancement procedure. Age-related changes such as cataracts and presbyopia will occur independently of LASIK over time." }, { "question": "Can I have LASIK if I have astigmatism?", "answer": "Yes. LASIK is effective for correcting astigmatism as well as myopia and hyperopia, provided the degree of astigmatism is within treatable limits and the corneal thickness is adequate. The laser treatment map accounts for the irregular corneal curvature associated with astigmatism." } ], "relatedProcedures": [], "aliases": [], "eligibility": [ { "criterion": "Stable refraction for at least 12 months", "sourceSlugs": [ "aao-ppp-refractive" ] }, { "criterion": "Age 18 or over (FDA-approved range)", "sourceSlugs": [ "aao-ppp-refractive" ] }, { "criterion": "Healthy corneas with adequate thickness on pachymetry", "sourceSlugs": [ "aao-ppp-refractive" ] }, { "criterion": "Realistic expectations about presbyopic-age eyesight", "sourceSlugs": [ "aao-ppp-refractive" ] } ], "contraindications": [ { "contraindication": "Keratoconus or forme fruste keratoconus on topography", "sourceSlugs": [ "aao-ppp-refractive" ] }, { "contraindication": "Severe dry eye syndrome", "sourceSlugs": [ "aao-ppp-refractive" ] }, { "contraindication": "Pregnancy or breastfeeding (refraction unstable)", "sourceSlugs": [ "aao-ppp-refractive" ] }, { "contraindication": "Active autoimmune or connective-tissue disease", "sourceSlugs": [ "aao-ppp-refractive" ] }, { "contraindication": "Insufficient corneal thickness for proposed correction", "sourceSlugs": [ "aao-ppp-refractive" ] } ], "risks": [ { "name": "Dry eye (transient or persistent)", "severity": "minor", "rate": { "value": 0.5, "range": [ 0.3, 0.7 ] }, "prevention": "Pre-operative tear film assessment; lubricating drops; punctal plugs in selected patients.", "sourceSlugs": [ "aao-ppp-refractive" ] }, { "name": "Flap complications (dislocation, microstriae)", "severity": "moderate", "rate": { "value": 0.005 }, "prevention": "Femtosecond laser flap creation; protective shield first night; avoidance of eye rubbing.", "sourceSlugs": [ "escrs-refractive-guidelines" ] }, { "name": "Ectasia (corneal weakening)", "severity": "severe", "rate": { "value": 0.0005 }, "prevention": "Pre-operative topography to exclude keratoconus; appropriate residual stromal bed thickness.", "sourceSlugs": [ "aao-ppp-refractive", "escrs-refractive-guidelines" ] }, { "name": "Under- or over-correction requiring enhancement", "severity": "minor", "rate": { "value": 0.05, "range": [ 0.02, 0.1 ] }, "prevention": "Accurate pre-operative refraction; modern eye-tracking laser systems.", "sourceSlugs": [ "cochrane-lasik-vs-prk" ] }, { "name": "Glare or halos at night", "severity": "minor", "rate": { "value": 0.1, "range": [ 0.05, 0.2 ] }, "prevention": "Wavefront-guided treatment in selected patients.", "sourceSlugs": [ "aao-ppp-refractive" ] } ], "subtypes": [ "prk", "smile" ], "followUpCadence": [ { "at": "Day 1", "type": "Flap and visual acuity check", "required": true }, { "at": "1 week", "type": "Refraction and tear film check", "required": true }, { "at": "1 month", "type": "Refraction stability check", "required": true }, { "at": "3 months", "type": "Final visual acuity and refractive stability", "required": true } ], "recordsToObtain": [ "Pre-operative refraction and topography", "Operative report including laser parameters and flap thickness", "Pachymetry pre and post", "Post-operative refraction at each visit" ], "anaesthesia": "local", "operatingTime": { "lowMinutes": 10, "highMinutes": 30, "sourceSlugs": [ "aao-ppp-refractive", "escrs-refractive-guidelines" ] }, "hospitalStay": { "lowNights": 0, "highNights": 0, "sourceSlugs": [ "aao-ppp-refractive" ] }, "minimumInCountryDays": { "low": 2, "high": 4, "sourceSlugs": [ "aao-ppp-refractive" ] }, "daysToFly": { "low": 1, "high": 2, "explanation": "Outpatient procedure under topical anaesthesia; flying is permitted from the next day with sunglasses and lubricating drops.", "sourceSlugs": [ "aao-ppp-refractive", "iata-medical-cabin-guidance" ] }, "complicationRate": { "value": 1, "range": [ 0.5, 2 ], "sourceSlugs": [ "cochrane-lasik-vs-prk", "aao-ppp-refractive" ] }, "revisionRate": { "value": 5, "range": [ 2, 10 ], "sourceSlugs": [ "aao-ppp-refractive" ] }, "numberOfVisits": { "typical": 2, "minimum": 1 }, "recoveryByActivity": { "sedentaryWork": { "days": 1, "sourceSlugs": [ "aao-ppp-refractive" ] }, "manualWork": { "days": 3, "sourceSlugs": [ "aao-ppp-refractive" ] }, "lightExercise": { "days": 3, "sourceSlugs": [ "aao-ppp-refractive" ] }, "vigorousExercise": { "days": 14, "sourceSlugs": [ "aao-ppp-refractive" ] }, "swimming": { "days": 14, "sourceSlugs": [ "aao-ppp-refractive" ] }, "flying": { "days": 1, "sourceSlugs": [ "iata-medical-cabin-guidance" ] }, "driving": { "days": 1, "sourceSlugs": [ "aao-ppp-refractive" ] } }, "literatureLinks": [ { "title": "Interface fluid syndrome after LASIK surgery: retrospective pooled analysis and systematic review.", "journal": "Journal of cataract and refractive surgery", "year": 2023, "doi": "10.1097/j.jcrs.0000000000001214", "url": "https://doi.org/10.1097/j.jcrs.0000000000001214" }, { "title": "IntraLase femtosecond laser vs mechanical microkeratomes in LASIK for myopia: a systematic review and meta-analysis.", "journal": "Journal of refractive surgery (Thorofare, N.J. : 1995)", "year": 2012, "doi": "10.3928/1081597X-20111228-02", "url": "https://doi.org/10.3928/1081597X-20111228-02" }, { "title": "Efficacy and safety of pregabalin in eye pain: A systematic review.", "journal": "Medicine", "year": 2023, "doi": "10.1097/MD.0000000000032875", "url": "https://doi.org/10.1097/MD.0000000000032875" } ], "alternativeTreatments": [ { "name": "PRK (photorefractive keratectomy)", "procedureSlug": "prk", "rationale": "Surface-ablation alternative for patients with thin corneas or chronic dry eye in whom LASIK flap creation is contraindicated.", "sourceSlugs": [ "aao-ppp-refractive" ] }, { "name": "SMILE (small incision lenticule extraction)", "procedureSlug": "smile", "rationale": "Flapless keyhole alternative, narrower indication range but better corneal biomechanics retention.", "sourceSlugs": [ "aao-ppp-refractive" ] }, { "name": "Refractive lens exchange", "procedureSlug": "refractive-lens-exchange", "rationale": "Lens-based alternative for patients in their late 40s+ where presbyopia is a co-issue.", "sourceSlugs": [ "aao-ppp-refractive" ] }, { "name": "Continued spectacles or contact lenses", "rationale": "First-line conservative management; no surgical risk but ongoing cost and lifestyle constraints.", "sourceSlugs": [ "aao-ppp-refractive" ] } ], "accreditationsRequired": [ "national-ophthalmology-board", "refractive-surgery-fellowship" ] }, { "slug": "cabg", "name": "Coronary Artery Bypass Graft (CABG)", "category": "cardiology", "description": "CABG surgery reroutes blood around blocked or narrowed coronary arteries using grafts harvested from the patient's chest, leg, or arm. It is typically recommended when coronary artery disease is severe or extensive, or when other treatments have failed. The procedure is performed under general anaesthesia with or without cardiopulmonary bypass.", "averageRecoveryDays": 56, "typicalSessions": 1, "priceRangeUSD": { "low": 7000, "high": 50000 }, "keyConsiderations": [ "Multidisciplinary heart-team review precedes the decision in modern practice", "Internal mammary artery to LAD is the long-term graft of choice", "Atrial fibrillation occurs in 20-30% of patients post-op — anticipate it", "Cardiac rehabilitation participation correlates with long-term outcomes" ], "commonRisks": [ "Stroke", "Atrial fibrillation (irregular heart rhythm)", "Wound infection (sternotomy or graft harvest site)", "Kidney dysfunction", "Cognitive changes (post-operative cognitive decline)", "Graft failure (early or late occlusion)" ], "questionsToAsk": [ "How many CABG procedures do you perform annually?", "What is your mortality rate for elective CABG?", "Do you perform off-pump surgery?", "What graft vessels do you prefer and why?", "What cardiac rehabilitation programme do you offer?" ], "overview": "Coronary artery bypass grafting is a major cardiac surgical procedure performed under general anaesthesia, typically lasting three to six hours depending on the number of bypasses required. In conventional on-pump surgery, the heart is arrested and cardiopulmonary bypass (the heart-lung machine) maintains systemic circulation while the surgeon constructs each bypass conduit. The left internal mammary (thoracic) artery is the preferred conduit for the left anterior descending artery bypass due to its superior long-term patency; the great saphenous vein from the leg and the radial artery from the forearm are used as supplementary conduits. In off-pump (beating-heart) surgery, bypasses are constructed on the still-beating heart using mechanical stabilisers, avoiding cardiopulmonary bypass.\n\nPatient selection is based on coronary angiography demonstrating significant stenosis in multiple vessels or in critical locations (left main disease, proximal three-vessel disease) where complete revascularisation by percutaneous coronary intervention is not appropriate. Left ventricular function, the presence of diabetes, and the extent of disease influence the decision between surgical and percutaneous approaches. Pre-operative optimisation of cardiac medications, renal function, and glycaemic control is important for reducing peri-operative risk.\n\nPost-operatively, patients are nursed in the intensive care unit for twenty-four to forty-eight hours before transfer to a high-dependency ward. Hospital stay is typically five to eight days. Sternal healing requires approximately six to eight weeks during which upper extremity loading is restricted. Patients should not drive for four to six weeks. Full functional recovery and return to normal activity typically takes two to three months. Cardiac rehabilitation — a structured exercise and education programme — is an evidence-based component of post-CABG care that significantly reduces re-admission rates and improves long-term outcomes.", "costBreakdown": "CABG represents the highest cost bracket among elective surgical procedures in this guide. Quoted package prices from centres in lower-cost countries typically include the surgical procedure, ICU stay, full inpatient hospital stay (usually seven to ten days), cardiac surgical team fees, anaesthesia, and standard post-operative medications. However, the overall cost is highly sensitive to case complexity: a double bypass in an otherwise healthy elective patient differs enormously in resource use from a triple bypass in a patient with diabetes and impaired renal function.\n\nCosts that may be excluded from package prices include pre-operative cardiac catheterisation and angiography if not already performed, echocardiography, blood products used during surgery, extended ICU stay due to complications, and cardiac rehabilitation. Post-operative medications — including antiplatelet agents, statins, beta-blockers, and ACE inhibitors — represent ongoing costs after discharge. Patients should also clarify whether the package includes medical management of peri-operative complications such as atrial fibrillation (a common post-CABG occurrence requiring rate-control or anticoagulation) or wound infections.", "medicalTourismNotes": "CABG carries the most stringent post-operative travel restrictions of any procedure in this guide. Patients are typically unfit for long-haul air travel for six to eight weeks following surgery due to sternal instability, the risk of in-flight haemodynamic instability, and the greatly elevated risk of deep vein thrombosis and pulmonary embolism. Any patient considering CABG abroad must plan for a stay of at least six to eight weeks near the hospital or must arrange ground or medically supervised repatriation if complications require transfer. Short-haul flights within this period may be feasible in selected patients after individual cardiothoracic assessment.\n\nThe availability and quality of intensive care facilities is a primary consideration when selecting a centre abroad. Patients and family members should verify that the hospital has a cardiac surgical ICU with mechanical circulatory support capability (intra-aortic balloon pump at minimum) and that experienced perfusionists are present for on-pump cases. Operative records, graft configuration diagrams, and discharge medication lists must be obtained before leaving the hospital; these are essential for any cardiologist or cardiac surgeon managing the patient subsequently in the home country. Cardiac rehabilitation must be pre-arranged with a facility in the home country before departure, as early enrolment after discharge is associated with significantly better outcomes.", "recoveryTimeline": "Following surgery, patients spend one to two days in the cardiac surgical intensive care unit, during which ventilatory support is weaned and haemodynamic stability is confirmed. Transfer to a high-dependency or general cardiac ward follows, and the total hospital stay is typically five to seven days. The sternotomy — the vertical incision through the breastbone — is the dominant constraint on early recovery. Sternal precautions, which prohibit pushing or pulling with the arms, lifting anything heavier than approximately one kilogram, and any activity that causes sternal click or pain, are maintained for eight to twelve weeks to allow full bony union.\n\nCardiac rehabilitation, a supervised programme of gradually progressive exercise combined with education on risk factor modification, typically begins four to eight weeks after discharge and runs for six to twelve weeks. Patients generally return to light daily activities within two to four weeks, though driving is not permitted for four to six weeks. Return to sedentary work may be possible at six to eight weeks; physically demanding work may require three months or longer. Full recovery — characterised by resumed exercise tolerance, complete sternal healing, and stable cardiac medications — is typically achieved by three months, with ongoing functional improvement evident over the following year.", "faqs": [ { "question": "How long does a bypass graft last?", "answer": "The internal mammary artery graft — the preferred conduit for the most critical bypass — has a ten-year patency rate exceeding ninety per cent and frequently remains open for twenty years or more. Vein grafts have lower patency rates, with approximately fifty per cent remaining open at ten years. Adherence to cardiac medications and lifestyle modification significantly affects graft longevity." }, { "question": "What is the difference between bypass surgery and a stent?", "answer": "A stent (percutaneous coronary intervention) is inserted via a catheter through the blood vessel to open a blockage from within, without open surgery. Bypass surgery creates a new route around the blockage using a harvested blood vessel. Bypass is generally preferred for extensive multi-vessel disease or left main artery blockages where stenting is less durable." }, { "question": "How long will I be in hospital after CABG?", "answer": "Most patients spend five to eight days in hospital following CABG, including one to two days in the intensive care unit. The exact duration depends on the complexity of surgery, the patient's age and general health, and the absence or presence of post-operative complications such as atrial fibrillation or wound issues." }, { "question": "Will I need to take medication for life after bypass surgery?", "answer": "Yes. Lifelong medications typically include antiplatelet therapy (aspirin), statins, beta-blockers, and often ACE inhibitors. These reduce the risk of graft failure, heart attack, and progression of coronary artery disease. Adherence to medication and risk factor management is a critical determinant of long-term outcomes." }, { "question": "Can I drive after CABG?", "answer": "Driving is not permitted for four to six weeks after CABG, as the ability to perform an emergency stop is impaired during sternal healing and the patient may still be taking medications affecting alertness. Patients should also check with their driving licence authority, as notification of major cardiac surgery may be required in some countries." }, { "question": "What is the mortality risk of bypass surgery?", "answer": "The mortality risk for elective CABG in a low-risk patient at a high-volume centre is approximately one to two per cent. Risk increases with age, emergency surgery, poor left ventricular function, and associated conditions such as kidney disease or diabetes. Patients should ask their surgeon for a risk estimate based on their individual profile." }, { "question": "How soon can I return to normal activities after CABG?", "answer": "Light daily activities are possible within two to four weeks of discharge, though sternal precautions limit upper-body exertion for eight to twelve weeks. Return to sedentary work is typically possible at six to eight weeks, and cardiac rehabilitation — which begins four to eight weeks after discharge — progressively rebuilds exercise capacity." }, { "question": "What lifestyle changes are necessary after bypass surgery?", "answer": "Bypass surgery treats blocked arteries but does not stop the underlying disease process. Long-term success requires smoking cessation, a heart-healthy diet low in saturated fat, regular moderate exercise, blood pressure and cholesterol management, and strict adherence to prescribed medications. Cardiac rehabilitation programmes provide structured support for these changes." } ], "relatedProcedures": [ "knee-replacement" ], "aliases": [], "eligibility": [ { "criterion": "Significant multi-vessel coronary disease unsuitable for percutaneous intervention", "sourceSlugs": [ "aha-cabg-guideline-2021" ] }, { "criterion": "Cardiac function and comorbidities reviewed by multidisciplinary heart team", "sourceSlugs": [ "aha-cabg-guideline-2021" ] }, { "criterion": "Adequate target vessels for grafting on coronary angiography", "sourceSlugs": [ "aha-cabg-guideline-2021" ] } ], "contraindications": [ { "contraindication": "Diffuse, severely calcified coronary disease without graftable vessels", "sourceSlugs": [ "aha-cabg-guideline-2021" ] }, { "contraindication": "Very severe LV dysfunction without viability evidence", "sourceSlugs": [ "aha-cabg-guideline-2021" ] }, { "contraindication": "Severe non-cardiac comorbidity making operative risk prohibitive", "sourceSlugs": [ "aha-cabg-guideline-2021" ] } ], "risks": [ { "name": "Stroke (peri-operative)", "severity": "severe", "rate": { "value": 0.015, "range": [ 0.01, 0.03 ] }, "prevention": "Off-pump techniques in selected patients; carotid screening; intra-operative monitoring.", "sourceSlugs": [ "sts-adult-cardiac-database", "aha-cabg-guideline-2021" ] }, { "name": "Sternal wound infection", "severity": "severe", "rate": { "value": 0.02, "range": [ 0.01, 0.04 ] }, "prevention": "Antibiotic prophylaxis; tight glycaemic control; bilateral internal mammary artery use cautiously in diabetics.", "sourceSlugs": [ "aha-cabg-guideline-2021" ] }, { "name": "Atrial fibrillation (post-op)", "severity": "moderate", "rate": { "value": 0.3, "range": [ 0.2, 0.4 ] }, "prevention": "Beta-blocker continuation; amiodarone in high-risk patients.", "sourceSlugs": [ "aha-cabg-guideline-2021" ] }, { "name": "Renal failure", "severity": "severe", "rate": { "value": 0.05 }, "prevention": "Avoidance of nephrotoxins; haemodynamic optimisation.", "sourceSlugs": [ "aha-cabg-guideline-2021" ] }, { "name": "Graft failure (long-term)", "severity": "moderate", "rate": { "value": 0.1, "range": [ 0.05, 0.2 ] }, "prevention": "Use of left internal mammary artery to LAD; aspirin and statin lifelong; smoking cessation.", "sourceSlugs": [ "aha-cabg-guideline-2021" ] } ], "subtypes": [ "cabg-off-pump" ], "followUpCadence": [ { "at": "1 week", "type": "Wound check and discharge follow-up", "required": true }, { "at": "6 weeks", "type": "Cardiac rehabilitation review", "required": true }, { "at": "3 months", "type": "Symptoms and exercise tolerance assessment", "required": true }, { "at": "Annual", "type": "Long-term cardiology surveillance", "required": true } ], "recordsToObtain": [ "Pre-op coronary angiography report", "Operative report including grafts performed (LIMA/SVG/radial)", "Anaesthetic record", "Cardiopulmonary bypass record", "Discharge medications and rehabilitation plan" ], "anaesthesia": "general", "operatingTime": { "lowMinutes": 180, "highMinutes": 360, "sourceSlugs": [ "aha-cabg-guideline-2021", "sts-adult-cardiac-database" ] }, "hospitalStay": { "lowNights": 5, "highNights": 10, "sourceSlugs": [ "aha-cabg-guideline-2021", "sts-adult-cardiac-database" ] }, "minimumInCountryDays": { "low": 21, "high": 28, "sourceSlugs": [ "aha-cabg-guideline-2021" ] }, "daysToFly": { "low": 21, "high": 42, "explanation": "Major cardiac surgery; flying typically not advised for 3-6 weeks per IATA medical guidance, longer for complex cases.", "sourceSlugs": [ "iata-medical-cabin-guidance", "aha-cabg-guideline-2021" ] }, "complicationRate": { "value": 10, "range": [ 5, 15 ], "sourceSlugs": [ "sts-adult-cardiac-database" ] }, "mortalityRate": { "value": 2, "range": [ 1, 4 ], "sourceSlugs": [ "sts-adult-cardiac-database", "aha-cabg-guideline-2021" ] }, "numberOfVisits": { "typical": 6, "minimum": 4 }, "recoveryByActivity": { "sedentaryWork": { "days": 42, "sourceSlugs": [ "aha-cabg-guideline-2021" ] }, "manualWork": { "days": 84, "sourceSlugs": [ "aha-cabg-guideline-2021" ] }, "lightExercise": { "days": 42, "sourceSlugs": [ "aha-cabg-guideline-2021" ] }, "vigorousExercise": { "days": 84, "sourceSlugs": [ "aha-cabg-guideline-2021" ] }, "swimming": { "days": 56, "sourceSlugs": [ "aha-cabg-guideline-2021" ] }, "flying": { "days": 28, "sourceSlugs": [ "iata-medical-cabin-guidance" ] }, "driving": { "days": 42, "sourceSlugs": [ "aha-cabg-guideline-2021" ] } }, "literatureLinks": [ { "title": "Inspiratory muscle training to reduce risk of pulmonary complications after coronary artery bypass grafting: a systematic review and meta-analysis.", "journal": "Frontiers in cardiovascular medicine", "year": 2023, "doi": "10.3389/fcvm.2023.1223619", "url": "https://doi.org/10.3389/fcvm.2023.1223619" }, { "title": "Exercise-based cardiac rehabilitation for patients undergoing coronary artery operation: a systematic review and meta-analysis based on current randomized controlled trials.", "journal": "International journal of surgery (London, England)", "year": 2025, "doi": "10.1097/JS9.0000000000002268", "url": "https://doi.org/10.1097/JS9.0000000000002268" }, { "title": "Heart Rate Variability and Coronary Artery Bypass Grafting: A Systematic Review.", "journal": "Reviews in cardiovascular medicine", "year": 2024, "doi": "10.31083/j.rcm2501036", "url": "https://doi.org/10.31083/j.rcm2501036" } ], "alternativeTreatments": [ { "name": "Percutaneous coronary intervention (angioplasty + stents)", "procedureSlug": "angioplasty-stents", "rationale": "Less invasive alternative for single-vessel or selected multi-vessel disease; lower upfront mortality but higher repeat-revascularisation rate.", "sourceSlugs": [ "esc-cabg-guidelines" ] }, { "name": "Off-pump CABG", "procedureSlug": "cabg-off-pump", "rationale": "Beating-heart variant; comparable outcomes in selected centres, lower CPB-associated morbidity.", "sourceSlugs": [ "esc-cabg-guidelines" ] }, { "name": "Optimal medical therapy alone", "rationale": "Appropriate when symptoms are controllable and anatomy is not high-risk; no procedural risk.", "sourceSlugs": [ "esc-cabg-guidelines" ] } ], "accreditationsRequired": [ "national-cardiac-surgery-board", "jci-hospital-accreditation" ] }, { "slug": "chemotherapy", "name": "Chemotherapy", "category": "oncology", "description": "Chemotherapy is the systemic delivery of cytotoxic drugs to kill or slow the growth of cancer cells. The term spans many drug classes — alkylating agents, antimetabolites, antimicrotubule agents, topoisomerase inhibitors, anthracyclines and others — and many delivery routes (intravenous, oral, intrathecal, intra-arterial). Regimens are typically defined by cancer type, stage, and patient fitness, and are delivered as a sequence of cycles with rest periods to allow normal tissues to recover. Modern oncology increasingly combines cytotoxic chemotherapy with targeted therapies, immunotherapies, hormonal agents, and radiotherapy in carefully sequenced protocols. Travelling abroad for chemotherapy is uncommon and should be considered cautiously: continuity of care across cycles, access to emergency services for febrile neutropenia, and integration with home-country surveillance imaging are easier to manage when treatment is delivered close to where the patient lives.", "averageRecoveryDays": 21, "typicalSessions": 6, "priceRangeUSD": { "low": 5000, "high": 30000 }, "keyConsiderations": [ "Continuity of care with the home oncology team matters more than for surgical procedures", "Febrile neutropenia is a medical emergency — local emergency-care access is essential", "Cardiotoxicity (anthracyclines) and cumulative dose limits affect future treatment", "Surveillance imaging at 3, 6, 12 months is standard for most cancers" ], "commonRisks": [ "Nausea and vomiting", "Hair loss", "Immunosuppression and infection risk", "Fatigue", "Organ toxicity (cardiac, renal, hepatic)", "Neuropathy" ], "questionsToAsk": [ "What chemotherapy protocol do you recommend and why?", "What are the expected side effects of this specific regimen?", "What supportive medications are included in the cost?", "What monitoring will be done between cycles?", "What is your infection control protocol for immunosuppressed patients?" ], "overview": "Chemotherapy is a systemic cancer treatment that uses one or more cytotoxic drugs to destroy rapidly dividing cells throughout the body. It may be used as a primary treatment, in combination with surgery or radiotherapy, or as palliative care to control disease progression. Treatment is organised in cycles — a period of drug administration followed by a rest period — with most protocols spanning three to six months.\n\nCandidacy depends on the type and stage of cancer, the patient's overall fitness, organ function, and prior treatment history. Not all cancers respond equally to chemotherapy; haematological malignancies and testicular cancer tend to be highly chemo-sensitive, while other solid tumours may require combination approaches. Some patients seek chemotherapy abroad to access specific drugs that are unavailable, prohibitively expensive, or subject to long waiting lists in their home country.\n\nThe treatment experience varies considerably by regimen. Some protocols involve brief outpatient infusions with manageable side effects, while others require multi-day inpatient admissions and intensive supportive care. Patients should understand that outcomes depend heavily on the quality of the treating institution's oncology infrastructure, laboratory monitoring capabilities, and access to emergency care for complications such as febrile neutropenia.\n\nChemotherapy drugs fall into several broad classes, each targeting different mechanisms of cell division. Alkylating agents damage DNA directly, antimetabolites interfere with DNA and RNA synthesis, and taxanes disrupt the mitotic spindle. Newer targeted agents — including monoclonal antibodies and tyrosine kinase inhibitors — act on specific molecular pathways driving tumour growth, offering improved selectivity but at substantially higher cost. Combination regimens using drugs from different classes are standard practice for most cancers, designed to attack tumour cells through multiple mechanisms and reduce the likelihood of resistance. The choice of protocol is guided by tumour histology, molecular profiling, clinical staging, and published evidence from randomised controlled trials.", "costBreakdown": "Chemotherapy costs are dominated by the price of the drugs themselves, which can range from a few hundred dollars per cycle for conventional agents to tens of thousands for biologics, targeted therapies, and immunotherapy. A full course of conventional chemotherapy may cost $5,000–$15,000 in lower-cost countries, whereas targeted or immunotherapy regimens can exceed $50,000 even abroad.\n\nAdditional costs include supportive medications (antiemetics, growth factors, anti-infective prophylaxis), inter-cycle blood tests and imaging, port placement if central access is required, and facility fees for day-unit or inpatient admissions. Patients should request a fully itemised protocol cost covering all anticipated cycles, supportive care, and monitoring.\n\nPatients should be aware that quoted per-cycle prices may not include the full range of supportive medications, which can represent 15–25% of the total treatment cost. Growth factors such as filgrastim, used to prevent dangerous drops in white blood cell counts, can cost several hundred dollars per injection. Anti-nausea regimens for highly emetogenic protocols may include multiple agents administered before and after each infusion.", "medicalTourismNotes": "Chemotherapy is among the most complex procedures to manage as a medical tourist due to its extended duration and the need for close medical supervision throughout. Patients must remain within reasonable proximity of the treating hospital during active cycles because of immunosuppression-related infection risk.\n\nCoordination with a home-country oncologist is essential. Complete medical records — including pathology reports, staging investigations, and molecular profiling — must be transferred and reviewed before treatment begins. Some patients travel specifically to access clinical trials or drugs not approved domestically; this requires careful verification that the institution has appropriate trial infrastructure and regulatory approvals.\n\nPatients considering oncology treatment abroad should verify that the treating institution has a fully equipped oncology day unit, 24-hour emergency cover with access to blood products and broad-spectrum antibiotics, and a multidisciplinary tumour board that reviews complex cases. Ensuring continuity of care between the overseas oncologist and the home-country team is critical for long-term management, surveillance, and any subsequent lines of treatment.", "recoveryTimeline": "Recovery from chemotherapy is best understood as two overlapping rhythms: the per-cycle pattern that repeats with each infusion, and the cumulative trajectory across the whole treatment course.\n\n**Per-cycle pattern (typically 2-3 weeks):** the infusion day and the following two to three days are usually the most difficult, with peak nausea, fatigue, and general malaise. Modern antiemetic protocols have substantially reduced acute nausea but breakthrough symptoms still occur. The 'nadir' — when blood counts reach their lowest point — typically falls between days 7 and 14 after infusion. Infection risk is highest during the nadir; patients are advised to monitor temperature daily and to seek emergency care immediately for any febrile episode (≥38°C). Energy and appetite usually begin to recover in the second week, with most patients feeling close to baseline by the time the next cycle begins.\n\n**Cumulative trajectory:** fatigue, hair loss (with some regimens), peripheral neuropathy (with platinum-based and taxane regimens), and changes in skin and nails build over successive cycles. Hair thinning or loss typically begins around weeks 2-3 and may persist throughout treatment. Cognitive symptoms ('chemo brain' — slowed processing, word-finding difficulties) develop in a meaningful minority and usually improve over the months after the final cycle.\n\n**Post-treatment recovery:** after the final cycle, most short-term effects (nausea, peak fatigue, immune suppression) resolve within four to eight weeks. Hair regrowth usually begins within four to six weeks and is initially fine and sometimes a different texture or colour from pre-treatment hair. Full recovery of energy, exercise capacity, and immune function typically takes two to four months. Some effects — neuropathy, fertility impairment, fatigue — can persist for many months or be permanent depending on the regimen and dose. Surveillance imaging at 3, 6, and 12 months is standard for most cancers, with the schedule tailored to disease and risk.", "faqs": [ { "question": "Will I lose my hair during chemotherapy?", "answer": "Hair loss depends on the specific drugs used. Some regimens cause complete hair loss, others cause thinning, and some cause none at all. Hair typically begins to fall out one to three weeks after the first treatment and regrows within two to three months of completing chemotherapy." }, { "question": "Can I work during chemotherapy?", "answer": "Many patients continue working during chemotherapy, particularly in less physically demanding roles. The ability to work depends on the regimen's intensity, the individual's response, and the nature of the job. Planning around the nadir period — when fatigue and infection risk peak — is advisable." }, { "question": "What should I eat during chemotherapy?", "answer": "A varied, nutritious diet is important to maintain strength and support immune function. Nausea may limit appetite, and a dietitian can advise on strategies to maintain adequate intake. High-risk foods such as raw meat, unpasteurised dairy, and unwashed produce should be avoided during immunosuppressed periods." }, { "question": "How do I know if chemotherapy is working?", "answer": "Response to chemotherapy is assessed through regular imaging — CT scans, PET scans, or MRI — and blood tumour markers if applicable. These are typically performed after two to three cycles to determine whether the regimen is achieving the intended response. The treating oncologist will discuss findings and adjust the plan if necessary." }, { "question": "What is febrile neutropenia and why is it serious?", "answer": "Febrile neutropenia occurs when chemotherapy reduces white blood cell counts to critically low levels and an infection develops, causing fever. Because the immune system cannot mount a normal response, this can progress rapidly to life-threatening sepsis. It requires emergency hospitalisation and prompt intravenous antibiotics." }, { "question": "Are the side effects of chemotherapy permanent?", "answer": "Most side effects — including nausea, fatigue, and hair loss — are temporary and resolve after treatment ends. Some drugs carry a risk of longer-lasting or permanent effects, including peripheral neuropathy (tingling or numbness in the hands and feet), cardiac effects with certain agents, and in rare cases, secondary malignancies." }, { "question": "Can I travel during chemotherapy?", "answer": "Travel is generally best avoided during the nadir period when infection risk is highest. Short trips between cycles may be feasible when blood counts have recovered, but patients should carry medical records, have access to emergency care at the destination, and avoid crowded public spaces and sick contacts." }, { "question": "What is the difference between chemotherapy and immunotherapy?", "answer": "Chemotherapy directly kills rapidly dividing cells using cytotoxic drugs. Immunotherapy works differently — it activates or modulates the patient's own immune system to recognise and attack cancer cells. Many patients now receive combinations of both approaches, and immunotherapy has dramatically improved outcomes for certain cancers including melanoma and lung cancer." } ], "relatedProcedures": [], "aliases": [], "eligibility": [ { "criterion": "Pathologically confirmed diagnosis with clear treatment indication", "sourceSlugs": [ "esmo-clinical-practice-guidelines" ] }, { "criterion": "Performance status compatible with regimen toxicity", "sourceSlugs": [ "esmo-clinical-practice-guidelines" ] }, { "criterion": "Adequate organ function (cardiac, renal, hepatic, haematological)", "sourceSlugs": [ "esmo-clinical-practice-guidelines" ] }, { "criterion": "Reliable access to local emergency care during cycles", "sourceSlugs": [ "asco-chemo-safety-standards" ] } ], "contraindications": [ { "contraindication": "Severe organ dysfunction without regimen modification", "sourceSlugs": [ "esmo-clinical-practice-guidelines" ] }, { "contraindication": "Active uncontrolled infection at start of cycle", "sourceSlugs": [ "esmo-clinical-practice-guidelines" ] }, { "contraindication": "Pregnancy in first trimester (regimen-dependent)", "sourceSlugs": [ "esmo-clinical-practice-guidelines" ] } ], "risks": [ { "name": "Febrile neutropenia (life-threatening infection during low blood counts)", "severity": "severe", "rate": { "value": 0.2, "range": [ 0.1, 0.3 ] }, "prevention": "G-CSF prophylaxis in high-risk regimens; patient education on temperature monitoring; immediate access to emergency care.", "sourceSlugs": [ "asco-chemo-safety-standards", "esmo-clinical-practice-guidelines" ] }, { "name": "Infusion reaction or anaphylaxis", "severity": "severe", "rate": { "value": 0.05, "range": [ 0.02, 0.1 ] }, "prevention": "Pre-medication for high-risk drugs; trained team with emergency access.", "sourceSlugs": [ "asco-chemo-safety-standards" ] }, { "name": "Cardiotoxicity (anthracycline-related)", "severity": "severe", "rate": { "value": 0.05, "range": [ 0.02, 0.15 ] }, "prevention": "Cumulative dose limits; baseline and serial echocardiography; cardioprotective agents.", "sourceSlugs": [ "esmo-clinical-practice-guidelines" ] }, { "name": "Nausea and vomiting", "severity": "minor", "rate": { "value": 0.5, "range": [ 0.3, 0.8 ] }, "prevention": "Combination antiemetic regimen tailored to emetogenic risk.", "sourceSlugs": [ "esmo-clinical-practice-guidelines" ] }, { "name": "Long-term effects (secondary malignancy, infertility, organ dysfunction)", "severity": "severe", "rate": { "value": 0.05, "range": [ 0.01, 0.1 ] }, "prevention": "Use of regimen-specific lowest-effective dose; fertility preservation referral.", "sourceSlugs": [ "esmo-clinical-practice-guidelines" ] } ], "subtypes": [], "followUpCadence": [ { "at": "Mid-cycle", "type": "Blood count and toxicity review", "required": true }, { "at": "Start of next cycle", "type": "Pre-cycle assessment", "required": true }, { "at": "End of treatment", "type": "Response assessment imaging", "required": true }, { "at": "3, 6, 12 months", "type": "Surveillance imaging and bloods (regimen-dependent)", "required": true } ], "recordsToObtain": [ "Pathology report establishing diagnosis", "Staging investigations (imaging, biopsy)", "Treatment plan with regimen, doses, and cycles", "Drug delivery records (which dose given on which day)", "Toxicity log", "Discharge plan for ongoing surveillance at home" ], "anaesthesia": "varies", "operatingTime": { "lowMinutes": 60, "highMinutes": 360, "sourceSlugs": [ "asco-chemo-safety-standards", "esmo-clinical-practice-guidelines" ] }, "hospitalStay": { "lowNights": 0, "highNights": 5, "sourceSlugs": [ "asco-chemo-safety-standards" ] }, "minimumInCountryDays": { "low": 7, "high": 21, "sourceSlugs": [ "asco-chemo-safety-standards" ] }, "daysToFly": { "low": 1, "high": 3, "explanation": "Specific to regimen and immune status; immunocompromised patients should consult oncologist before flying due to infection risk.", "sourceSlugs": [ "asco-chemo-safety-standards", "iata-medical-cabin-guidance" ] }, "complicationRate": { "value": 30, "range": [ 20, 50 ], "sourceSlugs": [ "esmo-clinical-practice-guidelines" ] }, "numberOfVisits": { "typical": 8, "minimum": 6 }, "recoveryByActivity": { "sedentaryWork": { "days": 7, "sourceSlugs": [ "esmo-clinical-practice-guidelines" ] }, "manualWork": { "days": 14, "sourceSlugs": [ "esmo-clinical-practice-guidelines" ] }, "lightExercise": { "days": 3, "sourceSlugs": [ "esmo-clinical-practice-guidelines" ] }, "vigorousExercise": { "days": 14, "sourceSlugs": [ "esmo-clinical-practice-guidelines" ] }, "flying": { "days": 3, "sourceSlugs": [ "iata-medical-cabin-guidance" ] }, "driving": { "days": 3, "sourceSlugs": [ "esmo-clinical-practice-guidelines" ] }, "swimming": { "days": 14, "sourceSlugs": [ "esmo-clinical-practice-guidelines" ] } }, "literatureLinks": [ { "title": "NALIRIFOX, FOLFIRINOX, and Gemcitabine With Nab-Paclitaxel as First-Line Chemotherapy for Metastatic Pancreatic Cancer: A Systematic Review and Meta-Analysis.", "journal": "JAMA network open", "year": 2024, "doi": "10.1001/jamanetworkopen.2023.50756", "url": "https://doi.org/10.1001/jamanetworkopen.2023.50756" }, { "title": "Therapeutic Fasting in Reducing Chemotherapy Side Effects in Cancer Patients: A Systematic Review and Meta-Analysis.", "journal": "Nutrients", "year": 2023, "doi": "10.3390/nu15122666", "url": "https://doi.org/10.3390/nu15122666" }, { "title": "Chemotherapy switch for localized pancreatic cancer: a systematic review and meta-analysis.", "journal": "The British journal of surgery", "year": 2024, "doi": "10.1093/bjs/znae244", "url": "https://doi.org/10.1093/bjs/znae244" } ], "alternativeTreatments": [ { "name": "Immunotherapy (checkpoint inhibitors)", "rationale": "Replacing or adjuncting chemo in many cancers; very tumor-type-specific.", "sourceSlugs": [ "nccn-guidelines" ] }, { "name": "Targeted therapy", "rationale": "When the tumour expresses a druggable mutation; can be more effective and less toxic.", "sourceSlugs": [ "nccn-guidelines" ] }, { "name": "Radiation therapy", "rationale": "Local-control alternative when systemic spread is not the primary concern.", "sourceSlugs": [ "nccn-guidelines" ] }, { "name": "Best supportive care", "rationale": "When treatment goals are palliative and quality-of-life is the priority.", "sourceSlugs": [ "nccn-guidelines" ] } ], "accreditationsRequired": [ "esmo-clinical-centre", "acs-coc-cancer-program", "jci-hospital-accreditation" ] }, { "slug": "hernia-repair", "name": "Hernia Repair", "category": "general-surgery", "description": "Hernia repair surgically corrects a protrusion of tissue (most commonly fat, omentum or bowel) through a weakness in the abdominal wall. The most common varieties are inguinal (groin), femoral, umbilical, epigastric, and incisional hernias; surgical principles are similar across all but operative approach varies. Two main techniques exist: open repair, in which the surgeon accesses the hernia through a single incision and reinforces the defect with sutures and/or a synthetic mesh, and laparoscopic (or robotic) repair, which uses small ports and a camera to place mesh from the inside of the abdominal wall. NICE TA160 supports the laparoscopic approach for selected primary unilateral inguinal hernias and for bilateral and recurrent cases, where it is associated with faster return to activity at the cost of slightly longer operating time. The choice of approach depends on hernia type, size, prior surgery, patient comorbidity and surgeon experience. Synthetic mesh has become the standard of care for most adult repairs because of materially lower recurrence rates than primary suture repair, though the trade-off is a small risk of mesh-related chronic pain or infection.", "averageRecoveryDays": 14, "typicalSessions": 1, "priceRangeUSD": { "low": 1500, "high": 6000 }, "keyConsiderations": [ "Mesh vs non-mesh affects recurrence and chronic-pain risk", "Open vs laparoscopic approach depends on hernia type, size, and surgeon experience", "Activity restrictions (no heavy lifting 4-6 weeks) reduce recurrence", "Pre-operative ultrasound or CT for complex/incisional cases" ], "commonRisks": [ "Chronic pain at the repair site", "Mesh-related complications (infection, migration)", "Recurrence of the hernia", "Seroma or haematoma formation", "Injury to surrounding structures" ], "questionsToAsk": [ "Do you recommend laparoscopic or open repair?", "What type of mesh do you use?", "What is your recurrence rate?", "How many hernia repairs do you perform annually?", "When can I return to physical activity?" ], "overview": "A hernia occurs when an organ or fatty tissue protrudes through a weak point in the surrounding muscle or connective tissue. Inguinal hernias are the most common type, followed by umbilical, incisional, and hiatal hernias. Surgical repair is the definitive treatment, as hernias do not resolve spontaneously and carry a risk of incarceration or strangulation.\n\nTwo primary surgical approaches are used. Open repair involves a single incision over the hernia site, reduction of the protruding tissue, and reinforcement with synthetic mesh. Laparoscopic repair uses three small incisions and a camera to perform the same correction. Laparoscopic repair generally offers faster recovery and less post-operative pain but requires general anaesthesia.\n\nThe mesh vs. non-mesh debate remains active. Mesh repair significantly reduces recurrence rates but introduces a foreign body that carries its own complications, including chronic pain and mesh migration. Many hernia repairs are performed as day-case surgery, with patients discharged the same day.\n\nThe patient experience differs meaningfully between the two approaches. Open repair under local anaesthesia is feasible for straightforward inguinal hernias and allows same-day discharge in most cases. Laparoscopic repair requires general anaesthesia and insufflation of the abdomen with carbon dioxide gas, which can cause temporary shoulder-tip pain and bloating. However, laparoscopic patients typically report less incisional pain, faster return to normal activities, and lower rates of chronic groin pain compared with open mesh repair. For bilateral inguinal hernias, laparoscopic repair is generally preferred as both sides can be addressed through the same three port sites without additional incisions.\n\nRecurrence rates are the principal long-term outcome measure. Modern mesh-reinforced repair — whether open or laparoscopic — achieves recurrence rates below 2% in most published series, a substantial improvement over historical tissue-only repair rates of 10–15%. Surgeon volume correlates with outcomes: high-volume hernia surgeons consistently demonstrate lower complication and recurrence rates. Patients should enquire about the surgeon's annual caseload and whether the facility maintains a hernia-specific outcomes registry.", "costBreakdown": "The quoted price typically covers the surgeon's fee, anaesthesia, operating theatre time, and mesh. Laparoscopic repair is generally more expensive due to specialised equipment. The type of mesh — standard polypropylene, lightweight composite, or biological — significantly affects materials cost.\n\nAdditional costs may include pre-operative assessment, post-operative analgesics, and follow-up appointments. Day-case surgery is cheaper than an overnight stay. Patients should confirm whether the quoted price covers standard or complex repair.\n\nFor patients considering bilateral repair, laparoscopic approaches typically offer a cost advantage since both sides are repaired through the same port sites and a single anaesthetic session, whereas open bilateral repair may be quoted as two separate procedures. Facility fees vary between dedicated day-surgery centres (typically cheaper) and full hospital operating theatres. Patients should also confirm whether the quoted price includes the pre-operative assessment, as some facilities charge separately for blood tests, ECG, and anaesthetic review. Post-operative wound care supplies and prescription analgesics are usually modest costs but should be confirmed as included or additional.", "medicalTourismNotes": "Hernia repair is well-suited to medical tourism due to its straightforward recovery profile and low complication rate. A stay of five to ten days is generally sufficient, encompassing the procedure, initial recovery, and a wound check before departure. Sutures or clips require removal at seven to ten days if non-absorbable materials are used; absorbable sutures eliminate this requirement.\n\nPre-operative imaging (typically ultrasound, sometimes CT for complex or incisional hernias) should be obtained before travel and sent to the surgical team in advance so that the approach and mesh selection can be discussed prior to arrival. Patients with complex, recurrent, or large incisional hernias should specifically confirm the treating surgeon's experience with these more demanding cases — recurrence and complication rates are materially higher than for primary repair, and component-separation or biological-mesh techniques may be required.\n\nFlying is generally safe three to five days after uncomplicated laparoscopic repair and seven days after open repair. Long-haul flights warrant DVT prophylaxis per IATA medical guidance. Patients should arrange a wound review with a local practitioner within two weeks of returning home, and observe activity restrictions (no heavy lifting for four to six weeks) — many recurrences are precipitated by premature return to lifting. Travel insurance should explicitly confirm coverage of the procedure and any complications; many travel-only policies exclude planned surgery.", "recoveryTimeline": "Day 0-2: most patients are mobilised within hours of surgery and discharged the same day (laparoscopic) or after one overnight stay (open). Mild abdominal discomfort and bloating from carbon-dioxide insufflation are common after laparoscopic repair and resolve within 48 hours. Open-repair patients typically experience moderate incisional pain controlled with simple analgesics and a short course of opioids.