Tag Archives: Cosmetic Surgeon

Breast reduction is a major cosmetic surgery procedure involving significant pre-operative preparation. Well-prepared patients will typically achieve safer and more effective outcomes.

During the initial consultation, the breast surgeon will discuss the preparatory steps with the patient and address her doubts and concerns, if any. Board certified plastic surgeon Dr. Bryson Richards provides breast reduction to patients in Las Vegas, NV, and surrounding communities.

Advance Preparatory Steps

The following steps should ideally be followed well before the scheduled date of breast reduction plastic surgery procedure.

• Contact the general physician, specialists and hospital for past health records to be submitted to the breast surgeon’s office for their review.
• Prepare a list of all medications, including both prescription and non-prescription drugs, blood thinners such as aspirin, herbal supplements and vitamins to present before the surgeon.
• Get any specialized mammograms, lab tests or x-rays done as recommended by the surgeon.
• Adjust the schedule of the prescription medications in consultation with the primary physician, as required.
• Stop smoking for a certain period of time prior to the breast reduction surgery, as per the surgeon’s advice.
• Complete any pressing tasks at the workplace or home before the date of surgery in order to ensure a fairly stress-free post-operative recovery phase.
• Arrange for a friend or family member to drive the patient back home after the breast reduction procedure.
• Arrange for aftercare for a few days or have someone stay at home with the patient to assist with household tasks.

Patients can improve their chances of a safer, more comfortable, and faster recovery when they follow these recovery instructions as closely as possible.

A Day Prior to the Surgery

Just a day prior to the breast reduction surgery, the patient should follow these simple guidelines, which will be provided by the cosmetic surgeon:

• Take adequate rest and have a full night’s sleep before the surgery day.
• Do not eat or drink anything for about eight hours before the surgery.
• Avoid alcohol for at least 48 hours before the scheduled time of surgery.
• Do not wear jewelry, other expensive accessories and body piercings on the day of the surgery.
• Wear loose fitting and comfortable clothes on way to the surgical center. The top should button in the front for easy handling after the surgery.
• Diabetics should make sure to have their vital parameters checked on the morning of the surgery.

Some degree of pre-operative stress and anxiety is expected a day prior to the surgery, and is not a cause for worry. The surgeon may prescribe a mild calming medication to be taken on the night before the surgery.

Pain meds, bandages, loose garments, extra pillows, and other essential items should be arranged at home in advance so that the patient will not face inconvenience when she returns home from the surgery center. Dr. Richards receives patients from Las Vegas, NV, and nearby areas for breast reduction surgery and other surgical and non-surgical cosmetic procedures.

If you would like more information on cosmetic surgery procedures and treatments performed by Las Vegas, Nevada plastic surgeon, Dr. Bryson Richards please contact us at 702.870.7070

Taking new patients from Las Vegas, Bullhead City,  Laughlin, Pahrump, Mesquite NV and surrounding areas.

Breast reduction cosmetic surgery is generally considered a safe and not a rigorous procedure, but patients should know about the potential risks associated with the surgery. Typical risks include the chance of infection, poor anesthesia reaction, and irregular nipple height. However, the potential benefits of breast reduction usually outweigh the risks associated with the surgery.

The breast surgeon will discuss about the potential risks and complications during the initial breast reduction consultation. The first goal of the surgeon will be to help the patient make an informed decision. Experienced plastic surgeon Dr. Bryson Richards provides breast reduction to patients in Las Vegas, NV and nearby areas.

Asymmetrical Breasts

One of the risks after breast reduction plastic surgery is that breasts may become significantly asymmetrical. However, if the procedure is performed by an experienced surgeon, this risk will be very rare. But if this condition occurs, it can be corrected by a subsequent revision surgery.

At the same time, patients should know that breasts are not entirely symmetrical. A minor difference in size and shape is natural, and should not prompt additional corrective surgery.

Irregular Nipple Height

Breast reduction involves changing the size and shape of the breasts and shifting of some skin. Therefore, there is a risk that the nipples will not be placed at the same height after reduction. In some cases, the nipple and areola will be detached and grafted back on the breast.

In other cases, the nipple will remain attached, but the breast skin will be altered to fit the smaller sized breasts. In both approaches, the risk of nipple height becoming uneven exists.   

