Lipo or Lifestyle?

Last week was liposuction week for me. We sucked 30 liters of fat from 6 ladies in one week. That’s a lot!! So, I decided to dedicate today’s blog to focus on diet and exercise…..Healthy living!! A lifestyle to be lived by on daily basis and not a one or two month diet cycle fad.

Your ideal daily calorie intake depends upon various factors such as your age, activity level and whether you are trying to lose, gain or maintain weight. During the past two decades obesity has doubled in the first world countries where indulgence with excess is a lifestyle and obesity its serious consequence. If people do not start taking action now they will experience reduced life expectancy.

It doesn't matter how big you are most can afford to lose some weight, even a modest loss of ten pounds has tremendous health benefits. To achieve this you need to find your balance between food intake and physical activity and each of us will have a different equation to deal with. As I say to most of patients during liposuction/lipocontouring consults: "To lose weight you need to eat less and move more." There are no secrets, just follow that simple rule.

Fifty years ago life for most people consisted of much activity and it didn't matter what you ate because you would exercise away excess calories. For many today life has become a very static experience that consists of long hours at work in front of a computer, a drive home and so tired that there is just enough energy remaining to eat and then sleep. It is no surprise that we're getting fatter.

Now for the good news

You don't have to give up your favorite meals to lose weight. You do need to exercise a little more each day and be aware of portion sizes that you eat. It is a fair assumption that people in the developed nations can afford to reduce calorie intake by about 300 per day. In less developed countries where people are more active in their daily lives this figure will be considerably lower, but they are unlikely to have an obesity problem anyway.

Eat Healthy:
  1. Avoid fast and high sodium foods
  2. Eat Plenty of vegetables
  3. Avoid sugary drinks
  4. Drink plenty of water (10-15 glasses daily)
  5. Start with a salad, protein and lastly carbs or sugars

Exercise values:

For a person who weighs 155 pounds (77 kilograms) the following calorie burn-off rate applies for each 1 hour of exercise:

Light exercise:
Hiking 60 min.s = 480 calories
Walking and carrying weight - 1-2 hr.s = 330 calories
Stretching exercises 30 min.s = 139 calories
Heavy exercise:
Jogging 40min.s = 328 calories
Bicycling 12-14mph = 530 calories
Aerobics high impact 40 min.s = 329 calories
Aerobics low impact 40 min.s =  285 calories

Note: If you weigh over 155 pounds the calorie burn-off will be greater, below 155 pounds the burn-off lesser. There is no accurate science that applies to each individual. For your own weight calculations go to: http://www.healthstatus.com/cgi-bin/calc/reload.pl

To lose weight and keep it off you should aim at losing one pound (450 grams) each week and to lose one pound you must reduce your present calorie intake by 3,500 calories. How you achieve it is up to you. I suggest 300 less calories each day in your food intake and burn an extra 200 calories each day through physical activity. As you become fitter you will find this ratio reversing.


Few Facts And Myths About Cosmetic Fillers

1) If you can only afford one anti-aging treatment–do cosmetic filler injections

Doing aesthetic filler injections is one of my very favorite procedures because it makes such an improvement in giving a healthy, youthful appearance. But you do have to be realistic about how many syringes you need, and the results that you can achieve with the number of syringes you can afford. It takes a certain volume to get a certain result. It is fine to do it a little at a time as you can afford it, but to say that: “filler didn’t work” when you needed three syringes but only did one is not a fair test. I always try to stay grounded in reality. If you are looking for more bang for your buck try doing fat and stem cell injections as you can get as much material injected as you want for one fixed price.

2) Don’t expect filler injections to remove etched lines

The hyaluronic acid fillers Esthelis, Juvederm and Restylane plump up wrinkles from below and provide lost fullness. But if the line is etched from being folded ten million times, you will need skin resurfacing to really smooth the sharp line. If you stretch the skin and the wrinkle totally disappears, usually filler is all you need. If there is still a surface crease, you will need resurfacing. But either way the line will look a lot better after injecting with a filler.

