Aug 17, 2014
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Winter Skin Care Tips

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The winter is about to begin…. Don’t forget about your skin.

“Oh the weather outside is frightful” as the popular holiday song reminds us, but there is no reason why your face needs to be.   Winter climates mean we must pay a bit more attention to our skin, if we want it to be youthful for many seasons to come and avoid the risk of permanent injury.

The rosy red cheeks we get after coming in from the cold can cause dryness tightness, flaking, cracking and inflammation of the skin called eczema.  And although the warmth from the heat or fireplace when you get inside feels great, that too is drying to the skin. If left unattended, this will lead to premature aging and potentially irreversible damage to the skin.

Here are some simple tips to keep the skin kissable, once the mistletoe is no longer around.

  1. Find a skin care specialist to help you choose the products that are right for you. All skin and skin care products are not the same. Many have little or no value, and some can actually cause injury to the skin. Our office is committed to the science of skin care programs to address the specific needs of various skin types, areas, and pigmentation. And our products will not break the bank in the process.
  2. Moisturize your skin because once the damage is done, it’s done! While you may have found a moisturizer for your skin that works in the summer, the winter is more demanding. Depending upon skin type, many lotions labeled “night creams” may be more protective to the skin and help retain moisture, in part because moisturizer is oil-based.
  3. Sunblock is not just for summer. Winter sports and snow glare make sunblock important.  Remember the rule of 30’s – SPF 30 and apply 30 minutes before you go out.  Photo-damage leads to permanent skin changes including wrinkles, deep pigment changes and skin cancer.
  4. Don’t forget about your hands. Because the skin is thinner on the hands, it is much more difficult to keep them moisturized in the winter.
  5. Avoid wet socks and gloves.  They can irritate the skin and cause cracking, drying and infection.
  6. Adding a humidifier at home can help to bring healing moisture into the air and prevent drying, cracking and ulceration of the skin.
  7. Don’t forget about your feet. Use an exfoliant to get dead skin off the feet so moisturizers will work better. And consider using a petroleum product for greater moisturizing.
  8. Avoid alcohol-based toners, cleaners and astringents, which strip protective oils from your skin. Consider cleansing milk, deep foaming cleaners or deep hydrating products we have in our office. We also carry Epionce products and often combine them to restore youthful healthy skin.

While winter is “the most wonderful time of the year” to many, it does require some preparation.  Follow these simple winter tips or call or visit our office. We’ll give you what you need to look your best. Then, “let it snow let it snow let it snow.”

The Surgeon and the General

20Featured news, Latest news

Dr Rochman and General Milley

General Mark A. Milley, 39th Chief of Staff of the United States Army and member of the Joint Chiefs of Staff, United States Department of Defense, and Dr. Guy Rochman, Chairman and Chief Operating Officer of Worldpath Health and Assistant Professor of Surgery, Harvard Medical School, discuss the importance of the Worldpath Health role in international healthcare, and agree that healthcare transcends politics and national borders.

General Milley is from Massachusetts, having attended Belmont Hill School and Princeton University with a Bachelor of Arts degree in political science. He holds a Master of Arts degree in international relations from Columbia University and the United States Naval War College. He is also a graduate of the MIT Center for International Studies.

Dr. Rochman is the founder of Worldpath Health, headquartered in Cambridge, Massachusetts. Dr. Rochman graduated “cum laude” from Harvard University and Boston University School of Medicine. He served as a General Surgery Intern and resident at the Beth Israel Deaconess Medical Center, Harvard University, Boston, Massachusetts, and completed his plastic surgery fellowship at Johns Hopkins Hospital in Baltimore, Maryland.

Pollution: Public Enemy Number One For Your Skin

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The danger of Sun Exposure and Ultraviolet Exposure (UV-A and UV-B) has long been known. I have written about the importance of protection from the sun in numerous articles and reports both here and elsewhere.  Even on cloudy days we must respect the power of the sun’s rays both in terms of cancer as well as premature aging of the skin.

However, our industrialized society also poses signification risks and hazards by exposure of chemicals and impurities to the protective barrier to the skin.

Pollution and smog result from chemicals that have become aerosolized and thus impact upon the purity of the air.  While urban areas are generally prone to higher risks, “air pollution” can be present and look different depending upon where one lives.  Arid and desert environments have a high incidence of dust pollution, areas near forests can have air polluted by smoke from wild fires, and agricultural areas can have air polluted by chemicals used on farms.

Any time chemical particulate matter is in the air, this type of pollution will play a role in the aging of skin.  This is why it is essential to defend your skin with a well-designed skin program.

