Issue #18 summary - GO BACK TO ARCHIVE

Body contouring after weight loss
Obesity is a rapidly growing disease that has spread widely in the western world and is an emerging issue in developing countries. Factors that are held responsible include cultural, social, and economic conditions, along with sedentary life habits and caloric excess in carbohydrate-rich diets.
   The increase of the obese population has popularised the demand for bariatric surgery—that is, stomach-reducing procedures. More than 70 per cent of patients who undergo such surgery state that the dramatic weight loss causes an unacceptable worsening of their body image, due to skin laxity and ptosis of certain anatomical areas.
   In this article, the various body contour deformities following massive weight loss are addressed, showing the senior author’s strategy in treating them. The concepts and principles that have been fundamental in developing these personal techniques over four decades have recently been reappraised for post-weight loss patients. The various techniques are briefly discussed in this overview paper, analysing the areas that most commonly present for surgery after weight loss, which include the face, breast, abdomen, the upper limbs, and the lower limbs.
   Very often, after bariatric surgery and massive weight loss, comes the need to consult a plastic surgeon for body-contouring surgery. The patients who have been successful in this attempt invariably complain of overhanging flaccid skin, causing not only severe aesthetic deformities but also certain difficulty in dressing and sports activities. This will consequently reflect in all aspects of the patient’s life.

Phototherapy for wound healing
The key to understanding phototherapy lies in its biostimulative effects. Photodynamic therapies do not actually cure anything.. What they do is to stimulate the body’s natural healing and regenerative capacity, resulting in faster wound healing and more pleasing cosmetic results.
   Light therapy has been used widely to treat wounds of diverse aetiologies since reports in 1967 indicated that low power laser treatment has a stimulatory effect on healing. Since then, both in vivo and in vitro studies have demonstrated light therapy with optical sources of low-energy photons improves wound healing.
   Some researchers were unable to show that low-power laser promoted wound healing, which might suggest that controversy still surrounds the effectiveness of low-power laser therapy. But researchers have shown that significant methodological biases in the studies and the use of optical devices with different physical characteristics are sufficient to explain such results.
   Low-level laser therapy (LLLT) affects the three overlapping phases of wound healing:inflammation, proliferation and remodelling. The duration of acute inflammation can be reduced by LLLT, the proliferative phase of repair during which granulation tissue is formed, begins earlier. The rate of wound contraction can be altered and angiogenesis increased.
   Healing involves the interaction and activity of many cell types. Research has been carried out on the effects of LLLT on keratinocytes, mast cells, macrophages and fibroblasts. Keratinocyte and fibroblast proliferation can be stimulated directly and also indirectly through growth factors released from irradiated macrophages.

Gain the upper hand
With the wide array of plastic surgery and dermatology procedures available—not to mention an international fitness craze—women are able to maintain a youthful appearance longer than ever. Next time you see a woman you know to be 50 but appears 40, look at her hands: they may reveal her true age.
   While many women have mastered the art of a youthful face and body, they often complain that their hands reveal their true age. What they do not know is that there are solutions.
   Hands age faster than the face, because—with the exception of gloves worn during the winter—they are rarely covered. Even the most avid sunscreen users neglect to apply sunblock to their hands, which is essential to slowing visible ageing.
   At what age do the hands typically reveal their true age? Women will usually start to notice a change in their 40s with raised fine lines. By their 50s, they will likely notice thicker brown spots on their skin. In their 60s, the veins become even more prominent and the hands take on a thinner appearance.
   Looking at a 70-year-old woman, one will see the skin on her hands is much thinner than the skin on her face. Signs of aged hands are brown spots, an overall wrinkled texture of the skin, a loss of fatty tissue, and more prominent veins.
   A popular product is a low concentration (15-30%) TCA (trichloroacetic acid) peel. There are many indications for its usage. But it is an excellent “refresher”, minimal downtime peel that can be frequently repeated for cumulative benefits.

Ritualistic healing
Eight years ago, while vacationing in Ecuador, Eve Bruce MD (ASAPS) was struck with a terrible fever. Her group leader took her to an Andean shaman, who healed her using smoke, chanting and prayer. The next day she was not only out of bed, but also up for a hike in the rain forest. “The experience was beyond the box of my reality,” says Dr Bruce, who felt stunned—and intrigued—by her instant recovery. After studying shamanism during visits to South America, she became the first non-Quechua woman to be initiated into the circle of Yachaks, the bird-people shamans of the high Andes. She is the author of Shaman MD, a book recounting her experiences, which is available at amazon.com

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