The Skinny On Fat Versus Fillers

Patients coming in for surgery to make them look younger often will ask about fat injections.
There has been a lot of attention in the press about fat injections as a way to fill the grooves and troughs around the face. The areas most commonly affected by aging are around the mouth and lips. There are the nasolabial creases, the pair of which looks like parentheses, extending from the side of the nose down to the corners of the mouth. Then, there are the marionette lines, also somewhat parenthetic and parallel, running from the corners of the lower lip to the chin.
Another area that frequently tends to shrink and flatten out is the cheek bone area, particularly toward the nose under the eye. Finally, the area that shows hollowness with increasing age is below the cheek bone in the mid-cheek area.
What are the options? Today, we have more than ever. First, there is fat grafting. It begins with liposuction from the abdomen or the buttocks. It is filtered, prepared, and then injected into the areas that show shrinkage.  In excellent and in experienced and highly specialized hands, fat injections can be successful. The alternative is to fill with man-made fillers. This would include Restylane, Juvederm, Radiesse, Artefill and Sculptra.
Now, Radiesse and Juvederm are very similar – each is composed of hyaluronic acid – a natural occurring substance in human bone cartilage and skin. The product is bio-engineered in the laboratory and is considered pure and free of any possible rejection phenomenon. Complications from these injections are very, very rare. One unique property of Juvederm and Restylane, being hyaluronic acid, is that in case of overinjection, they can be dissolved using an enzyme called hyaluronidase.
While Restylane and Juvederm have a relatively short life within the tissues, typically 4-6 months or a bit longer, some of the other products are engineered to last longer. I have seen nice results from Sculptra injections done five years prior.
So, what about this competition between fat injections and what I will group together as the “non-fat injections”? The non-fat injections, which are laboratory made, allow a major advantage in that when the injections take place, one can see the result. Now, Sculptra is somewhat of an exception because it takes several months for the body to make new collagen and capitalize on the presence of Sculptra. The other products render an immediate, visible improvement. That is a huge advantage because the patient gets to make a decision when he/she is happy with the amount of filling. Further, one can fill a moderate amount and see how it looks in a few weeks, and go back and “top off.”  There is no need to puncture the body to obtain this as there is with fat injections.
I happen to like the concept of “testing the waters” with the non-permanent hyaluronic products, Restylane and Juvederm, almost as a ”demo”. Their immediate effect and shortened longevity also allows the patient to quickly decide if they are happy with the results. If they do not see the demonstrable improvement, and do not feel that it is a reasonable investment of their time and money, they can refrain from any further injections. There is economy of dollars there.
Now, let’s look at fat injections. I want to cite the recent discussion that took place on the pages of an excellent cosmetic surgery magazine for surgeons, Cosmetic Surgery Times. The publication interviewed two veteran cosmetic surgeons who faced off on fat injections. In the fat injection corner was J. William Little, MD, and in the “non-fat” injection corner was Val Lambros, MD.
I do not know Dr. Little personally, but he enjoys an excellent reputation nationally and internationally. I do know Dr. Lambros, and I have always admired the work that he has done, including his very unique tracking of individual facial aging using medically-consistent photographs. He has been a very good student of the subject of where the face ages, how it ages, and how, to the eye, the signs of aging can be reversed.
 Dr. Lambros made a very strong case for the unpredictability of fat injections. Frankly, I sit in that camp, also. I have always seen the unpredictability as the major disadvantage of fat injections. It does not mean that you cannot have a spectacular result, but it would take a very experienced practitioner, and somewhat of a “good day.”  Remember, not all practitioners are experienced enough to have a long track of patient observations, and Dr. Lambros referred to that.  I have selected certain quotes from his commentary because I think they are very on point.
“Injected fat can grow. This will be the longest long-term problem with fat.”  Dr. Lambros goes on to mention that, indeed, “the injected fat cannot be removed.  Then, you have the issue of symmetry. The surgeon may inject equal amounts into both cheeks, but maybe some of the fat will take on one side, and more will take on the other.  Another point made was that, in fact, due to a variety of anatomic factors, the fat takes better in younger people.  But, it is the older people that need the fat more because the hollowing of the face is a function of aging.”
Further, Dr. Lambros agreed with my observation that it takes quite a bit of experience and, what he calls, “finesse” and “esthetic sensibilities.”  While these are laudable and important characteristics in the cosmetic surgeon, we have to admit that not all will have this. If so, that is a negative.
Young surgeons are always taken with technology. In fact, it is a little more exciting to harvest the fat, treat it, and inject it.  It is more mechanical, more surgical than the mere injection of a syringe filled with a non-fat filler, such as Restylane, Juvederm, Radiesse, Sculptra or Artefill.

