Johns Hopkins scientists have found that a safe and inexpensive antibiotic in use since the 1970s for treating acne effectively targets infected immune cells in which HIV, the virus that causes AIDS, lies dormant and prevents them from reactivating and replicating.

The drug, minocycline, likely will improve on the current treatment regimens of HIV-infected patients if used in combination with a standard drug cocktail known as HAART (Highly Active Antiretroviral Therapy), according to research published now online and appearing in print April 15 in The Journal of Infectious Diseases. “The powerful advantage to using minocycline is that the virus appears less able to develop drug resistance because minocycline targets cellular pathways not viral proteins,” says Janice Clements, Ph.D., Mary Wallace Stanton Professor of Faculty Affairs, vice dean for faculty, and professor of molecular and comparative pathobiology at the Johns Hopkins University School of Medicine.

“The big challenge clinicians deal with now in this country when treating HIV patients is keeping the virus locked in a dormant state,” Clements adds. “While HAART is really effective in keeping down active replication, minocycline is another arm of defense against the virus.”

Unlike the drugs used in HAART which target the virus, minocycline homes in on, and adjusts T cells, major immune system agents and targets of HIV infection. According to Clements, minocycline reduces the ability of T cells to activate and proliferate, both steps crucial to HIV production and progression toward full blown AIDS.

If taken daily for life, HAART usually can protect people from becoming ill, but it’s not a cure. The HIV virus is kept at a low level but isn’t ever entirely purged; it stays quietly hidden in some immune cells. If a person stops HAART or misses a dose, the virus can reactivate out of those immune cells and begin to spread.

The idea for using minocycline as an adjunct to HAART resulted when the Hopkins team learned of research by others on rheumatoid arthritis patients showing the anti-inflammatory effects of minocycline on T cells. The Hopkins group connected the dots between that study with previous research of their own showing that minocycline treatment had multiple beneficial effects in monkeys infected with SIV, the primate version of HIV. In monkeys treated with minocycline, the virus load in the cerebrospinal fluid, the viral RNA in the brain and the severity of central nervous system disease were significantly decreased. The drug was also shown to affect T cell activation and proliferation.

“Since minocycline reduced T cell activation, you might think it would have impaired the immune systems in the macaques, which are very similar to humans, but we didn’t see any deleterious effect,” says Gregory Szeto, a graduate student in the Department of Cellular and Molecular Medicine working in the Retrovirus Laboratory at Hopkins.

“This drug strikes a good balance and is ideal for HIV because it targets very specific aspects of immune activation.”

The success with the animal model prompted the team to study in test tubes whether minocycline treatment affected latency in human T cells infected with HIV. Using cells from HIV-infected humans on HAART, the team isolated the “resting” immune cells and treated half of them with minocycline. Then they counted how many virus particles were reactivated, finding completely undetectable levels in the treated cells versus detectable levels in the untreated cells.

“Minocycline reduces the capability of the virus to emerge from resting infected T cells,” Szeto explains. “It prevents the virus from escaping in the one in a million cells in which it lays dormant in a person on HAART, and since it prevents virus activation it should maintain the level of viral latency or even lower it. That’s the goal: Sustaining a latent non-infectious state.”

The team used molecular markers to discover that minocycline very selectively interrupts certain specific signaling pathways critical for T cell activation. However, the antibiotic doesn’t completely obliterate T cells or diminish their ability to respond to other infections or diseases, which is crucial for individuals with HIV.

“HIV requires T cell activation for efficient replication and reactivation of latent virus,” Clement says, “so our new understanding about minocyline’s effects on a T cell could help us to find even more drugs that target its signaling pathways.”

The research was supported by grants from the National Institutes of Health. Authors of the paper, in addition to Clements and Szeto, are Angela K. Brice, Sheila A. Barber and Robert F. Siliciano, all of Johns Hopkins. Also, Hung-Chih Yang of National Taiwan University Hospital.