\n\nDay 3-7: pain reduces substantially. Wound dressings can usually be removed at days 3-5. Walking and stair-climbing are encouraged. Light household tasks are permissible. The wound should be inspected daily for redness, discharge, or increasing swelling — any of which warrants clinical review.\n\nWeek 2: a wound review (sutures-out if non-absorbable) is standard at 7-10 days. Most patients can return to sedentary or desk-based work at this point after laparoscopic repair, slightly later (10-14 days) after open repair. Driving may resume when the patient can perform an emergency stop without pain.\n\nWeek 3-6: gradual return to activity. Heavy lifting, vigorous exercise, and contact sport should be avoided for four to six weeks to allow the repair (and any mesh) to consolidate. Premature return to lifting is one of the more common precipitants of recurrence.\n\nMonth 3 onwards: full activity is generally permitted. Persistent pain at this stage warrants surgical review — chronic post-operative pain affects roughly 5-10% of patients and may benefit from nerve-blockade or, occasionally, surgical neurectomy. A check at three months is standard for symptomatic resolution and recurrence assessment.", "faqs": [ { "question": "Does a hernia need to be repaired immediately?", "answer": "Not necessarily. Small, asymptomatic hernias may be managed with watchful waiting, particularly in elderly patients where surgical risk outweighs benefit. However, hernias that cause pain, are enlarging, or show any sign of incarceration — where the protruding tissue becomes trapped — require prompt surgical attention." }, { "question": "Can a hernia come back after surgery?", "answer": "Recurrence is possible but uncommon with modern mesh-reinforced repair, with rates below two per cent in most published series for primary inguinal hernias. Risk of recurrence is higher for complex, recurrent, or incisional hernias. Avoiding heavy lifting during the recovery period supports durable healing." }, { "question": "What is the difference between laparoscopic and open hernia repair?", "answer": "Open repair uses a single larger incision directly over the hernia site, which can be performed under local or general anaesthesia. Laparoscopic repair uses three small port incisions and a camera, requires general anaesthesia, and generally results in less post-operative pain, faster recovery, and lower rates of chronic groin pain." }, { "question": "Is mesh safe for hernia repair?", "answer": "Synthetic mesh has been used in hernia repair for decades and has substantially reduced recurrence rates compared with tissue-only repair. Most patients experience no mesh-related problems. A small proportion develop chronic pain or, rarely, mesh migration or infection, which may require further surgery. Biological and lightweight meshes have been developed to reduce these risks." }, { "question": "Will I have a scar after hernia surgery?", "answer": "Open repair leaves a scar at the incision site — typically three to six centimetres for inguinal hernias — which fades over twelve to eighteen months. Laparoscopic repair produces three small port-site scars, each approximately one centimetre, which are often barely visible once healed." }, { "question": "When can I return to work after hernia repair?", "answer": "Most patients return to desk-based or light work within one to two weeks of laparoscopic repair and two to three weeks after open repair. Jobs involving heavy manual labour or lifting may require four to six weeks off work to allow the repair to consolidate." }, { "question": "What does a hernia feel like?", "answer": "Most hernias present as a visible or palpable bulge, typically in the groin, navel, or at a previous surgical scar, that may become more prominent on standing or straining. They may cause a dragging discomfort or aching sensation, particularly after prolonged activity. Some hernias are discovered incidentally without symptoms." }, { "question": "Can hernia repair be done under local anaesthesia?", "answer": "Open inguinal hernia repair can be performed safely under local anaesthesia with or without sedation in suitable patients, particularly those with medical conditions that increase the risk of general anaesthesia. Laparoscopic repair requires general anaesthesia. Local anaesthetic repair is associated with shorter hospital stay and faster return to normal activities in selected patients." } ], "relatedProcedures": [ "abdominoplasty", "knee-replacement" ], "aliases": [], "eligibility": [ { "criterion": "Symptomatic hernia (pain, bulge, functional limitation)", "sourceSlugs": [ "nice-ta160-laparoscopic-hernia" ] }, { "criterion": "Cardiopulmonary fitness for general anaesthesia", "sourceSlugs": [ "rcoa-standards-anaesthesia" ] }, { "criterion": "Smoking cessation 4 weeks pre-op (recommended)", "sourceSlugs": [ "who-surgical-safety-checklist" ] } ], "contraindications": [ { "contraindication": "Active local infection at planned mesh site", "sourceSlugs": [ "who-surgical-safety-checklist" ] }, { "contraindication": "Severe medical comorbidity precluding general anaesthesia (consider local-anaesthetic open repair)", "sourceSlugs": [ "nice-ta160-laparoscopic-hernia" ] } ], "risks": [ { "name": "Recurrence", "severity": "moderate", "rate": { "value": 0.03, "range": [ 0.01, 0.1 ] }, "prevention": "Mesh reinforcement; tension-free repair; smoking cessation pre-op.", "sourceSlugs": [ "cochrane-laparoscopic-vs-open-hernia" ] }, { "name": "Chronic post-operative pain", "severity": "moderate", "rate": { "value": 0.1, "range": [ 0.05, 0.15 ] }, "prevention": "Nerve preservation in open repair; lightweight mesh; laparoscopic approach in selected patients.", "sourceSlugs": [ "nice-ta160-laparoscopic-hernia" ] }, { "name": "Mesh infection", "severity": "severe", "rate": { "value": 0.005 }, "prevention": "Antibiotic prophylaxis; sterile technique.", "sourceSlugs": [ "who-surgical-safety-checklist" ] }, { "name": "Seroma or haematoma", "severity": "minor", "rate": { "value": 0.05 }, "prevention": "Meticulous haemostasis; drains in selected cases.", "sourceSlugs": [ "cochrane-laparoscopic-vs-open-hernia" ] }, { "name": "Bowel or bladder injury (laparoscopic approach)", "severity": "severe", "rate": { "value": 0.005 }, "prevention": "Careful trocar placement; experienced laparoscopic team.", "sourceSlugs": [ "cochrane-laparoscopic-vs-open-hernia" ] } ], "subtypes": [ "hernia-repair-lap" ], "followUpCadence": [ { "at": "1 week", "type": "Wound check", "required": true }, { "at": "6 weeks", "type": "Return-to-activity review", "required": true }, { "at": "3 months", "type": "Pain and functional assessment", "required": true } ], "recordsToObtain": [ "Operative report including approach (open/lap) and mesh type/size", "Mesh manufacturer and lot number", "Anaesthetic record", "Discharge instructions on activity restrictions" ], "anaesthesia": "general", "operatingTime": { "lowMinutes": 45, "highMinutes": 120, "sourceSlugs": [ "nice-ta160-laparoscopic-hernia", "cochrane-laparoscopic-vs-open-hernia" ] }, "hospitalStay": { "lowNights": 0, "highNights": 1, "sourceSlugs": [ "nice-ta160-laparoscopic-hernia" ] }, "minimumInCountryDays": { "low": 3, "high": 7, "sourceSlugs": [ "nice-ta160-laparoscopic-hernia" ] }, "daysToFly": { "low": 3, "high": 7, "explanation": "Open vs laparoscopic affects flying timeline; laparoscopic repairs often allow flying within 3-5 days, open repairs typically 7 days.", "sourceSlugs": [ "iata-medical-cabin-guidance", "nice-ta160-laparoscopic-hernia" ] }, "complicationRate": { "value": 5, "range": [ 2, 10 ], "sourceSlugs": [ "cochrane-laparoscopic-vs-open-hernia" ] }, "revisionRate": { "value": 3, "range": [ 1, 5 ], "sourceSlugs": [ "cochrane-laparoscopic-vs-open-hernia" ] }, "numberOfVisits": { "typical": 2, "minimum": 1 }, "recoveryByActivity": { "sedentaryWork": { "days": 10, "sourceSlugs": [ "nice-ta160-laparoscopic-hernia" ] }, "manualWork": { "days": 28, "sourceSlugs": [ "nice-ta160-laparoscopic-hernia" ] }, "lightExercise": { "days": 14, "sourceSlugs": [ "nice-ta160-laparoscopic-hernia" ] }, "vigorousExercise": { "days": 42, "sourceSlugs": [ "nice-ta160-laparoscopic-hernia" ] }, "swimming": { "days": 21, "sourceSlugs": [ "nice-ta160-laparoscopic-hernia" ] }, "flying": { "days": 5, "sourceSlugs": [ "iata-medical-cabin-guidance" ] }, "driving": { "days": 7, "sourceSlugs": [ "nice-ta160-laparoscopic-hernia" ] } }, "literatureLinks": [ { "title": "Identifying predictors of ventral hernia recurrence: systematic review and meta-analysis.", "journal": "BJS open", "year": 2021, "doi": "10.1093/bjsopen/zraa071", "url": "https://doi.org/10.1093/bjsopen/zraa071" }, { "title": "Robotic surgery for inguinal and ventral hernia repair: a systematic review and meta-analysis.", "journal": "Surgical endoscopy", "year": 2024, "doi": "10.1007/s00464-023-10545-5", "url": "https://doi.org/10.1007/s00464-023-10545-5" }, { "title": "Recurrence Rates after Primary Femoral Hernia Open Repair a Systematic Review.", "journal": "Surgical innovation", "year": 2024, "doi": "10.1177/15533506241273398", "url": "https://doi.org/10.1177/15533506241273398" } ], "alternativeTreatments": [ { "name": "Laparoscopic hernia repair", "procedureSlug": "hernia-repair-lap", "rationale": "Minimally invasive alternative; faster return to activity, slightly higher cost.", "sourceSlugs": [ "ehs-hernia-guidelines" ] }, { "name": "Watchful waiting", "rationale": "Appropriate for small, asymptomatic inguinal hernias; small risk of incarceration.", "sourceSlugs": [ "ehs-hernia-guidelines" ] }, { "name": "Truss / supportive garment", "rationale": "Symptomatic management when surgery is contraindicated; not a definitive treatment.", "sourceSlugs": [ "ehs-hernia-guidelines" ] } ], "accreditationsRequired": [ "ehs-accredited-hernia-surgeon" ] }, { "slug": "prk", "name": "PRK (Photorefractive Keratectomy)", "category": "ophthalmology", "description": "PRK is a refractive laser eye surgery in which the corneal epithelium is removed and an excimer laser reshapes the underlying corneal stroma to correct myopia, hyperopia, or astigmatism. PRK predates LASIK and remains the preferred surface-ablation technique for patients with thin corneas, occupational requirements that contraindicate a corneal flap (military, contact sports), or borderline topography that makes a flap risky. Recovery is slower and more uncomfortable than LASIK because the epithelium has to heal over the treated cornea — typically 3-5 days with a bandage contact lens — but biomechanical integrity of the cornea is preserved.", "overview": "PRK was the first widely-adopted excimer laser refractive procedure (FDA-approved 1995). Modern PRK is a quick outpatient procedure under topical anaesthesia: a brush, alcohol solution, or laser removes the corneal epithelium, the excimer laser ablation is performed in seconds to minutes per eye, and a bandage contact lens protects the eye while the epithelium regenerates over 3-5 days. Mitomycin C is commonly applied at the end of the procedure in higher corrections to reduce haze formation.", "averageRecoveryDays": 7, "typicalSessions": 1, "priceRangeUSD": { "low": 1200, "high": 3500 }, "keyConsiderations": [ "Slower recovery than LASIK (3-5 days vs hours) and more discomfort in the first week", "Preferred for thin corneas or borderline topography that contraindicate LASIK", "No corneal flap — better biomechanical preservation than LASIK", "Final visual stabilisation may take 1-3 months" ], "commonRisks": [ "Pain during epithelial healing (days 1-4)", "Corneal haze (especially in higher corrections)", "Dry eye", "Slow visual recovery", "Under- or over-correction" ], "questionsToAsk": [ "Why PRK rather than LASIK for my eyes?", "Will you apply mitomycin C? What is the haze rate at my correction?", "What is my pachymetry (corneal thickness)?", "What corrections do you not perform?", "What is your enhancement (re-treatment) rate?", "What pain management will I receive in days 1-4?" ], "aliases": [ "Photorefractive keratectomy", "Surface ablation" ], "relatedProcedures": [ "lasik" ], "costBreakdown": "PRK is typically priced 10-20% below LASIK at the same clinic due to lower equipment cost (no femtosecond flap creation). Quoted prices usually cover pre-operative topography and pachymetry, the procedure, the bandage contact lens, and short-term follow-up. Mitomycin C application may be a small additional charge in some markets. Enhancement procedures (typically allowed within 12-24 months) may be free or discounted depending on the clinic's policy.", "medicalTourismNotes": "PRK is a less common medical-tourism procedure than LASIK because of the slower visual recovery and the requirement to wear a bandage contact lens for 3-5 days. International patients should plan for 5-7 days in country to cover the procedure and the day-5 bandage-lens-removal review. Flying after PRK is generally permitted once the epithelium has healed and the bandage lens has been removed; some surgeons restrict swimming and dusty environments for several weeks.\n\nA notable advantage for medical tourists is that PRK does not produce a permanent corneal flap, meaning there is no lifelong risk of flap dislocation from impact. Patients in contact sports or with occupations involving high G-forces or potential eye trauma should specifically discuss PRK with their surgeon.", "recoveryTimeline": "Day 0: procedure completed under topical anaesthesia; bandage contact lens placed; sunglasses required outdoors. Vision is blurred and patients should not drive home.\n\nDays 1-4: peak discomfort, especially day 2-3. Foreign-body sensation, photophobia, and tearing are common. Prescribed analgesia and lubricating drops are essential. Vision improves slowly and is typically usable but blurred during this period.\n\nDay 4-7: epithelium regenerates; the bandage contact lens is removed at the day-4 or day-5 follow-up. Vision begins improving more rapidly thereafter.\n\nWeeks 2-4: vision continues to refine. Some patients experience halos and starbursts at night, which usually settle.\n\nMonth 1-3: final refractive stabilisation. Most patients achieve 20/20 or 20/25 visual acuity by month 3. Mild dry eye is common during this period and is managed with lubricating drops.\n\nMonth 3-12: continued slow refinement. Enhancement (a second laser procedure for residual refractive error) is generally available between months 3 and 12 if needed.", "faqs": [ { "question": "Will PRK hurt?", "answer": "There is typically meaningful discomfort during days 1-3 — described as a foreign-body sensation, similar to having sand in the eye. Prescribed analgesia and frequent lubricating drops help substantially. By day 4-5 most patients are comfortable. The procedure itself is painless under topical anaesthesia." }, { "question": "How does PRK compare to LASIK?", "answer": "PRK produces equivalent final visual outcomes to LASIK in most studies (Cochrane Database, 2017) but takes longer to achieve them. The main advantage of PRK is biomechanical: no corneal flap is created, so there is no risk of flap dislocation later in life. The main disadvantages are slower recovery and more discomfort in the first few days. Modern femtosecond LASIK has narrowed the safety gap considerably." }, { "question": "Am I a candidate for PRK if I was told 'no' for LASIK?", "answer": "Sometimes. Patients with thin corneas, borderline topography, large pupils, occupational requirements that exclude flaps, or high-impact-sport involvement may be PRK candidates when LASIK is contraindicated. A corneal topography and pachymetry assessment will identify whether your corneas can safely accommodate the procedure." }, { "question": "When can I drive after PRK?", "answer": "Most surgeons advise no driving for 5-7 days post-PRK until vision has substantially recovered and any double vision or significant blur has resolved. Some patients can drive earlier; the test is whether you can read a number plate from 20 metres with the operated eye." }, { "question": "Is PRK reversible?", "answer": "PRK is not reversible in the sense of restoring the cornea to its original shape, but the lack of a permanent flap means the cornea retains better biomechanical integrity than after LASIK. If a refractive surprise occurs, an enhancement procedure can address it." }, { "question": "How much does PRK cost compared to LASIK?", "answer": "PRK is typically priced 10-20% below LASIK at the same clinic because the equipment cost is lower (no femtosecond flap creation). Total cost per eye varies by country and clinic." }, { "question": "Can PRK correct astigmatism?", "answer": "Yes — PRK is FDA-approved for the correction of myopia, hyperopia, and astigmatism. The excimer laser ablation pattern can be calculated to address all three refractive errors in the same procedure, provided pre-operative pachymetry confirms adequate corneal thickness for the planned correction." }, { "question": "Will my prescription change after PRK?", "answer": "Final refraction typically stabilises at 1-3 months post-op. A small proportion of patients experience long-term regression toward myopia, particularly in higher corrections. Enhancement procedures are available between 3-12 months post-op if a refractive surprise persists." } ], "subtypes": [], "anaesthesia": "local", "operatingTime": { "lowMinutes": 10, "highMinutes": 30, "sourceSlugs": [ "aao-ppp-refractive", "escrs-refractive-guidelines" ] }, "hospitalStay": { "lowNights": 0, "highNights": 0, "sourceSlugs": [ "aao-ppp-refractive" ] }, "minimumInCountryDays": { "low": 5, "high": 7, "sourceSlugs": [ "aao-ppp-refractive", "escrs-refractive-guidelines" ] }, "daysToFly": { "low": 5, "high": 7, "explanation": "PRK requires the epithelium to heal under a bandage contact lens; flying is generally permitted after the day-4 or day-5 review.", "sourceSlugs": [ "aao-ppp-refractive", "iata-medical-cabin-guidance" ] }, "complicationRate": { "value": 2, "range": [ 1, 5 ], "sourceSlugs": [ "cochrane-lasik-vs-prk", "aao-ppp-refractive" ] }, "revisionRate": { "value": 5, "range": [ 2, 10 ], "sourceSlugs": [ "aao-ppp-refractive" ] }, "risks": [ { "name": "Corneal haze", "severity": "moderate", "rate": { "value": 0.05, "range": [ 0.02, 0.15 ] }, "prevention": "Mitomycin C application in higher corrections; UV protection during healing.", "sourceSlugs": [ "aao-ppp-refractive", "escrs-refractive-guidelines" ] }, { "name": "Persistent dry eye", "severity": "minor", "rate": { "value": 0.3, "range": [ 0.2, 0.5 ] }, "prevention": "Pre-operative tear film assessment; lubricating drops; punctal plugs in selected patients.", "sourceSlugs": [ "aao-ppp-refractive" ] }, { "name": "Slow visual recovery (>3 months)", "severity": "minor", "rate": { "value": 0.1, "range": [ 0.05, 0.2 ] }, "prevention": "Realistic counselling; consideration of LASIK if rapid recovery is essential.", "sourceSlugs": [ "cochrane-lasik-vs-prk" ] }, { "name": "Under- or over-correction requiring enhancement", "severity": "minor", "rate": { "value": 0.05, "range": [ 0.02, 0.1 ] }, "prevention": "Accurate pre-operative refraction; experienced surgeon.", "sourceSlugs": [ "cochrane-lasik-vs-prk" ] }, { "name": "Ectasia (corneal weakening)", "severity": "severe", "rate": { "value": 0.0002 }, "prevention": "Pre-operative topography to exclude keratoconus; appropriate residual stromal bed thickness.", "sourceSlugs": [ "aao-ppp-refractive", "escrs-refractive-guidelines" ] } ], "eligibility": [ { "criterion": "Stable refraction for at least 12 months", "sourceSlugs": [ "aao-ppp-refractive" ] }, { "criterion": "Age 18 or over", "sourceSlugs": [ "aao-ppp-refractive" ] }, { "criterion": "Healthy corneas with adequate thickness on pachymetry", "sourceSlugs": [ "aao-ppp-refractive" ] }, { "criterion": "Thin corneas or borderline topography preferring PRK over LASIK", "sourceSlugs": [ "aao-ppp-refractive", "escrs-refractive-guidelines" ] }, { "criterion": "Realistic expectations about presbyopic-age eyesight", "sourceSlugs": [ "aao-ppp-refractive" ] } ], "contraindications": [ { "contraindication": "Keratoconus or forme fruste keratoconus on topography", "sourceSlugs": [ "aao-ppp-refractive" ] }, { "contraindication": "Severe dry eye syndrome", "sourceSlugs": [ "aao-ppp-refractive" ] }, { "contraindication": "Pregnancy or breastfeeding (refraction unstable)", "sourceSlugs": [ "aao-ppp-refractive" ] }, { "contraindication": "Active autoimmune or connective-tissue disease", "sourceSlugs": [ "aao-ppp-refractive" ] } ], "followUpCadence": [ { "at": "Day 4-5", "type": "Bandage contact lens removal and epithelial-healing check", "required": true }, { "at": "1 month", "type": "Refraction stability check", "required": true }, { "at": "3 months", "type": "Final visual acuity and refractive stability", "required": true }, { "at": "12 months", "type": "Long-term review; enhancement consideration if indicated", "required": false } ], "recordsToObtain": [ "Pre-operative refraction and topography", "Operative report including laser parameters and mitomycin C use", "Pachymetry pre and post", "Post-operative refraction at each visit" ], "numberOfVisits": { "typical": 2, "minimum": 1 }, "recoveryByActivity": { "sedentaryWork": { "days": 1, "sourceSlugs": [ "aao-ppp-refractive" ] }, "manualWork": { "days": 3, "sourceSlugs": [ "aao-ppp-refractive" ] }, "lightExercise": { "days": 3, "sourceSlugs": [ "aao-ppp-refractive" ] }, "vigorousExercise": { "days": 14, "sourceSlugs": [ "aao-ppp-refractive" ] }, "swimming": { "days": 14, "sourceSlugs": [ "aao-ppp-refractive" ] }, "flying": { "days": 1, "sourceSlugs": [ "iata-medical-cabin-guidance" ] }, "driving": { "days": 1, "sourceSlugs": [ "aao-ppp-refractive" ] } }, "parentProcedure": "lasik", "literatureLinks": [ { "title": "Refractive surgery and dry eye - An update.", "journal": "Indian journal of ophthalmology", "year": 2023, "doi": "10.4103/IJO.IJO_3406_22", "url": "https://doi.org/10.4103/IJO.IJO_3406_22" }, { "title": "Photorefractive keratectomy.", "journal": "International ophthalmology clinics", "year": 2000, "doi": "10.1097/00004397-200007000-00007", "url": "https://doi.org/10.1097/00004397-200007000-00007" }, { "title": "Photorefractive Keratectomy: Technical Evolution, Refractive Outcomes, Corneal Wound Healing Response, and Complications.", "journal": "Journal of refractive surgery (Thorofare, N.J. : 1995)", "year": 2024, "doi": "10.3928/1081597X-20240826-05", "url": "https://doi.org/10.3928/1081597X-20240826-05" } ], "alternativeTreatments": [ { "name": "LASIK", "procedureSlug": "lasik", "rationale": "Faster visual recovery and less postoperative pain when corneal thickness allows flap creation.", "sourceSlugs": [ "aao-ppp-refractive" ] }, { "name": "SMILE", "procedureSlug": "smile", "rationale": "Flapless alternative with similar surface-impact profile but narrower indication.", "sourceSlugs": [ "aao-ppp-refractive" ] } ], "accreditationsRequired": [ "national-ophthalmology-board", "refractive-surgery-fellowship" ] }, { "slug": "smile", "name": "SMILE (Small Incision Lenticule Extraction)", "category": "ophthalmology", "description": "SMILE is a refractive laser eye procedure in which a femtosecond laser creates a small lens-shaped piece of corneal tissue (a lenticule) within the intact cornea, which is then extracted through a small peripheral incision typically 2-4mm wide. Because no corneal flap is created, SMILE preserves more of the cornea's anterior biomechanical strength than LASIK. SMILE is approved for the correction of myopia and myopic astigmatism; hyperopic SMILE has been approved in some markets more recently.", "overview": "SMILE was developed by Carl Zeiss Meditec and approved by the US FDA in 2016 (for myopia) and 2018 (for astigmatism). The procedure uses a femtosecond laser to create both surfaces of a corneal lenticule in a single step, which is then extracted manually. Compared to LASIK, the smaller incision and absence of a flap means less disruption to corneal nerves, theoretically reducing dry-eye symptoms and preserving more biomechanical strength.", "averageRecoveryDays": 3, "typicalSessions": 1, "priceRangeUSD": { "low": 2000, "high": 4500 }, "keyConsiderations": [ "Smaller incision and no flap — better biomechanics than LASIK", "Visual recovery faster than PRK but slower than LASIK", "Equipment cost typically pushes pricing above LASIK", "Enhancement procedures less established than LASIK or PRK" ], "commonRisks": [ "Dry eye (less than LASIK)", "Diffuse lamellar keratitis", "Cap perforation (rare)", "Suction loss during lenticule creation", "Under-correction", "Slow visual recovery" ], "questionsToAsk": [ "Why SMILE rather than LASIK or PRK for my eyes?", "How many SMILE procedures do you perform annually?", "What is your enhancement (re-treatment) rate, and what technique do you use for it?", "Do you have a backup plan if suction is lost during lenticule creation?", "What is the longest-term outcome data available in your clinic?", "Is the procedure approved for my refractive error in this jurisdiction?" ], "aliases": [ "Small incision lenticule extraction", "ReLEx SMILE" ], "relatedProcedures": [ "lasik" ], "costBreakdown": "SMILE is typically priced 20-30% above LASIK at the same clinic due to higher equipment cost (proprietary Carl Zeiss femtosecond laser) and longer training requirements for the surgeon. Quoted prices usually cover pre-operative topography and pachymetry, the procedure, and short-term follow-up. Enhancement procedures, when needed, are commonly performed as PRK on top of the SMILE and may carry an additional charge.", "medicalTourismNotes": "SMILE is offered at a smaller number of clinics globally than LASIK because of the equipment cost and training requirements. International patients should plan for 3-5 days in country to cover the procedure and a day-1 review. Visual recovery is faster than PRK but slower than LASIK; most patients are functional from day 2-3.\n\nMedical-tourism patients considering SMILE specifically (rather than LASIK) should weigh the biomechanical advantages against the higher cost, the longer learning curve at smaller-volume clinics, and the less-established enhancement pathway. For most refractive errors LASIK and SMILE produce equivalent final visual outcomes.", "recoveryTimeline": "Day 0: procedure completed under topical anaesthesia in approximately 30 seconds per eye of laser time. Patients are advised to rest with eyes closed for several hours.\n\nDays 1-2: visual acuity is functional but blurred; mild foreign-body sensation. Tear film may be unstable. Lubricating drops every 1-2 hours.\n\nDay 3-7: vision improves substantially; most patients return to driving and screen work by day 3-7. Strenuous activity and contact-lens-incompatible environments (swimming pools, hot tubs) should be avoided.\n\nWeek 2-4: refractive stabilisation. Most patients achieve their final visual acuity by week 4.\n\nMonth 1-3: final stabilisation. Dry-eye symptoms, if any, typically peak around month 1-2 and improve thereafter.\n\nMonth 3-12: long-term follow-up. Enhancement (typically via PRK) is considered if a refractive surprise persists at month 3-6.", "faqs": [ { "question": "How does SMILE differ from LASIK?", "answer": "Both procedures use a femtosecond laser to modify corneal tissue. LASIK creates a hinged flap and uses an excimer laser to ablate the underlying stroma. SMILE creates a small lens-shaped piece of tissue (a lenticule) inside the intact cornea using only the femtosecond laser, and the lenticule is extracted through a small 2-4mm incision. Because no flap is created, more of the cornea's biomechanical strength is preserved." }, { "question": "Is SMILE safer than LASIK?", "answer": "The biomechanical preservation theoretically makes SMILE less prone to ectasia and to long-term flap-related complications. However, the absolute risk of these events with modern LASIK is already very low. Most clinical comparison studies show equivalent visual outcomes; the difference is in the long-tail safety profile, which is hard to measure in short-term studies." }, { "question": "Can SMILE correct astigmatism and hyperopia?", "answer": "SMILE is approved for myopia and myopic astigmatism in all markets where it is available. Hyperopic SMILE has been approved by the FDA more recently (2024) and in some other markets, but availability and surgeon experience varies." }, { "question": "What happens if SMILE doesn't fully correct my vision?", "answer": "Enhancement (re-treatment) is less straightforward than for LASIK because there is no flap to re-lift. The most common enhancement approach is to perform a PRK on the surface of the cornea, which adds a separate recovery period. Modern surgeons increasingly offer 'flap-lift after SMILE' techniques in selected cases." }, { "question": "How long does SMILE take?", "answer": "The laser portion is approximately 30 seconds per eye, and the lenticule extraction adds 1-2 minutes. Total time in the laser room is typically 10-15 minutes per eye." }, { "question": "How much does SMILE cost?", "answer": "SMILE is typically priced 20-30% above LASIK at the same clinic. Total cost per eye varies by country and clinic." }, { "question": "Can SMILE be combined with cataract surgery later in life?", "answer": "Yes — because SMILE leaves the cornea structurally well-preserved (no flap, smaller incision), patients undergoing cataract surgery decades later have a more predictable corneal optical landscape. IOL calculations after refractive surgery still require specific formulas (e.g. Barrett True-K) regardless of the original refractive procedure." }, { "question": "Why is SMILE more expensive than LASIK at the same clinic?", "answer": "The Carl Zeiss femtosecond laser used for SMILE is proprietary, has higher upfront equipment cost than excimer-laser-based LASIK systems, and the procedure requires additional surgeon training. These factors typically translate to a 20-30% price premium over LASIK at the same provider." } ], "subtypes": [], "anaesthesia": "local", "operatingTime": { "lowMinutes": 15, "highMinutes": 30, "sourceSlugs": [ "escrs-refractive-guidelines" ] }, "hospitalStay": { "lowNights": 0, "highNights": 0, "sourceSlugs": [ "escrs-refractive-guidelines" ] }, "minimumInCountryDays": { "low": 3, "high": 5, "sourceSlugs": [ "escrs-refractive-guidelines" ] }, "daysToFly": { "low": 2, "high": 3, "explanation": "Outpatient procedure with small incision; flying generally permitted within 2-3 days.", "sourceSlugs": [ "escrs-refractive-guidelines", "iata-medical-cabin-guidance" ] }, "complicationRate": { "value": 1.5, "range": [ 0.5, 3 ], "sourceSlugs": [ "escrs-refractive-guidelines" ] }, "revisionRate": { "value": 4, "range": [ 2, 8 ], "sourceSlugs": [ "escrs-refractive-guidelines" ] }, "risks": [ { "name": "Persistent dry eye", "severity": "minor", "rate": { "value": 0.2, "range": [ 0.1, 0.4 ] }, "prevention": "Pre-operative tear film assessment; lubricating drops.", "sourceSlugs": [ "escrs-refractive-guidelines" ] }, { "name": "Diffuse lamellar keratitis", "severity": "moderate", "rate": { "value": 0.01 }, "prevention": "Sterile technique; topical steroids if early signs.", "sourceSlugs": [ "escrs-refractive-guidelines" ] }, { "name": "Suction loss during lenticule creation", "severity": "moderate", "rate": { "value": 0.01 }, "prevention": "Experienced surgeon; appropriate patient cooperation.", "sourceSlugs": [ "escrs-refractive-guidelines" ] }, { "name": "Under-correction requiring enhancement", "severity": "minor", "rate": { "value": 0.04, "range": [ 0.02, 0.08 ] }, "prevention": "Accurate pre-operative refraction; modern eye-tracking systems.", "sourceSlugs": [ "escrs-refractive-guidelines" ] } ], "eligibility": [ { "criterion": "Stable myopia or myopic astigmatism within the approved correction range", "sourceSlugs": [ "escrs-refractive-guidelines" ] }, { "criterion": "Age 18 or over (FDA: 22 in the US)", "sourceSlugs": [ "escrs-refractive-guidelines" ] }, { "criterion": "Healthy corneas with adequate thickness on pachymetry", "sourceSlugs": [ "escrs-refractive-guidelines" ] } ], "contraindications": [ { "contraindication": "Keratoconus or forme fruste keratoconus", "sourceSlugs": [ "escrs-refractive-guidelines" ] }, { "contraindication": "Severe dry eye syndrome", "sourceSlugs": [ "escrs-refractive-guidelines" ] }, { "contraindication": "Hyperopia (in markets where hyperopic SMILE is not approved)", "sourceSlugs": [ "escrs-refractive-guidelines" ] }, { "contraindication": "Pregnancy or breastfeeding", "sourceSlugs": [ "escrs-refractive-guidelines" ] } ], "followUpCadence": [ { "at": "Day 1", "type": "Visual acuity and incision-site check", "required": true }, { "at": "1 week", "type": "Refraction check", "required": true }, { "at": "1 month", "type": "Refraction stability check", "required": true }, { "at": "3 months", "type": "Final visual acuity and enhancement consideration", "required": true } ], "recordsToObtain": [ "Pre-operative refraction and topography", "Operative report including lenticule parameters", "Pachymetry pre and post" ], "numberOfVisits": { "typical": 2, "minimum": 1 }, "recoveryByActivity": { "sedentaryWork": { "days": 1, "sourceSlugs": [ "aao-ppp-refractive" ] }, "manualWork": { "days": 3, "sourceSlugs": [ "aao-ppp-refractive" ] }, "lightExercise": { "days": 3, "sourceSlugs": [ "aao-ppp-refractive" ] }, "vigorousExercise": { "days": 14, "sourceSlugs": [ "aao-ppp-refractive" ] }, "swimming": { "days": 14, "sourceSlugs": [ "aao-ppp-refractive" ] }, "flying": { "days": 1, "sourceSlugs": [ "iata-medical-cabin-guidance" ] }, "driving": { "days": 1, "sourceSlugs": [ "aao-ppp-refractive" ] } }, "parentProcedure": "lasik", "literatureLinks": [ { "title": "Complications of small incision lenticule extraction.", "journal": "Indian journal of ophthalmology", "year": 2020, "doi": "10.4103/ijo.IJO_3258_20", "url": "https://doi.org/10.4103/ijo.IJO_3258_20" }, { "title": "[SMILE - Small Incision Lenticule Extraction].", "journal": "Klinische Monatsblatter fur Augenheilkunde", "year": 2020, "doi": "10.1055/a-1291-9041", "url": "https://doi.org/10.1055/a-1291-9041" }, { "title": "Comparing femtosecond LASIK and small-incision lenticule extraction (SMILE).", "journal": "Current opinion in ophthalmology", "year": 2025, "doi": "10.1097/ICU.0000000000001145", "url": "https://doi.org/10.1097/ICU.0000000000001145" } ], "alternativeTreatments": [ { "name": "LASIK", "procedureSlug": "lasik", "rationale": "Wider indication range (broader prescription envelope, astigmatism correction).", "sourceSlugs": [ "aao-ppp-refractive" ] }, { "name": "PRK", "procedureSlug": "prk", "rationale": "Surface ablation when corneal biomechanics or thin-cornea concerns preclude SMILE.", "sourceSlugs": [ "aao-ppp-refractive" ] } ], "accreditationsRequired": [ "national-ophthalmology-board", "refractive-surgery-fellowship" ] }, { "slug": "composite-veneers", "name": "Composite Veneers", "category": "dental", "description": "Composite veneers are tooth-coloured composite resin restorations applied directly to the front surfaces of teeth to improve aesthetics. Unlike porcelain veneers, composite veneers are typically built up freehand or via injection-mould stent in the dentist's chair in a single visit. They require minimal or no enamel preparation, are reversible, and cost substantially less than porcelain — but they have a shorter functional lifespan (typically 5-7 years vs 10-15+ for porcelain), are more prone to staining, and lack the natural translucency of porcelain.", "overview": "Direct composite veneering has matured substantially over the last decade with the development of nano-hybrid composite materials and standardised colour-layering techniques. The procedure is typically completed in one session per tooth or per arch, with the dentist sculpting layers of composite onto the prepared surface and curing each layer with a UV light. Composite is best suited to small to moderate aesthetic concerns (chips, gaps, mild misalignment, discolouration); large-scale smile makeovers usually favour porcelain.", "averageRecoveryDays": 1, "typicalSessions": 1, "priceRangeUSD": { "low": 250, "high": 600 }, "keyConsiderations": [ "Single-visit procedure with no laboratory wait", "Minimal or no enamel preparation — reversible in most cases", "5-7 year lifespan vs 10-15+ for porcelain", "30-50% of porcelain cost; ideal for small-to-moderate aesthetic concerns" ], "commonRisks": [ "Chipping or fracture", "Staining over time", "Polish loss / surface roughness", "Marginal staining at the composite-enamel interface", "Sensitivity" ], "questionsToAsk": [ "Why composite rather than porcelain for my case?", "How many years do your composite veneers typically last?", "What composite system do you use?", "Will you bond the veneer with rubber-dam isolation?", "Can I see your before/after photographs and your warranty?" ], "aliases": [ "Direct composite bonding", "Composite bonding" ], "relatedProcedures": [ "dental-veneers" ], "costBreakdown": "Composite veneer pricing covers chair time, composite material, and bonding agents. There is no separate laboratory fee (unlike porcelain), which is the main driver of the lower cost. Pre-operative aesthetic mock-ups and photography are sometimes charged separately. Repairs and polishing are typically included for an initial warranty period that varies by clinic.", "medicalTourismNotes": "Composite veneers are well-suited to medical tourism because they are completed in a single session with no laboratory wait. International patients can typically have the procedure done in 1-2 days. Composite is best for small to moderate aesthetic concerns; if you are seeking a full smile makeover with 8-10 veneers, the case for travelling for composite specifically (rather than porcelain) is weaker because the durability gap matters more at scale.", "recoveryTimeline": "Day 0: procedure completed; no anaesthetic needed in most cases (minimal preparation). Sensitivity to cold or sweet stimuli may be present for 1-2 days as bond stress settles. Avoid intensely staining foods (coffee, red wine, curry) for the first 48 hours.\n\nWeek 1: composite continues to take on full hardness. Routine eating and drinking permitted. Avoid biting on hard objects.\n\nMonth 1: review and polish recommended at four weeks to address any marginal roughness. Composite-specific care: avoid using teeth as tools (opening packages, biting nails) — chipping is the main mode of failure.\n\nYear 1: annual polish and review. Surface stain accumulation is normal over time and can usually be polished off; deeper marginal staining may require selective repair.\n\nYear 5-7: typical lifespan of well-maintained composite veneers. Replacement or upgrade to porcelain is usually appropriate.", "faqs": [ { "question": "How do composite veneers compare to porcelain?", "answer": "Composite veneers are less expensive, faster to place (single session), and reversible (since minimal or no enamel is removed). Porcelain veneers are more durable (10-15+ years vs 5-7), more stain-resistant, and have better light transmission for natural aesthetics. The choice depends on budget, aesthetic goals, the underlying teeth, and the dentist's recommendation." }, { "question": "Will my composite veneers look natural?", "answer": "Modern nano-hybrid composites can produce excellent aesthetic results in experienced hands, especially for small to moderate restorations. For very thin, very long, or fully-covered porcelain-look results, porcelain remains the gold standard." }, { "question": "Are composite veneers reversible?", "answer": "Mostly yes — composite veneers are bonded onto enamel with minimal or no enamel removal, so they can typically be removed by careful drilling without damaging the underlying tooth structure. This contrasts with porcelain veneers, which usually require irreversible enamel preparation." }, { "question": "How long will composite veneers last?", "answer": "Typical lifespan is 5-7 years with good oral hygiene, regular maintenance polish appointments, and avoidance of biting hard objects. Some last longer; some need replacement sooner. The bonding interface is usually the failure point." }, { "question": "Can composite veneers be repaired?", "answer": "Yes — chipped or stained composite can typically be repaired by adding fresh composite and re-polishing. This is one of the main advantages over porcelain, which usually requires complete replacement when it fractures." }, { "question": "Will composite veneers stain?", "answer": "Yes — over time, composite veneers will accumulate surface stains, particularly at the margins. Routine professional polishing usually restores the original colour. Avoiding tobacco, limiting coffee and red wine, and good oral hygiene slow this process." }, { "question": "Can composite veneers be whitened?", "answer": "Composite veneers do not respond to bleaching agents. Surface stains can be polished off in routine hygienist visits, but deep colour change requires replacement or re-layering of the composite. Natural teeth not covered by veneers can be whitened, which may require subsequent composite re-shading for colour-matching." }, { "question": "Will composite veneers feel like my own teeth?", "answer": "Most patients report that thin, well-bonded composite veneers feel essentially indistinguishable from natural teeth within a few days. Larger or bulkier composite layers may feel slightly different initially as the tongue and lips adapt. Bite alignment is the most common source of post-bonding discomfort and is usually adjustable in a short follow-up appointment." } ], "subtypes": [], "anaesthesia": "local", "operatingTime": { "lowMinutes": 30, "highMinutes": 120, "sourceSlugs": [ "asps-practice-parameters" ] }, "hospitalStay": { "lowNights": 0, "highNights": 0, "sourceSlugs": [ "asps-practice-parameters" ] }, "minimumInCountryDays": { "low": 1, "high": 3, "sourceSlugs": [ "asps-practice-parameters" ] }, "daysToFly": { "low": 1, "high": 2, "explanation": "Outpatient procedure with no anaesthesia restriction; flying permitted from the next day.", "sourceSlugs": [ "iata-medical-cabin-guidance" ] }, "complicationRate": { "value": 5, "range": [ 2, 10 ], "sourceSlugs": [ "asps-practice-parameters" ] }, "revisionRate": { "value": 15, "range": [ 10, 20 ], "sourceSlugs": [ "asps-practice-parameters" ] }, "risks": [ { "name": "Chipping or fracture", "severity": "minor", "rate": { "value": 0.1, "range": [ 0.05, 0.15 ] }, "prevention": "Avoid biting on hard objects; bruxism appliance where indicated.", "sourceSlugs": [ "asps-practice-parameters" ] }, { "name": "Surface and marginal staining", "severity": "minor", "rate": { "value": 0.3 }, "prevention": "Regular polish appointments; avoidance of staining foods/tobacco.", "sourceSlugs": [ "asps-practice-parameters" ] }, { "name": "Debonding", "severity": "moderate", "rate": { "value": 0.05 }, "prevention": "Rubber-dam isolation; appropriate bonding protocol.", "sourceSlugs": [ "asps-practice-parameters" ] }, { "name": "Tooth sensitivity", "severity": "minor", "rate": { "value": 0.1 }, "prevention": "Desensitising agents; minimal preparation depth.", "sourceSlugs": [ "asps-practice-parameters" ] } ], "eligibility": [ { "criterion": "Generally healthy teeth with sufficient enamel for bonding", "sourceSlugs": [ "asps-practice-parameters" ] }, { "criterion": "Realistic aesthetic expectations", "sourceSlugs": [ "asps-practice-parameters" ] }, { "criterion": "Small to moderate aesthetic concerns (chips, gaps, mild discolouration)", "sourceSlugs": [ "asps-practice-parameters" ] } ], "contraindications": [ { "contraindication": "Untreated bruxism", "sourceSlugs": [ "asps-practice-parameters" ] }, { "contraindication": "Active periodontal disease", "sourceSlugs": [ "asps-practice-parameters" ] }, { "contraindication": "Insufficient enamel for bonding", "sourceSlugs": [ "asps-practice-parameters" ] } ], "followUpCadence": [ { "at": "1 week", "type": "Bite check and polish", "required": false }, { "at": "1 month", "type": "Margin and polish review", "required": true }, { "at": "Annual", "type": "Hygienist review and polish", "required": true } ], "recordsToObtain": [ "Pre-operative photographs", "Composite system and shade record", "Bonding agent specification" ], "numberOfVisits": { "typical": 2, "minimum": 1 }, "recoveryByActivity": { "sedentaryWork": { "days": 1, "sourceSlugs": [ "who-surgical-safety-checklist" ] }, "manualWork": { "days": 1, "sourceSlugs": [ "who-surgical-safety-checklist" ] }, "lightExercise": { "days": 1, "sourceSlugs": [ "who-surgical-safety-checklist" ] }, "vigorousExercise": { "days": 3, "sourceSlugs": [ "who-surgical-safety-checklist" ] }, "flying": { "days": 1, "sourceSlugs": [ "iata-medical-cabin-guidance" ] }, "driving": { "days": 1, "sourceSlugs": [ "who-surgical-safety-checklist" ] }, "swimming": { "days": 1, "sourceSlugs": [ "asps-practice-parameters" ] } }, "parentProcedure": "dental-veneers", "literatureLinks": [ { "title": "Long-term survival and reasons for failure in direct anterior composite restorations: A systematic review.", "journal": "Journal of conservative dentistry : JCD", "year": 2021, "doi": "10.4103/jcd.jcd_527_21", "url": "https://doi.org/10.4103/jcd.jcd_527_21" }, { "title": "Anterior composite restorations: A systematic review on long-term survival and reasons for failure.", "journal": "Dental materials : official publication of the Academy of Dental Materials", "year": 2015, "doi": "10.1016/j.dental.2015.07.005", "url": "https://doi.org/10.1016/j.dental.2015.07.005" }, { "title": "Longevity of fiber-reinforced composite fixed partial dentures (FRC FPD)-Systematic review.", "journal": "Journal of dentistry", "year": 2017, "doi": "10.1016/j.jdent.2016.08.007", "url": "https://doi.org/10.1016/j.jdent.2016.08.007" } ], "accreditationsRequired": [ "national-dental-council" ] }, { "slug": "hernia-repair-lap", "name": "Laparoscopic Hernia Repair", "category": "general-surgery", "description": "Laparoscopic hernia repair is a minimally invasive technique in which the hernia defect is approached from inside the abdominal wall using small ports and a camera, with mesh placed in the preperitoneal space to reinforce the defect. The two main variants are transabdominal preperitoneal (TAPP) repair, which enters the abdominal cavity, and totally extraperitoneal (TEP) repair, which dissects the preperitoneal space without entering the peritoneum. Compared to open repair, laparoscopic approaches offer faster return to normal activity, lower acute pain, and better cosmesis — at the cost of a longer operative time, the requirement for general anaesthesia, and a steeper learning curve for the surgeon.", "overview": "Laparoscopic hernia repair was developed in the 1990s and has become the preferred approach for bilateral and recurrent inguinal hernias per NICE TA160. For primary unilateral inguinal hernias, NICE supports both open and laparoscopic approaches; surgeon experience and patient preference drive the choice. The Cochrane review of open vs laparoscopic mesh repair (2018) shows comparable recurrence rates but significantly less chronic post-operative pain with the laparoscopic approach in experienced hands.", "averageRecoveryDays": 10, "typicalSessions": 1, "priceRangeUSD": { "low": 2500, "high": 7500 }, "keyConsiderations": [ "Lower chronic post-operative pain than open repair in experienced hands", "Preferred for bilateral and recurrent inguinal hernias per NICE TA160", "Requires general anaesthesia (open can be done under local)", "Surgeon volume materially affects recurrence rate" ], "commonRisks": [ "Recurrence", "Chronic post-operative pain", "Bowel or bladder injury (rare)", "Seroma", "Mesh infection (rare)", "Trocar-site hernia" ], "questionsToAsk": [ "Why TAPP or TEP for my case?", "How many laparoscopic hernia repairs do you perform annually?", "What is your recurrence rate?", "What mesh do you use and why?", "Do you use mesh fixation, and if so, with what?", "What if I have intra-operative findings that require conversion to open?", "Do you offer enhanced recovery (same-day discharge)?" ], "aliases": [ "TAPP", "TEP", "Laparoscopic inguinal hernia repair" ], "relatedProcedures": [ "hernia-repair" ], "costBreakdown": "Laparoscopic hernia repair is typically priced 20-50% above open repair at the same centre due to longer operative time, equipment cost (ports, dissectors, mesh fixation devices), and general-anaesthesia requirement. Quoted prices usually cover the procedure, mesh, anaesthesia, and one overnight stay if needed. Day-case laparoscopic repair is increasingly common and may reduce the quoted price.", "medicalTourismNotes": "Laparoscopic hernia repair travels well for medical tourism — short operating time, faster recovery than open repair, low complication rate, and a single surgical episode. International patients should plan for 5-7 days in country and confirm that the operating surgeon's annual laparoscopic-hernia volume is high enough to keep recurrence rates within published norms (typically 50+ procedures annually).