3) Treat eyebrows, chin and temples

When you’re looking at doing filler augmentation of face lips, the corners of the mouth, and the smile lines are the first priority; cheeks next. But don’t forget the eyebrows, chin and temples. With age, the eyebrows thin and begin to droop, especially at the outer comers. The fat that sits on the brow bone begins to descend, taking the brows down with it. A relatively small amount of hyaluronic acid in the outside wing of the eyebrow gives 3 dimensional structure and helps reduce hooding of the upper eyelid. Sunken temples give you a skeletal look and make you look old. Adding a little filler to the chin you can balance the face beautifully.

4) Treat corners of the mouth

Turned down corners of the mouth make you look unhappy and older. Hyaluronic acid is injected below and to the side of the corner to turn it up. It breaks up the line from the corner down to the chin. You look happy.

5) With age, thin faces need volume

They do! Trust me on that. As we age we loose collagen, elastin, fat, muscle volume and bone density. Gravity pulls every thing down and thin faces look droopy and aged. The youthful V shape of face gets inverted and need restoration.

6) Face lift without filler = caught in a wind tunnel look

People with fuller faces don’t need filler after a face-lift and they look good with a face lift alone. But many people, thin women especially, and most women in general, really benefit from either targeted hyaluronic acid, or overall increased fullness from fat injections or Radiesse (a long term filler). In fact, the volume replacement alone is often called liquid lift or liquid facelift. Some women get enough tightening and lifting from volume replacement alone or volume replacement + Radiofrequency Tx, called Radio-Fill. Some don’t and need a surgical face-lift. Just as full and loose isn’t a good look, neither is tight.

7) If you don’t like it–reverse it

I am always amazed at the number of patients who come in and tell me that they got filler elsewhere, didn’t like it because of a bump, or weirdly done lips or something else, but put up with it for a year. The hyaluronic acid fillers Esthelis, Juvederm, Juvederm Plus, Restylane and Perlane (with or without anesthetic) etc. can be reversed with an injection of hyaluronidase. Try and avoid doing long term fillers which can't be corrected or removed. In case of a mistake you'd be sorry for a very long time.

 8) Hang on to your teeth

When teeth are pulled and dentures placed, the age related loss of bone in the upper and lower jaw is greatly accelerated. Just like astronauts lose bone mass in low gravity conditions, bone needs pressure placed on it to avoid de-mineralization. The pressure transmitted through the teeth with chewing keeps the bone strong. With dentures the pressure is not transmitted to the bone and bone in the jaw is lost. As the bone is reabsorbed, the mouth collapses inward and the cheeks hollow. Not uncommonly, the chin muscle becomes hyperactive in an effort to hold the dentures in the mouth, further pushing the mouth inward. Take care of your teeth. You need them to support your face and look youthful.

The long and short of all this is: right amount of filler in the right place can work wonders and wipe years off of your face!


Non Invasive Face Lift

Looking For A Miracle? perhaps  "Fairy Godmother’s Wand"!

“I don’t want a facelift, but can’t you just tighten up some of this saggy skin a little?” 

It’s a question asked in my aesthetic practice daily. With new advances in technology and treatment protocols, my answers are shifting from a tentative “maybe” to a qualified “yes.” 
Whether the energy comes from infrared broad-based light (IR), radiofrequency (RF), laser energy or ultrasound, noninvasive skin tightening devices do produce results. They work through thermal injury to underlying dermal tissue with little or no harm to the epidermis. Though multiple sessions are needed to make that magic happen. Results delivered are operator dependent but quantitative and long lasting. 

These devices have given us physician and our patients a lot of hope. The results are naturally dramatic compared to nipped and tucked dramatic of the the surgical lift. Downside is we have to wait for the results to appear. As, we do sessions and our body goes through the natural process of remodeling getting rid of old and damaged skin components and making new collagen and elastin. 
While we are waiting for our face to tighten and lift, life around us goes on.... Engagement parties, weddings, birthdays, anniversaries and we all want to look our best on the important moments of our life. Daily showing up at work the image you want people to perceive of you is: professional, sharp, fresh and energetic, it adds to your profile and your company’s image. Patience is a virtue but waiting isn't easy.
Doctor can you prescribe me something in the meantime? So I can look 10-15 years younger while I am waiting for my real results to appear. This is the second mostly commonly asked question in my office. I did a thorough a research to find some miracle instant “Cinderella Effect” elixir of youth to cater to my patients needs and I came across “Gone in sixty secondsTM” by a company called Aminogenesis.
Gone in sixty secondsTM contains a scientific blend of oxygenating peptides and firming proteins that tighten, firm, and reduce puffiness. 
Its advanced formula activates on contact and time releases key ingredients all day long. 
Its not permanent it lasts almost as long as your make-up does. 
I tried it myself and found all claims true. Now it’s my trusted prescription for my patients on a budget who can’t afford the expensive procedures like botox or energy assisted skin lifts. And it’s my-go-to product while we are waiting post procedure for the long term miracles to happen.


