Making the decision to have cosmetic surgery is a
serious one. You must be confident that you have chosen the right surgeon- does he have the appropriate training? Do you get along with him
on a personal level? Can he realistically achieve your goals? Dr. Shah strives, through experience, professionalism and amazing results to
make your decision an easy one.
Dr. Shah began his medical education at the prestigious combined BS/MD
program at the University of Missouri - Kansas City. This program chooses the most outstanding high school students in the country to
undergo a rigorous 6 year education in medical and surgical skills. Dr Shah graduated at the top of his class, at a US medical school. This
is an important fact in choosing a surgeon- an American Medical School graduate ensures the best medical school education in the
world.
Dr. Shah then continued his training locally at the Kern Medical Center- University of California
San Diego 5 year surgical training program, which ultimately led to his Board Certification in surgery ( http://www.facs.org). During his time at KMC, Dr Shah performed many operations on all body systems. From
Trauma Surgery to General Surgery to Heart Surgery, Dr. Shah has seen and done it all. His specialty, however, was always breast cancer and
breast cancer surgery. His excellence during this time in his career was rewarded with the prestigious XXXX award, given only to the most
outstanding surgical chief resident. He also was prolific in writing many articles which have been published in dozens of academic surgical
journals, started a surgical education website, and was an outstanding teacher of fellow medical students and residents. Dr Shah continues
his educational career by training many residents and lecturing around the country on cosmetic surgery and breast
reconstruction.
The pinnacle of Dr. Shah's career was his acceptance to the Mayo Clinic. Consinstent
ranked by US News and World Reports as one of the top three hospitals in the country. His extensive training there made him an expert in
cosmetic and reconstructive surgery, earning him the title of Plastic and Reconstructive Surgeon. It is also very important to note the
difference between a Cosmetic Surgeon, and a surgeon who has formally undergone Plastic and Reconstructive Surgery Education. Cosmetic
surgery is not a recognized specialty by the American Board of Medical Specialties, and does not involve the rigorous 2 year training
program in Plastic Surgery that educational institutions such as the Mayo Clinic can provide.
In
addition to educating the community and future surgeons as a clinical instructor on the topics of cosmetic, plastic and reconstructive
surgery, Dr Shah volunteers time and services to the less fortunate. Dr Shah is a founding member of The Promise, and organization which
travels to countries such as Africa, India, and South America to repair cleft lips and palates and treat burn
injuries.
The philosophy of Dr Shah's practice is to truly treat each patient as a family member, while
providing them with a world class luxurious experience and outstanding results. To achieve this goal, Dr Shah has trained his staff
extensively to make your experience an exceptional one. Dr Shah's office is beautifully decorated to mimic the comfort and beauty you will
feel during your cosmetic surgery experience. Dr Shah also attends a seminar on the latest techniques in plastic surgery almost once a
month, to keep his skills up to date and to provide his patients with the latest and greatest in plastic surgery. He has also created one
of the most technologically advanced office and operating room facilities in the country, to ensure your decision making process and
safety.
Trust only the Best. Please call Dr Shah's office
today.
Dr. Darshan Shah � Patient
Testimonials
Dr. Shah, About two years ago, my best friend and I went out to a
nightclub in town. I was having a good time until a complete stranger came up to me and cupped my breasts and said �How cute! This guy has
baby boobs!� and the crowd around me laughed. I quickly left the club with tears in my eyes. I hated the way I looked and from that night
on I have purchased every shirt in the biggest size I can find. Now, days after my operation I look into the mirror and I see and feel a
difference in my body. Thank you from the bottom of my heart. I am so happy and so glad that I decided to have this done. Thank you very
much for the cookie basket, too!
�The Girls�, I wanted to let all of you know how thankful I am for
every single one of you! All of you were so patient & kind throughout my entire surgery & recovery. You were all not only
professional, but extremely friendly � which made me feel very comfortable! All of you are great! Thank You!
Dear Dr. Shah, You were recently mentioned in one of our patient satisfaction surveys as providing
great care to them. They stated �he is the best�. I want to thank you for your open mind to solving tough situations and your team effort
toward providing high quality care. Thank you.
Dr. Shah & Staff, What a nice surprise. I think
this is the first time ever that I have received flowers from one of my doctors. They are very much appreciated as are you all for thinking
of me.