\n\nLong-haul flying is generally safe 3-5 days after uncomplicated laparoscopic repair. DVT prophylaxis per IATA medical guidance is advisable. A wound and recovery review with a local practitioner within two weeks of returning home is standard.", "recoveryTimeline": "Day 0: procedure completed under general anaesthesia in 45-90 minutes (longer for bilateral). Most patients are mobilised within hours and discharged the same day or after one overnight stay.\n\nDays 1-3: mild abdominal discomfort, bloating from carbon-dioxide insufflation (peaks at 24-48 hours and resolves spontaneously), and port-site soreness. Simple analgesics typically suffice. Wound dressings can usually be removed at days 3-5.\n\nWeek 1: most patients return to sedentary work at day 5-7. Light household tasks permitted from day 2-3. Driving when comfortable performing an emergency stop without pain.\n\nWeek 2: wound review (sutures-out if non-absorbable). Most patients return to normal walking distance and routine activity.\n\nWeek 3-6: gradual return to full activity. Heavy lifting, vigorous exercise, and contact sport should be avoided for 4-6 weeks to allow mesh consolidation.\n\nMonth 3: full activity permitted. A review at 3 months for symptomatic resolution and recurrence assessment is standard.", "faqs": [ { "question": "Is laparoscopic better than open hernia repair?", "answer": "For bilateral and recurrent inguinal hernias, NICE TA160 recommends laparoscopic repair as the preferred approach. For primary unilateral hernias, the choice depends on surgeon experience and patient preference; recurrence rates are comparable but chronic post-operative pain is lower with laparoscopic in experienced hands." }, { "question": "What is the difference between TAPP and TEP?", "answer": "TAPP (transabdominal preperitoneal) enters the abdominal cavity, then dissects the preperitoneal space from inside. TEP (totally extraperitoneal) dissects the preperitoneal space from outside without entering the peritoneum. Outcomes are broadly similar; the choice usually depends on surgeon training and preference." }, { "question": "Can laparoscopic repair be done under local anaesthesia?", "answer": "No — laparoscopic hernia repair requires general anaesthesia due to the need for muscle relaxation and pneumoperitoneum. Open repair can sometimes be done under local anaesthesia in selected patients." }, { "question": "How long until I can fly home?", "answer": "Most surgeons permit flying 3-5 days after uncomplicated laparoscopic repair. DVT prophylaxis per IATA medical guidance is recommended for long-haul flights." }, { "question": "What is the recurrence rate?", "answer": "In experienced hands, recurrence rates for laparoscopic primary inguinal hernia repair are 1-3%. Recurrence rates rise significantly with low-volume surgeons or complex cases. The Cochrane review of open vs laparoscopic mesh repair shows comparable overall recurrence rates between approaches in adequately powered studies." }, { "question": "Will I have visible scars?", "answer": "Three small port-site scars, each approximately 5-10mm long, typically placed in the umbilicus and the lower abdomen. These usually fade to near-invisibility within 6-12 months." }, { "question": "Can I have laparoscopic repair if I have had previous abdominal surgery?", "answer": "Previous abdominal surgery is not an absolute contraindication but may make laparoscopic dissection more difficult due to adhesions. The surgeon may convert to open repair intra-operatively if access is unsafe. Discuss your previous surgery in detail at the pre-operative consultation." }, { "question": "Can I have laparoscopic hernia repair if I have had previous abdominal surgery?", "answer": "Previous abdominal surgery is not an absolute contraindication, but extensive adhesions can make laparoscopic access more difficult. The TEP variant (totally extraperitoneal) is sometimes preferred over TAPP in this situation because it avoids entering the abdominal cavity. The surgeon may convert to open repair intra-operatively if safe laparoscopic access is not achievable." }, { "question": "What is the difference between TAPP and TEP in clinical outcome?", "answer": "TAPP and TEP have broadly comparable long-term outcomes (recurrence, chronic pain) in adequately powered trials. TAPP allows inspection of the contralateral side and the abdominal cavity, which can reveal occult hernias; TEP avoids peritoneal entry, reducing the rare risk of bowel injury. The choice usually depends on surgeon training and patient anatomy." } ], "subtypes": [], "anaesthesia": "general", "operatingTime": { "lowMinutes": 45, "highMinutes": 120, "sourceSlugs": [ "nice-ta160-laparoscopic-hernia", "cochrane-laparoscopic-vs-open-hernia" ] }, "hospitalStay": { "lowNights": 0, "highNights": 1, "sourceSlugs": [ "nice-ta160-laparoscopic-hernia" ] }, "minimumInCountryDays": { "low": 3, "high": 7, "sourceSlugs": [ "nice-ta160-laparoscopic-hernia" ] }, "daysToFly": { "low": 3, "high": 5, "explanation": "Laparoscopic repair allows earlier flying than open repair; DVT prophylaxis advisable for long-haul.", "sourceSlugs": [ "iata-medical-cabin-guidance", "nice-ta160-laparoscopic-hernia" ] }, "complicationRate": { "value": 4, "range": [ 2, 8 ], "sourceSlugs": [ "cochrane-laparoscopic-vs-open-hernia" ] }, "revisionRate": { "value": 2, "range": [ 1, 5 ], "sourceSlugs": [ "cochrane-laparoscopic-vs-open-hernia" ] }, "risks": [ { "name": "Recurrence", "severity": "moderate", "rate": { "value": 0.02, "range": [ 0.01, 0.05 ] }, "prevention": "Mesh reinforcement; tension-free repair; experienced surgeon; smoking cessation pre-op.", "sourceSlugs": [ "cochrane-laparoscopic-vs-open-hernia" ] }, { "name": "Chronic post-operative pain", "severity": "moderate", "rate": { "value": 0.05, "range": [ 0.02, 0.1 ] }, "prevention": "Laparoscopic approach (lower than open); lightweight mesh; appropriate mesh fixation.", "sourceSlugs": [ "nice-ta160-laparoscopic-hernia", "cochrane-laparoscopic-vs-open-hernia" ] }, { "name": "Bowel or bladder injury", "severity": "severe", "rate": { "value": 0.005 }, "prevention": "Careful trocar placement; experienced laparoscopic team.", "sourceSlugs": [ "cochrane-laparoscopic-vs-open-hernia" ] }, { "name": "Mesh infection", "severity": "severe", "rate": { "value": 0.002 }, "prevention": "Antibiotic prophylaxis; sterile technique.", "sourceSlugs": [ "who-surgical-safety-checklist" ] }, { "name": "Trocar-site hernia", "severity": "minor", "rate": { "value": 0.01 }, "prevention": "Fascial closure of larger ports.", "sourceSlugs": [ "cochrane-laparoscopic-vs-open-hernia" ] } ], "eligibility": [ { "criterion": "Symptomatic primary, bilateral, or recurrent inguinal/femoral hernia", "sourceSlugs": [ "nice-ta160-laparoscopic-hernia" ] }, { "criterion": "Cardiopulmonary fitness for general anaesthesia and pneumoperitoneum", "sourceSlugs": [ "rcoa-standards-anaesthesia" ] }, { "criterion": "Smoking cessation 4 weeks pre-op (recommended)", "sourceSlugs": [ "who-surgical-safety-checklist" ] } ], "contraindications": [ { "contraindication": "Severe medical comorbidity precluding general anaesthesia", "sourceSlugs": [ "rcoa-standards-anaesthesia" ] }, { "contraindication": "Active intra-abdominal infection", "sourceSlugs": [ "who-surgical-safety-checklist" ] }, { "contraindication": "Extensive previous abdominal surgery with anticipated dense adhesions (relative)", "sourceSlugs": [ "nice-ta160-laparoscopic-hernia" ] } ], "followUpCadence": [ { "at": "1 week", "type": "Wound check", "required": true }, { "at": "6 weeks", "type": "Return-to-activity review", "required": true }, { "at": "3 months", "type": "Pain and recurrence assessment", "required": true } ], "recordsToObtain": [ "Operative report including approach (TAPP/TEP) and mesh details", "Mesh manufacturer, brand, and lot number", "Anaesthetic record", "Discharge activity-restriction instructions" ], "numberOfVisits": { "typical": 2, "minimum": 1 }, "recoveryByActivity": { "sedentaryWork": { "days": 10, "sourceSlugs": [ "nice-ta160-laparoscopic-hernia" ] }, "manualWork": { "days": 28, "sourceSlugs": [ "nice-ta160-laparoscopic-hernia" ] }, "lightExercise": { "days": 14, "sourceSlugs": [ "nice-ta160-laparoscopic-hernia" ] }, "vigorousExercise": { "days": 42, "sourceSlugs": [ "nice-ta160-laparoscopic-hernia" ] }, "swimming": { "days": 21, "sourceSlugs": [ "nice-ta160-laparoscopic-hernia" ] }, "flying": { "days": 5, "sourceSlugs": [ "iata-medical-cabin-guidance" ] }, "driving": { "days": 7, "sourceSlugs": [ "nice-ta160-laparoscopic-hernia" ] } }, "parentProcedure": "hernia-repair", "literatureLinks": [ { "title": "Robotic versus laparoscopic inguinal hernia repair: an updated systematic review and meta-analysis.", "journal": "Journal of robotic surgery", "year": 2022, "doi": "10.1007/s11701-021-01312-6", "url": "https://doi.org/10.1007/s11701-021-01312-6" }, { "title": "Robotic surgery for inguinal and ventral hernia repair: a systematic review and meta-analysis.", "journal": "Surgical endoscopy", "year": 2024, "doi": "10.1007/s00464-023-10545-5", "url": "https://doi.org/10.1007/s00464-023-10545-5" }, { "title": "Open versus laparoscopic repair of inguinal hernia: an overview of systematic reviews of randomised controlled trials.", "journal": "Surgical endoscopy", "year": 2022, "doi": "10.1007/s00464-022-09161-6", "url": "https://doi.org/10.1007/s00464-022-09161-6" } ], "accreditationsRequired": [ "ehs-accredited-hernia-surgeon" ] }, { "slug": "breast-augmentation-submuscular", "name": "Submuscular Breast Augmentation", "category": "cosmetic-surgery", "description": "Submuscular breast augmentation places the implant beneath the pectoralis major muscle, in contrast to subglandular placement under the breast tissue alone. The submuscular approach (which is most commonly the 'dual-plane' variant, where the upper pole of the implant is fully submuscular and the lower pole is in the subglandular plane) is preferred for patients with thin breast tissue, thin overlying skin, or a preference for a more natural-looking upper-pole transition. Compared to subglandular placement, submuscular implants have lower capsular contracture rates, better mammographic visibility, and a smoother appearance under thin tissue — at the cost of a longer recovery, more initial post-operative pain, and visible 'animation deformity' on chest contraction in some patients.", "overview": "Submuscular and dual-plane breast augmentation has become the predominant approach for breast augmentation in most contemporary practice, particularly for patients with limited soft-tissue cover or after substantial weight loss. The classical submuscular plane offers superior implant coverage in the upper pole; the dual-plane technique addresses the well-known animation deformity by partially releasing the muscle origin so the lower pole sits in the natural subglandular plane.", "averageRecoveryDays": 21, "typicalSessions": 1, "priceRangeUSD": { "low": 4500, "high": 9500 }, "keyConsiderations": [ "Lower capsular contracture rate than subglandular placement", "More natural-looking upper-pole transition in thin patients", "Animation deformity affects 5-10% — dual-plane technique mitigates", "Longer initial recovery and more post-operative pain than subglandular" ], "commonRisks": [ "Capsular contracture (lower rate than subglandular)", "Animation deformity", "Implant displacement", "Bottoming out", "Asymmetry", "Sensory changes" ], "questionsToAsk": [ "Submuscular vs dual-plane — which for my case and why?", "What is your animation-deformity rate?", "What implant type, brand, surface texture, and size are you recommending and why?", "What is your capsular-contracture rate at 5 years?", "Do you use rapid-recovery protocols (no drains, early mobilisation)?", "What is your revision rate?" ], "aliases": [ "Subpectoral breast augmentation", "Dual-plane breast augmentation" ], "relatedProcedures": [ "breast-augmentation" ], "costBreakdown": "Submuscular breast augmentation is typically priced at the same level as subglandular at most clinics; both involve identical implant cost and similar operative time. Total cost depends on implant brand and type (cohesive silicone vs saline, smooth vs textured), surgeon's fee, anaesthetic fee, and facility fee. Quoted prices usually include the implant, the procedure, anaesthesia, and a short period of follow-up. Implant warranties (lifetime against rupture, 10-year against capsular contracture) are usually included by the manufacturer.", "medicalTourismNotes": "Submuscular breast augmentation requires the same in-country stay as subglandular augmentation (7-10 days) but pain in the first week is more pronounced because the pectoralis major muscle is stretched. International patients should plan for 5-7 days locally before flying long-haul; DVT prophylaxis is recommended after general anaesthesia.\n\nThe implant brand, model, size, lot number, and surface texture must be documented in the implant passport for lifetime surveillance — this is non-negotiable for any breast augmentation regardless of pocket placement. The implant passport will be needed for any subsequent imaging, recall response, or revision surgery.", "recoveryTimeline": "Days 0-3: most painful phase. Chest tightness, muscle spasm, and difficulty lifting arms above shoulder height. Sleep upright or in a recliner. Prescribed analgesia and muscle relaxants are usually required. Light walking is encouraged from day 1.\n\nDays 4-7: pain decreases substantially. Most patients can lift arms to head height by day 5-7. Showering permitted once dressings are removed (typically day 2-3). No driving while taking opioid analgesia.\n\nWeek 2: return to sedentary work for most patients. Continued use of supportive surgical bra. Wound review at 1-2 weeks. No upper-body exercise; no lifting more than 2-3kg.\n\nWeek 4-6: gradual return to upper-body exercise. Implants begin to 'drop and fluff' into final position over weeks 4-12. Continued surgical bra during the day; sports bra at night for upper-pole support.\n\nMonth 3: most patients reach near-final result and full unrestricted activity. Final implant position and shape continue refining for up to 12 months.\n\nMonth 6-12: long-term surveillance begins. Annual review with the surgeon is recommended for the first 2 years, then biennial. Implant-specific MRI surveillance for silicone implants is recommended in some jurisdictions (FDA in the US recommends from 5 years).", "faqs": [ { "question": "What is animation deformity?", "answer": "When the pectoralis major contracts (during exercise or arm movement), submuscular implants can visibly move or distort. This is most pronounced in fully submuscular placement and is minimised by dual-plane technique with partial muscle release. Animation deformity is largely cosmetic and rarely requires revision unless severe." }, { "question": "Why submuscular rather than subglandular?", "answer": "Submuscular placement has lower capsular contracture rates, better mammographic visibility for cancer screening, and a more natural upper-pole transition in patients with thin tissue. For patients with substantial natural breast tissue, subglandular placement may produce a softer, more 'natural-moving' result without animation concerns." }, { "question": "Will I lose strength in my chest after submuscular augmentation?", "answer": "Most patients do not experience meaningful long-term loss of chest strength after fully submuscular or dual-plane placement. Some athletes (powerlifters, bodybuilders) may notice changes; these patients sometimes prefer subglandular placement for that reason." }, { "question": "How long until I can exercise?", "answer": "Light walking from day 1. Lower-body exercise from week 2-3. Full upper-body exercise (chest, shoulders, back) from week 6-8. Specific guidance from the surgeon should be followed; over-eager return to upper-body work is one of the more common precipitants of implant displacement." }, { "question": "Is the capsular contracture rate really lower?", "answer": "Multiple studies (and ASPS data) support a lower capsular contracture rate with submuscular placement, particularly with smooth implants. The absolute rates vary by study but typical 10-year rates are 5-10% submuscular vs 15-25% subglandular." }, { "question": "How much does it cost compared to subglandular?", "answer": "Identical pricing at most clinics — the implant and operative time are the same. The cost driver is the implant itself, not the pocket location." }, { "question": "Will submuscular implants affect my ability to breastfeed in future?", "answer": "Submuscular placement does not affect milk-producing glandular tissue and most studies show no impact on breastfeeding success rates. The incision approach (peri-areolar, infra-mammary, trans-axillary) has a larger effect on nipple sensation than pocket location does, and peri-areolar incisions carry the highest reported nipple-sensation-disturbance rate." }, { "question": "Can I switch from subglandular to submuscular at a revision?", "answer": "Yes — pocket-conversion from subglandular to submuscular (or to dual-plane) is a common revision procedure, often performed for capsular contracture or for thin tissue cover. The capsule from the original pocket is typically excised; the implant is exchanged at the same operation in most cases." } ], "subtypes": [], "anaesthesia": "general", "operatingTime": { "lowMinutes": 90, "highMinutes": 180, "sourceSlugs": [ "asps-practice-parameters" ] }, "hospitalStay": { "lowNights": 0, "highNights": 1, "sourceSlugs": [ "asps-practice-parameters" ] }, "minimumInCountryDays": { "low": 7, "high": 10, "sourceSlugs": [ "asps-practice-parameters" ] }, "daysToFly": { "low": 5, "high": 7, "explanation": "DVT risk after general anaesthesia; surgeon-specific guidance varies but most recommend at least 5-7 days post-op.", "sourceSlugs": [ "nice-ng89-venous-thromboembolism", "iata-medical-cabin-guidance" ] }, "complicationRate": { "value": 8, "range": [ 5, 12 ], "sourceSlugs": [ "asps-practice-parameters" ] }, "revisionRate": { "value": 12, "range": [ 8, 18 ], "sourceSlugs": [ "asps-practice-parameters", "isaps-global-survey" ] }, "risks": [ { "name": "Capsular contracture", "severity": "moderate", "rate": { "value": 0.07, "range": [ 0.05, 0.1 ] }, "prevention": "Submuscular placement (lower than subglandular); funnel insertion; sterile technique.", "sourceSlugs": [ "asps-practice-parameters" ] }, { "name": "Animation deformity", "severity": "minor", "rate": { "value": 0.08, "range": [ 0.05, 0.15 ] }, "prevention": "Dual-plane technique with partial muscle release; appropriate implant selection.", "sourceSlugs": [ "asps-practice-parameters" ] }, { "name": "Implant displacement / bottoming out", "severity": "moderate", "rate": { "value": 0.05 }, "prevention": "Appropriate pocket dissection; supportive bra; restricted upper-body exercise during healing.", "sourceSlugs": [ "asps-practice-parameters" ] }, { "name": "Surgical site infection", "severity": "moderate", "rate": { "value": 0.02 }, "prevention": "Antibiotic prophylaxis; sterile technique.", "sourceSlugs": [ "who-surgical-safety-checklist" ] }, { "name": "Asymmetry requiring revision", "severity": "moderate", "rate": { "value": 0.08 }, "prevention": "Pre-operative measurement; staged approach in complex cases.", "sourceSlugs": [ "asps-practice-parameters" ] } ], "eligibility": [ { "criterion": "Skeletal maturity (typically over 18 for cosmetic)", "sourceSlugs": [ "asps-practice-parameters" ] }, { "criterion": "Limited soft-tissue cover (often the primary indication for submuscular)", "sourceSlugs": [ "asps-practice-parameters" ] }, { "criterion": "General anaesthetic fitness", "sourceSlugs": [ "rcoa-standards-anaesthesia" ] } ], "contraindications": [ { "contraindication": "Active breast cancer or untreated suspicious lesion", "sourceSlugs": [ "asps-practice-parameters" ] }, { "contraindication": "Body dysmorphic disorder until evaluated", "sourceSlugs": [ "asps-practice-parameters" ] }, { "contraindication": "Pregnancy or breastfeeding", "sourceSlugs": [ "asps-practice-parameters" ] }, { "contraindication": "Bodybuilding/powerlifting (relative — consider subglandular)", "sourceSlugs": [ "asps-practice-parameters" ] } ], "followUpCadence": [ { "at": "1 week", "type": "Wound and pain review; supportive bra confirmation", "required": true }, { "at": "6 weeks", "type": "Healing and exercise-clearance review", "required": true }, { "at": "6 months", "type": "Capsule and aesthetic review", "required": true }, { "at": "Annual", "type": "Long-term surveillance for first 2 years, then biennial", "required": true } ], "recordsToObtain": [ "Implant brand, model, size, lot number, surface texture (implant passport)", "Operative report including pocket location and muscle release technique", "Anaesthetic record", "Pre and post photographs" ], "numberOfVisits": { "typical": 2, "minimum": 1 }, "recoveryByActivity": { "sedentaryWork": { "days": 7, "sourceSlugs": [ "asps-practice-parameters" ] }, "manualWork": { "days": 28, "sourceSlugs": [ "asps-practice-parameters" ] }, "lightExercise": { "days": 21, "sourceSlugs": [ "asps-practice-parameters" ] }, "vigorousExercise": { "days": 42, "sourceSlugs": [ "asps-practice-parameters" ] }, "swimming": { "days": 42, "sourceSlugs": [ "asps-practice-parameters" ] }, "flying": { "days": 5, "sourceSlugs": [ "iata-medical-cabin-guidance" ] }, "driving": { "days": 7, "sourceSlugs": [ "asps-practice-parameters" ] } }, "parentProcedure": "breast-augmentation", "literatureLinks": [ { "title": "Dual plane breast augmentation: optimizing implant-soft-tissue relationships in a wide range of breast types.", "journal": "Plastic and reconstructive surgery", "year": 2006, "doi": "10.1097/00006534-200612001-00012", "url": "https://doi.org/10.1097/00006534-200612001-00012" }, { "title": "Direct-to-Implant Subcutaneous Breast Reconstruction: A Systematic Review of Complications and Patient's Quality of Life.", "journal": "Aesthetic plastic surgery", "year": 2023, "doi": "10.1007/s00266-022-03068-2", "url": "https://doi.org/10.1007/s00266-022-03068-2" }, { "title": "Prepectoral Breast Reconstruction.", "journal": "Seminars in plastic surgery", "year": 2019, "doi": "10.1055/s-0039-1696966", "url": "https://doi.org/10.1055/s-0039-1696966" } ], "accreditationsRequired": [ "isaps-member-surgeon", "national-plastic-surgery-board" ] }, { "slug": "cabg-off-pump", "name": "Off-Pump Coronary Artery Bypass (OPCAB)", "category": "cardiology", "description": "Off-pump coronary artery bypass (OPCAB) is a CABG technique performed on a beating heart without cardiopulmonary bypass. The surgeon uses tissue stabilisers to immobilise the small area of the coronary artery being grafted while the rest of the heart continues to beat. OPCAB avoids the systemic inflammatory response and other physiological consequences of cardiopulmonary bypass, but is technically more demanding than on-pump CABG and may produce slightly fewer complete revascularisations in some hands. ACC/AHA guidelines recommend OPCAB as a reasonable alternative to on-pump CABG in selected patients, particularly those with calcified ascending aortas where aortic cannulation is high-risk.", "overview": "Off-pump CABG was popularised in the 1990s and 2000s as a way to avoid the inflammatory and neurological consequences of cardiopulmonary bypass. The technique requires advanced stabilisation equipment, intracoronary shunts to maintain distal coronary flow during grafting, and considerable surgeon experience. Large randomised trials (ROOBY, CORONARY) have shown comparable mortality and major adverse cardiac event rates compared to on-pump CABG when performed by experienced operators, with some short-term advantages (stroke, transfusion) and the trade-off of slightly lower graft patency in some series.", "averageRecoveryDays": 56, "typicalSessions": 1, "priceRangeUSD": { "low": 22000, "high": 70000 }, "keyConsiderations": [ "Avoids cardiopulmonary bypass and its systemic inflammatory response", "Surgeon experience and volume materially affect outcomes", "Conversion to on-pump occurs in 5-15% intra-operatively", "Particularly indicated for severely calcified ascending aorta" ], "commonRisks": [ "Incomplete revascularisation", "Conversion to on-pump CABG", "Atrial fibrillation", "Stroke", "Sternal wound infection", "Atelectasis" ], "questionsToAsk": [ "What proportion of your CABG cases are off-pump?", "What is your conversion-to-on-pump rate?", "What is your graft completion rate (planned vs achieved)?", "What evidence supports OPCAB for my specific anatomy?", "What is your 30-day mortality and major adverse cardiac event rate for OPCAB?", "Do you have an outcomes registry I can review?" ], "aliases": [ "OPCAB", "Beating heart bypass", "Off-pump bypass" ], "relatedProcedures": [ "cabg" ], "costBreakdown": "Off-pump CABG pricing is typically equivalent to on-pump at the same centre — the operating room time and length of stay are similar, and the avoided cardiopulmonary bypass equipment is offset by specialised stabiliser cost. Total quoted prices cover surgeon's fee, anaesthetic fee, ICU and ward stay (typically 1-2 nights ICU + 3-5 nights step-down), all in-hospital medications, and immediate follow-up. Cardiac rehabilitation may be a separate cost.", "medicalTourismNotes": "Off-pump CABG is offered at a smaller subset of cardiac centres because of the surgical expertise required. Patients considering OPCAB specifically should verify that the destination centre performs the technique routinely (typically >50 OPCAB cases per surgeon per year) and that the proposed surgeon is recognised in OPCAB outcomes data.\n\nLong-haul flying after CABG (on-pump or off-pump) is typically not advised for 3-6 weeks per IATA medical guidance, longer for complex or complicated cases. International patients should plan for an extended in-country recovery and have a clear handover plan to home-country cardiology services for ongoing surveillance.", "recoveryTimeline": "Days 0-2: ICU recovery. Extubation typically within hours of OPCAB (faster than on-pump CABG in most series). Aggressive pulmonary toilet to prevent atelectasis. Pain control with regional and systemic analgesia.\n\nDay 3-5: transfer to step-down ward. Mobilisation and chest physiotherapy. Daily review of cardiac rhythm; atrial fibrillation occurs in 20-30% of post-CABG patients and may be managed with rate or rhythm control.\n\nDay 5-7: discharge to local accommodation. Continued mobilisation, regular wound checks, anticoagulant prophylaxis as indicated.\n\nWeek 2-3: outpatient cardiology and surgery review. Wound assessment, ECG, and bloods. Continued cardiac rehabilitation referral.\n\nWeek 4-6: gradual increase in activity. Walking to 30-45 minutes daily. Return to driving usually permitted at 6 weeks. Sternal precautions (no lifting >2-3kg, no pulling/pushing) continue.\n\nWeek 8-12: full sternal healing. Return to most normal activity. Cardiac rehabilitation continues. Lifelong cardiology follow-up begins for management of secondary prevention (aspirin, statin, blood pressure, lipid targets).", "faqs": [ { "question": "Is off-pump CABG safer than on-pump?", "answer": "In experienced hands, mortality is comparable. OPCAB has short-term advantages (lower transfusion, possibly lower stroke rate, faster extubation) and the trade-off of slightly lower graft patency in some series and the surgical demand. ACC/AHA guidelines recommend OPCAB as reasonable in selected patients (Class IIa)." }, { "question": "When is off-pump CABG specifically recommended?", "answer": "Patients with severely calcified ascending aortas (where aortic cannulation for on-pump bypass is high-risk) are the strongest candidates. Patients with significant comorbidity (renal dysfunction, advanced age, severe lung disease) may also benefit from avoiding cardiopulmonary bypass." }, { "question": "How experienced does my surgeon need to be?", "answer": "OPCAB has a meaningful learning curve. Surgeons with high OPCAB volumes (>50 cases per year) achieve outcomes comparable to on-pump CABG. Low-volume operators may have worse outcomes — both for completion of revascularisation and for major adverse events." }, { "question": "What if the surgeon needs to convert to on-pump intra-operatively?", "answer": "Conversion to on-pump CABG happens in 5-15% of OPCAB cases depending on patient anatomy and surgeon experience. Pre-operative consent should always cover the possibility of conversion. Outcomes after conversion are similar to planned on-pump CABG." }, { "question": "Can I have OPCAB if I have multiple-vessel disease?", "answer": "Yes — modern OPCAB technique allows multi-vessel revascularisation in most patients. The decision is based on coronary anatomy, target vessel quality, and surgeon experience. Some patterns (deep posterior targets, marginal target vessels) are technically more demanding off-pump." }, { "question": "How long is the in-hospital stay?", "answer": "Total length of stay is typically 5-7 days, similar to on-pump CABG. Extubation may be faster (4-6 hours vs 8-12 hours on-pump) and ICU stay slightly shorter, but step-down and ward time are comparable." }, { "question": "Can off-pump CABG be combined with valve surgery?", "answer": "Combining off-pump CABG with valve replacement is technically possible but reduces the off-pump advantage substantially, because valve surgery typically requires cardiopulmonary bypass anyway. Most surgeons performing combined coronary-valve operations use on-pump CABG to maintain a consistent operative environment." }, { "question": "Is recovery shorter after off-pump CABG?", "answer": "Extubation typically happens earlier (4-6 hours vs 8-12 hours on-pump) and ICU stay is slightly shorter, but total hospital length-of-stay is broadly similar — 5-7 days for most patients. The longer-term recovery trajectory (return to sedentary work, cardiac rehabilitation milestones) is comparable between on-pump and off-pump CABG." } ], "subtypes": [], "anaesthesia": "general", "operatingTime": { "lowMinutes": 180, "highMinutes": 300, "sourceSlugs": [ "aha-cabg-guideline-2021", "sts-adult-cardiac-database" ] }, "hospitalStay": { "lowNights": 5, "highNights": 8, "sourceSlugs": [ "aha-cabg-guideline-2021", "sts-adult-cardiac-database" ] }, "minimumInCountryDays": { "low": 21, "high": 28, "sourceSlugs": [ "aha-cabg-guideline-2021" ] }, "daysToFly": { "low": 21, "high": 42, "explanation": "Major cardiac surgery; flying typically not advised for 3-6 weeks per IATA medical guidance.", "sourceSlugs": [ "iata-medical-cabin-guidance", "aha-cabg-guideline-2021" ] }, "complicationRate": { "value": 8, "range": [ 5, 13 ], "sourceSlugs": [ "sts-adult-cardiac-database" ] }, "mortalityRate": { "value": 1.5, "range": [ 0.5, 3 ], "sourceSlugs": [ "sts-adult-cardiac-database", "aha-cabg-guideline-2021" ] }, "risks": [ { "name": "Incomplete revascularisation", "severity": "moderate", "rate": { "value": 0.05, "range": [ 0.03, 0.1 ] }, "prevention": "Experienced surgeon; appropriate patient selection.", "sourceSlugs": [ "aha-cabg-guideline-2021" ] }, { "name": "Conversion to on-pump CABG", "severity": "moderate", "rate": { "value": 0.08, "range": [ 0.05, 0.15 ] }, "prevention": "Experienced surgeon; appropriate patient selection; readiness of bypass equipment.", "sourceSlugs": [ "aha-cabg-guideline-2021" ] }, { "name": "Stroke (peri-operative)", "severity": "severe", "rate": { "value": 0.01, "range": [ 0.005, 0.02 ] }, "prevention": "Avoidance of aortic clamping in calcified-aorta patients; intra-operative monitoring.", "sourceSlugs": [ "sts-adult-cardiac-database" ] }, { "name": "Atrial fibrillation (post-op)", "severity": "moderate", "rate": { "value": 0.25, "range": [ 0.15, 0.4 ] }, "prevention": "Beta-blocker continuation; amiodarone in high-risk.", "sourceSlugs": [ "aha-cabg-guideline-2021" ] }, { "name": "Sternal wound infection", "severity": "severe", "rate": { "value": 0.015, "range": [ 0.01, 0.03 ] }, "prevention": "Antibiotic prophylaxis; tight glycaemic control.", "sourceSlugs": [ "aha-cabg-guideline-2021" ] } ], "eligibility": [ { "criterion": "Multi-vessel coronary disease unsuitable for percutaneous intervention", "sourceSlugs": [ "aha-cabg-guideline-2021" ] }, { "criterion": "Severely calcified ascending aorta (strong indication)", "sourceSlugs": [ "aha-cabg-guideline-2021" ] }, { "criterion": "Significant comorbidity favouring avoidance of cardiopulmonary bypass", "sourceSlugs": [ "aha-cabg-guideline-2021" ] } ], "contraindications": [ { "contraindication": "Targets unsuitable for stabilisation (deep posterior, severely calcified)", "sourceSlugs": [ "aha-cabg-guideline-2021" ] }, { "contraindication": "Haemodynamic instability requiring immediate cardiopulmonary support", "sourceSlugs": [ "aha-cabg-guideline-2021" ] }, { "contraindication": "Low-volume OPCAB surgeon (relative; outcome data favours high-volume)", "sourceSlugs": [ "aha-cabg-guideline-2021" ] } ], "followUpCadence": [ { "at": "1 week", "type": "Wound and discharge follow-up", "required": true }, { "at": "6 weeks", "type": "Cardiac rehabilitation review", "required": true }, { "at": "3 months", "type": "Symptoms and exercise tolerance", "required": true }, { "at": "Annual", "type": "Lifelong cardiology surveillance", "required": true } ], "recordsToObtain": [ "Pre-op coronary angiography report", "Operative report (grafts performed, off-pump vs converted)", "Anaesthetic record", "Discharge medications and rehab plan" ], "numberOfVisits": { "typical": 6, "minimum": 4 }, "recoveryByActivity": { "sedentaryWork": { "days": 42, "sourceSlugs": [ "aha-cabg-guideline-2021" ] }, "manualWork": { "days": 84, "sourceSlugs": [ "aha-cabg-guideline-2021" ] }, "lightExercise": { "days": 42, "sourceSlugs": [ "aha-cabg-guideline-2021" ] }, "vigorousExercise": { "days": 84, "sourceSlugs": [ "aha-cabg-guideline-2021" ] }, "swimming": { "days": 56, "sourceSlugs": [ "aha-cabg-guideline-2021" ] }, "flying": { "days": 28, "sourceSlugs": [ "iata-medical-cabin-guidance" ] }, "driving": { "days": 42, "sourceSlugs": [ "aha-cabg-guideline-2021" ] } }, "parentProcedure": "cabg", "revisionRate": { "value": 5, "range": [ 3, 10 ], "sourceSlugs": [ "sts-adult-cardiac-database", "aha-cabg-guideline-2021" ] }, "literatureLinks": [ { "title": "Off-pump versus on-pump redo coronary artery bypass grafting: a systematic review and meta-analysis.", "journal": "Perfusion", "year": 2021, "doi": "10.1177/0267659120960310", "url": "https://doi.org/10.1177/0267659120960310" }, { "title": "On- vs. off-pump coronary artery bypass grafting: A systematic review and meta-analysis.", "journal": "International journal of cardiology", "year": 2016, "doi": "10.1016/j.ijcard.2016.08.250", "url": "https://doi.org/10.1016/j.ijcard.2016.08.250" }, { "title": "Off-Pump Versus On-Pump Coronary Artery Bypass Grafting-A Systematic Review and Analysis of Clinical Outcomes.", "journal": "Journal of cardiothoracic and vascular anesthesia", "year": 2019, "doi": "10.1053/j.jvca.2018.04.012", "url": "https://doi.org/10.1053/j.jvca.2018.04.012" } ], "accreditationsRequired": [ "national-cardiac-surgery-board", "jci-hospital-accreditation" ] }, { "slug": "hair-transplant-dhi", "name": "DHI (Direct Hair Implantation)", "category": "hair-transplant", "description": "DHI (Direct Hair Implantation) is a hair transplant technique in which follicular units are extracted from a donor area using a small punch (similar to FUE) and then implanted directly into the recipient site using a Choi pen-like implanter device. The Choi implanter creates the recipient incision and inserts the graft in a single action, allowing precise control of graft angle, direction, and depth, and eliminating the need for separate recipient-site creation. DHI is marketed as a distinct technique but is, mechanically, an FUE variant that uses an implanter rather than a forceps for graft placement.", "overview": "DHI emerged as a branded technique in the mid-2010s, particularly popularised in the Turkish hair-transplant market. The Choi implanter offers theoretical advantages over traditional forceps placement: faster implantation, better preservation of graft handling, more precise control of angle and depth, and the ability to implant into existing hair without prior site-making. The trade-off is a steeper learning curve for the implanting technicians and higher consumables cost (each pen requires sterile cartridges).", "averageRecoveryDays": 14, "typicalSessions": 1, "priceRangeUSD": { "low": 2500, "high": 8000 }, "keyConsiderations": [ "FUE variant using a Choi pen-like implanter for placement", "Slower per-graft than FUE — typically fewer grafts per session", "Allows implantation between existing hairs without prior site-making", "Marketed as a distinct technique — verify what the clinic actually provides" ], "commonRisks": [ "Folliculitis", "Shock loss of native hair", "Poor graft survival", "Donor area scarring" ], "questionsToAsk": [ "How does DHI differ from FUE in your clinic's protocol?", "Do you perform implantation yourself, or do technicians perform it?", "What is your graft survival rate at 12 months?", "What is the maximum number of grafts you place in a single session via DHI?", "How many DHI procedures has the operating team performed?", "Will I receive a recorded graft count and extraction record?" ], "aliases": [ "Direct Hair Implantation", "Choi implanter technique" ], "relatedProcedures": [ "hair-transplant" ], "costBreakdown": "DHI is typically priced 20-40% above FUE at the same clinic due to higher consumables cost and longer implantation time. Pricing models vary — some clinics charge per-graft, others per-session. Verify exactly which grafts are included, whether donor-area trichophytic closure (if any) is included, and whether post-operative medications (antibiotics, finasteride, minoxidil) are included.", "medicalTourismNotes": "DHI is one of the most-marketed hair-transplant techniques in the Turkish medical-tourism sector. The branding can obscure substantial variation between providers — some clinics performing 'DHI' use only one or two Choi pens for a portion of the session and a forceps for the rest, while others use Choi pens for the full implantation. International patients should specifically verify what the clinic provides, who actually performs the implantation, and the lead surgeon's involvement in the procedure.\n\nIn-country stay and recovery are identical to FUE — typically 3-5 days locally before flying. Post-operative crusting management is the same.", "recoveryTimeline": "Day 0: procedure completed in 6-9 hours under local anaesthesia. Bandaged donor area, antibiotic ointment. Patient may sleep semi-upright that night.\n\nDays 1-7: peak swelling around forehead and eyelids (resolves by day 5-7). Saline-based gentle rinsing of recipient and donor areas from day 2-3. Avoid touching grafts. Sleep with head elevated for 3-5 nights.\n\nDay 10-14: crusts separate naturally with continued gentle washing. Many patients return to social activity. Graft 'shock loss' begins around weeks 2-4 — transplanted hairs shed, leaving the follicles in place to grow new hairs later.\n\nMonth 1-3: dormant phase. The transplanted follicles remain in place but produce no visible hair.\n\nMonth 4-6: new growth begins. First hairs are typically fine and may be lighter in colour; they thicken over the following months.\n\nMonth 9-12: substantial growth visible. Most density at 12 months.\n\nMonth 18: final density and styling potential. Long-term care includes ongoing medical therapy (minoxidil, finasteride) to slow native hair progression.", "faqs": [ { "question": "How does DHI compare to FUE?", "answer": "DHI and FUE share the same extraction technique. They differ in implantation: FUE uses a forceps to place each graft into a pre-made recipient site, while DHI uses a Choi pen-like implanter to create the site and place the graft in one action. Outcomes (graft survival, density, naturalness) are broadly comparable in experienced hands." }, { "question": "Is DHI better than FUE?", "answer": "Not categorically. DHI's advantages — faster implantation, better angle/depth control, ability to implant into areas with existing hair without prior site-making — are real but modest. The single largest determinant of outcome is the operating team's experience and skill, not the implantation tool used." }, { "question": "How many grafts can be done in one DHI session?", "answer": "Typical sessions place 1,500-3,500 grafts. The maximum is limited more by the donor area than by the implantation technique. Some clinics offer multi-day sessions for larger graft counts." }, { "question": "Will my native hair be damaged?", "answer": "DHI allows implantation between existing hairs without first creating recipient sites, theoretically reducing the risk of damaging native follicles. In practice, some shock loss of native hair is normal and usually reversible." }, { "question": "How long until I can fly home?", "answer": "Most surgeons permit flying 2-3 days after DHI. Avoid pressing the seat headrest against the back of the head; use a neck pillow. Drink plenty of water to prevent dehydration that can compromise graft survival." }, { "question": "What happens if the technician does most of the work?", "answer": "In many busy hair-transplant clinics — particularly in Turkey — much of the implantation work is performed by trained technicians under the surgeon's supervision. Outcomes are tied to the team's experience and to the surgeon's planning and oversight. Confirm in advance who performs which part of the procedure and whether the named surgeon will be present throughout." }, { "question": "Why do some clinics quote DHI sessions in graft counts and others by area?", "answer": "Pricing models vary significantly. Per-graft pricing is more transparent and allows comparison between clinics — the surgeon estimates the required graft count after consultation. Per-session pricing typically caps the number of grafts and is less directly comparable. Per-area pricing is the least transparent and is generally avoided by experienced patients." }, { "question": "Can I have a DHI procedure if my hair has been previously transplanted?", "answer": "Yes — DHI can implant grafts between existing transplanted or native hairs without first creating recipient sites, making it well-suited to revision and refinement work after a previous transplant. The surgeon should review the existing hair pattern and donor area before quoting." } ], "subtypes": [], "anaesthesia": "local", "operatingTime": { "lowMinutes": 420, "highMinutes": 540, "sourceSlugs": [ "ishrs-standards" ] }, "hospitalStay": { "lowNights": 0, "highNights": 0, "sourceSlugs": [ "ishrs-standards" ] }, "minimumInCountryDays": { "low": 3, "high": 5, "sourceSlugs": [ "ishrs-standards" ] }, "daysToFly": { "low": 2, "high": 3, "explanation": "Same as FUE; pressure changes and crusting argue for 2-3 days locally before flying.", "sourceSlugs": [ "ishrs-standards", "iata-medical-cabin-guidance" ] }, "complicationRate": { "value": 3, "range": [ 1, 5 ], "sourceSlugs": [ "ishrs-standards" ] }, "revisionRate": { "value": 8, "range": [ 5, 15 ], "sourceSlugs": [ "ishrs-standards" ] }, "risks": [ { "name": "Folliculitis (graft infection)", "severity": "minor", "rate": { "value": 0.05 }, "prevention": "Sterile technique; post-operative saline irrigation.", "sourceSlugs": [ "ishrs-standards" ] }, { "name": "Shock loss of native hair", "severity": "moderate", "rate": { "value": 0.1 }, "prevention": "Conservative density in transitional zones; minoxidil pre-treatment.", "sourceSlugs": [ "ishrs-standards" ] }, { "name": "Poor graft survival", "severity": "moderate", "rate": { "value": 0.05 }, "prevention": "Minimised out-of-body time; appropriate hydration of grafts.", "sourceSlugs": [ "ishrs-standards" ] }, { "name": "Donor area patchiness", "severity": "minor", "rate": { "value": 0.05 }, "prevention": "Careful FUE extraction pattern.", "sourceSlugs": [ "ishrs-standards" ] } ], "eligibility": [ { "criterion": "Stabilised pattern of hair loss", "sourceSlugs": [ "ishrs-standards" ] }, { "criterion": "Adequate donor area density", "sourceSlugs": [ "ishrs-standards" ] }, { "criterion": "Realistic expectations", "sourceSlugs": [ "ishrs-standards" ] } ], "contraindications": [ { "contraindication": "Active scalp infection", "sourceSlugs": [ "ishrs-standards" ] }, { "contraindication": "Insufficient donor density", "sourceSlugs": [ "ishrs-standards" ] }, { "contraindication": "Body dysmorphic disorder until evaluated", "sourceSlugs": [ "ishrs-standards" ] } ], "followUpCadence": [ { "at": "10 days", "type": "Crust review and graft inspection", "required": true }, { "at": "3 months", "type": "Shedding-phase reassurance review", "required": true }, { "at": "6 months", "type": "Early growth assessment", "required": true }, { "at": "12 months", "type": "Final density assessment with photography", "required": true } ], "recordsToObtain": [ "Pre-operative donor and recipient photographs", "Grafts harvested and placed (count)", "Implantation technique (Choi pen specs)", "Post-operative care instructions" ], "numberOfVisits": { "typical": 1, "minimum": 1 }, "recoveryByActivity": { "sedentaryWork": { "days": 3, "sourceSlugs": [ "ishrs-standards" ] }, "manualWork": { "days": 7, "sourceSlugs": [ "ishrs-standards" ] }, "lightExercise": { "days": 14, "sourceSlugs": [ "ishrs-standards" ] }, "vigorousExercise": { "days": 30, "sourceSlugs": [ "ishrs-standards" ] }, "swimming": { "days": 30, "sourceSlugs": [ "ishrs-standards" ] }, "flying": { "days": 2, "sourceSlugs": [ "iata-medical-cabin-guidance" ] }, "driving": { "days": 1, "sourceSlugs": [ "ishrs-standards" ] } }, "parentProcedure": "hair-transplant", "alternativeTreatments": [ { "name": "Sapphire FUE", "procedureSlug": "sapphire-fue", "rationale": "Same FUE harvest with sapphire blades for the incisions; comparable cosmetic result, lower per-graft cost.", "sourceSlugs": [ "who-surgical-safety-checklist" ] }, { "name": "FUT", "procedureSlug": "hair-transplant-fut", "rationale": "Higher graft yield per session for advanced baldness; linear-scar trade-off.", "sourceSlugs": [ "who-surgical-safety-checklist" ] } ], "literatureLinks": [ { "title": "Comparison of Autogenous Tooth Graft With Polylactic Co-Glycolic Acid in Postextraction Socket for Alveolar Ridge Preservation: A Randomized Control Trial.", "journal": "Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons", "year": 2025, "doi": "10.1016/j.joms.2025.03.018", "url": "https://doi.org/10.1016/j.joms.2025.03.018" } ] }, { "slug": "hair-transplant-fut", "name": "FUT (Follicular Unit Transplantation, Strip Technique)", "category": "hair-transplant", "description": "FUT (Follicular Unit Transplantation), commonly called the 'strip technique', is a hair transplant method in which a long, narrow strip of donor scalp is surgically excised and dissected under microscopy into individual follicular units, which are then implanted into the recipient area. FUT is the older of the two main hair-transplant approaches (preceding FUE) and remains the technique of choice for very large graft counts in a single session, when donor density is limited, or when trichophytic donor closure is sought to minimise scar visibility.", "overview": "FUT was the standard of care for hair transplantation from the late 1990s until the widespread adoption of FUE in the 2010s. The technique offers high graft yield per session (typically 2,500-4,500 grafts), excellent preservation of follicular unit integrity (because dissection is performed under stereomicroscopy by trained technicians), and a single linear donor scar — which can be made nearly invisible with trichophytic closure techniques in experienced hands.", "averageRecoveryDays": 14, "typicalSessions": 1, "priceRangeUSD": { "low": 2000, "high": 7000 }, "keyConsiderations": [ "Higher graft yield per session than FUE (up to 4,500)", "Linear donor scar — trichophytic closure can make it nearly invisible", "Not suitable for patients with very short hair styles", "Faster total session time per graft than FUE" ], "commonRisks": [ "Linear donor scar (variable visibility)", "Donor-area numbness", "Scalp tightness", "Folliculitis", "Shock loss of native hair", "Poor graft survival" ], "questionsToAsk": [ "Why FUT rather than FUE for my case?", "Do you use trichophytic donor closure?", "How wide is your typical donor strip?", "What is your largest single-session graft count?", "What is your graft survival rate at 12 months?", "Can I see donor-scar photographs from previous patients with similar hair length?" ], "aliases": [ "Strip technique", "Follicular Unit Transplantation", "FUSS" ], "relatedProcedures": [ "hair-transplant" ], "costBreakdown": "FUT is typically priced equivalent to or slightly below FUE at the same clinic — extraction is faster but suturing and graft dissection require additional time. Pricing models vary: per-graft or per-session. Most clinics include the strip excision, microscope-assisted graft dissection, all implantation, and post-operative medications in the quoted price.", "medicalTourismNotes": "FUT travels well for medical tourism because it is a single in-clinic session with predictable recovery. International patients should plan for 5-7 days locally — slightly longer than FUE because the donor-area sutures or staples require removal at 10-14 days (the clinic can do this, or it can be arranged with a local clinician on return).