To Schedule an acne treatment contact Dr. Milgraum at his New Jersey Dermatology office at 1800-laser-18

Source
Johns Hopkins Medicine

For the approximately 7.5 million Americans affected by psoriasis, the thick, red, scaly, itchy plaques it causes only scratch the surface when it comes to the overall implications of this disease. Now, ongoing research linking psoriasis to other serious medical conditions and the incredible toll it can take on a person’s overall quality of life are shifting the way psoriasis is viewed from a common skin disease to a complex systemic condition.

Speaking today at the 68th Annual Meeting of the American Academy of Dermatology (Academy), dermatologist Alan Menter, MD, FAAD, chair of the Psoriasis Research Unit at Baylor Research Institute in Dallas, addressed the need for psoriasis to be viewed as a serious disease affecting the whole body with significant quality of life issues.

“In the past, psoriasis was viewed primarily as a cosmetic nuisance that was not thought to extend beyond the obvious plaques apparent on the skin,” said Dr. Menter. “With the discovery of multiple genes related to psoriasis, a better understanding of the immune system responses involved in this disease, and the frequent associations with other serious diseases, we know that psoriasis is a much more complex disease that demands continual monitoring and evaluation by a dermatologist and, if necessary, other medical professionals to address related health issues.”

The Link between Psoriasis and Other Serious Medical Conditions

Over the years, multiple studies have found that psoriasis is associated with a number of potentially serious medical conditions, including cardiovascular disease, cancer and lymphoma, obesity and metabolic syndrome (also known as “Syndrome X”), autoimmune diseases (Crohn’s disease and diabetes mellitus I and II, for example), psychiatric diseases (such as depression and sexual dysfunction), psoriatic arthritis, sleep apnea, personal behavior issues, chronic obstructive pulmonary disease (COPD) and even increased mortality. Dr. Menter explained that the majority of these diseases can have a significant impact on a patient’s overall health and affect psoriasis patients in different degrees of severity.

“It is important to note that while we are unsure whether psoriasis causes other diseases or that these other diseases cause psoriasis, the fact that an association exists at all is critically important in treating psoriasis patients,” said Dr. Menter.

One recent observational study of 3,236 patients with psoriasis and 2,500 patients without psoriasis who served as the controls concluded that patients with psoriasis experienced an increased incidence of ischemic heart disease (where the blood vessels are blocked leading to the heart), cerebrovascular disease (where the blood vessels are blocked leading to the brain), and peripheral vascular disease (the obstruction of arteries in the arms and legs), and mortality.1

Another study examining the increased risk of mortality in psoriasis patients suggests that patients with severe psoriasis may have shorter life expectancies by an average of three to five years than individuals who are not affected by psoriasis. 2

In addition, other studies have shown that psoriasis patients are more likely to consume excessive amounts of alcohol and cigarettes, both of which can negatively impact a psoriasis patient’s health. These detrimental behaviors can further aggravate other conditions associated with psoriasis, such as heart disease and COPD.

Impact on Quality of Life from Psoriasis Cannot be Underestimated

Since psoriasis is a chronic lifelong disease that needs to be controlled with a customized treatment regimen, the constant presence of psoriatic lesions or unexpected flare-ups at times when patients least expect it can cause a considerable amount of stress and anxiety. In fact, psoriasis has long been known to cause considerable emotional stress for patients, including low self-esteem and feelings of rejection, introspection, weight gain, increased use of alcohol and tobacco, and depression (which in some cases can be severe).

Another study conducted by the National Psoriasis Foundation examining attitudes and beliefs about contagious diseases among the general population of young adults found that approximately one-third (36 percent) of those surveyed were unsure whether psoriasis was contagious. In addition, when asked their attitudes about dating and skin conditions, more than half (62 percent) of the respondents reported that they take the condition of a person’s skin into consideration when first asking someone out on a date.

Dr. Menter added that the findings of this survey lend credence to the belief held by many psoriasis patients that their disease can have a negative impact on their personal lives and affect their interpersonal relationships.

“We cannot underestimate the complexity of psoriasis, particularly the psychological impact the disease can have on young people,” said Dr. Menter. “Even at a young age, psoriasis can affect a person’s relationships at home, work or school, and the disease can contribute to an overall poor body image that can be hard to reverse throughout life.”