Our office has created skin care protocols and programs for both male and female skin which are uniquely designed to:

  • Reduce the visible appearing of aging
  • Clean out the pores and particulate matter and smooth the skin
  • Add anti-aging vitamins for the skin
  • Protect from UV damage
  • Provide a barrier against environmental factors that compromise the skin

The skin is the largest organ in our body, and our first line of defense against the environment.   With just a very few minutes of attention every day, our skin can remain youthful and healthy.  Contact our office for a consultation today to find out more about how to keep your skin at its best.

Remember, when it comes to sun, smog and smoke, we all have skin in the game!

Brighten up your face—have a good laugh

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“Summer time, and the livin’ is easy.  Fish are jumping, and the cotton is high.

Your daddy’s rich, and your momma’s good lookin…” Those George Gershwin lyrics from Porgy and Bess are 8 decades old, but still easy to relate to, especially as the days get shorter, the shadows get longer, and we savor the last days of our soft, short summer in Boston.

When we think of summer, we think of vacations. When my daughters were little ones, we would keep a special diary for each summer family vacation.   Everyone was encouraged to make a daily entry.  Everything was fair game.

Today, my daughters are successful and beautiful women.  And as the summer draws to a labor day close, and the academic world comes to life, we found ourselves sitting around the dinner table this past Sunday and reliving past summer holidays.   Somehow, as if by magic, those decades old vacation diaries appeared on the table, as we savored our apple pie.  The memories, dimmed by the background noise of life, seemed to jump off the pages, yellowed and wrinkled by the passage of time.   So there we sat for hours, reading our commentaries on vacations from years past. So hilarious, we laughed and laughed till our sides hurt!

I could not remember laughing so much in a long, long time. And when my eyes closed to a wonderful night, I marveled at how good I felt … invigorated, refreshed and uplifted.  How good it was to laugh

As a physician, and a surgeon, I know how important it is for our health and well-being to nourish our five senses.   Our Sunday dinner reminded me of how important it is to exercise the sixth sense— our sense of humor!

Every day we find ourselves facing difficult and trying situations. But when we laugh, somehow we are reminded that there is more than one way to look a situation.  Laughter shifts our perspectives.  It opens our minds to new possibilities

The scientific literature is replete with evidence documenting the importance of laughter in many aspects of health.  Laughter reduces the body production of numerous stress hormones.  Laughter boosts the body immune system.  Laughter increases our pain tolerance and enhances our creativity.  Humor has been shown to lower blood pressure, reduce anxiety and lessen depression. It makes us more likeable.  It’s fun. And guess what…it keeps us young!

As world-renowned associate professor of Neurology at Harvard Medical School. Dr. David Simon has said “discussing laughter is like talking about making love or talking about  a good meal.  The real value is not in the description but in the experience.  Let yourself get carried away with laughter”

The Changing Face of Plastic Surgery- Part One—The Millennial Factor

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America’s appetite for plastic surgery continues to grow, rising by a staggering 115% since the new millennium.  It seems, however, that some of the popular “menu items” are different. The types of procedures that patients are choosing is changing, as more specialized treatments become available.  There are several reasons for both the continued growth and the shift in trends.

We are seeing a new group of consumers entering the market place. According to a report released in April 2016 by the Pew Research Center and The United States Census Bureau, Millennial (born 1981-1997) have surpassed Baby Boomers (born 1946-1964) as America’s largest generation.   This generation came of age in the most technologically advanced time in the world, with plastic surgery as a household word. Their growing presence has helped to advance the market place in the direction of less invasive, more proactive and   more sophisticated procedures to “stay young”.

According to David H Song MD, President of the American Society of Plastic Surgery, “Patients have more options that ever before, and working closely with their surgeon, they’re able to focus on specific target areas of the body to achieve the look their desire.”

Over 1.7 million plastic surgery procedures were performed in 2015. The top 5 procedures are breast augmentation, liposuction, nose reshaping, eyelid surgery and tummy tuck.  For the first time since the year 2000, facelift surgery is not in the top 5.  Also of note is the fact that liposuction is down 37% since 2000, eyelid surgery is down 38 % since 2000.  This reflects the move toward new non- invasive or minimally invasive applications (e.g., lasers, light based procedures, ultrasonic fat reduction procedure) .

A closer look at the 15.9 million cosmetic procedures performed in the United

States in 2015 reveals that 14.2 million were minimally invasive.  Botox heads the list of the most common non-invasive procedures, up 759% since 2000.  Soft tissue fillers (e.g. Restylane, Juvederm) are the second most common procedure, up 274% since 2000.  Also on the list are non-invasive facial rejuvenation (lasers, peels etc.) and laser hair removal.  Less invasive procedures can be more affordable and appear to a broader range of patients.

