A new study of twins demonstrates how smoking causes premature aging of the face, causing more wrinkles around the lips and sagging under the eyes
Researchers led by Bahman Guyuron, M.D., of the department of plastic surgery at Case Western Reserve University and University Hospitals, Cleveland, set out to identify specific components of facial aging secondary to smoking. They did so by identifying 79 pairs of twins in which only one twin smoked or where one smoked at least five years longer than the other.
Participants completed questionnaires, and professional photographers took standardized photographs of the twins. A panel of three blinded judges analyzed the twins’ facial features and graded wrinkles using the Lemperle Assessment Scale, then ranked age-related facial features on a four-point scale.
According to the study, which was published in the November issue of Plastic and Reconstructive Surgery, twins who smoked compared significantly less favorably to their non-smoking siblings in scores for upper-eyelid skin redundancy, lower-lid bags, malar bags, nasolabial folds, upper lip wrinkles, lower lip vermillion wrinkles and jowls. Lower-lid hyperpigmentation in the smoking group fell just short of statistical significance. There was no statistical difference in transverse forehead wrinkles, glabellar wrinkles, crow’s feet and lower lip lines accentuated by puckering.
Among twins with greater than five years’ difference in smoking duration, twins who had smoked longer had worse scores for lower lid bags, malar bags and lower lip vermillion wrinkles.
“The most important finding is confirmation of what was assumed to be the aging changes as the consequence of smoking in a scientific manner,” Dr. Guyuron tells Dermatology Times. “The malar bags and hyperpigmentation of the lower lids seem to be the most common features of the ‘smoker face.’”
This news is brought to you courtesy of Dr. Mark Bishara and The Paragon Surgery & Med Spa
 
 

The US Food and Drug Administration (FDA) has approved Juvéderm Voluma XC(Allergan) to correct age-related volume deficits in the midface in adults aged 21 years and older, the company has announced.

Juvéderm Voluma XC is a gel composed of cross-linked hyaluronic acid suspended in phosphate-buffered saline with 0.3% lidocaine. It is the first dermal filler approved in the United States specifically for deep (subcutaneous and/or supraperiosteal) injection for cheek augmentation to correct age-related volume deficit in the midface.
As reported by Medscape Medical News, the FDA’s General and Plastic Surgery Devices Panel unanimously agreed that Juvéderm Voluma XC is effective and safe and that the benefits outweigh the risks, according to the clinical trial data presented to the panel.
“As people age, the cheek area can lose volume, causing the cheeks to flatten out and the skin to droop and sag,” Derek H. Jones, MD, said in a company news release announcing the approval. Dr. Jones is associate professor of dermatology at the University of California, Los Angeles; founder and medical director of Skin Care and Laser Physicians of Beverly Hills; and clinical investigator in the Juvéderm Voluma XC pivotal study.
In the study, “physicians and patients were able to see instant and visible results, including correction of age-related volume loss in the cheek area and a more youthful appearance to the face,” Dr. Jones said.
JUVEDERM VOLUMA(TM) XC is made with Allergan’s proprietary VYCROSS(TM) technology, an advanced manufacturing process that results in a smooth gel that flows easily and consistently. This unique formulation contributes to the lift capacity to correct volume loss in the cheek area and to the duration of the product.(2,3) Additionally, JUVEDERM VOLUMA(TM) XC contains a small amount of lidocaine which helps to numb the treatment area during the injection procedure. The JUVEDERM VOLUMA(TM) formulation without lidocaine was first introduced in Europe in 2005. JUVEDERM VOLUMA(TM) with lidocaine was first introduced outside the U.S. in 2009. As of August 31, 2013, JUVEDERM VOLUMA(TM) with lidocaine (branded as JUVEDERM VOLUMA(TM) XC in the U.S.) is distributed in 72 countries, including markets in Europe, Latin America, Middle East, Asia Pacific, and Canada. The JUVEDERM(R) family of products, including JUVEDERM(R) Ultra and Ultra Plus, are marketed and sold in 85 countries outside the United States.(4)
The most common adverse effects observed in the clinical trial included temporary injection-site tenderness, swelling, firmness, lumps/bumps, bruising, pain, redness, discoloration, and itching. The adverse effects were predominantly moderate (uncomfortable) in severity and lasted 2 to 4 weeks.
Juvéderm Voluma XC will soon be available at Dr. Mark Bishara’s office.  We will keep everyone updated when the product will be available in both of our Mansfield and Southlake offices.
This news is brought to you courtesy of Dr. Mark Bishara and The Paragon Plastic Surgery & Med Spa


 

