Last week I sent out an email discussing what cellulite is and how to treat it as discussed in an article by Len Kravtiz, PhD.  Today I will answer some of the questions that you submitted.

There are two types of cellulite.  The first affects almost all women and is from compression.  The second and the one people normally refer to when they want it treated has the appearance of a “mattress” or “orange peel”.

Thin women can also get cellulite since it is due to the structures just beneath the skin and not necessarily the overall amount of adipose tissue.

Cellulite gets worse the older you get because there is more laxity of the skin and underlying connective tissue.  Also, increased body fat from a number of reasons will contribute.

Some people are affected more than others because of the variation in skin anatomy.  Genetics has a lot to do with this.

 (Did You Know?   Liposuction is designed to improve contours and bulges putting the area in better harmony with its surroundings.  It does NOT help cellulite.) 

Again, the only effective way to improve cellulite is through diet and exercise.  Muscle strengthening through squats, lunges, and other specific leg exercises help.  Dieting obviously helps to reduce body fat and so does calorie burning exercise.

 An extensive article by Len Kravitz, Ph.D. reviews the essentials of cellulite and answers many questions.  First described in French medical literature over 150 years ago, it was thought to be a disease.  It is now known to be a unique and distinctive layer of subcutaneous fat common to females.   

Anatomy explains how cellulite occurs, why it is more common in females, and why some women are more predisposed.  Just beneath the skin is the uppermost layer of subcutaneous fat which has “standing fat-cell chambers” separated by connective tissue.  The connective tissue gives support and elasticity.  Small projections of fat cells protrude into the dermis from these fat chambers giving the unevenness we call cellulite.  With aging the skin thins and loses its elasticity causing more cellulite.

(Did You Know?   Email me this week at drmckenna@mckennamd.com with questions or to get more details about cellulite.  I will answer your questions anonymously in next week’s email.) 

What can be done to improve cellulite?  Two things that don’t help are creams and Endermologie.  Creams do not penetrate the skin in any appreciable amount to affect the condition.  Endermologie, a method of kneading the skin, does not show any legitimate efficacy.

Female athletes, however, do have less cellulite.  Extrapolating this, diet and exercise seem to be the logical route for improving the dimpling.  Both will reduce the body fat.  Resistance or strength training exercise builds muscles which reduces the “bumpy” effect of cellulite.  Squats and lunges for the thighs and buttocks are exercises for the most commonly affected areas.

Starting June 1^st and throughout the summer, skin care treatments with micropeels (lunchtime peels) are discounted.  Usually $85, individual peels will be $65 and if you bring in a friend both micropeels will be just $85! 

(Did You Know?  Care Credit financing agency has no interest loans for 6 months and longer loan terms.  These are not only good for surgery but can be used for skin care, Botox and fillers.) 

Latisse, the product that lengthens, darkens, and thickens eyelashes, is now on sale for only $90/box.  Try it and see an enhancement in your lashes within 6-8 weeks.  Buy one kit and save $50 off your next Botox or Juvederm treatment.  Go to mckennamd.com for details.

A recent article in Fitness Magazine brought my attention to twenty foods that are worth eating more regularly.  The benefits range from antioxidants to anticancer. 

Blueberries have tremendous amounts of antioxidants and while strawberries do too, they also have vitamin C.

Red wine not only has antioxidants but also resveratrol which may help against cancer and heart disease.  Beer has antioxidants too.  Liquor, wine or beer when taken as one drink a day has shown to lower blood pressure.

Almonds and peanuts have healthy oils that decreases total and LDL cholesterol which, in turn, reduces heart-disease risk.

Tomatoes also have the antioxidants common to this letter’s foods but also has lycopene which may help against cancer and heart disease.  Mushrooms have antioxidants and vitamin D.

Flaxseeds are packed with omega-3 fats and fiber.  Sunflower seeds have fiber, vitamin E, and thiamine.

Both broccoli and cauliflower are full of vitamin C.

Salmon is the source for omega-3 fats with trout providing similar benefits.  Halibut also has the fats but limit it to a weekly serving of 3 ounces since it is high in mercury.

Safflower oil and olive oils are high in monounsaturated fats-the good kind.

Edamame (a favorite of my kids) has both fiber and protein (my favorite combination).  Black beans have both which help in heart disease.  Black beans also have antioxidants.

Brown rice has more nutrients, minerals, and fiber than its white counterpart.  Barley also is a complex carb but with 8 times the amount of fiber as brown rice.  It is filling too.

A diet rich in these foods helps your body in many ways, some that we don’t understand completely.  Alcohol should always be taken in moderation.  Certainly there are other examples of “superfoods” which can help not only your health but also your appearance.

Both types of rays from the sun, UVA and UVB can do damage to collagen fibers leading to premature aging of the skin AND can damage DNA contributing to skin cancer.  UVA rays penetrate deeper into the skin and have the ability to pass through glass and clouds.  SPF is an acronym for Sun Protection Factor which only rates the amount of UVB rays that reach the skin.  Therefore it is important to use a “Broadspectrum” product for both UVB and UVA protection.

It is recommended that the SPF be a minimum of 15.  This allows 1/15^th of the sun’s UVB radiation to reach the skin.  SPF 30 allows 1/30^th of the rays and a 96% UVB protection.  It is also recommended to apply sun protection 30 minutes before sun exposure to allow the chemicals to absorb into the skin.  Reapplying the product every 2 hours is necessary because the formulas break down in the presence of sunlight within that time.