Changes in Sensation

Loss of sensation in the breast is a risk following reduction mammaplasty, particularly if the areola has been removed and then grafted. Although areola grafting is aesthetically pleasing, the detachment from the breast tissue could lead to loss of sensation in the nipples.

To some extent, even non-grafting breast reduction procedures have the risk of altered sensation in the nipples or breasts as a whole. Sometimes this change of sensation may be temporary, but in rare cases, the sensation loss can be permanent.

Breastfeeding Issues

Following breast reduction, it is possible that the woman may not be able to breastfeed. The amount of risk will depend on the type of surgical technique applied for the procedure. In case of traditional anchor pattern breast reduction, the risk affecting the ability to breastfeed increases. Several milk ducts are removed in this type of reduction, making it more difficult to breastfeed in the future.

In case of vertical incision breast reduction, the risk of not being able to breastfeed is reduced. In this case, at least a part of the nipple will remain connected to the milk ducts. Breastfeeding risks in breast reduction are usually minimal if the patient has more fatty tissue and less glandular tissue, and breast reduction is performed using liposuction.

Infection is another common risk in breast reduction, just like any other surgery. Patients in Las Vegas, NV and nearby areas have an opportunity to receive breast reduction performed by Dr. Richards.

If you would like more information on cosmetic surgery procedures and treatments performed by Las Vegas, Nevada plastic surgeon, Dr. Bryson Richards please contact us at 702.870.7070

Taking new patients from Las Vegas, Bullhead City,  Laughlin, Pahrump, Mesquite NV and surrounding areas.

Breast reduction cosmetic surgery procedure can help to create more proportionately sized breasts, and at the same time, alleviate pain and discomfort in the neck, back and shoulders. Women who are considering breast reduction should learn about the steps involved in the procedure, and then make a careful decision about going ahead with the surgery.

During the initial consultation, the breast surgeon will explain the procedure steps to educate the patient and help her make an informed choice. Patients should feel free to ask questions and relieve themselves of any pre-surgery anxiety. Dr. Bryson Richards is an experienced plastic surgeon providing breast reduction to patients in Las Vegas, NV and surrounding communities.

Consultation and Preparation

Prior to the breast reduction plastic surgery procedure, the surgeon will conduct a detailed consultation. The patient will have the opportunity to discuss her personal aesthetic goals from the procedure, and have her medical history evaluate to determine candidacy. The surgeon will also provide the guidelines for pre-operative preparation to help ensure that the surgery goes safe and smooth.

Administering Anesthesia

The first step in the breast reduction surgery will be to place the patient under general anesthesia. In a few cases, local anesthesia with IV sedation may be used. General anesthesia will put the patient to deep sleep during the procedure. A qualified anesthesiologist or a nurse anesthetist may be present throughout the surgery to monitor the patient’s response. The patient may experience mild side effects of anesthesia for a few hours after the surgery.  

Incision Placement

Breast reduction will involve one of three incision techniques: an anchor incision, a vertical incision or a scarless incision. The anchor incision is a traditional incision made around the areola, vertically down the breast, and then horizontally along the breast crease.

The vertical incision is placed around the areolar border and vertically down the breast for reduced scarring. A scarless incision involves tiny incisions made at the breast crease or at the armpit, and the excess fat is removed through liposuction.

Surgical Reduction

Through the incisions, the surgeon will remove excess fat, tissue and skin from the lower portion of the breast. If the patient has largely fat tissue in the breasts, she may just require liposuction to reduce the breast size. This will result in minimal scarring, less breast tissue trauma, and reduced chances of complications.

Nipple Repositioning

In case of breast reduction, the surgeon will reposition the nipples higher up on the breast. The procedure may or may involve removal of the nipple from the breast and then grafting it in the desired place. Women with very large breasts usually require the nipple to be removed for repositioning. The surgeon will let the patient know in advance whether or not nipple sensation may be altered or completely lost as a result.

Closing the Incision

The surgeon will close the incisions using removable or dissolvable sutures. The technique used for sealing the incisions will be discussed prior to the surgery. Dr. Richards is a dedicated and standout cosmetic surgeon who receives patients from Las Vegas, NV and nearby areas for .

If you would like more information on cosmetic surgery procedures and treatments performed by Las Vegas, Nevada plastic surgeon, Dr. Bryson Richards please contact us at 702.870.7070

Taking new patients from Las Vegas, Bullhead City,  Laughlin, Pahrump, Mesquite NV and surrounding areas.

