How to Make Smart Skin Care Choices Based on Science Not Hype
Intelligent anti-aging skin care based on independent research
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Skin Care 101
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Making Smart Skincare Choices via Science Not Hype
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Biology of Aging
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Skin Conditions
Anti-Aging Treatments
Given today's flood of skin care ads and infomercials, it's no small feat to pick
out the "gems" that are actually useful and avoid ineffective or even potentially
harmful products or procedures. The articles in this section help you avoid "being
taken for a ride" by some of the less scrupulous skin care manufacturers,
distributors and providers. We also expose common skin care myths and
misconceptions that may interfere with the effectiveness of your skin care.
Topical Actives
Can wrinkles disappear overnight? The hoax of before and after
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Wrinkle Fillers
Research studies versus testimonials
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Aging face: Fixing wrinkles is not enough
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http://www.smartskincare.com/smartchoices/[24/01/2012 22:33:13]
Can wrinkles disappear overnight? The hoax of before and after photos.
Intelligent anti-aging skin care based on independent research
Lose wrinkles, keep your bank account!
Skin Care 101
You are here: Making Smart Skin Care Choices >
-- advertisements --
Skin Care Basics
Skin Protection
Skin Biology
Can wrinkles disappear overnight? The hoax of
before and after photos.
Biology of Aging
Ingredient Guide
Skin & Nutrition
Skin Conditions
Anti-Aging Treatments
Topical Actives
Wrinkle Fillers
Noninvasive
Invasive
Skin Care Smarts
Smart Choices
Best Practices
Find Good Skin Doc
Quick Tips
Freebie Finder
Reviews & Research
Product Reviews
Reviews By Brand
Skin Care Research
Beware to base your judgment of an anti-wrinkle/skin rejuvenation products on
before and after photos provided by commercial vendors. In a strictly controlled
setting of an unbiased clinical study, before and after photos might be a useful
adjunct to other methods used to evaluate the efficacy of a treatment for wrinkles
or skin aging. Otherwise, before and after photos are often unintentionally or
intentionally misleading. In fact, some unscrupulous skin care providers have a
"bag of tricks" to create a false impression of skin rejuvenation.
For instance, the position of the lighting source has a dramatic effect on how
wrinkles appear to a viewer. When light comes from the side, wrinkles appear
deeper, whereas placing a light source in front of the face makes wrinkles much
less noticeable. You can make a little experiment to see that for yourself. Take a
lamp or a flashlight and then position yourself in front of a mirror. Then place the
lamp / flashlight so that the light comes to your face from the side and look in
the mirror. Then do the same with light coming to your face from the front. You
face will appear "years younger" although there has been no real change in
wrinkles or skin texture.
Another method involves using the light of different brightness and/or tint. Due to
the nature of light waves, wrinkles and other small details are easier to notice if the light has greenish-bluish rather than yellowish-reddish tint. On top of lighting
effects, some unscrupulous beauty specialists use tightening makeup that
temporarily smoothens the skin. The effect, of course, is transient but long
enough to take a photo. To sum it up, unless photos come from an unbiased
clinical study with full disclosure of the conditions under which they were taken,
they can not be assumed to be reliable. In some cases, a good observer may be
able to tell whether a particular set of before and after photos reflect a genuine
change, or a magic trick. For specific guidelines to help you be a better judge of
before and after photos see Skin Rejuvenation Infopack.
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http://www.smartskincare.com/smartchoices/photohoax.html[24/01/2012 22:33:21]
Research studies versus testimonials
Intelligent anti-aging skin care based on independent research
Lose wrinkles, keep your bank account!
Skin Care 101
You are here: Making Smart Skin Care Choices >
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Skin Care Basics
Skin Protection
Research studies versus testimonials
Naturally Reduce
Wrinkles
Skin Biology
Biology of Aging
Ingredient Guide
Skin & Nutrition
Skin Conditions
Anti-Aging Treatments
Topical Actives
Wrinkle Fillers
Noninvasive
Invasive
Skin Care Smarts
Smart Choices
Best Practices
View Before & After
Results. Find the
Right Treatment For
You.
What information can we use to make the right choice about using a particular
skin care product or procedure? The easiest way is to simply try it and see if it
works. The problem with this approach is that it takes a lot of time and money.
What's worse, with all the enormous variety of skin care products on the market,
you may never encounter right products.
