Curing Hemifacial spasm: Botox or surgery? Dr. Jaydev Panchwagh. 2021
Vložit
- čas přidán 10. 06. 2021
- Curing Hemifacial spasm with MVD surgery is a choice that has to be made with full knowledge that Botox is a temporary solution. Dr Jaydev Panchwagh, a neurosurgeon with more than 22 years experience and dedicated to pursuing Microvascular Decompression throws light:
Hemifacial spasm is not as rare as one might think it to be. It is caused by a blood vessel compressing the facial nerve in most cases. Cure for Hemifacial spasm can only be through surgery. Botox injections offer only temporary relief, while the root cause for the spasm continues inside the brain. Watch the video to know more about Botox injections for hemifacial spasm treatment versus Microvascular decompression surgery.
Hemifacial spasm symptoms:
Eye twitching, eye vibrations, cheek twitching, cheek vibrations, face cramps, involuntary movements of face, lip twitching, face being pulled to one side without control are some of the ways in which patients who suffer from hemifacial spasm describe its symptoms.
Hemifacial spasm Treatment:
Microvascular decompression surgery is the most effective and permanent treatment available at present for hemifacial spasms. MVD surgery is a brain surgery, performed by Dr Jaydev Panchwagh who is a top neurosurgeon for treatment of Trigeminal Neuralgia and Hemifacial spasm.
You can watch more videos on hemifacial spasm from our hemifacial spasm playlist:
• Hemifacial spasms- Mic...
00:00: Introduction
00:26 : why Hemifacial spasm occurs
03:09 : How Botox works?
03:42: blood vessel and facial nerve
5:31: Effect of botox
06:35: Why botox is not right
07:18: Depression because of hemifacial spasm
08:52: Botox and MVD surgery comparison
10:00: importance of experienced surgeon
11:18: MVD Centre in Pune
Dr Jaydev Panchwagh is a world-renowned neurosurgeon based in Pune, India. He has many national and international patients (from USA, Mauritius, Middle East, Philippines, Bangladesh, Myanmar, Kenya, Nigeria), who come to him for treatment of both Trigeminal neuralgia and Hemifacial spasm, among others like brain tumors, brain aneurysms and spine surgery.
He is director of the Advanced Brain and Spine surgery Centre, Pune. He is also founder member of Synapse Brain and Spine Foundation, India.
This film is uploaded by synapse brain and spine foundation for students, science enthusiasts and patients for education purpose.
You may please visit our website neurosurgerypune.com
The helplines for any questions or for appointment with Dr Jaydev Panchawagh are +91 9011333841, +91 7720948948 between 9am and 5pm Indian time.
E-MAIL: brainandspinesurgery60@gmail.com, brainspine66@gmail.com
Disclaimer: This Video is only for educational Purposes, all views expressed are personal. There maybe differences of opinion. Viewer discretion is advised. All viewer decisions are their responsibility.
Please consult the doctor personally for treatment. Videos cannot replace consultations.
#HemifacialSpasm #HemifacialSpasmCure #HemifacialSpasmTreatment #BotoxFor Hemifacialspasm #DraydevPanchwagh
~-~~-~~~-~~-~
Please watch: "Dr Jaydev Panchwagh"
• You did not know this ...
~-~~-~~~-~~-~ - Věda a technologie
Actually Botox worked only for temporary about 2 to 3 months only for me. So for the permanent cure I decided to choose surgery with you experience doctor for hemifacial spasm which I did it and getting spasm free since last 2 yrs. I’m very satisfied with you doctor & your entire team. Thanks a lot 🙏🙏🙏 all the way from Nepal 🇳🇵.
Thank you so much for your words of encouragement for other sufferers. Happy to recieve your feedback!
how much it cost for your surgery..?
Berapa kos bayarannya bang.
@@brainandspinesurgery surgery karne ke liye kitna price lagata he
@@brainandspinesurgery I am wondering any age group for surgery.My mom in law suffering for this 6 years .She is 70 now .
Thank you so so so much for this video,. I would have never known about any of this knowledge,. My neurologist never explained this to me , that I had options. And after watching your video I had so much knowledge he was taken aback by this ,. I opted to have the MVD surgery,. I had a hard recovery but it was so worth it. I'm almost symptom free,.
It's been about 2 months now. I still have headache but I'm getting better.