Read more: http://blogs.webmd.com/cosmetic-surgery/2011/10/the-skinny-on-fat-versus-fillers.html

Beat back the years while you sleep

We’re always hearing that one of the best beauty tips around is a good night’s sleep - and with the clocks going back yesterday, sleep is something we’ll all want a lot more of as winter sets in.

But if, like me, you woke up this morning feeling sleep-deprived and bemoaning the bags under your eyes, you probably don’t need convincing that how much sleep - and how good that sleep is - does make a difference to how you look.

But, surprisingly, given that dark circles are one of women’s biggest beauty bug- bears, science is still struggling to explain why we look so bad after a sleepless night.

“There’s a lack of evidence-based research into the relationship between sleep and appearance in the short term,” says consultant dermatologist Dr Nick Lowe. “There’s an increasing body of work suggesting that in the long-term, sleep deprivation could prematurely age skin.

“Chronic lack of sleep (consistently getting less than the seven to nine hours most adults need) has been shown, within weeks, to compromise the immune system, making it harder for skin to repair damage inflicted during the day,” he says.

“Other research has discovered a link between lack of sleep and increased levels of the stress hormone cortisol. At high levels, this can inhibit the formation of collagen, essential for healthy, youthful skin.”

Vogue’s former beauty director Kathy Phillips is so convinced of the importance of sleep that when she founded her aroma-therapy-based beauty company, This Works, she came up with an entire range of products designed to aid sleep, including a lavender bath soak and soothing pillow spray.

“If you don’t sleep well, everything suffers,” she says. “You eat the wrong things because you feel tired, you skip regular exercise and you work less efficiently.

“Some people are genetically programmed to get dark circles; others just feel listless and lacking in energy, have pasty skin and generally feel more fractious.” Let’s say, for argument’s sake, a good night’s sleep is the best beauty secret (no one would ever say too much sleep makes you look bad, would they?), but if you can’t get enough you at least want to make sure you’re using the most effective skincare products available while you are asleep.

The past few years have seen a huge growth in so-called “nocturnal” skincare, but do we really need an entirely separate regime for after dark?

Skincare expert Paula Begoun says no. “Day and night, skin needs the same ingredients to fight wrinkles, ageing, cellular damage and collagen breakdown.

“With the exception of sun protection, which for obvious reasons doesn’t need to be in a night cream, there’s no research showing that skin needs different ingredients or heavier formulations at night.”

But Dr Sian Morris, principal scientist with Olay, which recently launched its Regenerist Night Renewal Elixir, disagrees.

“Day creams have to prep skin for make-up, so most women prefer a light cream that’s quickly absorbed, but our research has found they like their night cream to be slightly richer and creamier.

“Science suggests it makes sense to have a more emollient cream at night. Skin at night is physiologically different from during the day; it needs more moisture and can be more receptive to certain ingredients.”

Her argument is supported by the growth of a field of medicine known as chronopharmacology, which has shown the efficacy of a drug is affected by the time at which it is taken.

This is because all of the biological systems in our bodies - digestion, brain, muscles, metabolism, capacity to sleep - run to certain patterns, known as circadian rhythms.