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One alternative is too see what other people have to say about the product. This
is not always a wise choice, especially if you rely on testimonials provided by the
vendor. For some products, testimonials are simply "medical fiction" supplied by
ghost writers. However, even true testimonial can grossly misrepresent reality.
Consider the following scenario. One million people tried a product and fifty had
an improvement (even with a sugar pill an occasional person will have an
improvement). Then the testimonials of these fifty are taken and attached to the
product. What do you think is the chance for an average consumer to benefit
from the product? Yes, about the same as winning a lottery. As sobering as it
may be, the only reliable way to find out if a product or treatment has a decent
chance to work is to analyze independent medical research performed by
institutions unrelated to the product's vendor. This is the kind of information the
articles on this site are based on.
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How to interpret skin care research data
Intelligent anti-aging skin care based on independent research
Lose wrinkles, keep your bank account!
Skin Care 101
You are here: Making Smart Skin Care Choices >
Skin Care Basics
Skin Protection
How to interpret skin care research data
Skin Biology
Biology of Aging
Ingredient Guide
Skin & Nutrition
Skin Conditions
Anti-Aging Treatments
Topical Actives
Wrinkle Fillers
Noninvasive
Invasive
Skin Care Smarts
Smart Choices
Best Practices
Find Good Skin Doc
Quick Tips
Freebie Finder
Under ideal circumstances, the best way to get reliable information about
biological phenomena, including anti-aging skin treatments, is to read and
analyze a large number of well-designed research studies. Unfortunately, many
people do not have the time to dig through raw biomedical research. Others may
have time but lack specialized expertise required to correctly interpret the data.
In fact, even scientists specializing in different branches of the same field
sometimes have difficulties in interpreting each other's work.
Still, these difficulties should not be an impenetrable obstacle between an
inquisitive mind and direct access to quality research. With common sense, one
can balance the information from raw research, scientific reviews, popular articles
and real-life experiences in order to come as close to the underlying truth as
possible. To that end, this site provides a comprehensive compilation of skin
care research abstracts. But first, here is a set of guidelines to help you navigate
the sea of raw research data.
General guidelines
Before reading research abstracts or articles on a particular topic, read an
overview of the issue written in plain English. Many skin rejuvenation
methods are discussed in Anti-Aging Treatments section of this site. For
example, before reading research abstracts on laser resurfacing, read our
article about it.
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There are two major types of research articles: a study report and a
scientific review. A study report is essentially an account of a research
study performed by the authors. A review, on the other hand, is a
summary and analysis of key studies in a particular (usually narrow) field
of research. In a review, the authors mainly discuss other people's
studies. If written by knowledgeable and impartial researchers, reviews
are useful because they allow the reader to quickly assimilate the results
of multiple studies. Still, reviews are a third party interpretation of the
research data and cannot fully replace reading the actual studies. In most
cases you can quickly figure out if an article is a review. Many reviews
contain the word "review" in the title or publication attributes. Also, if the
abstract does not contain specific, quantitative experimental findings,
chances are the publication is a review.
Make sure that you understand the meaning of the terms used. If you do
not understand some terms, do not try to guess their meaning from the
context - it is easier to get it wrong than right. In fact, some very common
words take on a different meaning when used in scientific articles. For
example, in a scientific paper, "significant improvement" does not
necessarily mean a substantial improvement. In most cases, it only
means that the observed improvement was statistically significant, i.e. not
likely to have happened by chance. In statistical terms, even a 3%
improvement can sometimes be considered significant as long as it has
been proved to fall outside the range of random fluctuations. In real terms,
however, such an improvement is not worth the time or money.
Always try to figure out the quantitative magnitude of the observed effects
(such as reduction in wrinkle deapth or increased skin elasticity).
Determine how these effects were measured. Physical measurements,
especially using several independent methods, are more credible than
visual observations or self-assessments of the study participants.
http://www.smartskincare.com/smartchoices/interpreting_research.html[24/01/2012 22:33:51]
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How to interpret skin care research data
Abstracts are adequate for scanning research data. However, if you come
across a particularly interesting or impressive new treatment (and
especially if you are seriously considering this treatment for yourself), get
the full text of the research articles. Unfortunately, due to copyrighting
restrictions we can only provide abstracts on this site. You can obtain the
full text of research articles in medical libraries or online at such sites as
medscape.com (depending on the journal, they may charge a fee per
article).
