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00:00it's not me anymore just can't accept it I worry that people might think she's
00:09gross wonder what's wrong with her I feel trapped in my skin I just want a
00:16normal life when our skin goes wrong it can really ruin lives it's extremely
00:23itchy it's like a feeling like ants are crawling all over you constantly you do
00:27not need to keep living like this we've spent 13,000 so far trying to sort this out so when
00:34people who are desperate come to see us Motti Rosie and I can't wait to help I think this
00:39will be fun to do if they've been turned away elsewhere because their skin condition is being
00:45deemed cosmetic well then that's even more of a privilege somebody has used the fact that this
00:51is a cosmetic problem more than once every skin condition is cosmetic because we can see it
00:57but there's a medical issue underlying it that needs understanding and treatment
01:02this is so heavy that's why you can't breathe through your nose and that's where we come in
01:07and squeeze deflated thank you so much wow it's gone
01:16hello she doesn't want mommy to go yeah they're gonna work
01:43thank you so much oh it's so hard leaving then
01:48so it's like the place what is it number one yeah I think it's that one over there with a big W
02:01good morning Dr. Creighton's office look at these we've got our new scrubs new scrubs yeah I have them on look at them I really like the colour oh they're really nice yeah the colour really pops on me yeah they're brilliant
02:18the condition is really embarrassing maybe somebody else could cope with it better than me but I can
02:33hello hello hello I'm Stuart I'm come to see Dr. Emma
02:43when I look in the mirror oh dear it's not me anymore
02:55I've had rosacea for 30 something years it's got worse I mean nose has got a lot bigger and there's splits in the skin
03:06used to have a lovely skin
03:09and army
03:11your face was all right there
03:13it was mate
03:15you look a bit like Sean Connery there never say never
03:17he's not happy with the way he looks
03:20who would be when your face is discharging every day
03:24he discharges out of every hole on me nose whether they're pores or what they are
03:31their stuff comes out of every single one and I'm not pressing that particularly hard
03:36some more I don't know how your body accumulates so much poison in such a small area I do feel dirty
03:46no it's all right
03:47you're right mate okay
03:49he basically it depresses me and I snap out of it with the help of me wife but
03:56Yeah, this, er, depresses me.
04:09You know, I'm a grown man...
04:13..crawling about something.
04:19Hi, this is Stuart. Yes.
04:21Nice to meet you. I'm Dr Emma. Come with me.
04:23Oh, lovely.
04:24I come in with him.
04:26Yeah, definitely.
04:27I always think two heads are better than one.
04:30OK, come on in and have a seat.
04:33And this is Mottie, he's our nurse. Hello.
04:35Hello there.
04:38OK, Stuart.
04:39What's been happening with the nose?
04:41It's rosacea.
04:43I've had it 30 years. 30 years?
04:45Yeah.
04:46And it's just gradually got worse.
04:49Now, it's closed me, nose, nasal channels.
04:54I can hear, cos your voice sounds as if it's struggling.
04:57Yeah, that's changed a little bit.
04:58Yeah, yeah. It does, doesn't it?
04:59How long has it been like this for?
05:01It's been about 18 months that one of your nostrils has been closed.
05:05Yeah, that has, yeah.
05:06Although he can breathe through one side, by the end of the day, he's like he's got a heavy cold that you can't breathe.
05:13But what is a concern is that the rosacea nail, if you just do that with it, it'll discharge.
05:19Yeah.
05:20Then you've got to clean it up again.
05:22I'm the same.
05:23What comes out of it?
05:24Is it a clear?
05:25White.
05:26White, the white stuff?
05:27OK, yeah.
05:28It's dirty.
05:29I feel dirty.
05:31I'm not a dirty person.
05:32No, it's nothing to do with that.
05:34But you feel it.
05:35Yes.
05:36And what kind of help have you had so far for this?
05:39We've been under the dermatologist in Peterborough, but they just refused to do cosmetic surgery.
05:46How did that make you feel?
05:48Well, you're disappointed, aren't you?
05:51I'm very conscious of it.
05:53Yeah.
