December 27th, 2011
No. That is utterly silly! Smoking does diminish blood flow to the skin via the constricting effects of nicotine on blood vessels. This in turn can magnify the aging process of skin where loss of thickness is partly due to poor nutrition as result of decreased blood supply. One can argue that thinner skin will fold more easily like an accordion and indeed this is partly why people have wrinkles around the mouth. The main reason for vertical skin folds around the mouth is the sphincteric action of the muscle around the mouth: obicularis oris. This muscle is used constantly throughout our lives and it is attached to our skin to allow different movements of our mouth. The constriction of the muscle will cause accordion-like vertical lines to appear. Women have more pronounced lines develope earlier than men. Why? Men’s skin is thicker with a better blood supply to support the beard. The combination prevents wrinkle formation for a longer time in men than in women. It certainly isn’t because men smoke less than women!
Posted in Laser skin treatment, Skin care | No Comments »
December 7th, 2011
Recent media attention to the relatively new reconstructive procedure of major facial transplantation for total or near total destruction of the human face has raised interesting points worth teaching. First, as most people realize, this surgery is not cosmetic! The purpose is to reconstruct a face that bears as much resemblance to facial features as possible. Once the initial transplant is successful, in terms of a stable blood supply and no rejection, the long process of recreating features that resemble the face begins. Through serial procedures the transplant that looks like a badly made mask takes on human shape. The skin is scored and sutured from the inside to recreate folds from the nose to the lips, muscles attach via scarring to the skin to recreate smile and frown lines where possible. Much that is done to give characteristics of facial features is completely the opposite what is the goal for cosmetic patients! Yes, it is nice to soften these features as we get older, but they should not be eliminated as they clearly (as demonstrated by facial transplantation) identify us.
Posted in Cosmetic surgery, psychology | No Comments »
October 31st, 2011
Yes it does remove hair permanently. The important fact that everyone has to keep in mind is that, like many other treatments of our body, it takes more than one procedure to accomplish this task. Hair exists in multiple phases at the same time. Some are in a growth phase, some in sleep, and some in a normal shedding. There are actually 5 phases, but for practical clinical purposes we talk about the above three. Laser works only on actively growing hair. This automatically means at least 3 treatments; and since there is no way of predicting the length of duration of these activities (varies in each person) the general advise that I give is that at least five laser treatments will be necessary, and perhaps more. With patience one can achieve good results. Light hair will require even more laser time since the laser wavelength for permanent hair removal works better on darker colors. The other good news about laser hair treatment is that it is relatively painless with the newer lasers. Sticking with the program will give you the results you want.
Posted in Laser skin treatment | No Comments »
September 12th, 2011
I see many people who have tried laser treatments fortheir leg spider veins with no visible improvement. The reason for this is that spider veins need to be injected with sclerosing agents first before laser has any effect. Injecting the vein with an irritant such as hyper-tonic saline will cause the vein to collapse thus removing 80% of the color which is due to the blood inside the vein. The remaining visible color is now only in the vein wall which thencan be treated with laser. If the vein is open and full of blood the amount of energy needed to collapse the vessel and remove the color would damage the overlying skin. No external laser can perform this safely. The safest and easiest method is to treat the vein with a safe sclerosing agent that will collapse the vein and do no further damage to the surrounding tissue; then laser the remaining color. Most people are happy with the injection alone, but certainly laser does improve the results even more.
Posted in Laser skin treatment, Skin care | No Comments »
July 18th, 2011
No! Unless one overeats. Liposuction is the only truly permanent procedure. It removes fat by suctioning out fat cells that contain the adipose tissue. These cells do not regrow. Therefore there are fewer cells in the area after treatment. When overeating occurs weight is gained, but now it is stored in other areas that have more fat cells i.e. where storage capacity is greater. This in turn will give the body a different profile and contour. The human body has almost an infinite capacity to store fat (once a source of energy during periods of starvation). Gluttony will always beat out surgery.
Posted in Cosmetic surgery, Liposuction | No Comments »
June 16th, 2011
Simple answer is no. Implants can last a life time, especially the gel (silicone) type. Implants need to be replaced only if there is some clinical sign (symptoms) that on further exam reveals a problem which otherwise cannot be corrected. This situation is not common.
Posted in breast augmentation, breast lift, Cosmetic surgery, mommy makeover | No Comments »
April 5th, 2011
Body mass index! The bane of everyone’s existence. This index, contrived using height and weight only, is being used to determine everyone’s status in regard to obesity. Unfortunately this rather simplistic formula corrals people into categories that misrepresent their true fitness level. While it works relatively well for the medium framed individual, it grossly miscalculates the people with small or large frames who may be very physically in-shape and have a large muscle mass component compared to fat. Because muscle weighs 5 times more per volume area, a very fit individual who looks thinner than an obese person of the same height will score a higher BMI mis-representing this individual as fat! I know an excellent personal trainer who was rejected by a special forces unit in a telephone interview on learning his height and weight. Once they saw him in person they begged him to re-apply. He now trains athletes and special forces. A better way to assess true levels of obesity is to measure fat to muscle ratio with calipers or electron conductivity/resistance. BMI is too simplistic and misrepresents a significant group of people. Demand an explanation of your BMI from your doctor!
Posted in Health | No Comments »
March 15th, 2011
We have watched, heard and read all types of Charlie Sheen stories; most as a source of amusement and entertainment. The media has exploited the man and we have allowed it, without any objection from any corner of the globe.
The argument goes that the man allows and invites public scrutiny/abuse by encouraging conversations/bouts with the media.
What if Mr. Sheen has a form of any number of possible manic diseases? What if some of what has occurred in Charlie Sheen’s recent past is not completely under his control? What if his out-sized personality stems from more than just ego?
Would the media and the general public make fun of human conditions not under our control? Would we poke fun of an amputee, laugh at a cerebral palsy victim, make a cancer patient the brunt of a joke.
If Mr. Sheen has a psychological component to his travails, then the media has not done him or us any service. We should all be embarrassed.
Posted in Conduct/Behavior, psychology | No Comments »
February 1st, 2011
Approximately 3 years ago I mentioned how a “general knowledge” erroneous statement about breast implants pervaded the Internet. This urban legend that implants need to be exchanged after 10 years just will not go away, no matter how many facts and the truth are published.Perhaps the origin of this misinformation stems from several clinical papers published 8-10 years ago reporting that saline implants showed a higher rate of deflation after 10 years. The percentage was still in single digits. It takes only one person to mis-interpret the data and set off our penchant for “dirty laundry” gossip served up as knowledge. Everyone who serves up this “news” can take credit for being “current” and “smart”.
Other urban legends include limitations on number of face lifts one can have; no face lifts possible because of sun burns; and two-fold recurrence of fat following liposuction. All are a result of mis-interpretation leading to mis-information.
Posted in breast augmentation, Conduct/Behavior, Face Lift, Liposuction | No Comments »
January 16th, 2011
I have already tried to warn the public about less than scrupulous physicians, not board certified in plastic surgery, who parade themselves as “cosmetic/plastic surgeons”. On a lighter note (and hopefully less dangerous public safety issue) it has become quite apparent to me that many of my patients report advise they have obtained from their friends, neighbors, colleagues and relatives. This well intended information on surgery and medicine is freely given by acquaintances once they have learned that their friend visited a plastic surgeon! Everyone has advise on something. The real test is whether they will take responsibility for it.
Posted in Conduct/Behavior, psychology | No Comments »