Dr. Shah & the Shaanti Staff - We would like to extend our appreciation for hosting a
mom�s nite out for our Twin & Triplet mothers. Our girls walked away with a renewed sense of self and some look forward to using your
services. Thank you once again for taking the time, patience and sincerity Dr. Shah!
Dr. Shah Thank
you and your staff for caring at the follow-up calls. It really encouraged me, that I might have a chance with Kaiser to okay the knee
plastic surgery.
Thank you Dr. Shah for everything you�ve done!
Thanks so much
for all that you do for me. It�s not forgotton, and it is greatly appreciated!
Dr. Shah, Thanks
so much for all that you did for me today. I know it took a big portion of your morning, so please enjoy Caf� Med on me since you were so
kind in not charging me. I just want you to know how much I appreciate all that you do for me! From your high maintenance patient and
friend.
Dr. Shah, Thank you so much for your friendliness and your professionalism. I am very
pleased with the results! You did a good job.
Dr. Shah, Thank you for all that you have done
for us. You are a very gracious person. Thanks.
Thank for everything! Always,
Doctor, I am not having any more surprises. In a months time you will have forgotton me and the
trouble I caused you. God bless you!
I cannot express how much better I have felt since my surgery. I have been given
a new life in more ways than one, and not a single neck or back pain has been experienced. My reduction has been one of many positive
changes in my life and I want to thank you for making that possible. Thank you.
Dr. Shah, Thank you so much � I am so happy with my new additions!
Thank you for my new look. I am so happy with it. I appreciate you both for your kindness & for making me feel
comfortable. You guys are the best! Thank you so much!
Dearest
Darshan, Thank you so much for your kindness and generosity. You are a wonderful guy. I appreciate your thoughtfulness. If you are in
Chicago, come see me!
Dr. Shah & Staff, I just wanted to say thank you for everything. Dr.
Shah, you did a beautiful job on my breasts. My boyfriend and I are very pleased. The staff is very helpful and friendly. Thank you so
much.
Dear Dr. Shah, I�d just like to thank you & your staff for being so kind to me. That
basket of cookies couldn�t have come at a better time! I was just beginning to get my appetite back! Perfect timing! Thank
you,
Just wanted to say thanks for all your help. It really means a lot.
After all the � I have went through it was nice to find someone with compassion. Again, thanks.
Dear Dr. Shah, Thank you very much for what you have done for me. You have made my life so much
better. I don�t have eyes looking at my chest. God has made you a very special person by caring about other people�s feelings. Thank you
again.
Dr. Shah, Thanks so much to you and your staff for all
your kindness & compassionate care. I really do appreciate you and all you�ve done for me. I know I can be neurotic when it comes to my
perfection and healing issues, so continue to be patient & reassuring. Thanks also for the beautiful flowers, they came at a time when
I was having a down moment, and they indeed cheered me up. You�re great Dr. Shah!
Dr. Shah, Saying �Thank You,� just doesn�t seem to express the gratitude & appreciation I have
for you! Nonetheless, allow me to say �Thank You� for absolutely everything. You�ve given me more than can be said. I can truly say I love
the way I look and that my confidence and excitement I feel is because of you. You are not only talented, but extremely personable. You
made me feel comfortable and confident that I chose the right surgeon. You have a gift and many years to come to give that gift to other
people like myself. You�re wonderful, Dr. Shah!
Dr. Shah, Thank
you so much for making me BEAUTIFUL! I would also like to thank your staff, with special thanks to Jenna! Jenna is a awesome person! So
patient, sweet and caring � never let her go! Again, thanks for all my life long beautiful changes!
Dear
Dr. Shah & His Staff, Thank you all for the help and being so kind to our family. It really means a lot to us that you & your
staff treated us so well. Especially Tyler. His eye looks 100% better, and we could never thank you for all you have done for us. God Bless
all of you at Bakersfield Surgical Center for the kindness you give to your patients and their families. Thanks again.
Dr. Shah, Just a note to thank you for taking time out of your busy schedule to participate in the
FAME interviews. Your enthusiasm & dedication to patients really shined through! I will be contacting you again when we do our segment
on Bariatrics. Thanks again!
Thank you Dr. Shah for doing such a great job and answering all my
questions! I really appreciate everything!
How do you say thank you in the right way?