05:54I don't kiss my wife on the lips anymore.
05:57Yeah, I wait for my snog.
05:59I won't do it.
06:00That's how I feel about it.
06:02So it's really changed a lot then with your relationship, hasn't it?
06:05And that's the truth.
06:06Yeah.
06:07I've been getting awkward and things like that.
06:09You're just depressed.
06:10Yeah, I do.
06:14I've never got used to it.
06:16Ever.
06:17In 30 years, I've never accepted it.
06:19I just can't.
06:20Is that wrong?
06:21No, it's not wrong at all.
06:23But we do need to do something.
06:25OK, I want to get in and have a look at this.
06:27Is that OK?
06:28That's fine.
06:29Perfect.
06:30OK, so this is really tumid.
06:31And by tumid, I mean kind of thick and firm.
06:40And then you've got this big bulbous bit on top of the tip.
06:46Your nostrils are fine, except this is so heavy that it's squashing them down.
06:51And that's why you, you know, you can't breathe through your nose because they're, you know, almost completely closed over.
06:58And you can also then see lots of the openings of the pores.
07:03These are the little holes that the discharge comes out of.
07:09OK, well, I mean undoubtedly this is rhinophyma, the type of rosacea.
07:14Your skin is an oilier type of a skin.
07:17That I've got.
07:18Yeah.
07:19And then what happens is, is the body's immune response reacts to the oiliness and becomes inflamed.
07:26Oh.
07:27And that action tells the tissue to grow.
07:29And this is a pretty severe case of it.
07:32It's collapsing the nose.
07:34And this is interfering with the things that you do in your day to day life, like breathing properly.
07:40What's the discharge?
07:42Is it poison?
07:43It's not poison at all.
07:45It's something called sebum.
07:47And everybody makes it.
07:48It's a really lovely substance that lubricates our skin and keeps it healthy.
07:52But you're just making more of it.
07:55But it's not a poison.
07:56It's not dirty.
07:57Nobody's ever told me that in all the years, nobody's ever explained to me what it is.
08:04Yeah.
08:06OK.
08:07So what's really important is that we try and switch off the inflammation first to stop it getting worse.
08:13And that will typically be with a tablet called isotretinoin.
08:17And then we'll do a few tests with the carbon dioxide laser to see how you heal with it.
08:24Sometimes when we use the carbon dioxide laser and we take everything all back, what can happen is is that the whole nose ends up with lots and lots of those big dipped holes in it and looks a little bit like a honeycomb.
08:39Right.
08:40And that's often not the most desirable of outcomes.
08:45So you'll come here and I'll do the laser treatment here in the test patches just to test it out to see how you heal.
08:52Because I think we have to do something.
08:54It can't keep going like this.
08:56Yeah.
08:57You're the boss.
08:58Whatever you want.
08:59Good.
09:00I like that.
09:01Everything was smashing.
09:06It really was made me feel like at last something is going to get done about it.
09:10I can just see there's a bit of hope now for it, which is lovely.
09:14The carbon dioxide laser is perfect for Stuart because what it will do is give me a very controlled depth of injury and then that's going to reduce the bulk of his tissue and start to reshape his nose.
09:28Long day, babe.
09:29Yeah.
09:30But a good one.
09:32But this is complicated because Stuart has a lot of inflammation.
09:37His nose is really thickened and those sebaceous glands, they're deep and they're arranged in a very haphazard way.
09:52Guess what we did yesterday?
09:54What did you do?
09:55Birthday party for me, Fee.
09:56Oh, you threw a birthday party for your dog?
09:58Yeah, look.
09:59It's so cute.
10:00Your presents and a card and everything.
10:01So nice.
10:08It's really busy here, isn't it?
10:09It's really busy, isn't it?
10:10Yeah.
10:12People say, look at that bloke over there with that lump on his head.
10:15You look at the state of it.
10:19Hi, I'm Steve.
10:20I'm here to see Dr. Emma.
10:21Fantastic.
10:22Just take a seat.
10:23We'll see you soon.
10:24Thank you very much.
10:25I do try to hide that.