“Studies show the permeability of the skin’s barrier is lower at night and skin blood flow is higher than during the day.

“Practically, that means greater amounts of the active ingredients within skincare products are likely to penetrate to the dermis (the deeper layer of the skin) to help tackle issues such as wrinkles. Use products that include vitamin A derivatives (the most effective anti-aging ingredients) only at night, because they are unstable when exposed to sunlight.”

These vitamin A derivatives also boost the skin’s natural exfoliation process, which studies have shown to be less efficient at night.

Other research suggests that skin is more prone to water loss while we sleep, so if you really want to wake up glowing and fresh-faced, it makes sense to look for products that are rich in ingredients that draw water to the skin (such as hyaluronic acid and glycerin).

To view this article in full visit: http://www.iol.co.za/lifestyle/style/beauty/beat-back-the-years-while-you-sleep-1.1171807

Soy Supplement May Improve Crow's Feet

An experimental supplement derived from soy may help postmenopausal women smooth their "crow's feet" a bit, a small pilot study suggests.

The supplement, known for now as SE5-OH, is under development by a Tokyo-based drug and supplement maker, Otsuka Pharmaceutical.

It contains a compound called S-equol, which is made from fermented soy germ.

The body can produce S-equol naturally, as a byproduct of digesting soy isoflavones, plant chemicals that are structurally similar to estrogen. S-equol itself is believed to attach to estrogen receptors on body cells, and may have weak estrogen-like effects.

Skin cells are among those that have estrogen receptors, and it's thought that women's waning estrogen levels after menopause may contribute to skin aging.

So for the new study, researchers at the Japanese company looked at whether giving postmenopausal women S-equol supplements might improve the appearance of crow's feet -- those lines that begin to surface at the outer corners of the eyes sometime in middle-age, or earlier.

The researchers, led by Ayuko Oyama, randomly assigned 101 postmenopausal Japanese women to one of three groups: one that took a higher dose of the S-equol supplement (30 milligrams) every day for 12 weeks, one that took a lower dose (10 mg) and one that took placebo tablets containing only starch.

"I think it's a very interesting study," said Dr. Carolyn Jacob, director of Chicago Cosmetic Surgery and Dermatology, and a fellow with the American Academy of Dermatology.

Jacob, who was not involved in the study, said it is plausible that S-equol could affect the appearance of crow's feet.

It would have been helpful, she said, if the researchers had taken skin biopsies to see if the supplement users actually showed changes in collagen -- a protein that helps keep the skin firm and elastic.

For now, Jacob said the findings are "encouraging," and longer-term studies should look at the effects of the supplement on skin aging.

In theory, S-equol supplements could have some of the negative effects of estrogen as well, including contributing to the risks of breast or uterine cancer. Oyama's team found no effects on women's breast or uterine tissue, which they gauged using mammograms and ultrasound, respectively.

However, the researchers say, longer-term studies of the supplement's safety are still needed.

For now, there are other ways to deal with crow's feet. One is to live with them. For women who want treatment, Jacob said that both Botox and Dysport "work very well."

The drugs, which work by relaxing the muscles underlying crow's feet, are given by injection, and their effects can last several months. The side effects can include soreness at the injection site and, in rare cases, muscle weakness that can lead to a temporarily droopy brow or eyelid.

It's also possible to delay the first appearance of crow's feet. Using sunblock to protect against damage from ultraviolet light can help, Jacob said. So can wearing sunglasses or hats to keep yourself from squinting -- a key contributor to crow's feet.People vary in their ability to produce S-equol from eating soy, with at least half of all individuals lacking the necessary intestinal flora and therefore being "non-producers," according to Oyama's team. All of the women in the current study were tested and deemed to be non-producers.

In the end, women who used the supplement showed, on average, a modest improvement in their crow's feet versus the placebo group -- as judged by a researcher who did not know which women had received supplements and which had taken the placebo.

The findings are reported in the medical journal Menopause.

