Issue #25 summary - GO BACK TO ARCHIVE

In search of the optimal diet
Genes respond to the environment you subject them to. Changing diet and lifestyle alters your gene expression, and consequently your physiology and your health, writes Michael Culp

You are unique. There is no one else in the world exactly like you. What makes you unique is a precise combination of genetic variation and environmental exposure. This combination of your genes and environment is also the major determinant of your health and longevity.  Small variations in your genes, known as single nucleotide polymorphisms (mercifully abbreviated as “SNPs”), account for most of your genetic individuality. In total, you have about 3,000,000 SNPs—that’s three million reasons why you are not like anyone else.
    Your genes carry information. They are the molecular blueprints for every protein in your body. But genes do more than simply carry information. Genes literally respond to changes in your environment.  Every food or nutrient you consume has not only direct biochemical effects but also affects gene transcription and translation.  Foods turn some genes on and other genes off. To illustrate this principle, consider the herb ginkgo biloba.  Biochemically, ginkgo is known to cause peripheral vasodilation and also to possess potent antioxidants. However at the molecular level, researchers found that giving ginkgo to mice more than doubled DNA transcription in 13 genes in the hippocampus and in 43 genes in the frontal cortex.
     Not only did ginkgo show a preferential activation of the central nervous system but it showed differential activation within specific parts the central nervous system. There is nothing extraordinary about ginkgo—every herb, every food, every nutrient, and every medication that we have previously thought of only in terms of their biochemical effects must be re-evaluated from the perspective of their direct effects on our genes. The scientific study of how diet and DNA interact is known as nutritional genomics.
     Why should our genes respond to the environment? The simple answer is survival. An organism that responds to environmental changes and quickly synchronises its physiology with those changes is more likely to survive and reproduce, which is, of course, the end game of evolution.

Mini-rhinoplasty
Dr Frédéric Braccini reveals mini-rhinoplasty’s attractive benefits, including minimal trauma and
faster recovery times, compared with conventional rhinoplasty

Rhinoplasty is probably one of the greatest plastic surgery procedures, but it’s also one of the most complicated. With a high rate of secondary surgeries attesting to the complex nature of the operation, it’s an area that calls on all the skills of an expert surgeon.
     Mini-rhinoplasty has been developed as a less-traumatic technique, with excellent aesthetic outcomes. Using a minimally invasive procedure, the method benefits from few complications in the postoperative period, with postoperative management of main importance. Based on the evidence of more than 500 surgical procedures, mini-rhinoplasty has been shown to meet with the evolving needs of plastic surgery, allowing a shorter recovery time for patients while maintaining all the advantages of the aesthetic goal.
     There is no standard rhinoplasty, so each surgeon has his or her own signature, and there is a different type of rhinoplasty for each patient. The main objective of aesthetic and artistic rhinoplasty is to make sure that the nose will still look natural while making it look nicer and in harmony with the rest of the face. But among all the techniques, mini-rhinoplasty is one of the most efficient.
     The method was developed in France by the team of professors Cannoni and Pech, and then by professor Thomassin. Based on the ever-increasing need for operations, these methods have to be quick, precise and not traumatic to enable the patients to go back to work as soon as possible. One of the main assets of mini-rhinoplasty is the flexibility afforded to the surgeon, who can change the surgical strategy at anytime. It does not prevent the use of an external approach, or a technique such as inserting a graft. Apart from these technical indications, minirhinoplasty can also be associated with some other facial plastic surgery. For example, with an elderly patient, the rejuvenating effect of a lifting or of a blepharoplasty can be improved by a mini-rhinoplasty.

The facelift gets a facelift
The emphasis in surgical facial rejuvenation has changed to maintaining a youthful, fresh appearance rather than producing dramatic alterations later in life, writes Mr Adrian Richards

Facial rejuvenation surgery has changed significantly over the past few years. Older techniques can produce an unnatural windblown appearance and were generally performed on patients in their 50s and 60s. More modern techniques produce less dramatic transformations and are often performed on patients in their 40s, when many of the gravitational ageing changes occur.
In my NHS consultant practice, I performed cosmetic and reconstructive cases. But I felt the case-loads were too broad and did not allow me to specialise.  I decided to focus on facial cosmetic surgery and feel my expertise has improved significantly over the past four years. Facial rejuvenation surgery performed correctly and for appropriate patients is extremely rewarding and is associated with a high rate of patient satisfaction.
     A comment I often hear is that people say their face no longer matches how they feel. More than 90 per cent of facial rejuvenation procedures are performed on women, and their increasing financial security and control may also contribute to the overall increase in these procedures.
When analysing the face, three main factors should be taken into account: the quality of the skin, dynamic facial lines caused by underlying muscle activity, and gravitational lines caused by descent of the facial structures.  Many factors influence the quality of the skin. These include skin type, sun exposure and cigarette smoking.  Familial factors, sun exposure, smoking and diet are among some of the other factors that affect the skin. Typically, these lead to decreased collagen formation, surface irregularity and mixed pigmentation.
     Dramatic changes can be produced by addressing the quality of the skin. These start with sensible preventative measures such as using a daily moisturiser containing sun block. Once the changes have occurred, laser or chemical peel treatment can be used to rejuvenate the skin.Dynamic facial lines are caused by activity of the underlying muscles. In youth, when the muscle relaxes, the skin fold will disappear.
     With repeated contraction, these lines deepen and become permanent. As these lines are caused by muscle hyperkinetic muscle activity, the logical approach is to weaken them selectively using Botox injections. These are effective at reducing dynamic lines in the following areas: frown lines in the glabella region between the eyebrows, transverse lines on the forehead and smile lines in the crow’s feet area.

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