Try to find several studies on your subject of interest. Only multiple
studies by unrelated, independent teams can fully substantiate the
treatment's effectiveness. It is best to rely on the studies performed by the
teams that are not affiliated with or funded by the pharmaceutical or skin
care companies. Unfortunately, such studies are harder to come by in our
market driven world.
How to determine the value and credibility of a research study
Not all scientific studies are created equal: some deserve more credence than
others. To distinguish among "the good, the bad and the ugly," we recommend
the following.
Look where a study has been published. The publication source should
by no means be your only criterion. However, just as newspapers, TV
shows or websites, not all scientific journals are created equal.
Respectable peer reviewed journals (e.g. Nature, JAMA, Lancet, etc.)
tend to be more rigorous in screening out flawed studies because their
reputation is their main asset. Hence the studies they publish tend to be
of better quality.
Long-term studies are more valuable that the shorter ones. Some
treatments work well in the short run but quickly lose their effectiveness or
even lead to long-term damage. While a short-term study is better than
nothing at all, the evidence of long-term benefits and safety (12 month or
longer) is far more valuable.
Studies with larger number of participants tend to be more reliable since a
larger sample provides more reliable statistics.
Studies in cell tissue culture or animal models are far less reliable that
those in human subjects. In most cases, an animal or tissue culture study
is an indicator of whether a human study is worthwhile, but by no means
the evidence that the treatment will work in humans too.
Studies with better controls hold more value. The golden standard of
medical research is a so-called randomized double-blind placebocontrolled study. In such a study the subjects are randomly assigned to
two similar groups. One group gets an active treatment and the other,
a.k.a. the control group, gets a placebo (hence the term placebocontrolled). Furthermore, neither the subjects nor the administering
physicians know which batch has the active substance and which is a
placebo (hence double-blind). In the studies of topical skin treatments, for
example, the placebo may be the base cream (i.e. inactive ingredients
mixed together). Notably, many skin care studies use each subject as her
own control by applying different agents (e.g. wrinkle cream vs inactive
base cream) to different sides of the face. However, this tends to be less
reliable because the subjects often have to apply the treatment
themselves and may confuse or forget the application rules. Unfortunately,
randomized double-blind placebo-controlled studies are relatively rare in
skin care research because they are costly and harder to perform
properly.
Studies with a thorough statistical analysis of results tend to be more
reliable. Imagine that we have just finished a study and observed some
http://www.smartskincare.com/smartchoices/interpreting_research.html[24/01/2012 22:33:51]
How to interpret skin care research data
effect, such as improved skin elasticity. How do we know that this is a
real effect rather than a transient natural fluctuation in people's skin
properties or a measurement error? Statistics to the rescue! It turns out
that statistical methods allow us to estimate the probability (p) that the
observed effect resulted from random fluctuations or errors rather than
biological activity of the treatment. The smaller the p, the more reliable
the result. You should give more credence to the studies where such
probability is less than 5% (p < 0.05) or, even better, less than 1% (p <
0.01). Whenever the researches confirm their results with a rigorous
statistical analysis they almost always include that value of p in the
abstract of the article. Hence if the abstract does not include the value of
p, chances are that such analysis has not been done (or perhaps it was,
but didn't come out favorably).
This article is by no means an exhaustive tutorial on how to interpret scientific
research and distinguish between reliable evidence and junk science. In fact, a
comprehensive discussion of this issue would take a sizeable book. While the
first-hand analysis of research can give you an edge in your quest for the truth, it
is no simple matter and should be done carefully and thoroughly. When deriving
conclusions, one should take into account the limitations of both the research
itself and one's expertise in interpreting it.
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http://www.smartskincare.com/smartchoices/interpreting_research.html[24/01/2012 22:33:51]
Aging face: Fixing wrinkles is not enough
Intelligent anti-aging skin care based on independent research
Lose wrinkles, keep your bank account!
Skin Care 101
You are here: Making Smart Skin Care Choices >
Skin Care Basics
Skin Protection
Aging face: Fixing wrinkles is not enough
Skin Biology
Biology of Aging
Ingredient Guide
Skin & Nutrition
Skin Conditions
Anti-Aging Treatments
Topical Actives
Wrinkle Fillers
Noninvasive
Invasive
Facial rejuvenation typically focuses on prevention and reduction of wrinkles.