Dr. Menter added that studies conducted regarding the effect of newer biologic medications, such as adalimumab, etanercept and infliximab, on psychiatric symptoms have shown that psoriasis patients may experience significant improvement in fatigue and other symptoms of depression. The newest biologic agent recently approved by the Food and Drug Administration (FDA), ustekinumab, also has been shown to improve sexual dysfunction in patients with moderate to severe psoriasis up to 10 fold.

“Although psoriasis is an incurable disease, it is controllable in the majority of cases with proper treatment,” said Dr. Menter. “Over the past several years, there have been a number of newer therapies introduced that are effective in managing psoriasis, and a patient’s dermatologist can determine which therapy would work best to control each patient’s disease.”

Headquartered in Schaumburg, Ill., the American Academy of Dermatology (Academy), founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. With a membership of more than 16,000 physicians worldwide, the Academy is committed to: advancing the diagnosis and medical, surgical and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin, hair and nails.

If you have Psoriasis contact Dr. Milgraum at his New Jersey Dermatology office at 1800-laser-18
References

(1) Archives of Dermatology: Vol 145 (NO. 6), June 2009, Pages 700-703

(2) Archives of Dermatology: Vol 147 (NO. 12), December 2007, Pages 1,493-1,499.

Source: American Academy of Dermatology (AAD)

A heart patient’s own skin cells soon could be used to repair damaged cardiac tissue thanks to pioneering stem cell research of the University of Houston’s newest biomedical scientist, Robert Schwartz.

His new technique for reprogramming human skin cells puts him at the forefront of a revolution in medicine that could one day lead to treatments for Alzheimer’s, diabetes, muscular dystrophy and many other diseases.

Schwartz brings his ground-breaking research to UH as the Cullen Distinguished Professor of Biology and Biochemistry and head of UH’s new Center for Gene Regulation and Molecular Therapeutics. He also is affiliated with the Texas Heart Institute at St. Luke’s Episcopal Hospital in the Texas Medical Center, where he is director of stem cell engineering.

“Professor Schwartz’s work will save lives, and his decision to pursue this pioneering research at UH is a big leap forward on our way to Tier-One status,” said John Bear, dean of the UH College of Natural Sciences and Mathematics. “Together with the many other outstanding scientists we’ve assembled here, Schwartz will help make this university a major player in medical research.”

Schwartz devised a method for turning ordinary human skin cells into heart cells. The cells developed are similar to embryonic stem cells and ultimately can be made into early-stage heart cells derived from a patient’s own skin. These then could be implanted and grown into fully developed beating heart cells, reversing the damage caused by previous heart attacks. These new cells would replace the damaged cardiac tissue that weakens the heart’s ability to pump, develops into scar tissue and causes arrhythmias. Early clinical trials using these reprogrammed cells on actual heart patients could begin within one or two years.

Although Schwartz is not the first scientist to turn adult cells into such stem cells, his improved method could pave the way for breakthroughs in other diseases. Schwartz’s method requires fewer steps and yields more stem cells. Armed with an effective way to make induced stem cells from a patient’s own skin, scientists can then begin the work of growing all kinds of human cells.

For example, new brain cells could treat Alzheimer’s patients or those with severe brain trauma, or a diabetic could get new insulin-producing cells in the pancreas. Generating new kidney, lung or liver tissue is also possible, with scientists even being able to one day grow an entirely new heart or other organ from these reprogrammed cells. Additionally, Schwartz and his team are working on turning induced stem cells into skeletal muscle cells to treat muscular dystrophy.

“We’re trying to advance science in ways folks never even dreamed about,” Schwartz said. “The idea of having your own bag of stem cells that you can carry through life and use for tissue regeneration is at the very cutting edge of science.”

This latest biomedical hire is a major step in the UH Health Initiative, an effort aimed at having the university become a world-class center for medical research. Creating new cross-disciplinary academic and health-related research opportunities for faculty and students is crucial to this initiative, as are collaborations with other Texas Medical Center member institutions. One of its top goals is to increase the amount of sponsored research expenditures awarded to UH, which is a key factor in attaining Tier-One status.

