Archive for the ‘Woman Issues’ Category

Blepharoplasty For Dark Circles Under The Eyes Must Include Arcus Marginalis Release And Fat Grafting Or Tear Trough Implants

There is much confusion regarding what people mean when they say they have dark circles under the eyes, often referred to as the tired look. There are 4 different conditions which can cause dark skin under the eyelid which people call dark circles under the eyes:

1. Dark purple skin color on the lower eyelid skin
2. Brown pigment on the lower eyelid skin
3. A hollow eyed appearance in which the lower eyelid is sunken in.
4. A depression or deep line along the lower edge of the eyelid just above the cheek called the naso-jugal fold, the true dark circle under the eyelid and most common form of dark circle under the eyes

1. Dark Purple Color of the Lower Eyelid Skin

When the skin of the lower eyelid is a dark purple or bluish color people often say they have dark circles under the eyes. If you look closely EVERYONE has darker skin color on the lower eyelid than on the skin of the rest of the face. This is because the lower eyelid skin is the thinnest skin on the face, so thin that you can see through the skin and see the purple color of the eyelid muscle showing through the skin. In people with thicker skin the color looks more bluish, but everyone’s lower eyelid skin is darker because of the color of the muscle beneath the thin skin. There are familial and racial differences in skin thickness and muscle color so there is great variation in the darkness of lower eyelid skin. I do not call this normal phenomena dark circles under the eyelid, rather I call this normal phenomena dark purple lower eyelid. The only solution for this problem is to use a cover up make up like Covermark® or Dermablend®.

2. Brown Pigment on the Lower Eyelid Skin

Sun damage to the skin, birth control pills and other medications, and the “mask of Pregnancy” and other metabolic conditions can cause the deposition of brown pigment in the lower eyelid skin. This is not called dark circles under the eyes but is called hyperpigmentation. The treatment is the removal or correction of the underlying cause-stop the medication, sun protection etc. Once the cause is corrected there are several remedies. Skin bleaching agents such as hydroquinone and Kojic Acid can help as can microdermabrasion®. Laser resurfacing or Microlaserpeel®, deep exfoliation techniques can also be helpful. IPL also called Photo Facial can also help. Very goods results can be achieved with these modalities.

3. A Hollowed Eye Appeance

Some people have a very sunken in or hollowed eye appearance. This is caused by a deficiency of the normal fat which surrounds the eyeball and normally plumps the lower eyelid skin. This deficiency of fat can be caused by heredity, racial factors, malnutrition, general disease, dehydration or trauma to the orbital bone which supports the eyeball.

The correction involves the correction of the underlying disease or medical problem when there is a medical cause.

For people who have this appearance because of heredity or racial factors, the fat must be grafted into the lower eyelid to replace the deficiency. I do this by performing a blepharoplasty through an incision on the inside pink portion of the lower eyelid called the transconjunctival approach. This avoids a scar on the outside of the lower eyelid. I then harvest or take fat from an area of the body where the fat will not be missed (hip or abdomen) and transplant the fat to the lower eyelid to plump the lower eyelid.

4. The Naso-jugal Fold or Tear Trough Deformity-the True Dark Circle Under the Eye.

The true dark circle under the eye is a crease or depression starting at the nose and running towards the outside of the lower eyelid running at the bottom of the eyelid just above the cheek. This dark circle or depression looks dark because it is attached to the underlying bone of the rim of the orbit or eye socket, and the unattached skin of the lower eyelid above the depression is free to move and bulge and creates a shadow which gives the crease a dark color. The cheek skin below the dark circle is also free to move and bulge and bulges above the dark circle, which contributes to the shadow.

The dark circle or naso-jugal fold or tear trough deformity gets worse or deepens as we age because the eyelid above and cheek below begin to sag with aging but the dark circle is attached to bone and cannot sag with the rest of the skin, so the lower eyelid skin hangs over more from sagging and bulging of fat, the depression deepens, the shadow gets worse and the dark circle becomes more noticeable.