From my heart. I�m so greatful you helped me to get back to a real living life. My prayers are always with you! God bless you and keep you
always.
Just wanted to give you a big thanx for helping me and being there for me. It meant so
much to me.
Dear Dr. Shah, I wanted to write you personally and
express my thanks for your generosity by providing the funds to purchase the 10x10 Disaster Canopy Tent. We needed it desperately as a tool
in disasters and community relations and did not have money in our budget to purchase it.
The Salvation
Army serves Kern County through an emergency food pantry, utility assistance, low income senior feeding program, tutoring and scouting
programs, disaster response and a variety of other programs designed to meet the holistic needs of our community in need. I am enclosing a
brochure that covers a more detailed list of ways we serve.
Please feel free to come by our building and see us in action as
we serve greater Bakersfield�one need at a time.
Again, thank you for your kindness and support. You are
appreciated!
Surrendered to serve, David Ebel, Captain Corps Officer and Kern County
Coordinator
Dear Dr. Shah, We wish to take this opportunity to thank you
for your services to the University and to our Physician Assistant Program during the spring semester, 2004. We are most appreciative and
grateful for the time you spent teaching our physician assistant students.
As a clinical preceptor, you provide the tools to
enhance the students� knowledge bases and their understanding of the profession they have chosen. Your dedication and abilities as a
preceptor prepare our students upon graduation, to successfully take their place within the health care team as qualified
professionals.
Your role as preceptor promotes our goal of building the highest quality physician assistant program in the
country. We look forward to continuing your association with Western University throughout the upcoming
years.
Sincerely, Roy A. Guizado, M.S., PA-C Chair, Primary Care Physician Assistant Program
Dr. Shah performs the following Plastic Surgery Procedures:
BREAST ENLARGEMENT (Augmentation
Mammaplasty)
Procedure: Enhance the size of breasts using inflatable implants filled with saline. Length: 1 to 2
hours. Anesthesia: Local with sedation, or general. In/Outpatient: Usually outpatient. Side Effects: Temporary soreness, swelling,
change in nipple sensation, bruising. Breast sensitive to stimulation for a few weeks. Risks: Lack of implant permanence -- surgical
removal or replacement of the implants may be required to treat problems, including: deflation; the formation of scar tissue around the
implant (capsular contracture), which may cause the breast to feel tight or hard; bleeding or infection. Increase or decrease in
sensitivity of nipples or breast skin, occasionally permanent. Mammography requires a special technique. (Note: Some women have reported
symptoms similar to those of immune disorders. Ask your doctor about these and other FDA concerns.) Recovery: Back to work: a few days.
Physical contact with breasts: 3 to 4 weeks. Fading of scars: several months to a year or more. Duration of Results: Variable. Implants
may require removal or replacement.
BREAST LIFT (Mastopexy)
Procedure:
Raise and reshape sagging breasts by removing excess skin and repositioning remaining tissue and nipples. Length: 1 to 3
hours. Anesthesia: Local with sedation, or general. In/Outpatient: Usually outpatient. Sometimes inpatient. Side Effects:
Temporary bruising, swelling, discomfort, numbness, dry breast skin. Permanent scars. Risks: Thick, wide scars; skin loss; infection.
Unevenly positioned nipples. Permanent loss of feeling in nipples or breast. Recovery: Back to work: 1 week or more. Strenuous
activities: 1 month. Fading of scars: several months to a year. Duration of Results: Variable; gravity, pregnancy, aging, and weight
changes may cause new sagging. Results may last longer or be enhanced when breast implants are inserted as part of the
procedure.
MALE BREAST REDUCTION
(Gynecomastia)
Procedure: Reduce enlarged, female-like breast in men using liposuction and/or cutting out excess
glandular tissue. (Sometimes covered by medical insurance.) Length: 1 hour or more. Anesthesia: General or local. In/Outpatient:
Usually outpatient. Side Effects: Temporary bruising, swelling, numbness, soreness, burning sensation. Risks: Infection. Fluid
accumulation. Injury to the skin. Rippling or bagginess of skin. Asymmetry. Pigmentation changes (may become permanent if exposed to sun).
Excessive scarring if tissue was cut away. Need for second procedure to remove additional tissue. Recovery: Back to work: 3 to 7 days.