10:26That's why I've got my glasses on it.
10:31Stop playing with it.
10:32Look at that.
10:33It's all squidgy.
10:34It's close.
10:37I think the lump has changed Steve's personality.
10:39He has become really withdrawn.
10:42He doesn't get involved in family activities.
10:44I used to go out all the time, but now I don't bother.
10:47I just stay home.
10:48I'm fed up with people going, well, how'd you do that?
10:51Hopefully Dr. Emma will take care of it.
10:53Yeah.
10:54This is my last hope now.
10:56If it can't go now, I'm just going to have to live with it.
11:15Hi, Steve.
11:16Hello.
11:17Hi, nice to meet you.
11:18I'm Dr. Emma.
11:19A little rest for your glasses.
11:20That's quite convenient, isn't it?
11:21Yeah.
11:22And this is Moti, who's our nurse.
11:23Hello.
11:24Hello.
11:25Perfect.
11:26So, I'm going to guess why you've come to see me today.
11:27Yeah.
11:28Because you've got a glasses rest on your forehead.
11:29Yeah.
11:30Do you always put your glasses on it?
11:31Yeah.
11:32It's wider, isn't it?
11:33I'm not sure it's either.
11:34I don't know, but I think it does.
11:35But tell me about this, because this is really obviously right there in the middle of your
11:36forehead, isn't it?
11:37Yeah.
11:3820-odd years ago, I was a tree surgeon and we were digging a root out.
11:42His brother was pushing the bar and I was pulling, and the bar slipped and split it open.
11:43And it was only real tiny.
11:44And that last 18 months, it's got real big.
11:45And is it painful?
11:46No.
11:47It's just squidgy.
11:48Yeah.
11:49It's just squidgy.
11:50It's just squidgy.
11:51It's just squidgy.
11:52It's just squidgy.
11:53It's just squidgy.
11:54It's just squidgy.
11:55It's just squidgy.
11:56It's just squidgy.
11:57And you always put your glasses on it.
11:58Yeah, it's wider, isn't it?
11:59I'm not sure it's either.
12:00I don't know, but I think it does.
12:01But tell me about this, because this is really obviously right there in the middle of your forehead,
12:02isn't it?
12:03And it was only real tiny.
12:06And that last 18 months, it's got real big.
12:09And is it painful?
12:10No.
12:11It's just squidgy.
12:12Do you play with it?
12:14Oh, I'm always doing it.
12:15Yeah.
12:16Have you named it?
12:17No, I didn't.
12:19Your mum did, didn't you?
12:21Mum did, yeah.
12:22What did mum call it?
12:23Richard.
12:24Richard.
12:25Is that the polite form?
12:28Yeah.
12:29Yeah.
12:34All joking aside, this is in a really prominent area of your face.
12:39You must get people just looking at it all the time.
12:41All the time.
12:42I don't work that often.
12:43All I do is go to work and come home.
12:44I don't socialise at all.
12:46Are you feeling really self-conscious about that?
12:48Yeah, yeah.
12:49I feel embarrassed.
12:50I don't look in the mirror.
12:52The only time I look in the mirror is when I have a shave.
12:54And then I try not to look in it.
12:56And you're trying to look just to where you're shaving.
12:58Yeah.
12:59Let's have a wee peek.
13:04OK, so I can see actually a little tiny scar over the top of it.
13:08And that must have been where you had this injury.
13:11It is very squidgy, as you said.
13:14The perfect squidgyness, in fact.
13:17And it's not fixed to the bone.
13:19You can feel it moving around really easily.
13:22OK.
13:23Well, undoubtedly this is a cyst.
13:28The best way of dealing with it is to just simply cut it out.
13:34Yeah.
13:35There's a tiny bit of anaesthetic.
13:36And then I gradually pop that little cyst out.
13:39And then I'm going to leave you with a scar.
13:41And it shouldn't be any thicker than the fine lines that you have on your forehead anyway.
13:46Right, yeah.
13:47Does that sound OK?
13:48Yeah, that seems brilliant.
13:49Although where are you going to put your glasses?
