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SKIN CARE FOR HEALTH AND AESTHETICS

The philosophy at the Institute of Aesthetic Plastic & Reconstructive Surgery, LLC is comprehensive, holistic aesthetic health care. Regardless of what your surgical or non-surgical procedural interests are, educating you on skin care is an essential part of our personalized plan. Our objective is to provide information you need to make intelligent decisions that benefit you today and tomorrow.

Since the skin is the largest organ of our body, it is essential to take care of it. Daily attention to its preservation and a sound care and rejuvenation program is fundamental to the health of you and your skin. We understand that everyone’s goals for their appearance, and how much time they wish to devote to skin care, are different. Whatever your goals are, we will help you develop an individualized skin care plan that works for you -- your lifestyle, needs and goals.

Preventative Measures

The sun is the most significant factor in accelerating the aging process, prematurely wrinkling and damaging the skin, and increasing the chances of diseases like cancer. Colorado is in the top five states in the country for the most days of annual sunshine, and, unfortunately, has one of the highest skin cancer rates in the country as well.

Contrary to what was believed in the past, a “healthy glow” or tan is nothing more than blatant evidence of injury to your skin. Depending upon your skin type, you may burn or tan without sufficient protection, however that is simply one of your body’s protective mechanisms. Sun damage is cumulative, a reflection of the total hours you have spent in your lifetime exposed to the ultraviolet rays of the sun. Approximately 80% of the sun damage we do to ourselves is before the age of 18, so protecting and educating your children is of utmost importance. Remember, each time you burn and/or tan, you increase your chance of disease, not to mention catalyzing signs of aging such as hyperpigmentation and wrinkles.

 Consistent, daily use of high quality broad/full-spectrum sunscreens is imperative.

 There are three known ultraviolet wavelengths from the sun: UVA, UVB and UVC. Each wavelength requires specific sunblock ingredients in order to obtain maximum protection. We recommend products with zinc-oxide and titanium-dioxide (UVA protection) and a minimum of SPF 30 (UVB protection). Today, zinc-oxide and titanium-dioxide are refined and transparent, unlike the white, pasty sunblocks of the past.

 Here are our selections for medical-grade sunblock products that are cosmetically elegant and have the most complete UV coverage. Some are specifically designed for ultra-sensitive skin and postoperative care. Some are mineral makeup formulas, or are water/sweat proof. Our office staff can help you choose the sunblock that is right for you.

• Obagi Healthy Protection SPF 50

• SkinCeuticals Physical Fusion SPF 50 & Sheer Physical SPF 50

• Jane Iredale Mineral Makeup

• Epionce Ultra Shield SPF 50

 Over time, the efficacy of sunblocks diminishes. Therefore, all sunblocks (even waterproof/sweatproof) should be reapplied frequently.

 Limit your daily sun exposure all hours of the day, especially during the hours of 10:00-4:00.

 Wear physical protection such as broad-rimmed hats and UVA protective clothing.

 Remember that sunscreens reduce the incidence of skin cancer by protecting the skin; however, do not justify increased sun exposure during their utilization.

Practices

Maintaining healthy skin and preventing the signs of premature aging are dependent upon how you care for your skin every day. In addition to the sun, another aging component unique to our environment is lack of humidity. This semi-arid climate leads to dehydration, progressive aging, inflammation, increased dermatitis and other conditions of the skin. Proper daily skin care helps avoid these problems and enhances the texture and quality of the skin.

• Home humidification: Furnace humidifiers are insufficient in our environment. It is my recommendation that you utilize a bedside humidifier, especially in the winter months.

• Limit your consumption of caffeinated and alcoholic beverages, since these are dehydrating.

• Drink 6-8 glasses of fluid (water) daily.

• Maintain a well balanced diet and avoid significant weight fluctuations. Weight gain stretches the skin and upon reduction leads to laxity of the skin.

• Limit or avoid consumption of fried and other high fat foods.

• A balanced diet with sufficient protein, fruits and vegetables

• Certain fat is excellent for the complexion. For example, omega-3 fatty acids in fish oil (i.e., salmon) are clinically proven to benefit the skin.

• A diet rich in antioxidants is beneficial in ridding the free-radicals (ultraviolet detrimental byproduct) from the skin. Please inquire about antioxidants and how to incorporate them into your diet.