Male patients now comprise about half of the cosmetic surgery market.  What is more dramatic than that number is the fact that men also account for more than 40 percent of aesthetic breast reduction surgeries.  A total of 27,465 procedures were performed on men in 2015 for reduction of male pattern breast tissue (gynecomastia) reflecting a 35% increase since 2000.

Statistics also show that 2015 was ‘the year of the rear’ with buttock implants being the most rapidly growing type of cosmetic surgery.  On average there was a buttock procedure performed every 30 minutes of every day?

The incontrovertible fact is that none of us will ever be any younger that we are this minute.  And the numbers clearly demonstrate that while the demographics may be changing, America’s love for plastic surgery remains a passionate affair.

LIGHT-YEARS. 7 Things you need to know when choosing lasers and light energy to help you look years younger!  

30Featured news

Laser resurfacing is a proven way of enhancing the appearance of your skin. It not only reduces wrinkles, age spots, acne scars, and unwanted hair, it will also tighten the skin and improve tone.

Because lasers can do so much, and there are so many competing products and promises on the market place, it can be difficult to choose the best treatment.  It is very important to be informed, but it is also easy to be overwhelmed.

So, before you get lost on the Google information highway, lets step back from the hype and confusion and focus on some important things that you need to know when considering facial rejuvenation.

  • Don’t get hung up on brand names, new gadgets, great deals, groupons, the latest article in Cosmo, or the newest “med spa” in your mall. The cosmetic world is full of ‘great new ideas’ that ended up with bad results and unhappy patients.  I love a great deal as much as anyone. But your face is not the place to go with the lowest cost option.  First, focus on your goals; what problems you want to address and what are the results you can reasonably expect to achieve.  Second, find a plastic surgeon you trust and respect to help you to tailor the best treatment options for your skin type.
  • Who performs your laser treatments will have a profound effect on your results. In the hands of a highly trained plastic surgeon, lasers are a safe and easy way to improve your appearance.  But in the hands of a poorly trained practitioner, laser treatments can be dangerous, lead to bad outcomes, or simply waste your time and money. Choose the person to perform you procedure based upon experience, training, qualifications and trust.
  • Different lasers are optimal for different treatments. If you aren’t being treated with the best laser for your skin and goals, you won’t get the best results. A professional with a long track record of success and access to numerous devices can choose the correct tools and treatment for you specific needs. Remember, if all you have is a hammer, everything looks like a nail.  Your plastic surgeon will have different lasers available and work with you to pick the right one for you
  • Having dark skin tones is no longer a contraindication to laser treatments. While it is true that darker skin tones can experience pigment changes, there are now lasers that can safely treat darker skin types including Hispanic, Asian, Middle Eastern and African American without affecting tone.  It is critical, however, to be certain that the correct device is used for those skin types. Your plastic surgeon will know what treatment is appropriate and safe for you.
  • Plan on having multiple treatments. While a single treatment will address patient needs in some cases, multiple procedures will often be part of the treatment plan to achieve the best results.  This trade-off comes with no down time and excellent long-term results.  Treatments should be custom designed for each patient.
  • Depending upon the procedure you choose, you may have some down time. Some treatments may require you to make adjust your social and work schedule for a few days. It is important to have a discussion with your Plastic Surgeon regarding the timing of your procedure and your tolerance for down time.  Our office offers evening and weekend hours to help you heal on your own time and get back to work and play quickly.
  • Certain medications and underlying medical conditions will affect the way your skin reacts to laser treatments. Your Plastic Surgeon will always take a detailed medical history, including any medications or medical supplements that might affect your recovery. Some acne medications can lead to poor healing or scaring following laser treatments.  Over the counter medications including aspirin and non-steroidal anti-inflammatories can lead to bleeding. If you are prone to cold sores, laser treatments may lead to an outbreak.  Your physician will want you to take medications before and after your treatment to help prevent post treatment cold sores and the problems associated with them.  Cigarette smoking, diabetes and other chronic medical conditions can also delay healing and adversely impact outcomes.  Your plastic surgeon will have a detailed discussion with you before your procedure and chose the best treatment for you.

 

Laser and light-based treatments can be a very safe, easy and effective way to maintain youthful appearance, healthy skin, and rejuvenate the aging face.  Our team has been an international center of excellence in facial rejuvenation for over two decades.

