The Centre, P.C. - Plastic Surgery Blog

A Primer on Human Hair - Wednesday, November 26, 2008

Although humans are considered "hairless" mammals, we are actually covered from head to toe with hair. It is called vellus hair and is fine and short so that we don't usually notice it. The hair we notice is terminal hair. A third type of hair is lanugo hair, which covers the body of a fetus but is mostly lost before birth. Hair is composed of dead cells -- if it were not, a haircut would be painful.

Structure of a Hair

Hairs consist of about 88 percent fibrous proteins called keratin. Keratin is also found in skin, teeth and nails, and in animal claws, hooves and tusks. It is a strong protein but can be either soft or hard. A hair grows from a hair follicle (its root) in the skin's middle layer, the dermis.

Each hair has:

• An outside cuticle which is translucent and consists of overlapping scales which cover the interior. Use of a hair conditioner after shampooing keeps these scales lying flat so the hair feels smooth.
• An interior core called the cortex or shaft, containing pigment granules (and some other structures). The pigment granules are small and solid and may vary in color within a single hair. They are clustered near the cuticle except in red hair, where they cluster in the center. They create melanin, the same substance which gives our skin its color.

Hair Growth

A normal scalp has between 100 and 150 thousand hairs though a blond head has more than either dark or red heads. Each hair is between 0.02 and 0.04 millimeter wide

Hairs grow at about a half-inch per month although that speed varies between individuals and can be affected by diet and by the seasons (faster in Spring and Summer). A healthy hair will live between two and six years and when it falls out a new one will start growing from that follicle. The lifetime of your hairs determines how long you can grow your hair -- whether you can have it be waist-length or even longer.

We have a total of about 1,400,000 hairs on our entire body. Men have about 30,000 in their moustaches or beards.

Hair Graying

As we age, the pigment granules in each hair gradually die out. That removes the hair's color, making it gray, silver or white. Any given hair may have scattered pigment granules remaining, making it partly gray and partly colored. The age at which our hair goes gray is hereditary.

Hair Removal

Laser hair removal is a very popular procedure. It is easiest done on dark hair with light skin. That is because the laser heat is absorbed by the pigment in the area. If the hair has little pigment, the laser is ineffective at removing it, and if the skin is strongly pigmented, the laser heat is absorbed there instead of in the hair.

Each person is individual in this respect, so please make no assumptions as to whether laser hair removal will work for you. Contact our cosmetic surgery office to set up a personal consultation and allow one of our doctors to examine your hair and skin.

Benefits of the Obagi Skin Care Products - Tuesday, November 25, 2008

Obagi Medical Products, Inc. is located in Long Beach, California. It is a pharmaceutical company headed up by Dr. Zein E. Obagi until 2006. The products were originally created in 1988 and since then the company has become international with a presence in over 35 countries.

One benefit of the Obagi skin care products is that they are prescription-strength products and more effective than anything store-bought. They need to be used at dosages and frequencies appropriate to your individual skin care conditions and are therefore available only through physicians.

Another great benefit is that they work together, giving better results than the application of miscellaneous separate products.

The Obagi-C Rx System

This product group is designed for young-looking skin which is beginning to develop signs of aging and has mild to moderate sun damage. It works to:

• Regulate production of melanin (skin pigment)
• Exfoliate the skin gently so as to maintain a youthful glow
• Neutralize free radicals and protect against both UVA and UVB rays

Please see our Obagi-C page for more details.

The Obagi Nu-Derm System

These products help aging skin with sun damage, fine lines and deeper wrinkles, sagging skin and adult acne. They work together to:

• Speed up the rate at which your skin produces new cells and discards old ones
• Suppress pigment production and promote even distribution of pigment to reverse and prevent discoloration
• Stimulate production of collagen and elastin, for better skin support
• Improve blood flow to the skin
• Provide skin moisture and nutrients

You can read more on our Nu-Derm System page.