Long Term Skin Care Program

Each patient who presents to the Institute of Aesthetic Plastic & Reconstructive Surgery is welcomed to a private consultation with Dr. Schmid, our Aesthetic Skin Care Consultant or our RN to assess their individual features and skin characteristics. Our goal is to develop a sensible regimen that is tailored to your desire for results, and offer long-term health benefits by helping you achieve a healthy lifestyle. Your patience, understanding and commitment will, in turn, increase the benefits you receive from any aesthetic technique you choose. The healthier you are preoperatively, the better off you will be postoperatively.

Proactive Skin Techniques

There are proactive measures an individual can take to stimulate, rejuvenate and refresh the appearance. These options should be used simultaneously with the basic skin care program previously discussed. For example, there are techniques to stimulate collagen production, encourage cell regeneration, eliminate discolorations and reverse sun damage. Choosing the right technique for you is based upon your overall health, your goals and lifestyle.

Superficial Skin Treatments:

These regimens address sun damaged skin, surface irregularities, superficial pigmentation problems and early fine lines and wrinkles.

 Alpha hydroxy acids (glycolic acid)

 Beta hydroxy acids (salicylic acid)

 Tretinoin (Retin-A)

 Alpha hydroxyl acid/glycolic acid peels (10-40%)

 Antioxidants including Idebenone, Vitamin C, Ferulic Acid, and Phloretin

Our Skin Care Product Recommendations Include:

 LATISSE:

• For Longer, Fuller, Darker eyelashes.

 OBAGI:

 NuDerm Restoration System: Actually corrects and transforms photo damaged skin. Exfoliates, improves pigmentation problems and fine lines, softens and smoothes the overall complexion.

 Obagi Professional-C Serum: This antioxidant is stable with proven absorption.

 CRX Skin Restoration System: Best for dry skin not prone to breakouts

 Tretinoin: Proven collagen stimulation for wrinkles and softening.

 SKINCEUTICALS:

 Regimes for prevention, protection, and correction. Known for moisturizing, cosmetically elegant sunblocks, and antioxidant serums.

 JANE IREDALE:

 Pure, mineral-based cosmetics that can be used for everyday wear. Specific application techniques also serve to camouflage complexion flaws or the signs of recovery after an aesthetic procedure.

 EPIONCE:

 To repair, hydrate and fortify the skin’s natural protective barrier. Deeply penetrating, this product line works at the core of the skins own protective and reparative systems by helping to block inflammatory factors.

 VIVITE:

 Exfoliates-removes nonproductive cells from outer layer to reveal healthy, new skin. Hydrates-to keep skin smooth. Protects-with antioxidants important in keeping skin from aging prematurely.

 PERSONALIZED SKIN CARE PACKAGES:

 Customized and specifically priced. Ask our Aesthetic Care Consultant for what is right for you.

Additional Treatments Available:

 Trichloroacetic acid peels (10-15%), customized Glycolic & Salicylic Peels

 Medical Microdermabrasions with skin cleansing and stimulants

 Facials for acne, skin rejuvenation and aging skin.

 Intense Pulsed Light PhotoRejuvenation and FotoFacials

 Laser Hair Removal of face and body

Injectibles:

 Botox Cosmetic

 Juvederm XC (non animal hyaluronic acid)

 Restylane

 Radiesse (calcium hydroxylapatite)

 Fat transplantation

Medium Depth Treatments: These treatments require a limited downtime of up to one week and are directed to treat age spots and freckles, very fine wrinkles and surface irregularities.

 Alpha hydroxy/glycolic acid peels (up to 70%; progressive serial treatments)

 TCA peels (10-20%)

 Superficial laser resurfacing

 Fractional CO2 Therapy

Deep Treatments: These are aggressive treatments for the skin, but are extremely therapeutic and offer excellent results. Most require a downtime of 10-14 days. These treatments address sun damaged skin, precancerous skin conditions, moderate to severe age spots, moderate to deep wrinkles, and skin laxity.

 Combination TCA 35% peels/IPL(Photorejuvenation) Treatments

 Phenol peels

 Dermabrasion

 Laser resurfacing (CO2)

Surgical Techniques

As the skin progressively ages and loses its elasticity, the skin often becomes furrowed, wrinkled, loose and sagging. It is at this stage of skin aging that surgical management of your concerns is required.

 Rhytidectomy (Facelift): Surgery to tighten and re-suspend the loose skin, deep soft tissues of the face and neck in order to correct the face, jowls, jaw and neckline.