13:51Oh, her mum's already sorted that out.
13:54She's brought, like, little plastic hooks.
13:56LAUGHTER
13:59Would you like me to do it today?
14:01Oh, I'd be brilliant if you could.
14:02Yeah?
14:03Yeah.
14:04Come on, then.
14:05Let's go.
14:06Often people will discount benign lesions as being something that you don't need to worry
14:18about.
14:19So I'll probably just fold that along there.
14:21But this is something that is clearly having an impact on everything that he's doing.
14:26Just wriggle your wee toes for me.
14:28Lovely.
14:29Very good.
14:30He's not socialising in the same way.
14:32And he's starting to get a really negative view of himself.
14:35So I want to be able to help him by removing it.
14:40OK.
14:43I'm just going to check the area before we begin.
14:46So just you tell me if you feel anything sharp.
14:49How does all that feel?
14:50Can't feel nothing.
14:51Great.
15:02You can see it.
15:03Yeah.
15:04You can see it is.
15:05What we want to try and do is listen it.
15:13OK.
15:14Here we go.
15:22There we go.
15:23Richard's deflated now.
15:24But Steve is elated.
15:36Just taking the cyst wall out now.
15:37It's actually quite tethered to where you had that scar before.
15:49Here's the last little bit.
15:50There he is.
15:51There he is.
15:52There he is.
15:53Oh, that looks lovely.
15:54We'll pop in our deep stitch.
15:55Isn't it amazing seeing as quick as that it is gone?
16:07Where are you going to go?
16:08Where are you going to go that you would have felt uncomfortable with going?
16:20Well, go to the pub.
16:21Go to the pub.
16:22Good.
16:23To celebrate the disappearance of Richard.
16:28There we go.
16:34OK, there's the mirror.
16:35So you can just have a little look now.
16:38And there we go.
16:40Wow.
16:41It's gone.
16:42Thank you very much.
16:43Do you want to see Richard?
16:44Yeah.
16:45Yeah.
16:46Yeah.
16:47Oh, wow, is that it?
16:50Yeah.
16:51So that's the sack.
16:53Yeah.
16:54And then that's all the contents of the sack.
16:56Looks like a cauldron with smoke or something.
16:58Yeah.
17:01There's nothing there.
17:05Right.
17:06This looks very comical, but it's necessary.
17:09OK?
17:10Yep.
17:11I can't say how grateful I am.
17:13I feel fantastic.
17:14The lump's gone.
17:16How did you get on?
17:17Brilliant.
17:18Yeah?
17:19Yeah.
17:20Richard's grown.
17:21He's not gotten bigger.
17:22I'm so glad that we're able to do that for Steve.
17:24Yeah.
17:25I can go out with all my mates.
17:27I can go out to the pub and enjoy myself, no?
17:30Thank God for I'm not doing it.
17:32Oh.
17:42Hi there.
17:43Hi there.
17:44Still, we've gotten a point with Dr. Emma.
17:47These lasers are so expensive,
17:49so we need to be really careful with them.
17:52You all right, babe?
17:53Not too bad.
17:54Not too bad.
17:55The level is all over.
17:56Yeah.
17:57Today we're doing the first round of laser treatments
18:00to start to reduce the size of Stuart's nose,
18:03and if it all heals well,
18:05then we'll progress to the rest of the treatments,
18:07and I think we'll probably do about five in total.
18:09Come and have a seat.
18:11Can you see these bits that are over at this side?
18:13Yeah.
18:14Yeah.
18:15I think what I'd quite like to do today is to do this part here.
18:18Yeah.
18:19And this part here.
18:20Yeah.
18:21So we're going to try and start to narrow the sides of the nose in bit by bit.
18:25Okey-dokey.
18:26So, Mori is going to put the injections in for us.
18:33Riggle your toes.
18:34Sharp scratch coming in.
18:40Just a little bit more.
18:42Just make it as comfortable as possible.
18:45All right.
18:46That should do the trick.
18:47Okay?
18:48So, this is about reducing the bulk of the nose.
19:08So, by doing this, we've taken off this top layer of the skin.
