The following post was written by Dr. Jim English.

We live in a society that has rather large midriffs.  There are two basic reasons for this: fat and a relaxed abdominal wall.  The fat is located not only on the outside of the belly wall, which can be treated with liposuction, but it is also found on the inside of the tummy wall where the intestines are located.  This depository of fat can only be reduced by exercise and diet.  The other scenario for a protruding abdomen is the relaxation of the muscular wall.  In women, this often exists from the belly button downward and is usually attributable to pregnancies.  In men, it is found from the belly button upwards and exists when the six-pack muscles separate either from over exertion and/or a rather large collection of inward fat.  This deformity is often worse after a large meal when the belly is even more protrusive because the muscular wall is not strong enough to hold the stomach in after having been filled.  The surgical redress for these issues are either liposuction, abdominoplasty (tummy tuck) and /or both.  In my practice, I prefer to liposuction the fat from around the abdomen and flanks followed several months later with an abdominoplasty where the stretched tissues are put back together.  Regardless, the goal for either gender is a smaller waist and a flatter tummy.  When indicated, staging the procedures by removing the fat first with liposuction and tightening the abdominal wall and skin later gives the very best results.

If you have any questions then you can submit them here.

*Image taken from Google Images

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The first question has been asked on the Ask the Dr. page!

Q: Can I put Retinol containing products under my eyes and on crows feet?

Crows Feet

A: Retinol is approximately one twentieth the strength of prescription strength retinoic acid which is utilized in the medicinal products prescribed by physicians.  However, its use on the face can provide a benefit though not as good as the gold standard, Retin-A.  The lower eyelid skin is the thinnest skin of the entire body except for the genitalia.  Any preparation applied to this area should be done in a cautionary fashion until response is verified.  The best time to apply such a product would be at bedtime.  The body goes through a regenerative process during REM sleep and any substance(s) necessary for this process to be successful would be most helpful at this time.  This information and any other questions you might have would best be incorporated with the advice of your personal physician/surgeon.

I hope this answers your question.  If anybody else has questions pertaining to plastic and cosmetic surgery that you feel would be best answered by a doctor, then you can submit them here.

I hope everyone had a fun and safe weekend. Happy Monday!

Was this information useful? What have you tried to reduce crows feet?

*Image taken from Google images

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This post was written by Dr. Jim English

The Egyptians once thought that a suntan was a sign of being under privileged because those that had one undoubtedly worked in the fields along the Nile River.  To have the time and/or the resources to keep a tanned appearance today reflects just the opposite socially.  However, years of sun worship can and will produce an aged appearance that most people find undesirable later in life.  The problem is that once acquired, it is most difficult to eradicate.  For millennia, humans would apply various and sundry remedies to their skin to remove the stigma of sun damage.  The Egyptians would apply sour milk to their skin for exfoliation purposes from the lactic acid contained within. The Turks would singe their skin lightly with fire to remove the outer layers to improve and tighten their skin.  The French would bathe in red wine to receive the oxidative benefit of the tartaric acid content within the grapes.

Fast forward to today and we are still trying to improve the ravages of the sun and age on our skin but now the gold standard is the fractionated CO2 laser.  This newest innovation with the carbon dioxide device allows the penetration of its energy into the outer and middle layers of skin much like the greens keeper on a golf course when they aerate the greens.  By burrowing as many as 250-500 minute holes per square centimeter on the skin’s surface, an organic debris field is created within its layers and the body’s defense mechanism is mandated to clean up the areas of damage much like a community would after a natural disaster.  The end result is a better and more aesthetically pleasing outcome with the vast amount of sun damage and photo aging removed with one treatment.

The down time is minimized to days instead of weeks because the entire surface of the skin is not removed as it was just a few years ago.  Also, this device can be used on any area of the body as it pertains to sun damaged and/or aged skin.  The patient’s in my clinic are extremely pleased with their results and so am I.  If you are not into bathing with sour milk or red wine, you might consider this treatment option for the improvement of your skin’s damage incurred as a result of living life.

Do you have any tricks like the Egyptians and the French in order to repair damaged skin? What are your favorite products to prevent sun damage?

Posted by Chevis English under medical spa and glowing skin. You can follow me on Twitter @chevis or @FaceDoctorette.

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CE: Why do we get dark circles under our eyes?

JE: Aside from heredity, there are four basic reasons for dark circles.

Number 1: Nasal allergies with pooling of venous blood beneath the thinner skin of the lower eyelid. Venous blood is much darker than arterial blood and its present in larger quantities from the allergies is reflected as such.

Number 2: Pseudoherniated lower eyelid fat. This produces a fullness that when struck by light can cast a shadow beneath it. This is exacerbated by a “dent” along the orbital rim from where the soft tissue of the rim has descended into the cheek area. These topographical undulations and their shadows are the major reason for lower eyelid darkness.

Number 3:  Darkness of the skin itself from photo damage from the sun or an increase melanin depositon within the skin secondary to increased hormonal activity.

Number 4: Hollowness of the lower eyelid area from previous surgery or significant weight loss. This gaunt appearance can produce an aged look. The surgical correction of these issues may require a lower eyelid blepharoplasty with the incision tucked inside the lower eyelid without visible scars, with or without the placement of fat along the orbital rim to fill in the lower eyelid hollowness. A chemical peel of a certain depth can tighten the lower eyelid crinkles without the removal of loose skin from the lower eyelid. These procedures can be performed in the office surgical suite in under thirty minutes under the anesthesia of your choice.

Posted by Chevis English under plastic surgery and doctor’s notes. You can follow me on Twitter @chevis or @FaceDoctorette.  Images were taken from the web site of English Plastic and Cosmetic Surgery Center Surgi-Spa.

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