Because of you I am smarter. Hahaha. My doctor was surprised how I knew the information you provided. I showed him your video.
I'm 56. Didn't want to wait until I'm old er
Thanks for sharing important and useful information 🙏🏻
🙏
Thanks for sharing useful and very important information Sir 🙏
Well said Docter..Thank u
THANK YOU
Thnku Sir... You made our mind clear. Really we feel embarrassing in many situations because of hemifacial spasm
Yes, I understand that. Best wishes to you
thanks Doc, this is very informative! helps me decide to go for MVD. God bless!
Thank you
Glad you found it useful. All the very best to you
@@brainandspinesurgery dear Doctor I'm having since 3 weeks ago. Any suggestions? Thanks
@@mariammakame6184hey bro I am in same condition, please suggest something
I like the explanation given regarding the botox treatment ,which is very true as it is only a short term help which in the long time it worsen the condition .I am 78 years and most of the time my Neurologist will advise me that this is not life threatening and it is too risky to go for a MVD. What is your opinion? ,as I am still healthy and go about daily .Some muscle relaxant drugs does help me in someway. I hope Dr.can give some advice in my case.
I never thought I would share my experience on a forum like this. But after 5 days surgery still 100% free of spasms, I am very happy I took this next step. 10 years HFS of with 8 with Botox, at last I feel free. Spread the news Dr Jaydev , you made it easy to understand.
I am so glad for you! Education about treatment options available is an important task, as many are unaware of surgery!
@ Dr Jaydev I was aware, but afraid of taking the next step. And that wasn't necessary , it went all very well, think it was a 2 hour operation.
@@brainandspinesurgery doctor I’m from Nepal I tried to explain my problems through WhatsApp but I found no response. Pls suggest me where I can get this surgery near Kathmandu Nepal?
@@namitachemjong8868 please write a message again...I am sure that it must have been an oversight.
@@namitachemjong8868 we have many patients from Nepal
Hello doctor, what is the different between meige syndrome, blephorspasm and hemifacial spasm?
What is the cost of this surgery? I have no insurance, and I need to get this fixed.
I am in Georgia USA. I was diagnosed with HFS. I cannot find a surgeon that does decompression surgery. Do you have any suggestions?
I am suffering for last 5 years. Can you pls tell me the details about the surgery ?
I registered for DrPrx last week on Friday to have a consultation with you online. Hoping to hear from you this week please. I'm really suffering. Jane Nganga
SURE. MY TEAM WILL COORDINATE
what if you are having spasms in other parts of the body too? Like your feet? Could this be a similar issue of blood vessel elongation?
Hi doctor. Mine is very severe. Pulls my mouth many directions where are you located at ?
Hello sir,I hv been suffering from hemifacial spasm for more then 10 yrs and take botox ...so can i still undergo for surgery?
O. K. Thank you sir
What type of risk is involved? Please kindly guide
Good morning Dr
5 months ago I had undergone hemifacial spasm and now continuously dizziness occurs when I am taking vertin16/stugeron 25 dizziness
Is more .So what should I do.
Hello, I am from the U.S. I have had HFS for years that initially started under my left eye and has progressed to my left cheek and mouth. It is not extremely visible and is not impacting my ability to open and close my eye, but it is a distraction when I am trying to focus and do detailed work. I am in medicine and do very fine work in aesthetics, so distraction is highly undesirable. Although my case is not severe, am. I still a surgical candidate? Secondly, can HFS cause headaches? I seem to get them frequently. Thank you so much.
VERY SEVERE HFS CAN CAUSE HEADACHE BEACUSE OF MUSCULAR OVERACTIVITY. MILD SYMPTOMS LIKE YOURS ARE HIGHLY UNLIKELY TO DO SO. HAVE YOU GOT AN MRI DONE? YOU WILL HAVE TO WEIGH THE RISKS/BENEFITS OF SURGERY WITH THE INTERFERENCE THAT HFS CAUSES IN YOUR PROFESSION...HOWEVER, IF IT IS TOO EARLY, WE WOULD ADVISE YOU TO WAIT A FEW MORE MONTHS TO SEE WHAT HAPPENS TO IT.
hello Dr. Jaydev is there any complicate after surgery in the future?