Indeed wrinkles are perhaps the most obvious and easily measurable aspect of
facial aging. Yet there are other factors that can contribute to the "aged look" at
least as much as wrinkles. Sometimes, wrinkles and fine lines are the only sign
of facial aging a person would have. This is typical of relatively young people
who have spent too much time in the sun without proper UV protection. But
more often wrinkles are just the tip of the iceberg. In fact, reducing or even
eliminating wrinkles may sometimes do relatively little to help take years off one's
face. A number of other age-related changes can contribute to facial aging to
varying degree, such as skin laxity & sag; muscle laxity, sag & atrophy; loss and
redistribution of facial fat; facial bone growth; and nose drooping. In this article I
discuss these often overlooked aspects of facial aging as well as the available
remedies.
Skin laxity and sag
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As the aging skin loses its structural proteins (collagen and elastin), it becomes
more lax and begins to sag, which contributes to tired and aged look. The
sagging can be slowed down by stimulating the synthesis and inhibiting the
degradation of collagen and elastin using topical agents. (See our articles on
collagen and elastin for more details.) However, once the sag has set in, topical
firming treatments (such as DMAE) tend to be only modestly effective at best.
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A noninvasive procedure called skin needling (a.k.a. percutaneous collagen
induction) shows some promise for modest skin tightening and has a good safety
profile. It may help correct mild skin laxity. (See also our article on skin
needling).
Another category of noninvasive procedures that may help reduce skin laxity and
facial sag is targeted radiofrequency therapy. The early variants of facial
radiofrequency treatments were inconsistently effective and associated with
significant occurrence of adverse reactions. The new generations of
radiofrequency treatments may be better on both counts but the jury is still out.
(For more details, see our articles on radiofrequency treatments in the section on
noninvasive procedures.)
In the case of severe skin laxity and facial sag, facelift surgery is likely to be the
only option to provide dramatic improvement. However, surgical risks, prolonged
recovery time and high costs associated with facelift procedure make it
unacceptable for many people. (See also our article on facelift surgery.)
Loss and redistribution of facial fat
Young faces are supple, properly padded with facial fat in all the right places,
yet without the excess of it. As we age, the distribution of facial fat tends to
change. In some areas of the face (e.g. under the lower eyelid), fat can
accumulate excessively, leading to the impression of permanent puffiness. More
often, however, fat padding thins out and/or migrates, leading to deep creases,
sunken cheeks and other unwelcome changes. Of particular cosmetic
significance is the so-called malar fat pad (a triangular fat pad adjacent to the
base the nose). Its thinning and shifting is a major factor in the development of
nasolabial folds (deep laugh lines).
The causes of redistribution of facial fat are not entirely clear but may include
age-related shifts in hormonal balance, repeated facial movements, certain
http://www.smartskincare.com/smartchoices/aging-face_not-just-wrinkles.html[24/01/2012 22:34:10]
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Aging face: Fixing wrinkles is not enough
disease conditions and so forth.
Again, topical treatments are not going to help. One minimally invasive approach
is to "return" the fat by taking it from elsewhere in the body and injecting in the
face. This approached is somewhat complicated and has a mixed record of longterm success because only a modest (and varying) percentage of the injected fat
becomes permanent. Yes it has been around for a long time, is well tested and
has a good safety profile. (See also our article on fat injections.)
Another approach is dermal fillers (and occasionally implants). Instead of trying
to restore the lost tissue, dermal fillers fill up the space left by the fat loss, thus
camouflaging the problem. This method is "farther from nature" than fat
injections but easier to apply and may provide greater flexibility, reliability and, in
some cases, be less costly. The risks and benefits of dermal fillers vary
depending on the particular filler and the skill & experience of the provider.
Generally speaking, all fillers carry some risk of rejection/tissue reaction, although
for many fillers such risk is quite low. (The reactions/rejection is not a problem
with fat injections because your own fat is injected.) For more information, see
our section on dermal fillers.
Finally, the more complex variants of the facelift surgery include repositioning of
facial fat pads to approximate a more youthful anatomy -- in particular, vertical
repositioning of malar fat pad. For best results, this requires a highly skilled
surgeon with extensive experience in this and other intricacies the facelift
procedure.
Muscle laxity and atrophy
As we age, the natural tendency of facial muscles (just as muscles elsewhere) is
to become more lax and atrophy. This contributes to facial sag, droopiness and
aged look.