Would you consider traveling to Mexico or India for a less-expensive rhinoplasty or breast augmentation procedure? Would you consider traveling to Texas for a Robotic Hair Transplant procedure?  Many Americans are doing just that-and the trend is having an impact on the market for cosmetic plastic surgery.
The paper, by ASPS Member Surgeon Dr. Kevin C. Chung and Lauren E. Franzblau of the University of Michigan, discusses “the rise and transformation of the medical tourism industry, foreign and domestic forces that influence cosmetic surgical tourism, and the pros and cons for all involved parties.” Chung and Franzblau write, “The rapid globalization of the industry also marks a fundamental shift in the world’s perception of elective procedures: patients are becoming consumers and these medical services are being viewed as commodities.”
At the office of Dr. Mark Bishara, with offices in Mansfield and Southlake, TX- we have patients traveling from all over the world for Robotic Hair Transplants.  We perform the surgery in both of our locations, making it even easier for patients to access the closest office for them.
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More ‘Medical Tourists’ Are Traveling for Cosmetic Surgery
Traveling for medical care is nothing new-but in the past, people were more likely to travel from poor countries to obtain higher-quality care in wealthier countries. Today, prompted by the ease and relatively low costs of travel, more patients from the United States and other western countries are traveling to the developing world to access less-costly medical and surgical procedures. Because cosmetic plastic surgery procedures aren’t covered by insurance, they make up a major part of the burgeoning medical tourism market.
Figures vary, but there’s a consensus that medical tourism is growing rapidly: India alone may have more than one million medical tourists per year. Other countries with growing medical tourism industries include Mexico, Dubai, South Africa, Thailand and Singapore.
In many countries, governments are working actively to foster their medical tourism industry. Some destinations even market procedures performed in resort-like settings, encouraging patients to combine a vacation with cosmetic surgery. Traveling abroad also lets patients recuperate privately, without anyone at home knowing that they’ve had plastic surgery.
Raising Potential Concerns Over Safety and Quality
The growth of medical tourism may have a significant impact on the cosmetic surgery market in the U.S., but also raises concerns over physical safety and legal protection. Although destination countries promote the quality and safety of their procedures and facilities, there is often little evidence to support these claims.
“Because the practice of medical travel does not appear to be going away in the foreseeable future, plastic surgeons must understand the international market and learn to compete in it,” Chung and Franzblau write. Since U.S. surgeons may find it hard to compete on price, effective strategies may include emphasizing superior quality and safety of care, or developing “niche markets” of procedures that can be profitably performed at home.
The authors emphasize that medical tourism “is not purely good or bad”-neither for patients nor the countries involved. Patients may be drawn by lower costs, but must consider the potential risks of undergoing surgery in a foreign country, as well as traveling after surgery. ASPS provides information for patients considering travel abroad for cosmetic surgery, including risks and follow-up care.
For the U.S. and other developed countries, medical tourism means fewer patients and less revenue-but may also bring increased opportunities for collaboration with rapidly modernizing countries in other parts of the world. Chung and Franzblau conclude, “To retain patients and be competitive in a global market, U.S. plastic surgery must be vigilant of the changes in medical tourism and must adapt accordingly.”
This news is brought to you courtesy of Dr. Mark Bishara and
The Paragon Surgery & Med Spa
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The Denver Broncos receiver had the procedure done prior to last season’s training camp with the Patriots.
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No, the Denver Broncos wideout didn’t have surgery on his knee or ankle last summer but a robotic hair transplant procedure at the Rhode Island office of Dr. Robert Leonard.
“[The growth] doesn’t happen right away,” Welker told For The Win. “You start to see a little bit after two or three months and in six months you get to see a little more. Once you get up to a year you’re really starting to see the difference. It takes a full 18 months till it’s fully grown in.”
While plenty of pro athletes wouldn’t want to make such a public admission of cosmetic procedures, Welker has no problem with his role as the president of the NFL’s new de facto hair club for men.
“It’s nothing to be embarrassed about,” he said. “If you want to have hair, have hair. I don’t like to sit there and say ‘What are you talking about? I never got my hair done.” People can notice it without wondering.”
And what of Welker’s former teammate Tom Brady? Brady’s hair has been the center of its transplant speculation.
“You know what – that’s still out for debate. He claims he hasn’t but who knows,” Welker said.
Welker said he’s received calls from numerous other NFL players asking him for his doctor’s number, although he didn’t name any specific current or former teammates. He was equally tight-lipped when asked about the effect that the Aaron Hernandez investigationRob Gronkowski injuries and acquisition of Tim Tebow could have on the locker room of his former team, the New England Patriots.
“I hope the best for them but it’s not my concern to worry about them,” Welker said. “I’m just trying to worry about myself.”
This news is brought to you courtesy of Dr. Mark Bishara and The Paragon Plastic Surgery & Med Spa in Mansfield and Southlake, TX
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New studies just released underscore the potential impact of healthy lifestyle choices in treating depression, the effects of aging, and learning. The research focused on the effects of mind/body awareness, exercise, and diet, and was presented at Neuroscience 2013, the annual meeting of the Society for Neuroscience and the world’s largest source of emerging news about brain science and health.

The experiences and choices people make throughout life actively impact the brain. As humans live longer, these choices also affect aging and quality of life. Lifestyle changes to diet and exercise will be important to aging populations as non-drug, easy-to-follow interventions with few side effects,make ideal potential therapies.
Today’s new findings show that:

  • As few as 12 consecutive days of exercise in aging rats helps preserve and improve movement function, an effect possibly caused by changes in dopamine. The results suggest that exercise could stave off or reverse the slowed movements that are hallmarks of age
  • Practices like yoga or meditation that increase mind/body awareness help people learn a brain-computer interface quicker. This finding may have implications for those who need brain-computer interfaces to function, such as people with paralysis
  • Long-term exercise in aging rats improves memory function, as well as increases the number of blood vessels in the white matter of their brains – the tracts that carry information between different areas of the brain. Increased blood flow may explain why exercise can help preserve memory
  • Regular, supervised exercise helped young adults with depression overcome their symptoms in a pilot study. The results suggest that exercise could be an important treatment for depression in adolescents
  • A low calorie diet starting in middle-age onward protected rats against the effects of aging on movement. The results suggest that dietary interventions can help preserve movement function in a manner similar to exercise

“We all know that keeping fit is critically important to a healthy lifestyle, from combating the effects of aging to boosting our mood,” said press conference moderator Teresa Liu-Ambrose of the University of British Columbia, who is an expert on exercise and its role in healthy aging. “Today’s results begin to show us not only how different types of exercise interventions can improve our lives, but how other types of lifestyle behaviors, from diet to meditative practice, can help us achieve wellness in our body and our brain as we age.”
This news is brought to you courtesy of Dr. Mark Bishara and The Paragon Surgery & Med Spa