The Obagi Blue Peel System

This is a one-hour treatment. It is best done after six to twelve weeks of using the Obagi Nu-Derm System, and you should resume using that System after the skin has healed from the peel. The strength and depth of your Blue Peel is determined by one of our cosmetic surgeons, whether Dr. Sullivan, Dr. Downs, or Dr. Viscardi.

The Blue Peel uses trichloracetic acid (TCA) in an inert blue-colored base. It may be applied in more than one coat, depending on your individual skin. Your skin will peel for several days soon after your treatment and be fully healed up after about ten days. You will see definite improvement at this point, and over the following four to six weeks, improvement will continue, as the skin becomes clearer, smoother, and more young-looking.

Please see our Obagi Blue Peel page for more information.

A Diet for Good Skin - Friday, November 21, 2008

Our previous blog in this space talked about free radicals and antioxidants. One of the ways free radicals harm the skin is by damaging or destroying its collagen and elastin. These are the fibrous proteins which interweave in the skin's middle layer. They form a supportive scaffolding which helps to keep the skin surface smooth. Loss of these collagen and elastin makes gaps and weakness in the scaffolding, so the skin surface subsides into those gaps, forming wrinkles.

Dietary Antioxidants

A good general principal to follow in maximizing your intake of antioxidants is: Eat Brightly Colored Fresh Foods.

Vitamins C and E

Research has been backing up the idea that Vitamins C and E help to reduce sun damage to DNA in the skin cells. Some foods that supply Vitamin C are:

• Citrus fruits
• Broccoli
• All green leafy vegetables
• Strawberries
• Tomatoes

Foods containing Vitamin E are:

• Whole grains
• Nuts and seeds
• Green leafy vegetables
• Vegetable oils

Vitamin A

Good sources of this excellent antioxidant are:

• Bright yellow or orange colored fruits and vegetables, such as carrots, corn, yellow squash, yams, peaches, apricots, mangos and cantaloupe
• Broccoli
• Tomatoes
• Kale and collard greens

Minerals in Your Diet

Zinc has been shown to be helpful with acne by cutting down on the skin's oil production. It may also help to clear up any existing lesions. Sources of zinc are chicken, turkey, oysters and lean beef or pork.

Copper works with Zinc and Vitamin C to promote elastin production. That helps to strengthen the supportive scaffolding and keep the skin smooth.

Selenium is a trace mineral that helps to prevent skin cancer and helps against sun damage. Good sources are eggs, whole-grain cereals, seafood and garlic.

Besides these specific nutrients, drinking plenty of water is essential for good skin. Skin dryness is a contributor to wrinkles and loss of the youthful glow and without adequate water intake, the skin will dry out, even if you use lotions constantly. Lastly, adequate protein intake is important. All the amino acids are necessary for the skin to produce healthy new cells.

To learn more about skin care and skin improvement, please call or email our cosmetic surgery office for a personal consultation.

What is an Antioxidant? - Thursday, November 20, 2008

Most people interested in good health and good skin care have read or heard about free radicals and how harmful they can be. What are free radicals and how to antioxidants help?

A Peek at the Chemistry

• The body is made of cells
• Cells contain atoms
• Atoms contain

• A nucleus which contains protons, which have a positive electrical charge
• Layers (shells) of orbiting electrons, which have a negative electrical charge and like to be in pairs. The shells fill up with electrons and when the outermost shell is full, the atom is inert. It doesn't form chemical bonds with other atoms.

When an atom's outer shell is not full but has an odd-man-out electron with no pair, that atom will do one of three possible things:

• Discard the single electron
• Acquire another electron to make a pair
• Bond with another atom which also has an odd-man-out electron

When any of these three actions is accomplished, that atom is stable and happy. An atom with an unpaired electron is a free radical. A molecule (several joined atoms) may also be a free radical if it has a missing electron.

A Chain Reaction Setting in

A free radical, trying to acquire an electron to make its last pair, might pull one from another atom (or molecule). If that was a stable, fully-paired atom, it now needs a replacement electron and may pull one from a third atom. Now the third atom needs one and may get it from a fourth atom. This is a chain reaction which can damage the cell containing these atoms and molecules.