The dark circle or naso-jugal fold or tear trough is tethered or held tight to the bony rim of the eye socket bone by a ligament called the arcus marginalis.

To correct the dartk circle I perform a transconjunctival blepharoplasty. During the procedure I release the arcus marginalis ligament which frees up the dark circle or naso-jugal fold. Once the dark circle is released the dark circle skin is free to move with the lower eyelid skin and the cheek skin and the dark circle or shadow is lessened. To prevent re-attachment of the arcus marginalis and to plump up the dark circle I place a fat graft underneath the dark circle. Some surgeons place an implant called a tear trough implant under the dark circle but I usually use fat.

Correction of dark circles under the eyes, also called the naso-jugal fold or tear trough deformity requires proper diagnosis. This condition needs to be differentiated from dark purple eyelid color, hyperpigmentation and hollow eyes. The correction of true dark circles requires a blepharoplasty operation with arcus marginalis release and fat grafting or tear trough implants.

Black Hair Care: How To Take Care Of Cornrows

Cornrows and braids are one of those timeless styles that have crossed all gender and ethnic gaps. In fact, nothing is more beautiful than heedful of intricate braids and rows and no two styles are exactly alike. That is why more and more people are choosing to express themselves and their individual style through braiding and rowing.

But as with all styles, cornrows come with their own special challenges and problems. One of the most obvious problems associated with any tight braiding technique is breakage. While black hair has fewer tendencies to break than Caucasian hair, it can still take a great deal of abuse if the braids are not done and cared for properly. In addition to breakage, you can also experience dull, frizzy and dry hair as a result of wearing cornrows or braids.

To avoid all of these drawbacks and to keep your braids looking shiny and neat, follow the following care tips:

· Choose your artist wisely – As with any artistic field, braiders come in many levels of expertise. Be sure to choose one that has been in the business for a good while. Also, ask to see sample photos of the stylist’s work. This will give you a good idea about their level of expertise.

· Grow hair to proper length – In order to get a good braid, your stylist has to have enough hair to work with. A good rule of thumb to follow on length is 10cm for straight hair and a minimum of 5 cm for curly hair.

· Cleanse without disrupting – Granted, shampooing your hair with all of those rows and braids is not an easy task. To clean down to the scalp without disrupting your style you can use a shower massager or dental water pick.

· Wrap to prevent frizz and breakage – When you’re sleeping, your hair comes into constant contact with your pillow and your movements cause friction and tension to be applied to your braids. This can result in fly away hair, frizz and breakage. To avoid this simply wrap your head with a do rag or cloth before sleeping.

· Keep salon appointments – If your braid artist tells you to get a trim every 6 weeks, do so. And if he or she tells you to get your braids redone within a certain time frame, be sure that you do. This will help keep your braids looking neat and fresh.

Black Hair Basics

The typical hair and hair follicles of those of African descent are tightly curled, thus producing hair that spirals. Black hair also typically has a larger diameter than Caucasian hair and retains less water, thus its relative “kinkiness.” The many styling methods utilized on Black hair cause concern with hair loss. Black hair is very strong, fortunately so because Black hair styles cause a great deal of stress on the hair and scalp.

For example, using a hair pick to pick the hair up to a bushy style is a very damaging process due to the constant pulling causing stress on the hair shaft as well as the follicle. In fact, combing Black hair in general can create high stress on Black hair and cause breakage, which perpetuates dryness. Conrowing and braiding are methods of hairstyling that pull the hair tight, and this can cause a great deal of stress on the hair and scalp resulting in hair loss. Braiding that results in the hair being pulled very tight can cause traumatic alopecia, a hair loss that is caused by trauma to the hair and scalp. Traumatic alopecia is usually reversible with proper hair care.

Hot combs and relaxers used to straighten hair can cause a great deal of heat and chemical damage to hair and scalp, which can also cause traumatic alopecia, and over time can cause permanent hair loss. This becomes especially true when the heat or chemically processed hair is pulled tight by rollers or a hot curling iron.

