TL;DR:
- Body shape often reflects internal metabolic, hormonal and genetic factors, not just lifestyle.
- Sagging arms: caused by muscle loss (declining growth hormone and testosterone), collagen loss (menopause, cortisol, yo-yo dieting) and crepey skin (elastin and collagen loss). Treated with exercise, bio-identical hormones, RF devices (Tripollar, Thermage, Velashape), PDO threads and PRP.
- Stretch marks: caused by weakened fibroblasts, increasingly seen in younger girls, possibly linked to environmental toxicity. LED therapy combined with RF can reduce them by up to 80% over 16 sessions.
- Abdominal fat: linked to insulin resistance, cardiometabolic syndrome and detox issues, not just diet and exercise. Needs a personalised approach alongside devices like Coolsculpting, Cavitation, Tripollar RF and Velashape.
Dr. Nedic writes about body revival – Spring 2015 issue, A2…
BODY BEAUTIFUL
Our body on the outside mirrors what is happening in our organism on the inside: metabolically, hormonally, nutritionally, hereditarily, and phenotypically. Subsequently, it is important not only to understand which parts we are responsible for, but which parts can be modified with aesthetic procedures and medical interventions.
Sagging Arms
Almost all women desire well-sculpted slim and toned arms, especially in South Africa (due to our long summer seasons). The three main components that cause sagging arms are:
1) Floppy muscles especially triceps muscle, as they’re usually responsible for batwings. These form as a result of a decreased level of Growth hormones present in one’s body, which can transpire as early as the mid-thirties. It then becomes worse with further aging, age-related sarcopenia (muscle loss), and a decline of Testosterone.
Treatment: Regular weight exercises during your thirties and forties are sufficient, however from one’s late forties a growth hormone, and topical testosterone are necessary to sustain muscle tone. Aesthetic body procedures like Tripollar RF with muscle contraction modality can help to locally sculpt and tone muscle.
2. Subcutaneous loss of collagen. Usually presents itself in a peri-menopausal period, which is the primary cause of estrogen loss in women of that age. It has recently been seen in younger generations due to the altered cortisol and environmental toxicity which are responsible for premature aging. It can also be seen in people who are constantly on a yo-yo diet and indulge in fast weight loss regimes. Treatment: Avoid rapid weight loss, junk food, and stress. For peri-menopausal and menopausal women, it is particularly necessary to support the above with bio-identical estrogen and oral supplementation with collagen and Vitamin C. Aesthetic procedures: Radio-Frequencies such as Thermage, Tripollar RF, and Velashape can help enhance collagen production. If the patient has excessive fat in this area, ultrasound cavitation for fat removal can also be added.
3. Crepey skin. This condition is always present during and after menopause, especially in the inner forearm area due to elastin and collagen loss. It is also caused by the thinning of the epidermis, which develops with hormonal depletion (mainly estrogen).
Treatment: It is virtually impossible to achieve long term results without internally supporting anti-aging modalities with bio-identical hormones and collagen supplementation. Aesthetic procedures: mesotherapy, PDO threads, PRP stem cells stimulation, Titan-infrared light, Thermage RF, and Tripollar.
Stretch marks
These either appear in areas where the skin is excessively tensed and the dermis is weakened constitutionally, or by hormonal and metabolic problems. Interrupting the production of collagen and elastin by damaged fibroblasts is the biggest problem – and although it is not harmful, it can affect one’s self-confidence. Some patients learn how to live with stretch marks (particularly the older generations) as there was nothing efficacious to treat this condition many years ago. Recently, though, we have a new generation of pubertal girls suffering from stretch marks in unusual places, such as the upper arms, knee area, side of thighs, and calves. It appears there is something in the environment (probably toxicity) that is responsible for the damage of the fibroblasts’ function. Prevention of stretch marks can be tough, but fortunately, there is an aesthetic procedure that can erase stretch marks by as much as 80%. New generation LED therapy (principally most LEDs from France) developed a specific light therapy setting (supported by a study) that can treat even 20-year-old stretch marks in all skin types. Combined with RF beforehand for immediate denaturation of the protein (collagen), this LED therapy is answerable for neo-collagenases. One needs 16 treatments in total, yet it’s important to note that it takes three months after the completion of the LED therapy for the improvement in collagen production to take place. Stretch marks appearing during pregnancy are combined with postpregnancy Velashape procedure.
Abdominal fat
Abdominal fat is usually perceived only as an aesthetic problem. It is associated with insulin resistance, which is usually complicated with cardiometabolic syndrome and diabetes type 2, fatty liver, polycystic ovarian syndrome, depression, and sleep apnea. In particular cases, it is also coupled with breast cancer, prostate, and colon cancer due to metabolically active visceral fat. The majority of patients also have love handles (who can love them?) with an underlying cause of insufficient detoxification. Through working with patients in my practice, it was interesting to find that this is a prominent condition in most women who eat chicken salad for lunch. This is because the meat is full of pesticides, herbicides, and “hormones” (xenoestrogens). Difficulties in getting rid of abdominal fat and its “stubbornness” are due to the complexity
of the cause: persistent organic pollutants, carbohydrates overwhelming the metabolic pathways, cortisol-insulin mismatch, stress, etc.
Treatment: Unfortunately there is little success with diet and exercise changes only, again as a result of the problem’s complexity. This is a condition that can only be solved with something called personalized medicine. That means in each person the underlying cause needs to be identified rather than a “one size fits all” approach, which is often advocated by gym instructors. In my practice, I witness this all the time, and I can help only once all the specific causes are identified. Getting patients to comply is a huge challenge, as they often don’t include the hidden sugars, alcohol, and toxins they consume – they tend to convince themselves that they are not there. Aesthetic procedures which can be used in addition to the personalized medical approach are Coolsculpting to freeze the fat, Cavitation to diminish a number of fat cells, Tripollar RF, Mesotherapy Lipolysis, Velashape, and Thermage to tone loose, fatty skin.