 Blepharoplasty (Eyelift): Surgery to address the aging and puffiness of the upper and lower eyelids.

 Forehead lift (Endoscopic or Open): Surgery to correct looseness of the forehead. Elevates the brows and softens forehead wrinkles.

 Rhinoplasty (Nose surgery): Surgery to correct prominence or droopiness of the nose that occurs with aging.

 Lobularplasty: Surgery to correct aging, sagging earlobes.

 Liposculpture/Laser Lipolysis: Surgery to correct excessive adipose (fatty) deposits that occur with aging.

Sunscreen

Besides wearing sunscreen when you visit the beach or take a dive in your swimming pool, how important really is sunscreen? Well, up to 90% of the visible damage on your skin can be attributed to sun exposure. In addition to aging the skin, sun exposure substantially increases the likelihood of developing skin cancer, the most common cancer in humans. It is estimated that about 1 in 5 people develop some form of skin cancer during their lifetime. People who hope to maintain their skin's youth and protect it from cancer, should seriously consider wearing sunscreen regularly.

Sunscreens are usually a white, creamy color, though they can sometimes be slightly tinted. Their primary use is filter out variant forms of UV light. Specifically, they prevent UV lights A and B from penetrating the skin and causing damage. This is why the FDA requested that it be called "sunscreen" rather than "sunblock."

Ultraviolet A (UVA) has a long wavelength, allowing it to penetrate into deeper layers of the skin, causing skin damages such as wrinkles (photoaging) and mutagenic effects in our DNA that can lead to skin cancer. UVA persists throughout the entire day, and can go through glass and clouds, so remember to wear your sunscreen before a drive, even on a cloudy day! 

Ultraviolet B (UVB) rays are strongest between the hours of 10AM-4PM. They're responsible for inducing the production of melanin in your skin, a protein that acts to protect the skin from photodamage. This is also what induces the tanning effect by essentially burning the superficial layer of the skin. Too much exposure to UVB can increase your risk of your skin cancers. 

Nevertheless, not all sunscreens are made alike. For instance, many sunscreens can potentially disrupt hormonal balance and are hazardous to our ocean's wildlife. Additionally, a significant percentage of people are vitamin D deficient, and they need exposure to the sun to produce vitamin D in their bodies. This is why it is important to find a sunscreen that only protects from UVA and UVB. So let's discuss what to look for in your sunscreen: 

What is SPF (sun protection factor)?

Each sunscreen should have an SPF number. This number indicates what ratio of UV light can still penetrate through your skin while the sunscreen is being used. To further explain, an SPF of 30 means that theoretically only 1/30th of sun rays can still penetrate through your skin. An SPF of 15, then, means 1/15th of rays can still penetrate through your skin. In other words, SPF 15 blocks 94% of UV light, while SPF 30 blocks up to 97%, SPF 45 blocks up to 98% and so on. 

Look for a “ broad spectrum sunscreen,” which blocks both UVA and UVB.

There are several types of UV sunscreens, such as chemical (organic) and non- chemical (inorganic). Be cautious of the word “organic,” which has a different implication here then what we're used to in our food. Here, organic is used to discuss organic chemicals versus inorganic minerals.

Organic sunscreens use chemicals manifactured in a lab that absorb the UV rays and convert it into heat. They usually contain one or more of the following ingredients: Oxybenzone, abvobenzone, octocrylene, homosalate, and/or octinoxate. Inorganic sunscreens, on the other hand, are mineral-based. 

Mineral (Inorganic) Sunscreens

Inorganic sunscreens are actually chemical free, natural sunscreens, which reflect and scatter the UV radiations.

They contain zinc oxide and/or titanium dioxide as the active ingredients.

Which to choose and why?

Mineral (inorganic) over chemical (organic). Mineral sunscreens are usually less irritating to the skin and are considered safer. Chemical sunscreens could potentially disrupt the estrogen hormone, and the chemical oxybenzone widely used in most chemical sunscreens can be disruptive to ocean wildlife.

Zinc Oxide

Zinc oxide is the best mineral-based sunscreen so far. It prevents UV lights better than titanium dioxide, and it's a critical mineral nutrient in many vitamin supplements. Zinc oxide is very safe for the skin, and the FDA has actually approved the use of zinc oxide in creams for babies with diaper rash, 

It has also been studied that zinc oxide has several other benefits to the skin. For example, tt is antiseptic, absorbs moisture, and especially useful for severe eczema. It also been approved to be used in facial skin redness as a soothing preparation.