"I think it's a very interesting study," said Dr. Carolyn Jacob, director of Chicago Cosmetic Surgery and Dermatology, and a fellow with the American Academy of Dermatology.

Jacob, who was not involved in the study, said it is plausible that S-equol could affect the appearance of crow's feet.

It would have been helpful, she said, if the researchers had taken skin biopsies to see if the supplement users actually showed changes in collagen -- a protein that helps keep the skin firm and elastic.

For now, Jacob said the findings are "encouraging," and longer-term studies should look at the effects of the supplement on skin aging.

In theory, S-equol supplements could have some of the negative effects of estrogen as well, including contributing to the risks of breast or uterine cancer. Oyama's team found no effects on women's breast or uterine tissue, which they gauged using mammograms and ultrasound, respectively.

However, the researchers say, longer-term studies of the supplement's safety are still needed.

For now, there are other ways to deal with crow's feet. One is to live with them. For women who want treatment, Jacob said that both Botox and Dysport "work very well."

Read more:http://www.foxnews.com/health/2011/10/28/soy-supplement-may-improve-crows-feet/#ixzz1c5bVCsrB

Middle-Aged Women Happier With Moderate Exercise

Middle-aged women encouraged to exercise at moderate intensity were much happier and more likely to continue working out than peers who exercised more intensely, according to a study.

Researchers led by Steriani Elavsky of Penn State University in Pennsylvania recruited 255 women between 40 and 60 years old to do either moderate or vigorous exercise, then followed the volunteers to monitor their reactions.

Overall, women who did moderate exercise were about twice as likely to feel energized and confident they could do more exercise in the future, and more of them also showed decreased feelings of sadness and anxiety than the vigorous-exercise group.

"Exercise makes you feel better but it is going to be more pleasant when performed at moderate intensity as compared to vigorous, especially when you have been previously inactive or may be overweight," Elavsky told Reuters Health.

They were activities "that would allow you to talk in short sentences while you are doing them, but would not allow you to sing," she added.

Middle-aged women are among the least active and their level of physical activity declines with age. Understanding whether exercise of different intensities has different effects on mood and whether these predict overall physical activity in midlife women is an important question to address, Elavsky added.

Elavsky and colleagues at the Middle East Technical University in Ankara, Turkey studied the 255 women, who were not on hormone therapy and who kept a daily diary of activities and feelings for two weeks. She presented their findings at the North American Menopause Society meeting in Washington D.C.

At the beginning of the study, the women completed two bouts of moderate or vigorous exercise. The vigorous workout involved exercising on a treadmill to the point where they could no longer tolerate the intensity, and moderate exercise involved a 30-minute session, also on a treadmill, at a pace the women selected for themselves but could be considered moderate.

All women also wore an accelerometer, a small device the size of a match box, to track their energy expenditure and their time spent in activities of different intensities.

The study found that moderate intensity exercise caused more women to report later that they were in a better mood and to have greater feelings of energy, psychological wellbeing and "self-efficacy."

Moderate physical activity was also much better in these terms for obese and out of shape women, Elavsky said.

Vigorous exercisers showed smaller benefits to mood, and those who were overweight or had symptoms of illness reported "significant decreases in calmness" after the exercise bouts.

Examples of moderate intensity exercise include brisk walking, ballroom and line dancing, biking on level ground or with few hills, canoeing, general gardening including raking, trimming shrubs, sports such as baseball, softball, volleyball, tennis (doubles) and water aerobics.

Elavsky added she hopes her study will reaffirm to women that exercise can be a powerful way to enhance their wellbeing, and that they don't have to go all out with their level of exertion.

Read more: http://www.foxnews.com/health/2011/09/30/middle-aged-women-happier-with-moderate-exercise/#ixzz1bQQVRQgF

Grooming Tips From Ageless Men

Some men seem to defy nature and cheat the hands of time. As everyone else goes geriatric with sagging skin and patchy hair, these guys seem to improve with age like a fine wine. 