Will it come back?
surgical complications are usually seen in the first few days, very rarely later. World over the recurrence rate of hemifacial spasm after MVD surgery is low
Hoping you will have a medical mission in the philippines. . We have a lot of cases regarding hemifacial spasm. . .thank you
i hope they will make a medical mission here also in Cebu.. i am a patient of thia desease... i am 65 y.o. already...
i dont know what to do..
hoping they will be here..
Sir, where are you located... I've 0 social interaction, no friends.. no social performance... I have socidal thoughts... I want to know if i can get this treatment? What's the cost of the operation?
Sir is Botox for synkenesis as a result of Bell’s palsy ok?
I can speak from experience.. I thought this stemmed from alcohol abuse prior to me getting sober 93 days ago. Symptoms have not diminished and its a nightmare on a daily basis. Speaking to people and having to apologize for my face twitching is awful. Have an appointment with my nuerologist tomorrow thankfully.. Thank you for the informative video
most welcome. I hope you get better
How are you doing now?
@@christylee35004 I went through step one. Has the Botox injections 2 weeks ago. The spasms have ceased but I developed a bit of a droopy eye lid. Next time they will apply a little less inwas told.
Doctor I have this condition it’s bad I had it for 12years I’m 85years old could it help me I need help.
Should we consult neurology doctor?
I have same problem . Many years ago plz how can i this treatement
Where is your clinic ?
Hlo dr.
My mother nu a problem c from last 7 years Sanu Kise dr. Ne pehla dsya c operate bare we start injection but now operation is done but face hje thik ne Hoya blinking band ho gyi par hje face shape correct ni Hoi o pehla vag he Hai a ke o thik Hou hun k ni 1 month Hoya operation nu
My first botox treatment didn't work at all, waiting for 2nd appointment end of January 2023
I diagnosed as essential tremor...now iam 41 year old
I want to ask if there is any procedure to do it to remove my essential tremor.
Hi Dr my mother is having sharp pain on left side of face. Her eye keeps blinking and smaller all time.Her left side of face looks pulled in upward direction.What treatment do you suggest her?does she need to go through mvd surgery
As you might well understand, I am unable to answer this based on your one sentence. She will need a consultation and history-taking. Please call us on +91 9011333841
This info is so helpful! Anybody from SA that had the surgery done?
Yes..she is now a citizen of Australia
i have synkensis ...what is treatment .
Hi sir, my name is Amrutha and I am from andra Pradesh. My age is 25 years and I am a software engineer. I am suffering with hemi facial spasam health issue from last 2 years.I used some medicines but not cured. Can you please reply in this age can i take any injection or surgery?
Is regular face exercise can do something
How much does the surgery costs doctor?
is it very expensive? i am from the Philippines.. i sufferred this hemifacial spasm... long time.. i am senior citizen..
how much is the cost of operation
Thanks a lot for your valuable information. I am a patient with HFS for the past 10 to 11 years. It's a terrible situation. When I consulted a neurologist he advised me to take botox and he gave me some tablets to relax the nerves. Like you say these are only external cure. After 2 months of botox again the twitching starts. If you were in sri lanka I would have done the surgery. But now like you say it's too late for surgery and am 69 years old. What do you suggest me to do. Very worried about this condition.
69 is certainly not too old if you are otherwise medically fit. Of course the choice and decision is yours and yours alone!!
@Eva Soliz just undergone my hfs surgery, after 10 years spasms, not one single spasms since then. Now having both eyes back . I'm sure I do it again if necessary and shall not wait one day to make a new appointment. But I hope it stays with this first one. Greetings
I have HS and I get Boxtox treatment every 3 month but it come and go. and now my mouth is twitching. Dr said the Surger very high risk you can dead from it .
I got MVD done 8 months ago and the spasms were absent only for 6 weeks and after that the spasms with one side of muscles crunches cam back with full vengeance. i am so fed up with the condition that my social, professional and personal life is so badly effected that i am contemplating meeting my maker as soon as possible.
you must consider getting in touch with an experienced team. Please remain strong
pubmed.ncbi.nlm.nih.gov/33862595/
An alternative to this invasive surgery!
Sir, I have on question
As u said with age muscle will elongate.
In surjary we are seperating them
But in future it will elongate more
So is there changes that it will touch nurve again and start spasm
Muscle does not elongate. Blood vessels do. The aim of inserting a teflon sponge between the blood vessel and nerve is to try and prevent this from happening again. Besides, where possible, we straighten the blood vessel and give it a different direction if possible
how do I get this surgery???
thank you doctor. As a 10-years-sufferer from hemifacial spasm I always hesitated to get botox. I'm still trying to live with it.
oh, have you not been offered mVD?
