One more reason to quit smoking: Adult Acne!

If you or someone you love is still smoking, here’s another good reason to quit this New Year: smoking increases the risk of developing adult acne!

A study was performed at the Istituti Fisioterapici Ospitalieri in Rome by Dr. Bruno Capitanio and his colleagues. It focused on 226 adult women with adult acne. The study’s goal was to learn whether there was a connection between smoking and the development of adult acne.

There is.

Two types of acne are most common in adults. The first one, called CPAA, is short for comedonal postadolescent acne that is much like regular teenage acne. A few breakouts here and there. The other acne more common in adults is the pustular kind, called papulopustular postadolescent acne.

The researchers were surprised to find that the most common acne in adult smokers was CPAA, not pustular acne. In fact, 66.3% of the 266 women in the study were smokers. Of those 159 smokers, less than 30% of them had papulopustular postadolescent acne. However, of the smokers, almost 73% had CPAA. Results of the study were published in the November issue of the Journal of the American Academy of Dermatology.

For those of you still smoking, this should give you another reason to quit! If you cannot quit, or if you have acne in the absence of smoking, we have a multitude of treatments available for you, such as the Portrait Skin Regeneration treatment for acne scarring. We also have prescription medications for acne here in our Delaware cosmetic surgery office.

There’s no reason to suffer with adult acne, as it can be treated. Call today and come in for a skin evaluation. 

To your health & beauty, 

Dr. Joe Danyo

WHATEVER HAPPENED TO SILICONE?

The news has revealed many of the disastrous results of silicone injections. Remember Priscilla Presley’s beautiful face? It was literally ruined by lowgrade silicone injections that her doctor told her were “better than Botox”. You can see the unfortunate results at left. Once injected, silicone is “forever” and can onlybe surgically removed, leading to the potential for some very nasty scarring.

Although it’s true that there is no FDA approval for using silicone for cosmetic purposes, I’m betting if you did a poll of your friends, most of them would think that it’s currently being injected into lips, buttocks, breasts and faces all over America. That’s because most people aren’t aware of the dangers. 

Back in the 1950’s and 60’s, silicone was used for breast enlargement. Unfortunately,  this led to lumps, bumps, injections and deformities and was banned. You probably recall that the original silicone breast implants were also recalled for similar concerns as well as concerns that leaked silicone led to auto-immune problems.

Please be sure that you and your friends are aware of the dangers of silicone injections, and the fact that they are not approved by the FDA. No reputable plastic surgeon would ever use them. Here at our Delaware plastic surgery office, we have multiple filler options that are safe and effective. Come in to see us and learn which might be right for your particular needs.

By the way, did you know that Botox has a treatment visualizer? It’s fun and effective, and a great way to see, in the privacy of your home, how you might look.

To your health & beauty,

Dr. Joe Danyo 

How Herbs Can Affect Cosmetic Procedure Outcomes

Although herbs such as Gingko Biloba, Garlic, Ginseng and St. John’s Wort have proven benefits for your health, did you know that many herbal supplements can actually interfere with your recovery from cosmetic procedures? Depending on the supplement in question, herbs can cause problems ranging from unwanted anesthesia reactions to increased bleeding.

For this reason, I always ask my patients to give me a complete list of all the medications they are taking and any herbal supplements as well. By informing me as to what you’re taking, we can avoid any unexpected interactions during and after your procedure.

Supplements that can increase bleeding:

• Gingko Biloba
• Garlic
• Ginseng
• Fish Oils (omega-3 fatty acids)
• Dong Quai
• Feverfew

Supplements that can have anesthetic effects:

• Valerian
• St John's Wort
• Kava

Supplements known to cause other types adverse events:

• St John's Wort (can cause photosensitivity, especially after laser or chemical peels)
• Ginseng (can cause hypoglycemia)

Divorce, Antidepressants, Or Weight Gain/Loss Can Add Years To Your Face

Remember that old saying, that if you want to see what a woman will look like as she ages, look at her mother? A recent identical twins study suggests that may no longer be the case. Although genetic makeup certainly plays its part, environmental factors can add years to your perceived age.

In the study, performed at University Hospitals Case Medical Center by Dr. Bahaman Guyuron and colleagues, 186 pairs of twins were given very detailed questionnaires to complete. When the questionnaires were gathered, the twins’ photos were also taken. Without sending the questionnaires along, the photos were given to an independent panel to see if the panel members would decide that each pair of siblings were twins, or if they believed that one sibling was older or younger than the other and, if so, approximately how many years’ difference was between them.

Divorce Apparently Ages Us:

Among the twin sets in which one was divorced, the divorced twin appeared older to the panel members (remember, the panel members had no inkling that these were twins, just that they were siblings). According to Dr. Guyuron, "the presence of stress could be one of the common denominators in those twins who appeared older." Panel members also judged those taking antidepressant medications as “significantly older.” This may be due to the relaxation of facial muscles in those taking antidepressants.

