Weight-Loss Surgery Unbalanced Among Men and Women

Evaluation of research data on patients who underwent bariatric surgery over a twelve year period identified a number of factors that explain why significantly more women than men have weight loss surgery.

Investigators at the University of California, San Diego examined data on more than 190,000 patients who had weight loss procedures between 1998 and 2010 and the findings were reported this week in the Journal of Laparoendoscopic & Advanced Surgical Techniques. Investigators concluded that eighty percent of the patients were women.

The study concluded that women tend to have a greater overall recognition of the risks of obesity and are less satisfied with the status of their health as compared to men. Men tend to delay surgery until they get older and it was statistically reported that the gender gap for weight-loss procedures actually narrows as men enter their 70’s.

Although an even division in obesity rates exists among US men and women, the results of this study suggest a need for increased awareness of the health risks and complications of obesity in men.

Minimally Invasive Procedures with Subtle Results

For those seeking improvement of their skin with natural looking results, there are several minimally invasive options. The use of fillers and peels can rejuvenate the appearance of the face and, if further improvement is desired, surgical procedures can be performed.

Botox and Dysport

Mechanism: 
Injections of the toxin weaken the muscle by blocking muscular nerve signals. Since the muscle can no longer contract, facial wrinkles are diminished. 

Purpose:
Helps with smoothing of wrinkles specifically, 
Frown lines between the eyes
Forehead lines
Crow’s feet and skin bands on the neck

Soft Tissue Fillers

Mechanism: 
A naturally derived or synthetic material is injected into the face
Add volume to areas of the face that have lost subcutaneous fat through aging, heredity, sun exposure and lifestyle. 

Purpose:
Helps restore volume and fullness in the face
Softens facial lines and plumps thin lips
Used to fill shallow contours, soften wrinkles and facial creases
Augments facial rejuvenation surgery, often used in combination with Botox or Dysport

Chemical Peel

Mechanism:
A chemical solution is applied to the face (and hands and neck) to remove damaged outer layers of skin caused by sun exposure, acne or aging. Newer, healthier skin cells are exposed. 

Purpose:
To peel away or diminish blemishes or other imperfections
Enhance skin tone and texture, helps erase scars
Lessens acne and acne scars and irregular skin pigmentation
Improve age spots and liver spots, rough and scaly skin
Diminishes freckles and fine lines and wrinkles 

Laser Hair Removal

Mechanism:
A highly concentrated beam of light is used to penetrate hair follicles
The light is absorbed by the pigment which damages the actively growing hair follicle

Purpose:
Future hair growth is slowed but may not be permanently removed
Several treatments may be needed to provide desired hair reduction
Periodic maintenance may be needed
Effective for most parts of the body

Microdermabrasion

Mechanism:
Skin is gently sanded with a minimally abrasive instrument
The thicker, uneven outer layer is removed

Purpose:
To treat light acne scarring and reduce or eliminate enlarge pores
Lessens the appearance of stretch marks
Reduce fine lines and wrinkles
Exfoliates the skin for a refreshed appearance
Improve age spots and diminish hyperpigmentation and discoloration from sun damage

Millions of minimally invasive procedures are performed annually with excellent results. Be sure to discuss your expectations with a certified plastic surgeon, cosmetic surgeon or dermatologist to determine your best options.

A Drug to Stop Wrinkles and Aging Skin Shows Promise

Following the administration of a drug to block the activity of Granzyme B, researchers discovered that, despite sun exposure, genetically engineered mice retained youthful looking skin as compared to the aged skin on normal mice. Scientists at the University of British Columbia are investigating the potential for a cosmetic product that will prevent normal, gradual aging of the skin due to UV light exposure.

Elevated levels of Granzyme B, a serine protease, have been implicated in several autoimmune and skin diseases.  The role of Granzyme B in atherosclerosis and heart attacks was under investigation by a team of researchers at the University of British Columbia. They were interested in determining if blood vessels of mice lacking Granzyme B were more resistant to hardening and narrowing of the arteries than normal mice. By blocking the activity of Granzyme B in certain places, the researchers were surprised to find that aging and deterioration could be prevented in tissues that depend on collagen, such as skin and blood vessels.

Based on this technology, a Granzyme-B inhibitor is currently being developed by viDA Therapeutics, a research based biotechnology company. Within two years, the company hopes to test a topically applied drug on people with discoid lupus erythematosus, an autoimmune disease that leads to facial scarring when skin is exposed to sunlight.

If the drug is effective, not only will there be potential for new cosmetic products, but also help for life-threatening conditions such as aneurysms, chronic obstructive pulmonary disease, and diseases caused by the breakdown of collagen and other proteins.

Enhanced Surfaces of Breast Implants May Reduce Post-Surgical Complications

Almost 400,000 breast augmentations and reconstructions are performed annually in the US and the number is increasing each year. Following surgery, about one in five women suffer from a complication known as capsular contracture. Scientists at a large research university in the UK have created an enhanced patterned surface for silicone implants to reduce the rate of complications.