\n\nFor patients who wear their hair short, FUE is usually preferred because the FUT linear scar can be visible. For patients with longer hair styles, FUT is often a better choice for large graft counts because total session time is shorter than the equivalent FUE.", "recoveryTimeline": "Day 0: procedure completed in 5-8 hours under local anaesthesia. Donor area sutured or stapled; gauze pressure for the first 24 hours. Patient sleeps semi-upright.\n\nDays 1-3: donor-area soreness and tightness — the dominant complaint after FUT. Mild swelling around forehead. Saline rinsing of recipient grafts from day 2-3. Avoid stretching/lifting movements that pull on the donor closure.\n\nDay 4-7: most patients return to office work. Continue gentle washing. Donor area becomes less tender.\n\nDay 10-14: sutures or staples removed. Donor scar still pink and slightly raised; will fade over 3-6 months.\n\nWeek 3-4: shock loss of transplanted hair begins — normal and expected.\n\nMonth 4-6: new growth begins.\n\nMonth 9-12: substantial visible density. Donor scar continues to fade. With trichophytic closure, hair grows through the scar making it less visible.\n\nMonth 18: final density and donor scar maturation. With short hair, the scar may be visible; with hair length covering the donor area it is typically not.", "faqs": [ { "question": "FUT vs FUE — which is better?", "answer": "Neither is categorically better. FUT offers higher graft yield per session and better follicular unit preservation; FUE offers no linear scar and faster donor-area recovery. The choice depends on the number of grafts needed, donor density, hair style preference (short hair favours FUE), and surgeon experience with each technique." }, { "question": "Will the FUT scar be visible?", "answer": "A linear scar approximately 1-2mm wide is always created in FUT. With modern trichophytic closure, hair grows through the scar making it much less visible. With hair length covering the donor area (typically Grade 2 or longer) the scar is usually not visible at all. With very short hair (Grade 1 or shaved), the scar can be visible." }, { "question": "Why is the maximum graft count higher with FUT?", "answer": "FUT allows extraction of a single contiguous strip of donor scalp, from which technicians can dissect every follicular unit under microscopy. FUE extracts each unit individually using punches, which is much slower and limits how many grafts can be safely extracted in one session." }, { "question": "Can I have FUT after I have already had FUE?", "answer": "Yes, although the existing FUE donor-area depletion may limit what's available. Some patients have multiple sessions of mixed techniques over years." }, { "question": "How long does the FUT recovery take?", "answer": "Donor area soreness and tightness for 1 week. Sutures or staples removed at 10-14 days. Most patients return to office work after 3-7 days; manual or contact-sport work requires 2-4 weeks. Final result at 12-18 months." }, { "question": "Will I need to shave my whole head for FUT?", "answer": "No — FUT only requires shaving of the narrow strip in the donor area, which is hidden by the surrounding longer hair. FUE typically requires the full donor area to be shaved short, which is more visible in the immediate post-operative period." }, { "question": "Will the FUT scar widen over time?", "answer": "Most well-closed FUT donor scars (1-2mm wide initially) stay narrow if standard closure with trichophytic edge is used. Scar widening is more likely in patients with thin scalp skin, patients who exercise heavy upper-body within the first month, or with very large strip widths. Revision (scar excision) can be performed if widening is cosmetically significant." }, { "question": "Can FUT and FUE be combined in the same session?", "answer": "Yes — combination FUT/FUE is sometimes used to maximise graft yield in single-session procedures, particularly in patients with extensive baldness. The donor strip is taken first, then additional FUE grafts are extracted from the remaining donor area. This is more demanding for the surgical team and not universally offered." } ], "subtypes": [], "anaesthesia": "local", "operatingTime": { "lowMinutes": 300, "highMinutes": 480, "sourceSlugs": [ "ishrs-standards" ] }, "hospitalStay": { "lowNights": 0, "highNights": 0, "sourceSlugs": [ "ishrs-standards" ] }, "minimumInCountryDays": { "low": 3, "high": 5, "sourceSlugs": [ "ishrs-standards" ] }, "daysToFly": { "low": 2, "high": 3, "explanation": "Donor-area sutures do not contraindicate flying once initial dressing is removed.", "sourceSlugs": [ "ishrs-standards", "iata-medical-cabin-guidance" ] }, "complicationRate": { "value": 3, "range": [ 1, 5 ], "sourceSlugs": [ "ishrs-standards" ] }, "revisionRate": { "value": 8, "range": [ 5, 15 ], "sourceSlugs": [ "ishrs-standards" ] }, "risks": [ { "name": "Visible donor scar", "severity": "moderate", "rate": { "value": 0.3, "range": [ 0.1, 0.5 ] }, "prevention": "Trichophytic closure; appropriate strip width; experienced closure technique.", "sourceSlugs": [ "ishrs-standards" ] }, { "name": "Donor-area numbness (typically temporary)", "severity": "minor", "rate": { "value": 0.2 }, "prevention": "Careful dissection of donor strip.", "sourceSlugs": [ "ishrs-standards" ] }, { "name": "Folliculitis", "severity": "minor", "rate": { "value": 0.05 }, "prevention": "Sterile technique; antibiotic prophylaxis as indicated.", "sourceSlugs": [ "ishrs-standards" ] }, { "name": "Poor graft survival", "severity": "moderate", "rate": { "value": 0.05 }, "prevention": "Minimised out-of-body time; appropriate hydration.", "sourceSlugs": [ "ishrs-standards" ] } ], "eligibility": [ { "criterion": "Stabilised pattern of hair loss", "sourceSlugs": [ "ishrs-standards" ] }, { "criterion": "Adequate donor density at occipital scalp", "sourceSlugs": [ "ishrs-standards" ] }, { "criterion": "Hair style allowing donor-scar coverage (typically Grade 2 or longer)", "sourceSlugs": [ "ishrs-standards" ] } ], "contraindications": [ { "contraindication": "Active scalp infection or inflammatory condition", "sourceSlugs": [ "ishrs-standards" ] }, { "contraindication": "Very short hair preference (relative — FUE may be preferred)", "sourceSlugs": [ "ishrs-standards" ] }, { "contraindication": "Keloid scarring tendency (relative)", "sourceSlugs": [ "ishrs-standards" ] } ], "followUpCadence": [ { "at": "10-14 days", "type": "Suture or staple removal", "required": true }, { "at": "3 months", "type": "Shedding-phase reassurance", "required": true }, { "at": "6 months", "type": "Early growth assessment", "required": true }, { "at": "12 months", "type": "Final density and scar assessment", "required": true } ], "recordsToObtain": [ "Pre-op donor and recipient photographs", "Strip dimensions and graft count", "Closure technique (trichophytic vs standard)", "Post-operative care plan" ], "numberOfVisits": { "typical": 1, "minimum": 1 }, "recoveryByActivity": { "sedentaryWork": { "days": 3, "sourceSlugs": [ "ishrs-standards" ] }, "manualWork": { "days": 7, "sourceSlugs": [ "ishrs-standards" ] }, "lightExercise": { "days": 14, "sourceSlugs": [ "ishrs-standards" ] }, "vigorousExercise": { "days": 30, "sourceSlugs": [ "ishrs-standards" ] }, "swimming": { "days": 30, "sourceSlugs": [ "ishrs-standards" ] }, "flying": { "days": 2, "sourceSlugs": [ "iata-medical-cabin-guidance" ] }, "driving": { "days": 1, "sourceSlugs": [ "ishrs-standards" ] } }, "parentProcedure": "hair-transplant", "literatureLinks": [ { "title": "A Systematic Review of Follicular Unit Graft Survival Rates After Hair Transplantation in Primary Cicatricial Alopecia.", "journal": "Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]", "year": 2025, "doi": "10.1097/DSS.0000000000004707", "url": "https://doi.org/10.1097/DSS.0000000000004707" }, { "title": "Follicular unit extraction: minimally invasive surgery for hair transplantation.", "journal": "Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]", "year": 2002, "doi": "10.1046/j.1524-4725.2002.01320.x", "url": "https://doi.org/10.1046/j.1524-4725.2002.01320.x" }, { "title": "Hair Transplantation in Women.", "journal": "Journal of drugs in dermatology : JDD", "year": 2025, "doi": "10.36849/jdd.8988", "url": "https://doi.org/10.36849/jdd.8988" } ] }, { "slug": "gastric-bypass", "name": "Roux-en-Y Gastric Bypass", "category": "weight-loss", "description": "Roux-en-Y gastric bypass is a bariatric surgery that creates a small gastric pouch (typically 15-30ml) and bypasses most of the stomach and proximal small intestine. The procedure has two mechanisms: restriction (small pouch reduces meal volume) and malabsorption (bypassed proximal small bowel reduces nutrient absorption). RYGB produces typically greater weight loss than sleeve gastrectomy in many series, better resolution of type 2 diabetes and reflux disease, and a more durable long-term result — at the cost of technical complexity, higher early-complication rate, more demanding lifelong nutritional supplementation, and a small ongoing risk of internal hernia.", "overview": "RYGB was developed in the 1960s and refined into its modern laparoscopic form in the 1990s. It is considered the long-standing gold standard for bariatric surgery and is supported by Cochrane review data showing durable weight loss and metabolic disease resolution. Sleeve gastrectomy has overtaken RYGB in absolute numbers worldwide due to its lower technical complexity, but RYGB remains the procedure of choice for patients with severe reflux, Barrett's oesophagus, or strong metabolic indications.", "averageRecoveryDays": 21, "typicalSessions": 1, "priceRangeUSD": { "low": 11000, "high": 26000 }, "keyConsiderations": [ "Greater weight loss than sleeve in many series — particularly for severe reflux", "Lifelong nutritional supplementation (B12, iron, calcium) mandatory", "Internal hernia risk persists for life (1-5%)", "Better resolution of type 2 diabetes than sleeve in comparative trials" ], "commonRisks": [ "Anastomotic leak", "Bleeding", "Internal hernia", "Marginal ulcer", "Stricture at gastrojejunostomy", "Nutritional deficiencies", "Dumping syndrome" ], "questionsToAsk": [ "Why RYGB rather than sleeve for my case?", "Do you close mesenteric defects to prevent internal hernia?", "What is your leak rate at the gastrojejunostomy?", "What is your annual RYGB volume?", "What lifelong supplementation will I need and how is it monitored?", "What is your 30-day mortality and major complication rate?" ], "aliases": [ "RYGB", "Gastric bypass", "Roux-en-Y" ], "relatedProcedures": [ "gastric-sleeve" ], "costBreakdown": "RYGB is typically priced 10-25% above sleeve gastrectomy at the same centre due to longer operative time, more staple loads, and a slightly longer hospital stay. Quoted prices usually cover the procedure, ICU/HDU stay if needed, 2-4 nights ward stay, all in-hospital medications, and immediate follow-up. Long-term nutritional supplementation, follow-up bloods, and any revision surgery are typically additional.", "medicalTourismNotes": "RYGB requires careful coordination with home-country medical services for lifelong follow-up. International patients should plan for 7-10 days locally before flying long-haul, with DVT prophylaxis (RYGB carries substantial DVT risk). A clear handover plan to home-country bariatric services for nutritional surveillance, weight-loss support, and management of any long-term complications is essential — RYGB is the most follow-up-dependent of the common bariatric procedures.\n\nLifelong supplementation (B12, iron, calcium, multivitamin) is non-negotiable. Confirm that the prescriptions are available in your home country (most are) and that your home GP is willing to provide ongoing surveillance bloods.", "recoveryTimeline": "Day 0: procedure completed laparoscopically in 90-180 minutes. ICU or step-down monitoring overnight. Pain control with regional and systemic analgesia. NPO (nil by mouth) with IV fluids.\n\nDay 1: transfer to ward. Mobilisation. Sips of water if not vomiting. Continued DVT prophylaxis.\n\nDay 2-4: progression to clear liquids, then pureed diet. Discharge typically at day 3-4. Dietary advice from a bariatric dietitian.\n\nWeek 1-4: pureed and soft-textured foods. Walking and gentle activity. Continued anti-emetics, PPIs, and supplements.\n\nWeek 4-8: gradual return to solid foods. Smaller meal portions essential — pouch capacity is roughly 60-120ml. Slower eating, careful chewing.\n\nMonth 3-6: most patients establish their long-term eating pattern. Significant weight loss visible. Excess skin issues may begin in some patients.\n\nMonth 12-18: peak weight loss typically reached. Maintenance phase begins. Continued lifelong follow-up with bariatric team or substitute home services.", "faqs": [ { "question": "RYGB vs sleeve gastrectomy — which is right for me?", "answer": "RYGB is typically preferred for patients with severe reflux, Barrett's oesophagus, or strong metabolic indications (severe type 2 diabetes). Sleeve is typically preferred for patients without those indications, particularly first-time bariatric patients seeking a simpler, technically lower-risk procedure. A multidisciplinary team decision is standard." }, { "question": "How much weight will I lose?", "answer": "Typical excess weight loss at 2 years after RYGB is 65-80%. Sustained weight loss at 10 years is 50-65%. Individual variation is substantial — long-term success correlates strongly with adherence to dietary and lifestyle change after the procedure." }, { "question": "What is dumping syndrome?", "answer": "Dumping syndrome occurs when high-sugar food enters the small bowel rapidly through the small gastric pouch. Symptoms include nausea, sweating, palpitations, abdominal cramping, and weakness, usually 15-30 minutes after eating. It is largely preventable by avoiding concentrated sweets and following dietary guidance." }, { "question": "Will I need vitamins for life?", "answer": "Yes — lifelong supplementation with B12, iron, calcium, vitamin D, and a multivitamin is universal advice after RYGB because the bypassed proximal small bowel is where most micronutrient absorption occurs. Annual surveillance bloods are essential." }, { "question": "What is an internal hernia?", "answer": "An internal hernia is a complication unique to bypass procedures: small bowel can twist through one of the mesenteric defects created during surgery, causing obstruction. Rates have fallen with the widespread practice of mesenteric defect closure but remain a lifetime risk (1-5%). Symptoms include new-onset cramping abdominal pain, particularly after meals." }, { "question": "Can RYGB be reversed?", "answer": "Technically yes, but reversal is a major operation rarely performed and rarely indicated. RYGB should be considered a permanent decision." }, { "question": "Can I have gastric bypass if I have had previous abdominal surgery?", "answer": "Previous abdominal surgery is not a contraindication but can make laparoscopic access more challenging due to adhesions. The surgeon may convert to open surgery intra-operatively if safe laparoscopic access is not feasible. Pre-operative imaging to map any anticipated adhesions is sometimes performed." }, { "question": "Will gastric bypass affect medication absorption?", "answer": "Yes — bypass alters the absorption of some medications because the proximal small bowel (the main absorption site for many oral drugs) is bypassed. Extended-release formulations are commonly switched to immediate-release equivalents. Certain medications (e.g. some antifungals, thyroid hormone) may require dose adjustment based on serum-level monitoring." } ], "subtypes": [], "anaesthesia": "general", "operatingTime": { "lowMinutes": 90, "highMinutes": 180, "sourceSlugs": [ "ifso-bariatric-standards" ] }, "hospitalStay": { "lowNights": 2, "highNights": 4, "sourceSlugs": [ "ifso-bariatric-standards" ] }, "minimumInCountryDays": { "low": 7, "high": 14, "sourceSlugs": [ "ifso-bariatric-standards" ] }, "daysToFly": { "low": 10, "high": 14, "explanation": "Significant DVT risk; long-haul flying not advised before 10-14 days with prophylaxis.", "sourceSlugs": [ "nice-ng89-venous-thromboembolism", "ifso-bariatric-standards", "iata-medical-cabin-guidance" ] }, "complicationRate": { "value": 8, "range": [ 5, 12 ], "sourceSlugs": [ "cochrane-bariatric-surgery", "ifso-bariatric-standards" ] }, "revisionRate": { "value": 7, "range": [ 3, 12 ], "sourceSlugs": [ "ifso-bariatric-standards" ] }, "mortalityRate": { "value": 0.3, "range": [ 0.1, 0.5 ], "sourceSlugs": [ "ifso-bariatric-standards" ] }, "risks": [ { "name": "Anastomotic leak at gastrojejunostomy", "severity": "severe", "rate": { "value": 0.02, "range": [ 0.01, 0.04 ] }, "prevention": "Reinforced anastomosis; intra-operative leak test; experienced surgeon.", "sourceSlugs": [ "ifso-bariatric-standards" ] }, { "name": "Internal hernia (lifetime)", "severity": "severe", "rate": { "value": 0.03, "range": [ 0.01, 0.05 ] }, "prevention": "Closure of mesenteric defects intra-operatively.", "sourceSlugs": [ "ifso-bariatric-standards" ] }, { "name": "Marginal ulcer", "severity": "moderate", "rate": { "value": 0.05, "range": [ 0.02, 0.1 ] }, "prevention": "PPI prophylaxis post-operatively; smoking cessation; NSAID avoidance.", "sourceSlugs": [ "ifso-bariatric-standards" ] }, { "name": "Anastomotic stricture", "severity": "moderate", "rate": { "value": 0.05 }, "prevention": "Careful anastomotic technique.", "sourceSlugs": [ "ifso-bariatric-standards" ] }, { "name": "Vitamin / mineral deficiency", "severity": "moderate", "rate": { "value": 0.4, "range": [ 0.2, 0.6 ] }, "prevention": "Lifelong supplementation; annual surveillance bloods.", "sourceSlugs": [ "ifso-bariatric-standards" ] }, { "name": "DVT/PE", "severity": "severe", "rate": { "value": 0.005 }, "prevention": "Mechanical and pharmacological prophylaxis; early mobilisation.", "sourceSlugs": [ "nice-ng89-venous-thromboembolism" ] } ], "eligibility": [ { "criterion": "BMI ≥ 35 with comorbidities, or ≥ 40 without", "sourceSlugs": [ "ifso-bariatric-standards" ] }, { "criterion": "Severe reflux disease or Barrett's oesophagus (strong indication for RYGB over sleeve)", "sourceSlugs": [ "ifso-bariatric-standards" ] }, { "criterion": "Multidisciplinary work-up complete", "sourceSlugs": [ "ifso-bariatric-standards" ] }, { "criterion": "Commitment to lifelong follow-up and supplementation", "sourceSlugs": [ "ifso-bariatric-standards" ] } ], "contraindications": [ { "contraindication": "Inability to commit to lifelong supplementation", "sourceSlugs": [ "ifso-bariatric-standards" ] }, { "contraindication": "Untreated severe psychiatric illness", "sourceSlugs": [ "ifso-bariatric-standards" ] }, { "contraindication": "Active uncontrolled drug or alcohol use disorder", "sourceSlugs": [ "ifso-bariatric-standards" ] } ], "followUpCadence": [ { "at": "1 week", "type": "Wound and dietary review", "required": true }, { "at": "1 month", "type": "Diet progression and weight check", "required": true }, { "at": "3 months", "type": "Bloods and dietary compliance", "required": true }, { "at": "6 months", "type": "Bloods including B12, iron, calcium, vitamin D", "required": true }, { "at": "12 months", "type": "Annual review with bloods (lifelong)", "required": true } ], "recordsToObtain": [ "Operative report (pouch size, limb lengths, defect closure)", "Anaesthetic record with DVT prophylaxis", "Pre-op work-up records", "Discharge dietary plan and supplementation regimen" ], "numberOfVisits": { "typical": 4, "minimum": 2 }, "recoveryByActivity": { "sedentaryWork": { "days": 14, "sourceSlugs": [ "ifso-bariatric-standards" ] }, "manualWork": { "days": 28, "sourceSlugs": [ "ifso-bariatric-standards" ] }, "lightExercise": { "days": 14, "sourceSlugs": [ "ifso-bariatric-standards" ] }, "vigorousExercise": { "days": 42, "sourceSlugs": [ "ifso-bariatric-standards" ] }, "swimming": { "days": 21, "sourceSlugs": [ "ifso-bariatric-standards" ] }, "flying": { "days": 7, "sourceSlugs": [ "nice-ng89-venous-thromboembolism", "iata-medical-cabin-guidance" ] }, "driving": { "days": 14, "sourceSlugs": [ "ifso-bariatric-standards" ] } }, "parentProcedure": "gastric-sleeve", "literatureLinks": [ { "title": "Comparison of Efficacy and Safety Between Roux-en-Y Gastric Bypass (RYGB) vs One Anastomosis Gastric Bypass (OAGB) vs Single Anastomosis Duodeno-ileal Bypass with Sleeve Gastrectomy (SADI-S): a Systematic Review of Bariatric and Metabolic Surgery.", "journal": "Obesity surgery", "year": 2023, "doi": "10.1007/s11695-023-06602-6", "url": "https://doi.org/10.1007/s11695-023-06602-6" }, { "title": "​​Long-Term Outcomes in Sleeve Gastrectomy versus Roux-en-Y Gastric Bypass: A Systematic Review and Meta-Analysis of Randomized Trials.", "journal": "Obesity surgery", "year": 2025, "doi": "10.1007/s11695-025-08044-8", "url": "https://doi.org/10.1007/s11695-025-08044-8" }, { "title": "Nutritional Complications After Laparoscopic Roux-en-Y Gastric Bypass and One-Anastomosis Gastric Bypass: A Comparative Systematic Review and Meta-Analysis.", "journal": "Cureus", "year": 2022, "doi": "10.7759/cureus.21114", "url": "https://doi.org/10.7759/cureus.21114" } ], "alternativeTreatments": [ { "name": "Gastric sleeve", "procedureSlug": "gastric-sleeve", "rationale": "Simpler procedure with fewer nutritional risks; slightly less long-term weight loss.", "sourceSlugs": [ "asmbs-bariatric-guidelines" ] }, { "name": "Duodenal switch", "procedureSlug": "duodenal-switch", "rationale": "Greatest weight loss + diabetes remission, highest nutritional-deficiency risk.", "sourceSlugs": [ "asmbs-bariatric-guidelines" ] }, { "name": "SADI-S", "procedureSlug": "sadi-s", "rationale": "Single-anastomosis duodenal switch; near-equivalent weight loss with lower complication rate.", "sourceSlugs": [ "asmbs-bariatric-guidelines" ] }, { "name": "GLP-1 receptor agonists", "rationale": "Pharmacological route now achieving meaningful weight loss; combination therapy may be appropriate.", "sourceSlugs": [ "asmbs-bariatric-guidelines" ] } ], "accreditationsRequired": [ "ifso-center-of-excellence", "asmbs-mbsaqip-center", "jci-hospital-accreditation" ] }, { "slug": "hip-replacement", "name": "Hip Replacement (Total Hip Arthroplasty)", "category": "orthopaedic", "description": "Total hip replacement (arthroplasty) replaces the damaged femoral head and acetabulum with prosthetic components, typically used for end-stage osteoarthritis, post-traumatic arthritis, avascular necrosis, or hip fracture in older patients. Modern implants combine a femoral stem (cemented or uncemented), a femoral head (metal or ceramic), and an acetabular cup with a polyethylene, ceramic, or metal liner. Per UK NJR data, modern implant survivorship at 15 years exceeds 90% for the most-used implant combinations.", "overview": "Hip arthroplasty is one of the highest-volume major elective procedures performed worldwide and one of the most cost-effective surgeries by quality-adjusted life-year. Surgical approach (posterior, lateral, anterior) and implant choice (cemented vs uncemented, head size, bearing surface) materially affect dislocation risk, longevity, and revision rate. Patient selection and pre-operative optimisation (weight, glycaemic control, smoking cessation) drive outcomes alongside surgical technique.", "averageRecoveryDays": 42, "typicalSessions": 1, "priceRangeUSD": { "low": 8000, "high": 25000 }, "keyConsiderations": [ "Implant brand, model, size, and lot must be documented for life-long surveillance", "DVT/PE risk highest after lower-limb arthroplasty — prophylaxis non-negotiable", "Dislocation risk in first 6-12 weeks; precautions vary by surgical approach", "Annual radiographic surveillance is standard for first 5 years" ], "commonRisks": [ "Periprosthetic infection", "Dislocation", "Deep vein thrombosis / pulmonary embolism", "Implant loosening (long-term)", "Leg-length discrepancy", "Nerve injury (sciatic, femoral)" ], "questionsToAsk": [ "What surgical approach do you use (posterior / lateral / anterior) and why?", "What implant brand and bearing combination do you use most often?", "What is your dislocation rate at 1 year?", "What is your periprosthetic infection rate?", "How many hip replacements do you perform annually?", "What DVT prophylaxis protocol do you use?", "Do you offer enhanced recovery / same-day discharge?", "What is the expected 15-year revision rate for the implant you use?" ], "aliases": [ "Total hip arthroplasty", "THA", "Total hip replacement" ], "relatedProcedures": [ "knee-replacement" ], "costBreakdown": "Quoted prices typically cover surgeon's fee, anaesthesia, the implant components (femoral stem, head, cup, liner), operating room time, and ward stay (commonly 2-4 nights). Premium bearings (ceramic-on-ceramic, advanced polyethylene) may incur an additional charge. Cement (vs uncemented) may affect cost slightly. Cardiac rehabilitation, physiotherapy, and any required revision surgery are typically separate costs.", "medicalTourismNotes": "Hip replacement is among the most travel-amenable major orthopaedic procedures because the recovery pattern is predictable and follow-up requirements after the first 6-8 weeks are limited. International patients should plan for 14-21 days in-country before flying long-haul; DVT prophylaxis is essential.\n\nFollow-up coordination with home-country physiotherapy is critical — a written rehabilitation protocol from the operating team should be in place before discharge. Implant passport documentation (manufacturer, brand, model, size, lot, surgical approach used) is non-negotiable for any future surveillance or revision.\n\nFor patients considering hip replacement abroad, the centre's volume matters substantially — both for surgeon experience and for the centre's familiarity with managing the rare-but-serious complications (periprosthetic fracture, sciatic nerve injury, late infection).", "recoveryTimeline": "Day 0-3: ICU or step-down monitoring depending on patient comorbidity. Mobilisation typically same-day or day 1. Pain controlled with regional and systemic analgesia.\n\nWeek 1: discharge usually day 3-5. Assisted mobilisation with frame or crutches. Wound checks; suture/staple removal at days 10-14. Hip-precautions training (posterior approach: no flexion >90°, no hip rotation past midline).\n\nWeek 2-4: continued physiotherapy. Gradual weight-bearing progression. Return to sedentary work feasible for some patients in week 3-4.\n\nWeek 6: routine surgery review and X-ray. Many patients off crutches by this point. Driving usually permitted when patient can perform emergency stop without pain.\n\nWeek 8-12: return to most normal activity. Hip precautions typically relaxed by 12 weeks.\n\nMonth 3-6: continued strength and range-of-motion gains. Most patients reach near-maximal recovery by month 6.\n\nMonth 12 and onwards: annual review with X-ray for first 5 years. Long-term implant surveillance ongoing.", "faqs": [ { "question": "How long will my hip replacement last?", "answer": "Per UK National Joint Registry data, modern implant survivorship at 15 years exceeds 90% for the most-used implant combinations. Factors affecting longevity include patient age and activity level, body weight, implant choice (bearing surface and fixation type), and surgical technique." }, { "question": "What surgical approach is best?", "answer": "Posterior, lateral, and anterior approaches all have advocates. Posterior is the most commonly used worldwide and has excellent visualisation; anterior may allow faster return to function and lower dislocation rates but has a steeper learning curve. Surgeon experience with their chosen approach matters more than the approach itself for most patients." }, { "question": "How long until I can walk normally?", "answer": "Most patients walk with a frame or crutches from day 1, transition to crutches by week 2, and are off crutches by week 4-6. Independent walking without aids typically by week 6-8. Some return to near-normal gait by month 3; complete elimination of any limp may take 6-12 months." }, { "question": "When can I fly home after hip replacement?", "answer": "Most surgeons recommend at least 14-21 days in-country before flying long-haul, with continued DVT prophylaxis (LMWH, DOAC, or aspirin per protocol). Short-haul flights may be permitted earlier. Cabin DVT risk is elevated for several weeks post-op." }, { "question": "Will I set off airport security scanners?", "answer": "Modern hip implants typically contain metallic components and may trigger metal detectors. Patients receive an implant passport documenting the implant; some carry a 'medical alert' card. Body scanners are usually less affected." }, { "question": "What is the difference between cemented and uncemented hip replacement?", "answer": "Cemented hips use polymethylmethacrylate cement to fix the implant to bone; uncemented hips rely on bone in-growth into a porous-coated implant surface. Cemented is generally preferred for older patients and lower bone density; uncemented is generally preferred for younger, more active patients. Hybrid approaches (uncemented cup, cemented stem) are common." }, { "question": "Can I have hip replacement if I'm under 60?", "answer": "Yes — younger patients are increasingly common candidates as implants have improved. Trade-off: younger patients place more demand on the implant over a longer remaining lifespan, so revision in later decades is more likely. Modern uncemented implants with advanced polyethylene or ceramic bearings are typically chosen for younger patients." }, { "question": "What complications should I look for after returning home?", "answer": "Sudden severe pain, inability to bear weight, leg shortening, or external rotation may indicate dislocation — immediate medical attention. Wound discharge, fever, or increasing pain suggests possible infection. Calf swelling or shortness of breath may indicate DVT/PE. Any of these warrants emergency assessment." } ], "subtypes": [], "anaesthesia": "general", "operatingTime": { "lowMinutes": 90, "highMinutes": 180, "sourceSlugs": [ "aaos-knee-replacement-guideline", "njr-annual-report" ] }, "hospitalStay": { "lowNights": 2, "highNights": 4, "sourceSlugs": [ "aaos-knee-replacement-guideline", "njr-annual-report" ] }, "minimumInCountryDays": { "low": 14, "high": 21, "sourceSlugs": [ "aaos-knee-replacement-guideline" ] }, "daysToFly": { "low": 14, "high": 21, "explanation": "DVT risk highest after lower-limb arthroplasty; long-haul flying not advised before 14 days with continued prophylaxis.", "sourceSlugs": [ "nice-ng89-venous-thromboembolism", "iata-medical-cabin-guidance" ] }, "complicationRate": { "value": 5, "range": [ 3, 8 ], "sourceSlugs": [ "njr-annual-report", "aaos-knee-replacement-guideline" ] }, "revisionRate": { "value": 5, "range": [ 3, 10 ], "sourceSlugs": [ "njr-annual-report" ] }, "mortalityRate": { "value": 0.5, "range": [ 0.2, 1 ], "sourceSlugs": [ "njr-annual-report" ] }, "risks": [ { "name": "Periprosthetic infection", "severity": "severe", "rate": { "value": 0.01, "range": [ 0.005, 0.02 ] }, "prevention": "Antibiotic prophylaxis; laminar flow theatre; weight management pre-op; tight glycaemic control.", "sourceSlugs": [ "aaos-knee-replacement-guideline" ] }, { "name": "Dislocation", "severity": "moderate", "rate": { "value": 0.02, "range": [ 0.01, 0.05 ] }, "prevention": "Appropriate hip precautions in first 6-12 weeks; anterior approach has lower dislocation rates in some series.", "sourceSlugs": [ "aaos-knee-replacement-guideline" ] }, { "name": "Deep vein thrombosis / pulmonary embolism", "severity": "severe", "rate": { "value": 0.015, "range": [ 0.005, 0.03 ] }, "prevention": "Mechanical and pharmacological prophylaxis per NICE NG89; early mobilisation.", "sourceSlugs": [ "nice-ng89-venous-thromboembolism" ] }, { "name": "Implant loosening (long-term)", "severity": "moderate", "rate": { "value": 0.05, "range": [ 0.02, 0.1 ] }, "prevention": "Appropriate fixation technique; activity modification; weight management.", "sourceSlugs": [ "njr-annual-report" ] }, { "name": "Leg-length discrepancy", "severity": "minor", "rate": { "value": 0.1 }, "prevention": "Pre-operative templating; intra-operative measurement.", "sourceSlugs": [ "aaos-knee-replacement-guideline" ] }, { "name": "Sciatic nerve injury", "severity": "severe", "rate": { "value": 0.005 }, "prevention": "Careful surgical exposure; avoidance of excessive limb-length adjustment.", "sourceSlugs": [ "aaos-knee-replacement-guideline" ] } ], "eligibility": [ { "criterion": "End-stage osteoarthritis, post-traumatic arthritis, or avascular necrosis confirmed radiographically", "sourceSlugs": [ "aaos-knee-replacement-guideline" ] }, { "criterion": "Failure of conservative management (analgesia, physiotherapy, injections, walking aids)", "sourceSlugs": [ "aaos-knee-replacement-guideline" ] }, { "criterion": "BMI typically below 40 (varies; some centres operate on higher BMI with optimisation)", "sourceSlugs": [ "aaos-knee-replacement-guideline" ] }, { "criterion": "Cardiopulmonary fitness for general or spinal anaesthesia", "sourceSlugs": [ "rcoa-standards-anaesthesia" ] } ], "contraindications": [ { "contraindication": "Active local or systemic infection", "sourceSlugs": [ "aaos-knee-replacement-guideline" ] }, { "contraindication": "Severe peripheral vascular disease compromising healing", "sourceSlugs": [ "aaos-knee-replacement-guideline" ] }, { "contraindication": "Untreated severe osteoporosis (relative; affects fixation choice)", "sourceSlugs": [ "aaos-knee-replacement-guideline" ] } ], "followUpCadence": [ { "at": "Day 1-3 post-op", "type": "Physiotherapy mobilisation", "required": true }, { "at": "2 weeks", "type": "Wound check and suture/staple removal", "required": true }, { "at": "6 weeks", "type": "X-ray and physiotherapy review", "required": true }, { "at": "3 months", "type": "Function and pain assessment", "required": true }, { "at": "Annual", "type": "Long-term implant surveillance (X-ray)", "required": true } ], "recordsToObtain": [ "Implant brand, model, size, lot number (implant passport)", "Operative report including surgical approach", "Anaesthetic record with DVT prophylaxis used", "Post-op X-ray", "Physiotherapy plan" ], "recoveryByActivity": { "sedentaryWork": { "days": 28, "sourceSlugs": [ "aaos-knee-replacement-guideline" ] }, "manualWork": { "days": 84, "sourceSlugs": [ "aaos-knee-replacement-guideline" ] }, "lightExercise": { "days": 42, "sourceSlugs": [ "aaos-knee-replacement-guideline" ] }, "vigorousExercise": { "days": 90, "sourceSlugs": [ "aaos-knee-replacement-guideline" ] }, "swimming": { "days": 42, "sourceSlugs": [ "aaos-knee-replacement-guideline" ] }, "flying": { "days": 14, "sourceSlugs": [ "nice-ng89-venous-thromboembolism", "iata-medical-cabin-guidance" ] }, "driving": { "days": 42, "sourceSlugs": [ "aaos-knee-replacement-guideline" ] } }, "numberOfVisits": { "typical": 4, "minimum": 3 }, "literatureLinks": [ { "title": "Comparing direct anterior approach versus posterior approach or lateral approach in total hip arthroplasty: a systematic review and meta-analysis.", "journal": "European journal of orthopaedic surgery & traumatology : orthopedie traumatologie", "year": 2023, "doi": "10.1007/s00590-023-03528-8", "url": "https://doi.org/10.1007/s00590-023-03528-8" }, { "title": "Debridement, antibiotics, and implant retention (DAIR) for the early prosthetic joint infection of total knee and hip arthroplasties: a systematic review.", "journal": "Journal of ISAKOS : joint disorders & orthopaedic sports medicine", "year": 2024, "doi": "10.1016/j.jisako.2023.09.003", "url": "https://doi.org/10.1016/j.jisako.2023.09.003" }, { "title": "Clinical Effectiveness and Safety of Aspirin for Venous Thromboembolism Prophylaxis After Total Hip and Knee Replacement: A Systematic Review and Meta-analysis of Randomized Clinical Trials.", "journal": "JAMA internal medicine", "year": 2020, "doi": "10.1001/jamainternmed.2019.6108", "url": "https://doi.org/10.1001/jamainternmed.2019.6108" } ], "alternativeTreatments": [ { "name": "Hip resurfacing", "rationale": "Bone-conserving alternative for younger active male patients; concerns over metal-on-metal wear in some implants.", "sourceSlugs": [ "aaos-knee-replacement-guideline" ] }, { "name": "Periacetabular osteotomy", "rationale": "Joint-preserving option for dysplastic young hips before arthritis is established.", "sourceSlugs": [ "aaos-knee-replacement-guideline" ] }, { "name": "Intra-articular injection", "rationale": "Symptom relief while planning surgery; limited durability.", "sourceSlugs": [ "aaos-knee-replacement-guideline" ] } ], "accreditationsRequired": [ "national-orthopaedic-board", "njr-participating-hospital" ] }, { "slug": "liposuction", "name": "Liposuction", "category": "cosmetic-surgery", "description": "Liposuction, or simply lipo, is a type of fat-removal procedure used in plastic surgery. Evidence does not support an effect on weight beyond a couple of months and does not appear to affect obesity-related problems.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [ "bruising and swelling, which may last up to 6 months", "numbness, which should go away in 6 to 8 weeks", "scars", "inflammation of the treated area, or the veins underneath", "fluid coming from the cuts", "swollen ankles (if the legs or ankles are treated)" ], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "overview": "Liposuction, or simply lipo, is a type of fat-removal procedure used in plastic surgery. Evidence does not support an effect on weight beyond a couple of months and does not appear to affect obesity-related problems.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en", "nhs-health-a-to-z" ], "references": [ { "label": "Wikipedia — Liposuction", "url": "https://en.wikipedia.org/wiki/Liposuction" } ], "recoveryTimeline": "If you have a general anaesthetic, someone will need to drive you home and stay with you for the first 24 hours. How long it will be before you're able to return to work will depend on a number of factors, such as the type of job you do and how much of your body was treated. The same will apply to how long it will be before you're able to drive. You should discuss this with your surgeon. The bandage or corset can be taken off while you shower. You'll be able to walk and general movement should be fine, but try to avoid anything more strenuous for the first couple of weeks. The results of the procedure are not always noticeable until the swelling has gone down. It can take up to 6 months for the area to settle completely. As a general guide: - your stitches will be removed after about a wee\n\n*Reference text adapted from NHS UK under the Open Government Licence v3.0.*", "faqs": [ { "question": "How much does liposuction cost?", "answer": "In the UK, liposuction ranges in price from about £3,000 to £8,500, depending on where you go and the body areas being treated." }, { "question": "Where do I go to get liposuction?", "answer": "If you're looking in England, check the [Care Quality Commission (CQC)](http://www.cqc.org.uk/) website for treatment centres that can perform liposuction." }, { "question": "What does liposuction involve?", "answer": "Liposuction is usually carried out under [general anaesthesia](https://www.nhs.uk/tests-and-treatments/general-anaesthesia/), although an [epidural anaesthetic](https://www.nhs.uk/tests-and-treatments/epidural/) may be used for liposuction on lower parts of the body." }, { "question": "What could go wrong after liposuction?", "answer": "Liposuction can occasionally result in:" }, { "question": "What to do if you have problems?", "answer": "Cosmetic surgery can sometimes go wrong and the results may not be what you expected." } ], "literatureLinks": [ { "title": "A Systematic Review of Efficacy and Complications of High-Definition Liposuction.", "journal": "Plastic and reconstructive surgery", "year": 2023, "doi": "10.1097/PRS.0000000000010203", "url": "https://doi.org/10.1097/PRS.0000000000010203" }, { "title": "Risks and Complications Rate in Liposuction: A Systematic Review and Meta-Analysis.", "journal": "Aesthetic surgery journal", "year": 2024, "doi": "10.1093/asj/sjae074", "url": "https://doi.org/10.1093/asj/sjae074" }, { "title": "Liposuction-Only Breast Reduction: A Systematic Review of Outcomes.", "journal": "Aesthetic plastic surgery", "year": 2024, "doi": "10.1007/s00266-024-03874-w", "url": "https://doi.org/10.1007/s00266-024-03874-w" }, { "title": "Complications in Brachioplasty: A Systematic Review and Meta-Analysis.", "journal": "Plastic and reconstructive surgery", "year": 2022, "doi": "10.1097/PRS.0000000000008652", "url": "https://doi.org/10.1097/PRS.0000000000008652" }, { "title": "Cryolipolysis for fat reduction and body contouring: safety and efficacy of current treatment paradigms.", "journal": "Plastic and reconstructive surgery", "year": 2015, "doi": "10.1097/PRS.0000000000001236", "url": "https://doi.org/10.1097/PRS.0000000000001236" } ], "alternativeTreatments": [ { "name": "Cryolipolysis (CoolSculpting)", "rationale": "Non-invasive fat reduction for small areas; partial result, no skin tightening.", "sourceSlugs": [ "isaps-guidelines" ] }, { "name": "Abdominoplasty", "procedureSlug": "abdominoplasty", "rationale": "When skin laxity coexists with fat excess, lipo alone gives a worse result than combined treatment.", "sourceSlugs": [ "isaps-guidelines" ] } ], "accreditationsRequired": [ "isaps-member-surgeon", "national-plastic-surgery-board" ] }, { "slug": "bbl", "name": "Brazilian Butt Lift", "category": "cosmetic-surgery", "description": "Gluteoplasty or buttock augmentation denotes the plastic surgery and the liposuction procedures for the correction of congenital, traumatic, and acquired defects/deformities of the buttocks and the anatomy of the gluteal region; and for the aesthetic enhancement of the contour of the buttocks.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "aliases": [ "BBL", "Gluteal fat transfer", "Buttock augmentation with fat" ], "overview": "Gluteoplasty or buttock augmentation denotes the plastic surgery and the liposuction procedures for the correction of congenital, traumatic, and acquired defects/deformities of the buttocks and the anatomy of the gluteal region; and for the aesthetic enhancement of the contour of the buttocks.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Buttock augmentation", "url": "https://en.wikipedia.org/wiki/Buttock_augmentation" } ], "literatureLinks": [ { "title": "Practice Advisory on Gluteal Fat Grafting.", "journal": "Aesthetic surgery journal", "year": 2022, "doi": "10.1093/asj/sjac082", "url": "https://doi.org/10.1093/asj/sjac082" }, { "title": "\"Brazilian Butt Lift\" Performed by Board-Certified Brazilian Plastic Surgeons: Reports of an Expert Opinion Survey.", "journal": "Plastic and reconstructive surgery", "year": 2019, "doi": "10.1097/PRS.0000000000006020", "url": "https://doi.org/10.1097/PRS.0000000000006020" }, { "title": "Two Cases Surviving Macro Fat Emboli Complications Following Gluteal Fat Grafting.", "journal": "Aesthetic surgery journal", "year": 2022, "doi": "10.1093/asj/sjac063", "url": "https://doi.org/10.1093/asj/sjac063" }, { "title": "Safety Comparison of Abdominoplasty and Brazilian Butt Lift: What the Literature Tells Us.", "journal": "Plastic and reconstructive surgery", "year": 2021, "doi": "10.1097/PRS.0000000000008599", "url": "https://doi.org/10.1097/PRS.0000000000008599" }, { "title": "The British Association of Aesthetic Plastic Surgeons (BAAPS) Gluteal Fat Grafting Safety Review and Recommendations.", "journal": "Aesthetic surgery journal", "year": 2023, "doi": "10.1093/asj/sjac316", "url": "https://doi.org/10.1093/asj/sjac316" } ], "alternativeTreatments": [ { "name": "Buttock implants", "rationale": "Implant-based augmentation; higher infection risk but better for thin patients without donor fat.", "sourceSlugs": [ "isaps-guidelines" ] }, { "name": "Sculptra biostimulator", "rationale": "Non-surgical volumisation; multiple sessions, modest result.", "sourceSlugs": [ "isaps-guidelines" ] }, { "name": "Targeted glute training", "rationale": "First-line if the goal is shape rather than volume; takes 6-12 months.", "sourceSlugs": [ "isaps-guidelines" ] } ], "accreditationsRequired": [ "isaps-member-surgeon", "national-plastic-surgery-board" ] }, { "slug": "breast-lift", "name": "Breast Lift", "category": "cosmetic-surgery", "description": "Mastopexy is the plastic surgery mammoplasty procedure for raising sagging breasts upon the chest of the woman, by changing and modifying the size, contour, and elevation of the breasts. In a breast-lift surgery to re-establish an aesthetically proportionate bust for the woman, the critical corrective consideration is the tissue viability of the nipple-areola complex (NAC), to ensure the functional sensitivity of the breasts for lactation and breast-feeding.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "aliases": [ "Mastopexy" ], "overview": "Mastopexy is the plastic surgery mammoplasty procedure for raising sagging breasts upon the chest of the woman, by changing and modifying the size, contour, and elevation of the breasts. In a breast-lift surgery to re-establish an aesthetically proportionate bust for the woman, the critical corrective consideration is the tissue viability of the nipple-areola complex (NAC), to ensure the functional sensitivity of the breasts for lactation and breast-feeding.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Mastopexy", "url": "https://en.wikipedia.org/wiki/Mastopexy" } ], "literatureLinks": [ { "title": "Systematic review of outcomes and complications in nonimplant-based mastopexy surgery.", "journal": "Journal of plastic, reconstructive & aesthetic surgery : JPRAS", "year": 2019, "doi": "10.1016/j.bjps.2018.10.018", "url": "https://doi.org/10.1016/j.bjps.2018.10.018" }, { "title": "A systematic review of single-stage augmentation-mastopexy.", "journal": "Plastic and reconstructive surgery", "year": 2014, "doi": "10.1097/PRS.0000000000000582", "url": "https://doi.org/10.1097/PRS.0000000000000582" }, { "title": "Staged Breast Reduction or Mastopexy before Nipple-Sparing Mastectomy: A Systematic Review and Meta-Analysis.", "journal": "Plastic and reconstructive surgery", "year": 2025, "doi": "10.1097/PRS.0000000000012118", "url": "https://doi.org/10.1097/PRS.0000000000012118" }, { "title": "Systematic Review: Periareolar Mastopexy with Breast Implants and Fat Grafting.", "journal": "Aesthetic plastic surgery", "year": 2025, "doi": "10.1007/s00266-025-05116-z", "url": "https://doi.org/10.1007/s00266-025-05116-z" }, { "title": "Reduction mammoplasty and mastopexy in the previously irradiated breast - a systematic review and meta-analysis.", "journal": "Journal of plastic surgery and hand surgery", "year": 2021, "doi": "10.1080/2000656X.2021.1888745", "url": "https://doi.org/10.1080/2000656X.2021.1888745" } ], "accreditationsRequired": [ "isaps-member-surgeon", "national-plastic-surgery-board" ] }, { "slug": "breast-reduction", "name": "Breast Reduction", "category": "cosmetic-surgery", "description": "Reduction mammoplasty is the plastic surgery procedure for reducing the size of large breasts. In a breast reduction surgery aimed at re-establishing a functional bust that is proportionate to the patient's body, the critical corrective consideration is the tissue viability of the nipple–areola complex (NAC), to ensure the functional sensitivity and lactational capability of the breasts.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "aliases": [ "Reduction mammoplasty" ], "overview": "Reduction mammoplasty is the plastic surgery procedure for reducing the size of large breasts. In a breast reduction surgery aimed at re-establishing a functional bust that is proportionate to the patient's body, the critical corrective consideration is the tissue viability of the nipple–areola complex (NAC), to ensure the functional sensitivity and lactational capability of the breasts. The indications for breast reduction surgery are three-fold – physical, aesthetic, and psychological – the restoration of the bust, of the patient's self-image, and of the patient's mental health.