Penny Carow is 21 and pretty. She has short, cropped hair and deep blue eyes. Though she is attractive, she is conscious about her skin. A couple of months ago she had a smattering of acne on her face and ever since, the scars have marred her skin. Penny is wondering if there is any treatment that can help her get back her smooth skin. Well, there are six types of treatments that Penny or anyone who wants scar-free skin can avail off.

Dermabrasion: Dermabrasion, sometimes called surgical skin planing, is often used to treat a variety of skin conditions including acne scars. The process includes anesthetizing the treatment area then an abrasive instrument is used to remove the damaged outer layers of skin. For the first few days following the procedure, the treated area may be discolored red and very sensitive. It is not unusual to feel a burning sensation in the treated area, and the discomfort can usually be treated with over the counter pain medication.

Chemical Peels: Chemical peels can enhance your complexion, appearance and self confidence by removing the damaged outer layers, leaving a smooth and improved skin texture. This process is best used on scars which are not very deep and can soften or even remove acne scarring. Side effects of chemical peels may include redness, stinging or other irritation and infrequently infection or additional scarring.

Collagen Injections: Used primarily as wrinkle filler, collagen injections can also be used to reduce the visibility of acne scars. With a fine needle, the dermatologist will inject the collagen just underneath skin. The injected material pushes the depression created by the acne scar outward creating a smoother look.

Autologous Fat Transfer: This is similar to collagen injections. The only difference in autologous fat transfer is that the material is harvested from the patient’s skin and processed into a liquid.

Punch Grafts: The procedure essentially transplants skin grafts from behind the ear and places the grafts over areas of excised acne scarred areas.

Laser Resurfacing: As the name suggests, this procedure is performed by passing a laser over the affected area, where it removes the damaged skin one layer at a time. This procedure encourages the creation of additional natural collagen, which results in the reduction of the acne scars. Side effects from this procedure may include scarring, infection and the reduction or increase in skin pigment.

Are you planning to have laparoscopic weight loss surgery? Do you want to go ahead with this surgery because you are obese or for vanity purposes? Whether you are morbidly obese or slightly overweight, you need to know the risks of weight loss surgery.

Laparoscopic surgery is a minimal invasive surgical procedure where five small incisions are made in the abdominal area. The surgeon then inserts the laparoscope into these incisions to perform the weight-loss surgery inside the abdominal area.

Part of the procedure is inflating the abdominal area with gases so that the surgeon can easily perform the procedure. It is often found that some of the gases used to inflate the abdominal area remain behind after the operation. This can cause severe discomfort for long periods of time. For example, these gas bubbles can cause severe pain when breathing.

Scarring will also take place after the surgery. Even though the five incisions on the abdomen are small, they will remain as light colored scars for the rest of your life.

In case of severe obesity, the benefits of weight loss surgery will definitely outweigh the risks. But if you’re slightly overweight and want to have this surgery, then you need to think seriously about the surgery. Reputable surgeons will probably deny performing this surgery on you. However, even if you can find one who would be willing to perform the procedure on you without you being severely obese, you should be extremely cautious.

If you don’t really need the weight loss surgery to look slimmer, then you should try reducing your weight through exercise and a healthy diet.

Penelope DiMaggio just had weight loss surgery. Her friends thought that weight loss surgery was like an instant pill – a weight loss surgery would make Penelope slim and trim. But that was not the case. Patients who undergo weight loss surgery (WLS) sign-up for a lifetime of rigid behaviors to guarantee their long-term success. Penelope had a rigorous routine ahead of her. These are the rules that she would have to live by, if she wanted to reap the results of weight loss surgery.

Protein: Gastric Bypass patients have to eat protein for three daily meals. Animal products are the most nutrient rich source of protein and include fish, poultry and meat. Dairy protein, including eggs, is another excellent source of protein. Nuts and legumes are also good sources of protein, but sometimes difficult for the bariatric patient to consume.

The body contains over fifty-thousand different active proteins all made out of the same building blocks: amino acids. Amino acids are made of carbon, hydrogen, oxygen and nitrogen as well as sulfur, phosphorus and iron. Many diseases – including obesity – indicate an amino acid deficiency.

The distinction must be made between high fat proteins and lean proteins. A gastric bypass patient cannot tolerate high fat proteins such as bacon, fatty beef or sausage products or greasy fried chicken: these foods cause nausea and vomiting.

Drink lots of water: Gastric-bypass patients must drink a lot of water. Water is one of the most important nutrients the body needs to stay healthy, vibrant and energetic. Water regulates body temperature, removes wastes, carries nutrients and oxygen to the cells, cushions the joints, prevents constipation, flushes toxins from the kidneys and liver and dissolves vitamins, minerals and other nutrients for the body’s use.