Weight was a definite factor—in both directions!

Among twins aged 40 and younger, the panel members believed that the thinner twin was younger. However, for those sets of twins above the age of 40, the chubbier sibling was perceived to be younger, and often by several years.

"This research is important for two reasons," Dr. Guyuron said. "First, we have discovered a number of new factors that contribute to aging and second, our findings put science behind the idea that volume replacement rejuvenates the face."

I heartily agree. Volume replacement with fillers or fat transfer is definitely the way to look younger. Youthful faces have volume; it’s not just the absence of wrinkles. One would think that identical twins over the age of 40 would have the identical wrinkle pattern, right? Therefore, the primary difference that led panel members to view the heavier twin as younger would be based solely on a heavier facial appearance, ie, a fuller face.

Are you surprised by these findings?

To your health and beauty,

Dr. Joe Danyo

Does My Butt Look Big in This?

A recent survey reports that 85% of women worry about the shape and size of their rear, leading to the old question before going out for the night: “does my butt look big in this?”

The UK cosmetic surgery practice, The Hospital Group, surveyed women to understand why the Brits are experiencing a huge increase in procedures such as buttock lifts and body sculpting to create a better bum. Even lipo is up 64% since last year. Certainly, the growing popularity of bottoms like Beyonce’s and Kim Kardashian’s are part of the reason. The study also discovered that clothes shopping caused 55% of women to feel self-conscious and 62% were concerned about how to dress for the holidays to either show off or minimize their derrieres.

The study also revealed that there are 4 distinct bottom shapes!

• The tomato shape is “bigger, plumper, rounder and squishier,” and is possessed by about 45% of women.
• The potato shape is wide, long and frumpy and, unfortunately, 35% of British women have it.
• The pear bum is narrower at the top and twice the size at the fullest part of the bottom.
• The perfect derriere is called the nectarine, which looks like two bowling balls pushed together. One wonders why they don’t call that one a strike…

Buttock lifts and buttock implants are increasingly popular in the US as well, with approximately 5,000 buttock augmentations performed each year. Buttock augmentation and lifts increased by 37.3% and 24.6%, respectively, from 2008 to 2009. 

While some buttock augmentations are performed with implants, I find fat grafting to be a much better alternative. Not only does fat grafting eliminate the problems with implants (of which there are many), it uses liposuction to obtain the fat for grafting into the buttocks. Nice to think you can take fat away from a place on your body where you don’t want it and put it into having a rounder rump, don’t you think?

To your health & beauty,

Joe Danyo, MD

How Lasers Work to Improve Skin

Laser technology for cosmetic usage has been around for the past 40 years, but has come into its own in the past five years, offering men and women a variety of treatments including hair removal, body sculpting and skin resurfacing. Occasionally, a patient will ask me how the laser actually works. Truth is, until recently, nobody has known the exact underlying processes that occur with lasers! Is it the laser light that motivates the collagen to rebuild or is it the heat that the laser delivers?

A researcher by the name of Susanne Dams, with Philips Research Eindhoven, conducted her own studies on lasers to find the answers.

Dams treated cell cultures and human skin with heat shocks of 45 and 60 degrees Centigrade, without using a laser light. (This is equivalent to 113 to 140 degrees Fahrenheit. Water boils at 212 degrees Fahrenheit, so 113-140 is hot but not boiling hot.) Her results show that the heat shocks increased the production of collagen. When laser light was added, the only measureable difference was the ability of the laser to pinpoint the exact location of heat delivery. This is an important part of the treatment, inasmuch as heating smaller areas of skin is safer than heating larger areas of skin. In fact, her study also showed that heating the skin to 113 degrees Fahrenheit for 8-10 seconds was the optimal amount of heat to increase collagen. Above that temperature there is no added benefit and, in fact, causes skin cell damage.

Collagen is a skin protein that gives skin elasticity and firmness, the “bounce back” that young skin enjoys. Beginning in the mid-20’s, our collagen production begins to decrease, leading to wrinkles and sagging skin.

Three ways to increase your collagen levels

Studies show that there are 3 primary collagen-builders for those of us in the over-30 crowd:

·      Laser Skin Treatments.

o   Although the CO2 laser is considered the Gold Standard for skin resurfacing, the after-effects force patients to hide from the world for 2-3 weeks as their faces crust over and peel. Not a pretty site and most people don’t have 2-3 weeks to spend for recovery. Fraxel treatments and even chemical peels can obtain similar results, with little to no downtime. Instead of one big treatment, chemical peels and fractionated laser treatments are divided into 4-6 treatments, giving essentially the same results without the recovery time.

·      Retinoids.

o   Retin-A is the only topical skin treatment that is proven to increase collagen. No matter what they tell you on TV, this is a fact. For those in need of this, I can prescribe Retin-A.