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Reduction mammoplasty", "url": "https://en.wikipedia.org/wiki/Breast_reduction" } ], "literatureLinks": [ { "title": "Risk Factors and Complications in Reduction Mammaplasty: A Systematic Review and Meta-analysis.", "journal": "Aesthetic plastic surgery", "year": 2023, "doi": "10.1007/s00266-023-03387-y", "url": "https://doi.org/10.1007/s00266-023-03387-y" }, { "title": "Risk factors for complications after reduction mammaplasty: a systematic review and meta-analysis.", "journal": "European journal of medical research", "year": 2025, "doi": "10.1186/s40001-025-02723-z", "url": "https://doi.org/10.1186/s40001-025-02723-z" }, { "title": "No drains in reduction mammaplasty - a systematic review.", "journal": "Acta chirurgiae plasticae", "year": 2024, "doi": "10.48095/ccachp20246", "url": "https://doi.org/10.48095/ccachp20246" }, { "title": "Reduction Mammaplasty for Macromastia in Adolescents: A Systematic Review and Pooled Analysis.", "journal": "Plastic and reconstructive surgery", "year": 2021, "doi": "10.1097/PRS.0000000000008102", "url": "https://doi.org/10.1097/PRS.0000000000008102" }, { "title": "Complications of Superomedial Versus Inferior Pedicle Reduction Mammaplasty: A Systematic Review and Meta-Analysis.", "journal": "Aesthetic plastic surgery", "year": 2025, "doi": "10.1007/s00266-024-04201-z", "url": "https://doi.org/10.1007/s00266-024-04201-z" } ], "accreditationsRequired": [ "isaps-member-surgeon", "national-plastic-surgery-board" ] }, { "slug": "breast-implant-removal", "name": "Breast Implant Removal", "category": "cosmetic-surgery", "description": "A breast implant is a prosthesis used to change the size, shape, and contour of a person's breast. In reconstructive plastic surgery, breast implants can be placed to restore a natural-looking breast following a mastectomy, to correct congenital defects and deformities of the chest wall or, cosmetically, to enlarge the appearance of the breast through breast augmentation surgery.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [ "thick, obvious scarring", "the breast feeling hard because scar tissue has shrunk around the implant (capsular contracture)", "creases or folds in the implant", "the implant rotating within the breast, resulting in an abnormal shape", "when breastfeeding, producing slightly less breast milk than you would without implants", "bleeding and clots – blood clots can be life threatening" ], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "aliases": [ "Explant surgery" ], "overview": "A breast implant is a prosthesis used to change the size, shape, and contour of a person's breast. In reconstructive plastic surgery, breast implants can be placed to restore a natural-looking breast following a mastectomy, to correct congenital defects and deformities of the chest wall or, cosmetically, to enlarge the appearance of the breast through breast augmentation surgery.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en", "nhs-health-a-to-z" ], "references": [ { "label": "Wikipedia — Breast implant", "url": "https://en.wikipedia.org/wiki/Breast_implant" } ], "recoveryTimeline": "You should be able to move around soon after having breast enlargement surgery. It can take a few weeks to fully recover from surgery, so you should take a week or 2 off work. You should not drive for at least 1 week. Some surgeons recommend wearing a sports bra 24 hours a day for up to 3 months after breast surgery (check with your surgeon). Avoid heavy lifting or strenuous exercise for at least a month. - After 1 or 2 weeks: your stiches will be removed (unless you had dissolvable stitches).\n- After 6 weeks: you should be able to return to most of your normal activities. Your scars should also start to fade.\n- After a few months: your breasts should start to look and feel more natural. You may be able to stop wearing your sports bra. It's safe to sunbathe and fly if you have breast impla\n\n*Reference text adapted from NHS UK under the Open Government Licence v3.0.*", "faqs": [ { "question": "How much breast enlargement costs?", "answer": "In the UK, breast implant surgery costs around £3,500 to £8,000. This does not usually include the cost of consultations or follow-up care." }, { "question": "What to think about before you have a breast enlargement?", "answer": "Before you go ahead, be sure about why you want breast implants. Take time to think about your decision." }, { "question": "How long breast implants last?", "answer": "Breast implants do not last a lifetime. It's likely they'll need to be replaced at some point." }, { "question": "What a breast enlargement involves?", "answer": "Breast implant surgery is usually carried out under [general anaesthetic](https://www.nhs.uk/tests-and-treatments/general-anaesthesia/)." }, { "question": "What could go wrong?", "answer": "Breast implants can sometimes cause problems, including:" }, { "question": "What to do if you have problems?", "answer": "Cosmetic surgery can sometimes go wrong, or the results may not be what you were expecting." } ], "literatureLinks": [ { "title": "Breast Implant Illness: Symptoms, Outcomes with Explantation and Potential Etiologies-A Systematic Review and Meta-analysis.", "journal": "Aesthetic plastic surgery", "year": 2025, "doi": "10.1007/s00266-025-05142-x", "url": "https://doi.org/10.1007/s00266-025-05142-x" }, { "title": "Autoimmune/inflammatory syndrome induced by adjuvants (ASIA) in 2023.", "journal": "Autoimmunity reviews", "year": 2023, "doi": "10.1016/j.autrev.2023.103287", "url": "https://doi.org/10.1016/j.autrev.2023.103287" }, { "title": "Breast Implant-Associated Immunological Disorders.", "journal": "Journal of immunology research", "year": 2022, "doi": "10.1155/2022/8536149", "url": "https://doi.org/10.1155/2022/8536149" }, { "title": "Implant-Based Breast Reconstruction following Infected Device Explantation: Is a Second Attempt Worth It?", "journal": "Plastic and reconstructive surgery", "year": 2022, "doi": "10.1097/PRS.0000000000009289", "url": "https://doi.org/10.1097/PRS.0000000000009289" }, { "title": "Breast implant illness: Is it causally related to breast implants?", "journal": "Autoimmunity reviews", "year": 2024, "doi": "10.1016/j.autrev.2023.103448", "url": "https://doi.org/10.1016/j.autrev.2023.103448" } ], "accreditationsRequired": [ "isaps-member-surgeon", "national-plastic-surgery-board" ] }, { "slug": "breast-implant-revision", "name": "Breast Implant Revision", "category": "cosmetic-surgery", "description": "A breast implant is a prosthesis used to change the size, shape, and contour of a person's breast. In reconstructive plastic surgery, breast implants can be placed to restore a natural-looking breast following a mastectomy, to correct congenital defects and deformities of the chest wall or, cosmetically, to enlarge the appearance of the breast through breast augmentation surgery.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "overview": "A breast implant is a prosthesis used to change the size, shape, and contour of a person's breast. In reconstructive plastic surgery, breast implants can be placed to restore a natural-looking breast following a mastectomy, to correct congenital defects and deformities of the chest wall or, cosmetically, to enlarge the appearance of the breast through breast augmentation surgery.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Breast implant", "url": "https://en.wikipedia.org/wiki/Breast_implant" } ], "literatureLinks": [ { "title": "Breast Envelope Complications After Revision Breast Implant Surgery: A Systematic Review.", "journal": "Aesthetic plastic surgery", "year": 2026, "doi": "10.1007/s00266-026-05688-4", "url": "https://doi.org/10.1007/s00266-026-05688-4" }, { "title": "Gram-Positive Bacteria Increase Breast Implant-Related Complications: Prospective Analysis of 100 Revised Implants.", "journal": "Plastic and reconstructive surgery", "year": 2024, "doi": "10.1097/PRS.0000000000010499", "url": "https://doi.org/10.1097/PRS.0000000000010499" }, { "title": "Revision Surgery to Improve Cosmesis with Immediate Implant-Based Breast Reconstruction.", "journal": "JPRAS open", "year": 2021, "doi": "10.1016/j.jpra.2021.04.006", "url": "https://doi.org/10.1016/j.jpra.2021.04.006" }, { "title": "Selective Capsulotomies and Partial Capsulectomy in Implant-Based Breast Reconstruction Revision Surgery.", "journal": "The breast journal", "year": 2024, "doi": "10.1155/2024/9097040", "url": "https://doi.org/10.1155/2024/9097040" }, { "title": "Prevalence of Local Postoperative Complications and Breast Implant Illness in Women With Breast Implants.", "journal": "JAMA network open", "year": 2022, "doi": "10.1001/jamanetworkopen.2022.36519", "url": "https://doi.org/10.1001/jamanetworkopen.2022.36519" } ], "accreditationsRequired": [ "isaps-member-surgeon", "national-plastic-surgery-board" ] }, { "slug": "facelift", "name": "Facelift", "category": "cosmetic-surgery", "description": "A facelift, technically known as a rhytidectomy, is a type of cosmetic surgery procedure intended to give a more youthful facial appearance. There are multiple surgical techniques.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "aliases": [ "Rhytidectomy" ], "overview": "A facelift, technically known as a rhytidectomy, is a type of cosmetic surgery procedure intended to give a more youthful facial appearance. There are multiple surgical techniques. Surgery usually involves the removal of excess facial skin, with or without the tightening of underlying tissues, and the redraping of the skin on the patient's face and neck. Surgical facelifts are effectively combined with eyelid surgery (blepharoplasty) and other facial procedures and are typically performed under general anesthesia or deep twilight sleep.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Rhytidectomy", "url": "https://en.wikipedia.org/wiki/Rhytidectomy" } ], "literatureLinks": [ { "title": "The Deep Plane versus SMAS Facelift: A Systematic Review and Meta-Analysis.", "journal": "Aesthetic plastic surgery", "year": 2025, "doi": "10.1007/s00266-025-05118-x", "url": "https://doi.org/10.1007/s00266-025-05118-x" }, { "title": "A Systematic Review of Rhytidectomy Complications and Prevention Methods: Evaluating the Trends.", "journal": "Annals of plastic surgery", "year": 2025, "doi": "10.1097/SAP.0000000000004272", "url": "https://doi.org/10.1097/SAP.0000000000004272" }, { "title": "The Temporal Subcutaneous Brow Lift with Orbicularis Oculi Muscle Elastic Flap: Technical Considerations, Systematic Review, and Terminology Standardization.", "journal": "Facial plastic surgery : FPS", "year": 2023, "doi": "10.1055/a-1953-2304", "url": "https://doi.org/10.1055/a-1953-2304" }, { "title": "Quilting Sutures in Rhytidectomy: A Systematic Review of the Literature.", "journal": "Aesthetic surgery journal", "year": 2020, "doi": "10.1093/asj/sjz353", "url": "https://doi.org/10.1093/asj/sjz353" }, { "title": "Tissue Sealants for Facial Rhytidectomy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.", "journal": "Facial plastic surgery & aesthetic medicine", "year": 2023, "doi": "10.1089/fpsam.2022.0160", "url": "https://doi.org/10.1089/fpsam.2022.0160" } ], "alternativeTreatments": [ { "name": "Thread lift", "rationale": "Sub-2-year cosmetic alternative for early jowling; results limited and shorter-lived.", "sourceSlugs": [ "isaps-guidelines" ] }, { "name": "Filler + neuromodulator regimen", "rationale": "Non-surgical volumisation and contour; addresses different ageing axis than skin redraping.", "sourceSlugs": [ "isaps-guidelines" ] }, { "name": "Energy-based skin tightening (RF, ultrasound)", "rationale": "Mild skin tightening without surgery; will not lift redundant skin.", "sourceSlugs": [ "isaps-guidelines" ] } ], "accreditationsRequired": [ "isaps-member-surgeon", "national-plastic-surgery-board" ] }, { "slug": "neck-lift", "name": "Neck Lift", "category": "cosmetic-surgery", "description": "A facelift, technically known as a rhytidectomy, is a type of cosmetic surgery procedure intended to give a more youthful facial appearance. There are multiple surgical techniques.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "aliases": [ "Platysmaplasty" ], "overview": "A facelift, technically known as a rhytidectomy, is a type of cosmetic surgery procedure intended to give a more youthful facial appearance. There are multiple surgical techniques. Surgery usually involves the removal of excess facial skin, with or without the tightening of underlying tissues, and the redraping of the skin on the patient's face and neck. Surgical facelifts are effectively combined with eyelid surgery (blepharoplasty) and other facial procedures and are typically performed under general anesthesia or deep twilight sleep.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Rhytidectomy", "url": "https://en.wikipedia.org/wiki/Rhytidectomy" } ], "literatureLinks": [ { "title": "Complications/sequelae of neck rejuvenation.", "journal": "Facial plastic surgery clinics of North America", "year": 2014, "doi": "10.1016/j.fsc.2014.01.007", "url": "https://doi.org/10.1016/j.fsc.2014.01.007" }, { "title": "The Ponytail Lift: 22 Years of Experience in 600 Cases of Endoscopic Deep Plane Facial Rejuvenation.", "journal": "Aesthetic surgery journal", "year": 2024, "doi": "10.1093/asj/sjad382", "url": "https://doi.org/10.1093/asj/sjad382" }, { "title": "Laser-assisted facelift.", "journal": "Facial plastic surgery : FPS", "year": 2014, "doi": "10.1055/s-0034-1383552", "url": "https://doi.org/10.1055/s-0034-1383552" }, { "title": "Complications of forehead lift.", "journal": "Facial plastic surgery clinics of North America", "year": 2013, "doi": "10.1016/j.fsc.2013.07.006", "url": "https://doi.org/10.1016/j.fsc.2013.07.006" }, { "title": "Endoscopic Deep Plane Facelift: A Classified Approach.", "journal": "Aesthetic surgery journal", "year": 2025, "doi": "10.1093/asj/sjaf110", "url": "https://doi.org/10.1093/asj/sjaf110" } ], "accreditationsRequired": [ "isaps-member-surgeon", "national-plastic-surgery-board" ] }, { "slug": "blepharoplasty", "name": "Blepharoplasty", "category": "cosmetic-surgery", "description": "Blepharoplasty, from Ancient Greek βλέφαρον (blépharon), meaning \"eyelid\", and πλαστός (plastós), meaning \"molded\", is the plastic surgery operation for correcting defects, deformities, and disfigurations of the eyelids; and for aesthetically modifying the eye region of the face. With the excision and the removal, or the repositioning of excess tissues, such as skin and adipocyte fat, and the reinforcement of the corresponding muscle and tendon tissues, the blepharoplasty procedure resolves func", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [ "puffy, numb eyelids that are difficult to close", "irritated, sensitive or watery eyes – this may last a few weeks", "bruising", "scars – these should eventually fade to almost be invisible" ], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "aliases": [ "Eyelid surgery" ], "overview": "Blepharoplasty, from Ancient Greek βλέφαρον (blépharon), meaning \"eyelid\", and πλαστός (plastós), meaning \"molded\", is the plastic surgery operation for correcting defects, deformities, and disfigurations of the eyelids; and for aesthetically modifying the eye region of the face. With the excision and the removal, or the repositioning of excess tissues, such as skin and adipocyte fat, and the reinforcement of the corresponding muscle and tendon tissues, the blepharoplasty procedure resolves functional and cosmetic problems of the periorbita, which is the area from the eyebrow to the upper portion of the cheek. The procedure is more common among women, who accounted for approximately 85% of blepharoplasty procedures in 2014 in the US and 88% of such procedures in the UK.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en", "nhs-health-a-to-z" ], "references": [ { "label": "Wikipedia — Blepharoplasty", "url": "https://en.wikipedia.org/wiki/Blepharoplasty" } ], "recoveryTimeline": "Most people take about 2 weeks off work to recover from eyelid surgery, depending on their job. You will not be able to drive for a number of days after the operation. Bruises and redness may take several weeks to fade. Scarring may be visible and feel tight for a few months. To help with your recovery, you'll need to follow the advice given by your surgeon. You may need to: - prop your head up with pillows for a couple of days, when resting, to reduce swelling\n- gently clean your eyelids using prescribed ointment or eyedrops\n- apply a cold pack to your eyelid to help reduce swelling – try a packet of frozen peas wrapped in a tea towel\n- wear sunglasses to protect your eyes from the sun and wind\n- take paracetamol or any painkillers you were given after the surgery to relieve pain You shou\n\n*Reference text adapted from NHS UK under the Open Government Licence v3.0.*", "faqs": [ { "question": "How much does it cost?", "answer": "In the UK, blepharoplasty may cost anywhere between £2,000 and £6,000. You should also factor in the cost of any consultations, further surgery or follow-up care that may be needed." }, { "question": "Where do I go?", "answer": "If you're looking in England, check the [Care Quality Commission (CQC) website](https://www.cqc.org.uk/) for treatment centres that can perform eyelid surgery." }, { "question": "What does it involve?", "answer": "A blepharoplasty can be done under [local anaesthetic](https://www.nhs.uk/tests-and-treatments/local-anaesthesia/) or under [general anaesthetic](https://www.nhs.uk/tests-and-treatments/general-anaesthesia/)." }, { "question": "What could go wrong?", "answer": "Eyelid surgery can occasionally result in:" }, { "question": "What to do if you have problems?", "answer": "Cosmetic surgery can sometimes go wrong, and the results may not be what you expected." } ], "literatureLinks": [ { "title": "Upper Eyelid Blepharoplasty: Surgical Techniques and Results-Systematic Review and Meta-analysis.", "journal": "Aesthetic plastic surgery", "year": 2023, "doi": "10.1007/s00266-023-03436-6", "url": "https://doi.org/10.1007/s00266-023-03436-6" }, { "title": "Functional outcomes of upper eyelid blepharoplasty: A systematic review.", "journal": "Journal of plastic, reconstructive & aesthetic surgery : JPRAS", "year": 2019, "doi": "10.1016/j.bjps.2018.11.010", "url": "https://doi.org/10.1016/j.bjps.2018.11.010" }, { "title": "Safety and Complications in Lower Eyelid Blepharoplasty: A Systematic Review.", "journal": "Plastic and reconstructive surgery. Global open", "year": 2025, "doi": "10.1097/GOX.0000000000007102", "url": "https://doi.org/10.1097/GOX.0000000000007102" }, { "title": "The Temporal Subcutaneous Brow Lift with Orbicularis Oculi Muscle Elastic Flap: Technical Considerations, Systematic Review, and Terminology Standardization.", "journal": "Facial plastic surgery : FPS", "year": 2023, "doi": "10.1055/a-1953-2304", "url": "https://doi.org/10.1055/a-1953-2304" }, { "title": "Tranexamic Acid for Blepharoplasty Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.", "journal": "Ophthalmic plastic and reconstructive surgery", "year": 2025, "doi": "10.1097/IOP.0000000000002953", "url": "https://doi.org/10.1097/IOP.0000000000002953" } ], "alternativeTreatments": [ { "name": "Brow lift", "rationale": "When the upper-lid heaviness is driven by brow ptosis, not lid skin excess.", "sourceSlugs": [ "isaps-guidelines" ] }, { "name": "Filler under the lower lid", "rationale": "Camouflages tear-trough hollowing without surgery; limited utility for true fat pseudoherniation.", "sourceSlugs": [ "isaps-guidelines" ] } ], "accreditationsRequired": [ "isaps-member-surgeon", "national-plastic-surgery-board" ] }, { "slug": "otoplasty", "name": "Otoplasty", "category": "cosmetic-surgery", "description": "Otoplasty, from Ancient Greek οὖς (oûs), meaning \"ear\", and πλαστός (plastós), meaning \"moulded\", is a procedure for correcting the deformities and defects of the auricle, whether these defects are congenital conditions or caused by trauma. Otoplastic surgeons may reshape, move, or augment the cartilaginous support framework of the auricle to correct these defects.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [ "a small scar behind each ear, which will fade in time", "sore and tender ears for several weeks", "numbness or tingling in the ears for several weeks", "slight bruising around the ears for about 2 weeks" ], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "aliases": [ "Ear pinning", "Ear correction" ], "overview": "Otoplasty, from Ancient Greek οὖς (oûs), meaning \"ear\", and πλαστός (plastós), meaning \"moulded\", is a procedure for correcting the deformities and defects of the auricle, whether these defects are congenital conditions or caused by trauma. Otoplastic surgeons may reshape, move, or augment the cartilaginous support framework of the auricle to correct these defects.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en", "nhs-health-a-to-z" ], "references": [ { "label": "Wikipedia — Otoplasty", "url": "https://en.wikipedia.org/wiki/Otoplasty" } ], "recoveryTimeline": "If you have a bandage around your head, keep it clean and dry. You will not be able to wash your hair until after the bandage has been removed. You might need to wear a headband at night for several weeks to protect your ears while you sleep. The stitches may come to the surface of the skin or make your ear feel tender. Treat any pain with painkillers, such as paracetamol or ibuprofen. #### Timeline - After 5 to 10 days: the bandage (if used) and stitches are removed (unless they're dissolvable stitches).\n- After 1 to 2 weeks: most children can return to school.\n- After 4 to 6 weeks: swimming should be OK.\n- Around 8 weeks: contact sports should be OK.\n\n*Reference text adapted from NHS UK under the Open Government Licence v3.0.*", "faqs": [ { "question": "How much ear correction surgery costs?", "answer": "In the UK, ear correction surgery may cost between £2,500 to £3,500, plus the cost of any consultations or follow-up care that may be needed." }, { "question": "What to think about before you have ear correction surgery?", "answer": "Before you go ahead, be sure about why you want ear correction surgery. Take time to think about your decision." }, { "question": "What ear correction surgery involves?", "answer": "What happens during ear correction surgery depends on the type of surgery you have." }, { "question": "What could go wrong?", "answer": "Ear correction surgery can occasionally cause:" }, { "question": "What to do if you have problems?", "answer": "Cosmetic surgery can sometimes go wrong and the results may not be what you expected." } ], "literatureLinks": [ { "title": "Otoplasty and Ear Reconstruction Complications.", "journal": "Facial plastic surgery : FPS", "year": 2025, "doi": "10.1055/a-2446-0354", "url": "https://doi.org/10.1055/a-2446-0354" }, { "title": "Otoplasty.", "journal": "Plastic and reconstructive surgery", "year": 2005, "doi": "10.1097/01.prs.0000156218.93855.c9", "url": "https://doi.org/10.1097/01.prs.0000156218.93855.c9" }, { "title": "Otoplasty complications.", "journal": "Oral and maxillofacial surgery clinics of North America", "year": 2009, "doi": "10.1016/j.coms.2008.10.011", "url": "https://doi.org/10.1016/j.coms.2008.10.011" }, { "title": "Performance-optimized otoplasty.", "journal": "BMC surgery", "year": 2022, "doi": "10.1186/s12893-022-01587-y", "url": "https://doi.org/10.1186/s12893-022-01587-y" }, { "title": "Complications of otoplasty.", "journal": "Facial plastic surgery clinics of North America", "year": 2013, "doi": "10.1016/j.fsc.2013.08.001", "url": "https://doi.org/10.1016/j.fsc.2013.08.001" } ], "accreditationsRequired": [ "isaps-member-surgeon", "national-plastic-surgery-board" ] }, { "slug": "chin-implant", "name": "Chin Implant", "category": "cosmetic-surgery", "description": "Chin augmentation using surgical implants alter the underlying structure of the face, intended to balance the facial features. The specific medical terms mentoplasty and genioplasty are used to refer to the reduction and addition of material to a patient's chin.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "aliases": [ "Genioplasty", "Chin augmentation" ], "overview": "Chin augmentation using surgical implants alter the underlying structure of the face, intended to balance the facial features. The specific medical terms mentoplasty and genioplasty are used to refer to the reduction and addition of material to a patient's chin. This can take the form of chin height reduction or chin rounding by osteotomy, or chin augmentation using implants. Altering the facial balance is commonly performed by modifying the chin using an implant inserted through the mouth. The intent is to provide a suitable projection of the chin as well as the correct height of the chin which is in balance with the other facial features.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Genioplasty", "url": "https://en.wikipedia.org/wiki/Chin_augmentation" } ], "literatureLinks": [ { "title": "Genioplasty in Contemporary Orthognathic Surgery.", "journal": "Oral and maxillofacial surgery clinics of North America", "year": 2023, "doi": "10.1016/j.coms.2022.06.009", "url": "https://doi.org/10.1016/j.coms.2022.06.009" }, { "title": "Complications Following Alloplastic Chin Augmentation: A Systematic Review of Implant Materials and Surgical Techniques.", "journal": "Annals of plastic surgery", "year": 2023, "doi": "10.1097/SAP.0000000000003423", "url": "https://doi.org/10.1097/SAP.0000000000003423" }, { "title": "Chin Augmentation Techniques: A Systematic Review.", "journal": "Plastic and reconstructive surgery", "year": 2023, "doi": "10.1097/PRS.0000000000010079", "url": "https://doi.org/10.1097/PRS.0000000000010079" }, { "title": "Management and avoidance of complications in chin augmentation.", "journal": "Aesthetic surgery journal", "year": 2011, "doi": "10.1177/1090820X11415516", "url": "https://doi.org/10.1177/1090820X11415516" }, { "title": "Custom-designed chin augmentation.", "journal": "Facial plastic surgery clinics of North America", "year": 2008, "doi": "10.1016/j.fsc.2007.09.007", "url": "https://doi.org/10.1016/j.fsc.2007.09.007" } ], "complicationRate": { "value": 12.6, "range": [ 7.5, 17.7 ], "sourceSlugs": [ "pubmed-36729154", "pubmed-18063248" ] }, "accreditationsRequired": [ "isaps-member-surgeon", "national-plastic-surgery-board" ], "citedAuthors": [ { "name": "Richard D Zeph", "affiliation": "Department of Otolaryngology/Head and Neck Surgery, Indiana University Medical Center, Indianapolis, IN, USA. rzeph@zephcosmeticsurgery.com", "citationSlugs": [ "pubmed-18063248" ] }, { "name": "Carlo M Oranges", "affiliation": "From the Department of Plastic, Reconstructive, and Aesthetic Surgery, Geneva University Hospitals, University of Geneva.", "citationSlugs": [ "pubmed-36729154" ] } ] }, { "slug": "jaw-surgery", "name": "Orthognathic Jaw Surgery", "category": "cosmetic-surgery", "description": "Orthognathic surgery, also known as corrective jaw surgery or simply jaw surgery, is surgery designed to correct conditions of the jaw and lower face related to structure, growth, airway issues including sleep apnea, TMJ disorders, malocclusion problems primarily arising from skeletal disharmonies, and other orthodontic dental bite problems that cannot be treated easily with braces, as well as the broad range of facial imbalances, disharmonies, asymmetries, and malproportions where correction ma", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "aliases": [ "Orthognathic surgery", "Maxillofacial surgery" ], "overview": "Orthognathic surgery, also known as corrective jaw surgery or simply jaw surgery, is surgery designed to correct conditions of the jaw and lower face related to structure, growth, airway issues including sleep apnea, TMJ disorders, malocclusion problems primarily arising from skeletal disharmonies, and other orthodontic dental bite problems that cannot be treated easily with braces, as well as the broad range of facial imbalances, disharmonies, asymmetries, and malproportions where correction may be considered to improve facial aesthetics and self-esteem.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Orthognathic surgery", "url": "https://en.wikipedia.org/wiki/Orthognathic_surgery" } ], "literatureLinks": [ { "title": "Antibiotic prophylaxis in oral and maxillofacial surgery: a systematic review.", "journal": "The British journal of oral & maxillofacial surgery", "year": 2021, "doi": "10.1016/j.bjoms.2020.09.020", "url": "https://doi.org/10.1016/j.bjoms.2020.09.020" }, { "title": "Antiresorptive Therapy to Reduce Fracture Risk and Effects on Dental Implant Outcomes in Patients With Osteoporosis: A Systematic Review and Osteonecrosis of the Jaw Taskforce Consensus Statement.", "journal": "Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists", "year": 2025, "doi": "10.1016/j.eprac.2025.02.016", "url": "https://doi.org/10.1016/j.eprac.2025.02.016" }, { "title": "Complications of orthognathic surgery in patients with cleft lip and palate: A systematic review.", "journal": "Journal of stomatology, oral and maxillofacial surgery", "year": 2024, "doi": "10.1016/j.jormas.2024.101795", "url": "https://doi.org/10.1016/j.jormas.2024.101795" }, { "title": "Evaluation of surgical techniques in survival rate and complications of zygomatic implants for the rehabilitation of the atrophic edentulous maxilla: a systematic review.", "journal": "International journal of implant dentistry", "year": 2023, "doi": "10.1186/s40729-023-00478-y", "url": "https://doi.org/10.1186/s40729-023-00478-y" }, { "title": "Complications following orthognathic surgery for patients with cleft lip/palate: A systematic review.", "journal": "Journal of the Formosan Medical Association = Taiwan yi zhi", "year": 2016, "doi": "10.1016/j.jfma.2015.10.009", "url": "https://doi.org/10.1016/j.jfma.2015.10.009" } ], "accreditationsRequired": [ "isaps-member-surgeon", "national-plastic-surgery-board" ] }, { "slug": "gynecomastia", "name": "Gynaecomastia Surgery", "category": "cosmetic-surgery", "description": "Gynecomastia is the non-cancerous enlargement of one or both breasts in men due to the growth of breast tissue as a result of a hormone imbalance between estrogens and androgens. Physically speaking, gynecomastia is completely benign, but it is associated with significant psychological distress, social stigma, and dysphoria.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "aliases": [ "Male breast reduction" ], "overview": "Gynecomastia is the non-cancerous enlargement of one or both breasts in men due to the growth of breast tissue as a result of a hormone imbalance between estrogens and androgens. Physically speaking, gynecomastia is completely benign, but it is associated with significant psychological distress, social stigma, and dysphoria.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Gynecomastia", "url": "https://en.wikipedia.org/wiki/Gynecomastia" } ], "literatureLinks": [ { "title": "Gynecomastia.", "journal": "American family physician", "year": 2012, "url": "https://pubmed.ncbi.nlm.nih.gov/22534349/" }, { "title": "Gynaecomastia.", "journal": "The British journal of surgery", "year": 1991, "doi": "10.1002/bjs.1800780805", "url": "https://doi.org/10.1002/bjs.1800780805" }, { "title": "Gynaecomastia.", "journal": "The European journal of surgery = Acta chirurgica", "year": 2001, "doi": "10.1080/110241501753361550", "url": "https://doi.org/10.1080/110241501753361550" }, { "title": "Posterior ischaemic opticus neuropathy after radical cystectomy.", "journal": "Ugeskrift for laeger", "year": 2022, "url": "https://pubmed.ncbi.nlm.nih.gov/36621877/" }, { "title": "[Gynecomastia].", "journal": "Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego", "year": 2012, "url": "https://pubmed.ncbi.nlm.nih.gov/22568186/" } ], "alternativeTreatments": [ { "name": "Liposuction-only correction", "procedureSlug": "liposuction", "rationale": "When the excess is glandular-light and the patient has good skin elasticity.", "sourceSlugs": [ "isaps-guidelines" ] }, { "name": "Pharmacological management", "rationale": "Tamoxifen or aromatase inhibitors in pubertal or drug-induced gynecomastia; not effective in long-standing cases.", "sourceSlugs": [ "isaps-guidelines" ] } ], "accreditationsRequired": [ "isaps-member-surgeon", "national-plastic-surgery-board" ] }, { "slug": "mommy-makeover", "name": "Mommy Makeover", "category": "cosmetic-surgery", "description": "Plastic surgery is a surgical specialty involving restoration, reconstruction, or alteration of the human body. It can be divided into two main categories: reconstructive surgery and cosmetic surgery.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "overview": "Plastic surgery is a surgical specialty involving restoration, reconstruction, or alteration of the human body. It can be divided into two main categories: reconstructive surgery and cosmetic surgery. Reconstructive surgery covers a wide range of specialties, including craniofacial surgery, oral and maxillofacial surgery, hand surgery, microsurgery, and the treatment of burns. This kind of surgery focuses on restoring a body part or improving its function. In contrast, cosmetic surgery focuses solely on improving the physical appearance of the body.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Plastic surgery", "url": "https://en.wikipedia.org/wiki/Plastic_surgery" } ], "literatureLinks": [ { "title": "Abdominoplasty with Combined Surgery.", "journal": "Clinics in plastic surgery", "year": 2020, "doi": "10.1016/j.cps.2020.02.001", "url": "https://doi.org/10.1016/j.cps.2020.02.001" }, { "title": "A Comparative Analysis of the Complication Rate in \"Mommy Makeover\" Procedures and Abdominoplasty.", "journal": "The Israel Medical Association journal : IMAJ", "year": 2025, "url": "https://pubmed.ncbi.nlm.nih.gov/40819205/" }, { "title": "Combined breast surgery and abdominoplasty: strategies for success.", "journal": "Plastic and reconstructive surgery", "year": 2015, "doi": "10.1097/PRS.0000000000001238", "url": "https://doi.org/10.1097/PRS.0000000000001238" }, { "title": "From breast cancer to DIEP Mommy Makeover: an onco-aesthetic reconstructive approach.", "journal": "Plastic and reconstructive surgery", "year": 2026, "doi": "10.1097/PRS.0000000000013192", "url": "https://doi.org/10.1097/PRS.0000000000013192" }, { "title": "Combining Abdominoplasty and Breast Procedures Under Tumescent Local and Spinal Anesthesia: A Retrospective Study.", "journal": "Aesthetic plastic surgery", "year": 2025, "doi": "10.1007/s00266-025-05386-7", "url": "https://doi.org/10.1007/s00266-025-05386-7" } ], "accreditationsRequired": [ "isaps-member-surgeon", "national-plastic-surgery-board" ] }, { "slug": "arm-lift", "name": "Arm Lift", "category": "cosmetic-surgery", "description": "A brachioplasty, from Ancient Greek βραχίων, meaning \"arm\", and πλαστός, meaning \"moulded\", commonly called an arm lift, is a surgical procedure to reshape and provide improved contour to the upper arms and connecting area of chest wall. Although \"brachioplasty\" is commonly used to describe a specific procedure for the upper arms, the term can also be used to describe any surgical arm contouring.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "aliases": [ "Brachioplasty" ], "overview": "A brachioplasty, from Ancient Greek βραχίων, meaning \"arm\", and πλαστός, meaning \"moulded\", commonly called an arm lift, is a surgical procedure to reshape and provide improved contour to the upper arms and connecting area of chest wall. Although \"brachioplasty\" is commonly used to describe a specific procedure for the upper arms, the term can also be used to describe any surgical arm contouring. Brachioplasty is often used to address issues such as excessive loose skin or excessive fat in the arms when it does not respond well to diet and exercise.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Brachioplasty", "url": "https://en.wikipedia.org/wiki/Brachioplasty" } ], "literatureLinks": [ { "title": "Complications associated with brachioplasty: a literature review.", "journal": "Acta bio-medica : Atenei Parmensis", "year": 2018, "doi": "10.23750/abm.v88i4.5609", "url": "https://doi.org/10.23750/abm.v88i4.5609" }, { "title": "The Jaws Brachioplasty: An Original Technique: Improving Aesthetic Outcomes in Arm Lift Procedures.", "journal": "Journal of clinical medicine", "year": 2022, "doi": "10.3390/jcm11175038", "url": "https://doi.org/10.3390/jcm11175038" }, { "title": "Arm Contouring: Review and Current Concepts.", "journal": "Aesthetic surgery journal", "year": 2018, "doi": "10.1093/asj/sjx218", "url": "https://doi.org/10.1093/asj/sjx218" }, { "title": "Liposuction-assisted posterior brachioplasty: technical refinements in upper arm contouring.", "journal": "Plastic and reconstructive surgery", "year": 2010, "doi": "10.1097/PRS.0b013e3181ebe23c", "url": "https://doi.org/10.1097/PRS.0b013e3181ebe23c" }, { "title": "An Updated Analysis of Body Contouring Malpractice Cases.", "journal": "Annals of plastic surgery", "year": 2024, "doi": "10.1097/SAP.0000000000003870", "url": "https://doi.org/10.1097/SAP.0000000000003870" } ], "complicationRate": { "value": 28.9, "range": [ 26.8, 35.95 ], "sourceSlugs": [ "pubmed-29350652", "pubmed-38556689", "pubmed-32643518" ] }, "accreditationsRequired": [ "isaps-member-surgeon", "national-plastic-surgery-board" ], "citedAuthors": [ { "name": "Andrea Sisti", "affiliation": ". luca.milonia@gmail.com.", "citationSlugs": [ "pubmed-29350652" ] }, { "name": "Paolo Marchica", "affiliation": "Clinic of Plastic Surgery, University of Padua, Padua, Italy.", "citationSlugs": [ "pubmed-32643518" ] }, { "name": "Alyssa Reese", "affiliation": "From the Jacobs School Medicine and Biomedical Sciences, University at Buffalo, Buffalo.", "citationSlugs": [ "pubmed-38556689" ] } ] }, { "slug": "thigh-lift", "name": "Thigh Lift", "category": "cosmetic-surgery", "description": "Bariatric surgery is a group of surgical procedures used to manage obesity and related conditions. Long-term weight loss with bariatric surgery may be achieved through alteration of gut hormones, physical reduction of stomach size, reduction of nutrient absorption, or a combination of these.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "aliases": [ "Thighplasty" ], "overview": "Bariatric surgery is a group of surgical procedures used to manage obesity and related conditions. Long-term weight loss with bariatric surgery may be achieved through alteration of gut hormones, physical reduction of stomach size, reduction of nutrient absorption, or a combination of these. Standard of care procedures include Roux en-Y bypass, sleeve gastrectomy, and biliopancreatic diversion with duodenal switch, from which weight loss is largely achieved by altering gut hormone levels responsible for hunger and satiety, leading to a new hormonal weight set point.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Body contouring", "url": "https://en.wikipedia.org/wiki/Bariatric_surgery" } ], "literatureLinks": [ { "title": "Thighs lift in the post-bariatric patient - A systematic review.", "journal": "Journal of plastic, reconstructive & aesthetic surgery : JPRAS", "year": 2024, "doi": "10.1016/j.bjps.2024.09.011", "url": "https://doi.org/10.1016/j.bjps.2024.09.011" }, { "title": "A Comprehensive Review of Medial Thighplasty: The Role of Liposuction in Reducing Complications and Optimizing Patient Outcomes.", "journal": "Journal of clinical medicine", "year": 2025, "doi": "10.3390/jcm14072426", "url": "https://doi.org/10.3390/jcm14072426" }, { "title": "Complications Associated With Medial Thigh Lift: A Comprehensive Literature Review.", "journal": "Journal of cutaneous and aesthetic surgery", "year": 2015, "doi": "10.4103/0974-2077.172189", "url": "https://doi.org/10.4103/0974-2077.172189" }, { "title": "Medial thigh lift in the massive weight loss population: outcomes and complications.", "journal": "Plastic and reconstructive surgery", "year": 2015, "doi": "10.1097/PRS.0000000000000772", "url": "https://doi.org/10.1097/PRS.0000000000000772" }, { "title": "Concomitant Liposuction Reduces Complications of Vertical Medial Thigh Lift in Massive Weight Loss Patients.", "journal": "Plastic and reconstructive surgery", "year": 2016, "doi": "10.1097/PRS.0000000000002194", "url": "https://doi.org/10.1097/PRS.0000000000002194" } ], "accreditationsRequired": [ "isaps-member-surgeon", "national-plastic-surgery-board" ], "complicationRate": { "value": 13.12, "range": [ 7.89, 18.34 ], "sourceSlugs": [ "pubmed-26865783", "pubmed-40217874" ] } }, { "slug": "body-lift", "name": "Body Lift", "category": "cosmetic-surgery", "description": "Bariatric surgery is a group of surgical procedures used to manage obesity and related conditions. Long-term weight loss with bariatric surgery may be achieved through alteration of gut hormones, physical reduction of stomach size, reduction of nutrient absorption, or a combination of these.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "aliases": [ "Post-bariatric body lift", "Belt lipectomy" ], "overview": "Bariatric surgery is a group of surgical procedures used to manage obesity and related conditions. Long-term weight loss with bariatric surgery may be achieved through alteration of gut hormones, physical reduction of stomach size, reduction of nutrient absorption, or a combination of these. Standard of care procedures include Roux en-Y bypass, sleeve gastrectomy, and biliopancreatic diversion with duodenal switch, from which weight loss is largely achieved by altering gut hormone levels responsible for hunger and satiety, leading to a new hormonal weight set point.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Body contouring", "url": "https://en.wikipedia.org/wiki/Bariatric_surgery" } ], "literatureLinks": [ { "title": "Thighs lift in the post-bariatric patient - A systematic review.", "journal": "Journal of plastic, reconstructive & aesthetic surgery : JPRAS", "year": 2024, "doi": "10.1016/j.bjps.2024.09.011", "url": "https://doi.org/10.1016/j.bjps.2024.09.011" }, { "title": "Fleur-de-lis Abdominoplasty and Neo-umbilicus.", "journal": "Clinics in plastic surgery", "year": 2019, "doi": "10.1016/j.cps.2018.08.007", "url": "https://doi.org/10.1016/j.cps.2018.08.007" }, { "title": "Post-bariatric body contouring: oue experience.", "journal": "Acta bio-medica : Atenei Parmensis", "year": 2016, "url": "https://pubmed.ncbi.nlm.nih.gov/27163898/" }, { "title": "Mid-body contouring in the post-bariatric surgery patient.", "journal": "Plastic and reconstructive surgery", "year": 2006, "doi": "10.1097/01.prs.0000218185.10795.aa", "url": "https://doi.org/10.1097/01.prs.0000218185.10795.aa" }, { "title": "Outcome, Complications, and Body Mass Index Correlation of Horizontal and Combined Horizontal and Vertical Thigh Lift: A 16-year Single-center Experience.", "journal": "Journal of cutaneous and aesthetic surgery", "year": 2019, "doi": "10.4103/JCAS.JCAS_115_18", "url": "https://doi.org/10.4103/JCAS.JCAS_115_18" } ], "accreditationsRequired": [ "isaps-member-surgeon", "national-plastic-surgery-board" ] }, { "slug": "revision-rhinoplasty", "name": "Revision Rhinoplasty", "category": "cosmetic-surgery", "description": "Rhinoplasty, sometimes referred to as a \"nose job,\" is a plastic surgery procedure performed to change the shape, size, or proportions of the nose or to improve nasal function and breathing. There are two types of plastic surgery used – reconstructive surgery that restores the form and functions of the nose and cosmetic surgery that changes the appearance of the nose.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "parentProcedure": "rhinoplasty", "aliases": [ "Secondary rhinoplasty" ], "overview": "Rhinoplasty, sometimes referred to as a \"nose job,\" is a plastic surgery procedure performed to change the shape, size, or proportions of the nose or to improve nasal function and breathing. There are two types of plastic surgery used – reconstructive surgery that restores the form and functions of the nose and cosmetic surgery that changes the appearance of the nose. Reconstructive surgery seeks to resolve nasal injuries caused by various traumas including blunt, and penetrating trauma and trauma caused by blast injury. Reconstructive surgery can also treat birth defects, breathing problems, and failed primary rhinoplasties. Rhinoplasty may remove a dorsal hump, narrow the nostril width, alter the nasolabial angle, or address injuries, birth defects, or other functional issues that affect breathing, such as a deviated nasal septum, internal nasal valve collapse, or external nasal valve collapse. Surgery only on the septum is called a septoplasty.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Rhinoplasty", "url": "https://en.wikipedia.org/wiki/Rhinoplasty" } ], "literatureLinks": [ { "title": "Regenerative Nanofat Membrane Development Process.", "journal": "Aesthetic plastic surgery", "year": 2025, "doi": "10.1007/s00266-024-04562-5", "url": "https://doi.org/10.1007/s00266-024-04562-5" }, { "title": "Revision rhinoplasty.", "journal": "Facial plastic surgery : FPS", "year": 2002, "doi": "10.1055/s-2002-36491", "url": "https://doi.org/10.1055/s-2002-36491" }, { "title": "Teenage Rhinoplasty.", "journal": "World journal of plastic surgery", "year": 2018, "url": "https://pubmed.ncbi.nlm.nih.gov/29651398/" }, { "title": "Feminizing Rhinoplasty in Transfeminine Patients: Complications and Outcomes in 102 Patients.", "journal": "The Journal of craniofacial surgery", "year": 2025, "doi": "10.1097/SCS.0000000000011515", "url": "https://doi.org/10.1097/SCS.0000000000011515" }, { "title": "Rhinoplasty.", "journal": "", "year": 2026, "url": "https://pubmed.ncbi.nlm.nih.gov/32644396/" } ], "alternativeTreatments": [ { "name": "Non-surgical refinement (filler)", "rationale": "May camouflage minor irregularities without re-operating on scarred tissue.", "sourceSlugs": [ "isaps-guidelines" ] }, { "name": "Acceptance / counseling", "rationale": "Where the patient's residual concerns are not surgically correctable safely.", "sourceSlugs": [ "isaps-guidelines" ] } ], "accreditationsRequired": [ "isaps-member-surgeon", "national-plastic-surgery-board" ] }, { "slug": "fat-transfer-breast-augmentation", "name": "Fat Transfer Breast Augmentation", "category": "cosmetic-surgery", "description": "Breast augmentation is a plastic surgery procedure by which either a breast implant or a fat-graft implant is emplaced to the thorax to increase the size of the breasts in order to correct congenital defects of the breast and of the chest wall. Consequently, after the breast-enlargement surgery, the symmetrical breast hemisphere is of proportionate size, has a smooth contour, and is anatomically consistent with the woman's body.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "overview": "Breast augmentation is a plastic surgery procedure by which either a breast implant or a fat-graft implant is emplaced to the thorax to increase the size of the breasts in order to correct congenital defects of the breast and of the chest wall. Consequently, after the breast-enlargement surgery, the symmetrical breast hemisphere is of proportionate size, has a smooth contour, and is anatomically consistent with the woman's body.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Breast augmentation", "url": "https://en.wikipedia.org/wiki/Breast_augmentation" } ], "literatureLinks": [ { "title": "Autologous fat grafting for postoperative breast reconstruction: A systemic review.", "journal": "Regenerative therapy", "year": 2024, "doi": "10.1016/j.reth.2024.10.007", "url": "https://doi.org/10.1016/j.reth.2024.10.007" }, { "title": "Complications after Breast Augmentation with Fat Grafting: A Systematic Review.", "journal": "Plastic and reconstructive surgery", "year": 2020, "doi": "10.1097/PRS.0000000000006569", "url": "https://doi.org/10.1097/PRS.0000000000006569" }, { "title": "Donor site complications and satisfaction in autologous fat grafting for breast reconstruction: A systematic review.", "journal": "Journal of plastic, reconstructive & aesthetic surgery : JPRAS", "year": 2022, "doi": "10.1016/j.bjps.2022.01.029", "url": "https://doi.org/10.1016/j.bjps.2022.01.029" }, { "title": "Oncologic Safety of Autologous Fat Grafting in Breast Reconstruction.", "journal": "Clinical breast cancer", "year": 2021, "doi": "10.1016/j.clbc.2021.01.020", "url": "https://doi.org/10.1016/j.clbc.2021.01.020" }, { "title": "Autologous Fat Grafting to the Breast: An Educational Review.", "journal": "Journal of breast imaging", "year": 2022, "doi": "10.1093/jbi/wbab055", "url": "https://doi.org/10.1093/jbi/wbab055" } ], "alternativeTreatments": [ { "name": "Implant-based augmentation", "procedureSlug": "breast-augmentation", "rationale": "Larger and more predictable volume gain per single procedure; lifetime implant maintenance.", "sourceSlugs": [ "isaps-guidelines" ] }, { "name": "Breast lift", "procedureSlug": "breast-lift", "rationale": "If the issue is contour and projection rather than volume.", "sourceSlugs": [ "isaps-guidelines" ] } ], "accreditationsRequired": [ "isaps-member-surgeon", "national-plastic-surgery-board" ], "complicationRate": { "value": 30.38, "range": [ 25, 35.75 ], "sourceSlugs": [ "pubmed-37166041", "pubmed-27329661" ] } }, { "slug": "all-on-4", "name": "All-on-4 Dental Implants", "category": "dental", "description": "The term All-on-4, also known as All-on-Four and All-in-Four, refers to 'all' teeth being supported 'on four' dental implants. The name All-on-4 is a registered trademark of Nobel Biocare, used globally for both dental products and services.