19:12So, what we're doing here is just essentially ablating this rhinophyma tissue.
19:19So, you can see it just being heated up by the laser and essentially being sucked up.
19:27And then what you can actually see are the sebaceous glands all here.
19:31So, here they are here.
19:32If you squeeze on them, you can see the contents of it come out.
19:35That's the discharge that he's talking about.
19:38All right.
19:39So, over to the other side.
19:41So, we're just going down to just below the level of these sebaceous glands to stop the
19:54discharge.
19:55It does mean it gets riskier when you go beneath the sebaceous glands because you do more risk
20:00of scarring.
20:01And the aim is to get just below them.
20:04So, you've still got the ability for it to heal without leaving a scar.
20:08Well done, Stuart.
20:11How did that feel?
20:14Not too bad.
20:15Not too bad.
20:16OK.
20:17We can take your wee eyes off you.
20:19Hiya.
20:20Hello.
20:21I just wanted to show you what we've done before we put the dressing on, if that's OK.
20:25So, I've brought this down this side.
20:28OK.
20:29So, we've done it all in here.
20:30Yeah.
20:31And we've done the same thing on this side here.
20:34The next stage, we'll do this bit all over the middle.
20:37Yeah.
20:38And then we'll tackle this bit here.
20:39OK.
20:40You all right, sweetheart?
20:41May?
20:42What's wrong, Stuart?
20:43I don't know.
20:44You've just had it for so long, haven't you?
20:45It's a bit different.
20:46Yeah?
20:47Sure.
20:48That's OK.
20:49Is it painful?
20:50Yeah.
20:51I don't know what it is.
20:52Relieved to get it done, mate, isn't it?
20:53Yeah?
20:54It's just all the tension in the week coming out, that's all.
20:57Yeah.
20:58Yeah.
20:59Yeah.
21:00OK, mate.
21:01You're all right.
21:02You're all right.
21:03I wish I could do more.
21:04I wish I could do more in one go.
21:06But I just know it's not the right thing and I have to take this slowly.
21:10But I can start to see the shape of his nose reforming.
21:13Let's get out, Hank.
21:14Oh, oh, yeah, please.
21:15Today was quite a big step, yeah.
21:18Oh, you all right, love?
21:19Yeah, you're not too bad.
21:20The injections were quite painful, really.
21:22The laser treatment, it was pretty bad.
21:23And this was a little bit of a whoa-oh.
21:24You were a baby-a-all.
21:25It was a baby-a-all.
21:26It was a baby-a-all.
21:27What's the big step?
21:28Um, I don't think I think it was a baby-a-all.
21:29And this was a baby-a-all.
21:30It just was the grunt.
21:31And this was the baby.
21:32As an baby-a-all.
21:33That's the baby.
21:34And this was the baby.
21:35It was the baby.
21:36It was a baby-a-all.
21:37too bad the injections was quite painful really the laser treatment I found a
21:43little bit uncomfortable I'm ready ready for home he's so anxious isn't it yeah
21:50I just think that then it's gonna take time he has to not worry about the
21:55discharge is gonna come from them yeah but yeah he's he's so he's so anxious
22:07apparently we're in Fitzrovia it definitely affects my confidence a lot I've had people
22:21stop even kids say like oh what's wrong with her face hi my name's summer fantastic just
22:29take a see doctor we'll see you soon my condition started about four years ago so I was what 12 13
22:40at the time it usually comes up with quite big red spots it's very painful quite pussy it does ooze
22:50quite a lot that one's really yellow that area hurts the most near my eyebrow since I left high
22:58school I haven't really spoken to the people I was friends with because I barricade myself away
23:05just for worrying what people are gonna think summer before acne was bubbly outgoing but now she's shell
23:21all of that and it makes me really sad
23:25oh great you've already started with the bed yes yes I
23:41hi summer hi nice to meet you I'm dr. Emma come with me come on hello hi okay come on in guys
23:53okay so tell me a little bit about what's brought you to clinic today I've got quite severe acne and
24:04and we've literally been everywhere and nobody's given us anything that's worked oh dear when did
24:11when did this all start about four years ago okay so how old are you nice 16 16 so it started when
24:18you were about 12 yeah okay and it's a long time to have lots of spots on your face especially because
24:24you know you're a teenager and lots of things are about appearance isn't it yeah it is hard you see
24:30people always having something to say or looking at you in a certain way so it's difficult right well
24:35I'm gonna have a good look at your skin I can see there's lots of these tiny little essentially
24:47follicular openings but they're blocked and we call those blackheads or comedones so we have those