·      Hyaluronic Acid Fillers:

o   Fillers made with hyaluronic acid, such as Juvederm, Restylane and Perlane, have been shown to increase collagen. This explains why, over time, you may need less filler each time you come in for a filler treatment. It’s not because you retain the filler from the last treatment, but because your own collagen is rebuilding.

Some things that damage collagen, by the way, are sun exposure and tobacco usage. Avoid the sun and tobacco and you'll go a very long way toward keeping your looks as you age.

To your health & beauty,

Joe Danyo, MD

Avoiding Post-Lipo Weight Gain During the Holidays

Liposuction is the 4^th most popular cosmetic surgery procedure in the US. Almost 200,000 procedures were performed last year. Do you wonder how many people kept the weight off?

According to a study published in Plastic and Reconstructive Surgery, the official publication of the ASPS (American Society of Plastic Surgeons), those patients who did not adhere to a good diet following liposuction were 3 times more likely to gain weight. Those who didn’t exercise were 4 times more likely to gain weight.

The study surveyed over 200 patients. The good news is that 25% lost weight and 32% maintained their weight. That means that more than half of liposuction patients either lose or maintain their weight following a liposuction procedure. Unfortunately, 43% of liposuction patients in the survey gained weight after liposuction, with the greatest weight gain occurring approximately six months after their procedure.

Liposuction is not a quick fix for weight loss. It’s a commitment to resolving stubborn areas of fat that plague you and don’t disappear even with diligent workouts and avoidance of junk food. All of us are genetically programmed to store fat in specific areas. Perhaps it’s your thighs or around your waist. Some people are prone to fat in the buttocks. Liposuction is a method to eliminate fat cells in these problem areas. Unfortunately, if you don’t make a commitment to maintaining your results, you’ll gain weight.

With the holidays coming up, I thought you might like some tips for maintaining your weight (whether or not you’ve had lipo) when the treats are up front and center over the next eight weeks:

·       Drink the recommended 8 glasses of water daily.

§  Keeping yourself well hydrated not only keeps you feeling full, it also helps with mood and concentration.

§  Drink two full glasses of water, iced tea or low-cal beverage before a festive meal. You’ll still enjoy yourself, but will feel full sooner.

·       Watch the alcohol.

§  Beer, wine and mixed drinks contain empty calories. Drinking also lowers your inhibitions, leaving you vulnerable to overeating.

·       Enjoy in moderation.

§  Having said the above, sticking to one glass of wine, one bottle of beer or one cocktail allows you the enjoyment without risking too many empty calories

§  The same goes with treats. One or two cookies, one slice of pie, one day of falling off the commitment to eat well doesn’t have to lead to a week of overeating.

o   Eat Before You Leave

§  Enjoy a ½ turkey sandwich on whole grain bread or pita with sprouts, lettuce and tomatoes before leaving for the restaurant, party or family dinner. It will keep you from feeling starved by the time the meal is served.

o   Be on the Lookout

§  Focus on seafood, chicken, veggies and cheeses at parties and avoid the deep-fried canapés and other rich foods or limit yourself to one of the high fat offerings. You’ll feel better about yourself and the weight will stay off!

Holidays mean food, fun, and family, but they don’t have to mean weight gain. Having a positive mental attitude and a commitment to maintaining your new shape will get you to January feeling and looking wonderful!

What tips would you like to share to manage your weight during the holidays?

To your health and beauty, 

Dr. Joe Danyo

Is gold the new buzzword in skin creams?

According to legend, 5,000 years ago, Cleopatra slept in a gold face mask every night because she believed it made her skin luminous and soft. Whether that was true or not, Cleopatra is said to have had beautiful skin. But then again, in that day and age, women lived to a ripe old age of 30-something, so who is to know. Cleopatra herself lived only to 39.

Many new skin products coming on the market contain gold particles, reported to tighten loose skin, reduce discoloration and ward off the sun’s damaging UV rays. Unfortunately, there are no studies that have documented these claims, and the creams are enormously expensive, as you might guess.

The truth is, few skin care ingredients have been proven to create real results in skin tone, texture and luminosity. Among them are Retin-A. Laser skin rejuvenation, microdermabrasion and chemical peels have also been proven to rejuvenate collagen beneath the skin and create a much smoother, more youthful appearance. 

Top Op in the UK? Lipo for Men!

Following on the footsteps of their beloved soccer star, Ronaldo, who had abdominal lipo last year, British men have been flooding plastic surgeries with a desire to trade their love handles for 6-packs—to the tune of a 117% increase just since last August! Previously, the Brits were hot for man boob treatments, to avoid looking like Simon Cowell, famous for his noticeable nipples in t-shirts.

In America, there was an increase of 9% in men’s cosmetic surgery procedures from 2008 to 2009, with a total of almost a million surgical procedures for men. Lipo was the top pick, followed by nose jobs, eyelid surgery, breast reduction and halr transplantation to round out the top five US men’s procedures.