More strenuous activity: 2 to 3 weeks. Swelling and bruising: 3 to 6 months. Duration of Results:
Permanent
ABDOMINOPLASTY (Tummy Tuck)
Procedure: Flatten
abdomen by removing excess fat and skin and tightening muscles of abdominal wall. Length: 2 to 5 hours. Anesthesia: General, or local
with sedation. In/Outpatient: Either depending on individual circumstances and extent of surgery. Side Effects: Temporary pain.
Swelling, soreness, numbness of abdominal skin, bruising, tiredness for several weeks or months. Risks: Blood clots. Infection. Bleeding
under the skin flap. Poor healing resulting in conspicuous scarring or skin loss. Need for a second operation. Recovery: Back to work: 2
to 4 weeks. More strenuous activity: 4 to 6 weeks or more. Fading and flattening of scars: 3 months to 2
years.
CHEMICAL PEEL (Phenol and trichloroacetic acid [TCA])
Procedure:
Restore wrinkled, blemished, unevenly pigmented, or sun-damaged facial skin, using a chemical solution to peel away skin's top layers.
Works best on fair, thin skin with superficial wrinkles. Length: 1 to 2 hours for full face. Anesthesia: None; sedation & EKG
monitoring may be used. In/Outpatient: Usually outpatient. Full-face phenol peel may require admission for 1 to 2 days. Side Effects:
Both: Temporary throbbing, tingling, swelling, redness; acute sensitivity to sun. Phenol: Permanent lightening of treated skin; permanent
loss of ability to tan. Risks: Both: Tiny whiteheads (temporary); infection; scarring; flare-up of skin allergies, fever blisters, cold
sores. Phenol: Abnormal color changes (permanent); heart irregularities (rare). Recovery: Phenol: Formation of new skin: 7 to 21 days.
Normal activities: 2 to 4 weeks. Full healing and fading of redness: 3 to 6 months TCA: New skin within 5 to 10 days. Duration of
Results: Phenol: permanent, although new wrinkles may form as skin ages. TCA: variable
(temporary).
COLLAGEN / FAT INJECTIONS
Procedure: Plump up creased,
furrowed, or sunken facial skin; add fullness to lips and backs of hands. Works best on thin, dry, light-colored skin. Length: 15
minutes to 1 hour per session. Anesthesia: Collagen: usually none; local may be included with the injection. Fat:
local. In/Outpatient: Outpatient. Side Effects: Temporary stinging, throbbing, or burning sensation. Faint redness, swelling, excess
fullness. Risks: Collagen: allergic reaction including rash, hives, swelling, or flu-like symptoms; possible triggering of
connective-tissue or autoimmune diseases. (A skin test is required before collagen treatment to determine whether an allergy exists.) Both:
Contour irregularities, infection. Duration of Results: Variable; a few months to 1
year.
DERMABRASION
Procedure: Mechanical scraping of the top layers of
skin using a high-speed rotary wheel. Softens sharp edges of surface irregularities, including acne and other scars and fine wrinkles,
especially around the mouth. Length: A few minutes to 1 hour. May require more than 1 session. Anesthesia: Local, numbing spray, or
general. In/Outpatient: Usually outpatient. Side Effects: Temporary tingling, burning, itching, swelling, redness. Lightening of
treated skin. Acute sensitivity to sun; loss of ability to make pigment (tan). Risks: Abnormal color changes (permanent). Tiny
whiteheads (temporary); infection; scarring; flare-up of skin allergies, fever blisters, cold sores. Recovery: Back to work: 2 weeks.
More strenuous activities: 4 to 6 weeks. Fading of redness: about 3 months. Return of pigmentation/sun exposure: 6 to 12
months. Duration of Results: Permanent, although new wrinkles may form as skin ages.
EAR
SURGERY (Otoplasty)
Procedure: Set prominent ears back closer to the head, or reduce the size of large ears. Most
often done on children between the ages of 4 and 14 years. (Occasionally covered by insurance.) Length: 2 to 3 hours. Anesthesia:
Young children: usually general. Older children or adults: general or local, with sedation. In/Outpatient: Usually outpatient. Side
Effects: Temporary throbbing, aching, swelling, redness, numbness. Risks: Infection of cartilage. Excessive scarring. Blood clot that
may need to be drained. Mismatched or artificial- looking ears. Recurrence of the protrusion, requiring repeat surgery. Recovery: Back
to work or school: 5 to 7 days. Strenuous activity, contact sports: 1 to 2 months. Duration of Results: Usually
permanent.