Hot oil conditioners are excellent for Black hair, as hot oil treatments contain proteins and polymers vital to repairing the hair cuticles. Hot oil treatments involve heating the oil and putting it into the hair and scalp, then covering the hair with a plastic cap to allow the oil to soak in. Follow the recommendations on the treatment you are using for the amount of time you should leave the treatment on the hair. This process can heal breakages and shinier stronger hair will be the result.

Consider that hair relaxers commonly used on Black hair contain lye or similar chemicals that break down the hair shaft. Left on beyond the recommended time, these chemicals would eat right through the hair and cause it to fall out in clumps. This is why these same products are used in products like Drano® to clean clogged drains which often are clogged by hair. No-lye relaxers are very popular today, mainly because it leads people to believe that the product is not caustic. This is far from the truth. The combination of calcium hydroxide and guanidine carbonate are combined to form guanidine hydroxide, which could just as easily clean a sink. Repeated use of such products can cause some degree of hair loss, and if scarring occurs while using these chemicals, the hair loss can be permanent in that area of the scalp. One must ask themselves is it wise to place such caustic chemicals in the hair on a regular basis for the sake of desired appearance? The question must be answered by each individual, however the facts should be known.

There is little that can be done to alleviate this syndrome without changing the typical hairstyles of African Americans. There is a catch-22 concerning relaxing Black hair, since combing natural Black hair causes so much stress and breakage of hair, while chemicals cause so much harm to the hair and scalp as well. There are a few hair-relaxing products on the market that use chemicals and are somewhat less harsh than sodium hydroxide (lye) or its popular equivalent in “no-lye” relaxers: calcium hydroxide (quicklime) mixed with guanidine carbonate. One such product is called Natural-Laxer® and Sahara Clay® by Baka ProductsTM that has been on the market since 1990. This product is all natural and because it does not contain many of the harsh chemicals of commercial relaxers and actually contains only a finely ground plant called Daphne Gnidium and clay from Africa it is figured to be relatively safe. Of course this product does not straighten hair in most instances the same way as commercial relaxers, however it does tend to make Black hair more manageable. There is yet another product on the market that is reported to be 92-96% natural which is called Naturalaxer Kit In A Jar™ that does not require the applicant to comb through the hair during the application, which results in a lot less damage.

Of course the bottom line is once again, if you can leave your hair in its natural state then you will experience less stress and damage to the hair and thus prevent at least one cause of hair loss. There is a growing segment of the Black population that is becoming comfortable with wearing their hair in natural styles. One such style is dreadlocks. There are many rumors and myths concerning dreadlocks, as there is little proper information available concerning this style, and as with anything that is misunderstood many myths arise around it. Dreadlocks can and must be washed; otherwise they will smell badly like any other dirty hair. The best process to use to wash dreadlocks is to use a residue-free shampoo. Most commercially made shampoos leave residue and can cause hair not to lock, lending fuel to the rumor that hair had to be dirty to form dreadlocks. Clean hair actually locks much better than dirty hair, as dirt is a residue in itself that will inhibit hair from locking. For best results one should use a fragrance free, conditioner free shampoo. Dreadlocks do not react well to oily and greasy substances, yet there are many good substances that are on the market today that will assist you in forming dreadlocks.

Dreadlocks are formed through a process, not simply by not combing or brushing the hair. Generally, one should start with hair about two inches in length, and the hair should be separated into even squares of hair and twisted gently together using a bonding or gel substance. Many use natural beeswax containing no petroleum, while others use loc and twist gels specifically formulated for locks. Once the hair is separated and twisted into small locks, it is important that they are left alone and allowed to bond naturally. The length of time it will take to lock will depend on the coarseness of your hair, but one can normally expect to wait several months before locks begin to form. While the hair is locking, it will need to be washed. Here is where washing should be extended for a while if possible, so that the hair can be allowed to lock for two weeks to about a month without manipulation. When you do wash your hair, use a stocking cap or “do-rag”, and low-pressure water to make sure that the newly forming locks do not come loose. It will be necessary to rinse for a much longer time than you normally do, because of the lower pressure of the water and the lack of direct manipulation of your hair with your hands. The water is good for your hair and locking process, so this is not a problem. It is also imperative as indicated before that you use a shampoo that does not contain a conditioner and leaves as little residue as possible. A little research on your