Free radicals are also formed naturally as metabolic by-products when cells use oxygen. The immune system creates them as a way of neutralizing invading bacteria or viruses. They are also created by environmental factors -- chemical pollution in the air, radiation, and herbicides, for example.

How Antioxidants Help

Antioxidants can end the chain reaction by donating an electron. It doesn't turn them into another free radical because they are stable with single electrons and don't participate in the chain reaction. In effect, they are scavengers of free radicals.

• Vitamin C is the most common water-soluble antioxidant
• Vitamin E is the most common fat-soluble antioxidant

A Word to the Wise

Because Vitamins C and E (and many other substances not mentioned in this small space) are excellent antioxidants, that does not mean that more is better. Mega-dosing yourself may be harmful. A lot of research needs to be done before there is clear understanding of free radicals and nutrition. To stock your body with manageable amounts of antioxidants, eat a diet high in fresh fruit and veggies.

To learn more about skin care and the products and procedures we offer for skin improvement, please call or email our cosmetic surgery office today.

What are Spider Veins? - Sunday, November 16, 2008

Structure of the Skin - Friday, November 14, 2008

To care for the skin in the best possible way, it helps to have a clear picture of its structure. Although it seems like a thin membrane and we take it for granted much of the time, skin is complex and has layers and sub-layers. It is a protection for the body, being water-resistant, filled with blood vessels for heat regulation, and cushioned by fat for insulation.

Three Main Layers

1. The epidermis on top, containing five sub-layers. New cells are formed in the lowest sub-layer and move upwards to the top sub-layer, where they are discarded. Epidermal cells contain keratin, a tough, fibrous protein which forms a callus when the skin is rubbed or put under chronic pressure. This is added protection and can be useful, as when a guitar player develops them on the fingertips, for example.
2. The dermis in the middle, containing two sub-layers. It also contains many structures such as sweat glands, hair follicles, sebaceous glands, blood vessels, and nerves. Collagen and elastin, two fibrous proteins, interweave here to form a support matrix for the skin.
3. The subcutaneous layer which is not strictly part of the skin. It contains fat which provides insulation for the body and more support for the skin's surface.

Effective Skin Care

When lotions are applied to the skin they do not penetrate to the dermis. Lotions containing collagen or elastin are therefore not going to bolster the support matrix in that layer. To do that, injectable fillers are used, which work in different ways to add volume. This plumps up the skin surface and makes it smoother and more youthful-looking.

Lotions and creams are highly valuable though, as they add moisture to the epidermal layers. These layers take a beating from the environment, with UV rays, dry air, cold, air pollution, wind and so forth. The skin regenerates itself as we sleep so good skin care at night is important.

The Centre, P.C. offers several lines of excellent skin care products: Obagi, Centre Yourself, and Kinerase, plus nutritional supplements that help with skin care. It usually benefits your skin most if you settle on a cluster of products which give you good results and stick to them. Develop a routine which you can comfortably fit into your schedule, using the same beneficial products each day.

To learn more about good skin care please call or email our cosmetic surgery office today and we will set up a personal consultation for you.

How Lasers can Rejuvenate the Skin - Friday, November 07, 2008

The goal of all skin rejuvenating procedures is to stimulate the skin to replace old cells with new, tighter cells throughout the skin's epidermis (surface layer) and dermis (middle layer).

Collagen and elastin are two fibrous proteins which weave together in the dermis, forming a supportive matrix for the skin's surface. With aging, the production of new collagen and elastin cells slows down. The matrix weakens and forms little gaps, and this contributes to wrinkles.

What is a Laser?

Lasers are lights that are man-made for specific purposes. They are classified according to the medium used to make them: gas lasers, solid state lasers, semi-conductor lasers etc. Each type of laser has a specific wavelength, corresponding to a specific color. The light travels in a parallel, directional fashion unlike a flashlight, for example, which scatters light. Lasers can be pinpoint-tiny in their focus because they keep their light waves coherent.