I had a failed MVD surgery and my spasm never stopped and it’s been over a year now since my MVD, do you do redo MVD surgeries? I know the risk is higher for a second surgery but I need these spasm to finally stop
Yes, I do perform Redo MVDs
@@brainandspinesurgery
dear
sir I have hemifacial spams bouth side but its not severe pain
I don't why Pakistan is deprived from such talented doctors
Treatment charges
Doctor I have tmd issue and severe pain in right side of my face.. plz suggest should I go for surgery? I texted also on your WhatsApp number .
Morning doktor, pada bln march 2021 aku terkena hemifacial aku ada berjumpa ke doktor. Sampai skrg aku belum ada buat apa2 pada wajah ku sebab doktor pun entah aku pun kurang pasti, sekarang aku sangat susah untuk bercakap lama2 atau membaca lama sebab aku ada rasa ketegangan pada leher seakan ada urat yg tertarik ini menyebabkan aku kalau mahu membaca dgn cara memperlahankan gerakan bibir kalau tidak ia akan menyakitkan urat leher ku, menyebabkan aku dalam keadaan risau berfikir macam2 spt stress kadang2 malas mahu berbicara disebabkan bila membuka mulut sahaja bibir akan melencong ke kanan dan urat leher rasa tertegang, minta nasihat daripada doktor apa yg harus aku lakukan. Terima kasih doktor.
Awak org mn?
@@86knsyamimi Kita dari Swak.
Doctor, is the lasic operation in the eye could lead to hemificial spasm? I did it 4 years ago and now i have a hemificial spasm on the right side?could u tell me what to do doctor please?
It is highly unlikely, near impossible for lasik to cause HFS. It might be coincidental
Hello sir am a 58 yrs old retired nurse. Iam having HFS since 2006 ( mild ). Taken botox totally 4 times.As there is no nerve compression in my both M. R. I.'s M. V. D. Is not indicated (opnion of neurologist ). Last botox was taken in Dec 2020 but still I get occasional H. F. S.what is your opnion in my case? Is M.V. D. Could be helpful? Kindly advice
I think you will need a consultation with me, only then we can decide the way forward. Please call on 9011333841 to my team coordinator for arranging this.
@@brainandspinesurgery hello sir am having HFS for 6years now my MRI proves normal my neurologist kick against Botox injections medicines aren't helping either am from Ghana how do I have appointment with you and how much does it cost 🙏
This morning, my 6 year old son face did this smh I don't know how I feel 😔 😪.
This is exactly how my face looks like. I had it for almost 2 years. I had 2 MRI’s which both have normal results so the doctor couldn’t figure out what’s wrong with me. They said maybe I’m just stressed. It is very embarrassing. It affects my job, my social life, and I really get depressed at times. I tried chiropractor and acupuncture too but nothing helps.
We know!! why dont you ask your doctor for this option?
Ask for a referral to a good neurologist
Thanks. What are the causes of having hemifacial spasm? I’m trying to figure out how I got it. I don’t remember doing anything different before it started. Just one day my left eyelid started to twitch and then my left lip then my left face. And the twitching got stronger as day goes.
@@brainandspinesurgery dr please how can i get contact with you .. I live in UAE and i want to take your opinion for my case .. i have himi facial spasm 3 years ago .. i want to send you my MRI report to know if you can accept my case or no?
@@rashahelal9243 how's your health now
I have face twitching and crambs like on the right side of the face, i haven't had blinking of eyelids, is it the same as hemifacial spasms. My spasm last for 5 to 10 mins near my lip side specially and more on the right side.
Need to see your video. Please contact on 9011333841
Is there any doctor who done this operation in Pakistan i m suffering this problem and feel depressed because of this
Sir I have twitches while speaking brushing grinding food I have cervical spondylosis so nerves pinching and compressing become regular I scare of having Hemifacial spasms pl advise sir
Fear does not help anybody. Please consult a doctor
Thanks for the informative video. I wish I could travel to India and meet you. I'm having hemifacial spasms and willing for MVD. I'm fully aware of this rare disorder. Is there any advice you can give in managing this disease. I'm afraid I can't even afford it. Thank you
We can see what we can do to help you. In the meanwhile, you can write to us on whatsapp on +91 9011333841
@@brainandspinesurgery Thank you. It's really encouraging that someone like you understands what I'm going through.
