Most chemical agents damage the skin by producing a chemical reaction rather than hyperthermic injury. Although some chemicals produce considerable heat as the result of an exothermic reaction when they come into contact with water, their ability to produce direct chemical changes on the skin accounts for most significant injury. Specific chemical changes depend on the agent, including acids, alkalis, corrosives, oxidizing and reducing agents, desiccants and vesicants, and protoplasmic poisons. The concentration of toxic agent and duration of its contact primarily determine the degree of skin destruction. When the skin is exposed to toxic chemicals, its keratinous covering is destroyed, and underlying dermal tissues are exposed to continuous necrotizing action.

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Earlier this year the American Society for Aesthetic Plastic Surgery reported findings from a new study published in the November/December 2008 issue of Aesthetic Surgery Journal that suggested a combination treatment using laser energy and fat transplantation shows promise in significantly improving cellulite. Cellulite is a common condition that gives the appearance of lumpiness and dimpling across the skin and is most prevalent in the thigh, hip, and buttock areas.

“Cellulite is caused by bands of fibrous tissue that connect the muscle to the skin,” says Alan Gold, MD, President of the American Society for Aesthetic Plastic Surgery (ASAPS). “If these bands are tight and the fat between the muscle and the skin bulges out between them, there will be dimpling over each of those bands. There is nothing otherwise special or unique about the fat itself in those areas.” Almost all women (and some men) have cellulite, stemming from genetic predisposition, hormonal changes and weight gain. And in major cities such as Los Angeles and San Diego cosmetic surgery procedures may provide significant improvement in the dimpled appearance of cellulite.

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The popularity of Fraxel treatment continues to grow as more and more people discover how this laser technology enables skin rejuvenation and effectively treats wrinkles, frown lines, skin pigmentation, acne and surgical scars.

In this first of a series of articles, we look at two types of Fraxel treatment currently available, Fraxel Restore and Fraxel Repair and how they differ. We’ll then go on to give a short overview the types of skin conditions they deal with. In future articles we will go into greater detail about how particular skin problems can be treated by Fraxel.

First of all, let me give you a potted history of Fraxel. Developed by Reliant Technologies Inc., Fraxel uses fractionated technology to treat microscopic areas of skin with a laser that uses an Intelligent Optical Tracking® system to leave the surrounding skin untouched. These untouched areas stimulate a natural healing process, helping the treated areas to heal more quickly after treatment than if a large area of skin had been treated with the laser.

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Cellulite remedies are real. At least some of them are. You have a great opportunity to see what can be done about cellulite based on real science if you can find it. The mother lodes of free information on this topic are available at the U.S. Patent and Trademark Office website and at PubMed, the online medical database at the National Institutes of Health. Based on what I have found at these government sites alone, cellulite can be reduced or eliminated naturally. More importantly, you can use this public information to sort through all the weak and scientifically unsupported claims by thousands of manufacturers about their cellulite remedies. This is the best way, in my opinion, for accepting and rejecting different products.

U.S. Patents

The government patent site is free, so you can do a search yourself, using the word ‘cellulite’ in a patent title search. By doing so, you will find 37 patent titles. You can click on the links to each one to see what the main herbal composition is. (This does not give you a full copy of any patent, though. If you really want one, you can order it through the website. The last time I bought one it cost $6.00, which is a bargain.)

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Few things are worse than feeling uncomfortable with your body. This discomfort can come from many different places and can plague you through much of you life because you might feel the need to avoid wearing certain types of clothing or doing certain things to not reveal the part of your body that you are unhappy with. However, no one should have to live like this and there are many things that you can do to help with your body image issues and start living a happier life.

One body image problem that lots of people struggle with is spider veins. This is a body image issue because these veins can be seen as very undesirable and can be a pain to try and get rid of. If you do not have the means to seek treatment for these veins, you might try seeing them in a new light and begin to accept them as part of your body. One way to do this could be to remind yourself that many people have these types of visible veins, so you are certainly not along in having them. Knowing that other people also have these veins and are struggling with body image issues relating to them can make you feel more at ease knowing you are not alone and that you are just like many other people out there.

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No procedure in plastic surgery has been the subject of greater scrutiny and controversy, both scientific and political, than breast augmentation. After banning silicone breast implants in 1992, the government urged plastic surgeons to produce studies validating both the safety and patient satisfaction with breast implants.

In response, one study of 112 women demonstrated improved self-image, decreased self-consciousness, and heightened self confidence. Overall satisfaction rates approached 86% (Mathes and Nahai- Textbook of Plastic Surgery)

Surgical Incisions and Procedure

Four separate incisional sites-inframammary, periareolar, axillary, and transumbilical-have been used for placement of breast prostheses.