No snacking: Gastric bypass patients are instructed to avoid snacking. If patients snack they cease to lose weight and could possibly regain weight. In addition gastric bypass snackers risk severe swings in blood sugar levels and glucose overdose, they fail to move forward to the healthy life that surgery makes possible.

Exercise: Patients must exercise regularly. Exercise means moving the body: walking, stretching, bending, inhaling and exhaling.

 

Jane Fonda and Sally Field have made a pact with each other that they will not have any more plastic surgery in their lives and age naturally now. 69-year-old Jane Fonda, who previously had a breast augmentation and facelift, wants to age gracefully without surgical intervention.

“I realized that I’m going to be 70 in a year, and I have chosen not to have any more plastic surgery,” says Jane. “It’s really hard, especially if you’re a public person. But I want to give a face to aging,” adds Jane Fonda, mentioning that she has made a pact with Sally field about not having further cosmetic surgery.

Lately, 60-year-old Sally Field and Jane Fonda have spent a lot of time together trying to understand this sudden feeling of ‘becoming whole’ that comes unexpectedly with age. Jane Fonda has also started a radio network to help empower women with a positive voice. Fonda wants to instill a message of self acceptance in women and her message is “Good is good enough. We’re not supposed to be perfect. We are supposed to be complete.”

More and more teenagers are opting to have cosmetic surgery. Cosmetic surgery for young people, 18 years and younger, increased by almost 10 percent between 2000 and 2005, according to the American Society of Plastic Surgeons.  Rhinoplasty represented 61 percent of the cosmetic procedures. Here are some snapshots of teenagers who have had cosmetic surgery.

Betty Pierce is a cute looking 16-year-old. She had rhinoplasty or nose surgery a year ago to get a smaller nose. “I never liked my big nose and wanted a better looking nose,” says Betty, adding that her face was swollen and bruised after the surgery but within a few weeks she could see the improvement. “I got a lot of praise from people when I got back to school,” she says. Though Betty feels that she did the right thing by having rhinoplasty, she feels that if she had enough self-confidence she wouldn’t have been so bothered about her appearance and could have done without cosmetic surgery.

Eighteen-year-old Anne Goldberg decided to have breast reduction surgery because her double D size made her the butt of jokes at school. It was also difficult for Anne to run, walk and play like other teens of her age because of large breasts. “All my friends were sporting cute little tops and I couldn’t be part of the fashion because tiny T-shirts never fit me. I couldn’t even get into a bathing suit,” explains Anne. Apart from the scarring, Anne is happy after the breast reduction surgery and doesn’t feel left out anymore.  

Angel Whitman, now 18, had a nose job when she was 15. She is thrilled to bits about how her nose looks after rhinoplasty. “Plastic surgery may not be the answer to all your problems, but it can solve a small portion of it,” says Angel, adding that if you don’t like what you see on the outside, you’re not going to feel good on the inside.

 

Cosmetic surgery has caught the fancy of college students and an increasing number of college students are opting to have cosmetic surgery. Cosmetic and reconstructive surgeries are the two different forms of plastic surgery. Reconstructive surgery involves correcting physical disfigurements while cosmetic surgery makes people look better. There are some patients who want to look like celebrities through cosmetic surgery, while there are some who want to stand out.

Most college students want to bring about a change in their lives through cosmetic surgery. Young people want to have cosmetic surgery to boost their self-confidence, to be more competitive in the professional world and to find a partner. A physical change can lead to improvements in social and business life. Plastic surgeons say that many times patients attribute their success in life to the surgery. Many patients get added confidence and a boost in self-esteem after having cosmetic surgery.

Ear surgery, nose jobs and breast augmentations are the most popular cosmetic surgeries with college students. Since college is the time when people start looking for jobs and planning their lives, image becomes a big part of success. This puts a lot of pressure on college students to look good.

Most people don’t like wrinkles and lines on their face. That’s when collagen fillers come to the rescue.

Before we tell you about collagen fillers, it’s important to know about the structure of the skin. Your skin consists of two layers, the epidermis and the dermis.  The dermis contains blood vessels, nerves and hair follicles and is made up of a protein called collagen. This protein forms a network of fibers that provides a framework for the growth of cells and blood vessels. Collagen acts like a support structure for the skin.

The body produces collagen naturally – the fibroblast in the body stimulates the production of collagen. But with age, the structure of collagen degenerates. This is where collagen injections come in. Collagen filler injections replenish the skin’s natural collagen. Collagen fillers can be used safely on the face where there are folds, wrinkles and acne pits.

