Cosmetic Surgery Center | Vasdev Rai, M.D., F.A.C.S.

Some people make weight loss into a time-consuming daily chore with calorie counting, special diets, support groups, grueling exercise programs, gym expenses, and great will power struggles. It does not have to be so complicated. The basic principle is simple:

• Take in fewer calories than you use up each day
  

If you want to be precise that does mean a couple of calculations at the outset. You can then develop a routine of food types and varieties along with regular exercise of some type. Once you get into the new rhythm you can forget about any daily struggle and just weigh yourself each week or two weeks until you have met your weight loss goal.

If you don't want to bother with calculating calories, you can simply follow a few general principles:

• Eat mostly fresh vegetables and fruits along with modest amounts of protein and carbohydrates (that is, avoid fatty and sugary foods including all fast and processed foods)
• Eat only when you are hungry and stop eating before you feel very full
• Exercise at least three times a week. Exercise increases your metabolic speed -- you use more calories up each day.
  

Granted, it is sometimes difficult to switch your daily routines. Success in weight loss depends on your level of motivation, just as success in anything does. A firm decision has to be made that you will indeed reduce your weight to a new specific level.

Your Basal Metabolic Rate (BMR)

Your BMR is an estimation of the minimum energy (caloric intake) your body needs to maintain its basic functions such as digestion, blood circulation and breathing. In other words, it is the number of calories you need to function each day. You can find BMR calculators by doing an internet search. Take the results with a grain of salt if the calculator appears to be sponsored by manufacturers of diet foods.

Your Body Mass Index (BMI)

Your BMI is a measurement of your body fat in relation to your height and weight. Here is a formula for calculating your BMI:

• Square your height in inches (i.e., multiply it by itself)
• Divide your weight in pounds by your height in inches squared
• Multiply that new number by 703
  

A BMI between about 18 and 25 is considered normal and a BMI between 25 and 30 is regarded as overweight. Above 30 is obese. Some people lose weight evenly throughout the body. Others lose it first from certain areas and some retain fat in certain areas regardless of how much they lose in other areas. The abdomen is famous for retaining fat.

Liposuction is very popular and much in the news. But it is not a weight loss surgery. Most of your extra weight must be shed before you can have liposuction.

If you would like to know more about liposuction as a quick way of removing fat in specific body areas, please call or email our cosmetic surgery office today. We will be glad to give you a personal consultation.

Any time the skin surface is breached down through the second skin layer called the dermis, a scar will form. Scarring is the body's way of healing the incision, burn or accidental cut. Fibrous connective tissue forms at the site and draws the skin edges together, forming a ridge which may be straight or may not, depending on the nature of the wound.

Scar Features

A skin scar has no hair follicles, blood vessels or sweat glands. It is not the same as skin cells and is more susceptible to UV rays. Scars typically take about a year to fully heal, shrink and fade. A normal scar becomes a thin pale line. But there are abnormal scars which remain red and raised (Hypertrophic scars) and can even spread well beyond the wound site (Keloid scars). In those cases, the body is producing too much connective tissue

Each person scars in an individual way, some more quickly and others more slowly or less effectively. Some have a tendency towards Hypertrophic or Keloid scars which appears to be genetic. There is surgery to remove an unsightly scar but since it cuts the skin it will create a new scar. But a skilled surgeon can perform the scar revision surgery so as to leave you with a smaller scar, and that is the purpose of the surgery.

The heart can be scarred by a heart attack. The scar forms in the heart muscle and weakens that muscle, so that heart failure is more likely in the future. Other body organs can also form scars, such as the eyes and kidneys, but bones heal without scarring.

Incision Sites

When you have a cosmetic surgery such as breast augmentation or a facelift, the incisions are carefully placed so as to give you the smallest and least-visible scars possible.

If there is a cosmetic procedure that you would like to know more about, please call or email our cosmetic surgery office to schedule a free consultation. Bring all your questions and we will answer them clearly.

In the news lately has been some coverage of Donatella Versace's current appearance, evidently the result of plastic surgery. Her age is 53. She has lost a lot of weight and now has a skeletal appearance in bikini photographs. That reveals the clear outline of her breast implants. Instead of being submerged beneath natural tissue they form two perfect circles with an unnatural look. One cosmetic surgeon who was questioned about it opined that they contained about 300 cc.