“Dr. Schwartz will expand UH’s expertise in promising new areas of scientific discovery to alleviate human disease. By recruiting premier scientists like Schwartz, UH is fast becoming a major player in the regional biomedical research community,” said Kathryn Peek, assistant vice president of University Health Initiatives at UH.

Schwartz has decades of experience at the Texas Medical Center. Before coming to UH, he was director of the Institute of Biosciences and Technology, a research component of the Texas A&M Health Science Center. He also was a longtime tenured professor at Baylor College of Medicine and co-directed the school’s Center for Cardiovascular Development. The new research center Schwartz heads at UH will be housed in state-of-the-art laboratory facilities at the university’s Science and Engineering Research Center.

What attracted him to UH was the commitment of administrators and faculty to making the university a premier center for biomedical research. His hiring comes just a year after the arrival of Jan-Åke Gustafsson, a world-renowned scientist and cancer researcher. They join other leading UH faculty, ranging from biochemists to computer scientists and mathematicians, who are deeply involved in cutting-edge medical research.

To Schedule a consultation contact Dr. Milgraum at his New Jersey Dermatology office at 1800-laser-18

The Dead Sea is the only place in the world that combines year-round hot weather, an oxygen-enriched atmosphere, therapeutic UVB solar radiation, a mineral-rich salt sea, world famous mineral-rich mud, thermo-mineral hot springs and luxurious spas.

Research has shown that the combined climatic factors have a long-lasting therapeutic effect on dermatological diseases such as psoriasis and eczema, as well as on rheumatic or degenerative joint diseases.

Dead Sea resorts are now introducing their world-renowned treatment for people with dermatological diseases.

A unique combination of natural resources having therapeutic effects has turned the Dead Sea area into a healing center unparalleled anywhere else on the face of the earth.

The salty seawater, with its unusually high concentration of minerals, the natural hot springs rich in minerals and sulphur, the therapeutic black mud and the extraordinary climatic conditions – including uniquely filtered sun rays and oxygen-rich dry air, due to the high barometric pressure prevailing in the lowest spot on earth (417 meters below sea level) – all combine in providing the basis for the successful effect of the Dead Sea therapies. These natural resources have been shown to have a beneficial effect on various illnesses, including chronic incurable diseases, and have led to the reputation of the Dead Sea area as a natural spa promoting health and improving quality of life.

The Dead Sea resorts are offering these treatments along with a fun vacation, where you can enjoy the best of both worlds.

Source
Dead Sea Resorts

If you have psoriasis or eczema contact Dr. Milgraum at his New Jersey Dermatology office at 1800-laser-18 for a free consultation.

It is the most common cosmetic operation in America and the United Kingdom. Over 400,000 liposuction procedures are carried out in the USA each year.

Patients who undergo liposuction generally have a stable body weight, but would like to remove undesirable deposits of body fat in specific parts of the body. It is not an overall weight-loss method – it is not a treatment for obesity. Liposuction does not remove cellulite, dimples or stretch marks. The aim is esthetic – the patient wishes to change and enhance the contour of his/her body.

Liposuction permanently removes fat cells from the body. It can alter the shape of a body. However, if the patient does not lead a healthy lifestyle after the operation there is a risk that the remaining fat cells grow bigger.

The amount of fat than can be safely removed is limited. Liposuction has a number of possible risks, including infection, numbness and/or scarring. If too much fat is removed there may be lumpiness or dents in the skin. Experts say that the surgical risks are linked to the amount of fat removed.

Some medical conditions may benefit from liposuction, including:

• Lipomas – benign fatty tumors.
• Gynecomastia – where fatty breast tissue has developed in men.
• Lipodystrophy syndrome – a lipid (fat) metabolism disturbance in which there is too much fat in some parts of the body and partial or total absence of fat in other parts. Sometimes a side effect of some HIV medications.

According to Medilexicon’s medical dictionary:

Liposuction is a “Method of removing unwanted subcutaneous fat using suction cannulae inserted through short, strategically placed incisions; used in body contouring.”

Short history of liposuction

Liposuction was invented in 1974 by two Italian-American surgeons – Doctors Giorgio and Arpad Fischer. The roots of liposuction date back to the 1920s. Dr. Dujarier, a French surgeon performed a fat removal procedure on a model in 1926 which tragically resulted in gangrene in one of her legs; consequently, interest in body contouring receded for several decades.