part will be necessary here; your health food store should contain a variety of natural shampoos. Have a skilled professional or a friend re-twist the hair gently, reapplying the twist gel or beeswax that you used previously. Repeat this process every two weeks to a month, the longer you are able to wait the better, and within a few months your hair will begin to lock. Again, if you have a fine grade of hair rather than a kinky grade of hair, a beautician skilled at forming locks (“locktitian”) or a friend who is very familiar with the hairstyle should be consulted. Even though dreadlocks are mainly a hairstyle for Blacks, there are other races that have people that enjoy the hairstyle. In general, it tends to be a style of hair that in the long run will give the hair and scalp needed rest from the rigors of chemical and heat treatments and rigorous combing and brushing, and therefore can contribute to longer life for your hair.

Bipolar Imbalances And Hormones.

Working as a nurse in the emmergency room you meet a beautiful variety of people. Among those for whom I feel a special sympathy are those with bipolar. They can of course be quite the characters: some hear voices, some live on the streets, some have an extraordinary sense of humor, some love to sing and entertain… and much more. One thing bipolar patients have in common is that they take heavy medications, particularly antidepressants that have many side effects. To whatever question you ask these patients, the answer will often be, “Well, I have bipolar.” As if this one sad fact is sufficient explanation for all possible questions.

But the word “bipolar”, of course, does not explain everything, and this is particularly true for women having problems with hormonal changes. For example, one woman had a hysterectomy because of severe bleeding, then had to go on hormone replacement therapy. After a couple of months she completely “lost it”. She became convinced that she had to move far, far away and take up missionary work – to the alarm of her concerned family. Bingo. She was put on antidepressants and given the convenient label of “bipolar.” Well – she took her antipressants cross-country with her and ended up living on the streets with the homeless. Rescued finally, by some good friends, she was brought back home, where she if now off most medication, trying to stay as sane as possible, and still saddled with the heavy label of “bipolar.”

Many women in and around menopause go haywire… but is that necessarily bipolar? I often wonder at how strongly hormones can affect mental health, as is often the case with women after childbirth, with the so-called ‘baby blues’. Often due to the hormone progesterone easy to fix with natural progesterone cream. Likewise, women – and men in their own hormonal midlife crisis – often get depressed. But should this really be any surprise? After all, so many things are changing at this point – it’s like adolesence all over again, but in reverse! New sensations and a new view of life… letting go of the old ways and struggling with the new… There can be a lot of confusion with many challenging questions demanding to be lived. Unfortunately, many take the easy road and simply dodge the whole thing. They accept being depressed and can even console themselves with the mantra, “After all, I’m bipolar.”

One solution might simply be to use common sense. Bipolar or not, it’s essential to take in enough essential amino acids and different forms of protein. Many people’s protein intake is limited and unvarying: just red meat, chicken and eggs. If you read Dr. Eric Braverman’s book “The Edge Effect”, you’ll see that we need protein from many sources, including meat, poultry, nuts, eggs, fish, dairy, beans, and vegetables.

This approach is helpful for all of us, but especially for those with bipolar – whether it’s the real thing or not. Dark chocolate can be helpful too, offering some of the same benefits as such antidepressants as Prozac and Paxil, but with no side effects. Just as healthy foods are vital for growing children, they are crucial for anybody going through big changes or having a difficult time. So be sure to eat well and exercise, and study Dr. Braverman’s “The Edge Effect”. Give yourself what your brain needs to function well and create harmony in your being. Don’t worry so much about your bipolar – or the bipolar label. Apply your thoughts to the constructive self-healing that is possible.

Common sense is not so common. Good luck with finding what works for you!

Warmly, Pieternel