It is important that the collagen filler is injected by a trained health care professional. By supplementing your skin’s own collagen, collagen replacement therapy helps smooth facial lines and scars.

The surgeon carries out the treatment by injecting a needle filled with saline-collagen, along the edge of your wrinkle or line. The collagen filler solution is then pumped into the adjacent tissue, over-filling the area to reduce lines and to accommodate for future absorption of some of the collagen.

The risks of collagen fillers are minimal. It includes bruising or asymmetry. Collagen injections and injectable fillers are for those who want a plumper and smoother skin.

Meet Dr. Josh Bernstein - a leading cosmetic dentist based in the San Francisco Bay Area. The Richards Report, one of dentistry's most popular journals, recently honored Dr. Bernstein with the award of 'Dental Practice of the Year.'
 
Dr. Bernstein was also selected by The Consumers Research Council of America as one of 'America's Top Dentists.' 
 
BritishSurgery: Thank you, Dr. Bernstein for taking time to speak to SurgeryWatch. You are a leading cosmetic dentist and perform a number of cosmetic dental procedures, ranging from smile makeovers to instant orthodontics; full mouth restoration to non-surgical facelifts. How did you decide to become a dentist and pursue cosmetic dentistry?
 
Dr. Bernstein:  My mom made delicious desserts when I was a kid and since I grew up in the generation just before fluoridated water, I got a lot of cavities.  I was fortunate to have a wonderful dentist named Allan Hyman who never, ever hurt me.  In fact, I never even knew he was giving me Novocain.  Somehow I just got numb.  He also did some very cool things to make me comfortable, like let me use headphones to listen to fairy tales.  When I was older, I decided that I wanted to be the kind of dentist Allan Hyman was.
 
BS: Where did you receive your dentistry training?
 
Dr. Bernstein:  After I graduated from Cal Berkeley, I went to UOP Dental School in San Francisco.  However, a dental license to me is just a ticket to begin learning the profession.  I am a big believer in Continuing Education.  Now that I don't have to do homework or take tests, that is!  The bulk of my postdoctoral education is from LVI, the Las Vegas Institute for Advanced Dental Studies.  After completing the LVI curriculum, I was asked to join the faculty.
 
BS: There has been a lot of advancement in the field of cosmetic dentistry. What are the latest advances in this field and how has cosmetic dentistry evolved over the last few years?
 
Dr. Bernstein:  Adhesive technology and porcelain materials have been huge advances, allowing us to replace tooth enamel with lifelike substitutes.  However, recent acceptance of dentists as bite experts has enabled those of us who are trained in this area to accomplish some wonderful things for patients.  By improving the bite, we have learned to relieve chronic headaches, jaw tension, head posture, even dizziness and other ailments not normally considered 'dental.'
 
BS: Cosmetic dentistry is about improving your health and comfort along with your appearance. Please tell us more about cosmetic dentistry, what it involves and the different procedures?
 
Dr. Bernstein:  Many of the procedures that we do in our office are smile makeovers with porcelain veneers.  However, we also do 'regular' dentistry-we just want the 'regular' dentistry to look like real teeth.  When we have a patient with bite problems, we establish the most comfortable jaw posture first-then we use a number of different treatments to keep the patient comfortable-bite adjustments, orthotics, orthodontics, and resurfacing worn tooth structure with porcelain.
 
BS: Is there any particular procedure that you enjoy doing most? Which procedure is the most challenging? 
 
Dr. Bernstein:  I love doing smile makeovers with porcelain veneers.  TMJ problems and dental phobias are definitely challenging, but when we can solve these issues, it is enormously rewarding.
 
BS: What is TMJ? And how is TMJ caused?
 
Dr. Bernstein:  TMJ (or TMD) is a syndrome caused by a bad bite in most cases.  Stress is a factor, but a bad bite is the overriding cause.  Symptoms include headaches, jaw tension, an unstable bite, dizziness, ear congestion, neck tension and many other symptoms not typically considered 'dental.'
 
BS: How do you treat patients suffering from TMJ?
 
Dr. Bernstein:  First we find the correct jaw posture using some technology that we have.  We use TENS therapy to help relax the muscles.  We also measure the electrical output of the muscles to find the most relaxed posture of the jaw.  Once we find the ideal jaw posture we have several different methods to relieve symptoms.  Sometimes a simple bite adjustment is all it takes.  In other cases, we make an orthotic to allow the patient to relax in their most comfortable jaw posture.  
 
BS: In your website, you've mentioned that Instant Orthodontics eliminates braces all together. Please tell us more about this procedure.
 