All of the sun protection products at our office have both UVA and UVB formulations.  Call to make an appointment to see one of our skin care nurses who will clarify which product would be best for you.  Also, ask us how to enhance your protection with products that can be paired with sunscreens and sunblocks.  The skin care nurses are available Monday through Friday with some evening and Saturday hours. 

Do you know how many units of Botox other doctors inject?  Current recommendations of Botox are 15 units per site (forehead, between eyebrows, and crow’s feet) for most patients.  The usual price is $15/unit thus $225/site.  On April 20th we will reduce this to $13/unit.  This means most sites will be improved for only $195!  Those with special requests, deeper wrinkles, or need a touch up will be charged the extra $13/unit on this day.  That way you only pay for what you need. 

(Did You Know?   Purchase Latisse and receive a $50 rebate after a treatment with Botox OR Juvederm XC; a $100 rebate after receiving Botox AND Juvederm XC.) 

Filler prices have dropped too.  Restylane and Juvederm will now be $500, Juvederm Ultra Plus will be $550 and Radiesse will be $600.  On Filler Days we will continue the 10% discount.  HOWEVER, any new patient or a current patient wishing to try fillers for the first time will also receive the 10% discount on any office day.

To celebrate the one year anniversary of Latisse and over 1 million bottles sold, a rebate for Botox and Juvederm XC filler is being offered.  Simply purchase one kit of Latisse and receive a rebate certificate for $50 off a treatment of Botox OR a syringe of Juvederm XC filler.  The certificate is also good for a $100 off a dual treatment of Botox AND Juvederm XC.

Botox relaxes muscles that cause some facial wrinkles most commonly between the eyebrows, forehead and crow’s feet areas.  Juvederm XC is a skin filler that is designed to raise and smooth wrinkles.  It is commonly used to reduce lines around the mouth and other facial areas.  Juvederm XC has numbing medicine in it drastically reducing injection discomfort.

The Latisse purchase and Botox/Juvederm XC treatments must be completed by 7/15/10.  See www.latisse1year.com for details.

Two recent articles describe ways to optimize your heart health.

 The American Heart Association has identified seven keys to an ideal heart and includes:

            -Never smoked or quit more than one year ago.

            -Body Mass Index (BMI) less than 25.

            -Moderate exercise of at least 150 minutes per week or 75 minutes if vigorous.

            -Four to five of the components of a “healthy diet”.

            -Total cholesterol less than 200.

            -Blood pressure below 120/80.

            -Fasting blood sugar less than 100.

With chocolate Easter eggs still present in many homes, it’s only appropriate to mention that chocolate could reduce heart risks.  German researchers found that those who ate about one square of chocolate per day had a 39% lower risk of heart attack or stroke.  Experts think that the flavonols in the chocolate (also present in vegetables and red wine) dilate the blood vessels and reduce blood pressure.  Of course, too much of anything isn’t good for you either!

It’s not too late to get a summer tune-up to reduce unwanted hair or unsightly leg veins.  Our FDA approved laser reduces the number of hairs in areas such as underarms, bikini, leg and facial.  For men it helps on the back.  It requires a number of treatments to be most effective but can be helpful even before this summer.

Spider veins may be noticeable by wearing shorts in warmer weather.  Fortunately one or two treatments can drastically reduce the most visible veins.  Recuperation is modest and most can resume normal activities the next day.

(Did You Know?  For those with a smartphone (blackberry, iphone, and other web accessible phones), mckennamd.com is easily accessible and reduced from its computer-based web site.  There are also savings on skin care products by using your smartphone.) 

Recently, Allergan (the makers of Botox, Latisse, and Juvederm) has come out with Juvederm with lidocaine.  This filler and numbing medicine significantly decreases the discomfort of the injection.  There is no need for numbing creams or other numbing injections.

Lastly, to get you ready for summer, our current skin care product special is sunscreens.  They are reduced 15%.

Call us if you have questions about these or wish to set up a complimentary consultation.

Recently a friend shared with me his experience with prostate cancer.  You have to understand that he is in his mid-fifties and is quite an athlete, not the stereotypical older man.  This didn’t stop his PSA levels from creeping up this past year.  Once diagnosed there are three treatment options: Surgery to remove the prostate, external beam radiation, or implanting radioactive pellets in the prostate.

(Did You Know?  Here are six steps to reduce the risk of prostate cancer published recently in Men’s Health magazine.

       1.      Drink more coffee.  It is unknown why and it doesn’t matter if it has caffeine in it.  2.     Give your prostate gland a workout.  A 2004 study in the Journal of the American Medical Association of over 29,000 men found that those who had 21 or more orgasms a month were 30% less likely to develop prostate cancer than those who had 4-7 per month. 3.         Eat more tomato products since they contain lycopenes which reduce the risk of prostate cancer.  4.         Exercise reduces the fatal forms of prostate cancer by 41 percent.  5.         Eat more fish since omega-3 fatty acids reduce the risk of aggressive prostate cancer by 25 percent.  6.         Reduce trans-fatty acid intake which may double the chances of developing prostate cancer.)

My friend chose the surgical treatment of robotic radical prostatectomy.  Despite the unglamorous explanation of his post-operative course, he is doing well and resumes his exercising next week.  Even with a diagnosis of “cure” and as all cancer survivors can attest to, he’ll have follow-up appointments the rest of his life.  Prevention and early detection are the keys to beating not only prostate cancer but also many others.