In the late 1960s Leon Forrester Tcheupdjian, a European surgeon used primitive curettage techniques to remove fat – however, results were patchy, there was a lot of bleeding and morbidity was high.

What we know as ‘modern liposuction’ started with a presentation in 1982 by Dr. Yves-Gerard Illouz, a French surgeon. He started what became known as the ‘Illouz Method” – a technique of suction-assisted lipolysis (breakdown or destruction of fats) after infusing fluid into tissues using blunt cannulae and a high-vacuum suction. Illouz demonstrated both reproducible good results and low morbidity. During that decade several US surgeons experimented with liposuction, developing some variations from the Illouz Method, with mixed results.

In 1985 the tumescent technique was described by Drs. Jeffrey Alan Klein (USA) and Patrick Lillis (USA), which added elevated volumes of liquid containing a local anesthetic, allowing the technique to be carried out in an office setting under intravenous sedation, rather than general anesthesia. There were concerns about the high volume of fluid and lidocaine toxicity potential with tumescent techniques, which eventually led to the concept of lower volume super wet tumescence.

Near the end of the last century ultrasound was introduced to assist in the removal of fat, which was initially liquefied through the application of ultrasonic energy. However, there was an increase in reported cases of complications.

In recent years laser tipped probes – which induce thermal lipolysis – have been introduced. How beneficial they are over traditional techniques still remains to be determined.

Over the last three decades, advancement in liposuction techniques have meant that a larger number of fat cells can be removed with less blood loss, risk, discomfort, and shorter recovery periods. Fat can also be used today as a natural filler (autologous fat transfer), where fat is taken from one part of the body, cleaned, and then injected into another area of the body – for example, to enhance the shape of the buttocks or reduce wrinkles.

What are the uses of liposuction?

Liposuction is mainly used to improve how a person looks, rather than providing any physical health benefits. In many cases, the patient would probably achieve the same results, and sometimes better ones if they adopted a healthy lifestyle – good diet, regular exercise and a good night’s sleep every night.

Experts say that liposuction should ideally only be used if the individual did not achieve the desired results with a lifestyle change. For example, if some obstinate areas of fat that are resistant to exercise and diet.

When you gain weight each fat cell increases in size and volume. Liposuction reduces the number of fat cells in isolated areas. How much is removed from a specific area depends on its appearance and the volume of fat. Contour changes resulting from liposuction can be long-lasting, as long as the patient’s weight does not increase.

Liposuction is only done in relatively small areas of the human body, and is in no way a treatment for obesity or long-term weight loss. It should not be used if the person wants to get rid of stretch marks, cellulite, dimpling, or other skin surface irregularities.

Patients should discuss the pros and cons of liposuction with their GP (general practitioner, primary care physician) before deciding on whether to proceed. If the individual still wants to go ahead, they should talk to their surgeon sincerely about why they want to do it, what they hope to gain out of it personally, and what their expectations are.

Liposuction should only be done after a lot of thought. Results are never dramatic; they are subtle.

The following body areas are commonly targeted for liposuction treatment:

• Abdomen
• Back
• Buttocks
• Chest
• Inner knees
• Hips
• Flanks (love-handles)
• Neckline and the area under the chin (submental)
• Thighs – saddlebags (outer thighs), and inner thighs
• Upper arms

According to the American Society of Aesthetic Plastic Surgery, liposuction is performed more commonly on the thighs and abdomen of women, and the abdomen and flanks (sides, love-handles) of men.

Experts say that the best liposuction candidates are those who have good skin tone and elasticity, where the skin molds itself into new contours. People whose skin lacks elasticity may end up with loose-looking skin in areas where the procedure was done. The patient needs to be in good health – people with circulation (blood flow) problems, such as coronary artery disease, diabetes, as well as those with weakened immune systems should not undergo liposuction. Candidates should be over the age of 18 years. Liposuction is sometimes used to treat certain conditions, including:

• Lymphedema – a chronic (long-term) condition in which excess lymph (fluid) collects in tissues, causing edema (swelling). The edema commonly occurs in the arms or legs. The fluid accumulation occurs faster than it can be drained away. Liposuction is sometimes used to reduce swelling, discomfort and pain.