Severe suntanning combined with long platinum blond hair looks like an attempt to be 18 years old. The facial skin looks firm and strangely unlined for a woman of 53 and does not match the rest of her skin which looks looser.

Her lips look enormous, clearly from over-use of one of the injectable fillers. Apparently she has always had large lips, but now they look out of proportion. A Beverly Hills plastic surgeon who was interviewed thought her eyes looked unnaturally hollow as if some over-aggressive eyelid surgery has been done, and that her nose appears too big and somewhat crooked as if poor nose surgery was done.

This is a woman who has been a fashion model and designer all her life with prominence, wealth and fame. For a person in that situation it must be even harder to grow old than it is for the rest of us. Other celebrities have clearly had a great deal of cosmetic surgery and Michael Jackson is like the "poster child" for too much plastic surgery -- a famous child struggling not to look old.

In the real world, cosmetic surgery must be done judiciously to give a natural look. It does not prevent aging; it just softens it. Even with a facelift, liposuction, and all the rest of the sophisticated cosmetic surgery procedures that are now available, an older person still looks better if he or she agrees to age gracefully.

Dr. Rai believes in good patient education and will be glad to give you a personal consultation if you contact our cosmetic surgery office today.

BOTOX is the most popular non-invasive cosmetic surgery procedure, according to the American Society for Aesthetic Plastic Surgery (ASAPS). They have not issued any figures yet for 2008, but in 2007 there were 2,775,176 BOTOX procedures done.

Another injectable is currently in FDA testing and is expected to be approved for cosmetic use shortly. Its name is Reloxin and it is based on the same substance that BOTOX is based on: the botulinum toxin, produced by the bacteria which cause food poisoning. Although that may sound like a questionable recommendation for a cosmetic injectable, BOTOX is very effective, quick, and painless and smoothes out wrinkles for three to four months before a repeat treatment is needed.

How BOTOX and Reloxin Work

Both BOTOX and Reloxin work by temporarily paralyzing the muscle where they are injected. BOTOX injections are usually made around the forehead to smooth out frown lines and horizontal wrinkles, or around the mouth to smooth lip lines. By preventing the muscles from contracting, they prevent the wrinkles from forming and the skin relaxes.

BOTOX has had medical use for about 30 years, being very effective in treating muscle spasms which may happen after a burn injury, or involuntary muscle movements as happen with cerebral palsy, for example.

Reloxin has been used for several years in European countries with the brand name of Dysport. It is reputed to start acting more quickly than BOTOX -- in one or two days, whereas BOTOX takes three or four days to show effects. The clinical trials are suggesting that it may give longer-lasting results also -- five or six months as opposed to the three months for BOTOX.

Allergan, the manufacturer of BOTOX, is reminding physicians that a new drug will not have the established safety record of BOTOX.

At the Cosmetic Surgical Center, we offer BOTOX as well as several effective dermal fillers for facial rejuvenation. If you would like to know more about BOTOX or dermal fillers and how they might help you, please contact our cosmetic surgery office today for a personal consultation.

In Shanghai there are about 230 private cosmetic surgery clinics. There are also uncounted numbers of low-cost and unlicensed clinics. This is at a time when China's economy is slowing down for the first time in six or seven years. Tens of thousands of women are lining up for a range of cosmetic surgery procedures, both invasive and non-invasive.

Hung Huang, the fashion editor of a popular Shanghai magazine was recently interviewed by a reporter from the U.S. Christian Broadcasting Network (CBN). "Chinese women are going completely gaga about fixing up their face, fixing up their breasts, fixing up their legs," he said.

"I usually see between five and ten patients every day," said one Dr. Lee, a head cosmetic surgeon at Shanghai's Ninth People's Hospital. That hospital has 16 operating rooms dedicated to plastic surgery and uses them for tens of thousands of surgeries per year. It receives hundreds of calls each day for consultations. All its rooms are booked and some operating rooms have to accommodate two or three patients at the same time.

What Procedures are in Demand?

By far the majority of Chinese people cannot afford cosmetic surgery. Many, perhaps most, of the women seeking cosmetic procedures are young, recently graduated from High School, and seeking jobs. They are looking for an edge in the competitive work world and leaning on their affluent parents to pay the costs.