I also started experiencing this the last month. It’s slowly getting worse. I wish I could travel there but I don’t have a passport 😔
Nashville Tennessee see Dr Ulm about MVD surgery
I have hemifacial spasm for about 7 years now. I had surgery done and it was the wrong one. Then I had it done again and they put cotton in and not sponge and it came back in 7 months. Do you think because cotton was use not sponge is the reason it came back? I need help
I’ve have this condition and it’s an awful. I’ve been on Botox treatment since 2016. Would surgery still be an option?
Most certainly yes...but from an experienced team.
Dr. I have HFS since1year, and i consult a neurologist, and MRI, Angiogram he advised, in that, one nerve touches other, when it impulses, he changed so many medicine s, but i have no relief it is increasing, now he told me after 2months will start botox injection, now i watched your vedio i think I won't take botox. Dr, iam in Kerala, what is your advice for me. And these medication s am very tired also, iam 54 year old lady. Ihave a history of CA Brest, since 19 years. Complete ly cured. In MRI, no evidence of tumor. What i will do🙏
Why don't you contact my team on 9011333841 on whatsapp. They will surely guide you
Hi Doctor
Can microvascular decompression surgeries for hemifacial spasm can be done more than once or twice?
My sister had 2 Brain surgeries but the spasm is not going away..
Third MVD is rarely done.
I am experiencing this HFS..almost 3years.. started with few involuntary.. but now the spasm getting more wjrst.. i wish MVD is available here in the Philippines.. i am just curious of how much it will cost to have this surgery?
me too from Cebu.. 3 years already i suffered this kind of desease😭
Hello doctor, i get some twiches on my chin while i speak, so is this also hemifacial spasm ?
highly unlikely. keep a close watch
sir i am in Pakistan how can i contact with you.
What is cost of surgery and are tablets/medicine are useful in treating this problem.i am 39 year old from mp and having right hemi facial spasm from last 6 months.
Medical treatment is usually not helpful, but can be tried initially. Please contact us on 9011333841 on our helpline to know more about this disease
Can excessive caffeine cause hemifacial spasms?
Surgury k liye kitne price hai
I've been diagnosed with hemifacial spasm but my MRI scan didn't show anything. Am I still qualified for this surgery?
If CISS sequences of the facial nerve have been done, I would like to see it. It is possible that somebody who is not regularly dealing with hemifacial spasm may miss small blood vessels causing compression.
I need this- my lower lid on the right and upper lid on the left keep twitching!! It’s sooo annoying. 😫😫😫😫😫
I understand
Doc i am suffering from hemifacial spasm for 13 years. How can i meet you doc? Thanks. Im fom ilocos sur Phil.
Thanks ...do send us a whatsapp message on +919011333841 or +91 7720948948
Sr I have this problem for the last 19 years I want to know that if it is possible to get rid of this problem
Yes, of course!!
Doctor, please recommend a place in Dubai where I can get Hemifacial Spasm treated.
People from Dubai come here for treatment
Sir surgery fees
Hello sir, I am 24 yrs old my lower eyelid twitches not strong but normally and its been a week and also in the middle of bows a little twitch do I need to go to doctor?
please observe..you can always visit a neurologist
@@aditisharma3900 I’m only having a little weak twitching on cheek area….
I just had surgery done. The left side of face is has feeling but no movement. What majority of cases have facial paralysis on left side and what percentage will have facial movement return? Is this temporary?
facial palsy is most likely temporary, but your surgeon will be the best person to advise you on this, since he/ she is most likely to know!!
@@brainandspinesurgery thank you for your input.
@@brainandspinesurgery2:14 2:14
AoA
Dr meri mother ki age 45 ha unhy HFS diagnose hua ha to kia sugery best option ha ? Or kia apsy consult karna possible ha?
Aap whatsapp kar sakte hain
My husband is suffering from eye twitching problem. Neurologist said that it is meige syndrome. What is its permanent solutions. He is on medication but not getting much relief.