Following breast implant surgery, the body reacts by forming a protective lining of scar tissue in the form of a capsule around the implant. In some cases, an excess amount of scar tissue is formed which results in the shrinkage of the capsule and a squeezing or hardening of the breast caused by the interaction of the capsule with the implant. This complication is referred to as a capsular contracture. While the cause is unknown, many surgeons use a 'No Touch’ implant insertion technique to reduce the likelihood of a complication. In its early stages, capsular contracture is commonly treated with vitamin E, certain drugs or massage, however in many cases, surgery to release or remove the capsule is necessary.

Textured, or roughened implant surfaces have previously been shown to reduce the amount of scar tissue formed around breast implants and currently, implants on the market have smooth or larger textured surfaces. Scientists at the University of Manchester have created smaller textured areas on the surface of implants and their findings indicate that these surfaces imitate the body’s own cell surfaces. It is also suggested that the smaller areas of texture create a more suitable micro environment for adherence and growth of breast tissue cells and, as a result, the likelihood of complications following breast implant surgery is reduced. More lab studies will need to be conducted prior to the clinical use of these enhanced patterned surfaces.

For further information on the findings: University of Manchester. “Breast implants could be safer thanks to cell-friendly surface.” Medical News Today. MediLexicon, Intl., 22 Mar. 2015.Web.

Use of Google Glass in Plastic Surgical Procedures

Introduced on a limited basis in 2013, Google Glass is a hands-free, computerized type of eyewear that has the potential for use in plastic surgery as well as in other healthcare fields. Surgical procedures performed using the Glass can be seen live or recorded which will provide surgeons with a wide range of possible uses and applications.

Google Glass eyewear provides the wearer with the ability to control the device using voice commands, touch or a change in head position. The live streaming option gives surgeons the capacity to augment training, join in remote consultations and virtually assist during actual procedures. Recorded procedures can enable surgeons to self-evaluate, share videos and provide surgical training. As reported in the March 2015 issue of Plastic and Reconstructive Surgery (ASPS), additional uses may include providing quick access to medical documentation such as patient records and imaging studies. The hands-free nature of Google Glass may also help reduce the spread of infection.

As upgrades and options continue to be developed, there will be additional purposes, applications and challenges with the use of Google Glass.

High Satisfaction Rates from Autologous Breast Reconstruction

Following mastectomy, women report higher satisfaction from breast reconstruction using their own tissues, rather than from the use of implants.  While both methods provided good outcomes, a new study indicates that patients with autologous reconstruction were more satisfied with the results and with their quality of life after reconstruction surgery.

According to a study published in a recent issue of Plastic and Reconstructive Surgery, ninety-two women completed a BREAST-Q survey following breast reconstruction between 2006 and 2010.  Approximately half of the women in the study had autologous breast reconstruction that was performed using “donor” flaps from their abdomen to create their new breasts and the other half received implant-based reconstruction. On a 100-point scale, the satisfaction scores for overall results were about ten to twelve points higher for autologous reconstruction than for implant reconstruction. There were no significant differences between the two methods in terms of scores for quality of life.

It is important to note several differences between the two groups. Women who chose autologous reconstruction were generally older, were more likely to have undergone radiation therapy and had received delayed reconstruction surgery. Implant reconstruction was typically performed on younger women who had a double mastectomy with reconstruction immediately following surgery.

Women have many options for breast reconstruction and a single ideal reconstruction method is not appropriate for all patients. The researchers concluded that patient characteristics between the two groups accounted for the preliminary results and that further studies are needed to evaluate the reasons for the differences in overall satisfaction rates. 

Injectable Drug Dissolves Double Chin

If you are bothered by moderate to severe excess fat under your chin or neck, your treatment options have previously been limited to a neck lift, liposuction or jawlift surgery. There is now a new, FDA approved, less-invasive, cost-effective injectable treatment option from Kythera Biopharmaceuticals. 

Over the last eight years, Kythera has been developing an injectable drug to contour submental fullness as it is estimated that about seven of ten people are concerned about their double chin. The patented formulation called ATX-101 is a pure, non-animal derived version of deoxycholic acid, a molecule that occurs naturally in the body and aids in the rupture and breakdown of dietary fat. Through a process of adipocytolysis and preferential targeting of cells with low protein content, the drug was reported to have relatively no effect on the surrounding blood vessels, nerves and muscles. Patients in the drug study received a series of treatments at intervals of one month apart and high rates of satisfaction were reported. Side effects included redness, bruising, itching, pain in the chin, nodules, numbness and burning sensations. Best results were seen on patients without advanced skin laxity.  

For people who long for a newly defined chin and jawline, it is anticipated that this new treatment option will be commercially available in 2015.