The sticker price is one of the key starting points for many women who want to receive breast reduction cosmetic surgery procedure. The breast surgeon will explain the cost aspects in detail and enable a woman to make a well-informed decision about undergoing breast reduction. The patient should consider the costs of the procedure in context of the quality standards and services offered at a particular practice.

Breast reduction costs can vary from one practice to another and even from one patient to another at the same practice in a few cases. Insurance coverage, whether full or partial, may sometimes be available in case of breast reduction surgery. Dr. Bryson Richards is a dedicated plastic surgeon providing breast reduction to patients in Las Vegas, NV and surrounding communities.

Factors Impacting the Price

The dollar figure of breast reduction plastic surgery will be influenced by several factors. Some of the key financial components that constitute the overall cost may include:

• Fee charged by the breast surgeon
• Surgical venue costs
• Fee of the anesthesiologist or nurse anesthetist
• Mammograms and other pre- and post-surgical tests
• Prescription drugs
• Surgical bra and compression garment
• Post-op visits to the surgeon’s office

Breast reduction will often be performed as an outpatient procedure. But in a few cases, overnight hospital stay may be required, which will add to this surgical episode. Other factors that will affect the costs include:

• Location of the practice
• Skill and experience of the operating surgeon
• Extent of surgery and type of surgical technique
• Need for additional procedures such as liposuction

Costs and Quality Relationship

In a few cases, the patient may get unusually low priced offers for breast reduction. The patient should treat such offers with abundant caution and conduct their own due diligence before selecting the practice just because the price appears too compelling. Such offers may entail some hidden charges, which the patient will only learn about later.

The patient should ideally choose a practice for its quality standards, the services and facilities offered, and the credentials of the cosmetic surgeon who will perform breast reduction. Safety and predictability of results along with reasonable costs should be the right factors to consider for such a major surgery. Dr. Richards receives patients from Las Vegas, NV and nearby areas for reduction mammaplasty and other procedures.

Insurance Aspect

Breast reduction is among the handful of cosmetic procedures where the insurer may cover the full or partial costs under specific conditions. If the patient needs breast reduction solely to treat medical problems caused due to excessively large breasts, she may be eligible for insurance coverage.

Nagging pain in the back, shoulders or neck, repetitive skin infections and rashes caused at the base of the breast due to oversized, sagging breasts may make breast reduction a medically necessary treatment with insurance coverage.

The patient should talk to their insurer and the surgeon well in advance. The surgeon’s office may be able to support with legitimate insurance paperwork in cases where they determine that breast reduction is medically recommended.

If you would like more information on cosmetic surgery procedures and treatments performed by Las Vegas, Nevada plastic surgeon, Dr. Bryson Richards please contact us at 702.870.7070

Taking new patients from Las Vegas, Bullhead City,  Laughlin, Pahrump, Mesquite NV and surrounding areas.

Women with oversized, sagging breasts will usually make sterling candidates for breast reduction cosmetic surgery. Excessively large breasts can lead to pain in the neck and back, limit a woman’s lifestyle choices and activities, create shoulder discomfort or indents where bra straps are support, and even lead to breathing issues.

Candidates for reduction mammaplasty will usually feel burdened by the large size of their breasts. Following breast reduction, these candidates can usually achieve a more proportional figure and renewed feeling of self-confidence and physical relief. Dr. Bryson Richards is an experienced plastic surgeon providing breast reduction to patients in Las Vegas, NV, and surrounding communities.

Candidate Characteristics

Ideal candidates for breast reduction plastic surgery will include women who are bothered by the appearance of large, pendulous breasts. The breasts will typically get in the way of their everyday activities and cause occasional or persistent pain and discomfort. A majority of woman candidates who choose to undergo breast reduction are concerned about eliminating physical pain and irritation above all else.

However, even in cases where a woman is not much troubled by the physical effects of oversized breasts, she may still want to have breast reduction to achieve an enhanced self-image – one of the several benefits of this surgery. Some women may also like to receive this procedure to fit better into clothing of their choice.

Breast reduction is ideally recommended only for candidates who are mature and have fully developed breasts. But in exceptional cases, the surgery can be performed on younger candidates if their breasts are causing significant physical hardship and pain. The procedure should not be performed on women who have plans to breastfeed because the surgery will remove many of the milk ducts that lead to the nipples.