Look Fabulous at any age

Happy New Year dear readers!!

Clock is ticking and aging process is happening every second of every day. Can some simple routine things in our daily habits help us slow the process a little bit? Answer is Yes, simple things like proper daily skin care and eating healthy can contribute a lot to our skin and aging process.  Here are few tips on how to take care of our skin and look fresh naturally in 2012.

If you're in your 20’s: You’re at your prime. You’re blessed with effortlessly glowing, supple skin so preservation is the name of the game.

  • Sun protection is more important now than at any other time of your life so use a good sunscreen, preferably with zinc. Don’t rely on the SPF in your cosmetics—those are chemical sunscreens that don’t offer enough photoprotection.
  • It’s critical to wash your face before bed, especially if you struggle with acne. Leaving makeup, sweat and pollution on the skin overnight leads to breakouts and dirty skin build-up. 
  • It’s common to want to dry acne out, but excessive drying leads to inflammation and ultimately more breakouts. Try a lightweight lactic acid moisturizer to rid the skin of excess debris and regulate oil production.
In your 30’s: Your skin is still radiant and youthful and if you start a smart anti-aging regimen now, you’ll set the course for a lifetime of good skin.

  • Washing thoroughly with warm, not hot water. 
  • Use retinol products.
  • Trade in after-work cocktails for pure spring water and green tea are small daily changes that can keep skin vibrant. 
  • Lifestyle and nutritional changes are the fountain of youth for women in their 30s. 
  • Eat high-quality proteins, take Omega-3 fish oil capsules, cut out sugary and starchy foods and coffee and get regular exercise.
In your 40’s: While lines may have started forming in your 20s and 30s, now is when you start to see laxity. The good news is, the whole range of in-office dermatological treatment options: lasers, Botox, injectible fillers will now benefit you more than anyone.

  • Use an SPF with antioxidants as well as prescription Retin-A. Retin-A speeds up cell turnover to get rid of damage below the skin that begins to surface now. 
  • Specialized treatments like mesotherapy, stem cell treatments and plasma cell treatments help to rejuvenate and extend youthfulness.  
  • If you want your skin to glow take Omega-3 fatty acid supplements.
In your 50’s: This decade is about knowing your skin type and specifically what you want to address. While everyone is concerned with wrinkle prevention, blotchiness and acne are also major concerns for women in their 50s. Target each concern individually for maximum results.

  • Use products with peptides and retinoids to stimulate collagen and regain a vibrant complexion.
  • If you get blotchy, products with hydroquinone will prevent irregular pigmentation—apply especially well over bony areas. 
  • And just like when you were in your teens, salicylic acid is still the best treatment for acne.

Eat Yourself Young

Remember putting your best face forward starts with making healthy skin start from the inside out. Unless your skin is getting the nutrients from food that it needs, it just won't look its best. Instead of just covering a blemish or hydrating a dry patch, head them off entirely by tossing these power foods into your grocery bag.


Hey, guess what? Almonds are seeds, not nuts, and they're stuffed with vitamin E, a potent sun blocker. A study done at the Yale University showed volunteers who consumed 14 milligrams of the vitamin per day (about 20 almonds) and then were exposed to UV light sunburned less than those who took none. Vitamin E acts as an antioxidant that helps to protect skin cells from UV light and other environmental factors that generate cell-damaging free radicals.
Suitable Switch 2 Tbsp peanut butter; 1/2 cup broccoli