How the Skin Laser Works

Medical lasers are cooler and do not harm the body. For skin rejuvenation, there are five types of lasers used. We use a pulsed carbon dioxide laser, which is infrared (invisible beyond the red end of the color spectrum). It targets water in and between the skin cells. In pulses of less than one millisecond, it vaporizes water with its heat, never burning because a millisecond is so short.

It is passed over the treatment area with a certain amount of overlapping each pass until the entire area is stimulated.

Recovery

Recovery time depends on how deeply the laser work was done. There will be some redness and puffiness and the skin will peel, sloughing off many more cells than it normally would have. In that process, scar cells and over-pigmented cells are discarded and replaced with young, tighter cells. This makes the skin smoother and more evenly-colored. Fresh surface cells rise to the top layer and increased collagen and elastin production strengthens the supportive matrix.

The end result is skin that is more youthful, more refreshed and less marred by sun damage, wrinkles or scarring. Depending on the exact type of work done, several treatments in a series may give the best results.

To learn more about laser skin rejuvenation please contact our office. We will schedule a personal consultation for you where you can have all your questions answered.

An Experiment in Facelifts - Thursday, November 06, 2008

In the search for a perfect way to rejuvenate the face, a new type of facelift was introduced in the U.S. this week at the American and International Academy of Aesthetic Medicine, in Miami, Florida. It is a stem cell facelift.

The stem cells involved are the patient's own stem cells, taken from the lower abdomen. They are contained in abdominal fatty tissue and have been found to produce hormone-like substances that improve the skin.

When transplanted to the face, they stimulate the facial skin and fat cells, and stem cells, to reproduce themselves. This new growth of cells compensates for the slowing down of cell production created by aging. As a result, the face becomes plumper, more refreshed, and more evenly colored. Results are long-lasting, since it is the person's own facial cells which are increasing youthfulness.

The Procedure

The stem cell facelift takes about an hour, as an outpatient procedure with a local anesthetic. No surgery is necessary as the stem cells are injected beneath the facial skin like a dermal filler. Recovery takes about seven days and involves reduction of swelling and redness. Camouflage makeup can be used within a few days.

Stem cell facelifts have not been tested or approved by the Food and Drug Administration. That means they are not available yet in the U.S. They have been done in France for several years and so far have a good safety record.

At The Centre, P.C., we offer surgical facelifts and mid-facelifts which have been rigorously tested and have excellent safety records. We also offer other facial rejuvenation such as soft tissue fillers and BOTOX.

Please call or email our office if you would like to schedule a personal consultation and learn more about facial rejuvenation. We will be happy to answer questions and explain how the various options could help.

Tummy Tuck: Standard, Mini, or Extended? - Tuesday, November 04, 2008

A tummy tuck, known medically as an abdominoplasty, removes extra skin and fat from the abdomen that can accumulate as we age, after weight loss or after pregnancy. There are three tummy tuck types that do similar things, but on different size areas of the lower body.

Standard Tummy Tuck

There are two incisions. One is long, running between the hip bones at the pubic area. The other is small, around the navel. The entire abdomen is targeted from the lowest rib to the pubis. Extra fat and skin are removed, the vertical abdominal muscle is tightened by being pulled together and stitched, and the navel is repositioned.

Mini Tummy Tuck

There is only one incision, running between the hip bones at the pubic area, but shorter than the incision for the standard tummy tuck. The targeted area is from the navel to the pubis, and excess fat and skin are removed. The navel is not repositioned.

Extended Tummy Tuck

This is also called a circumferential tummy tuck, belt lipectomy or body lift. A long incision runs from flank to flank, extending around to the back. The targeted area includes the abdomen and also the hips and lower back. Muscles are tightened in all these areas to create a more uniform look, instead of recontouring just the abdomen and leaving excess weight and sagging at the sides and back.

If you think you are a candidate for a tummy tuck and would like to know more about the procedure, please contact our office. The best procedure will be recommended after a careful and detailed personal consultation.