Topical treatments are not going to help here either. Skin tightening procedures
might temporarily mask muscle sag but their results, if any, tends not to last if
the underlying problem is not addressed.
Can anything be done? The simplest, safest and arguably cheapest approach is
to try facial exercise. Body exercises tone and bulk up the muscles, making them
plumper and less saggy. In theory, the exercises targeting facial muscles should
be no different - hence they may reduce facial sag, add volume to the face and
tighten up the skin (by propping it up with the increased muscle bulk). Facial
exercise has been a popular topic in the media and lay skin care literature.
Unfortunately, the rigorous scientific proof of its effectiveness is scarce due to
relative lack of scientific studies. (This may be partly due to the lack of funding facial exercise is next to impossible to patent.) Still, before considering more
drastic measures, facial exercise may be worth a try even before there is more
scientific proof to support its effectiveness. After all, the downside of trying it is so
much less than that of the alternatives (like facelift).
Notably, facial exercise has an "automated" cousin, the facial electrical muscle
stimulation. This method employs a device (typically called facial muscle
stimulator or toner) that sends electrical impulses making your facial muscles
contract (as opposed to nerve signals that make muscles contract during real
exercise). This approach may produce more consistent results than facial
exercise but also lacks sufficient support by clinical studies. Facial electrical
muscle stimulation may cause side effects (usually minor), such as skin irritation
from electrodes.
The ultimate long-term (albeit still not permanent) solution for facial muscle laxity
is facelift surgery where the surgeon repositions the muscles to achieve a more
youthful anatomy. Not all variants of facelift surgery include muscle repositioning
but the more comprehensive ones often do. For best results, this requires a
highly skilled surgeon with extensive experience in this and other intricacies the
facelift procedure.
http://www.smartskincare.com/smartchoices/aging-face_not-just-wrinkles.html[24/01/2012 22:34:10]
Aging face: Fixing wrinkles is not enough
Bone structure changes
Many human bones, such as bones in the arms or legs, do not change much
once you have reached adulthood while other bones continue to grow and
readjust as we age. Unfortunately, facial bones appear to belong to that "untildeath-do-you-grow" category, their continuous changes contributing to the aged
look.
Several studies, conducted at such prestigious medical schools as Stanford and
Duke, have looked into this matter using sophisticated computerized tomography
of skull bones. The overall conclusion was that facial bones grow and readjust
throughout life. One important consequence is that forehead moves forward and
the cheekbones move backward. There are also indirect repercussions. Dr.
Richard Woodward, a Duke researcher who co-authored one of the studies,
explains: "The facial bones also appear to tilt forward as we get older, which
causes them to lose support for the overlying soft tissues. That results in more
sagging and drooping."
Furthermore, age-related facial bone changes may impact more that one's
appearance. For example, as the growing brow bones protrude, the drooping of
the tissue around the eye increases, which may lead to vision problems, dry
eyes or, conversely, excessive tearing.
The degree of age-related facial bone changes appears to vary considerably
from person to person. Overall, the effects appear to be greater in women than
in men. It is unclear whether menopausal hormonal changes (and the resultant
osteoporosis) are a contributing factor.
Can something be done about this sneaky problem? Unfortunately, as of the time
of this writing, the only available solutions come from the field of reconstructive
plastic surgery. Furthermore, most reconstructive plastic surgeons do not perform
facial bone reshaping just for the sake of cosmetic rejuvenation. As a result,
such procedures are not common and the best operating practices are not
standardized. Still, a few surgeons do offer variants of facial bone surgery for
purely cosmetic rejuvenation (e.g. forehead reshaping and brow bone reduction
procedures).
Nose shape changes
As if all the above problems weren't enough, there's more: the shape of your
nose may also be affected by aging. This subject has not been studied much but
it appears that the nose may undergo subtle age-related changes, such as
drooping and soft tissue growth, contributing to the aged look.
The rhinoplasty surgery (a.k.a. nose job) can reduce or eliminate the problem.
However, rhinoplasty is not commonly performed to address the age-related
nose changes alone.
Since some of the nose consists of soft tissue, a radiofrequency treatment, which
tightens and shrinks soft tissue, might in theory "tighten up" the nose and reduce
its droopiness. However, whether this approach can safely and effectively work in
practice is unknown.