Candidacy for Specific Types of Reduction

Women in general who want to receive breast reduction should have realistic expectations about the surgery and be knowledgeable about the surgical options available to them. With this knowledge, they can engage more effectively with the cosmetic surgeon to determine their candidacy for a particular breast reduction technique.

Women with excessively large breasts may be good candidates for traditional anchor pattern breast reduction surgery. This technique allows for a significant amount of excess skin and breast tissue to be removed than other techniques. The traditional technique is also more effective for candidates who have more glandular tissue than fat. This is often the case for women with excessively dense breast tissue, very thin women, and the ones who have not yet reached menopause.

Vertical incision breast reduction may be more appropriate for women with moderate to large breasts. Women requiring the removal of very large amounts of breast tissue and fat may not be good candidates for this method. Women with more of fatty breast tissue than glandular tissue may be stellar candidates for scarless breast reduction because liposuction can only reduce the volume of fat in the breast.

Dr. Richards receives patients from Las Vegas, NV and nearby areas for breast reduction and various other surgical and non-surgical procedures.

If you would like more information on cosmetic surgery procedures and treatments performed by Las Vegas, Nevada plastic surgeon, Dr. Bryson Richards please contact us at 702.870.7070

Taking new patients from Las Vegas, Bullhead City,  Laughlin, Pahrump, Mesquite NV and surrounding areas.

Signs of aging will first show on the face before they appear in other areas. That makes facelift a critical cosmetic surgery procedure for many people who want to extend their youthful facial appearance by several years. But to achieve best outcomes with facelift, the patient should have full clarity about the procedure, make the right choices about the practice, the surgeon and the surgical technique, and maintain reasonable expectations.

Dr. Bryson Richards is a board certified plastic surgeon providing facelift and various other cosmetic and reconstructive procedures. During the initial consultation, Dr. Richards will address all questions, concerns, and doubts of the patient in accurate details, and help them make an informed decision. Patients in Las Vegas, NV and surrounding communities have an opportunity to receive facelift surgery from Dr. Richards.

Key Questions

It is a fabulous idea for the patient to prepare a list of all the questions they want to ask the surgeon during the facelift plastic surgery consultation. Some of the important questions may include:

• Are you a general surgeon or a trained plastic surgeon?
• Do you have a board certification in plastic surgery?
• For how long have you been working in the field of plastic surgery?
• Have you previously performed facelift surgery, and what is your success rate for this procedure?
• Do you have staff privileges to perform facelift at a local hospital?
• Would you recommend a hospital or another surgical venue for my procedure?
• Is your team of medical assistants fully trained and experienced?
• Do you receive most of your patients from in and around Las Vegas, NV?
• Will I make a suitable candidate for facelift surgery?
• Are there any non-surgical alternatives to facelift?
• What according to you would be an excellent, average and poor outcome in facelift surgery?
• Can I have access to facelift before and after images of some of your previous patients?
• Can I speak to one of your staff members or take an office tour to familiarize myself with your practice?
• Would you provide me testimonials of your some of your past patients who have received facelift surgery?
• Will you perform facelift using general or local anesthesia?
• Can your practice deal with any emergency that may occur during or after the surgery?
• Will you be accessible during all my visits to your office with regard to facelift surgery?
• How much time will it take inside the surgery room?
• Will I have to undergo any prior medical tests?
• What are the risks and complications that are usually associated with facelift surgery?

Additional Tips

Before visiting the facelift cosmetic surgeon for a consultation, the patient should review their practice website, blog or social media accounts. With some amount of background knowledge, the patient will be better placed during the consultation to ask relevant questions. Dr. Richards receives patients from Las Vegas, NV and nearby areas for facelift surgery and various other surgical and non-surgical procedures.

If you would like more information on cosmetic surgery procedures and treatments performed by Las Vegas, Nevada plastic surgeon, Dr. Bryson Richards please contact us at 702.870.7070

Taking new patients from Las Vegas, Bullhead City,  Laughlin, Pahrump, Mesquite NV and surrounding areas.

Breast reduction is major cosmetic surgery procedure that will involve a considerable recovery time. The patient should know in advance about the estimated downtime and period of full recovery in order to prepare appropriately for it. Board certified plastic surgeon Dr. Bryson Richards provides breast reduction to patients in Las Vegas, NV and surrounding communities.