EYELID SURGERY (Blepharoplasty)
Procedure: Correct drooping
upper eyelids and puffy bags below the eyes by removing excess fat, skin, and muscle. (Upper-eyelid surgery may be covered by insurance if
used to correct visual field defects) Length: 1 to 3 hours. Anesthesia: Usually locally with sedation or general. In/Outpatient:
Usually outpatient. Side Effects: Temporary discomfort, tightness of lids, swelling, bruising. Temporary dryness, burning, itching of
eyes. Excessive tearing, sensitivity to light for first few weeks. Risks: Temporary blurred or double vision. Infection, bleeding.
Swelling at the corners of the eyelids. Dry eyes. Formation of whiteheads. Slight asymmetry in healing or scarring. Difficulty in closing
eyes completely (rarely permanent). Pulling down of the lower lids (may require further surgery). Blindness (extremely rare). Recovery:
Reading: 2 or 3 days. Back to work: 7 to 10 days. Contact lenses: two weeks or more. Strenuous activities, alcohol: about 3 weeks. Bruising
and swelling gone: several weeks. Duration of Results: Several years. Sometimes
permanent.
FACELIFT (Rhytidectomy)
Procedure: Improving sagging facial
skin, jowls, and loose neck skin by removing excess fat, tightening muscles, redraping skin. Most often done on men and women over
40. Length: Several hours. Anesthesia: Local with sedation, or general. In/Outpatient: Usually outpatient. Some patients may
require short inpatient stay. Side Effects: Temporary bruising, swelling, numbness and tenderness of skin; tight feeling, dry skin. For
men, permanent need to shave behind ears, where beard-growing skin is repositioned. Risks: Injury to the nerves that control facial
muscles or feeling (usually temporary but may be permanent). Infection, bleeding. Poor healing; excessive scarring. Asymmetry or change in
hairline. Recovery: Back to work: 10 to 14 days. More strenuous activity: 2 weeks or more. Bruising: 2 to 3 weeks. Must limit exposure
to sun for several months. Duration of Results: Usually 5 to 10 years.
FACIAL IMPLANTS
Procedure: Change the basic shape and balance of the face using carefully shaped implants to build up a receding
chin, add prominence to cheekbones, or reshape the jawline. Length: 30 minutes to 2 hours. Anesthesia: Local with sedation, or
general. In/Outpatient: Usually outpatient. Occasionally overnight hospital stay. Side Effects: Temporary discomfort, swelling,
bruising, numbness and/or stiffness. In jaw surgery, inability to open mouth fully for several weeks. Risks: Shifting or imprecise
positioning of implant, or infection around it, requiring a second operation or removal. Excess tightening and hardening of scar tissue
around an artificial implant ("capsular contracture"), causing unnatural shape. Recovery: Back to work: about 1 week. Normal appearance:
2 to 4 weeks. Activity that could jar or bump face: 6 weeks or more. Duration of Results:
Permanent.
FOREHEAD LIFT (Browlift)
Procedure: Minimize forehead creases,
drooping eyebrows, hooding over eyes, furrowed forehead and frown lines by removing excess tissue, altering muscles and tightening the
forehead skin. May be done using the traditional technique, with an incision across the top of the head just behind the hairline; or with
the use of an endoscope, which requires 3 to 5 short incisions. Most often done on people over 40. Length: 1 to 2 hours. Anesthesia:
Local with sedation, or general. In/Outpatient: Usually outpatient. Side Effects: Temporary swelling, numbness, headaches, bruising.
Traditional method: Possible itching and hair loss. Risks: Injury to facial nerve, causing loss of motion, muscle weakness, or
asymmetrical look. Infection. Broad or excessive scarring. Recovery: Back to work: 7 to 10 days, usually sooner for endoscopic
forehead lift. More strenuous activity: several weeks. Full recovery from bruising: 2 to 3 weeks. Limit sun exposure for several
months. Duration of Results: Usually 5 to 10 years.