Bottom line
Facial aging is not just about the skin surface. Therefore getting your skin to
look wrinkle-free is not always enough to avoid the aged look. For more dramatic
results you may need to analyze (preferably with the help of experts) what
factors contribute the most to your facial aging and look into possible remedies.
However, some of the remedies, even if available, may have significant
limitations and costs. This is one of those situations where the ends do not
always justify the means.
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http://www.smartskincare.com/smartchoices/aging-face_not-just-wrinkles.html[24/01/2012 22:34:10]
Aging face: Fixing wrinkles is not enough
Skin needling
Radiofrequency and combinations
Dermal & soft-tissue fillers
Facial implants
Facelift surgery
The youthful cheek and the deep medial fat compartment
Common Questions on Forehead Reshaping and Contouring
Science News: Facial Aging Is More Than Skin Deep
Medscape: Facelift anatomy (Caution: graphic anatomic imagery)
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The dark side of liposuction
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Liposuction is a cosmetic surgery procedure that removes excess fat from
different areas on the body, including thighs, buttocks, abdomen, upper arms and
neck. It sculpts the body, making its contours more aesthetically appealing and
eliminating unsightly pockets of fat.
The results of liposuction are virtually immediate and often dramatic. For a few
thousand dollars, your excess thigh fat, or belly fat, or love handles can be gone
tomorrow. Perhaps you don’t have to skip ice cream or crispy fries after all. And
if they end up on your thighs again, you’d just need to find a few more thousand
smackers for another liposuction, right? Well, many people appear to think so -almost half a million liposuctions are performed in the US each year. But it
appears that there is no free lunch as far as liposuction is concerned -- or at
least no free lunch that won’t go to your thighs or belly.
You probably think I am talking about the possible risks and side effects of
surgery – after all liposuction is an invasive surgical procedure typically
performed under general anesthesia (see our article on liposuction). While these
are real concerns, serious side effects affect a relatively small percentage of
people undergoing liposuction; most people are believed to get good results
without any downside except for the expense.
But recent research indicates that liposuction also has a not-so-obvious
downside affecting most if not all of the subjects. The fat comes back within
about a year. The reason this effect was hard to spot sooner is that the
"returning" fat seems to be distributed differently. For instance, the fat sucked out
of a thigh would mainly "return" to the abdomen, upper arms, and shoulders.
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This "return-of-the-living-fat" phenomenon was a subject of the study conducted
by Dr. Teri Hernandez and colleagues at the University of Colorado and
published in the journal Obesity in July 2011. The study involved healthy nonobese women with prominent fat deposits in thighs. The study was randomized
(one of the indicators of good design), i.e. half of the women were randomly
assigned to have liposuction (in thigh area), while others served as untreated
controls. After the liposuction, as expected, the women who underwent
liposuction had reduction in both the percentage of overall body fat and the
amount of thigh fat. However, within a year, the percentage of body fat in the
liposuction group approached the pre-treatment levels. Notably, in the liposuction
group, thigh fat remained reduced after one year whereas fat in the abdominal
area (and possibly elsewhere) modestly increased.
Dr. Felmont Eaves III, the president of the American Society for Aesthetic Plastic
Surgery has called the results surprising (according to The New York Times). I
have to stress that a single clinical study, even if properly conducted, is usually
insufficient to firmly establish a medical fact. But assuming this phenomenon is
real, I would not consider it particularly surprising. In fact, it is in line with the key
principle of physiology called homeostasis.
Essentially, homeostasis is a proper balance of the organism's internal
environment. To be able to function normally, the body needs its physiological
parameters to be within a certain optimal range: the temperature should be
about 37oC (98.6F), blood pressure about 120/80, blood sugar 70-120 mg/dl,
and so forth. Homeostasis is a tendency of the system to maintain internal
stability, which involves keeping dozens of physiological parameters within an
optimal range. The body fat content is likely to be one of the key homeostatic
parameters and is carefully balanced with related parameters, such as food
http://www.smartskincare.com/smartchoices/liposuction-dark-side.html[24/01/2012 22:34:29]
The dark side of liposuction
intake and energy expenditure. If homeostasis is disrupted by liposuction, the
body will likely attempt to restore the balance in some way. The question is:
How?