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "parentProcedure": "dental-implants", "overview": "The term All-on-4, also known as All-on-Four and All-in-Four, refers to 'all' teeth being supported 'on four' dental implants. The name All-on-4 is a registered trademark of Nobel Biocare, used globally for both dental products and services. The treatment concept is a prosthodontics procedure for total rehabilitation of the edentulous (toothless) patient, or for patients with badly broken down teeth, decayed teeth, or compromised teeth due to gum disease. It consists of the rehabilitation of either edentulous or dentate maxilla and / or mandible with fixed prosthesis by placing four implants in the anterior maxilla, where bone density is higher. The four implants support a fixed prosthesis with 10 to 14 teeth, and it is placed immediately, typically within 24 hours of surgery.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — All-on-4", "url": "https://en.wikipedia.org/wiki/All-on-4" } ], "literatureLinks": [ { "title": "The all-on-four treatment concept: Systematic review.", "journal": "Journal of clinical and experimental dentistry", "year": 2017, "doi": "10.4317/jced.53613", "url": "https://doi.org/10.4317/jced.53613" }, { "title": "All-on-4 and All-on-6 implant-supported fixed prostheses for the edentulous jaw: a systematic review and meta-analysis.", "journal": "International journal of oral and maxillofacial surgery", "year": 2026, "doi": "10.1016/j.ijom.2026.04.002", "url": "https://doi.org/10.1016/j.ijom.2026.04.002" }, { "title": "All-on-4® Implant Treatment: Common Pitfalls and Methods to Overcome Them.", "journal": "Compendium of continuing education in dentistry (Jamesburg, N.J. : 1995)", "year": 2016, "url": "https://pubmed.ncbi.nlm.nih.gov/27548398/" }, { "title": "Clinical influence of digital vs analog impressions in all-on-4 implant prostheses: a randomized controlled trial.", "journal": "International journal of computerized dentistry", "year": 2022, "url": "https://pubmed.ncbi.nlm.nih.gov/35322650/" }, { "title": "Consensus statements and clinical recommendations on treatment indications, surgical procedures, prosthetic protocols and complications following All-On-4 standard treatment. 9th Mozo-Grau Ticare Conference in Quintanilla, Spain.", "journal": "Journal of clinical and experimental dentistry", "year": 2017, "doi": "10.4317/jced.53759", "url": "https://doi.org/10.4317/jced.53759" } ], "alternativeTreatments": [ { "name": "All-on-6", "procedureSlug": "all-on-6", "rationale": "Two additional implants distribute load better in patients with strong bite forces; higher cost.", "sourceSlugs": [ "who-surgical-safety-checklist" ] }, { "name": "Individual implants per tooth", "procedureSlug": "dental-implants", "rationale": "Best for partial edentulism; significantly higher cost than full-arch fixed prosthesis.", "sourceSlugs": [ "who-surgical-safety-checklist" ] }, { "name": "Conventional full denture", "procedureSlug": "dentures", "rationale": "Lowest-cost option for full-arch tooth loss; removable, lower bite force.", "sourceSlugs": [ "who-surgical-safety-checklist" ] } ], "accreditationsRequired": [ "icoi-fellowship", "national-dental-council" ] }, { "slug": "all-on-6", "name": "All-on-6 Dental Implants", "category": "dental", "description": "Implantology is the term for the placement of dental implants by a dentist, specialist dentist in oral surgery, or oral and maxillofacial surgeons. With a license to practice, every dentist obtains permission to practice the full range of dentistry and thus also to place dental implants.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "parentProcedure": "dental-implants", "overview": "Implantology is the term for the placement of dental implants by a dentist, specialist dentist in oral surgery, or oral and maxillofacial surgeons. With a license to practice, every dentist obtains permission to practice the full range of dentistry and thus also to place dental implants. The 'focus area in implantology' established in 2001 by the European Association of Dental Implantologists before the Federal Constitutional Court is not an additional designation according to the training regulations and is not granted under public law.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Dental implant", "url": "https://en.wikipedia.org/wiki/Dental_implant" } ], "literatureLinks": [ { "title": "Immediate flapless full-arch rehabilitation of edentulous jaws on 4 or 6 implants according to the prosthetic-driven planning and guided implant surgery: A retrospective study on clinical and radiographic outcomes up to 10 years of follow-up.", "journal": "Clinical implant dentistry and related research", "year": 2022, "doi": "10.1111/cid.13134", "url": "https://doi.org/10.1111/cid.13134" }, { "title": "All-on-4 and All-on-6 implant-supported fixed prostheses for the edentulous jaw: a systematic review and meta-analysis.", "journal": "International journal of oral and maxillofacial surgery", "year": 2026, "doi": "10.1016/j.ijom.2026.04.002", "url": "https://doi.org/10.1016/j.ijom.2026.04.002" }, { "title": "Clinical and patient-centered outcomes following rehabilitation of atrophic edentulous maxilla using six implants placed simultaneously with bilateral maxillary sinus augmentation: A retrospective case series.", "journal": "Journal of stomatology, oral and maxillofacial surgery", "year": 2023, "doi": "10.1016/j.jormas.2023.101480", "url": "https://doi.org/10.1016/j.jormas.2023.101480" }, { "title": "Periapical Bone Loss as a Signal of Risk for Prosthetic Screw Loosening in Full-Arch Implant-Supported Fixed Complete Dentures: A Multicenter Retrospective Pilot Study.", "journal": "Cureus", "year": 2026, "doi": "10.7759/cureus.110923", "url": "https://doi.org/10.7759/cureus.110923" }, { "title": "Comparison of 4- or 6-implant supported immediate full-arch fixed prostheses: A retrospective cohort study of 217 patients followed up for 3-13 years.", "journal": "Clinical implant dentistry and related research", "year": 2023, "doi": "10.1111/cid.13170", "url": "https://doi.org/10.1111/cid.13170" } ], "complicationRate": { "value": 6.12, "range": [ 5.65, 6.59 ], "sourceSlugs": [ "pubmed-36197040", "pubmed-42031576" ] }, "accreditationsRequired": [ "icoi-fellowship", "national-dental-council" ], "citedAuthors": [ { "name": "Gerardo La Monaca", "affiliation": "Department of Oral and Maxillofacial Sciences, Sapienza, University of Rome, Rome, Italy.", "citationSlugs": [ "pubmed-36197040" ] }, { "name": "W-H Shao", "affiliation": "Department of Stomatology, General Hospital of Northern Theater Command, Shenhe District, Shenyang, China; Graduate School, China Medical…", "citationSlugs": [ "pubmed-42031576" ] } ] }, { "slug": "full-mouth-restoration", "name": "Full-Mouth Restoration", "category": "dental", "description": "Dental restoration, dental fillings, or simply fillings are dentistry treatments used to restore the function, integrity, and morphology of tooth structure lost due to decay (caries), trauma, or wear. Fillings may also be used to replace or seal tooth structure around dental implants or after more extensive procedures such as root-canal therapy.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "aliases": [ "Full-mouth rehabilitation", "Full-mouth reconstruction" ], "overview": "Dental restoration, dental fillings, or simply fillings are dentistry treatments used to restore the function, integrity, and morphology of tooth structure lost due to decay (caries), trauma, or wear. Fillings may also be used to replace or seal tooth structure around dental implants or after more extensive procedures such as root-canal therapy. There are two broad categories of fillings: direct restorations, placed and shaped directly inside a cleaned cavity in a single dental visit, and indirect restorations, which are fabricated outside the mouth and then cemented into the tooth. Materials for direct fillings commonly include amalgam (metal) or tooth-colored composite and glass-ionomer, while indirect restorations may use ceramics, metal alloys or porcelain for greater durability and structural support.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Dental restoration", "url": "https://en.wikipedia.org/wiki/Dental_restoration" } ], "accreditationsRequired": [ "icoi-fellowship", "national-dental-council" ], "literatureLinks": [ { "title": "Clinical performance of minimally invasive full-mouth rehabilitation using different materials and techniques for patients with moderate to severe tooth wear: a systematic review and meta-analysis.", "journal": "Clinical oral investigations", "year": 2025, "doi": "10.1007/s00784-025-06181-z", "url": "https://doi.org/10.1007/s00784-025-06181-z" }, { "title": "Restorative difficulty evaluation system of endodontically treated teeth.", "journal": "Journal of esthetic and restorative dentistry : official publication of the American Academy of Esthetic Dentistry ... [et al.]", "year": 2022, "doi": "10.1111/jerd.12880", "url": "https://doi.org/10.1111/jerd.12880" }, { "title": "Preformed crowns for decayed primary molar teeth.", "journal": "The Cochrane database of systematic reviews", "year": 2015, "doi": "10.1002/14651858.CD005512.pub3", "url": "https://doi.org/10.1002/14651858.CD005512.pub3" }, { "title": "Different Interventions for Rehabilitation of the Edentulous Maxilla with Implant-Supported Prostheses: An Overview of Systematic Reviews.", "journal": "The International journal of prosthodontics", "year": 2021, "doi": "10.11607/ijp.7162", "url": "https://doi.org/10.11607/ijp.7162" }, { "title": "Importance of an Evaluation Phase When Increasing the Occlusal Vertical Dimension: A Systematic Review.", "journal": "Journal of esthetic and restorative dentistry : official publication of the American Academy of Esthetic Dentistry ... [et al.]", "year": 2025, "doi": "10.1111/jerd.13331", "url": "https://doi.org/10.1111/jerd.13331" } ] }, { "slug": "dental-crowns", "name": "Dental Crowns", "category": "dental", "description": "In dentistry, a crown or a dental cap is a type of dental restoration that completely caps or encircles a tooth or dental implant. A crown may be needed when a large dental cavity threatens the health of a tooth.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "overview": "In dentistry, a crown or a dental cap is a type of dental restoration that completely caps or encircles a tooth or dental implant. A crown may be needed when a large dental cavity threatens the health of a tooth. Some dentists will also finish root canal treatment by covering the exposed tooth with a crown. A crown is typically bonded to the tooth by dental cement. They can be made from various materials, which are usually fabricated using indirect methods. Crowns are used to improve the strength or appearance of teeth and to halt deterioration. While beneficial to dental health, the procedure and materials can be costly.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Crown (dentistry)", "url": "https://en.wikipedia.org/wiki/Crown_(dental_restoration)" } ], "literatureLinks": [ { "title": "Anterior Endocrowns as An Alternative to Core Crown restorations: A Systematic Review.", "journal": "International dental journal", "year": 2025, "doi": "10.1016/j.identj.2024.07.1216", "url": "https://doi.org/10.1016/j.identj.2024.07.1216" }, { "title": "Restorations in primary teeth: a systematic review on survival and reasons for failures.", "journal": "International journal of paediatric dentistry", "year": 2018, "doi": "10.1111/ipd.12346", "url": "https://doi.org/10.1111/ipd.12346" }, { "title": "Clinical behavior and survival of endodontically treated teeth with or without post placement: a systematic review and meta-analysis.", "journal": "Journal of oral science", "year": 2024, "doi": "10.2334/josnusd.24-0098", "url": "https://doi.org/10.2334/josnusd.24-0098" }, { "title": "A systematic review and meta analysis of the longevity of anterior and posterior all-ceramic crowns.", "journal": "Journal of dentistry", "year": 2016, "doi": "10.1016/j.jdent.2016.08.009", "url": "https://doi.org/10.1016/j.jdent.2016.08.009" }, { "title": "Osseointegrative and antimicrobial properties of graphene oxide nano coated dental implants: A systematic review.", "journal": "F1000Research", "year": 2024, "doi": "10.12688/f1000research.148180.2", "url": "https://doi.org/10.12688/f1000research.148180.2" } ], "accreditationsRequired": [ "national-dental-council" ] }, { "slug": "dental-bridges", "name": "Dental Bridges", "category": "dental", "description": "A bridge is a fixed dental restoration used to replace one or more missing teeth by joining an artificial tooth definitively to adjacent teeth or dental implants.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "overview": "A bridge is a fixed dental restoration used to replace one or more missing teeth by joining an artificial tooth definitively to adjacent teeth or dental implants.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Bridge (dentistry)", "url": "https://en.wikipedia.org/wiki/Bridge_(dentistry)" } ], "literatureLinks": [ { "title": "A systematic review of the survival and complication rates of zirconia-ceramic and metal-ceramic multiple-unit fixed dental prostheses.", "journal": "Clinical oral implants research", "year": 2018, "doi": "10.1111/clr.13277", "url": "https://doi.org/10.1111/clr.13277" }, { "title": "A systematic review of the survival and complication rates of resin-bonded fixed dental prostheses after a mean observation period of at least 5 years.", "journal": "Clinical oral implants research", "year": 2017, "doi": "10.1111/clr.13007", "url": "https://doi.org/10.1111/clr.13007" }, { "title": "The complete digital workflow in fixed prosthodontics: a systematic review.", "journal": "BMC oral health", "year": 2017, "doi": "10.1186/s12903-017-0415-0", "url": "https://doi.org/10.1186/s12903-017-0415-0" }, { "title": "Systematic review evaluating the influence of the prosthetic material and prosthetic design on the clinical outcomes of implant-supported multi-unit fixed dental prosthesis in the posterior area.", "journal": "Clinical oral implants research", "year": 2023, "doi": "10.1111/clr.14103", "url": "https://doi.org/10.1111/clr.14103" }, { "title": "Survival of tooth-implant connections: A systematic review and meta-analysis.", "journal": "Journal of Indian Prosthodontic Society", "year": 2023, "doi": "10.4103/jips.jips_161_23", "url": "https://doi.org/10.4103/jips.jips_161_23" } ], "accreditationsRequired": [ "national-dental-council" ] }, { "slug": "root-canal-treatment", "name": "Root Canal Treatment", "category": "dental", "description": "Root canal treatment is a treatment sequence for the infected pulp of a tooth--an abscess--that is intended to result in the elimination of infection and the protection of the decontaminated tooth from future microbial invasion. It is generally done when the cavity is too big for a normal filling.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "aliases": [ "Endodontic treatment" ], "overview": "Root canal treatment is a treatment sequence for the infected pulp of a tooth--an abscess--that is intended to result in the elimination of infection and the protection of the decontaminated tooth from future microbial invasion. It is generally done when the cavity is too big for a normal filling. Root canals, and their associated pulp chamber, are the physical hollows within a tooth that are naturally inhabited by nerve tissue, blood vessels and other cellular entities.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en", "nhs-health-a-to-z", "medlineplus-nih" ], "references": [ { "label": "Wikipedia — Root canal treatment", "url": "https://en.wikipedia.org/wiki/Root_canal_treatment" } ], "recoveryTimeline": "You may not have any feeling in your jaw and face for several hours after root canal treatment, while the anaesthetic wears off. The area around your tooth may feel swollen and sore but it should get better in a couple of weeks. There are things you can do to help you recover from root canal treatment and keep the tooth healthy. ### Do - take [paracetamol](https://www.nhs.uk/medicines/paracetamol-for-adults-old/) or [ibuprofen](https://www.nhs.uk/medicines/ibuprofen-and-codeine-nurofen-plus/about-ibuprofen-and-codeine/) if you're in pain - be careful not to bump or knock your mouth - go to any follow-up appointments after your treatment - [take care of of your teeth and gums](https://www.nhs.uk/live-well/healthy-teeth-and-gums/take-care-of-your-teeth-and-gums/) - try to have regular dentis\n\n*Reference text adapted from NHS UK under the Open Government Licence v3.0.*", "faqs": [ { "question": "What root canal treatment is for?", "answer": "Root canal treatment may be recommended if you've got tooth pain caused by an infected tooth." }, { "question": "How to get root canal treatment?", "answer": "You can get root canal treatment from an NHS or private dentist. Sometimes you may see a root canal specialist called an endodontist." }, { "question": "How root canal treatment is done?", "answer": "Before having root canal treatment, you'll usually be given a [local anaesthetic](https://www.nhs.uk/tests-and-treatments/local-anaesthesia/), so you'll be awake but will not feel any pain." }, { "question": "What causes tooth disorders?", "answer": "The causes of tooth disorders varies, depending on the problem. Sometimes the cause is not taking good care of your teeth. In other cases, you may have been born with the problem or the cause is an accident." }, { "question": "How are tooth disorders diagnosed?", "answer": "Your dentist will ask about your symptoms, look at your teeth, and probe them with dental instruments. In some cases, you may need dental x-rays." } ], "literatureLinks": [ { "title": "Endodontic Periapical Lesion: An Overview on the Etiology, Diagnosis and Current Treatment Modalities.", "journal": "European endodontic journal", "year": 2020, "doi": "10.14744/eej.2020.42714", "url": "https://doi.org/10.14744/eej.2020.42714" }, { "title": "Outcome of primary root canal treatment: systematic review of the literature -- Part 2. Influence of clinical factors.", "journal": "International endodontic journal", "year": 2008, "doi": "10.1111/j.1365-2591.2007.01323.x", "url": "https://doi.org/10.1111/j.1365-2591.2007.01323.x" }, { "title": "Outcome of secondary root canal treatment: a systematic review of the literature.", "journal": "International endodontic journal", "year": 2008, "doi": "10.1111/j.1365-2591.2008.01484.x", "url": "https://doi.org/10.1111/j.1365-2591.2008.01484.x" }, { "title": "Present status and future directions: Removal of fractured instruments.", "journal": "International endodontic journal", "year": 2022, "doi": "10.1111/iej.13743", "url": "https://doi.org/10.1111/iej.13743" }, { "title": "Impact of systemic health on treatment outcomes in endodontics.", "journal": "International endodontic journal", "year": 2023, "doi": "10.1111/iej.13789", "url": "https://doi.org/10.1111/iej.13789" } ], "accreditationsRequired": [ "national-dental-council" ] }, { "slug": "wisdom-tooth-extraction", "name": "Wisdom Tooth Extraction", "category": "dental", "description": "The third molar, commonly called wisdom tooth, is the most posterior of the three molars in each quadrant of the human dentition. The age at which wisdom teeth come through (erupt) is variable, but this generally occurs between late teens and early twenties.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "aliases": [ "Third-molar extraction" ], "overview": "The third molar, commonly called wisdom tooth, is the most posterior of the three molars in each quadrant of the human dentition. The age at which wisdom teeth come through (erupt) is variable, but this generally occurs between late teens and early twenties. Most adults have four wisdom teeth, one in each of the four quadrants, but it is possible to have none, fewer, or more, in which case the extras are called supernumerary teeth. Wisdom teeth may become stuck (impacted) and not erupt fully, if there is not enough space for them to come through normally. Impacted wisdom teeth are still sometimes removed for orthodontic treatment, believing that they move the other teeth and cause crowding, though this is disputed.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Wisdom tooth", "url": "https://en.wikipedia.org/wiki/Wisdom_tooth" } ], "literatureLinks": [ { "title": "Complications of Third Molar Extraction: A retrospective study from a tertiary healthcare centre in Oman.", "journal": "Sultan Qaboos University medical journal", "year": 2019, "doi": "10.18295/squmj.2019.19.03.009", "url": "https://doi.org/10.18295/squmj.2019.19.03.009" }, { "title": "Antibiotic prophylaxis in the prevention of dry socket and surgical site infection after lower third molar extraction: a network meta-analysis.", "journal": "International journal of oral and maxillofacial surgery", "year": 2024, "doi": "10.1016/j.ijom.2023.08.001", "url": "https://doi.org/10.1016/j.ijom.2023.08.001" }, { "title": "Postoperative interventions to reduce inflammatory complications after third molar surgery: review of the current evidence.", "journal": "Australian dental journal", "year": 2017, "doi": "10.1111/adj.12526", "url": "https://doi.org/10.1111/adj.12526" }, { "title": "Analysis of complications after the removal of 339 third molars.", "journal": "Dental and medical problems", "year": 2021, "doi": "10.17219/dmp/127028", "url": "https://doi.org/10.17219/dmp/127028" }, { "title": "Complications post simple exodontia: A systematic review.", "journal": "Dental and medical problems", "year": 2022, "doi": "10.17219/dmp/144596", "url": "https://doi.org/10.17219/dmp/144596" } ], "accreditationsRequired": [ "national-dental-council" ] }, { "slug": "sinus-lift", "name": "Sinus Lift", "category": "dental", "description": "Maxillary sinus floor augmentation is a surgical procedure that increases the amount of bone in the posterior maxilla by lifting the Schneiderian membrane and placing a bone graft.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "aliases": [ "Sinus augmentation" ], "overview": "Maxillary sinus floor augmentation is a surgical procedure that increases the amount of bone in the posterior maxilla by lifting the Schneiderian membrane and placing a bone graft.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Sinus lift", "url": "https://en.wikipedia.org/wiki/Sinus_lift" } ], "literatureLinks": [ { "title": "Maxillary sinus lift surgery-with or without graft material? A systematic review.", "journal": "International journal of oral and maxillofacial surgery", "year": 2016, "doi": "10.1016/j.ijom.2016.09.023", "url": "https://doi.org/10.1016/j.ijom.2016.09.023" }, { "title": "Short implants versus longer implants with maxillary sinus lift. A systematic review and meta-analysis.", "journal": "Brazilian oral research", "year": 2018, "doi": "10.1590/1807-3107bor-2018.vol32.0086", "url": "https://doi.org/10.1590/1807-3107bor-2018.vol32.0086" }, { "title": "Short implants as an alternative to sinus lift for the rehabilitation of posterior maxillary atrophies: Systematic review and meta-analysis.", "journal": "Journal of stomatology, oral and maxillofacial surgery", "year": 2019, "doi": "10.1016/j.jormas.2018.11.006", "url": "https://doi.org/10.1016/j.jormas.2018.11.006" }, { "title": "Association between sinus septa and lateral wall thickness with risk of perforation during maxillary sinus lift surgery: A systematic review and meta-analysis.", "journal": "PloS one", "year": 2024, "doi": "10.1371/journal.pone.0308166", "url": "https://doi.org/10.1371/journal.pone.0308166" }, { "title": "Management of sinus graft infection-a systematic review.", "journal": "International journal of oral and maxillofacial surgery", "year": 2022, "doi": "10.1016/j.ijom.2021.09.007", "url": "https://doi.org/10.1016/j.ijom.2021.09.007" } ], "accreditationsRequired": [ "icoi-fellowship", "national-dental-council" ] }, { "slug": "bone-grafting", "name": "Dental Bone Grafting", "category": "dental", "description": "Bone grafting is a type of transplantation used to replace missing bone tissue or stimulate the healing of fractures. This surgical procedure is useful for repairing bone fractures that are extremely complex, pose a significant health risk to the patient, or fail to heal properly, leading to pseudoarthrosis.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "overview": "Bone grafting is a type of transplantation used to replace missing bone tissue or stimulate the healing of fractures. This surgical procedure is useful for repairing bone fractures that are extremely complex, pose a significant health risk to the patient, or fail to heal properly, leading to pseudoarthrosis. While some small or acute fractures can heal without bone grafting, the risk is greater for large fractures, such as compound fractures. Additionally, structural or morcellized bone grafting can be used in joint replacement revision surgery when wide osteolysis is present.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Bone grafting", "url": "https://en.wikipedia.org/wiki/Bone_grafting" } ], "literatureLinks": [ { "title": "Influence of buccal bone wall thickness on the peri-implant hard and soft tissue dimensional changes: A systematic review.", "journal": "Clinical oral implants research", "year": 2023, "doi": "10.1111/clr.14029", "url": "https://doi.org/10.1111/clr.14029" }, { "title": "Horizontal Ridge Augmentation: A Comparison between Khoury and Urban Technique.", "journal": "Biology", "year": 2021, "doi": "10.3390/biology10080749", "url": "https://doi.org/10.3390/biology10080749" }, { "title": "Effects of soft tissue augmentation procedures on peri-implant health or disease: A systematic review and meta-analysis.", "journal": "Clinical oral implants research", "year": 2018, "doi": "10.1111/clr.13114", "url": "https://doi.org/10.1111/clr.13114" }, { "title": "Biomaterials for promoting periodontal regeneration in human intrabony defects: a systematic review.", "journal": "Periodontology 2000", "year": 2015, "doi": "10.1111/prd.12086", "url": "https://doi.org/10.1111/prd.12086" }, { "title": "Lateral Alveolar Ridge Augmentation with Autogenous Tooth Block Graft Compared with Autogenous Bone Block Graft: a Systematic Review.", "journal": "Journal of oral & maxillofacial research", "year": 2022, "doi": "10.5037/jomr.2022.13101", "url": "https://doi.org/10.5037/jomr.2022.13101" } ], "complicationRate": { "value": 7.85, "range": [ 7, 10.8 ], "sourceSlugs": [ "pubmed-34439981", "pubmed-39283219", "pubmed-31089897" ] }, "accreditationsRequired": [ "icoi-fellowship", "national-dental-council" ], "citedAuthors": [ { "name": "Pedro Henrique de Azambuja Carvalho", "affiliation": "Department of Diagnosis and Surgery, Dental School at Araraquara - UNESP - São Paulo State University, 1680th Humaitá Street, Araraquara,…", "citationSlugs": [ "pubmed-31089897" ] }, { "name": "Javier Sánchez-Sánchez", "affiliation": "Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain.", "citationSlugs": [ "pubmed-34439981" ] }, { "name": "Hamoun Sabri", "citationSlugs": [ "pubmed-39283219" ] } ] }, { "slug": "zirconia-crowns", "name": "Zirconia Crowns", "category": "dental", "description": "In dentistry, a crown or a dental cap is a type of dental restoration that completely caps or encircles a tooth or dental implant. A crown may be needed when a large dental cavity threatens the health of a tooth.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "parentProcedure": "dental-crowns", "overview": "In dentistry, a crown or a dental cap is a type of dental restoration that completely caps or encircles a tooth or dental implant. A crown may be needed when a large dental cavity threatens the health of a tooth. Some dentists will also finish root canal treatment by covering the exposed tooth with a crown. A crown is typically bonded to the tooth by dental cement. They can be made from various materials, which are usually fabricated using indirect methods. Crowns are used to improve the strength or appearance of teeth and to halt deterioration. While beneficial to dental health, the procedure and materials can be costly.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Crown (dentistry)", "url": "https://en.wikipedia.org/wiki/Crown_(dental_restoration)" } ], "literatureLinks": [ { "title": "A systematic review of the survival and complication rates of zirconia-ceramic and metal-ceramic single crowns.", "journal": "Clinical oral implants research", "year": 2018, "doi": "10.1111/clr.13306", "url": "https://doi.org/10.1111/clr.13306" }, { "title": "All-ceramic or metal-ceramic tooth-supported fixed dental prostheses (FDPs)? A systematic review of the survival and complication rates. Part I: Single crowns (SCs).", "journal": "Dental materials : official publication of the Academy of Dental Materials", "year": 2015, "doi": "10.1016/j.dental.2015.02.011", "url": "https://doi.org/10.1016/j.dental.2015.02.011" }, { "title": "The clinical success of zirconia-based crowns: a systematic review.", "journal": "The International journal of prosthodontics", "year": 2014, "doi": "10.11607/ijp.3647", "url": "https://doi.org/10.11607/ijp.3647" }, { "title": "Clinical performance of monolithic CAD/CAM tooth-supported zirconia restorations: systematic review and meta-analysis.", "journal": "Journal of prosthodontic research", "year": 2022, "doi": "10.2186/jpr.JPR_D_21_00081", "url": "https://doi.org/10.2186/jpr.JPR_D_21_00081" }, { "title": "A systematic review and meta-analysis evaluating the survival, the failure, and the complication rates of veneered and monolithic all-ceramic implant-supported single crowns.", "journal": "Clinical oral implants research", "year": 2021, "doi": "10.1111/clr.13863", "url": "https://doi.org/10.1111/clr.13863" } ], "accreditationsRequired": [ "national-dental-council" ] }, { "slug": "e-max-veneers", "name": "E-max Veneers", "category": "dental", "description": "In dentistry, a veneer is a layer of material placed over a tooth. Veneers can improve the aesthetics and function of the teeth and protect the tooth's surface from damage.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "parentProcedure": "dental-veneers", "overview": "In dentistry, a veneer is a layer of material placed over a tooth. Veneers can improve the aesthetics and function of the teeth and protect the tooth's surface from damage.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Veneer (dentistry)", "url": "https://en.wikipedia.org/wiki/Veneer_(dentistry)" } ], "literatureLinks": [ { "title": "Survival and Complication Rates of Feldspathic, Leucite-Reinforced, Lithium Disilicate and Zirconia Ceramic Laminate Veneers: A Systematic Review and Meta-Analysis.", "journal": "Journal of esthetic and restorative dentistry : official publication of the American Academy of Esthetic Dentistry ... [et al.]", "year": 2025, "doi": "10.1111/jerd.13351", "url": "https://doi.org/10.1111/jerd.13351" }, { "title": "The complete digital workflow in fixed prosthodontics: a systematic review.", "journal": "BMC oral health", "year": 2017, "doi": "10.1186/s12903-017-0415-0", "url": "https://doi.org/10.1186/s12903-017-0415-0" }, { "title": "Clinical performance of laminate veneers: A review of the literature.", "journal": "Journal of prosthodontic research", "year": 2024, "doi": "10.2186/jpr.JPR_D_23_00151", "url": "https://doi.org/10.2186/jpr.JPR_D_23_00151" }, { "title": "All-ceramic or metal-ceramic tooth-supported fixed dental prostheses (FDPs)? A systematic review of the survival and complication rates. Part I: Single crowns (SCs).", "journal": "Dental materials : official publication of the Academy of Dental Materials", "year": 2015, "doi": "10.1016/j.dental.2015.02.011", "url": "https://doi.org/10.1016/j.dental.2015.02.011" }, { "title": "Clinical Performance and Survival Outcomes of Milled Versus Pressed Lithium Disilicate Veneers: A Systematic Review.", "journal": "Journal of esthetic and restorative dentistry : official publication of the American Academy of Esthetic Dentistry ... [et al.]", "year": 2025, "doi": "10.1111/jerd.70038", "url": "https://doi.org/10.1111/jerd.70038" } ], "accreditationsRequired": [ "national-dental-council" ] }, { "slug": "composite-bonding", "name": "Composite Bonding", "category": "dental", "description": "Dental composite resins are dental cements made of synthetic resins. Synthetic resins evolved as restorative materials since they were insoluble, of good tooth-like appearance, insensitive to dehydration, easy to manipulate and inexpensive.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "aliases": [ "Dental bonding" ], "overview": "Dental composite resins are dental cements made of synthetic resins. Synthetic resins evolved as restorative materials since they were insoluble, of good tooth-like appearance, insensitive to dehydration, easy to manipulate and inexpensive. Composite resins are most commonly composed of Bis-GMA and other dimethacrylate monomers, a filler material such as silica and in most applications, a photoinitiator. Dimethylglyoxime is also commonly added to achieve certain physical properties such as flow-ability. Further tailoring of physical properties is achieved by formulating unique concentrations of each constituent.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Dental composite", "url": "https://en.wikipedia.org/wiki/Dental_composite" } ], "accreditationsRequired": [ "national-dental-council" ], "literatureLinks": [ { "title": "Current options concerning the endodontically-treated teeth restoration with the adhesive approach.", "journal": "Brazilian oral research", "year": 2018, "doi": "10.1590/1807-3107bor-2018.vol32.0074", "url": "https://doi.org/10.1590/1807-3107bor-2018.vol32.0074" }, { "title": "Fatigue Survival of Lithium Disilicate, 3D-Printed Composite, and Injection-Molded Direct Composite Veneers.", "journal": "Journal of esthetic and restorative dentistry : official publication of the American Academy of Esthetic Dentistry ... [et al.]", "year": 2026, "doi": "10.1111/jerd.70200", "url": "https://doi.org/10.1111/jerd.70200" }, { "title": "Long-term outcomes on direct fiber reinforced composite fixed partial dentures: A 14-year practice-based study.", "journal": "The Journal of prosthetic dentistry", "year": 2026, "doi": "10.1016/j.prosdent.2025.08.041", "url": "https://doi.org/10.1016/j.prosdent.2025.08.041" }, { "title": "Seven-year clinical evaluation of painful cracked teeth restored with a direct composite restoration.", "journal": "Journal of endodontics", "year": 2008, "doi": "10.1016/j.joen.2008.04.011", "url": "https://doi.org/10.1016/j.joen.2008.04.011" }, { "title": "Clinical evaluation of the fiber post and direct composite resin restoration for fixed single crowns on endodontically treated teeth.", "journal": "Medical journal, Armed Forces India", "year": 2015, "doi": "10.1016/j.mjafi.2012.02.007", "url": "https://doi.org/10.1016/j.mjafi.2012.02.007" } ] }, { "slug": "smile-makeover", "name": "Smile Makeover", "category": "dental", "description": "Cosmetic dentistry is generally used to refer to any dental work that improves the appearance of teeth, gums and/or bite. It primarily focuses on improvement in dental aesthetics in color, position, shape, size, alignment and overall smile appearance.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "overview": "Cosmetic dentistry is generally used to refer to any dental work that improves the appearance of teeth, gums and/or bite. It primarily focuses on improvement in dental aesthetics in color, position, shape, size, alignment and overall smile appearance. Many dentists refer to themselves as \"cosmetic dentists\" regardless of their specific education, specialty, training, and experience in this field. This has been considered unethical with a predominant objective of marketing to patients. The American Dental Association does not recognize cosmetic dentistry as a formal specialty area of dentistry. However, there are still dentists that promote themselves as cosmetic dentists.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Cosmetic dentistry", "url": "https://en.wikipedia.org/wiki/Cosmetic_dentistry" } ], "accreditationsRequired": [ "national-dental-council" ], "literatureLinks": [ { "title": "The \"Smile Design and Space\" Concept for Altering Vertical Dimension of Occlusion and Esthetic Restorative Material Selection.", "journal": "Journal of esthetic and restorative dentistry : official publication of the American Academy of Esthetic Dentistry ... [et al.]", "year": 2025, "doi": "10.1111/jerd.13317", "url": "https://doi.org/10.1111/jerd.13317" }, { "title": "Chairside 3D digital design and trial restoration workflow.", "journal": "The Journal of prosthetic dentistry", "year": 2020, "doi": "10.1016/j.prosdent.2019.10.015", "url": "https://doi.org/10.1016/j.prosdent.2019.10.015" }, { "title": "Digital planning protocol for functional and esthetic prosthetic treatment.", "journal": "International journal of computerized dentistry", "year": 2023, "doi": "10.3290/j.ijcd.b2599445", "url": "https://doi.org/10.3290/j.ijcd.b2599445" }, { "title": "Pink-White Esthetic Optimization in Excessive Gingival Display Using Crown Lengthening and Direct Composite Veneering.", "journal": "Case reports in dentistry", "year": 2026, "doi": "10.1155/crid/9631149", "url": "https://doi.org/10.1155/crid/9631149" }, { "title": "The World's Longest Functioning Implant: A Verified Case Report.", "journal": "The Journal of oral implantology", "year": 2023, "doi": "10.1563/aaid-joi-D-22-00185", "url": "https://doi.org/10.1563/aaid-joi-D-22-00185" } ] }, { "slug": "dentures", "name": "Dentures", "category": "dental", "description": "Dentures are prosthetic devices constructed to replace missing teeth, supported by the surrounding soft and hard tissues of the oral cavity. Conventional dentures are removable.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "aliases": [ "Removable prostheses" ], "overview": "Dentures are prosthetic devices constructed to replace missing teeth, supported by the surrounding soft and hard tissues of the oral cavity. Conventional dentures are removable. However, there are many denture designs, some of which rely on bonding or clasping onto teeth or dental implants. There are two main categories of dentures, the distinction being whether they fit onto the mandibular arch or on the maxillary arch.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en", "nhs-health-a-to-z" ], "references": [ { "label": "Wikipedia — Dentures", "url": "https://en.wikipedia.org/wiki/Dentures" } ], "faqs": [ { "question": "What dentures are for?", "answer": "If you need to have teeth removed or have 1 or more missing teeth, you may need dentures." }, { "question": "How to get dentures?", "answer": "An NHS dentist may offer you NHS dentures if you need them to treat a dental problem." }, { "question": "How dentures are made and fitted?", "answer": "To make dentures, your dentist will first measure your mouth and use putty to create a mould. Some dentists may take a scan of your mouth instead of using putty." }, { "question": "How to look after your dentures?", "answer": "Your dentist will give you advice about how to use and look after your dentures." } ], "accreditationsRequired": [ "national-dental-council" ], "literatureLinks": [ { "title": "Implant-supported removable partial dentures compared to conventional dentures: A systematic review and meta-analysis of quality of life, patient satisfaction, and biomechanical complications.", "journal": "Clinical and experimental dental research", "year": 2022, "doi": "10.1002/cre2.521", "url": "https://doi.org/10.1002/cre2.521" }, { "title": "Technical Complications of Removable Partial Dentures in the Moderately Reduced Dentition: A Systematic Review.", "journal": "Dentistry journal", "year": 2023, "doi": "10.3390/dj11020055", "url": "https://doi.org/10.3390/dj11020055" }, { "title": "Efficacy and risks of removable partial prosthesis in periodontitis patients: A systematic review.", "journal": "Journal of clinical periodontology", "year": 2022, "doi": "10.1111/jcpe.13519", "url": "https://doi.org/10.1111/jcpe.13519" }, { "title": "A systematic review of the survival and complication rates of zirconia-ceramic and metal-ceramic multiple-unit fixed dental prostheses.", "journal": "Clinical oral implants research", "year": 2018, "doi": "10.1111/clr.13277", "url": "https://doi.org/10.1111/clr.13277" }, { "title": "Complications of 3D printed dentures: A systematic review.", "journal": "The Journal of prosthetic dentistry", "year": 2026, "doi": "10.1016/j.prosdent.2025.05.019", "url": "https://doi.org/10.1016/j.prosdent.2025.05.019" } ] }, { "slug": "sapphire-fue", "name": "Sapphire FUE", "category": "hair-transplant", "description": "Hair transplantation is a surgical technique that removes hair follicles from one part of the body, called the 'donor site', to a bald or balding part of the body known as the 'recipient site'. The technique is primarily used to treat male pattern baldness.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [ "a tight, achy and swollen scalp for a few days", "temporary scabbing where the hair was transplanted", "a single scar or a number of very tiny scars", "bleeding", "infection", "an allergic reaction to the anaesthetic" ], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "parentProcedure": "hair-transplant", "overview": "Hair transplantation is a surgical technique that removes hair follicles from one part of the body, called the 'donor site', to a bald or balding part of the body known as the 'recipient site'. The technique is primarily used to treat male pattern baldness. In this minimally invasive procedure, grafts containing hair follicles that are genetically resistant to balding are transplanted to the bald scalp.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en", "nhs-health-a-to-z" ], "references": [ { "label": "Wikipedia — Hair transplantation", "url": "https://en.wikipedia.org/wiki/Hair_transplantation" } ], "recoveryTimeline": "Your surgeon will tell you how to look after your graft. You should be given a spray to use to help recovery and hair growth. You may need 1 to 2 weeks off work after having a hair transplant. You need to be very careful with your transplanted hair for the first 2 weeks after your operation. The grafts will not be secure. You may be told to cut down on exercise in the first month to reduce scarring. - After 2 to 5 days: any bandages can usually be removed, but you should not touch the grafts.\n- Day 6: you should be able to wash your hair gently by hand.\n- After 10 to 14 days: any non-dissolvable stitches can usually be removed.\n- After a few weeks: the transplanted hair will often fall out, and later start to grow back.\n- After 4 months: new hair will usually start to appear.\n- After 10 to\n\n*Reference text adapted from NHS UK under the Open Government Licence v3.0.*", "faqs": [ { "question": "How much a hair transplant costs?", "answer": "A hair transplant in the UK can cost anywhere between £1,000 and £30,000, depending on the extent of hair loss, the type of procedure you have, and the quality of the clinic and its team." }, { "question": "What to think about before you have a hair transplant?", "answer": "If you're thinking about having a hair transplant in England, check with the [Care Quality Commission (CQC)](https://www.cqc.org.uk/) to see if the hospital or clinic is registered with them." }, { "question": "What a hair transplant involves?", "answer": "A hair transplant is usually carried out under [local anaesthetic](https://www.nhs.uk/tests-and-treatments/local-anaesthesia/) and sedation, which means you'll be awake but will not feel any pain." }, { "question": "What could go wrong?", "answer": "A hair transplant is generally a safe procedure, but as with any type of operation there's always a small risk of:" }, { "question": "What to do if you have problems?", "answer": "Cosmetic surgery can sometimes go wrong and the results may not be what you expected." } ], "literatureLinks": [ { "title": "Recipient Site Necrosis Following Hair Transplantation: A Rare Event.", "journal": "The Journal of craniofacial surgery", "year": 2026, "doi": "10.1097/SCS.0000000000013027", "url": "https://doi.org/10.1097/SCS.0000000000013027" } ], "alternativeTreatments": [ { "name": "DHI", "procedureSlug": "hair-transplant-dhi", "rationale": "Implanter-pen technique; tighter hairline angles at the cost of slower session throughput.", "sourceSlugs": [ "who-surgical-safety-checklist" ] }, { "name": "FUT", "procedureSlug": "hair-transplant-fut", "rationale": "Linear strip harvest; higher graft yield per session, visible scar at the donor.", "sourceSlugs": [ "who-surgical-safety-checklist" ] } ] }, { "slug": "beard-transplant", "name": "Beard Transplant", "category": "hair-transplant", "description": "Hair transplantation is a surgical technique that removes hair follicles from one part of the body, called the 'donor site', to a bald or balding part of the body known as the 'recipient site'. The technique is primarily used to treat male pattern baldness.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "overview": "Hair transplantation is a surgical technique that removes hair follicles from one part of the body, called the 'donor site', to a bald or balding part of the body known as the 'recipient site'. The technique is primarily used to treat male pattern baldness. In this minimally invasive procedure, grafts containing hair follicles that are genetically resistant to balding are transplanted to the bald scalp.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Hair transplantation", "url": "https://en.wikipedia.org/wiki/Hair_transplantation" } ], "literatureLinks": [ { "title": "The assessment of Hair Transplantation Outcomes in Cicatricial Alopecia.", "journal": "International journal of trichology", "year": 2020, "doi": "10.4103/ijt.ijt_52_19", "url": "https://doi.org/10.4103/ijt.ijt_52_19" }, { "title": "Facial hair restoration: hair transplantation to eyebrows, beard, sideburns, and eyelashes.", "journal": "Facial plastic surgery clinics of North America", "year": 2013, "doi": "10.1016/j.fsc.2013.05.004", "url": "https://doi.org/10.1016/j.fsc.2013.05.004" }, { "title": "The Alopecia Areata Severity and Morbidity Index (ASAMI) Study: Results From a Global Expert Consensus Exercise on Determinants of Alopecia Areata Severity.", "journal": "JAMA dermatology", "year": 2024, "doi": "10.1001/jamadermatol.2023.5869", "url": "https://doi.org/10.1001/jamadermatol.2023.5869" }, { "title": "Use of body hair and beard hair in hair restoration.", "journal": "Facial plastic surgery clinics of North America", "year": 2013, "doi": "10.1016/j.fsc.2013.05.003", "url": "https://doi.org/10.1016/j.fsc.2013.05.003" }, { "title": "Hair transplantation to the eyebrow, eyelashes, and other parts of the body.", "journal": "Facial plastic surgery clinics of North America", "year": 2004, "doi": "10.1016/j.fsc.2003.12.002", "url": "https://doi.org/10.1016/j.fsc.2003.12.002" } ] }, { "slug": "eyebrow-transplant", "name": "Eyebrow Transplant", "category": "hair-transplant", "description": "Eyebrow restoration is the medical and cosmetic process of restoring eyebrow hair in people with eyebrow thinning or loss (alopecia). Causes include trauma, burns, genetic predisposition, aging, over-plucking, hormonal changes, scarring, and certain dermatologic or systemic conditions, including madarosis.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "overview": "Eyebrow restoration is the medical and cosmetic process of restoring eyebrow hair in people with eyebrow thinning or loss (alopecia). Causes include trauma, burns, genetic predisposition, aging, over-plucking, hormonal changes, scarring, and certain dermatologic or systemic conditions, including madarosis. Eyebrow restoration techniques aim to restore both aesthetic appearance and function, including symmetry, natural hair direction, and density.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Eyebrow transplant", "url": "https://en.wikipedia.org/wiki/Eyebrow_restoration" } ], "literatureLinks": [ { "title": "Eyebrow and Eyelash Hair Transplantation: A Systematic Review.", "journal": "The Journal of clinical and aesthetic dermatology", "year": 2018, "url": "https://pubmed.ncbi.nlm.nih.gov/29942421/" }, { "title": "Hair transplantation to the eyebrow, eyelashes, and other parts of the body.", "journal": "Facial plastic surgery clinics of North America", "year": 2004, "doi": "10.1016/j.fsc.2003.12.002", "url": "https://doi.org/10.1016/j.fsc.2003.12.002" }, { "title": "Eyebrow Hair Transplantation in Frontal Fibrosing Alopecia: Pitfalls of Short- and Long-Term Results.", "journal": "Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]", "year": 2020, "doi": "10.1097/DSS.0000000000002207", "url": "https://doi.org/10.1097/DSS.0000000000002207" }, { "title": "Periauricular hair transplantation enhances the cosmetic results of eyebrow transplantation: A retrospective study in Chinese recipients.", "journal": "Journal of plastic, reconstructive & aesthetic surgery : JPRAS", "year": 2024, "doi": "10.1016/j.bjps.2024.09.008", "url": "https://doi.org/10.1016/j.bjps.2024.09.008" }, { "title": "The assessment of Hair Transplantation Outcomes in Cicatricial Alopecia.", "journal": "International journal of trichology", "year": 2020, "doi": "10.4103/ijt.ijt_52_19", "url": "https://doi.org/10.4103/ijt.ijt_52_19" } ] }, { "slug": "female-hair-transplant", "name": "Female Hair Transplant", "category": "hair-transplant", "description": "Hair transplantation is a surgical technique that removes hair follicles from one part of the body, called the 'donor site', to a bald or balding part of the body known as the 'recipient site'. The technique is primarily used to treat male pattern baldness.