Plastic Surgery Then and Now

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I have been in practice for 28 years and have seen a 180 degree change in the specialty of Plastic Surgery.    In 2010,  the term “Plastic Surgery” clearly misrepresents the specialty.   A better umbrella to cover all of the techniques now available to rejuvenate the face and body would be “cosmetic medicine.”    Not “cosmetic surgery”  but  “cosmetic medicine”  I  prefer the use of the term medicine. It underscores the multilayered approach that a good plastic surgeon takes to a patients chief complaint.  My first consideration after good general health is the nutritional investment each patient has in themselves.  Proactive involvement in the process of looking better/younger is mandatory! Are they overweight?  Have they made a commitment to their body by  eating what is natural and healthy.   Do they exercise regularly?  Are they psychologically stable?  Are the expectations appropriate for the selected procedure?  Can they  really afford the procedure without undue financial stress?   Only after considering all of these issues, should the “cosmetic medical” plan be “prescribed.”  It might be Botox in one patient, laser lipo in another  and a facelift in another, but at the end of the day, each case is customized.

The Brain and Body Image

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You might find this hard to believe but after 28 years of morphing my patients bodies with plastic surgical procedures and 20 years of an avid interest in body building, I continue to be perplexed on how people perceive their physical appearance, their body image.  I continue to study neurobiology since it is clear to me that the answer to most issues that seem so illogical is found in the uncontrollable and unpredictable chemical reactions in the brain.    The study of Neurobiology has  clearly improved my understanding of body image more than all of my experience in dealing with patients and friends who are devoted to “controlling” their images/bodies.  Basically, our brains are  hard-wired to see  shapes and contours.  These are stored in our brains.   Once registered , it is difficult to change  neural “impressions” or brain memory  despite a change in appearance that is clearly seen with the eyes.  Basically, the objective reality of the body is only processed by the eyes, and delivered to the brain for perception.  This is a pivotal mechanism in understanding the lack of positive feedback in some people who have lost significant weight,  or had extensive plastic surgery, or  dramatically changed their bodies with exercise/diet regimens.  I  now understand the genesis of the problem.  Modifying the brain is another issue!

BROWN FAT AND LOOKING YOUNGER

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It may seem evident to most that losing weight and looking younger are complimentary.  This is not usually the case in folks who lose weight with non-nutritional restrictive diets.  In The Brown Fat Revolution and Lose the Fat/Lose the Years, I make the case for eating well AND losing weight so that all tissues are rejuvenated.   Once  nutritional discipline sets in, why not seize the opportunity to not only achieve optimal weight but to restore your skin, muscles, bones and fat to look, feel and act younger?  All it takes is  attention to the  “natural” quality of what you eat.  So simple, yet so rewarding!  Your body needs fat  “on it” to look young.  It is the fat that creates the “volumes” of youth that we see in a young woman’s body and face.  But it must be high quality, well nourished fat that hugs the underlying bones and supports the overlying skin creating the three dimensional contours of youth.  Just as you can change your skin to look younger with stress control, diet, exercise and topical care….you can modify the quality of your fat with nutrition and exercise and look younger!

Cozy Foods

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Barbara, the monster snow storm is hitting Connecticut today and my wife and I are pretty much in a welcome lock down at home.   As the author of The Brown Fat Diet , I intuitively know what to eat to stay in shape;  however, this morning,  I found my mind acting differently.  I was thinking about baking a cake/brownies or having pancakes for breakfast!   The power of the brain and memory!   Hmmm how to handle this conflict of food choice that I am sure so many of us feel on days like today?

The brain (specifically, the amygdala) has this incredible ability to connect to past experiences and create cravings for things associated with good times.  In this case, probably,  those  unexpected and welcome days off from school, when my mom would cook all the comfort foods.

Those of you who follow me or have read my book, The Brown Fat Revolution, know that I strongly believe that occasional side steps when you are on a diet are OK and actually work to keep you comfortable with food and not feel deprived.  So, I will have a brownie today and whole wheat pancakes with low sugar syrup/no butter and not feel at all guilty.

Life is about the experience and not to embrace the connections that we have garnered from the past in a positive way and enjoy is nonsense.  After 20 years of eating according to the principles of The Brown Fat Diet, I can firmly testify that this one day of  relaxation combined with visual beauty (the snow) and gustatory coziness will not affect the shape of my body!

Wave Goodbye to Fatty Arms

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One of the most common complaints I get from my patients is that they hate their fatty arms. Women notice that despite their best efforts to exercise, their bodies begin to deposit fat in the triceps (arm) area.  In some, this deposition, combined with loose skin, creates the “bat wings” effect.  In addition to never wearing sleeveless dresses, these patients complain that they can’t wear suits since their arms are too bulky!

This problem is due to fat deposition:  After menopause fat begins to deposit in a characteristic way and unfortunately, one of the selected sites is the arms.  This is an estrogen-dependent phenomenon and not really related to exercise per se.  So no need for self-blame or guilt here. 

I have performed innumerable brachioplasties (arm lifts) and liposuctions on such patients, both very effective techniques; however, most women can do quite well with a double-pronged attack on their arms, the attack that I propose in my book, The Brown Fat Revolution.  There are two components here:  diet and exercise.  By adhering to the principles of the Post-Menopause Brown Fat Diet and, at the same time, increasing the number of days per week doing arm exercises specifically targeting the triceps, a woman can wave goodbye to fatty arms.  As the loose yellow fat shreds off of the arm, the lean muscle increases and the new layer of healthy fat supports the skin so it does not sag.  These effects can be seen within weeks after starting the combined program.  It is all about fat!