Here in my Delaware plastic surgery practice, liposuction enables me to predictably contour all kinds of fatty areas, including the jawline, thighs, belly, flanks (the dreaded love handles!), the neck, buttocks, almost anywhere. Traditional lipo works best on people with good skin quality, so that there isn’t loose skin hanging around at the end of the procedure. For those who are a bit older and whose skin might not “snap back” after lipo, here in our practice in Delaware, tummy tuck procedures are a great alternative to abdominal liposuction, both for men and for women. It’s a popular choice for women who have finished childbearing (as well as for the men who gained weight during their wife’s pregnancy!)

If you’re thinking about lipo for the man in your life, or for yourself, come in and see me in consultation. You’ll be surprised how sexy and young you feel afterwards! 

Could Beauty be Bone Deep instead of Skin Deep?

Like other plastic surgeons, I have focused on lifting the muscle and skin of my aging patients when performing a face lift in my Delaware plastic surgery office. Fat is often moved, as well—specifically the fat pad of the cheek—to a higher position to eliminate the flat look of the aging face. Sometimes, fat is injected to plump up that part of that face in need, such as around the temples, and between the mouth and nose, called the nasolabial folds.

However, researchers at the University of Rochester Medical Center, joined by colleagues from Harvard and Stanford, have discovered, through an evaluation of 120 individuals’ CT scans, that beauty may indeed be bone deep, and this research may change the way plastic surgeons perform face lifts.

The 120 participants were divided into three groups by age: 20-36, 41-64 and 65+. Measurements of the facial bones were taken to evaluate whether or not the facial bone structure becomes smaller with age. Scientists know that most of us will shrink as we age, and these researchers discovered that a similar phenomenon occurs in the face: the jaw bone, especially, will shrink in size, causing sagging in the lower face and a jawline that seems to disappear with the years. Their research suggests that future face lift procedures may include bone grafting or the use of plastic prosthetics to “beef up” the lower face and allow the face lift to be just that much better. 

Arms: Your Greatest Beauty Asset?

Put those uncomfortable stilettos back in the closet. According to StyleList.com, a recent study has found that men are more attracted to a woman’s arms than her legs.

The study, which was administered by the University of New South Whales in Sydney, was recently published in the Journal of Evolutionary Biology. The study involved Chinese and Australian women and men. The men were asked to watch videos of 96 women from the ages of 20 to 49 and then to rate their appearance.

The researchers found that the length of a woman’s legs had no significant impact on how attractive she was perceived. On the contrary, women who had long arms were ranked continuously as the most attractive. Although the study pointed to a strong appeal to long arms, lead researcher Professor Robert Brooks attributes attraction to a combination of good traits.

"The dimensions can tell observers if that person is suitable as a potential mate, a long-term partner, or perhaps the threat they pose as a sexual competitor,” Professor Brooks told the Daily Mail.

Waist-to-hip ratio, age and weight are also common factors that play into our judgment of appearance.  Next time you go to the gym, you might want to consider trading in squats and opting for push-ups instead.

Drink Those Wrinkles Away

According to the Deccan Herald, a new study has found that drinking water can help reduce the appearance of wrinkles. Not only that, certain waters can reduce wrinkle depth more than others.

Any medical professional will tell you that drinking eight glasses of water a day is good for your health. For years, we have been told that staying hydrated adds to clear skin and a youthful complexion.  Now there is solid evidence to back up these claims.

During the double-blind, placebo-controlled study, female volunteers has their skin analyzed with the VISIA complexion imaging system.  Following their initial analysis, the women were asked to drink 1.5 liters of water daily for 8 weeks. In addition, the women were not advised not to change their diet or exercise routines.

A number of the participants drank only tap water over the course of 8 weeks, while others were given mineral-rich Willow Water from England.  Willow Water contains willow bark extract that is high in salicin, an anti-inflammatory agent that metabolizes into salicylic acid. Salicylic acid is commonly found in many skincare and acne products.

At the end of the 8 weeks, the women had their skin analyzed once more with the VISIA complexion imaging system. Researchers found that the participants who drank tap water saw an overall 19% reduction of wrinkles, while the Willow Water-drinkers saw a 24% reduction.

The great news is you can now drink your way to better skin. The bad news? Willow Water is only available in the UK—for now.

Tip Asymmetry Leading Request for Rhinoplasty, Revision Rhinoplasty

There are many reasons why someone would undergo rhinoplasty: deviated septum, collapsed nostrils, crooked nose, etc. HealthDay News recently reported that the number one aesthetic reason for rhinoplasty and revision rhinoplasty in patients is tip asymmetry.

The study, which was published in the September/October issue of the Archives of Facial Plastic Surgery, was administer by Kathy Yu, M.D. of Columbia College and Cornell University in New York. Yu and her colleagues used a questionnaire to analyze the functional and aesthetic concerns of 104 patients considering revision rhinoplasty.

According to the investigators, tip asymmetry topped the list as the most common aesthetic concern for surgeons and patients alike. The second most popular was the crooked middle third of the nose, followed by upper third irregularity. An average of 79 percent of surgeons shared the same aesthetic concerns as their patients.