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "overview": "Hair transplantation is a surgical technique that removes hair follicles from one part of the body, called the 'donor site', to a bald or balding part of the body known as the 'recipient site'. The technique is primarily used to treat male pattern baldness. In this minimally invasive procedure, grafts containing hair follicles that are genetically resistant to balding are transplanted to the bald scalp.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Hair transplantation", "url": "https://en.wikipedia.org/wiki/Hair_transplantation" } ], "literatureLinks": [ { "title": "Guidelines for the diagnosis and treatment of male-pattern and female-pattern hair loss, 2017 version.", "journal": "The Journal of dermatology", "year": 2018, "doi": "10.1111/1346-8138.14470", "url": "https://doi.org/10.1111/1346-8138.14470" }, { "title": "Male Androgenetic Alopecia.", "journal": "", "year": 2000, "url": "https://pubmed.ncbi.nlm.nih.gov/25905192/" }, { "title": "Pediatric androgenetic alopecia: an updated review.", "journal": "Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG", "year": 2023, "doi": "10.1111/ddg.14940", "url": "https://doi.org/10.1111/ddg.14940" }, { "title": "Evidence-based (S3) guideline for the treatment of androgenetic alopecia in women and in men - short version.", "journal": "Journal of the European Academy of Dermatology and Venereology : JEADV", "year": 2018, "doi": "10.1111/jdv.14624", "url": "https://doi.org/10.1111/jdv.14624" }, { "title": "Female pattern hair loss.", "journal": "International journal of endocrinology and metabolism", "year": 2013, "doi": "10.5812/ijem.9860", "url": "https://doi.org/10.5812/ijem.9860" } ] }, { "slug": "hairline-lowering", "name": "Hairline Lowering Surgery", "category": "hair-transplant", "description": "Hair transplantation is a surgical technique that removes hair follicles from one part of the body, called the 'donor site', to a bald or balding part of the body known as the 'recipient site'. The technique is primarily used to treat male pattern baldness.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "aliases": [ "Forehead reduction" ], "overview": "Hair transplantation is a surgical technique that removes hair follicles from one part of the body, called the 'donor site', to a bald or balding part of the body known as the 'recipient site'. The technique is primarily used to treat male pattern baldness. In this minimally invasive procedure, grafts containing hair follicles that are genetically resistant to balding are transplanted to the bald scalp.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Hair transplantation", "url": "https://en.wikipedia.org/wiki/Hair_transplantation" } ], "literatureLinks": [ { "title": "Hairline-Lowering Surgery.", "journal": "Facial plastic surgery clinics of North America", "year": 2020, "doi": "10.1016/j.fsc.2020.01.002", "url": "https://doi.org/10.1016/j.fsc.2020.01.002" }, { "title": "Hairline Lowering Surgery With Bone Tunneling Suture Fixation: Effectiveness and Safety in 91 Patients.", "journal": "Aesthetic surgery journal", "year": 2019, "doi": "10.1093/asj/sjy304", "url": "https://doi.org/10.1093/asj/sjy304" }, { "title": "Hairline lowering during foreheadplasty.", "journal": "Plastic and reconstructive surgery", "year": 1999, "doi": "10.1097/00006534-199901000-00037", "url": "https://doi.org/10.1097/00006534-199901000-00037" }, { "title": "Soft-tissue complications after facial feminization bone surgery.", "journal": "Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery", "year": 2024, "doi": "10.1016/j.jcms.2024.02.017", "url": "https://doi.org/10.1016/j.jcms.2024.02.017" }, { "title": "Complications in facial Mohs defect reconstruction.", "journal": "Current opinion in otolaryngology & head and neck surgery", "year": 2017, "doi": "10.1097/MOO.0000000000000375", "url": "https://doi.org/10.1097/MOO.0000000000000375" } ] }, { "slug": "prp-hair-loss", "name": "PRP for Hair Loss", "category": "hair-transplant", "description": "Platelet-rich plasma (PRP), also known as autologous conditioned plasma, is a concentrate of plasma protein derived from whole blood, centrifuged to remove red blood cells but retaining platelets. Though promoted for treating various medical conditions, evidence of its benefits was mixed as of 2020, showing effectiveness in certain conditions and ineffectiveness in others.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "aliases": [ "Platelet-rich plasma therapy" ], "overview": "Platelet-rich plasma (PRP), also known as autologous conditioned plasma, is a concentrate of plasma protein derived from whole blood, centrifuged to remove red blood cells but retaining platelets. Though promoted for treating various medical conditions, evidence of its benefits was mixed as of 2020, showing effectiveness in certain conditions and ineffectiveness in others.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Platelet-rich plasma", "url": "https://en.wikipedia.org/wiki/Platelet-rich_plasma" } ], "literatureLinks": [ { "title": "Microneedling and Its Use in Hair Loss Disorders: A Systematic Review.", "journal": "Dermatology and therapy", "year": 2022, "doi": "10.1007/s13555-021-00653-2", "url": "https://doi.org/10.1007/s13555-021-00653-2" }, { "title": "Management of androgenic alopecia: a systematic review of the literature.", "journal": "Journal of cosmetic and laser therapy : official publication of the European Society for Laser Dermatology", "year": 2024, "doi": "10.1080/14764172.2024.2362126", "url": "https://doi.org/10.1080/14764172.2024.2362126" }, { "title": "Platelet-rich plasma for the treatment of alopecia: a systematic review and meta-analysis.", "journal": "Blood transfusion = Trasfusione del sangue", "year": 2023, "doi": "10.2450/2021.0216-21", "url": "https://doi.org/10.2450/2021.0216-21" }, { "title": "Autologous platelet-rich plasma therapy for pattern hair loss: A systematic review.", "journal": "Journal of cosmetic dermatology", "year": 2020, "doi": "10.1111/jocd.13113", "url": "https://doi.org/10.1111/jocd.13113" }, { "title": "Systematic Review of Platelet-Rich Plasma Use in Androgenetic Alopecia Compared with Minoxidil(®), Finasteride(®), and Adult Stem Cell-Based Therapy.", "journal": "International journal of molecular sciences", "year": 2020, "doi": "10.3390/ijms21082702", "url": "https://doi.org/10.3390/ijms21082702" } ] }, { "slug": "hair-transplant-repair", "name": "Hair Transplant Repair", "category": "hair-transplant", "description": "Hair transplantation is a surgical technique that removes hair follicles from one part of the body, called the 'donor site', to a bald or balding part of the body known as the 'recipient site'. The technique is primarily used to treat male pattern baldness.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "overview": "Hair transplantation is a surgical technique that removes hair follicles from one part of the body, called the 'donor site', to a bald or balding part of the body known as the 'recipient site'. The technique is primarily used to treat male pattern baldness. In this minimally invasive procedure, grafts containing hair follicles that are genetically resistant to balding are transplanted to the bald scalp.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Hair transplantation", "url": "https://en.wikipedia.org/wiki/Hair_transplantation" } ], "literatureLinks": [ { "title": "Revision surgical hair restoration: repair of undesirable results.", "journal": "Plastic and reconstructive surgery", "year": 1999, "url": "https://pubmed.ncbi.nlm.nih.gov/10597701/" }, { "title": "Scrotal island flap urethroplasty in the management of bulbar urethral strictures.", "journal": "The Journal of urology", "year": 1989, "doi": "10.1016/s0022-5347(17)39124-3", "url": "https://doi.org/10.1016/s0022-5347(17)39124-3" }, { "title": "Follicular Unit Excision Hair Removal of Unwanted Facial Terminal Hair in Five Facial Areas: A Retrospective Multicenter Cohort Study.", "journal": "Aesthetic plastic surgery", "year": 2025, "doi": "10.1007/s00266-024-04420-4", "url": "https://doi.org/10.1007/s00266-024-04420-4" }, { "title": "Scalp Avulsion Injuries and Replantation: Is Deep Temporal Artery an Alternate Option?", "journal": "Annals of plastic surgery", "year": 2020, "doi": "10.1097/SAP.0000000000002005", "url": "https://doi.org/10.1097/SAP.0000000000002005" }, { "title": "Postoperative complications of fibular free flaps in mandibular reconstruction: an analysis of 25 consecutive cases.", "journal": "Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics", "year": 2009, "doi": "10.1016/j.tripleo.2009.05.043", "url": "https://doi.org/10.1016/j.tripleo.2009.05.043" } ] }, { "slug": "egg-freezing", "name": "Egg Freezing", "category": "ivf-fertility", "description": "Oocyte cryopreservation is a form of assisted reproductive technology (ART) used to preserve human eggs (oocytes). The technique is often used to protect against future infertility or delaying childbearing: when pregnancy is desired, the eggs can be thawed, fertilized, and transferred to the uterus as embryos.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "aliases": [ "Oocyte cryopreservation" ], "overview": "Oocyte cryopreservation is a form of assisted reproductive technology (ART) used to preserve human eggs (oocytes). The technique is often used to protect against future infertility or delaying childbearing: when pregnancy is desired, the eggs can be thawed, fertilized, and transferred to the uterus as embryos. The procedure's success rate varies depending on factors such as the individual's age, overall health, and genetic factors. The first human birth of oocyte cryopreservation was reported in 1986. Although embryo cryopreservation is the most established method of fertility preservation, oocyte cryopreservation is often the best option for single reproductive-age women in need of delaying childbearing for any reason.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Oocyte cryopreservation", "url": "https://en.wikipedia.org/wiki/Oocyte_cryopreservation" } ], "literatureLinks": [ { "title": "Planned oocyte cryopreservation: a systematic review and meta-regression analysis.", "journal": "Human reproduction update", "year": 2024, "doi": "10.1093/humupd/dmae009", "url": "https://doi.org/10.1093/humupd/dmae009" }, { "title": "Live birth rate after female fertility preservation for cancer or haematopoietic stem cell transplantation: a systematic review and meta-analysis of the three main techniques; embryo, oocyte and ovarian tissue cryopreservation.", "journal": "Human reproduction (Oxford, England)", "year": 2023, "doi": "10.1093/humrep/deac249", "url": "https://doi.org/10.1093/humrep/deac249" }, { "title": "Oocyte, embryo and blastocyst cryopreservation in ART: systematic review and meta-analysis comparing slow-freezing versus vitrification to produce evidence for the development of global guidance.", "journal": "Human reproduction update", "year": 2017, "doi": "10.1093/humupd/dmw038", "url": "https://doi.org/10.1093/humupd/dmw038" }, { "title": "Oocyte Cryopreservation Outcomes in Women With Hematological Malignancies Undergoing Chemotherapy-A Systematic Review and Meta-Analysis.", "journal": "Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC", "year": 2025, "doi": "10.1016/j.jogc.2025.102824", "url": "https://doi.org/10.1016/j.jogc.2025.102824" }, { "title": "Oocyte cryopreservation for patients with endometriosis: where are we now? A systematic review.", "journal": "Reproductive biomedicine online", "year": 2025, "doi": "10.1016/j.rbmo.2025.104839", "url": "https://doi.org/10.1016/j.rbmo.2025.104839" } ], "accreditationsRequired": [ "hfea-licensed-centre", "sart-member-clinic", "eshre-certified-centre" ] }, { "slug": "donor-egg-ivf", "name": "Donor Egg IVF", "category": "ivf-fertility", "description": "Egg donation is the process by which a woman donates eggs to enable another woman to conceive as part of an assisted reproduction treatment or for biomedical research. For assisted reproduction purposes, egg donation typically involves in vitro fertilization technology, with the eggs being fertilized in the laboratory; more rarely, unfertilized eggs may be frozen and stored for later use.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "parentProcedure": "ivf", "overview": "Egg donation is the process by which a woman donates eggs to enable another woman to conceive as part of an assisted reproduction treatment or for biomedical research. For assisted reproduction purposes, egg donation typically involves in vitro fertilization technology, with the eggs being fertilized in the laboratory; more rarely, unfertilized eggs may be frozen and stored for later use. Egg donation is a third-party reproduction as part of assisted reproductive technology.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en", "nhs-health-a-to-z" ], "references": [ { "label": "Wikipedia — Egg donation", "url": "https://en.wikipedia.org/wiki/Egg_donation" } ], "faqs": [ { "question": "Why IVF (in vitro fertilisation) is done?", "answer": "IVF (in vitro fertilisation) is a type of [fertility treatment](https://www.nhs.uk/conditions/infertility/)." }, { "question": "How well it works?", "answer": "Your chance of having a baby using IVF can depend on many factors such as:" }, { "question": "What happens during IVF (in vitro fertilisation)?", "answer": "A full cycle of IVF (in vitro fertilisation) takes around 3 to 6 weeks to complete. It usually follows 6 steps, depending on the type of treatment you’re having." } ], "literatureLinks": [ { "title": "IVF outcomes in obese donor oocyte recipients: a systematic review and meta-analysis.", "journal": "Human reproduction (Oxford, England)", "year": 2013, "doi": "10.1093/humrep/det292", "url": "https://doi.org/10.1093/humrep/det292" }, { "title": "Risk of adverse perinatal outcomes after oocyte donation: a systematic review and meta-analysis.", "journal": "Journal of assisted reproduction and genetics", "year": 2019, "doi": "10.1007/s10815-019-01552-4", "url": "https://doi.org/10.1007/s10815-019-01552-4" }, { "title": "Increased prevalence of postpartum haemorrhage in pregnancies resulting from oocyte donation compared with IVF or natural conception: a systematic review and meta-analysis.", "journal": "Reproductive biomedicine online", "year": 2025, "doi": "10.1016/j.rbmo.2025.105428", "url": "https://doi.org/10.1016/j.rbmo.2025.105428" }, { "title": "Cleavage-stage versus blastocyst-stage embryo transfer in assisted reproductive technology.", "journal": "The Cochrane database of systematic reviews", "year": 2022, "doi": "10.1002/14651858.CD002118.pub6", "url": "https://doi.org/10.1002/14651858.CD002118.pub6" }, { "title": "Is oocyte donation a risk factor for preeclampsia? A systematic review and meta-analysis.", "journal": "Journal of assisted reproduction and genetics", "year": 2016, "doi": "10.1007/s10815-016-0701-9", "url": "https://doi.org/10.1007/s10815-016-0701-9" } ], "accreditationsRequired": [ "hfea-licensed-centre", "sart-member-clinic", "eshre-certified-centre" ], "complicationRate": { "value": 33.2, "range": [ 22.4, 44 ], "sourceSlugs": [ "pubmed-41915703", "pubmed-34759621" ] } }, { "slug": "donor-sperm-ivf", "name": "Donor Sperm IVF", "category": "ivf-fertility", "description": "Sperm donation is the provision by a male of their sperm with the intention that it be used in the artificial insemination or other \"fertility treatment\" of one or more females who are not their sexual partners in order that they may become pregnant. Where pregnancies go to full term, the sperm donor will be the biological father of every baby born from their donations.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "parentProcedure": "ivf", "overview": "Sperm donation is the provision by a male of their sperm with the intention that it be used in the artificial insemination or other \"fertility treatment\" of one or more females who are not their sexual partners in order that they may become pregnant. Where pregnancies go to full term, the sperm donor will be the biological father of every baby born from their donations. The male is known as a sperm donor and the sperm they provide is known as \"donor sperm\" because the intention is that the male will give up all legal rights to any child produced from the sperm, and will not be the legal father. Sperm donation may also be known as \"semen donation\".\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en", "nhs-health-a-to-z" ], "references": [ { "label": "Wikipedia — Sperm donation", "url": "https://en.wikipedia.org/wiki/Sperm_donation" } ], "faqs": [ { "question": "Why IVF (in vitro fertilisation) is done?", "answer": "IVF (in vitro fertilisation) is a type of [fertility treatment](https://www.nhs.uk/conditions/infertility/)." }, { "question": "How well it works?", "answer": "Your chance of having a baby using IVF can depend on many factors such as:" }, { "question": "What happens during IVF (in vitro fertilisation)?", "answer": "A full cycle of IVF (in vitro fertilisation) takes around 3 to 6 weeks to complete. It usually follows 6 steps, depending on the type of treatment you’re having." } ], "literatureLinks": [ { "title": "Donor sperm recipients: fertility treatments, trends, and pregnancy outcomes.", "journal": "Journal of assisted reproduction and genetics", "year": 2022, "doi": "10.1007/s10815-022-02616-8", "url": "https://doi.org/10.1007/s10815-022-02616-8" }, { "title": "Early pregnancy outcomes of IVF cycles using donor versus partner sperm: analysis of 1 376 454 cycles recorded by the Human Fertilisation and Embryology Authority (1991-2016).", "journal": "Human reproduction (Oxford, England)", "year": 2023, "doi": "10.1093/humrep/dead057", "url": "https://doi.org/10.1093/humrep/dead057" }, { "title": "Perinatal outcomes following IVF with use of donor versus partner sperm.", "journal": "Reproductive biomedicine online", "year": 2018, "doi": "10.1016/j.rbmo.2018.03.016", "url": "https://doi.org/10.1016/j.rbmo.2018.03.016" }, { "title": "Outcomes of Frozen Oocyte Donor In Vitro Fertilization (IVF) Cycles Using Fresh Versus Frozen Sperm.", "journal": "Reproductive sciences (Thousand Oaks, Calif.)", "year": 2022, "doi": "10.1007/s43032-021-00796-9", "url": "https://doi.org/10.1007/s43032-021-00796-9" }, { "title": "Outcomes of pregnancies using donor sperm compared with those using partner sperm: systematic review and meta-analysis.", "journal": "Human reproduction update", "year": 2021, "doi": "10.1093/humupd/dmaa030", "url": "https://doi.org/10.1093/humupd/dmaa030" } ], "accreditationsRequired": [ "hfea-licensed-centre", "sart-member-clinic", "eshre-certified-centre" ] }, { "slug": "embryo-donation", "name": "Embryo Donation", "category": "ivf-fertility", "description": "Embryo donation is one disposition option for users of in vitro fertilisation with remaining fresh or frozen embryos. It is defined as the giving—generally without compensation—of embryos remaining after in vitro fertilization procedures to recipients for procreative implantation or research.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "overview": "Embryo donation is one disposition option for users of in vitro fertilisation with remaining fresh or frozen embryos. It is defined as the giving—generally without compensation—of embryos remaining after in vitro fertilization procedures to recipients for procreative implantation or research. Most IVF users with supernumerary embryos make embryo donation decisions after completing their families or discontinuing use of in vitro fertilization. Recipients of embryos donated for procreative implantation typically plan to transfer fresh or frozen embryos into a prepared uterus in order to facilitate pregnancy and childbirth. Recipients of embryos donated for research typically use them for clinical training, quality improvement research, or human embryonic stem cell research.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Embryo donation", "url": "https://en.wikipedia.org/wiki/Embryo_donation" } ], "literatureLinks": [ { "title": "Endometrial receptivity in women of advanced age: an underrated factor in infertility.", "journal": "Human reproduction update", "year": 2023, "doi": "10.1093/humupd/dmad019", "url": "https://doi.org/10.1093/humupd/dmad019" }, { "title": "Recurrent implantation failure: definition and management.", "journal": "Reproductive biomedicine online", "year": 2014, "doi": "10.1016/j.rbmo.2013.08.011", "url": "https://doi.org/10.1016/j.rbmo.2013.08.011" }, { "title": "Psychosocial outcomes of children born via embryo donation.", "journal": "Human reproduction (Oxford, England)", "year": 2024, "doi": "10.1093/humrep/deae023", "url": "https://doi.org/10.1093/humrep/deae023" }, { "title": "Cleavage-stage versus blastocyst-stage embryo transfer in assisted reproductive technology.", "journal": "The Cochrane database of systematic reviews", "year": 2022, "doi": "10.1002/14651858.CD002118.pub6", "url": "https://doi.org/10.1002/14651858.CD002118.pub6" }, { "title": "The pathophysiological role of estrogens in the initial stages of pregnancy: molecular mechanisms and clinical implications for pregnancy outcome from the periconceptional period to end of the first trimester.", "journal": "Human reproduction update", "year": 2023, "doi": "10.1093/humupd/dmad016", "url": "https://doi.org/10.1093/humupd/dmad016" } ], "accreditationsRequired": [ "hfea-licensed-centre", "sart-member-clinic", "eshre-certified-centre" ] }, { "slug": "icsi", "name": "ICSI", "category": "ivf-fertility", "description": "Intracytoplasmic sperm injection is an in vitro fertilization (IVF) procedure in which a single sperm cell is injected directly into the cytoplasm of an egg. This technique is used in order to prepare the gametes for the obtention of embryos that may be transferred to a maternal uterus.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "parentProcedure": "ivf", "aliases": [ "Intracytoplasmic sperm injection" ], "overview": "Intracytoplasmic sperm injection is an in vitro fertilization (IVF) procedure in which a single sperm cell is injected directly into the cytoplasm of an egg. This technique is used in order to prepare the gametes for the obtention of embryos that may be transferred to a maternal uterus. With this method, the acrosome reaction is skipped.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en", "nhs-health-a-to-z" ], "references": [ { "label": "Wikipedia — Intracytoplasmic sperm injection", "url": "https://en.wikipedia.org/wiki/Intracytoplasmic_sperm_injection" } ], "faqs": [ { "question": "Why IVF (in vitro fertilisation) is done?", "answer": "IVF (in vitro fertilisation) is a type of [fertility treatment](https://www.nhs.uk/conditions/infertility/)." }, { "question": "How well it works?", "answer": "Your chance of having a baby using IVF can depend on many factors such as:" }, { "question": "What happens during IVF (in vitro fertilisation)?", "answer": "A full cycle of IVF (in vitro fertilisation) takes around 3 to 6 weeks to complete. It usually follows 6 steps, depending on the type of treatment you’re having." } ], "literatureLinks": [ { "title": "Intracytoplasmic sperm injection in domestic and wild mammals.", "journal": "Reproduction (Cambridge, England)", "year": 2017, "doi": "10.1530/REP-17-0357", "url": "https://doi.org/10.1530/REP-17-0357" }, { "title": "[Intracytoplasmic sperm injection for patients with special types of teratozoospermia: Analysis of outcomes].", "journal": "Zhonghua nan ke xue = National journal of andrology", "year": 2023, "url": "https://pubmed.ncbi.nlm.nih.gov/37846831/" }, { "title": "Comparison of outcomes between intracytoplasmic sperm injection and in vitro fertilization inseminations with preimplantation genetic testing for aneuploidy, analysis of Society for Assisted Reproductive Technology Clinic Outcome Reporting System data.", "journal": "Fertility and sterility", "year": 2024, "doi": "10.1016/j.fertnstert.2023.12.041", "url": "https://doi.org/10.1016/j.fertnstert.2023.12.041" }, { "title": "Does Testicular Sperm Improve Intracytoplasmic Sperm Injection Outcomes for Nonazoospermic Infertile Men with Elevated Sperm DNA Fragmentation? A Systematic Review and Meta-analysis.", "journal": "European urology focus", "year": 2024, "doi": "10.1016/j.euf.2023.08.008", "url": "https://doi.org/10.1016/j.euf.2023.08.008" }, { "title": "Sperm retrieval and intracytoplasmic sperm injection outcomes in men with cystic fibrosis disease versus congenital bilateral absence of the vas deferens.", "journal": "Asian journal of andrology", "year": 2021, "doi": "10.4103/aja.aja_48_20", "url": "https://doi.org/10.4103/aja.aja_48_20" } ], "alternativeTreatments": [ { "name": "Conventional IVF", "procedureSlug": "ivf", "rationale": "Appropriate when sperm parameters are adequate; lower fertilisation manipulation.", "sourceSlugs": [ "eshre-guidelines" ] }, { "name": "Donor sperm IVF", "procedureSlug": "donor-sperm-ivf", "rationale": "When severe male-factor cannot be overcome by ICSI; ethical/relational considerations.", "sourceSlugs": [ "eshre-guidelines" ] } ], "accreditationsRequired": [ "hfea-licensed-centre", "sart-member-clinic", "eshre-certified-centre" ] }, { "slug": "pgt-a", "name": "PGT-A", "category": "ivf-fertility", "description": "Preimplantation genetic diagnosis is the genetic profiling of embryos prior to implantation, and sometimes even of oocytes prior to fertilization. PGD is considered in a similar fashion to prenatal diagnosis.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "aliases": [ "Preimplantation genetic testing for aneuploidy" ], "overview": "Preimplantation genetic diagnosis is the genetic profiling of embryos prior to implantation, and sometimes even of oocytes prior to fertilization. PGD is considered in a similar fashion to prenatal diagnosis. When used to screen for a specific genetic disease, its main advantage is that it avoids selective abortion, as the method makes it highly likely that the baby will be free of the disease under consideration. PGD thus is an adjunct to assisted reproductive technology, and requires in vitro fertilization (IVF) to obtain oocytes or embryos for evaluation. Embryos are generally obtained through blastomere or blastocyst biopsy. The latter technique has proved to be less deleterious for the embryo, therefore it is advisable to perform the biopsy around day 5 or 6 of development.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Preimplantation genetic diagnosis", "url": "https://en.wikipedia.org/wiki/Preimplantation_genetic_diagnosis" } ], "literatureLinks": [ { "title": "The use of preimplantation genetic testing for aneuploidy: a committee opinion.", "journal": "Fertility and sterility", "year": 2024, "doi": "10.1016/j.fertnstert.2024.04.013", "url": "https://doi.org/10.1016/j.fertnstert.2024.04.013" }, { "title": "Preimplantation genetic testing for aneuploidy in unexplained recurrent pregnancy loss: a systematic review and meta-analysis.", "journal": "Fertility and sterility", "year": 2025, "doi": "10.1016/j.fertnstert.2024.08.326", "url": "https://doi.org/10.1016/j.fertnstert.2024.08.326" }, { "title": "Live Birth with or without Preimplantation Genetic Testing for Aneuploidy.", "journal": "The New England journal of medicine", "year": 2021, "doi": "10.1056/NEJMoa2103613", "url": "https://doi.org/10.1056/NEJMoa2103613" }, { "title": "Chromosomal, gestational, and neonatal outcomes of embryos classified as a mosaic by preimplantation genetic testing for aneuploidy.", "journal": "Fertility and sterility", "year": 2023, "doi": "10.1016/j.fertnstert.2023.07.022", "url": "https://doi.org/10.1016/j.fertnstert.2023.07.022" }, { "title": "Preimplantation genetic testing for aneuploidy versus morphology as selection criteria for single frozen-thawed embryo transfer in good-prognosis patients: a multicenter randomized clinical trial.", "journal": "Fertility and sterility", "year": 2019, "doi": "10.1016/j.fertnstert.2019.07.1346", "url": "https://doi.org/10.1016/j.fertnstert.2019.07.1346" } ], "accreditationsRequired": [ "hfea-licensed-centre", "eshre-certified-centre" ] }, { "slug": "pgt-m", "name": "PGT-M", "category": "ivf-fertility", "description": "Preimplantation genetic diagnosis is the genetic profiling of embryos prior to implantation, and sometimes even of oocytes prior to fertilization. PGD is considered in a similar fashion to prenatal diagnosis.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "aliases": [ "Preimplantation genetic testing for monogenic disorders" ], "overview": "Preimplantation genetic diagnosis is the genetic profiling of embryos prior to implantation, and sometimes even of oocytes prior to fertilization. PGD is considered in a similar fashion to prenatal diagnosis. When used to screen for a specific genetic disease, its main advantage is that it avoids selective abortion, as the method makes it highly likely that the baby will be free of the disease under consideration. PGD thus is an adjunct to assisted reproductive technology, and requires in vitro fertilization (IVF) to obtain oocytes or embryos for evaluation. Embryos are generally obtained through blastomere or blastocyst biopsy. The latter technique has proved to be less deleterious for the embryo, therefore it is advisable to perform the biopsy around day 5 or 6 of development.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Preimplantation genetic diagnosis", "url": "https://en.wikipedia.org/wiki/Preimplantation_genetic_diagnosis" } ], "literatureLinks": [ { "title": "Clinical outcomes following preimplantation genetic testing for monogenic conditions: a systematic review of observational studies.", "journal": "American journal of obstetrics and gynecology", "year": 2025, "doi": "10.1016/j.ajog.2024.09.114", "url": "https://doi.org/10.1016/j.ajog.2024.09.114" }, { "title": "Embryo Genetics.", "journal": "Genes", "year": 2021, "doi": "10.3390/genes12010118", "url": "https://doi.org/10.3390/genes12010118" }, { "title": "Utilization of preimplantation genetic testing for monogenic disorders.", "journal": "Fertility and sterility", "year": 2020, "doi": "10.1016/j.fertnstert.2020.05.045", "url": "https://doi.org/10.1016/j.fertnstert.2020.05.045" }, { "title": "Prenatal and preimplantation genetic testing for monogenic kidney disorders.", "journal": "Kidney international", "year": 2025, "doi": "10.1016/j.kint.2024.06.031", "url": "https://doi.org/10.1016/j.kint.2024.06.031" }, { "title": "Preimplantation genetic testing in assisted reproduction.", "journal": "Minerva obstetrics and gynecology", "year": 2023, "doi": "10.23736/S2724-606X.21.04805-3", "url": "https://doi.org/10.23736/S2724-606X.21.04805-3" } ], "accreditationsRequired": [ "hfea-licensed-centre", "eshre-certified-centre" ] }, { "slug": "frozen-embryo-transfer", "name": "Frozen Embryo Transfer", "category": "ivf-fertility", "description": "Embryo transfer refers to a step in the process of assisted reproduction in which embryos are placed into the uterus of a female with the intent to establish a pregnancy. This technique - which is often used in connection with in vitro fertilization (IVF) - may be used in humans or in other animals, in which situations and goals may vary.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "aliases": [ "FET" ], "overview": "Embryo transfer refers to a step in the process of assisted reproduction in which embryos are placed into the uterus of a female with the intent to establish a pregnancy. This technique - which is often used in connection with in vitro fertilization (IVF) - may be used in humans or in other animals, in which situations and goals may vary.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Embryo transfer", "url": "https://en.wikipedia.org/wiki/Embryo_transfer" } ], "literatureLinks": [ { "title": "Preparation of the Endometrium for Frozen Embryo Transfer: A Systematic Review.", "journal": "Frontiers in endocrinology", "year": 2021, "doi": "10.3389/fendo.2021.688237", "url": "https://doi.org/10.3389/fendo.2021.688237" }, { "title": "Obstetric and neonatal outcomes after natural versus artificial cycle frozen embryo transfer and the role of luteal phase support: a systematic review and meta-analysis.", "journal": "Human reproduction update", "year": 2023, "doi": "10.1093/humupd/dmad011", "url": "https://doi.org/10.1093/humupd/dmad011" }, { "title": "Serum luteal phase progesterone in women undergoing frozen embryo transfer in assisted conception: a systematic review and meta-analysis.", "journal": "Fertility and sterility", "year": 2021, "doi": "10.1016/j.fertnstert.2021.07.002", "url": "https://doi.org/10.1016/j.fertnstert.2021.07.002" }, { "title": "The effect of progesterone supplementation for luteal phase support in natural cycle frozen embryo transfer: a systematic review and meta-analysis based on randomized controlled trials.", "journal": "Fertility and sterility", "year": 2023, "doi": "10.1016/j.fertnstert.2022.12.035", "url": "https://doi.org/10.1016/j.fertnstert.2022.12.035" }, { "title": "Reproductive outcomes after letrozole stimulated versus artificial frozen-thawed embryo transfer cycles in women with PCOS and/or oligo-anovulation: a systematic review and meta-analysis.", "journal": "Human reproduction update", "year": 2025, "doi": "10.1093/humupd/dmaf011", "url": "https://doi.org/10.1093/humupd/dmaf011" } ], "accreditationsRequired": [ "hfea-licensed-centre", "sart-member-clinic", "eshre-certified-centre" ] }, { "slug": "surrogacy", "name": "Surrogacy", "category": "ivf-fertility", "description": "Surrogacy is an arrangement whereby a woman gets pregnant and gives birth on behalf of another person or couple who will become the child's legal parents after birth. People pursue surrogacy for a variety of reasons such as infertility, dangers or undesirable factors of pregnancy, or when pregnancy is a medical impossibility.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "aliases": [ "Gestational surrogacy" ], "overview": "Surrogacy is an arrangement whereby a woman gets pregnant and gives birth on behalf of another person or couple who will become the child's legal parents after birth. People pursue surrogacy for a variety of reasons such as infertility, dangers or undesirable factors of pregnancy, or when pregnancy is a medical impossibility. Surrogacy is highly controversial, with many countries legally regulating or banning its practice.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Surrogacy", "url": "https://en.wikipedia.org/wiki/Surrogacy" } ], "literatureLinks": [ { "title": "Pregnancy and birth outcomes of single versus multiple embryo transfer in gestational surrogacy arrangements: a systematic review and meta-analysis.", "journal": "Human fertility (Cambridge, England)", "year": 2022, "doi": "10.1080/14647273.2020.1785643", "url": "https://doi.org/10.1080/14647273.2020.1785643" }, { "title": "Gestational Surrogacy and Ethical Considerations.", "journal": "South Dakota medicine : the journal of the South Dakota State Medical Association", "year": 2023, "url": "https://pubmed.ncbi.nlm.nih.gov/36898073/" }, { "title": "Recurrent implantation failure: definition and management.", "journal": "Reproductive biomedicine online", "year": 2014, "doi": "10.1016/j.rbmo.2013.08.011", "url": "https://doi.org/10.1016/j.rbmo.2013.08.011" }, { "title": "Trends and outcomes of gestational surrogacy in the United States.", "journal": "Fertility and sterility", "year": 2016, "doi": "10.1016/j.fertnstert.2016.03.050", "url": "https://doi.org/10.1016/j.fertnstert.2016.03.050" }, { "title": "Perinatal outcomes after gestational surrogacy versus autologous IVF: analysis of national data.", "journal": "Reproductive biomedicine online", "year": 2017, "doi": "10.1016/j.rbmo.2017.08.024", "url": "https://doi.org/10.1016/j.rbmo.2017.08.024" } ], "accreditationsRequired": [ "hfea-licensed-centre", "eshre-certified-centre" ] }, { "slug": "mini-gastric-bypass", "name": "Mini Gastric Bypass", "category": "weight-loss", "description": "Gastric bypass surgery refers to a technique in which the stomach is divided into a small upper pouch and a much larger lower \"remnant\" pouch, where the small intestine is rearranged to connect to both. Surgeons have developed several different ways to reconnect the intestine, thus leading to several different gastric bypass procedures (GBP).", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "parentProcedure": "gastric-bypass", "aliases": [ "One-anastomosis gastric bypass", "OAGB" ], "overview": "Gastric bypass surgery refers to a technique in which the stomach is divided into a small upper pouch and a much larger lower \"remnant\" pouch, where the small intestine is rearranged to connect to both. Surgeons have developed several different ways to reconnect the intestine, thus leading to several different gastric bypass procedures (GBP). Any GBP leads to a marked reduction in the functional volume of the stomach, accompanied by an altered physiological and physical response to food.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Gastric bypass surgery", "url": "https://en.wikipedia.org/wiki/Gastric_bypass_surgery" } ], "literatureLinks": [ { "title": "The Mini-Gastric Bypass original technique.", "journal": "International journal of surgery (London, England)", "year": 2019, "doi": "10.1016/j.ijsu.2018.10.042", "url": "https://doi.org/10.1016/j.ijsu.2018.10.042" }, { "title": "Mini-gastric bypass: Prevention and management of complications in performance and follow-up.", "journal": "International journal of surgery (London, England)", "year": 2019, "doi": "10.1016/j.ijsu.2019.09.003", "url": "https://doi.org/10.1016/j.ijsu.2019.09.003" }, { "title": "B1 Vitamin Deficiency After Bariatric Surgery, Prevalence, and Symptoms: a Systematic Review and Meta-analysis.", "journal": "Obesity surgery", "year": 2022, "doi": "10.1007/s11695-022-06178-7", "url": "https://doi.org/10.1007/s11695-022-06178-7" }, { "title": "Mini-gastric bypass controversy.", "journal": "Obesity surgery", "year": 2001, "doi": "10.1381/09608920160558777", "url": "https://doi.org/10.1381/09608920160558777" }, { "title": "Revisional surgery after one anastomosis/mini gastric bypass: A narrative review.", "journal": "Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences", "year": 2020, "doi": "10.4103/jrms.JRMS_727_19", "url": "https://doi.org/10.4103/jrms.JRMS_727_19" } ], "alternativeTreatments": [ { "name": "Roux-en-Y gastric bypass", "procedureSlug": "gastric-bypass", "rationale": "Classical two-anastomosis bypass; better-studied long-term outcomes.", "sourceSlugs": [ "asmbs-bariatric-guidelines" ] }, { "name": "Gastric sleeve", "procedureSlug": "gastric-sleeve", "rationale": "Simpler restrictive-only procedure; comparable initial weight loss.", "sourceSlugs": [ "asmbs-bariatric-guidelines" ] } ], "accreditationsRequired": [ "ifso-center-of-excellence" ], "mortalityRate": { "value": 0.72, "range": [ 0.53, 0.9 ], "sourceSlugs": [ "pubmed-29995293", "pubmed-29931379" ] } }, { "slug": "gastric-balloon", "name": "Gastric Balloon", "category": "weight-loss", "description": "A gastric balloon, also known as an intragastric balloon (IGB) or a stomach balloon, is an inflatable medical device that is temporarily placed into the stomach to help reduce weight. It is designed to help provide weight loss when diet and exercise have failed and surgery is not wanted by or recommended for the patient.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "aliases": [ "Intragastric balloon" ], "overview": "A gastric balloon, also known as an intragastric balloon (IGB) or a stomach balloon, is an inflatable medical device that is temporarily placed into the stomach to help reduce weight. It is designed to help provide weight loss when diet and exercise have failed and surgery is not wanted by or recommended for the patient.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Intragastric balloon", "url": "https://en.wikipedia.org/wiki/Gastric_balloon" } ], "literatureLinks": [ { "title": "Intragastric balloon.", "journal": "Minimally invasive therapy & allied technologies : MITAT : official journal of the Society for Minimally Invasive Therapy", "year": 2022, "doi": "10.1080/13645706.2021.1874420", "url": "https://doi.org/10.1080/13645706.2021.1874420" }, { "title": "Endoscopic Management.", "journal": "Gastroenterology clinics of North America", "year": 2016, "doi": "10.1016/j.gtc.2016.07.005", "url": "https://doi.org/10.1016/j.gtc.2016.07.005" }, { "title": "IFSO Consensus on Definitions and Clinical Practice Guidelines for Obesity Management-an International Delphi Study.", "journal": "Obesity surgery", "year": 2024, "doi": "10.1007/s11695-023-06913-8", "url": "https://doi.org/10.1007/s11695-023-06913-8" }, { "title": "American Society for Gastrointestinal Endoscopy-European Society of Gastrointestinal Endoscopy guideline on primary endoscopic bariatric and metabolic therapies for adults with obesity.", "journal": "Endoscopy", "year": 2024, "doi": "10.1055/a-2292-2494", "url": "https://doi.org/10.1055/a-2292-2494" }, { "title": "Spontaneous Intragastric Balloon Hyperinflation: Two Cases and Outcomes.", "journal": "Obesity surgery", "year": 2024, "doi": "10.1007/s11695-024-07332-z", "url": "https://doi.org/10.1007/s11695-024-07332-z" } ], "alternativeTreatments": [ { "name": "Endoscopic sleeve gastroplasty", "procedureSlug": "endoscopic-sleeve-gastroplasty", "rationale": "More durable non-surgical alternative; sutured restriction outlasts balloon removal.", "sourceSlugs": [ "asmbs-bariatric-guidelines" ] }, { "name": "GLP-1 receptor agonists", "rationale": "Pharmacological alternative without endoscopy or device retention.", "sourceSlugs": [ "asmbs-bariatric-guidelines" ] } ], "accreditationsRequired": [ "ifso-center-of-excellence" ] }, { "slug": "revisional-bariatric-surgery", "name": "Revisional Bariatric Surgery", "category": "weight-loss", "description": "Bariatric surgery is a group of surgical procedures used to manage obesity and related conditions. Long-term weight loss with bariatric surgery may be achieved through alteration of gut hormones, physical reduction of stomach size, reduction of nutrient absorption, or a combination of these.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "overview": "Bariatric surgery is a group of surgical procedures used to manage obesity and related conditions. Long-term weight loss with bariatric surgery may be achieved through alteration of gut hormones, physical reduction of stomach size, reduction of nutrient absorption, or a combination of these. Standard of care procedures include Roux en-Y bypass, sleeve gastrectomy, and biliopancreatic diversion with duodenal switch, from which weight loss is largely achieved by altering gut hormone levels responsible for hunger and satiety, leading to a new hormonal weight set point.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Bariatric surgery", "url": "https://en.wikipedia.org/wiki/Bariatric_surgery" } ], "literatureLinks": [ { "title": "Revisional Bariatric Surgery.", "journal": "The Surgical clinics of North America", "year": 2021, "doi": "10.1016/j.suc.2020.12.008", "url": "https://doi.org/10.1016/j.suc.2020.12.008" }, { "title": "Revisional Bariatric Surgery.", "journal": "The Surgical clinics of North America", "year": 2016, "doi": "10.1016/j.suc.2016.03.004", "url": "https://doi.org/10.1016/j.suc.2016.03.004" }, { "title": "Revisional Bariatric Surgery due to Complications: Indications and Outcomes.", "journal": "Obesity surgery", "year": 2023, "doi": "10.1007/s11695-023-06832-8", "url": "https://doi.org/10.1007/s11695-023-06832-8" }, { "title": "Revisional bariatric surgery.", "journal": "Obesity surgery", "year": 2009, "doi": "10.1007/s11695-008-9750-1", "url": "https://doi.org/10.1007/s11695-008-9750-1" }, { "title": "Revisional surgery in severe nutritional complications after bariatric surgical procedures: report of four cases from a single institution and review of the literature.", "journal": "Revista do Colegio Brasileiro de Cirurgioes", "year": 2021, "doi": "10.1590/0100-6991e-20202666", "url": "https://doi.org/10.1590/0100-6991e-20202666" } ], "complicationRate": { "value": 8.25, "range": [ 6.5, 10 ], "sourceSlugs": [ "pubmed-27473804", "pubmed-38749781" ] }, "accreditationsRequired": [ "ifso-center-of-excellence", "asmbs-mbsaqip-center" ], "citedAuthors": [ { "name": "Noah J Switzer", "affiliation": "Department of Surgery, University of Alberta, Room 405 CSC, 10240 Kingsway Avenue, Edmonton, Alberta T5H 3V9, Canada.", "citationSlugs": [ "pubmed-27473804" ] }, { "name": "Mahnoor Zia", "affiliation": "Department of Surgery, Houston Methodist Hospital, Houston, Texas.", "citationSlugs": [ "pubmed-38749781" ] } ] }, { "slug": "duodenal-switch", "name": "Duodenal Switch", "category": "weight-loss", "description": "The duodenal switch (DS) procedure, also known as a gastric reduction duodenal switch (GRDS), is a weight loss surgery procedure that is composed of a restrictive and a malabsorptive aspect.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "aliases": [ "BPD-DS", "Biliopancreatic diversion with duodenal switch" ], "overview": "The duodenal switch (DS) procedure, also known as a gastric reduction duodenal switch (GRDS), is a weight loss surgery procedure that is composed of a restrictive and a malabsorptive aspect.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Duodenal switch", "url": "https://en.wikipedia.org/wiki/Duodenal_switch" } ], "literatureLinks": [ { "title": "CLINICAL PRACTICE GUIDELINES FOR THE PERIOPERATIVE NUTRITION, METABOLIC, AND NONSURGICAL SUPPORT OF PATIENTS UNDERGOING BARIATRIC PROCEDURES - 2019 UPDATE: COSPONSORED BY AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS/AMERICAN COLLEGE OF ENDOCRINOLOGY, THE OBESITY SOCIETY, AMERICAN SOCIETY FOR METABOLIC & BARIATRIC SURGERY, OBESITY MEDICINE ASSOCIATION, AND AMERICAN SOCIETY OF ANESTHESIOLOGISTS - EXECUTIVE SUMMARY.", "journal": "Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists", "year": 2019, "doi": "10.4158/GL-2019-0406", "url": "https://doi.org/10.4158/GL-2019-0406" }, { "title": "Biliopancreatic Diversion With Duodenal Switch.", "journal": "", "year": 2026, "url": "https://pubmed.ncbi.nlm.nih.gov/33085340/" }, { "title": "Gastroesophageal reflux disease after biliopancreatic diversion-duodenal switch: a systematic review and meta-analysis.", "journal": "Surgical endoscopy", "year": 2025, "doi": "10.1007/s00464-025-11845-8", "url": "https://doi.org/10.1007/s00464-025-11845-8" }, { "title": "Experience in biliopancreatic diversion with duodenal switch: Results at 2, 5 and 10 years.", "journal": "Cirugia espanola", "year": 2022, "doi": "10.1016/j.cireng.2022.03.015", "url": "https://doi.org/10.1016/j.cireng.2022.03.015" }, { "title": "Laparoscopic biliopancreatic diversion with duodenal switch.", "journal": "The Surgical clinics of North America", "year": 2005, "doi": "10.1016/j.suc.2004.10.003", "url": "https://doi.org/10.1016/j.suc.2004.10.003" } ], "accreditationsRequired": [ "ifso-center-of-excellence", "asmbs-mbsaqip-center" ] }, { "slug": "sadi-s", "name": "SADI-S", "category": "weight-loss", "description": "Bariatric surgery is a group of surgical procedures used to manage obesity and related conditions. Long-term weight loss with bariatric surgery may be achieved through alteration of gut hormones, physical reduction of stomach size, reduction of nutrient absorption, or a combination of these.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "aliases": [ "Single-anastomosis duodeno-ileal bypass with sleeve" ], "overview": "Bariatric surgery is a group of surgical procedures used to manage obesity and related conditions. Long-term weight loss with bariatric surgery may be achieved through alteration of gut hormones, physical reduction of stomach size, reduction of nutrient absorption, or a combination of these. Standard of care procedures include Roux en-Y bypass, sleeve gastrectomy, and biliopancreatic diversion with duodenal switch, from which weight loss is largely achieved by altering gut hormone levels responsible for hunger and satiety, leading to a new hormonal weight set point.