The body’s endocrine system appears to monitor the size of fat stores by
sampling the bloodstream for hormones released by fat cells, most notably
leptin. On the other hand, it does not seem to track the specific contribution of
each body part to the level of leptin. If some of the thigh fat is gone, the
endocrine system would "know" that some fat is missing but not the exact
location of the lost fat. The likely upshot is that the body would attempt to restore
its fat content by simply telling all the remaining fat depots to accumulate some
extra fat. Besides, it is possible that liposuction destroys the connective tissue
scaffolding required for growing new fat cells, which makes it harder for fat to
return to the treated area. All in all, it is actually plausible rather than surprising
that the sucked-out fat comes back but is distributed differently than before. Still,
even a plausible single result needs to be confirmed by other studies.
Assuming future studies verify Dr. Hernandez’s findings, what would this mean in
practice for people considering liposuction? At a minimum, it would mean that
liposuction should not be considered a tool for weight loss. Medical professionals
generally do not recommend using liposuction for the purposes of weight loss
anyway. And yet some people view liposuction as a backup weight loss plan. Dr.
Hernandez’s study points to the folly of such attitude.
What about the esthetic value of liposuction in the light of the return of the fat?
Notably, after Dr. Hernandez’s study had ended, the women who had liposuction
were still happy with the results. They valued the improvement in the shape of
their thighs. Furthermore, half of the women in the control group chose to have
liposuction later on, fully aware of the study results. It appears that many women
value liposuction as a body contouring procedure (rather than a weight loss tool)
and may be willing to live with mild fat gain throughout the body for the sake of
losing fat in a particular problem area. Thus, even if the results of Dr.
Hernandez’s study are fully validated by others, liposuction will likely retain its
utility as a body contouring procedure -- albeit with a downside of mild
compensatory fat gain in untreated areas.
So, if you still wish to consider liposuction, do it for the right reasons. Keep in
mind that it cannot replace a trip to a gym or offset unhealthy eating habits.
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Skin Care Myths and Misconceptions: Natural vs synthetic
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Many people feel compelled to use skin care with natural ingredients only. This
is understandable: humankind has synthesized enough harmful chemicals to
scare virtually anyone. Still, the all-or-nothing approach may not be the most
productive.
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Synthetic chemicals identical to the natural ones work exactly the same and can
be used in exactly the same way. In fact, take away the labels, and you won't be
able to distinguish between the two -- even if using cutting edge analytical
equipment. Synthetic chemicals not found in nature are structurally different and
may indeed work differently. However, there is no direct relationship between the
benefits and dangers of a paticular chemical and its origin as a natural or
manmade substance. Many natural chemicals can be harmful, especially if
misused. Many synthetic chemicals not found in nature are life-saving drugs.
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First, according to modern science, biological effects of a particular chemical are
the same whether it is isolated from natural sources or synthesized in the lab.
Second, we should distinguish between the chemicals that are synthetic but
structurally identical to the natural ones, and synthetic chemical not found in
nature.
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Skin Care Myths and Misconceptions: Are proven ingredients guaranteed to work?
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Many people think that as long as they use only the treatments backed by
plentiful scientific evidence the results are virtually guaranteed. Such optimism,
however invigorating, is unfounded. Due to variations in individual skin
chemistry, only a percentage of people respond to even proven treatments. Also,
a proven ingredient has a chance to be effective only if it is delivered deep
enough into the skin in sufficient amounts. This, in turn, depends on whether the
product is properly formulated (in terms of concentration, stability, skin
penetration, etc.) and whether you apply it correctly. (See our article on how to
apply skin care products.)
Bottom line
It is only the first step to find out which active ingredients are backed by solid
science. You should also select a proper formulation and apply it correctly.
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Skin Care Myths and Misconceptions: Collagen creams
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Collagen creams have been around for decades. At the first glance, they seem
useful. After all, the skin is made of collagen; so if you put on a cream with
collagen, the skin should absorb it and thereby improve. This does not work. Let
me give you an analogy. Imagine you live in a brick house and your neighbor is
throwing bricks at it. Will your walls become stronger or smoother? Of course
not: those bricks will simply lay scattered on the ground.
Same happens when you apply a collagen cream. Collagen is a large molecule,
it does not penetrate the skin but stays idly on top of it, only to be washed off
during your next shower. Traditional collagen creams are not entirely useless
because collagen can hold moisture and makes a decent moisturizer. But do not
expect these creams to strengthen your skin.