HAIR REPLACEMENT
SURGERY
Procedure: Fill in balding areas with a patient's own hair using a variety of techniques including scalp
reduction, tissue expansion, strip grafts, scalp flaps, or clusters of punch grafts (plugs, miniplugs and microplugs). Works best on men
with male pattern baldness after hair loss has stopped. Length: 1 to 3 hours. Some techniques may require multiple procedures over 18
months or more. Anesthesia: Usually local with sedation. Flaps and tissue expansion may be done with general
anesthesia. In/Outpatient: Usually outpatient. Side Effects: Temporary achy, tight scalp. Unnatural look in early stages. Risks:
Unnatural look. Infection. Excessive scarring. Failure to "take." Loss of scalp tissue and/or transplanted hair. Recovery: Back to work:
usually 2 to 5 days. More strenuous activities: 10 days to 3 weeks. Final look: may be 18 months or more, depending on
procedure. Duration of Results: Permanent.
LASER FACIAL
RESURFACING
Procedure: Smooth the face and smooth fine wrinkles using a carbon dioxide (CO2) laser device that
treats layers of damaged skin. Softens lines around the eyes and mouth and minimizes facial scars and unevenly pigmented areas. Length:
A few minutes to 1 hour. May require more than 1 session. Anesthesia: Local with sedation, or general. In/Outpatient: Usually
outpatient, unless combined with other surgical procedures that require hospitalization. Side Effects: Temporary swelling, discomfort.
Lightening of treated skin. Acute sun sensitivity. Increased sensitivity to makeup. Pinkness or redness in skin that may persist for up to
6 months. Risks: Burns or injuries caused by laser heat. Scarring. Abnormal changes in skin color. Flare-up of viral infections ("cold
sores") and other infections (rare). Recovery: Back to work: 2 weeks. More strenuous activities: 4-6 weeks. Complete fading of redness:
6 months or less. Return of pigmentation/light sun exposure: 6-12 months. Duration of Results: Long-lasting, but does not stop aging.
New wrinkles, expression lines may form as skin ages.
LIPOSUCTION (Suction-Assisted
Lipectomy)
Procedure: Improve body shape by removing exercise-resistant fat deposits with a tube and vacuum device. Can be
performed using the tumescent technique, in which targeted fat cells are infused with saline containing solution with a local anesthetic
before liposuction to reduce post-operative bruising and swelling. Common locations for liposuction include chin, cheeks, neck, upper arms,
above breasts, abdomen, buttocks, hips, thighs, knees, calves, ankles. For larger volumes of fat or for fibrous body areas,
ultrasound-assisted lipoplasty (UAL) may be used. UAL is a new technique in which a ultrasound probe is inserted beneath the skin to
"liquify" the fat before it is suctioned. Length: 1 to 2 hours or more. UAL: 20-40 percent longer than traditional
liposuction. Anesthesia: Local, epidural, or general. In/Outpatient: Usually outpatient. Extensive procedures may require short
inpatient stay. Side Effects: Temporary bruising, swelling, numbness, soreness, burning sensation. Tumescent: Temporary fluid drainage
from incision sites. UAL: Larger incisions for cannula. Risks: Asymmetry. Rippling or bagginess of skin. Pigmentation changes. Skin
injury. Fluid retention. Excessive fluid loss leading to shock. Infection. UAL: thermal burn injury caused by the heat from the ultrasound
device. Recovery: Back to work: 1 to 2 weeks. More strenuous activity: 2 to 4 weeks. Full recovery from swelling and bruising: 1 to 6
months or more. Use of tumescent technique or UAL may decrease post-operative bruising and swelling. Duration of Results: Permanent,
with sensible diet and exercise.
NOSE SURGERY
(Rhinoplasty)
Procedure: Reshape nose by reducing or increasing size, removing hump, changing shape of tip or
bridge, narrowing span of nostrils, or changing angle between nose and upper lip. May also relieve some breathing problems. (May be covered
by insurance.) Length: 1 to 2 hours or more. Anesthesia: Local with sedation, or general. In/Outpatient: Usually
outpatient. Side Effects: Temporary swelling, bruising around eyes, nose and headaches. Some bleeding and stiffness. Risks:
Infection. Small burst blood vessels resulting in tiny, permanent red spots. Incomplete improvement, requiring additional
surgery. Recovery: Back to work: 1 to 2 weeks. More strenuous activities: 2 to 3 weeks. Avoid hitting nose or sunburn: 8 weeks. Final
appearance: 1 year or more. Duration of Results: Permanent.
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