24:54blocks along the nose and then especially inside the ear and there's a lot of excess oil inside the ear
25:02this oil is great for our skin but when it gets a bit too much it can sometimes block the follicles
25:09which are the red spots that have got pus in them this is a perfect example of one okay very good
25:15so this is definitely an acne the first thing and the most important thing is that we get rid of the
25:25excess oil because the excess oil is the very first point in causing acne and there's really two avenues
25:35of treatment that we know that do this one is a hormone treatment it's a bit like the oral contraceptive
25:42pill works to help with the regulation of the and the hormones and then the acne as well the other
25:50option is a different tablet called iso tretinoin yeah it is a really effective treatment for acne it
26:00has more side effects yeah things like dry skin dry lips dry eyes well we went to the dermatologist
26:10before they were saying there was a lot of risks of like mental health and you would have to get
26:15regular blood tests and stuff and obviously i was a bit like nervous not quite sure if that's worth
26:20yeah the risk there is a very very low risk of um mood change on this tablet yeah are you gonna go for
26:28the second one well we'll go for the first one you want to go for the first one yeah what make do you
26:34make that choice what are you scared of what are you afraid of what's the thing that makes you worried
26:45oh i'm just don't want to take it and then get all just i know like it's not likely but almost
27:09because of the way we have to prescribe it now we talk so much about the side effects offer that it puts a
27:15lot of people off having it if we need to stop we can yeah anytime i've never admitted a person
27:21the hospital and iso tretinoin ever and we can stay on a low dose for a longer period of time does
27:28that make it easier to understand a bit i don't think i'll go for that one then i think that's the
27:37right answer i really do so i think we've got a plan haven't we and we'll get you some nice skin
27:46care as well that you can use to wash the face and moisturize but at any point you ever have any
27:52questions or you want to ask anything at all you can just message me and let me know is that okay yep
27:57i completely understand why summer finds the idea of going on to iso tretinoin a little bit scary
28:07because the side effect profile can be a little bit overwhelming dr emma was really nice she
28:14definitely took the time to explain the different options and the side effects which helped to reassure
28:21me a lot when making my decision with the right kind of monitoring most people go through this
28:28incredibly safely and the outcomes for the skin well it can be just life-changing
28:33you did really well thank you that was tough doors closing like the doors
28:46can we go again here we go again are you nervous yep
28:52i'm just looking at stuart so he's all nice to try to know and to try and calm the information down
28:57but i also started to do some ablation just to see how you would respond to it
29:01so we'll get him back look at this and then we'll do some more ablation on the rest of the nose
29:07the last time i had injections on me nose and i'm not really what you call a wimp but that hurt
29:15okay so that's good looks really good how long did it take to heal up three weeks perfect
29:23okay pop your wee head back for me lovely a wee scratch wriggly wriggly jiggly toes well done
29:32all the injections done sure you didn't even flinch that's because you could have it
29:38well i have had a bit of practice i'm sure you have
29:43should we tie it so we look like 1920s vogue models oh peanut girls yeah land girls land girls
29:50all right we're going to battle
29:58okay can you just tell me if you can feel anything sharp or sore uncomfortable okay
30:02you just move your head back there lovely thank you
30:14okay and then this is quite useful to just to see where you are in line with the sebaceous glands so
30:20there you go so we can still go deeper there i'm gonna do this bit here as well
30:32well done well done stewart that sits shrunken down nicely
30:45okay and no matter how hard you'll squeeze this now
30:51there's nothing coming out of it and i won't bother
30:55we'll see you again and then we'll make a start on the the tip of the nose well you made a right
31:05mess of me hair
31:09sore but uh i didn't feel no pain this time of search
31:14you at the beginning stewart was really anxious and scared about this whole procedure but i think