  However, doctors tend only to use liposuction with patients who have severe symptoms. After the operation patients have to wear a compression bandage for several months, sometimes up to a year after the operation.

• Gynecomastia – sometimes fat accumulates under a man’s nipples. Liposuction can remove some of the fat, reducing the swelling.
• Lipodystrophy syndrome – fat accumulates in one part of the body and is lost in another. Liposuction can improve the patient’s appearance by providing a more natural looking body fat distribution.
• Extreme weight loss after obesity – if a morbidly obese person has lost at least 40% of his/her BMI (body mass index) after perhaps a gastric band or bypass procedure, excess skin and other abnormalities may need treatment. Sometimes liposuction is used to correct abnormalities.

What happens before and during the liposuction operation?

Before the operation – patients will need to undergo some health tests to ensure that they are fit for surgery. The medical team will ask the patient to:

• Stop taking aspirin and anti-inflammatory drugs for at least two weeks before the surgery.
• Women – if undergoing an extensive operation, they may be asked to stop taking the contraceptive pill for a specific period before the operation.
• Patients with anemia – they will be asked to take iron supplements for a specific period before the operation.
• Consent form – the patient will be asked to sign a consent form, which confirms that they are fully aware of the risks, benefits and possible alternatives to the procedure.

During the operation

Doctor cutting with a scalpel in a liposuction
surgery

The surgeon will mark out lines on the patient’s body, indicating where treatment will take place. Photos of the target area, and sometimes the patient’s whole body may be taken; they will be compared to pictures of the same areas taken afterwards.

Anesthesia – the patient will most likely be under a general anesthetic; they are put to sleep before the procedure and remain so during it. A liposuction operation may last from 1 to 4 hours. The doctor may use an epidural for treatments on the lower body – the anesthetic is injected the epidural space surrounding the dura (fluid-filled sac) around the spine, partially numbing the abdomen and legs. A local anesthetic may be used when liposuction is done on very small areas.

Patients may feel a dull rasping during the procedure as the cannula moves under the skin. This is normal. If any acute or different pain is felt the doctor needs to be told, as the medication or movements may need modification.

If the patient requires only local anesthesia, he/she may be asked to stand up during the procedure to ensure proper fat removal.

One of the following liposuction techniques may be used:

• Tumescent liposuction – several liters of a saline solution with a local anesthetic lidocaine and vessel-constrictor epinephrine (adrenaline) is pumped subcutaneously (below the skin) in the area that is to be suctioned. Epinephrine helps minimize bleeding, bruising and post-operative swelling. The fat is suctioned (sucked out) through small suction tubes (microcannulas). This is the most popular form of liposuction.

  The amount of liquid pumped into the area may be up to three times the amount of fat to be removed. This volume of fluids creates a space between the muscle and the fatty tissue, allowing more maneuverability for the cannula.

• Wet liposuction – a small amount of fluid with less volume than the amount of fat to be removed is injected into the target area. The fluid is similar to the one used in tumescent liposuction and minimizes bleeding and bruising. The fluid helps loosen the fat cells. The fat cells are suctioned out.
• Super-wet liposuction – this technique uses less liquid that tumescent liposuction; about the same amount of liquid as fat to be removed. Otherwise, the technique is very similar to tumescent liposuction. The patient may need a separate anesthetic.
• Dry liposuction – no fluid is injected before fat is removed. This method is seldom used today. There is a higher risk of bruising and bleeding.
• Ultrasound-assisted liposuction (UAL) , also known as ultrasonic liposuction – the cannula is energized with ultrasound. This makes the fat melt away on contact – the ultrasound vibrations burst the walls of the fat cells, emulsifying the fat (liquefying it) and making it easier to suction out. This method is a good choice for working on more fibrous areas, such as the male breast, back, and in areas where liposuction had been done before.