But they aren’t cyborgs or gatekeepers to a secret fountain of youth. And there is no need for genetic jealousy here. Sure, science plays a role in continuing to look great as the years pass, but fighting Father Time is also an art. These men are worth more than a passing glance because a quick study of their grooming habits may just teach you a thing or two about how to become an ageless man.

Rigorous exercise
Staying in shape is the key to maintaining health over the long term. Regular exercise of 30 minutes three times a week not only keeps weight off, it can also help prevent heart disease, stroke, high blood pressure, diabetes, arthritis, and bone loss. But working out isn’t all physical -- it’s psychological, too. 

Exercise relieves stress and promotes mental clarity by releasing increased levels of serotonin to the brain.

Perhaps that’s how Daniel Craig played a James Bond who was both smart and shredded. It may take a little more than a jog on the treadmill to get a buff body like Craig, and at age 41, he could give any 20-something a run for their money.

Let your hair thin in style
About 40 percent of men experience some hair loss by the age of 35. But that doesn’t mean that your looks -- and perceived virility -- are going down the drain with your shedding strands. Contrary to popular belief, longer locks are a shining spotlight on bald spots and make hair appear thinner. And a Trump-esque comb-over is like raising a white flag and throwing in the towel. But in this game, there is no admitting defeat. Splashing on hair-growth serum, popping a pill and cropping your coif into something more flattering are the ways to win.

Read more: http://www.foxnews.com/health/2011/10/11/grooming-tips-from-ageless-men/?test=painmgt#ixzz1aml7RfkE

Skin recovery: 4 ways to reverse sun damage

You're a pro when it comes to protecting against sun damage. You've got sunscreen on your keychain, in your lip balm, and all over your skin. But you could still have plenty of sun damage left over from your youth. (Remember squirming away from your mom as she tried to coat you with sunblock?)

Unfortunately, sun damage isn't only skin-deep. UV radiation alters the actual DNA of your skin cells, causing lines, wrinkles, discoloration, and even cancer. "There's a meter in your skin. Every minute you're out in the sun, your body registers it," says Neal Schultz, M.D., a cosmetic dermatologist based in New York City and creator of DermTV.com.
But here's a ray of (UV-free) light: You can reverse the damage. "Whenever you start protecting yourself from the sun, you will stop the process of additional damage and start to reverse, to some extent, what you've already accumulated," Schultz says. Throw in this four-step treatment, and you are well on your way to some serious skin recovery.
Step 1: Exfoliate the right way You want to smooth your skin to create brightness and luster, and chemical exfoliation is the best way to do just that, Schultz says. Chemical exfoliation dissolves dead skin cells instead of scrubbing them off (usually unevenly) the way buffers and granule cleansers do.
When choosing a chemical exfoliant, opt for a product with a 5 percent to 8 percent concentration of glycolic acid, like BeautyRX Daily Exfoliating Therapy Serum ($65, drugstore.com). The active ingredient is vital in removing the extra layers of dead cells that are holding all of the brown pigment that has clumped and accumulated over the years. And whichever exfoliant you choose, follow the directions!
Step 2: Beat brown spots The next step is to rid yourself of those brown splotches. While the product you need is commonly called "skin bleach," there's nothing bleachy about it. It will have the end effect of lightening the brown areas of your skin, but it will do so by stopping the skin's uneven production of melanin (brown pigment) that your skin churns out when it tries to fight UV radiation. Look for a bleach, like Murad Age Spot & Pigment Gel ($60, sephora.com) with a 2 percent concentration of hydroquinone (the active ingredient), and apply it two to three times a day on the darkened areas.
Bonus points If you followed step 1 before jumping to step 2 — exfoliation actually helps the hydroquinone work better by allowing it to better penetrate the skin.