31:20now he's getting used to the environment and he's starting to see his nose come back to the shape
31:26that he remembers he's definitely starting to relax a bit more oh well babe all done all done
31:33all done for this time anyway this is going to be a lengthy process and we just have to do it bit by
31:39bit but we'll get there i've been taking the treatment for about two weeks now this is the ice
31:50dressing i'm in i've had the side effects of the dry lips but other than that i haven't had any issues
31:56and i've definitely seen an improvement this cream is quite strong but it definitely makes a big
32:05difference when i use it it must seem to feel a lot more soft there's definitely a lot less larger
32:11spots than there have been and i'm just excited to keep using it and see the difference
32:17hey it's our next patient here yet not yet but i'll let you know when they're okay
32:35this way uh that way that way so my condition makes me feel self-conscious it makes me feel
32:43like that i've got something wrong with me hopefully this is our first time in london
32:48oh yeah so it was picked up by my husband i had like a little vest top on he said
32:54what's that lump on your back and obviously it was just instant panic
32:58hi it's natasha to see dr emma fantastic just take a seat she'll be with you thank you
33:03i phoned the doctors they had a look at it and they said that because i've got bacon rolls and i'm
33:08overweight um that's why i've got this lump on my back it's very nice isn't it i do worry about what
33:17people see and what people are saying have you seen that lump on that girl's back and that's what
33:21goes through my mind 24 7 all the time
33:42hi natasha hi yeah come with me
33:44thank you nice to see you and you thank you and this is rosie he's our nurse nice to meet you
33:53come and have a wee seat so tell me what's brought you to clinic today so i've got him a bit of a
33:58lump on my back um a fatty lump okay and how long have you had it for coming up to two years now but i
34:03went to the doctors and they said it's because i'm overweight it made me boost my weight loss journey
34:08because i was so conscious of it and thinking if i lost weight maybe it'd go so you've lost a lot of
34:13weight then three and a half stone oh my gosh that is a lot yeah you lose weight to make yourself feel
34:18better but actually it looks more prominent you didn't get this because you were overweight that
34:23that wasn't there for that reason it's not about what you've been eating or your lifestyle or anything
34:28like that at all right okay that's good to know yeah and how does it make you feel then it's not my
34:32confidence and i'm just conscious of what i'm wearing all the time just constantly thinking i need to be
34:38covering it up i need to be putting a card to go on and i'm conscious of what if other people are saying
34:43what's that thing on her back yeah a very rubbish situation isn't it well i think we'll get you into
34:48a gown is that okay yeah that's perfect
34:54okie dokie let's have a look at this then oh yes we can just about see it popping out there
35:00and it's it's really quite technical term here squishy yeah um and it's not fixed at all
35:09and it extends all the way down to here in a perfect egg shape a cream egg oh yeah
35:17it is a cream egg because when it gets yellow inside oh god
35:24okay so undoubtedly this looks and feels like a lipoma okay so essentially it's a collection of fat
35:32cells and often it's held together in a very very thin capsule right but there's no way to get it out
35:39of you unless we make a little cut on the surface yeah i just gently tease the little lipoma out yeah
35:46through that little mark that i've made and then i'll stitch it up yeah so you would have a tiny little
35:52scar how does that sound yeah i'd much rather that than have a big lump on my back okay and i'm super
35:58happy to do it today or if you'd like yeah that's amazing let's go yeah
36:05your little cream egg i do love cream eggs actually you like cream yeah this might put me off now
36:11yeah i was gonna say you're gonna feel a wee tiny scratch well done
36:21okie dokie so you know rosie's just had a baby oh yeah how old she's 11 months now wow
36:31i can't believe she's 11 months like that is just nuts isn't it can you just tell me if you feel
36:37anything sharp or sore nope perfect
36:47we're just moving our way down to expose where the lycoma itself is
36:51and we're just going round listening it up
37:06ready go
37:07what's coming team work team work made the lipoma work
37:19and it's a love heart
37:25that was a very clean lipoma would you like to see your cream egg yes