Several important considerations on sunscreen and sun exposure:

For most people, it only takes 5 to 10 minutes to burn without sunscreen, however it depends on the UV index, skin type, severity of the sun, etc. However, it may take hours to see the manifestation of the burn, even though the damage to skin occured much earlier.

It's usually recommended that you reapply sunscreen every 120 minutes after initial proper application. Apply again after swimming, sweating, and towel wiping. Use water resistant sunscreen if swimming.

How long a person can stay in sun with sunscreen application

You can calculate the time by multiplying the SPF by 6. For example, in the case of SPF 30, the maximum time one can stay under the sun steadily with sunscreen without burning is 180 minutes. Reapplication of the sunscreen does not prolong this time. Meaning, after about 3 hours, people with fair skin should try to get out of the sun. 

Men Facial Aging and Beauty 

Abstract

Gender differences play an important factor in facial anatomy, behavior, and beauty concerns. In men, a balance between masculinity and femininity is important in outcome satisfaction. Most men are more concernered with their hairline, periocular, and jawline.

Introduction

Like women, men facial aging, is due to changes in skin, soft tissue, and skeletal structures. Factors affecting men’s aging are either due to intrinsic or extrinsic factors. Intrinsic, includes genes and hormonal effects. Extrinsic, include environmental factors such as sun exposure, smoking, etc. 

Despite known factors in men’s aging, the rate and pattern of aging, is unique to each individual, which is itself influenced by genetic, anatomical, and behaviorial aspects of each person.

What is less understood, however, is the aesthetic goal for men and what is ideal beauty or “man-some” for men. Since "beauty is in the eye of beholder," it is important to understand the male aesthetic ideal, for rendering the aesthetic service for ideal result, which should be align with the patient goal.

Male Facial Aging

Men, are aging poorly due to both, intrinsic and extrinsic factors. They have reduced innate antioxidant capacity than women. Also they are less knowledgeable or protective against UV radiation and engage in more health riskier behavior, like ; they smoke more than women.

Men develop wrinkles earlier and more severe, also, it’s pattern is different due to difference in facial muscle movement and cutaneous appendages. Wrinkles are more preocular and less perioral areas. The shape of wrinkles also different; U-shape in glabellar area mor common in men and the lower lis sags more and deeper.

Men lose their facial soft tissue steadily as opposed to women which their loss accelerates around menopausal age. Also, men lose earlier and more hair loss than women, at least %50 of caucasian have some hair loss by age 50. Hair loss make men appear older than their stated of age and make them less youthful.

Male is different in regard to facial anatomy, testosteron attributes to secondary sexual characteristics which is masculine. Men face is wider and larger at every level, also, more angular. Chin is more square in men. The supraorbital ridge is more prominent.

Men,has less subcutaneous tissue than women, and is more evenly distributed. They have more sud-Q fat at lateral mid face as opposed to women in medial mid face.

“Man some” or male beauty

The aesthetic concerns in men are somewhat different than women. In surveys, they want to “look good for my age” and “more youthful”. The number one cosmetic concern in men, is the hair loss and hair line. Also, they exhibit concern on their preocular ( crews feet and tear trough). Maintaining masculine jawline, by treating submental fullness and chin is another priority.

Overall, strike a right balance, between masculinity and femininity, could provide a better facial aesthetic outcome. Attractiveness to the opposite sex is an important factor , however, patient aesthetic concern should be addressed for better satisfaction.Most men are internally driven to look better rather attracting a mate or competing at work.

Conclusions

Men, currently comprise about %10 of cosmetic procedure, however, it is growing rapidly. Men, comprise %40 of luxury fashion market, and it is growing faster than women’s one.

A through understanding of gender differences and priorities, as well as, mastering the knowledge of male anatomy, facial aging, and cosmetic concerns and developing a comprehensive aesthetic plan for male patient, practitioner can capitalize in this growing segment of aesthetic care.

Neurotoxins: Wrinkle Relief & Prevention

Abstract:

Onabotulinum Toxin A ( BoTNA), is the gold standard treatment for temporary reduction of dynamic rhytid. However there are some evidences which repeated treatments over a long time may have preventative and progressive reductions of rhytides, however more study required to explain the exact mechanism of additional benefits of BoNTA beyond temporary paralysis of muscle.