Step 3: Burn no more To maintain your improvement, use sunscreen every day to prevent additional damage. New FDA recommendations emphasize using sunscreen labeled as broad spectrum (meaning it protects against both UVA and UVB rays) with SPF values of 15 or higher. While new sunscreen label regulations won't take full effect until summer 2012, some are already broad-spectrum now. Try MDSolarSciences Mineral Screen Gel ($30, mdsolarsciences.com). To maximize the sunscreen's protection, apply it 30 minutes before exposure and reapply at least every two hours. "The amount of sunscreen that you need to use for your entire body, assuming you're at the beach and you're just wearing a bathing suit, is about an ounce in order to get the actual SPF value," Schultz says. Not too good at ounces? It's a shot glass's worth.

 To view this article in full visit: http://www.msnbc.msn.com/id/44092172/ns/health-skin_and_beauty/#.To8RG7JCA9E

Is a Liquid Face Lift Right for Me?

Is a Liquid Face Lift for Me? Liquid Face Lift procedures have been making a noticeable impact in aesthetic medicine during the past few years. A liquid face lift can help many individuals who are concerned with any one of a variety of Liquid Face Lift Tips issues, as well as providing an alternative for a traditional surgical face lift in a number of instances. Perhaps you are considering cosmetic surgery. Something to consider when contemplating surgery is that a liquid face lift has benefits that can't be found with surgery, such as restoring natural facial contours and volume. (A growing number of cosmetic surgeons are augmenting surgery with liquid face lift products to restore natural 3-dimensional contours to the face.) Also, a liquid face lift is typically more subtle than surgery. An increasing number of individuals are trying liquid facelift procedures before traditional face lift procedures. Maybe you are considering sticking with lotions and other skin care products. As compared with the potential for a liquid face lift, over-the-counter creams, ointments and other remedies rarely provide any meaningful lift, volume or contouring of facial features. (However, some topical applications can help slow facial features from needing a liquid face lift, and a few over the counter products - and several medical grade products - can enhance the endurance of liquid face lift procedures. Ask your physician.) Skin care products treat the skin from the outside and liquid face lift products treat the skin from the inside. The right mix of treatment regimens can be very complementary to maintain natural facial contours for a lifetime. However, a liquid face lift is not for everyone. Patients who have medical histories with hypersensitivity to medicines or foreign objects, certain types of cardiovascular disease, neuromuscular disorders, or other severe health issues, should consult their doctor before undergoing any of the procedures mentioned on this Liquid Face Lift Tips web site. A liquid face lift procedure also might not provide the type of dramatic improvement that some individuals need or desire. For those individuals, plastic surgery might be the best solution. Another thing to consider is that most liquid face lift procedures don't provide permanent results, so an individual will need to have periodic touch up treatments over time to maintain the desired outcome. That said, if an individual maintains results with touch up treatments before the products have completely dissipated from the body, then over time the patient may need far less product and experience gradually longer intervals between touch up treatments. So, you may be wondering what you should do. You want the downturned corners of the mouth lifted for a friendlier smile - you want to look more rested and energetic - you don't like the bags, dark circles or sunkenness under the eyes - you want your upper eye lids and brows more open, alluring and vibrant - you wish your jowls weren't so noticeable - you wish you had some of the natural curves and dimensions that have flattened or squared over time - you want less wrinkles -or- maybe you want a general overhaul. But, you are worried about expense, or safety, or whether you should just go ahead and invest in cosmetic surgery…or maybe you should just stick with creams and ointments…. Here is a suggestion. Most individuals considering a liquid face lift procedure have multiple concerns and desires. Many experienced liquid face lift physicians will suggest you start with one concern or desire. Correct or improve that single concern. Then maintain it regularly for a period of time. If you - like many individuals - begin to need less product, begin to experience longer intervals between touch ups, and you are happy with the outcome, then try a second area, and so forth. To learn more about the Liquid Face Lift Association visit: http://www.liquidfacelift.com/index.asp To speak with our offices about liquid face lift procedures visit www.drskellchock.com