37:29yes there you go oh wow god looks bigger on there doesn't it yeah wow so we're just going to pop the
37:40stitches in okay natasha's lipoma popped out just as i thought in a perfect cream egg shape we've
37:47stitched it up with stitches just on the inside so she doesn't have any marks hopefully on the surface
37:52as well of her lovely back
37:56hi yeah all done yeah all done nice i'm not going to give you a hug yeah you know i want to
38:01yeah i'm really relieved that he's gone now dr emma's lovely she really made me feel at ease
38:07right should we go and do a bit of shopping where do you want to go oxford street's not far away
38:10from here isn't it all them dresses you've been dreaming about wearing yeah be lovely
38:23hi i'm someone here to see dr emma my confidence has definitely grown i'm now looking in the mirror
38:30in the morning and just a lot more happy with what i'm seeing hiya summer hi how are you good
38:37good come with me and summer what a difference definitely a lot of improvement i didn't see it at
38:45first until i look at old pictures and i'm like wow okay there has been a bit of a change and actually
38:51i haven't seen you for a little while um and there is a big difference so do you feel her
38:56confidence is really loads yeah she's freely going out i don't remember the last time i heard her say
39:03she felt like somebody was looking at her or judging her or the last time she had a negative comment
39:09because we've had lots of positive i mean rightly so can i have a close-up look is that okay hey good
39:16this is great summer absolutely brilliant
39:27it's just so smooth now
39:31and then inside the ear that was jam-packed full of comedones is clear
39:35and all around the chin the blackheads are finished the nose looks lovely and clear brilliant
39:47okay well this is just doing perfectly and in terms of the kind of side effects because that was the
39:53thing that you were a bit nervous about what kind of side effects have you had the only ones i've had
40:01the dry lips but it did improve very quickly you were brave enough and you took the decision okay
40:08this is the right path for us a distant memory
40:13you know you've had this then for all of your um teenage years no more
40:18i'm very glad that i trusted dr mr with the side effects because this treatment has definitely
40:28changed my life bye bye thank you now i'm ready to take on the world and just excited for all the
40:35people that i meet along the way seeing me as i am now instead of how i was with my acne
40:48when i first met stewart just over a year ago he had one of the most complex and inflammatory
40:54rhinophimus i've ever seen and so i can't wait to see him back today after all of these multiple
41:01treatments where we've been refining the shape of his nose good morning i've got an appointment with
41:07dr emma stewart i've had six operations it's uh looking to treat now yeah it's fabulous
41:15now you can breathe i can hear you snoring now hi steward and pipa how are you how are you
41:24good to see you again who are you
41:30okay come and have a seat well hi both of you good to see you how's things with you look at you chirpy chap
41:39you're a bit different yeah i feel good yeah i really do
41:49this was really a complex kind of rhinophimor the problem for you was the breathing because
41:56the nose had just closed over that's fabulous now i can breathe properly it's something that
42:00you take for granted yeah don't you breathe in until you can't do it and you absolutely hated the stuff
42:06that was coming out of it oh goodness me yeah it was horrible wasn't it i just felt dirty yeah i don't
42:14have to make an appointment to the bathroom now can i have a close-up look is that okay by all me thank you
42:21oh look at the shape of it i'm so happy with that
42:34does this remind you of the nose that he had before yeah very very similar yeah it's a good nose
42:39yeah and just look at that and see right up your nose
42:48you're breathing with your mouth closed yeah very good
42:54so i i am really super super happy with how this is going for you you're really like a different person
43:01well i said you're looking a bit like sean connery but i'm more like me old still you are yeah
43:06much more laughing and yeah it's fabulous and a snob now yeah oh now she's going too far
43:17i can't thank dr emma enough for what she's done she's been absolutely wonderful and she has
43:24changed my life that's getting my train back i think yeah yeah just a job yeah
43:33no longer worried about walking outside and things like that let's have a look at you
43:40it's good
43:53so
44:01you
44:13you
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