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April 19 2014

styledotcom An embarrassment of riches in the Berkshires: stylem.ag/1h44ScB

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Dr. Thomas Connelly Talks Teeth

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backstage-smileWe will be the first to admit that on our long list of health and grooming tasks, sometimes our teeth are an afterthought. Sad but true. But because we are determined to make dental maintenance a priority this year, it seemed like the ideal time to talk teeth with an expert. Enter Dr. Thomas Connelly, who, besides running a practice on Manhattan’s Upper East Side for nearly twenty years, has also delved into the world of oral healthcare products—he launched the 32 Effervescent Breath Treatment with IsoVoxy last year, and this May marks the release of 32 SNO, a new home whitening system. Here, Connelly answers a few of our pressing teeth-related questions.

Do we really need to spring for an electric toothbrush? Does it do that much better of a job than the old-school variety?

The truth is you do not have to if you are willing to spend two full minutes brushing adequately. Most of us live our lives in fast-forward and spend only about thirty seconds brushing, and thirty seconds with an electric toothbrush is far better than thirty seconds with a manual toothbrush. So the choice is yours.

Let’s talk halitosis (aka bad breath): No one wants it, but unfortunately, it’s a reality for many. What causes it and what can we do to prevent it?

Bad breath has been a documented concern since ancient Greek and Roman times. Oral malodor can be classified into two basic categories: intrinsic and extrinsic. Extrinsic oral malodor originates from the ingestion of substances (such as cheese, garlic, tobacco) that contain malodorous compounds. The duration of extrinsic malodor is proportional to the amount and frequency of ingestion of the offending substances and the amount of time required to “wash out” the malodorous substances. Intrinsic malodor has its origin within the individual, and is most commonly caused by substances produced by bacteria in the oral cavity. Anaerobic bacteria found in the rear folds of the tongue are believed to generate the VSCs (volatile sulfur compounds = bad breath). The main cause of oral malodor is the putrefaction of sulfur-containing protein substances, predominately by gram-negative bacteria. The human nose is highly sensitive to sulfur, so bad breath when present is very easy to detect. “Morning breath” has been attributed to the overnight putrefaction of food deposits, salivary deposits, and other types of oral accumulation and debris. This is why the best time to really clean your mouth, including serious flossing, is before bedtime. Your mouth becomes dry overnight. Saliva is not flowing as it does during waking hours and saliva does help clean the oral cavity. To prevent halitosis, adequate oral hygiene that includes brushing, flossing, and tongue cleaning is required.

Every year we resolve to floss more, and every year we fail miserably. Any guidance you can offer?

Take a realistic approach. Non-flossers do not realize how gross it really is to not floss. The key to becoming a flosser is to discover this grossness. People do notice the plaque between your teeth, and plaque buildup (the bacteria living in a sticky film they produce) smells bad, therefore affecting your breath. I would challenge a non-flosser to do a good flossing and take notice of the crud that comes out of your teeth.

A number of friends have started in recent years to complain about receding gums. Can you explain how that happens and if there is anything to curb the issue?

Gums can recede from brushing too aggressively with your toothbrush, so be gentle. But more frequently, gums recede from imbalances in the way our teeth bite together (called occlusion). Sometimes the recession is so extensive, the teeth may need to be lightly adjusted to correct the manner in which they occlude. Once the bite issue is corrected, the recession will halt. Sometime a “graft” of gum tissue from the roof of your mouth is needed to repair the gums in a certain area.

Dr. Marmur On Getting Even

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BalmainThis column features tips and advice from a revolving cast of industry leaders on hand to discuss your beauty dilemmas, from blemishes to Botox.

The journal of the American College of Toxicology stated in 1994 that hydroquinone is not safe for topical use, yet it’s still widely available today (despite being banned in multiple countries outside of the U.S.). Do you still recommend using this ingredient to treat hyperpigmentation?

It is safe to use for three to six months at a time on small areas, such as the face. Black-market hydroquinone creams at concentrations over 4 percent (the amount found in most prescription versions), however, are the instigators of most problems, such as a blue-black discoloration called ochronosis. If you still have concerns, there are other alternative actives—like retinol, vitamin C, kojic acid, and niacinamide—that can lighten skin effectively.

For an over-the-counter formula that helps even your complexion minus hydroquinone, try SkinMedica Lytera Skin Brightening Complex, $125, www.skinmedica.com.

Dr. Ellen Marmur is a board-certified dermatologist and dermatologic surgeon, the founder of Marmur Medical, and the associate clinical professor at Mount Sinai Medical Center in the Department of Dermatology and the Department of Genetics and Genomic Research.

Photo: Sonny Vandevelde/ Indigitalimages.com

A Post-Baby Belly Like Gisele’s

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Gisele post-babyThis column features weekly tips and advice from a revolving cast of industry leaders on hand to discuss your beauty dilemmas, from blemishes to Botox.

I have persistent belly fat that I just can’t seem to lose post-baby. I used to love wearing body-conscious dresses, but now I’m self-conscious about my pouch. What can be done to get rid of it?