Admittedly, there are a few emerging techniques to create a better collagen
cream. Some companies use partially hydrolyzed collagen, i.e. collagen chopped
up into fragments small enough to penetrate the skin. But even if such
downsized collagen penetrates the skin, the fragments are too small to properly
integrate into the skin's own collagen framework. They are likely to be quickly
washed out of the skin via lymphatic flow. Finally, a few companies claim to
possess unique transdermal technologies to deliver full-size collagen deep into
the skin via topical application. This is an intriguing claim not yet supported by
sufficient evidence. Even if true, it is unclear whether even successful
transdermal delivery of full-size collagen will cause it to integrate into the skin
matrix and improve the skin's strength and regularity. This research is worth
following though. (See also our article on collagen treatments).
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Skin Care Myths and Misconceptions: Cucumber for under eye puffiness
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It is a popular practice to place freshly cut cucumber slices over one's eyes in
order to reduce puffiness and "that tired look". Some think that cucumber flesh
can reduce swelling and revitalize skin. Alas, it cannot.
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Cucumber is over 90 percent water and the rest is mostly inert fiber with no skin
benefits. However, cucumber slices do sometimes reduce puffiness a bit. That's
because they are cold! You store your cucumbers in the refrigerator, don't you?
It is the cold (not the cucumber) that shrinks the swelling by constricting blood
vessels and thus reducing inflow of fluid into soft tissues. You can get the same
results with a washcloth dipped in cold water.
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Skin Care Myths and Misconceptions: Retinol vs Retin A
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Many anti-wrinkle and skin rejuvenation products contain retinol, which is a form
of vitamin A. Many people confuse retinol with Retin A, which is a brand of
tretinoin also referred to as trans-retinoic acid or simply retinoic acid. Retinol and
retinoic acid are related but distinctly different. Retinol and other forms of vitamin
A, such as retinal and retinyl palmitate, do not have much direct effect on the
skin. They first need to be converted by special enzymes into the active
metabolite, retinoic acid. Only retinoic acid directly affects skin cells and helps
reduce some signs of aging.
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In theory, one should be able to apply retinol to the skin, wait till it gets
converted to retinoic acid, and eventually get the known skin benefits of the
latter. In reality, the conversion rate is low and varies greatly among individuals.
Besides, when exposed to air either during storage or use, much retinol may get
oxidized or degraded even before it can become availalbe for conversion to
retinoic acid in the skin. As a result, significantly less people respond to retinol
creams than to retinoic acid (tretinoin, Retin A), and the degree of response
tends to be less too.
It is true that retinol products tend to have fewer side-effects than retinoic acid
(tretinoin, Retin A). The reason is the same: lower biological activity of retinol
due do slow conversion and, possibly, degradation. Notably, some companies
have developed stabilized high-concentration retinol formulas that seem to be
more effective than run-of-the-mill retinol products. However, high concentrations
of retinol can be almost as irritating to the skin as retinoic acid. (See our article
on active retinol for more about such products.)
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Retinoic acid a.k.a. tretinoin (sold as Retin A, Renova and other brands) appears
to provide a better shot at eliminating fine lines and reducing wrinkles than even
the best retinol formulations. (Not to mention many virtually ineffective retinol
products.) Tretinoin users who experience skin irritation and/or chronic peeling
could try to eliminate the side effects by reducing the concentration and/or
frequency of application. If that fails, a well-selected retinol product may be worth
a try. Caution: neither tretinoin nor retinol should be used in the event of
continuing chronic side-effects.
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Skin Care Myths and Misconceptions
Intelligent anti-aging skin care based on independent research
Lose wrinkles, keep your bank account!
Skin Care 101
You are here: Making Smart Skin Care Choices > Myths and Misconceptions
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Wrinkle Fillers
Like many health and fitness related fields, skin care sits somewhere between hard science,
precarious word-of-mouth knowledge and wild hype. It is important to know what has been proven
to work by science. But it is just as important to know what does not work, or works differently than
you think, or can even be harmful. This section exposes some of the common skin care myths and
misconceptions. This knowledge can help you save time, money and effort, which should rather be
channeled into trying proven treatments in a correct way.
Natural vs synthetic
Collagen creams
Noninvasive
Cucumber for under eye puffiness
Invasive
Are proven ingredients guaranteed to work?
Skin Care Smarts
Smart Choices
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Sleep and skin repair
Topical vitamins
Retinol vs Retin A
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