Please contact our offices at The Mount Auburn Hospital in Cambridge Massachusetts or The Beth Israel Deaconess Hospital in Milton Massachusetts (www.rochmanmd.com) or WorldPath Health (www.worldpathmedicine.com) and schedule a consultation to learn what options are best for you

 

The International Age—Anti-Aging Answers for Every Ethnicity

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The association of youth and beauty is universally accepted in society. The desire for beautiful skin color and texture, absence of wrinkles, lustrous hair has fueled huge growth in the cosmetic and surgical industries. Women who possess a youthful appearance are consistently rated more attractive than older appearing women. Studies on skin texture and color have demonstrated that humans have a preference for younger appearing skin that is viewed as both healthier and more attractive.

In the current cauldron of political correctness, it may seem impolitic to say, but facial wrinkles, spots, saggy skin and aging faces discriminate based on skin color. White, Black, Latino, Middle Eastern, Asian are all different skin types, which  develop lines, laxity and loss of volume  in different ways and at different rates.  Indeed, the aging process transcends politics and national borders.  It’s how we battle back that makes the difference.

Aging is a complex process that reflects biological, environmental and genetic influences. Deeper pigmented, darker skin has characteristics that make its aging process unique.  The thicker and more compact dermis  makes facial lines less noticeable.   Increased  concentration of the pigment melanin  also make the skin more vulnerable to pigment changes and scaring.  It is critical to understand the unique structural and functional differences among ethnicities, and to have the appropriate modalities for various skin types, both of which are essential to treat the signs of again. Over the past 20 years we have specialized in rejuvenation of the aging face, and the unique requirements of patients from around the globe

**Here is the simple truth about White skin; the Irish, English, Scandinavian “peaches” complexion is going show more signs of aging.  Blame the sun, and the fact that light skin has very little pigment, or melanin, to protect against it.  UV rays from the sun break down collagen, and cause wrinkles that start as early as your 20’s.  Your skin produces pigment to protect itself.  Along with that come the dark spots.

And the skin cancers.  I have seen many young people in there 20’s with their first skin cancer.

The good news for this skin type is that we can be more aggressive with laser and other anti-aging treatments, since light skin does not absorb as much laser energy and we don’t have to worry about hyperpigmentation,

The essentials for your skin type;

  • Sunblock, sunblock, sunblock.  At least SPF 30 or greater, every day, re-applied every 3 hours or so.
  • Good anti-aging skin care regimen. We have designed an anti-aging and anti-pigment protocol unique to this skin type. There are others, but there is also a lot of junk.   Make sure you are investing in quality.
  • Quit smoking. It is the fast track to wrinkles, and worse.

 

**“Black is beautiful” has never been more true than when talking about aging skin types. You can smile and laugh and squint all you want because you wont even begin to see wrinkles until your 50”s.  The increased melanin, which gives the skin its deep pigment, along with thicker dermis and prolonged keratinocyte life, protects it against wrinkles, often for many decades.

Increased pigment, however does lead to uneven skin tone.  The pigment cells are larger and can react dramatically to minimal irrigation with dramatic color irregularities and scaring   Volume loss is also a telltale sign of aging in people with this skin type

Things to think about include topical skin care regimens, which include bleaching and fading creams, and fillers for volume replacement.

 

** Middle Eastern Skin types are blessed with extra pigment in the skin, so that lines don’t show up until well into your 40’s 50’s or even later.  I have seen many women with this skin type who never develop permanent wrinkles

But when in comes to skin, no one gets a free ride.  Folks with Middle Eastern skin have also been exposed to Middle Eastern sun…. This skin type has a good chance of developing dark blotches from enhanced sun exposure, dryness, irritation, and hormonal changes.  UV exposure also leads to breakdown of collagen and volume loss at an earlier age.

There are many new modalities now available to treat this skin type.  I use the E-matrix Sublative Laser, designed specifically to treat this skin type. It is important to maintain the skin tone with regular light/laser based peels to continue to correct and improve dark spotty skin.  We also create a personally designed skin care program of products to treat pigmentary changes and keep acne under control. I recommend a multi-tiered approach to early volume replacement and maintenance with products determined by specific location.  And of course, don’t forget the sunblock.