  UAL is especially useful for stubborn fat accumulations. However, longer incisions in the skin are needed for this procedure, and there is a risk of skin or internal burns. This procedure takes longer than the others, because it is often done alongside tumescent liposuction. It is also more expensive. After ultrasonic liposuction, it is necessary to perform suction-assisted liposuction to remove the liquefied fat.

  UAL techniques were initially linked with cases of tissue damage, generally because of over-exposure to ultrasound energy. A third-generation UAL device – the Vaser Lipo system – prevents this problem by using pulsed energy delivery and a specialized probe that allows surgeons to safely remove excess fat.

• Power-assisted liposuction (PAS) , also known as Powered liposuction – uses a specialized cannula with a mechanized system that rapidly moves back-and-forth, allowing the surgeon to pull out fat more easily. It is similar to traditional UAL, but the surgeon does not need to make so many manual movements, as in other methods.

  This method may sometimes cause less swelling and pain, and may allow the surgeon to remove fat with more precision, especially in smaller areas.

• Laser Assisted Lipolysis (LAL) , or laser-guided lipo – requires the use of tumescent fluid. It is a far less invasive and bloody procedure than the traditional liposuction method for removing fat. A microcannula is inserted through a small incision to deliver laser energy and heat into subcutaneous fat (fat under the skin).

Liposuction surgery tools

The liposuction cannula – this is a stainless steel tube, which is inserted through an incision in the skin and is used to suction the fat (suck the fat out).

The liposuction microcannula – is a very small cannula with an inside diameter of less than 3 mm (some experts define them with less than 2.2mm diameter).

The size of the cannula can influence how smooth the skin is after liposuction. Large cannulae tend to create irregularities more commonly than microcannulas. Large cannulae are more frequently used for total-body liposuction.

After an area has been prepared for treatment, a small cut is made (sometimes several, depending on the size of the area), and a microcannula is inserted into the cut. The microcannula is attached to a special vacuum machine. The microcannula first loosens and then sucks the fat out of the area.

Draining out excess fluid and blood – after the operation the surgeon may leave the incisions open so that fluid can drain from the body.

After the liposuction operation

• Anesthetic – patients who underwent a general anesthetic usually spend the night in hospital. Those who had a local anesthetic may be able to leave hospital on the same day. Patients should not drive for at least 24 hours after receiving an anesthetic.
• Support bandages – the patient will be fitted with either an elasticated support corset or bandages for the targeted area after the operation. They help reduce inflammation and bruising. They should be worn for several weeks. It is important to follow the doctor’s advice on keeping the area clean and how to do this.
• Antibiotics – patients may be given antibiotics immediately after the operation.
• Painkillers – the doctor will most likely prescribe or recommend analgesics (painkillers) to relieve pain and inflammation.
• Stitches – the patient will be given a follow-up appointment to have the stitches removed.

Bruising – there will be significant bruising in the targeted area. The amount of bruising is usually linked to how big the targeted area was. The bruising may go on for several weeks; in some cases for as long as six months.

• Numbness – patients may experience numbness in the area where fat was removed. This should improve within six to eight weeks.

Results – patients and their doctors will not be able to fully appreciate the results of liposuction until the inflammation has gone down, which in some cases may take several months. Typically, most of the swelling will have settled after about four weeks and the area where fat was removed should appear less bulky.

Patients who maintain their weight can usually expect permanent results. Those who gain weight after the procedure may find that their fat distribution alters. Those who previously had fat accumulating in their hips might find that their buttocks become the new problem area.

If a patient has thought everything through carefully beforehand, talked to their GP and surgeon about their aims, motives and expectation, the surgeon is skilled and well qualified, and there are no complications, most patients are pleased with their results.

What are the risks of liposuction?

