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 following post was written by Dr. Jim English and can also be read on his blog.

Breast lifting procedures have undergone a paradigm shift in the past several years to include a procedure known as a vertical mammoplasty.  This surgical technique when indicated, can produce a more attractive breast with less scar(s) than the more conventional procedures that have been performed over the past several decades.  With few exceptions, I have gone to this style of operative technique in my practice.  This type of surgery is especially indicated in patients who have small to moderate sized breasts and a significant amount of ptosis or sagging.  The goal is to remove unwanted, loose skin  while reshaping the remaining tissue into a more youthful breast mound.  If implants are desired, these are placed in a separate procedure several months later to allow the incisions from the vertical mammoplasty to heal without tension.

For before and after photos you can visit our image gallery.

*Image taken from Google images.

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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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No dark circles here!

I was unfortunately blessed with lovely dark under eye circles, but I have recently learned a new trick to camouflage the darkness.  I read somewhere (quite possibly Glamour magazine, but I can’t say for sure) that you can mix a highlighter with your eye cream in the morning before applying and it will help combat dark circles.  After trying this, I could definitely tell a difference, but one can never know for sure if something is actually working or if your mind is just telling you it is.  About a week later, someone said that I looked so refreshed (might I add this was the morning after a wedding) and I was more than happy to hear this because obviously it wasn’t just in my mind!

I am sure that any eye cream and highlighter will do the trick, but I prefer mixing Boots No7 High Lights Illuminating Lotion with my favorite eye cream from SkinCeuticals.

Why do we get these dark circles in the first place? In most cases it is hereditary and is caused by thin skin around the eye.  Also, some blood is darker than others, venous blood in particular, so that causes darkness as well.  Other causes can be nasal allergies, photo damage, hormonal activity, melanin and shadowing.  For those who want to surgically fix this, a common procedure for its correction is a lower eyelid blepharoplasty.  Fat transfer to the eye area combined with a chemical peel can help restore a more youthful contour from lash to cheek area.

What are your tricks to eliminate dark circles? Would you ever undergo surgery in order to fix dark circles?

Posted by Chevis English under beauty tips and great products. You can follow me on Twitter @chevis and @FaceDoctorette.

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