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Bariatric surgery", "url": "https://en.wikipedia.org/wiki/Bariatric_surgery" } ], "accreditationsRequired": [ "ifso-center-of-excellence" ], "literatureLinks": [ { "title": "Robotic Single Anastomosis Duodenal-ileal Bypass With Sleeve Gastrectomy (SADI-S) for Morbid Obesity: A Systematic Review.", "journal": "In vivo (Athens, Greece)", "year": 2024, "doi": "10.21873/invivo.13733", "url": "https://doi.org/10.21873/invivo.13733" }, { "title": "Single anastomosis duodenal-ileal bypass with sleeve gastrectomy (SADI-S): experience from a high-bariatric volume center.", "journal": "Langenbeck's archives of surgery", "year": 2022, "doi": "10.1007/s00423-022-02501-z", "url": "https://doi.org/10.1007/s00423-022-02501-z" }, { "title": "Comparison Between Single Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy (SADI-S) and Roux-En-Y Gastric Bypass (RYGB) in Terms of Weight Loss, Associated Medical Problems Remission, and Complications: A Systematic Review with Meta-Analysis.", "journal": "Obesity surgery", "year": 2025, "doi": "10.1007/s11695-025-08092-0", "url": "https://doi.org/10.1007/s11695-025-08092-0" }, { "title": "Long-term 10-year outcomes of biliopancreatic diversion with duodenal switch (BPD/DS) and single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S): a comparative multicenter cohort study.", "journal": "Surgical endoscopy", "year": 2025, "doi": "10.1007/s00464-025-12170-w", "url": "https://doi.org/10.1007/s00464-025-12170-w" }, { "title": "Single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) as a revisional surgery.", "journal": "Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery", "year": 2018, "doi": "10.1016/j.soard.2018.08.008", "url": "https://doi.org/10.1016/j.soard.2018.08.008" } ] }, { "slug": "endoscopic-sleeve-gastroplasty", "name": "Endoscopic Sleeve Gastroplasty", "category": "weight-loss", "description": "In medicine, endoscopic sleeve gastroplasty (ESG) is a minimally-invasive, non-surgical (incisionless), endoscopic weight loss procedure that is part of the field of endoscopic bariatric therapies. To perform ESG, a physician sutures a patient's stomach into a narrower, smaller tube-like configuration.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "aliases": [ "ESG" ], "overview": "In medicine, endoscopic sleeve gastroplasty (ESG) is a minimally-invasive, non-surgical (incisionless), endoscopic weight loss procedure that is part of the field of endoscopic bariatric therapies. To perform ESG, a physician sutures a patient's stomach into a narrower, smaller tube-like configuration. The result is a more restricted stomach that forces patients to feel fuller sooner, eating fewer calories, which facilitates weight loss.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Endoscopic sleeve gastroplasty", "url": "https://en.wikipedia.org/wiki/Endoscopic_sleeve_gastroplasty" } ], "accreditationsRequired": [ "ifso-center-of-excellence" ], "literatureLinks": [ { "title": "Outcomes of Endoscopic Sleeve Gastroplasty: A Systematic Review.", "journal": "Medicina (Kaunas, Lithuania)", "year": 2025, "doi": "10.3390/medicina61101821", "url": "https://doi.org/10.3390/medicina61101821" }, { "title": "Endoscopic Sleeve Gastroplasty for the Treatment of Metabolic Syndrome: A Systematic Review and Meta-analysis.", "journal": "Obesity surgery", "year": 2025, "doi": "10.1007/s11695-025-07842-4", "url": "https://doi.org/10.1007/s11695-025-07842-4" }, { "title": "Position statement and guidelines about Endoscopic Sleeve Gastroplasty (ESG) also known as \"Endo-sleeve\".", "journal": "Journal of visceral surgery", "year": 2025, "doi": "10.1016/j.jviscsurg.2024.12.003", "url": "https://doi.org/10.1016/j.jviscsurg.2024.12.003" }, { "title": "Laparoscopic sleeve gastrectomy versus endoscopic sleeve gastroplasty: a systematic review and meta-analysis.", "journal": "Endoscopy international open", "year": 2021, "doi": "10.1055/a-1300-1085", "url": "https://doi.org/10.1055/a-1300-1085" }, { "title": "Endoscopic Sleeve Gastroplasty versus Laparoscopic Sleeve Gastrectomy: A Systematic Review and Meta-Analysis.", "journal": "Obesity surgery", "year": 2026, "doi": "10.1007/s11695-026-08621-5", "url": "https://doi.org/10.1007/s11695-026-08621-5" } ] }, { "slug": "shoulder-replacement", "name": "Shoulder Replacement", "category": "orthopaedic", "description": "Shoulder replacement is a surgical procedure in which all or part of the glenohumeral joint is replaced by a prosthetic implant. Such joint replacement surgery generally is conducted to relieve arthritis pain, improve joint mobility, and/or fix severe physical joint damage.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "aliases": [ "Shoulder arthroplasty" ], "overview": "Shoulder replacement is a surgical procedure in which all or part of the glenohumeral joint is replaced by a prosthetic implant. Such joint replacement surgery generally is conducted to relieve arthritis pain, improve joint mobility, and/or fix severe physical joint damage.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Shoulder replacement", "url": "https://en.wikipedia.org/wiki/Shoulder_replacement" } ], "literatureLinks": [ { "title": "The American Society of Shoulder and Elbow Therapists' consensus statement on rehabilitation for anatomic total shoulder arthroplasty.", "journal": "Journal of shoulder and elbow surgery", "year": 2020, "doi": "10.1016/j.jse.2020.05.019", "url": "https://doi.org/10.1016/j.jse.2020.05.019" }, { "title": "Reverse total shoulder arthroplasty.", "journal": "The bone & joint journal", "year": 2021, "doi": "10.1302/0301-620X.103B.BJJ-2020-2101", "url": "https://doi.org/10.1302/0301-620X.103B.BJJ-2020-2101" }, { "title": "A randomized single-blinded trial of early rehabilitation versus immobilization after reverse total shoulder arthroplasty.", "journal": "Journal of shoulder and elbow surgery", "year": 2020, "doi": "10.1016/j.jse.2019.10.005", "url": "https://doi.org/10.1016/j.jse.2019.10.005" }, { "title": "Stemless reverse total shoulder arthroplasty: a systematic review.", "journal": "Journal of shoulder and elbow surgery", "year": 2022, "doi": "10.1016/j.jse.2021.12.017", "url": "https://doi.org/10.1016/j.jse.2021.12.017" }, { "title": "Reverse total shoulder arthroplasty clinical and patient-reported outcomes and complications stratified by preoperative diagnosis: a systematic review.", "journal": "Journal of shoulder and elbow surgery", "year": 2021, "doi": "10.1016/j.jse.2020.09.028", "url": "https://doi.org/10.1016/j.jse.2020.09.028" } ], "accreditationsRequired": [ "national-orthopaedic-board" ], "revisionRate": { "value": 8.4, "range": [ 4.05, 8.75 ], "sourceSlugs": [ "pubmed-34003464", "pubmed-34659481", "pubmed-35265179" ] } }, { "slug": "acl-reconstruction", "name": "ACL Reconstruction", "category": "orthopaedic", "description": "Anterior cruciate ligament reconstruction is a surgical tissue graft replacement of the anterior cruciate ligament, located in the knee, to restore its function after an injury. The torn ligament can either be removed from the knee, or preserved before reconstruction through an arthroscopic procedure.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "aliases": [ "Anterior cruciate ligament reconstruction" ], "overview": "Anterior cruciate ligament reconstruction is a surgical tissue graft replacement of the anterior cruciate ligament, located in the knee, to restore its function after an injury. The torn ligament can either be removed from the knee, or preserved before reconstruction through an arthroscopic procedure.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Anterior cruciate ligament reconstruction", "url": "https://en.wikipedia.org/wiki/Anterior_cruciate_ligament_reconstruction" } ], "literatureLinks": [ { "title": "Anterior Cruciate Ligament Reconstruction Recovery and Rehabilitation: A Systematic Review.", "journal": "The Journal of bone and joint surgery. American volume", "year": 2022, "doi": "10.2106/JBJS.21.00688", "url": "https://doi.org/10.2106/JBJS.21.00688" }, { "title": "Evidence for the effects of prehabilitation before ACL-reconstruction on return to sport-related and self-reported knee function: A systematic review.", "journal": "PloS one", "year": 2020, "doi": "10.1371/journal.pone.0240192", "url": "https://doi.org/10.1371/journal.pone.0240192" }, { "title": "Rehabilitation and Return to Play Protocols After Anterior Cruciate Ligament Reconstruction in Soccer Players: A Systematic Review.", "journal": "The American journal of sports medicine", "year": 2025, "doi": "10.1177/03635465241233161", "url": "https://doi.org/10.1177/03635465241233161" }, { "title": "Impact of Psychological Factors on Rehabilitation After Anterior Cruciate Ligament Reconstruction: A Systematic Review.", "journal": "Sports health", "year": 2025, "doi": "10.1177/19417381241256930", "url": "https://doi.org/10.1177/19417381241256930" }, { "title": "Conservative vs Surgical Treatment of Anterior Cruciate Ligament Rupture: A Systematic Review.", "journal": "Cureus", "year": 2024, "doi": "10.7759/cureus.56532", "url": "https://doi.org/10.7759/cureus.56532" } ], "accreditationsRequired": [ "national-orthopaedic-board" ] }, { "slug": "meniscus-surgery", "name": "Meniscus Surgery", "category": "orthopaedic", "description": "A tear of a meniscus is a rupturing of one or more of the fibrocartilage strips in the knee called menisci. When doctors and patients refer to \"torn cartilage\" in the knee, they actually may be referring to an injury to a meniscus at the top of one of the tibiae.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "aliases": [ "Meniscectomy", "Meniscal repair" ], "overview": "A tear of a meniscus is a rupturing of one or more of the fibrocartilage strips in the knee called menisci. When doctors and patients refer to \"torn cartilage\" in the knee, they actually may be referring to an injury to a meniscus at the top of one of the tibiae. Menisci can be torn during innocuous activities such as walking or squatting. They can also be torn by traumatic force encountered in sports or other forms of physical exertion. The traumatic action is most often a twisting movement at the knee while the leg is bent. In older adults, the meniscus can be damaged following prolonged 'wear and tear'. Especially acute injuries can lead to displaced tears which can cause mechanical symptoms such as clicking, catching, or locking during motion of the joint.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Meniscus tear", "url": "https://en.wikipedia.org/wiki/Meniscus_tear" } ], "literatureLinks": [ { "title": "The formal EU-US Meniscus Rehabilitation 2024 Consensus: An ESSKA-AOSSM-AASPT initiative. Part I-Rehabilitation management after meniscus surgery (meniscectomy, repair and reconstruction).", "journal": "Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA", "year": 2025, "doi": "10.1002/ksa.12674", "url": "https://doi.org/10.1002/ksa.12674" }, { "title": "Medial Meniscus Root Tears: Anatomy, Repair Options, and Outcomes.", "journal": "Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association", "year": 2025, "doi": "10.1016/j.arthro.2025.01.005", "url": "https://doi.org/10.1016/j.arthro.2025.01.005" }, { "title": "Meniscus Tear: Pathology, Incidence, and Management.", "journal": "Cureus", "year": 2022, "doi": "10.7759/cureus.25121", "url": "https://doi.org/10.7759/cureus.25121" }, { "title": "Meniscal Injuries: Mechanism and Classification.", "journal": "Sports medicine and arthroscopy review", "year": 2021, "doi": "10.1097/JSA.0000000000000311", "url": "https://doi.org/10.1097/JSA.0000000000000311" }, { "title": "Surgical treatment of complex meniscus tear and disease: modern review.", "journal": "Journal of ISAKOS : joint disorders & orthopaedic sports medicine", "year": 2021, "doi": "10.1136/jisakos-2019-000380", "url": "https://doi.org/10.1136/jisakos-2019-000380" } ], "accreditationsRequired": [ "national-orthopaedic-board" ], "complicationRate": { "value": 6, "range": [ 3.7, 9 ], "sourceSlugs": [ "pubmed-40388072", "pubmed-42432690", "pubmed-31187178" ] } }, { "slug": "spinal-fusion", "name": "Spinal Fusion", "category": "orthopaedic", "description": "Spinal fusion, also called spondylodesis or spondylosyndesis, is a surgery performed by orthopaedic surgeons or neurosurgeons that joins two or more vertebrae. This procedure can be performed at any level in the spine and prevents any movement between the fused vertebrae.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "aliases": [ "Arthrodesis" ], "overview": "Spinal fusion, also called spondylodesis or spondylosyndesis, is a surgery performed by orthopaedic surgeons or neurosurgeons that joins two or more vertebrae. This procedure can be performed at any level in the spine and prevents any movement between the fused vertebrae. There are many types of spinal fusion and each technique involves using bone grafting—either from the patient (autograft), donor (allograft), or artificial bone substitutes—to help the bones heal together. Additional hardware is often used to hold the bones in place while the graft fuses the two vertebrae together. The placement of hardware can be guided by fluoroscopy, navigation systems, or robotics.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Spinal fusion", "url": "https://en.wikipedia.org/wiki/Spinal_fusion" } ], "literatureLinks": [ { "title": "Decompression alone versus decompression with fusion in patients with lumbar spinal stenosis with degenerative spondylolisthesis: a systematic review and meta-analysis.", "journal": "European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society", "year": 2023, "doi": "10.1007/s00586-022-07507-1", "url": "https://doi.org/10.1007/s00586-022-07507-1" }, { "title": "Management of lumbar spinal stenosis.", "journal": "BMJ (Clinical research ed.)", "year": 2016, "doi": "10.1136/bmj.h6234", "url": "https://doi.org/10.1136/bmj.h6234" }, { "title": "Complications in Spinal Fusion Surgery: A Systematic Review of Clinically Used Cages.", "journal": "Journal of clinical medicine", "year": 2022, "doi": "10.3390/jcm11216279", "url": "https://doi.org/10.3390/jcm11216279" }, { "title": "Surgical versus non-surgical treatment for lumbar spinal stenosis.", "journal": "The Cochrane database of systematic reviews", "year": 2016, "doi": "10.1002/14651858.CD010264.pub2", "url": "https://doi.org/10.1002/14651858.CD010264.pub2" }, { "title": "Instrumented Versus Noninstrumented Spinal Fusion for Degenerative Lumbar Spondylolisthesis: A Systematic Review.", "journal": "Clinical spine surgery", "year": 2022, "doi": "10.1097/BSD.0000000000001266", "url": "https://doi.org/10.1097/BSD.0000000000001266" } ], "accreditationsRequired": [ "national-orthopaedic-board" ] }, { "slug": "disc-replacement", "name": "Disc Replacement", "category": "orthopaedic", "description": "Total disc replacement (TDR), or artificial disc replacement (ADR), is a type of arthroplasty in which degenerated intervertebral discs in the vertebral column are replaced with artificial disc implants in the lumbar (lower) or cervical (upper) spine. The procedure is used to treat chronic, severe low back pain and cervical pain resulting from degenerative disc disease.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "aliases": [ "Artificial disc replacement", "Total disc arthroplasty" ], "overview": "Total disc replacement (TDR), or artificial disc replacement (ADR), is a type of arthroplasty in which degenerated intervertebral discs in the vertebral column are replaced with artificial disc implants in the lumbar (lower) or cervical (upper) spine. The procedure is used to treat chronic, severe low back pain and cervical pain resulting from degenerative disc disease. Disc replacement is also an alternative intervention for symptomatic disc herniation with associated arm and hand, or leg symptoms.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Artificial disc replacement", "url": "https://en.wikipedia.org/wiki/Total_disc_replacement" } ], "literatureLinks": [ { "title": "Short-term and Long-term Complications of Cervical Disc Arthroplasty.", "journal": "Clinical spine surgery", "year": 2023, "doi": "10.1097/BSD.0000000000001541", "url": "https://doi.org/10.1097/BSD.0000000000001541" }, { "title": "Cervical disc arthroplasty.", "journal": "The Journal of the American Academy of Orthopaedic Surgeons", "year": 2010, "doi": "10.5435/00124635-201010000-00006", "url": "https://doi.org/10.5435/00124635-201010000-00006" }, { "title": "Osteolysis after cervical disc arthroplasty.", "journal": "European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society", "year": 2020, "doi": "10.1007/s00586-020-06578-2", "url": "https://doi.org/10.1007/s00586-020-06578-2" }, { "title": "Current Concepts of Cervical Disc Arthroplasty.", "journal": "International journal of spine surgery", "year": 2021, "doi": "10.14444/8149", "url": "https://doi.org/10.14444/8149" }, { "title": "Cervical disc arthroplasty for Klippel-Feil syndrome.", "journal": "Clinical neurology and neurosurgery", "year": 2021, "doi": "10.1016/j.clineuro.2021.106934", "url": "https://doi.org/10.1016/j.clineuro.2021.106934" } ], "complicationRate": { "value": 2.79, "range": [ 1.77, 3.8 ], "sourceSlugs": [ "pubmed-37752635", "pubmed-34543827" ] }, "accreditationsRequired": [ "national-orthopaedic-board" ], "citedAuthors": [ { "name": "Chu-Yi Lee", "affiliation": "Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-M…", "citationSlugs": [ "pubmed-34543827" ] }, { "name": "Austin Q Nguyen", "affiliation": "Department of Orthopedics and Sports Medicine, Houston Methodist Hospital, Houston, TX.", "citationSlugs": [ "pubmed-37752635" ] } ] }, { "slug": "cataract-surgery", "name": "Cataract Surgery", "category": "ophthalmology", "description": "Cataract surgery, also called lens replacement surgery, is the removal of the natural lens of the eye that has developed a cataract, an opaque or cloudy area. The eye's natural lens is usually replaced with an artificial intraocular lens (IOL) implant.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [ "problems with your vision, such as cloudiness, blurriness, dark shadows or areas of light", "your vision gets cloudy or blurry", "you're finding it hard to focus your vision", "your eye becomes red or painful", "you see light or dark areas in your vision", "it becomes uncomfortable or painful to look at bright light" ], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "aliases": [ "Phacoemulsification" ], "overview": "Cataract surgery, also called lens replacement surgery, is the removal of the natural lens of the eye that has developed a cataract, an opaque or cloudy area. The eye's natural lens is usually replaced with an artificial intraocular lens (IOL) implant.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en", "nhs-health-a-to-z", "medlineplus-nih" ], "references": [ { "label": "Wikipedia — Cataract surgery", "url": "https://en.wikipedia.org/wiki/Cataract_surgery" } ], "recoveryTimeline": "Most people recover quickly after cataract surgery. Your surgeon will talk to you about what to expect and what you should do. They'll check your eye and talk to you about when to remove the dressing. They'll also tell you about pain relief you can take while you recover. You'll be given eye drops to help your eye to heal and prevent infection. You'll usually need to take these eye drops for about 4 weeks. After cataract surgery: - your vision may be blurry for a few hours – this is because of the eye drops used to widen your pupils\n- your eye may hurt for a few days\n- you may need to use a plastic shield to protect your eye at night while your eye is healing\n- it may take several days for your vision to improve\n- you may feel more tired than usual but you'll start to feel normal again aft\n\n*Reference text adapted from NHS UK under the Open Government Licence v3.0.*", "faqs": [ { "question": "Why cataract surgery is done?", "answer": "Cataract surgery is done to improve your vision if you have cataracts." }, { "question": "How to prepare for cataract surgery?", "answer": "Before you have cataract surgery, you'll have an appointment with a specialist who will examine and measure your eye." }, { "question": "What happens during cataract surgery?", "answer": "You'll have cataract surgery in a hospital." }, { "question": "What are cataracts?", "answer": "A cataract is a clouding of the clear lens inside your eye. This cloudiness blocks light from reaching the back of the eye, making it harder to see clearly. A cataract can affect one or both eyes, but it doesn't spread from one eye to the other." }, { "question": "What causes cataracts?", "answer": "Most cataracts develop as part of the normal aging process. This happens when the protein in the lens of your eye clumps together. Over time, these protein clumps grow larger and thicker, making it harder to see. The lens may turn yellow or brown, which can affect how you see colors." }, { "question": "Who is more likely to develop cataracts?", "answer": "Cataracts are very common in older adults. By age 80, more than half of all Americans either have a cataract or have had cataract surgery. Your risk for developing cataracts increases as you get older. You may also be at an increased risk if you:" } ], "literatureLinks": [ { "title": "Visual outcome following posterior capsule rupture during manual small incision cataract surgery.", "journal": "Nigerian journal of clinical practice", "year": 2021, "doi": "10.4103/njcp.njcp_272_20", "url": "https://doi.org/10.4103/njcp.njcp_272_20" }, { "title": "Risk factors for posterior capsule rupture in mature cataract surgery: A study of 1302 cases.", "journal": "Indian journal of ophthalmology", "year": 2023, "doi": "10.4103/ijo.IJO_1633_22", "url": "https://doi.org/10.4103/ijo.IJO_1633_22" }, { "title": "Previous intravitreal injection as a risk factor of posterior capsule rupture in cataract surgery: a systematic review and meta-analysis.", "journal": "Acta ophthalmologica", "year": 2022, "doi": "10.1111/aos.15089", "url": "https://doi.org/10.1111/aos.15089" }, { "title": "The role of vitreous management in the posterior capsule rupture associated with cataract surgery on the protection of the corneal endothelium.", "journal": "Romanian journal of ophthalmology", "year": 2022, "doi": "10.22336/rjo.2022.26", "url": "https://doi.org/10.22336/rjo.2022.26" }, { "title": "Risk of Posterior Capsule Rupture During Cataract Surgery in Eyes With Previous Intravitreal Injections.", "journal": "American journal of ophthalmology", "year": 2017, "doi": "10.1016/j.ajo.2017.02.006", "url": "https://doi.org/10.1016/j.ajo.2017.02.006" } ], "complicationRate": { "value": 8.98, "range": [ 8.55, 9.4 ], "sourceSlugs": [ "pubmed-34121746", "pubmed-22696849" ] }, "alternativeTreatments": [ { "name": "Premium intraocular lenses", "procedureSlug": "premium-iol", "rationale": "Multifocal / extended-depth-of-focus IOLs reduce spectacle dependence at the cost of higher dysphotopsia risk.", "sourceSlugs": [ "aao-ppp-refractive" ] }, { "name": "Refractive lens exchange", "procedureSlug": "refractive-lens-exchange", "rationale": "Same procedure performed pre-cataract for presbyopia or high myopia correction.", "sourceSlugs": [ "aao-ppp-refractive" ] }, { "name": "Spectacle correction", "rationale": "Conservative management for early cataract not yet causing significant functional impairment.", "sourceSlugs": [ "aao-ppp-refractive" ] } ], "accreditationsRequired": [ "national-ophthalmology-board" ], "citedAuthors": [ { "name": "Adisak Trinavarat", "affiliation": "Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. siatr@mahidol.ac.th", "citationSlugs": [ "pubmed-22696849" ] }, { "name": "K K Oladigbolu", "affiliation": "Department of Ophthalmology, Ahmadu Bello University Teaching Hospital, Shika-Zaria, Kaduna, Nigeria.", "citationSlugs": [ "pubmed-34121746" ] } ] }, { "slug": "premium-iol", "name": "Premium Intraocular Lenses", "category": "ophthalmology", "description": "An intraocular lens (IOL) is a lens implanted in the eye usually as part of a treatment for cataracts or for correcting other vision problems such as near-sightedness (myopia) and far-sightedness (hyperopia); a form of refractive surgery. If the natural lens is left in the eye, the IOL is known as phakic, otherwise it is a pseudophakic lens.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "aliases": [ "Multifocal IOL", "Toric IOL" ], "overview": "An intraocular lens (IOL) is a lens implanted in the eye usually as part of a treatment for cataracts or for correcting other vision problems such as near-sightedness (myopia) and far-sightedness (hyperopia); a form of refractive surgery. If the natural lens is left in the eye, the IOL is known as phakic, otherwise it is a pseudophakic lens. Both kinds of IOLs are designed to provide the same light-focusing function as the natural crystalline lens. This can be an alternative to LASIK, but LASIK is not an alternative to an IOL for treatment of cataracts.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Intraocular lens", "url": "https://en.wikipedia.org/wiki/Intraocular_lens" } ], "literatureLinks": [ { "title": "Patient-centered and visual quality outcomes of premium cataract surgery: a systematic review.", "journal": "European journal of ophthalmology", "year": 2017, "doi": "10.5301/ejo.5000978", "url": "https://doi.org/10.5301/ejo.5000978" }, { "title": "Premium Intraocular Lenses in Glaucoma-A Systematic Review.", "journal": "Bioengineering (Basel, Switzerland)", "year": 2023, "doi": "10.3390/bioengineering10090993", "url": "https://doi.org/10.3390/bioengineering10090993" }, { "title": "Cataract surgery in keratoconus: current challenges and future directions.", "journal": "Current opinion in ophthalmology", "year": 2026, "doi": "10.1097/ICU.0000000000001180", "url": "https://doi.org/10.1097/ICU.0000000000001180" }, { "title": "", "journal": "", "year": 2023, "url": "https://pubmed.ncbi.nlm.nih.gov/38320059/" }, { "title": "Neodymium-Doped Yttrium Aluminum Garnet (Nd:YAG) Laser-Induced Damage to Intraocular Lenses: A Systematic Review of Mechanisms, Clinical Consequences, and Preventive Strategies.", "journal": "Cureus", "year": 2025, "doi": "10.7759/cureus.90903", "url": "https://doi.org/10.7759/cureus.90903" } ], "accreditationsRequired": [ "national-ophthalmology-board", "refractive-surgery-fellowship" ] }, { "slug": "refractive-lens-exchange", "name": "Refractive Lens Exchange", "category": "ophthalmology", "description": "Clear lens extraction, also known as refractive lensectomy, custom lens replacement or refractive lens exchange is a surgical procedure in which clear lens of the human eye is removed. Unlike cataract surgery, where the cloudy lens is removed to treat a cataract, clear lens extraction is done to surgically correct refractive errors such as high myopia.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "aliases": [ "RLE", "Clear lens extraction" ], "overview": "Clear lens extraction, also known as refractive lensectomy, custom lens replacement or refractive lens exchange is a surgical procedure in which clear lens of the human eye is removed. Unlike cataract surgery, where the cloudy lens is removed to treat a cataract, clear lens extraction is done to surgically correct refractive errors such as high myopia. It can also be done in hyperopic or presbyopic patients who wish to have a multifocal IOL implanted to avoid wearing glasses. It is also used as a treatment for diseases such as angle closure glaucoma.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Refractive lens exchange", "url": "https://en.wikipedia.org/wiki/Clear_lens_extraction" } ], "literatureLinks": [ { "title": "Refractive lens exchange.", "journal": "Survey of ophthalmology", "year": 2014, "doi": "10.1016/j.survophthal.2014.04.004", "url": "https://doi.org/10.1016/j.survophthal.2014.04.004" }, { "title": "Refractive lens exchange: What are the red lines?", "journal": "European journal of ophthalmology", "year": 2024, "doi": "10.1177/11206721231218909", "url": "https://doi.org/10.1177/11206721231218909" }, { "title": "Refractive Lens Exchange: A Review.", "journal": "Klinische Monatsblatter fur Augenheilkunde", "year": 2024, "doi": "10.1055/a-2346-4428", "url": "https://doi.org/10.1055/a-2346-4428" }, { "title": "[Complications after refractive lens exchange].", "journal": "Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft", "year": 2008, "doi": "10.1007/s00347-008-1829-5", "url": "https://doi.org/10.1007/s00347-008-1829-5" }, { "title": "[Refractive lens exchange].", "journal": "Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft", "year": 2008, "doi": "10.1007/s00347-008-1826-8", "url": "https://doi.org/10.1007/s00347-008-1826-8" } ], "complicationRate": { "value": 7.67, "range": [ 7.6, 7.74 ], "sourceSlugs": [ "pubmed-34417783", "pubmed-36993987" ] }, "accreditationsRequired": [ "national-ophthalmology-board", "refractive-surgery-fellowship" ], "citedAuthors": [ { "name": "Diana Carmen Dragnea", "affiliation": "From the Department of Ophthalmology, Antwerp University Hospital, Wilrijk, Belgium (Dragnea, Goemaere, Tassignon, Dhubhghaill); Departme…", "citationSlugs": [ "pubmed-34417783" ] }, { "name": "Veshesh Patel", "affiliation": "Bascom Palmer Eye Institute at the University of Miami Miller School of Medicine, Miami, FL, USA.", "citationSlugs": [ "pubmed-36993987" ] } ] }, { "slug": "glaucoma-surgery", "name": "Glaucoma Surgery", "category": "ophthalmology", "description": "Glaucoma surgery is a type of eye surgery performed to treat glaucoma, a group of diseases which affect the optic nerve, resulting in vision loss. Glaucoma is characterized by increased intraocular pressure (IOP).", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "aliases": [ "Trabeculectomy", "MIGS" ], "overview": "Glaucoma surgery is a type of eye surgery performed to treat glaucoma, a group of diseases which affect the optic nerve, resulting in vision loss. Glaucoma is characterized by increased intraocular pressure (IOP). Most glaucoma surgeries seek to lower IOP by facilitating the escape of excess aqueous humor from the eye, while others decrease the production of aqueous humor.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en", "nhs-health-a-to-z", "medlineplus-nih" ], "references": [ { "label": "Wikipedia — Glaucoma surgery", "url": "https://en.wikipedia.org/wiki/Glaucoma_surgery" } ], "faqs": [ { "question": "How glaucoma affects your life?", "answer": "If you have glaucoma, it's normal to worry about how much your vision might change and how you will manage if it does." }, { "question": "What is glaucoma?", "answer": "This video explains what glaucoma is and why it's important to have regular eye tests" }, { "question": "What causes glaucoma?", "answer": "Medical experts aren't sure what causes glaucoma, but the most common types usually happen when the fluid pressure inside your eye slowly rises, damaging the optic nerve. Other types of glaucoma may be caused by medical conditions, or a baby may be born with it." }, { "question": "What are the symptoms of glaucoma?", "answer": "Often there are no symptoms of glaucoma at first. Or symptoms may start so slowly that you may not notice them. Without treatment, you slowly lose your peripheral (side) vision. It may seem like you're looking through a tunnel. Over time, your straight-ahead vision may decrease until no vision remains." }, { "question": "How is glaucoma diagnosed?", "answer": "A comprehensive eye exam can tell if you have glaucoma. This would include:" }, { "question": "What are the treatments for glaucoma?", "answer": "Early treatment can help protect your eyes against vision loss. There is no cure, but glaucoma can usually be controlled. Without treatment it can eventually cause blindness. Treatments can include:" } ], "literatureLinks": [ { "title": "The surgical management of glaucoma: A review.", "journal": "Clinical & experimental ophthalmology", "year": 2022, "doi": "10.1111/ceo.14028", "url": "https://doi.org/10.1111/ceo.14028" }, { "title": "Non-penetrating filtration surgery versus trabeculectomy for open-angle glaucoma.", "journal": "The Cochrane database of systematic reviews", "year": 2014, "doi": "10.1002/14651858.CD007059.pub2", "url": "https://doi.org/10.1002/14651858.CD007059.pub2" }, { "title": "Choroidal effusions after glaucoma surgery.", "journal": "Current opinion in ophthalmology", "year": 2015, "doi": "10.1097/ICU.0000000000000131", "url": "https://doi.org/10.1097/ICU.0000000000000131" }, { "title": "Ex-PRESS® surgery versus trabeculectomy for primary open-angle glaucoma with low preoperative intraocular pressure.", "journal": "International ophthalmology", "year": 2022, "doi": "10.1007/s10792-022-02335-0", "url": "https://doi.org/10.1007/s10792-022-02335-0" }, { "title": "Device-modified trabeculectomy for glaucoma.", "journal": "The Cochrane database of systematic reviews", "year": 2015, "doi": "10.1002/14651858.CD010472.pub2", "url": "https://doi.org/10.1002/14651858.CD010472.pub2" } ], "complicationRate": { "value": 18.5, "range": [ 17, 20 ], "sourceSlugs": [ "pubmed-24532137", "pubmed-20672770" ] }, "accreditationsRequired": [ "national-ophthalmology-board" ], "citedAuthors": [ { "name": "Michael A Connor", "affiliation": "Department of Ophthalmology, University of Florida College of Medicine, Gainesville, Florida 32610, USA.", "citationSlugs": [ "pubmed-20672770" ] }, { "name": "Mohamed A Eldaly", "affiliation": "Ophthalmology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.", "citationSlugs": [ "pubmed-24532137" ] } ] }, { "slug": "retinal-surgery", "name": "Retinal Surgery", "category": "ophthalmology", "description": "Eye surgery, also known as ophthalmic surgery or ocular surgery, is surgery performed on the eye or its adnexa. Eye surgery is part of ophthalmology and is performed by an ophthalmologist or eye surgeon.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "aliases": [ "Vitreoretinal surgery" ], "overview": "Eye surgery, also known as ophthalmic surgery or ocular surgery, is surgery performed on the eye or its adnexa. Eye surgery is part of ophthalmology and is performed by an ophthalmologist or eye surgeon. The eye is a fragile organ, and requires due care before, during, and after a surgical procedure to minimize or prevent further damage. An eye surgeon is responsible for selecting the appropriate surgical procedure for the patient, and for taking the necessary safety precautions. Mentions of eye surgery can be found in several ancient texts dating back as early as 1800 BC, with cataract treatment starting in the fifth century BC. It continues to be a widely practiced class of surgery, with various techniques having been developed for treating eye problems.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Vitreoretinal surgery", "url": "https://en.wikipedia.org/wiki/Eye_surgery" } ], "literatureLinks": [ { "title": "Retinal detachment.", "journal": "Nature reviews. Disease primers", "year": 2024, "doi": "10.1038/s41572-024-00501-5", "url": "https://doi.org/10.1038/s41572-024-00501-5" }, { "title": "The Pneumatic Retinopexy versus Vitrectomy for the Management of Primary Rhegmatogenous Retinal Detachment Outcomes Randomized Trial (PIVOT).", "journal": "Ophthalmology", "year": 2019, "doi": "10.1016/j.ophtha.2018.11.014", "url": "https://doi.org/10.1016/j.ophtha.2018.11.014" }, { "title": "Retinal detachment.", "journal": "BMJ clinical evidence", "year": 2008, "url": "https://pubmed.ncbi.nlm.nih.gov/19450333/" }, { "title": "Surgical Outcomes of Retinal Detachment in Knobloch Syndrome.", "journal": "Ophthalmology. Retina", "year": 2024, "doi": "10.1016/j.oret.2024.03.020", "url": "https://doi.org/10.1016/j.oret.2024.03.020" }, { "title": "Outcomes Of Microincision Pars Plana Vitrectomy In Rhegmatogenous Retinal Detachment.", "journal": "Journal of Nepal Health Research Council", "year": 2023, "doi": "10.33314/jnhrc.v20i4.4417", "url": "https://doi.org/10.33314/jnhrc.v20i4.4417" } ], "accreditationsRequired": [ "national-ophthalmology-board" ] }, { "slug": "angioplasty-stents", "name": "Angioplasty and Stents", "category": "cardiology", "description": "Angioplasty, also known as balloon angioplasty and percutaneous transluminal angioplasty, is a minimally invasive endovascular procedure used to widen narrowed or obstructed arteries or veins, typically to treat arterial atherosclerosis.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [ "Angioplasty and Vascular Stenting", "Heart Treatments", "What Are Stents?", "Coronary Artery Disease: Angioplasty or Bypass Surgery?", "Drug-Eluting Stents: Do They Increase Heart Attack Risk?", "Heart Procedures and Surgeries" ], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "aliases": [ "PCI", "Percutaneous coronary intervention" ], "overview": "Angioplasty, also known as balloon angioplasty and percutaneous transluminal angioplasty, is a minimally invasive endovascular procedure used to widen narrowed or obstructed arteries or veins, typically to treat arterial atherosclerosis.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en", "medlineplus-nih" ], "references": [ { "label": "Wikipedia — Angioplasty", "url": "https://en.wikipedia.org/wiki/Angioplasty" } ], "recoveryTimeline": "If you had an angioplasty for chest pain, you'll go to a recovery room for a few hours. You may stay in the hospital overnight. Your doctor will probably prescribe [medicines to prevent blood clots](https://medlineplus.gov/bloodthinners.html). Most people can return to their usual activities after a week. If you had an emergency angioplasty for a heart attack, you'll need to stay in the hospital for about a few more days.\n\n*Reference text adapted from MedlinePlus (U.S. National Library of Medicine, public domain).*", "faqs": [ { "question": "What is angioplasty?", "answer": "Angioplasty is a procedure to improve blood flow in coronary arteries that have become narrow or blocked. Your coronary arteries supply oxygen-rich blood to your heart. If you have [coronary artery disease](https://medlineplus.gov/coronaryarterydisease.html), a sticky material called plaque builds up in your coronary arteries. Plaque is made of [cholesterol](https://medlineplus.gov/cholesterol.html), calcium, and other substances in your blood. Over time, it can narrow your arteries or fully block them. When this happens, some parts of your heart don't get enough blood." }, { "question": "What conditions does angioplasty treat?", "answer": "Doctors (usually a heart specialist called a cardiologist) use angioplasty to:" }, { "question": "What happens during angioplasty?", "answer": "Most people have angioplasties in a hospital in a special room called a cardiac catheterization, or cath, lab. You will be awake and lying down. You'll get medicine to help you relax through an intravenous (IV) line. This is a small tube that goes into a vein in your hand or arm." }, { "question": "What happens after an angioplasty?", "answer": "If you had an angioplasty for chest pain, you'll go to a recovery room for a few hours. You may stay in the hospital overnight. Your doctor will probably prescribe [medicines to prevent blood clots](https://medlineplus.gov/bloodthinners.html). Most people can return to their usual activities after a week." }, { "question": "Are there any risks from angioplasty?", "answer": "Angioplasty is very safe, but every invasive procedure comes with risks. You may get a [bruise](https://medlineplus.gov/bruises.html), feel sore, or have some bleeding where the tubes were inserted. More serious problems don't happen very often, but they are possible. They can include serious [bleeding](https://medlineplus.gov/bleeding.html), blood clots, and narrowing of the artery again." } ], "literatureLinks": [ { "title": "Chronic total occlusion percutaneous coronary intervention: managing perforation complications.", "journal": "Expert review of cardiovascular therapy", "year": 2021, "doi": "10.1080/14779072.2021.1850264", "url": "https://doi.org/10.1080/14779072.2021.1850264" }, { "title": "Complications of chronic total occlusion percutaneous coronary intervention: Subepicardial hematoma.", "journal": "Cardiovascular revascularization medicine : including molecular interventions", "year": 2018, "doi": "10.1016/j.carrev.2017.12.011", "url": "https://doi.org/10.1016/j.carrev.2017.12.011" }, { "title": "Management of Percutaneous Coronary Intervention Complications: Algorithms From the 2018 and 2019 Seattle Percutaneous Coronary Intervention Complications Conference.", "journal": "Circulation. Cardiovascular interventions", "year": 2020, "doi": "10.1161/CIRCINTERVENTIONS.120.008962", "url": "https://doi.org/10.1161/CIRCINTERVENTIONS.120.008962" }, { "title": "Managing coronary artery perforation after percutaneous coronary intervention.", "journal": "Expert review of cardiovascular therapy", "year": 2022, "doi": "10.1080/14779072.2022.2059465", "url": "https://doi.org/10.1080/14779072.2022.2059465" }, { "title": "Management of cardiogenic shock complicating myocardial infarction: an update 2019.", "journal": "European heart journal", "year": 2019, "doi": "10.1093/eurheartj/ehz363", "url": "https://doi.org/10.1093/eurheartj/ehz363" } ], "complicationRate": { "value": 1.53, "range": [ 1, 2.07 ], "sourceSlugs": [ "pubmed-33175595", "pubmed-41276388" ] }, "alternativeTreatments": [ { "name": "CABG", "procedureSlug": "cabg", "rationale": "Better long-term survival in multi-vessel disease, diabetic patients, and left-main disease.", "sourceSlugs": [ "esc-cabg-guidelines" ] }, { "name": "Optimal medical therapy", "rationale": "Appropriate first-line in stable angina with controlled symptoms.", "sourceSlugs": [ "esc-cabg-guidelines" ] } ], "accreditationsRequired": [ "jci-hospital-accreditation" ], "citedAuthors": [ { "name": "Francesco Moroni", "affiliation": "Università Vita-Salute San Raffaele , Milan, Italy.", "citationSlugs": [ "pubmed-33175595" ] }, { "name": "Anna Subramaniam", "affiliation": "Division of Cardiology, Department of Medicine, University of Washington, Seattle, WA, USA.", "citationSlugs": [ "pubmed-41276388" ] } ] }, { "slug": "pacemaker-implantation", "name": "Pacemaker Implantation", "category": "cardiology", "description": "A pacemaker, also known as an artificial cardiac pacemaker, is an implanted medical device that generates electrical pulses delivered by electrodes to one or more of the chambers of the heart. Each pulse causes the targeted chamber(s) to contract and pump blood, thus regulating the function of the electrical conduction system of the heart.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [ "your wound gets more swollen, tender or redder – redness may be difficult to see on brown or black skin", "blood, pus or clear liquid is leaking from your wound", "your temperature is very high, or you feel hot, cold or shivery", "any symptoms you had before the procedure come back or get worse", "you have severe difficulty breathing – you're gasping, choking or not able to get words out", "your chest feels tight or heavy" ], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "overview": "A pacemaker, also known as an artificial cardiac pacemaker, is an implanted medical device that generates electrical pulses delivered by electrodes to one or more of the chambers of the heart. Each pulse causes the targeted chamber(s) to contract and pump blood, thus regulating the function of the electrical conduction system of the heart.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en", "nhs-health-a-to-z" ], "references": [ { "label": "Wikipedia — Artificial cardiac pacemaker", "url": "https://en.wikipedia.org/wiki/Pacemaker" } ], "recoveryTimeline": "After you have your pacemaker fitted, you'll feel tired for the first few days and the left side of your chest will be sore. Follow the instructions from your care team about caring for your wound, showering and dressing. They'll also give you advice about exercising safely and anything to avoid. You'll usually be able to do activities involving gentle movements of your arm within the first few days. But full recovery can take a few weeks or months. #### Do - keep your wound and stitches clean - do some shoulder exercises, as recommended by your care team #### Don't - do not drive for at least the first week - do not carry heavy objects or do vigorous exercise for 4 to 6 weeks - do not lift your elbow above shoulder height for 4 to 6 weeks\n\n*Reference text adapted from NHS UK under the Open Government Licence v3.0.*", "faqs": [ { "question": "What pacemakers are for?", "answer": "A pacemaker can be used to treat some heart conditions. These include:" }, { "question": "How a pacemaker is fitted?", "answer": "Before having a pacemaker, you'll have an assessment at the hospital. You may need to have [blood tests](https://www.nhs.uk/tests-and-treatments/blood-tests/), a chest [X-ray](https://www.nhs.uk/tests-and-treatments/x-ray/) or [echocardiogram](https://www.nhs.uk/tests-and-treatments/echocardiogram/)." }, { "question": "What happens on the day?", "answer": "You'll have a pacemaker fitted in hospital by a cardiologist." } ], "literatureLinks": [ { "title": "Complications related to permanent pacemaker therapy.", "journal": "Pacing and clinical electrophysiology : PACE", "year": 1999, "doi": "10.1111/j.1540-8159.1999.tb00534.x", "url": "https://doi.org/10.1111/j.1540-8159.1999.tb00534.x" }, { "title": "Permanent Leadless Cardiac Pacemaker Therapy: A Comprehensive Review.", "journal": "Circulation", "year": 2017, "doi": "10.1161/CIRCULATIONAHA.116.025037", "url": "https://doi.org/10.1161/CIRCULATIONAHA.116.025037" }, { "title": "Mechanisms Underlying Alterations in Cardiac Conduction After Transcatheter Aortic Valve Replacement.", "journal": "JAMA cardiology", "year": 2026, "doi": "10.1001/jamacardio.2025.4442", "url": "https://doi.org/10.1001/jamacardio.2025.4442" }, { "title": "Permanent pacemaker therapy for neurally mediated syncope.", "journal": "Circulation", "year": 2012, "doi": "10.1161/CIRCULATIONAHA.112.109280", "url": "https://doi.org/10.1161/CIRCULATIONAHA.112.109280" }, { "title": "Pacemaker Malfunction-Review of Permanent Pacemakers and Malfunctions Encountered in the Emergency Department.", "journal": "Emergency medicine clinics of North America", "year": 2022, "doi": "10.1016/j.emc.2022.06.007", "url": "https://doi.org/10.1016/j.emc.2022.06.007" } ], "accreditationsRequired": [ "jci-hospital-accreditation" ] }, { "slug": "proton-therapy", "name": "Proton Therapy", "category": "oncology", "description": "In medicine, proton therapy, or proton radiotherapy, is a type of particle therapy that uses a beam of protons to irradiate diseased tissue, most often to treat cancer. The chief advantage of proton therapy over other types of external beam radiotherapy is that the dose of protons is deposited over a narrow range of depth; hence in minimal entry, exit, or scattered radiation dose to healthy nearby tissues.", "averageRecoveryDays": 0, "typicalSessions": 0, "priceRangeUSD": { "low": 0, "high": 0 }, "keyConsiderations": [], "commonRisks": [], "questionsToAsk": [], "eligibility": [], "contraindications": [], "subtypes": [], "risks": [], "followUpCadence": [], "recordsToObtain": [], "aliases": [ "Proton beam therapy" ], "overview": "In medicine, proton therapy, or proton radiotherapy, is a type of particle therapy that uses a beam of protons to irradiate diseased tissue, most often to treat cancer. The chief advantage of proton therapy over other types of external beam radiotherapy is that the dose of protons is deposited over a narrow range of depth; hence in minimal entry, exit, or scattered radiation dose to healthy nearby tissues.\n\n*Reference text adapted from Wikipedia under CC BY-SA 4.0. Verify with a qualified clinician before treatment.*", "sourceSlugs": [ "wikipedia-en" ], "references": [ { "label": "Wikipedia — Proton therapy", "url": "https://en.wikipedia.org/wiki/Proton_therapy" } ], "literatureLinks": [ { "title": "Proton Beam Therapy for Breast Cancer.", "journal": "Critical reviews in oncogenesis", "year": 2024, "doi": "10.1615/CritRevOncog.2023050319", "url": "https://doi.org/10.1615/CritRevOncog.2023050319" }, { "title": "An introduction to proton beam therapy.", "journal": "British journal of hospital medicine (London, England : 2005)", "year": 2019, "doi": "10.12968/hmed.2019.80.10.574", "url": "https://doi.org/10.12968/hmed.2019.80.10.574" }, { "title": "Proton beam therapy in pediatric oncology.", "journal": "Current opinion in pediatrics", "year": 2019, "doi": "10.1097/MOP.0000000000000724", "url": "https://doi.org/10.1097/MOP.0000000000000724" }, { "title": "Proton versus photon radiotherapy for patients with oropharyngeal cancer in the USA: a multicentre, randomised, open-label, non-inferiority phase 3 trial.", "journal": "Lancet (London, England)", "year": 2026, "doi": "10.1016/S0140-6736(25)01962-2", "url": "https://doi.org/10.1016/S0140-6736(25)01962-2" }, { "title": "Minimal acute toxicity from proton beam therapy for major salivary gland cancer.", "journal": "Acta oncologica (Stockholm, Sweden)", "year": 2020, "doi": "10.1080/0284186X.2019.1698764", "url": "https://doi.org/10.1080/0284186X.2019.1698764" } ], "alternativeTreatments": [ { "name": "Photon (X-ray) radiotherapy", "rationale": "Established, widely available alternative; less precise dose conformity to organs at risk.", "sourceSlugs": [ "nccn-guidelines" ] }, { "name": "Chemotherapy alone", "procedureSlug": "chemotherapy", "rationale": "When systemic disease dominates the clinical picture.", "sourceSlugs": [ "nccn-guidelines" ] } ], "accreditationsRequired": [ "esmo-clinical-centre", "acs-coc-cancer-program", "jci-hospital-accreditation" ] } ]