Immediate Post-Op Phase

Following the breast reduction procedure, the surgeon will place drains below the skin in the incision areas to prevent fluid build-up. The drains will remain in place for about a week, and the surgeon will provide specific instructions about emptying the drain every day and measuring the amount of fluid collected.

The breasts will be wrapped in sterile dressings immediately after the breast reduction plastic surgery. These may have to be changed after one to two days, and will eventually be replaced with a surgical bra. The patient will be required to wear the surgical bra for several weeks to support healing.

First Two Weeks

Mild bruising and swelling will occur after the surgery, but will gradually subside over a few weeks. The surgeon may recommend the use of a moisturizer over the breast area to mitigate dryness and itching, while avoiding direct application over the incisions. If the surgeon has placed removable stitches to close the incisions, these may be removed around the end of first week along with the drain tubes.

Heavy lifting of weights, excessive bending, strenuous exercises and other vigorous activities should be avoided for at least two to three weeks after breast reduction. Depending on their profession, most patients can return to work in about 10 days after the surgery. Sexual activity should be avoided for at least one week or more because sexual arousal can lead to inflammation in the incision sites.

First Few Months

The patient should ensure that any contact with the breasts is gentle for the first one to two months following breast reduction. During the first menstrual period following the surgery, the breasts may swell and become tender. Some women may experience intermittent pain in the initial months, particularly during menstruation. Mild pain meds may be prescribed by the cosmetic surgeon to make the recovery process more comfortable.

Altered sensation may occur in the nipples and incision areas following breast reduction. Some women may experience numbness in these areas for up to a year, while some others may complain of hypersensitivity in the breast area. In most cases, these changes are temporary and will resolve over time on their own. Dr. Richards receives patients from Las Vegas, NV and nearby areas for breast reduction surgery.

Long-term Recovery

Breast reduction surgery will typically involve significant disruption of the breast tissue. Therefore, it may take about six months to a year before the swelling is completely resolved. Full results of the surgery will become apparent only at that stage.

Breast reduction scars will appear red and lumpy for several months before they start fading to thin white lines. Patients who follow all recovery instructions of the surgeon will be able to have a safer and faster recovery.

If you would like more information on cosmetic surgery procedures and treatments performed by Las Vegas, Nevada plastic surgeon, Dr. Bryson Richards please contact us at 702.870.7070

Taking new patients from Las Vegas, Bullhead City,  Laughlin, Pahrump, Mesquite NV and surrounding areas.

Breast reduction, clinically called reduction mammaplasty, is a cosmetic surgery procedure to reduce the size and volume of excessively large breasts to make them more proportionate to the rest of the body.

Although many women choose breast reduction for cosmetic enhancement, but it may also be a medically necessary surgery for some women who experience persistent pain and skin rashes or irritation due to oversized breasts.

Problems with Oversized Breasts

Overly large breasts will not just compromise the body’s balance and proportion, but also cause difficulties in the execution of some types of physical movements, sports activities, and simple acts involving bending. A lot of women with this problem are reluctant to wear tighter clothes of their choice, and feel embarrassed about their body in social settings.

Excessively large breasts may also create medical issues such as frequent pain and discomfort in the back, shoulders and neck. Rashes or skin infection may occur in the breast fold or crease. Board certified plastic surgeon Dr. Bryson Richards provides breast reduction and various other cosmetic and reconstructive procedures to patients in Las Vegas, NV and surrounding communities.

Candidacy

Breast reduction plastic surgery procedure may be recommended to healthy woman who is bothered by the appearance of very heavy and pendulous breasts. Some of the candidates may not have a cosmetic concern, but may be suffering from physical discomfort or movement limitations, or may feel self-conscious in their social life due to their overly large breasts.

A magnificent candidate will be a non-smoker or committed to refrain for smoking for a certain period prescribed by the surgeon. She should have a positive mindset, clear aesthetic priorities, and realistic expectations. She should also be dedicated to maintaining a healthy diet and active lifestyle after the surgery.

Procedure

After placing the patient under anesthesia, the cosmetic surgeon will begin the breast reduction procedure by making an incision in an inconspicuous location as per the pre-determined surgical plan. The incision may be placed around the areola or created in a keyhole pattern. Vertical or anchor shaped incisions may be used depending on the extent of fat tissue to be removed.