Botox MAY give relief briefly if it is meige syndrome. Sorry to hear this
Sir Kitna kharch lagega surgery me
Impartial lacture and from dedicated Dr. Pain talking Dr.
thank you
Esi card se tritment hosekta h
Dr is there anyone here in the states that is able to perform this surgery or do I have to travel all the way to India to see you or a member of your team?? I'm experiencing this inconvenience now at 45. It's been going on for about 1-1/2yrs
I am sure there are a few places in the USA which do this surgery. If you do not have insurance or if your co-pay is high, you might realise that its cheaper in India!!! You may contact us on +919011333841 if you have any queries, on Whatsapp
@Jacqueline Dr. Joshua Bederson at Mt. Sinai is where I’m trying to go. Mine are horrific and on both sides of my face. I’m seeking treatment now. I have permanent facial paralysis following 2 middle fossa craniotomies in under 8 months. I feel like I’m trapped in hell.
Same problem with me I have clear reports of MRI and ct scan yet I have been suffering from Right side hemifacial spasm for 2 year please suggest me any treatment for is this mvd ??? And now soooo much medication doctors suggest me for botox ..also I have cluster headache on right side . please tell me ???
please contact 9011333841
I’ve been trying to get the number on WhatsApp but can’t. I’m in Jamaica and I start experiencing these spasms 2 weeks now. Please advise
have you tried sending a whatsapp message?
My friend is suffering from this problem What foods he need to avoid Can he have non vegetarian food Plz guide He is bit nervous having MVD surgery
Every person needs to have a trial and error for themselves about food as triggers.
You cann visit my website www.trigeminalneuralgiatreatment.org to know more
How much will theCost of surgery, sir?
depends on many factors...please call on 9011333841...we will have to assess you medically
Fui diagnosticada com o esparmo hemifacial. Moro em cidade de interior com pouquíssimos recursos. De imediato entendi que conviveria com a doença. Não quero ser escrava de medicação controlada ou botox. Já à cirurgia, está fora de meu alcance. Gratidão por esse vídeo e suas palavras.
MUCHÍSIMAS GRACIAS. TUVE QUE TRADUCIR TU COMENTARIO PARA ENTENDER LO QUE ESCRIBISTE
Where are you located?
pune india
hello sir , you have been checked my MRI . you said there is no need to do surgery so please tell what should i do with this desease (hemifacial spasm) i cant't live with this taboo
It is too early to take a serious decision like MVD for you at present. Please wait. Let us be patient and see how it evolves. And please note that it is a neurologic disorder, and that is how you should tell your friends and relatives. They will be understanding when you explain to them.
Same problem with me I have clear reports of MRI and ct scan yet I have been suffering from Right side hemifacial spasm for 2 year please suggest me any treatment for is this mvd ??? And now soooo much medication they suggest me for botox ..also I have cluster headache on right side . please tell me ???
@@brainandspinesurgery sir what the treatment for phrase syndrome??
frey**
Sir dawai se theek ho sakta hai..ya kya upchar hai
aapne theek se suna to aapko sab options samajh me aayenge...sab kuch discuss kiya hai video me
Doc.howmuch a cost if i will go beyond surgery.i am only tricycle driver pls help me almost 7 years of suffering this illness.God bless you doc pls help me i am carlos v.ilustrisimo 57 yeàrs old.i live in 73 Carnation street NBBS proper navotas city Philippines
Please contact us on whatsapp on 9011333841
Sir mare right side face fadakta rahata h
Doc is their a chance that a blood vessel come back it it's size never continue to elongated
If it has been decompressed well, unlikely. But there is no predicting how every human body behaves
@@brainandspinesurgery thank you doc. Last question doc how much does the surgery will cost?
How much is the surgery?
please call on 9011333841
from this srgry Huntington's disease can go away for always?
What is the cause?
@@brainandspinesurgery Sir don't know cause but Revocon, Rexipra and Rejunex CD tablet is going on and hemifacial spasm is written on prescription. Sir can you tell cause? but yes I had bells pelsy before hemifacial Smasm.
I really need you doc please help me im from philippines
Please contact whatsapp between 9am and 6pm indian time 0n +91 9011333841
How much MDV costs?
variable depending on many factors like medical illnesses, room choice, number of days in hospital etc
How much this surgery cost?
+919011333841 on whatsapp
ho much for MVD?
range is dependant on room choice and medical conditions. Please communicate on whatsapp on 9011333841 for specifics