Introduction:

BoNTA has been introduced over two decades ago and is the most common cosmetic treatment in USA. It blocks the release of acetylcholine and prevents the treated muscle to contract. As a result the dynamic rhytides ( wrinkles induced by facial movements) will be reduced or completely fades away. However,there are evidences, in people who receives repeated treatment over glabellar, pre-orbital and frontal muscles, over time, it can prevent new dynamic rhytids formation and may progressively reduce static (resting) wrinkles as well.

It also improve the quality of skin.

The exact mechanisms are not known, however, it may be due to triggering new collagen formation by stimulating fibroblasts, and or reorganizing the old collagen fibers on treated areas.

Also, the interval of next treatment maybe wider with people who received repeated treatment, over time.

Mechanism of additional benefits of BoNTA with repeated treatment ( theories):

First, theory of learned response, in which patients avoid using as much as used which causes wrinkles.

Second;physiologic muscle response, in which even a single injection causes some atrophy(shrinking) of the treated muscle for a period of up to 12 months. It is obvious wrinkle formation stops after muscle movement inhibited by injection of BoTNA.

However, what is less known, its reducing effect on established wrinkles over repeated treatments progressively and cumulatively.

To be able to explain better, it is worth mentioning that human skin has three important biomechanical characteristic: strength, pliability ( ability to stretch) and elasticity ( ability to recoil). With aging these biomechanical features change and exacerbates with UV exposure.

Recent study ( a Cohort study on 48 women, with a single treatment of BoNTA) shows a significant improvement in elasticity and pliability could be measured up to four months after the treatment. The biomechanical changes in the skin induced by BoNTA are the opposite of caused by aging.

The extracellular matrix ( ECM) of skin, composed mainly, of collagen, in addition to glycosaminoglycans and elastin fibers. Collagen, is the most abundant protein in the skin, and is responsible for the integrity and proper functioning of the skin.

Biopsy of the skin in 18 volunteers with moderate to severe wrinkles, before and 3 months after

Periorbital injection of BoTNA shows the collagen became more compact and organized compare to baseline biopsy, however, histochemical analysis did not show any change in the level of elastin or collagen fibers.So, this may explain the extended improvement and results induced by, repeated injection in extended periods. Other study shows BoNTA may activate fibroblast cell activity which causes skin remodeling.

Individual practitioners, often, influenced by their own daily observation and patients feedbacks which, further proves, that regular and repeated injections of BoNTA, results in better skin quality, less wrinkles and longer lasting results in compare to sporadic treatment. This makes sense, as repeated injection, prevents return of muscle function, consequently, less muscle movement causes less crease and better collagen reorganization which prevents new wrinkle formation and more youthful skin.

Conclusions:

BoNTA, is inseparable part of cosmetic medicine and the most common non invasive cosmetic treatment in the past two decades. It has become evident, that it is no longer merely a temporary muscle paralyzing agent, as, it can induce better skin quality, less wrinkles and its effect last longer if been performed on a regular base for a longer period vs. sporadic use

Rejuvenation ( Non or Minimally Invasive) For Aging Gracefully

Introduction:

Traditionally improving aging patient appearance focused on skin laxity and surgery to remove excess skin which resulted sudden change and often unnatural appearance.

Later deep chemical, dermabrasion and even early laser treatment helped skin texture, toning and color, however required long downtime and not infrequently resulted hyperpigmentation and skin color changes.

Advances in new injectables, cosmeceuticals and energy based devices made it possible to improve appearances, younger and preserve natural beauty in a more realistic way. At times, combinations of these options required to achieve the goal, in a short or longer periods, depending the age, gender, race and circumstances.

Thorough knowledge, in skin physiology, anatomy and skill helps to improve outcomes.

It is also very important a proper through assessment during consultation, paying attention facial anatomical landmarks, asymmetry, facial skin quality and volume depletions.

It is very important to explain the reachable objectives that is realistic and achievable in a specific time frame.

In elder clients it may require more volume replacement

continues..

Acne Vulgaris(AV) Pathogenesis:

Abstract

It is the most common skin disorder(D/O), regardless of gender, skin color or ethnicity. For a long time it was thought it is due to abnormal desquamation of the keratinocytes and hyperkeratinization of the sebaceous glands which causes acne lesions. However the pathogenesis of acne believed to be due to an inflammatory skin D/O which is present before the acne lesions manifestation.