Think of them as orange wonder wands—good for eyeballs, good for clearing up breakouts. Credit vitamin A. It helps prevent the overproduction of cells in the skin's outer layer. That's where dead cells and sebum combine and clog pores. Another reason to snack on carrots: Vitamin A also reduces the development of skin-cancer cells. Nibble on a half-cup of baby carrots (that's about 16) per day.
Suitable Switch Milk (1 cup); cheddar cheese (1 slice)

Dark Chocolate: 

It's medicine—so of course you need it! Flavonols, the antioxidants in dark chocolate, reduce roughness in the skin and protect against sun damage. In a study published in The Journal of Nutrition, women who drank cocoa fortified with 326 milligrams of flavonols (equal to a standard Hershey's Special Dark bar) had better skin texture and stronger resistance to UV rays than those who drank cocoa containing just a small amount of the antioxidant. You need just a few ounces a day.
Sort-of-Suitable Switch Blackberries, blueberries, cherries, raspberries—though you'd have to eat a huge amount.


These wee seeds contain omega-3 fatty acids, which erase spots and iron out fine lines. The British Journal of Nutrition reported that participants in one study who downed just over two grams (about half a teaspoon) of O-3's in six weeks experienced significantly less irritation and redness, along with better-hydrated skin. The fats are believed to stifle your body's response to irritation and attract water to skin cells to plump up the skin and reduce wrinkles. Sprinkle seeds on oatmeal or veggies.
Suitable Switch Flaxseed oil (1 Tbsp with sauteed veggies); salmon (4 oz); walnuts (1 oz, or about 14 halves)

Green Tea: 

What can't green tea do? OK, your taxes. Anyway, when it's hot, the bionic brew releases catechins, a type of antioxidant with proven anti-inflammatory and anti-cancer properties. (The tea's antioxidants start to degrade as it cools, so drink it while it's hot.) A 2007 study in The Journal of Nutritional Biochemistry found that drinking two to six cups a day not only helps prevent skin cancer but may reverse the effects of sun damage by neutralizing the changes that appear in sun-exposed skin.
Suitable Switch White tea

Safflower Oil: 

The omega-6 fatty acids found in safflower oil can be the ultimate moisturizer for people who suffer from painfully dry, flaky, itchy skin. They keep cell walls supple, allowing water to better penetrate the skin. Scientists have found that this oil may help people who suffer from severe conditions like eczema. So shoot for an amount that gives you 5 to 10 percent of your daily calories.
Suitable Switch Cooking oils like borage, soybean, or corn oil


You could probably build a fortress against the Big C with these leaves. In a study published in the International Journal of Cancer, people who ate the most leafy greens actually had half as many skin tumors over 11 years as those who ate the least. It's thought that the folate in these veggies may help repair and maintain DNA—basically bolstering cells' ability to renew themselves. That reduces the likelihood of cancer-cell growth. The added bonus to Popeye's fix: The water in greens penetrates cell membranes—which makes for plumper and less wrinkled skin.
Suitable Switch Collard greens

Sweet Potatoes: 

They not only pack a big yum; they're also loaded with vitamin C, which smooths out wrinkles. Vitamin C is essential to collagen production and the more collagen you have, the less creased your skin looks. In fact, a recent study in The American Journal of Clinical Nutrition found that volunteers who consumed about four milligrams of C (that's about half a small sweet tater) daily for three years decreased the appearance of wrinkles by 11 percent.
Suitable Switch Carrots (1 large or 16 baby); orange juice (6 oz)


Sure, they're swell on salads, but cook them down and these plump little beauties can help save your skin. Why? Lycopene, the phytochemical that makes tomatoes red, helps eliminate skin-aging free radicals caused by ultraviolet rays. Your body gains the most sun-shielding nutrients when the vegetable is heated. Just a half-cup of cooked tomatoes or pasta sauce has 16 milligrams of lycopene; along with ample sunscreen, that daily dose should help keep you out of the red.
Suitable Switch Watermelon (1/16 of a whole melon) 

Tuna in a Can: 

Your favorite sandwich melt has a little secret: selenium. This nutrient helps preserve elastin, a protein that keeps your skin smooth and tight. The antioxidant is also believed to buffer against the sun (it stops free radicals created by UV exposure from damaging cells). Three ounces, or half a can per day, can help.
Suitable Switch Brazil nuts (about 12); turkey (1 cup)