Popular procedures are:

• Eyelid surgery -- a crease is created in the top eyelid to give the eyes a more wide-open look.
• Rhinoplasty -- nose surgery to raise and sharpen the nose outline.
• Breast augmentation
• Leg surgery -- metal rods inserted in the legs after the bones are broken. This is to give the woman extra height.
• Skin whitening -- products to make the facial skin more pale
  

Beauty according to Western standards is everywhere on display -- billboards, magazines, TV programs. "The look is so appealing and glamorous," said young lady to the CBN reporter on the streets of Shanghai.

China is not the only country experiencing a boom in cosmetic surgery -- it appears to be a worldwide phenomenon. If you would like to know more about the procedures we offer and which ones would most enhance your appearance, please contact cosmetic surgeon Dr. Rai for a personal consultation.

A group of women at the University of British Columbia in Vancouver recently completed a survey of cosmetic surgery coverage in popular women's magazines. They studied articles published between 2002 and 2006 in publications such as Cosmopolitan, Prevention, Flare and The Oprah Magazine.

The procedures most often written about were:

• Breast augmentation
• Liposuction
• Facelifts and
• Specific facial surgeries such as rhinoplasty and facial implants.

The researchers found that 59 percent of the articles made a specific link between pre- and post-surgery emotional health. They used such language as "restoring lost youth" and referred to aging as "a problem that needs to be fixed". The message they were trying to send was that cosmetic surgery will make you young again and that new youth will endow you with sexiness, personal confidence, more friends, a better job, and more prosperity.

What Are the Facts?

It's true that cosmetic surgery can rejuvenate the skin and enhance body contours and facial features. And it's often true that after such physical improvements a person has increased social and/or professional confidence. But looking more like a movie star will not transform your life into that of a movie star.

There's a fine line that is often overstepped by journalists. Cosmetic physical enhancements do not change who you are. They cannot necessarily get you a higher-paid job or more friends or a new spouse. They do not automatically overhaul your entire life. Certainly you might overhaul your entire life by working at it and being courageous and honest with yourself -- and some cosmetic surgery might help you in that endeavor.

It is a mistake however, to expect any specific cosmetic surgery to make a magical change to your entire being. If you would like to change some of your old habits or find new friends or a new job, those are separate goals requiring different kinds of work on your part.

As an example, if you lose your extra weight, Dr. Rai can then help you fine-tune your new attractive appearance with perhaps an arm lift or a thigh lift. But he cannot remove the extra weight for you. Having realistic expectations are part of being a good candidate for any cosmetic surgery procedure.

But by all means include some cosmetic surgery in your life-improvement work, and Dr. Rai and his team will be happy to help you with that. The first step would be to contact Cosmetic Surgical Center to schedule a personal consultation.

Several recent news reports items have reported an increase in cosmetic surgery procedures in the current "slumping" economy. This includes increasing numbers of men who have been laid off and want to look more vigorous and youthful in their upcoming job interviews.

Eyelid surgery and liposuction have been among the most-demanded surgeries, as men have been working on eliminating the evidence of fatigue and ill-health.

"No-one wants to hire someone who looks fat, tired and unhealthy," said one patient featured in one of the news reports. This man had facial liposuction for his double chin and a skin rejuvenation procedure to reduce wrinkles. That was after he first had a gastric bypass to deal with obesity.

Male hair transplants and chin augmentation are also in greater demand. The period between being laid off and interviewing for another job is a good downtime for cosmetic surgery, as it gives time for complete recovery before you have to "show your face" again.

Competing With Younger People?

When experienced employees have to go job searching and compete with younger people, their experience in itself may or may not be an advantage. Many companies prefer to hire people who look young and healthy because it is part of the company's overall image.

BOTOX is another popular procedure. At The Cosmetic Surgical Center we offer several excellent facial fillers, but BOTOX works differently. It achieves smoother, younger-looking skin but instead of doing that by depositing a support substance beneath the skin surface, it does it by paralyzing a specific muscle.

The BOTOX injections are most often made into the frown muscle to prevent it contracting. The nerve message coming from the brain is blocked, keeping the muscle relaxed. This smoothes out the frown lines -- more so as you have repeat treatments. The same effect can be achieved on horizontal forehead lines by injecting BOTOX into a different muscle.

If you would like to learn more about the cosmetic procedures which might be best for you, please call or email cosmetic surgeon Dr. Rai today. We will schedule a personal consultation for you.