Introduction

AV is a chronic inflammatory skin D/O which involves pilosebaceous unit. It is a a most pervasive skin D/O regardless of gender, skin color and ethnicity.

For many years it is thought acne lesions develop due to hyperkeratinization and abnormal desquamation which facilitated by increase in circulating androgen during puberty.

It is thought the above development provides a medium which Propionibacterium Acne colonizes. This will result in inflammatory and chemotactic elements and inflammation.

However recent studies shows subclinical inflammatory cells before and during hyperkeratinization and manifestations of microcomedone.

Further investigations like biopsies, showed inflammatory cells like CD3, CD4, Interleukin (IL1),

And macrophages are present even in normal appearing skin of AV patients as well as in acne lesions.

The paradigm of pathogenesis of AV has shifted from a simple hyperproliferation of sebaceous glands to an inflammatory skin D/O.

The role of Propionibacterium Acne (P.acnes)in pathogenesis of AV

The exact mechanism of P.acnes in AV still under study, however considerable evidence delineates its involvement in AV.

Studies have shown P.acne activates cytokine and other inflammatory responses via its receptors.

In addition P.acnes has several genotypes 1, 2 and 3 also subtype A and B. type 1A has an extremely high association with acne.

Gene Array profiling

In lieu of evidences of chronic subclinical inflammatory process in the pathogenesis of AV and discovering numerous biomarkers in the process AV, gene expression profiling in AV been studied which revealed 211 genes been upregulated in the biopsies of the AV lesions.

 

AV and scarring

AV patients has different responses to scarring base on their initial cell mediated immune response type. Patients with less prone to AV scarring shows more CD4, T-cell and macrophage and more HLA DR. Also shows more angiogenesis in early stage of AV legions developments.

Conclusions:

Recent discoveries has changed the pathogenesis of AV from a primarily a hyperproliferative D/O of pilosebaceous unit to chronic inflammatory skin D/O.

Furthermore it also been discovered that not all type P.acne are involved in AV lesions which further supports the AV not primarily an infectious disease as it is rather an inflammatory D/O.

Furthermore the inflammation continues even after the resolution of papules and pustules.

Vitamins save lives, literally. Interestingly enough, however, the average person tends to know so little about them, and how they help our body. For instance, Vitamin B wasn’t discovered until years after the disease Beriberi caused an epidemic in the late 19thcentury. Beriberi is essentially a disease caused by a thiamine deficiency (a Vitamin B1 deficiency). It was the national disease of Japan in the 19thcentury, primarily because the population depended heavily on refined, white rice rather than a whole grain diet (like brown rice, which contains the amine groups).

In fact, the only known US health epidemic occurred from the 1920s to the 1960s due to a Vitamin B3 deficiency which caused the disease Pellagra. Thousands died every year from Pellagra, experiencing symptoms such as broken, dry skin and causing delirious behavior (so badly so that tens of thousands of people were put into insane asylums).

So what’s my point, am I trying to say that a lack of knowledge about Vitamins is going to cause you to contract a terrible illness? No, but hopefully throughout the series of vitamin blogs, I am able to convince you of the power vitamins have to keep your body healthy. There’s an incredible amount of valuable information that could be helpful to your everyday health just waiting to be revealed, and I’m going to begin this journey by discussing Vitamin B.

There are 8 different water-soluble Vitamin B vitamins that make up what we like to call the B-complex. These vitamins are primarily responsible for aiding in metabolic processes such as carbohydrate, protein, and fat synthesis. They aide in the synthesis and repair of DNA and RNA, and they can help maintain healthy skin and muscle. Since these vitamins are water soluble, they are easily excreted from the body, so they need be replenished almost daily. This isn’t too much of an issue, considering Vitamin B is so readily available in a balanced diet. However, the issue is so many of us don’t have a balanced diet. With the fast pace of everyday life, and the extensive amount of hip, dessert-like pop up stores coming out with new food trends, it’s easy to skip the basic essentials. With that being said, lets cover the B-complex, one vitamin at a time!

• Vitamin B1: Thiamine
• Thiamine is generally responsible for converting food to energy, and it can also have neurological benefits (who doesn’t love a healthy brain!)
• Some of the best sources for thiamine are whole grains, milk, and eggs.
• Fortunately, Thiamine deficiencies are rare in the US because even processed grains tend to be fortified with Thiamine.