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Liposuction continues to the most common plastic surgery procedure all over the world, and also in India. It is basically a permanent removal of fat cells by the use of a suctioning device. It is a safe procedure, with minimum down time, and fast recovery. It has been shrouded in small controversies, and bad results, but this has been due to the procedure being done by untrained personnel, and other medicos who are not Cosmetic Surgeons. So it is important that a potential client look through the profile of their treating physician and asses really whether that person is actually capable of delivering all that he promises. Do not be led away by claims that they can remove 10 kgs or 12 kgs of fat and make you super thin. Please remember that the safe limits of liposuction are between 3-5% of the total body weight.

Procedure

The procedure involves infiltration of fluid into the areas to be liposuctioned. This has multiple benefits. It helps to loosen the fat, reduces the bleeding dramatically, and allows pain control after surgery as well. Usually I would infiltrate fluid in a ratio of 1:1 with the amount of fat that I plan to aspirate, ie, if I feel that I will aspirate about 1000 cc of fat from an area, I would like to infiltrate less than 10000 cc of the fluid in that area. I actually infiltrate much less than that, only about 0.5 :1 ratio. This has the benefit that I never face the risk of fluid overload ( potentially dangerous condition, where there is too much water in the body, and the lungs get filled with water). The other benefit is that, what is aspirated is pure fat, and not water mixed with fat. This gives an exact estimate of the amount of fat taken out. We surgeons have a bad habit of including the amount of fluid aspirated into the total volume taken out also, so that we can boast of having done large liposuctions. What is important is not the amount taken out, but how much of actual fat there is.

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Large breasts were at one time considered extremely aesthetic and very sociable, but in today’s world it is often a source of embarrassment. It also brings with it the problems of ill-fitting clothes, inability to wear modern, designer kind of hip clothing as well as the problem of back pain, bra strap marks on the shoulder, sweating and fungal infection below the breast line, and a general decreased self esteem.

Large breasts may be from teenage itself or more commonly after childbirth and lactation. The major complaint women have after childbirth and feeding is that the breast have now sagged down, and started to look very bad. The only treatment for these problems is surgical reduction known as reduction mammoplasty or breast reduction. No other non surgical procedure is successful, may it be use of ultrasound technology or radio frequency based devices. It should be understood, that there is an absolute increase of breast tissue as well as skin, which needs to tackled, and surgery is the only option

Procedure

Breast reduction involves an actual removal of excess breast tissue as well as skin, and shaping the breast to a more aesthetic and shapely figure as per the pre-operative discussions with the patient. Commonly this involves two types of procedures. One is a wise pattern with inverted ‘T’ scar pattern; the other is vertical short scar pattern. The latter technique is now well established, has a smaller scar, but takes significantly more time to give the final breast shape.

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LASERS today are almost the in thing in every aspect related to beauty, but we need to understand that lasers are not magic and they need to be clearly understood by both the physician administering the laser as well as the client. Lasers have specific indications and there are over 25 different lasers for specific indications in cosmetic surgery practice. Some of the common indications are for hair removal, facial rejuvenation, birth marks, acne scar removal, correction of dark pigmentation, etc. What are the different lasers available to us? A lot of different companies market the lasers. in fact today the infamous “Chinese” tag has also been associated with lasers. A lot of Chinese products are the best in the world. But like products from every country, not everything is the best, nor it it the worst.

It is important for the clients to know details of the company of the laser and what type of laser is being used. For Hair reduction, some of the common lasers being used are ND YAG, Diode, IPL, and more recently SHR. All have their indications and limitations. Diode most closely matches the wavelength of the hair folicle pigment, melanin, but it is time taking and painful. ND YAG, tends to leave behind a lot of the finer hair. IPL is probably believed by a lot of plastic surgeons to be the most inferior of the lot.

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Loose hanging skin in the region of the abdomen is very resistant to any kind of exercise. It is very distressing for the person, because it prevents wearing of proper clothes, and is visible as a hanging flab of tissue. This is particularly more common in post pregnant women, where the expanded abdominal skin fails to retract back to its normal contour. This is however less common in men.

The surgical procedure done in this condition is known as a tummy tuck or an “abdominoplasty”. A tummy tuck involves removal of the excess hanging skin along with the underlying fat to give a flat and toned abdomen. This procedure tightens the abdominal muscles and gives a new and rejuvenated abdomen. The position of the umbilicus is also shifted to a more natural position.

The scar

Patients are worried about the scar of the tummy tuck. It is reassuring to know that the scar can be placed according to the type of clothing that the patient prefers to wear, and it is not visible from under the clothing. Thus, if the patient wants to wear a particular type of bikini, we can site the scar accordingly. The scar can be shaped according to the type of jeans or dresses, which the patient may prefer. The scar is fine and tends to mature a lot over time.

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