"In conclusion, this study sheds light on the major concerns of patients seeking revision rhinoplasty and compares them with the surgeon's objective findings. These findings emphasize the importance of physician awareness of patients' concerns, understanding the causes of post-surgical nasal obstruction, and clearly explaining nasal aesthetics to patients seeking revision rhinoplasty,” the authors wrote.

For patients considering rhinoplasty for the first time or revision rhinoplasty, it is important that your doctor understand your aesthetic concerns and objectives. Whether it is difficulty breathing, a crooked middle third or an asymmetrical tip, it is important that the patient’s concerns are adequately communicated to their plastic surgeon.

The Line Between Cosmetics and Cosmeceuticals is Getting Thinner

A recent article by Plastic Surgery Practice reports that the gray area between the skin care and cosmetics industry is growing. Global Industry Analysts, Inc., revealed that the color cosmetics market will reach $41.4 billion by 2015. This is due in part to the inclusion of UV protection, moisturizing components, and natural and organic ingredients in cosmetics.  Makeup is now available in a multitude of formats, textures and pigments.

Not only that, consumers are now benefiting from an array of different treatment options available in the cosmetics, including anti-aging effects. There is a cosmetic product made for virtually every skin type and condition.

Going green is another trend that has been affecting the cosmetics industry. Product manufacturers are now beginning to include ‘natural’ and ‘organic’ ingredients such as vitamin E and plant extracts to attract consumers.

Once upon a time, makeup contained heavy pigments that clogged pores and caused skin irritation. Now, mineral blends and light-capturing crystals, like topaz and mother-of-pearl, are being used to give skin a natural, flawless appearance. To produce an intense color and limit smudging, lipsticks are beginning to incorporate vitamins A, C and E.

Referred to as cosmeceuticals, products with skincare benefits were once only made by high-end makeup lines such as Jane Iredale. Nowadays, one can walk into a drug store and nearly every makeup brand offers SPF-enriched or mineral products. With this growing gray area, it will be interesting to see how the boundaries of the FDA will adjust.

A Way to Treat Those Aging Lobes

Just like any other area of skin, earlobes are prone to the signs of aging. From drooping earring holes wrinkled skin, your ears deserve to look just as beautiful as you do.

Dermal fillers—such as Juvederm or Radiesse—can now be used to treat aging earlobes. More commonly used for wrinkles in the face, these fillers can rejuvenate your maturing lobes. For earring holes that have drooped due to heavy jewelry, fillers can be injected to minimize the size of the whole and add support.

Plastic surgeons can also treat wrinkles on the earlobe with fillers as they would treat wrinkles around the eyes or mouth.

Avoiding sun exposure and heavy earrings are ways to prevent premature aging of the skin, however, collagen and elastin naturally breaks down over time.

While some patients prefer to undergo otoplasty for more permanent wrinkle reduction, dermal fillers both deliver permanent results and no downtime. If you are a Delaware resident considering fillers for your ears,  our friendly staff at Danyo Plastic Surgery would be happy to address any questions or concerns you may have.

The Future of the Body Contouring Market

Let’s face it, North America, particularly the U.S., is getting fatter. With rising obesity rates comes an increased demand in the body contouring market. Patients are seeking at latest ways to get their body in shape, and doctors are increasingly adapting to advancements in body contouring technology.

A recent article from BusinessWire.com predicts how the introduction of new devices, as well as the recession, will have an effect on the body contouring market over the next few years. There have been numerous devices approved since 2008 in the way of laser-assisted liposuction(LAL) and cryolipolysis that have recently become more available to consumers.

Despite the rising frequency of body contouring devices, the price of treatment may deter patients during the recession. Doctors have to earn back their investment on said devices, which cost upwards of $100,000, and do so through the cost of the treatment to patients. The cosmetic surgery industry is currently facing many obstacles; however, as patients postpone or even forego these elective procedures in order to conserve funds.

Despite the decline in device sales from 2008 to 2009, Millennium Research Group predicts an economic revival of the body contouring market to be reported for 2010.

SmartLipo MPX, the first dual-wavelength LAL device available in the market, was launched in Canada and the U.S. in 2008. Other big launches to take place in 2009 included CoolLipo by CoolTouch, SlimLipo by Palomar Medical Technologies, Syneron’s LipoLite, Sciton’s ProLipo PLUS and SmoothLipo by Elem Medical.

The first transdermal ultrasound device to be available in Canada was UltraShape’s Contour 1. In 2009, Medicis’ LipoSonix, which has had difficulty getting FDA approval, received Health Canada approval. To date, there are no transdermal ultrasound devices available in the U.S. In the way of cryolipolysis, Coolsculpting by Zeltiq has been available for off-label fat removal since last summer.

Even with the threats of the recession affecting the body contouring market, the obesity problem in North America guarantees a growing number of prospective patients available.  Furthermore, as body contouring technology advances there will be a growing consumer demand and market growth.