• Vitamin B2: Riboflavin
• Riboflavin is also responsible for helping to convert food to energy, and it has the added benefit of being great for your vision and skin health!
• The best sources for this vitamin are similar to those of Vitamin B1 and include whole grains, milk, and eggs.

• Vitamin B3: Niacin
• Niacin helps convert carbohydrates, fats, and alcohols into energy, while aiding in proper digestion and a healthy appetite. It can also help your skin maintain its health!
• Some of the best sources of niacin include chicken, fish, liver, red meat, and whole grains.
• Deficiencies in niacin are not commonly seen in the US because people tend to love their meat

• Vitamin B5: Pantothenic acid
• Pantothenic acid is especially important for the breakdown of fatty acids, along with carbohydrate and protein metabolism.
• Some easy, popular ways to get pantothenic acid into your diet is to eat avocados and yoghurt (a favorite of many!)
• Some studies have shown that pantothenic acid ointment on the skin can help shorten the healing time of wounds and reduce scar tissue.

• Vitamin B6: Pyridoxine
• Pyridoxine helps the body turn food into energy, and it can also help the body fight infections.
• Pregnant/Breastfeeding women need more pyridoxine to help their baby’s brain function.
• The best sources include tuna, salmon, chicken breast, watermelon, spinach, potatoes, ground beef, and whole grains.

• Vitamin B7: Biotin
• Biotin is needed for energy metabolism, fat synthesis, amino acid metabolism, and glycogen synthesis.
• There is usually no worry for a deficiency of Biotin; however, bodybuilders who consume a lot of raw egg whites can have deficiencies because a protein in egg whites inhibits biotin absorption. This can lead to dry, cracked skin, hallucinations, depression, hair loss, and muscle pain.
• High biotin uptake, on the other hand, can lead to high cholesterol.

• Vitamin B9: Folate/Folic acid
• Folate fosters the growth of red blood cells.
• Some simple sources include red meats, whole grains, citrus fruits, fish, legumes, and green leafy vegetables.

• Vitamin B-12: Cobalamin
• Cobalamin helps regulate the nervous system and plays a role in the growth and formation of red blood cells.
• The best sources of Cobalamin can be found in meat & dairy products (vegans likely need B12 supplements).

With a balanced diet, having a sufficient amount of Vitamin B should be easy! However, note that because the B-complex is water soluble, excessive intake of alcohol can inhibit the absorption of the B vitamins.

We can’t stop ourselves from aging, but that doesn’t mean we have to let our skin show it. Belotero Balance is a prescription filler that is FDA approved to temporarily smooth out and fill the wrinkles around the mouth.

Belotero is right for you if the skin around your mouth:

• Lost structural volume
• Has etched-in lines and wrinkles, even when not smiling
• Vertical lip lines

A benefit of using Belotero is that it integrates within your skin’s own tissue, smoothing wrinkles and providing a look that is natural to the touch. It can smooth moderate-to-severe etched-in facial wrinkles, and it will also allow you to maintain normal movement and facial expressions. Have your skin look fresh and natural. Give us a call if you have any questions or wish to schedule a consultation.

Anaheim Medical & Cosmetic Clinic. (657) 230-9434.

The Juvèderm family includes two different types of fillers that are used to addressed various needs. The first is Juvèderm XC, which is a filler in the US used for moderate to severe facial wrinkles and folds to temporarily add volume to the skin, especially around the nose and mouth. The second is Juvèderm Voluma XC, which is a filler intended to correct age-related volume loss in the cheeks in patients over the age of 21.

The Juvèderm Family of fillers are injectable gels made from modified Hyaluronic acid (HA). HA is a complex sugar that is found naturally in the body which helps the skin retain both its moisture and its softness. Juvèderm XC fillers also contain lidocaine, an anesthetic that will help reduce discomfort. Your healthcare profession will inject these smooth gels under the skin with the use of a very fine needle. While Juvèderm XC will help fill deep lines for a smoother appearance, Juvèderm Voluma XC will instantly add volume and lift to the cheeks for a more youthful profile.

Some of the benefits of choosing Juvèderm over different treatments include:

• Nonsurgical
• Instant results
• Natural Looking
• Long lasting
• In-office procedure