Dr. Bernstein:  Sometimes traditional orthodontics with braces or with Invisalign is the best option.  But straight teeth aren't always pretty, especially if they are discolored, chipped, or worn.  Using porcelain veneers, we can eliminate the braces altogether and make the teeth straight, white, and ideal.
 
BS: What are Non-surgical Facelifts and Neuromuscular Dentistry?
 
Dr. Bernstein: When a person\'s bite is worn down, the jaw becomes overclosed, giving an aged appearance to the face, and an overclosed jaw often makes the patient uncomfortable.  By finding the ideal jaw posture, we can rejuvenate the appearance and get the patient comfortable again.  Neuromuscular dentistry is the science that allows us to find the most ideal physiologic jaw posture.  We use some very sophisticated technology to assist us with this.  It is the dental equivalent of an EKG.  Once we find the correct jaw posture, we can use today\'s conservative porcelain bonding techniques to restore patients permanently to their ideal jaw posture-this is a non-surgical face lift. 
 
BS: You're always in search of new ways to make dentistry more comfortable than ever. What kind of facilities, pampering and care do you offer your patients to make it a unique experience for them?
 
Dr. Bernstein:  We pay attention to the basics of customer service like running on time and being friendly and helpful.  We also keep a clean, uncluttered, up to date office.  Patients are constantly commenting on how gorgeous our bathroom is!  Beyond the basics, we exercise compassion, whether it's during the numbing process or during cleanings.
 
BS: Would you like to share a few such special moments with us where the patient has been made to feel very special? 
 
Dr. Bernstein:  We have done quite a bit of work with battered women.  It is extraordinarily rewarding to give back a smile to someone who has had it taken away from them with violence.  Aside from that, we are constantly searching for ways to make patients feel special.  For example, we have a patient from the U.K who had an appointment at 4 pm one day-tea time.  When he arrived, we had a copy of the London Times for him, along with a steaming hot cup of Prince of Wales tea.  It just so happens that he went to school with the Prince of Wales!
 
BS: What is sedation dentistry and how does it help patients? What are the risks of sedation dentistry?
 
Dr. Bernstein:  I am trained and licensed in Oral Conscious Sedation.  The patient takes a safe, commonly prescribed sleeping pill one hour before their appointment.  By the time they arrive, they are very relaxed and frequently fall in and out of sleep throughout the appointment.  This works incredibly well even for people who are normally terrified at the dentist.  If the patient is in good health, this is very safe.
 
BS: You use cutting edge technology, such as 'the wand', 'microultrasonic', and 'virtual reality movie glasses'. How do these help in making patients more comfortable?
 
Dr. Bernstein:  A slow injection is a comfortable injection, especially if the gums are pre-numbed with a powerful topical-which we have.  The Wand takes the human error out of giving a slow injection since it is computer controlled.  Microultrasonics have virtually replaced scraping instruments to clean teeth.  MUS is more comfortable and is better for the teeth and gums than the scraping instruments.  Patients absolutely love the movie glasses!  It is not uncommon to hear patients laugh during an injection because they are at a funny point in a video!
 
BS: Apart from dentistry, you write articles and have a blog on cosmetic dentistry, and are a faculty at LVI. How do you manage to pack in so much in a day?
 
Dr. Bernstein:  Very carefully!  I never manage to get everything done, but it is always waiting for me when I get back to the office!  I do love teaching at LVI and I learn so much when I go there because I get the opportunity to participate in treating so many patients, while consulting with the top dentists in the world.
 
BS: You have worked at rehabilitating the smiles of abused women and are part of the Women in Need (WIN) program. Please tell us more about the kind of work this involves; and, the response that you get.
 
Dr. Bernstein:  We have worked with women who live in shelters and other women who reach us through WIN and GBAS (Give Back a Smile).  There are some very generous porcelain labs out there that help us with this such as World Lab, Williams Dental Lab, and Microdental.  And of course, our work is entirely voluntary.  These poor women have been brutalized by violence.  It is our pleasure to give these women an all new smile.
 
BS: Please tell us about your family and how you like to spend time with them.  What do you like to do when you are not working in the practice?
 
Dr. Bernstein:  I like to get outdoors with my family.  My wife and I like to go for long walks.  I like to ski and go boating with my kids.  And I love to watch my kids participate in their sports, like swimming, water polo, lacrosse, and equestrian events.
 
BS:  Thank you very much for taking the time to speak to us!
 
Dr. Bernstein: Thank you for taking an interest!


To learn more about Dr. Bernstein, and his cosmetic dentistry and neuromuscular dentistry practice in the San Francisco area, please visit http://www.allnewsmiles.com or Dr. Bernstein’s sedation dentistry website at http://www.sanfranciscosedationdentist.com/.