Cosmetic Surgery is No Cure for Body Dysmorphic Disorder

Body dysmorphic disorder (BDD) has been getting a lot of attention in the media recently.  The condition, which drives people to constantly alter their appearance in a desire to be perfect, is oftentimes linked to plastic surgery. But do BDD sufferers actually benefit emotionally by undergoing plastic surgery? A new study’s says ‘no’. Despite these findings, there are surgeons who still provide requested surgeries to BDD sufferers.

The study, which was recently published in the Annals of Plastic Surgery, was spearheaded by Katharine A. Phillips, MD, is the director of the body image program at Rhode Island Hospital. Phillips defines BDD as “a psychiatric disorder characterized by preoccupation with an imagined or slight defect in appearance which causes clinically significant distress or functional impairment. A majority of these individuals believe they have an actual deformity that can be corrected by cosmetic treatments to fix these perceived defects rather than seeking psychiatric intervention."

Phillips co-authored the study with Canice Crerand, PhD, of the Children’s Hospital of Philadelphia. The researchers reported that previous studies showed BDD to be relatively common among individuals who underwent plastic surgery, accounting for roughly 7-8% American plastic surgery patients. The duo retrospectively studied 200 individuals with BDD. Of the group, 31% sought and 21% received surgical or minimally invasive treatments to remedy their BDD symptoms.

The study found that almost all of the individuals still experienced BDD symptoms, while some even developed new appearance fixations. The researchers also surveyed 265 cosmetic surgeons, of which 65% reported treating patients with BDD symptoms. Only one percent of the reported cases that were treated resulted in symptom improvement.

The most common surgical procedures among the patients were rhinoplasty and breast augmentation, while the most popular non-invasive treatments were dermal fillers and microdermabrasion. Three-quarters of all the desired procedures involved the face, and more than a third of the patients studied underwent numerous different treatments.

In the long-term, only 25% of patients with BDD showed a more positive appraisal of their treated body parts. Not only that, only two percent of treated patients saw a lasting improvement of their overall BDD symptoms.   

Of the patients who sough treatment, 20% did not receive a procedure. Surprisingly, patients with BDD were turned down more often due inability to pay for a procedure than they were for their symptoms. Thirty percent of patients could not undergo their procedure due to financing, while 26% were refused treatment by a doctor. The researchers also found that surgeons were significantly less likely to refuse a cosmetic treatment than other procedures, such as dermatological, dental or otherwise.

"This suggests that many surgeons were not aware of the patient's BDD or do not consider BDD a contraindication to treatment,” says Phillips.  “In a survey of 265 cosmetic surgeons, only 30 percent believed that BDD was always a contraindication to surgery."

While some cases of body dysmorphic disorder are easy to recognize, other cases are not so clear-cut. This study is an indicator that there should be more training and sensitivity in the aesthetic plastic surgery industry to the symptoms of BDD.  While most patients have a healthy desire to simply enhance their features, the crippling symptoms of BDD could be the motive for patients to undergo cosmetic surgery.

2009 International Aesthetic Trends Now Available

For the first time ever, accurate aesthetic plastic surgery statistics are available to the public. The International Society of Aesthetic Plastic Surgery (ISAPS) issued the "ISAPS Biennial Global Survey™" to surgeons in order to gauge aesthetic trends in the top 25 countries and regions for plastic surgery. The Survey represented 75% of all procedures performed in 2009.

Although the ISAPS Biennial Global Survey™ confirmed that the United States remains the country with the most procedures performed annually, there are some countries that are emerging as major centers that may be surprising. Making the top ten list are a few other countries that are not always associated with plastic surgery:
1.    United States
2.    China
3.    Brazil
4.    India
5.    Mexico
6.    Japan
7.    South Korea
8.    Germany
9.    Turkey
10.    Spain

The Survey also revealed that, contrary to popular belief, breast augmentation is not the most popular invasive procedure performed internationally. The top 5 invasive aesthetic procedures are as follows:
1.    Liposuction-18.8%
2.    Breast Augmentation-17%
3.    Blepharoplasty-13.5%
4.    Rhinoplasty-9.4%
5.    Abdominoplasty or Tummy Tuck-7.3%

As for as non-surgical procedures go, neuromodulators like Botox® top the list in popularity. Not only that, the overall number of non-surgical cosmetic treatments performed surpassed the number of surgical procedures. The top 5 non-invasive aesthetic treatments for 2009 were:
1.    Neuromodulators such as Botox® and Dysport®-32.7%
2.    Hyaluronic acid injections such as Juvederm and Radiesse-20.1%
3.    Laser hair removal-13.1%
4.    Fat grafting-5.9%
5.    IPL treatments-4.4%

Amongst other things, the Survey established that there are approximately 30,817 board certified (or national equivalent) plastic surgeons currently practicing. The number of surgical procedures performed globally in 2009 was 8,536,379, while the number of non-invasive treatments was 8,759,187.

