Richard Baker Blog

What is arthritis of the thumb?

Arthritis at the base of the thumb is very common particularly, in women over the age of 40 years old. It’s probably caused by weakening of the ligaments over the years through exposure to estrogen which is the female hormone. Weakening of the ligament means the thumb partially dislocates from its joint on the hand leading to wear and tear of the cartilage which is essentially what arthritis is. It leads to new bone formation, causing spikes of bone which can dig into the surrounding flesh and causing inflammation of the tissues around the joint. This leads to pain but also to deformity of the joint and reduced range of motion, strength and function. In many patients it’s painful for a few years and then burns it’s self out. In other patients, it’s persistently painful and these patients require treatment. The main treatment is avoiding activities that cause pain but also wearing splints at times of exacerbation of pain, taking pain killers, both tablets but also creams and gels which can be applied to the skin, steroid injections where the steroid is injected directly into the joint under a local anaesthetic, sometimes it’s necessary to use ultrasound on an x-ray machine to ensure the needles are in the right place, very often this can be administered in clinic. Often the joint is more painful after a steroid injection for a day or two and it can take several days for the steroid to kick in and can last up to six months. Steroid injections can be repeated over time and tend to last for shorter and shorter periods. We’re not quite sure why steroid injections work but steroids dampen down inflammation and inflamed tissue is painful.

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Richard Baker Blog

Who are seeking breast uplift and implants?

This week I’ve seen several patients who are seeking breast uplift and implants. Otherwise known as augmentation mastopexy. It strikes me after seeing several different types of patients requesting this surgery, that there are two main groups of patients who request this but actually need slightly different operations. The first type of patient is a woman who’s had children and has breast fed and has lost volume, such that the breasts have then become deflated and droopy. These patients require a small implant to restore lost volume particularly in the upper part of the chest as well as a lift to tighten up the skin and reduce the droopiness. As a small implant is being used and no breast tissue is being removed, this can be safely performed in one procedure.

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