The surgeon will then remove the excess breast fat tissue through the incision and excise the loose skin. Underlying weak breast muscles may be tightened in a few cases. Resizing of the areolas and repositioning of nipples may also be performed. The surgeon will suture the breast tissue deep inside to support the new breast shape.

Following the breast reduction, the surgeon will carefully close the incisions with removable or dissolvable sutures. Dr. Richards receives patients from Las Vegas, NV and nearby areas for breast reduction and other surgical and non-surgical procedures.

Recovery

Within a week to 10 days after the breast reduction surgery, most patients will be in a position to return to their regular daily activities or go back to work. Bruising in the incision areas will subside from the second week, but swelling will dissipate gradually over a period of several weeks or months.

If you would like more information on cosmetic surgery procedures and treatments performed by Las Vegas, Nevada plastic surgeon, Dr. Bryson Richards please contact us at 702.870.7070

Taking new patients from Las Vegas, Bullhead City,  Laughlin, Pahrump, Mesquite NV and surrounding areas.

Breast revision is usually a more complex procedure than the primary breast cosmetic surgery. The patient may seek this procedure if she is dissatisfied with the aesthetic results of the primary surgery, or a complication has developed with the breast implants. The surgeon will educate the patient on all aspects of breast revision during the initial consultation.

Many surgeons prefer to present breast revision before and after photographs at the time of initial consultation. The first goal of the surgeon is to help the patient make a well-considered decision about breast revision. Board certified plastic surgeon Dr. Bryson Richards provides breast revision to patients in Las Vegas, NV and surrounding communities.

What are Breast Revision Before and After Photographs?

Before and after photographs in case of breast revision plastic surgery refer to a pair or group of pictures belonging to a previous patient who has undergone a similar revision procedure with a satisfactory outcome. The photographs include pictures taken before the surgery and after the surgery at a stage when the bruising and swelling in the incision areas has been completely resolved and full effects of breast revision are visible.

The breast surgeon will take care to ensure that breast revision before and after images are obtained with the full consent of the patient and shown to new patients in an appropriate manner. The patient’s identity may be kept confidential as required. The only purpose of the surgeon in this exercise is to use these photographs as a visual aid to explain the potential effectiveness of breast revision to new patients.

Advantages 

When a patient is considering breast revision surgery, she is more likely to be apprehensive about the outcome because she already had an undesirable result in the primary procedure. To reassure her about the revision procedure, the surgeon may make use of breast revision before and after photos.

Some patients may require minor improvements following breast lift or breast reduction, while some others may need breast implant removal or replacement following breast augmentation. The procedure and the outcomes in each case will vary, and the surgeon can help the patient to make best decisions with the help of breast revision before and after photos.

Maintaining Realistic Expectations

At the time of breast revision consultation, the cosmetic surgeon will be more careful about explaining the limitations of the revision procedure, and how far it may help to correct the problems caused by the primary surgery. The patient will be able to appreciate the results much better when she has realistic expectations.

Therefore, experienced surgeons prefer to present breast revision before and after photos at the very first consultation to let the patient know clearly what the procedure can or cannot do for her. This mitigates the risk of any disappointment occurring at a later stage for the patient. Dr. Richards receives patients from Las Vegas, NV and nearby areas for breast revision.

The plastic surgeon also has the option to present breast revision plastic surgery before and after photos on their practice website to provide free online access to the photos to new patients. Now patients can make vital decisions based on valuable information they can obtain from the comfort of their home or sitting down with their laptop at the nearby grocery store at the interior coffee shop. With vivid website pictures, patients can make more informed decisions without taking up so much of the surgeon having them explain to them the procedure.

Digital technology has altered the landscape of so many industries and the plastic surgery community is one of them. Now patients do not have to rely on picture books, the spoken word, or some brochure that only offers a glimpse on what breast implant surgery is really about and what it entails. Now patients can have a clearer reference point and a better understanding on what they are signing up for.

If you would like more information on cosmetic surgery procedures and treatments performed by Las Vegas, Nevada plastic surgeon, Dr. Bryson Richards please contact us at 702.870.7070

Taking new patients from Las Vegas, Bullhead City,  Laughlin, Pahrump, Mesquite NV and surrounding areas.