The ISAPS Biennial Global Survey™ was created and proctored by Industry Insights, Inc., an independent research firm from Columbus, OH.  Scott Hackworth, a CPA who, along with the firm, has 15 years of experience in researching trends in aesthetic plastic surgery, led the Survey. The two-page, English-based questionnaire was administered to different international plastic surgery societies and focused on the aesthetic procedures performed in 2009.

Study: Less Frequent Botox Injections Achieve Same Results

A study recently found that patients require less frequent Botox® injections after two years of treatment to maintain the same wrinkle-reducing effect.

“After two years of treatment at recommended intervals, patients can potentially cut the frequency, and thus, the cost of their Botox® treatments by half,” says Roger A. Daily, leader of the study and professor of oculofacial plastic surgery at the Oregon Health & Science University (OHSU). The research also showed that Botox® injections are capable of preventing wrinkles in patients who begin treatment during their 30s.

During the study, 50 females aged 30 to 50-years-old were analyzed over two years while they underwent regular Botox® injections. Dailey and his colleagues found that, after undergoing injections every four months for two years, patients can slow the frequency to once every six months and still see desired results.

Physicians previously advised patients—based on earlier research—that they should undergo Botox® injections every three months to see maximum wrinkle-smoothing benefits. According to Dailey, the cost and frequency of Botox® deterred some patients from starting or even continuing their treatment.

Botox® was approved by the FDA for cosmetic purposed eight years ago. In 2009 alone, more than 2.5 million Americans underwent the popular injection (source: ASPAS). Botox® in Delaware should be injected by, or under the supervision of, a board certified plastic surgeon.

Japan Makes Sizable Advances in the Use of Stem Cells During Fat Grafting

Fat grafting is an alternative used during soft tissue augmentation that has grown in popularity over the past few years. Although this technique has been around for over a decade, recent international advancements and the use of stem cells have dramatically increased the presence of fat grafting in the plastic surgery industry.

Fat grafting is beneficial in that it only leaves incisional scars and often has less complication then injecting dermal fillers and other foreign substances into the body. Although doctors around the world have been working hard to improve the final result of fat grafting, physicians in Japan have recently made the most important headway

Kotaro Yoshimura, M.D., associate professor of plastic surgery at the University of Tokyo, is leading the investigation into the use of stem cells of aesthetic applications. The doctor and his team recently developed a strategy called cell-assisted lipotransfer (CAL) to overcome some common issues with traditional fat grafting such as unpredictable results and low fat cell survival rates due to necrosis.

How CAL Works:
Stem cells found within adipose (fat) tissue are combined with traditionally lipoinjection. The fat removed after liposuction is split in half and stem cells from one half of the fat are removed and added to the other part of the fat. This process creates stem cell-enriched fat. Dr. Yoshimura and his colleagues found that after grafting fat, some of the cells die off and are replaced by new fat generated by the stem cells. The amount of stem cells contained in the graft is crucial in determining the final results following lipoinjection.

Dr. Yoshimura has tested the CAL process on more than 450 breast augmentation and restoration patients since 2003. The results demonstrated CAL as a safe and effective alternative for soft tissue augmentation.

How Stem Cells Are Isolated:
There are three basic steps executed during CAL: fat and stem cells are extracted from a donor site, the soft tissue is purified, and then the tissue is injected elsewhere into the body. The most difficult step in the process is isolating the stem cells from the rest of the fat cells. This can be done manually using a cell-processing room or automatically using Tissue Genesis technology.

According to Dr. Yoshimura, using stem cell-enriched fat during grafting may boost the safety and effectiveness of the traditional methods. The fat stem cells may even have a therapeutic effect, similar to bone marrow-derived stem cells, which can aid in the healing process following lipoinjection.

These advances in stem cell technology are certainly promising, however, Dr. Yoshimura stresses that the long term safety and efficacy of CAL still needs to be studied. Patients with a low BMI may also be poor candidates for fat grafting as issues may arise in harvesting enough fat and stem cells to make the procedure successful.

C-Tucks: Unsafe For Regaining a Post-Baby Body

While celebrities like Jessica Alba and Gisele Bundchen may be able to bounce back to their pre-baby bodies quite easily, not all women can slim down with ease just weeks after childbirth. Skinny celeb mommas—who have the luxury of hiring personal trainers, chefs, and nutritionists—have sparked rumors about a controversial new cosmetic procedure: the ‘C-Tuck’.

The C-Tuck is a cesarean section for childbirth, immediately followed by a tummy tuck (abdominoplasty).  If the idea of having a little nip and tuck during childbirth sounds too good to be true, it probably is. It is hard to find a doctor offering the procedure, however, this is not a surprise as the C-Tuck is considered to be relatively unsafe. While OB/GYNs or other unlicensed individuals may be performing C-Tuck’s under the radar, you won’t catch a board-certified plastic surgeon cashing in this trend.