Any type of major surgery carries a risk of bleeding, infection and an adverse reaction to anesthesia. Risk of complications is usually associated with how large the procedure is, as well as the surgeons skills and specific training. The following risks, unpleasant side effects, or complications are possible:

• Bad bruising – this is especially the case if patients have been taking anti-inflammatory medications or aspirin. Patients with a tendency to bleed are also at higher risk of bad bruising.
• Inflammation – the swelling in some cases may take up to six months to settle. Sometimes fluid may continue to ooze from the incisions.
• Thrombophlebitis – a blood clot forms in a vein, causing inflammation of that vein. This may affect liposuction patients, especially inside the knee and on the inside of the upper thigh (when these areas have been treated).
• Contour irregularities – if the patient has poor skin elasticity, has healed in an unusual way, or fat removal has been uneven, the skin may appear withered, wavy or bumpy. This undesirable result may be permanent. The cannula may cause damage that makes the skin appear spotted. Seromas may form under the skin (temporary pockets of fluid), which may need to be drained.
• Numbness – the area that was worked on may feel numb for a while; this is usually only temporary. There may also be temporary nerve irritation.
• Infections – although rare, skin infections may occur after liposuction surgery. Sometimes this needs to be treated surgically, with the risk of scarring.
• Internal organ punctures – this is very rare. If the cannula goes in too deeply one of the internal organs may be punctured. Further surgery may be required. Internal organ punctures can be life-threatening.
• Death – anesthesia carries with it a small risk of death.
• Kidney or heart problems – as fluids are being injected and or suctioned, the change in the body’s fluid levels may cause kidney or heart problems.
• Pulmonary embolism – fat gets into the blood vessels and travels to the lungs, blocking the lungs. This can be life-threatening.
• Pulmonary edema – this may be a result of fluid being injected into the body. Fluid accumulates in the lungs.
• Allergic reaction – there may be an allergic reaction to medications or material used during surgery.
• Skin burns – the cannula movement may cause friction burns to the skin or nerves.
• Lidocaine toxicity – in the super-wet or tumescent methods, too much saline fluid may be pumped into the body, or the fluid may have excessively high concentrations of lidocaine. If lidocaine levels are too high for the patient’s system he/she may experience lidocaine poisoning (toxicity) – initially they will experience tingling and numbness, then seizures, followed by unconsciousness, and possibly respiratory or cardiac arrest.

To Schedule a liposuction screening contact Dr. Milgraum at his New Jersey Dermatology office at 1800-laser-18

Medical News today

Argh! You cleaned out your high school locker years ago and now you have acne pimples on your jaw this morning. You’re not alone — 1 in every 5 women over 25 has acne.

laser acne treatments

Adult acne, in contrast to the teenage type, occurs more often in women. For some women, this is the first time they had acne; we call this late-onset acne. For other women, their acne never stopped from childhood into adulthood; we call this persistent acne. Many of my women patients have other names for adult acne, but they cannot be printed here.

It Must Be Hormones

We like to blame everything on hormones. In the case of acne, hormones contribute, but they are not the only factor. Stopping birth control pills causes a change in hormones and is a cause for acne in adult women. Similarly, using progestin-only birth control pills affects hormones in such a way as to cause breakouts. Pregnancy is a time of dramatic hormone fluctuations and for some women, dramatic acne. Similarly, menopause can trigger outbreaks. Despite these known hormonal triggers, most women who have acne do not have hormonal imbalances (they are normal fluctuations in hormones). Foods or supplements that claim to balance women’s hormones don’t. So save your time and money, they won’t help your acne.

You Can’t Scrub Acne Away

Exfoliating to open pores can help, but only when done in moderation. Harsh scrubs or repeated microdermabrasion will irritate the skin and make acne worse. Instead, use mild chemical exfoliators such as salicylic acid or glycolic acid which are found in many women’s cosmetics and in acne treatments. Products that contain benzoyl peroxide also help to exfoliate and will treat adult acne.

Don’t Give Up Your Scharffen Berger Chocolate

Although myths of chocolate and pizza causing acne have been disproved, it is true that consuming cow’s milk (which contains hormones) as well as eating a diet high in carbohydrates (which causes inflammation) can contribute to acne. Eating chocolate once and a while, especially good chocolate, will not cause or worsen your acne.

Cosmetics Cause Acne

Many skincare products contain ingredients that clog your pores, triggering acne. Pantene shampoo as well as many hair conditioners have been known to cause this problem. Also, sunscreens are notorious for causing acne. If you notice that your acne is worse around your hairline or that it has flared since you started sunscreens, then try changing your products; it might be all you need to clear up your face.