 

**The Asian paradigm for beautiful skin is pale and silky.  And while many Asian women want lighter, radiant and luminous skin, this skin type is actually thicker; with more pigment producing cells that fair skin.  Asian skin is prone to prominent dark spots, very uneven skin tone especially around the cheeks and forehead, melasma that makes the skin look dusty and dull.  This skin type is also prone to raised round keratoses that may require early surgical intervention. Because of the facial contour, volume loss is common.  I recommend appropriate custom designed skin care regimen, control of acne, Syneron EPL and RF based therapy, specifically programed to Asian skin, and volume replacement when it becomes necessary

Pigments in Latina skin can be as varied as the cultures. There are light skinned Latinas who age more like Caucasians, and very dark pigmented Latinas whose skin ages like black skin.  The universal complaint is discoloration of the cheeks, chin, upper lip and forehead.  According to one survey up to 66% of women will develop some form of melasma during pregnancy.  Sunscreens are important, but melasma is not just from UV radiation so it is important to use a sunblock that contains zinc oxide or titanium dioxide.

Home remedies to correct pigment changes are often used, and generally a bad idea.  Lime and lemon based treatments can cause a toxic reaction when applied to sun exposed skin, and lead to severe hyperpigmentation.   Cocoa Butter is very thick and occludes the pores, leading to acne and further scarring and pigmentation.  Plus, they don’t work to lighten the skin

Across all skin types, across all continents and cultures, the aging process includes photo damage, volume redistribution, and loss of connective tissue and wrinkling of the skin. As life expectancy continues to increase, almost doubling over the past century, and as youthful appearance has become more pivotal to personal success and wellbeing, appearance continues to become of increasing concern.  Our global cultures are now intermixed.  Society has become more heterogeneous.   Ethnic differences are clearly evident every day, in every culture.  Dark Skinned individuals have firmer smoother skin than those with lighter skin of the same age, however aging does occur in all cultures with regard to pigment, wrinkles, volume loss and laxity

When seeking plastic surgical rejuvenation of the aging face our patients know we have been caring for the international community for over two decades, and offer a comprehensive knowledge of the functional principles of ethnic and aging skin, and can property care for aging skin of all populations.

 

 

Guy M  Rochman MD

Assistant Professor of Surgery, Harvard Medical School

Chief, Division of Plastic Surgery, Beth Israel Deaconesss Hospital Milton

CEO, WorldPath Health

Mommy Makeover Step aside. Its time for the Ultra Shape “Dad Bod”

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Dad Bod is a phenomenon fueled by the fact that society is starting to find the normal physique sexy. We are a more health, appearance and fashion conscious society. We live in a more competitive work and social environment.  Men’s fashion has become more tapered and revealing. For these reasons and a host of others, the Dad Bod phenomenon has taken hold. An equally important factoid—Ladies like dad bods. (Thank you Leonardo DiCaprio)

Conventional wisdom, and Madison Avenue advertising agencies might suggest that the Abercrombie and Fitch half naked men with rock hard bodies and cut off jean shorts are iconic. Perhaps it dates back to primordial times, when women needed brutes to slaughter beasts and fight off the warring tribes, or perhaps plow the fields and protect the house. But today, while women still need and want men, it may not be the macho one with the thick biceps who spends all day and the gym searching for his masculine ego. A dad bod means a guy who has career and responsibilities, loves kids, and has enough money to look after himself (and order the extra guacamole and dessert) and has a soft tummy to lay on after a long work day.

The phenomenon of the Dad Bod has a lot to do with many men being more in touch with their appearance than ever before. It also means confidence. The Dad Bod is for the male human over the age of 30 whose testosterone levels no longer burn with irrational desire. Dad Bods don’t want excess belly fat. They don’t want a “beer belly” but they don’t expect or want “6 pack abs” either. They want to look and feel better about themselves and fit and feel better and more comfortable in (and out of) clothes

Enter Ultra Shape- the newest generation of non-invasive body sculpting -which is perfect for men. Speaking as one, men are often less tolerant of discomfort from aesthetic procedures, and want quick procedures that have no down time, quick recovery and quick results that get rid of excess belly fat. Men are learning from word of mouth, media and significant others that this non-invasive, no pain, no downtime option is exactly what the doctor ordered!

We are born with a finite amount of fat cells, which do not increase in number after adolescence. Ultra Shape ultrasonic body contouring, targets and destroys fat cells in a painless, totally non- invasive fashion, requiring as few as three brief office procedures. Patients return immediately to work, play and exercise with absolutely no down time. It is literally a lunch hour procedure, and since fat cells do not regenerate the results are permanent. We have seen Dad Bods loose 4 inches on their waist – that’s 2 suit sizes. And we have used it with great success across the Dad Bod spectrum (love handles, muffin top, man boobs).

Dad Bod is a balance between going to the gym and also having a pizza from time to time. It is confident and unpretentiousness.  And in six weeks, she wont be able to keep her hands off your Dad Bod.