The average abdominoplasty can take up to five hours, which would require an unsafe amount of anesthesia for both the mother and child. Combining an abdominoplasty with a cesarean section could be potentially deadly for both parties.  In addition, a woman’s hormone levels are spiked during childbirth and therefore the skin and soft tissue of the abdomen may not heal the same with a C-Tuck as it would with a standard tummy tuck.

C-Tucks can also run a high risk of infection as there are numerous cavities exposed to a combination of fluids during a cesarean section. By adding another in another procedure, there is more tissue exposed to pathogens. Combining a hysterectomy with a tummy tuck is a more controlled procedure that is more commonly practiced.

If you are a mom who is considering a tummy tuck, I recommend waiting at least nine months after childbirth before undergoing the procedure. Patients will see optimum results if they allow their body to heal and the abdominal skin to shrink as much as possible.  Also, you should not undergo an abdominoplasty unless you do not plan on having any more children. Giving birth after a tummy tuck can reverse the results of the procedure completely.

While C-Tucks would certainly make life easier on moms, they are neither realistic nor safe. Tummy tucks in Delaware should only be performed by a board-certified plastic surgeon, not an OB/GYN or otherwise.

All About SmartLipo

SmartLipo is the latest form of liposuction technology that combines traditional fat removal methods with laser technology for maximum results. Laser technology, which is used routinely in dental procedures, lasik eye surgery, facial rejuvenation and hair removal, is what sets SmartLipo apart from its competition.

“Laser” is an acronym for Light Amplification by Stimulated Emission of Radiation. Medical-grade lasers create a powerful light beam that is adjusted to a specific frequency range to precisely treat targeted areas.

SmartLipo differs from traditional liposuction in that it uses a carefully calibrated laser to liquefy fat deposits through the top layer of the patient’s skin. The fat is then removed through a tiny incision in the skin made by the doctor.

What makes SmartLipo different from traditional liposuction is that it can also seal blood vessels as it liquefies the fat cells. This reduces swelling, bleeding and bruising and gives the patient less down time. SmartLipo may reduce downtime drop reduce complications.

SmartLipo is also an FDA approved liposuction treatment that has undergone rigorous clinical trials. The laser used also stimulates the production of collagen in the skin, giving it a firmer, more youthful appearance. Delaware residents who are interested in liposuction will benefit greatly from the advantages that SmartLipo has to offer over traditional liposuction.

While SmartLipo is considered minimally invasive, it is still a procedure that should be performed by a physician. When considering liposuction, choose a board-certified plastic surgeon who has experience in the latest technologies in fat removal.

Cigarettes Not Only Cause Wrinkles, They Cause Acne

Cigarettes are undoubtedly bad for you. They’re expensive, have been linked to cancer and are known to cause premature wrinkles. If that isn’t enough to make someone kick the habit for good, the American Academy of Dermatology recently published a report claiming that smoking is correlated to adult non-inflammatory acne.

The study, which was done in Rome, found that 85% of the women had comedonal post-adolescent acne (CPAA), a type of acne characterized by black heads and large pores. Prior to the study, CPAA was believed to be less common than cystic inflammatory acne.

Not only did the majority of subjects have CPAA, 72.9% of the women with CPAA smoked. On the contrary, only 29.4% of women with cystic inflammatory acne identified themselves as smokers. The study also found that the more the women smoked, the worse their CPAA was. Smoking showed no effect on the skin of women with cystic inflammatory acne.

The average smoker spends $2,000 a year alone on cigarettes. Add in medical costs, skincare treatments and other related expenses and you have yourself one expensive habit. Not only that, the negative effects to your health should be enough to persuade anyone to quit. For Delaware residents who are interested in quitting, the state Quit Line is an excellent resource for support advice.

Get Botox®, Get Happy!

The running joke with Botox® is that patients can’t frown or show emotion. A recent study has found that this inability to show emotion may make you a happier person.

Botulinum toxin, the active ingredient in Botox®, is used to temporarily weaken the muscles in the face that cause wrinkles. This not only gets rids of lines in the face, it also limits the body’s ability to move the muscles in the face and express emotion.

The study, which was administered by Barnard College in New York, found that people who have a limited ability to physically express emotion might in turn feel less emotional. Botox® prevents feedback to the brain about such facial expressivity, therefore tricking the brain into thinking that there is less emotion felt during an event.

Joshua Davis, a psychologist at Barnard, and his colleagues showed people emotionally charged videos both before and after they were injected with Botox®. After viewing the videos, the subjects that were injected with Botox® exhibited a significant decrease in the strength of the emotional experience as opposed to the control group.

The study findings tie into a long-standing idea in psychology that dates back to Charles Darwin. The facial feedback hypothesis, which was later developed by William James, simply states that facial movement can influence emotional experience.

If simply frowning can ruin your mood, then not being able to frown should make you a happier person. Now that’s something to smile about!