This is how I start the conversation when a woman comes in about her post-baby “pouch”: The abdominal wall is made up of three layers—skin, fat, and the deep abdominal wall (usually referred to as “muscle,” but the thing that is corrected here is actually the tissue connecting the muscles together, not the muscle itself). The appropriate procedure for you depends on which layer it is that needs adjustment, and can range from a small amount of liposuction under local anesthesia to a full tummy tuck (abdominoplasty). Continue Reading “A Post-Baby Belly Like Gisele’s” »

Help, My Man Has Love Handles

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Dr Is InThis column features weekly tips and advice from a revolving cast of industry leaders on hand to discuss your beauty dilemmas, from blemishes to Botox.

My husband has lost about fifteen pounds over the last year, but his love handles don’t seem to be going anywhere. He often talks about smart lipo, but I’ve read that the fat comes back—that it migrates from other parts of the body. Is that as true for men as it is for women? Do men and women achieve the same kind of results from the treatment?

First of all, my husband is skinny and narrow up and down like a ferret and has those same love handles. Almost every man, unless he is a professional athlete or has incredible genetics and spends all of his free time working out, starts to develop fat deposits, or “lipodystrophy,” on his lower abdomen and flanks (or “love handles”) once he hits his early thirties. Those of us who are otherwise fit and just have one or two specific, offending areas are actually the best candidates for liposuction.

However, the term smart lipo needs to be defined. Smart Lipo is a laser that was falsely advertised through media and marketing, and became equivalent in the consumers’ eyes with “liposuction under local anesthetic.” When patients come in asking for smart lipo, what they usually mean is that they want the fat removed with a simple, minimally invasive office procedure without any general anesthesia. There is no such thing. The truth is that the Smart Lipo laser alone does very little for the removal of fat. I know this because I have one in my office and always have to combine it with conventional liposuction to get any kind of result. This can be done under either local (the “tumescent” technique), IV sedation, or general anesthesia. The bottom line is that liposuction requires the removal of fat with a suction cannula. The Smart Lipo laser can be added for possible skin tightening, but even this has not been proven.

After the removal of fat cells by liposuction, the fat cannot “migrate” to other parts of the body. Once the fat is gone, it’s gone, and it can stay gone—as long as you take care of yourself. Usually what I tell my patients is that to keep their fantastic results, they need to kick it up a notch with diet and exercise. If you get lazy once the fat you couldn’t get rid of is gone, you can gain weight back. But fat cells don’t multiply—they just get bigger. What I’ve found is that the fat will start to come back a little in the areas from where it was removed, and then once those remaining fat cells are “full,” they will start filling up elsewhere.

In good candidates, liposuction is a safe, effective procedure that works equally well for both men and women.

Located in Beverly Hills, Dr. Suzanne Trott is a board-certified plastic surgeon who specializes in breast and body contouring. Her areas of expertise include liposuction and the new “natural breast augmentation” procedure with autologous body fat. She answers your questions on her blog, Lipo Queen, an international resource for unbiased information regarding all of the newest developments in plastic surgery and cosmetic medicine. Her book, Lipo Queen will be available next year. Further information about Dr. Trott and her practice can be found at Drtrott.com.

In Need of a Lift?

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woman-breasts-B-cupThis column features weekly tips and advice from a revolving cast of industry leaders on hand to discuss your beauty dilemmas, from blemishes to Botox.

I was barely a B cup, then I breast-fed my baby. I wish my breasts were fuller, but I hate the unnatural plastic look of boob jobs. What kind of results can I expect from a breast-lift? Or injecting fat from other parts of my body? Do the results look natural? Breast augmentation gets a bad rap, because the only ones that everyone knows about are the ones that look fake. Many women are walking around with implants that appear natural. However, the term natural has to be defined. Once you hit your late twenties, and especially after breast-feeding, true natural usually means the start of sagging and lack of fullness on the top part of the breast, or what is referred to as upper pole fullness.

When someone in your situation asks to look natural, she usually means she wants me to make her breasts in proportion to her body habitus (or body type), and to give her some upper pole fullness, making her look like she’s wearing a padded bra when she’s really not. This can be done with an implant, as long as the implant is not too big for the dimensions of the breast. For someone like you, who has breast-fed, you usually have some looseness of the breast skin that allows space for a small implant to sit nicely, without looking like a round ball stuck on your chest.

At a small B cup, a breast-lift alone will require at least a scar around your nipple, or a “lollipop” incision, and will not give you the upper pole fullness you are probably looking for. If you absolutely do not want an implant (and you have the fat to spare), fat transfer with or without a lift could be a great option.

The fat transfer looks and feels completely natural and requires no incisions on the breasts. The only real downside is that you cannot guarantee exactly how much of the fat will stay permanently, so if you have your heart set on being a certain size, this is not a good choice for you. I tell my patients that we should know their final cup size at three months after the procedure. The biggest bonuses are that not only is it two procedures in one, but since your body fat has been redistributed, if you gain weight later, it will disproportionately go to your breasts!

Located in Beverly Hills, Dr. Suzanne Trott is a board-certified plastic surgeon who specializes in breast and body contouring. Her areas of expertise include liposuction and the new “natural breast augmentation” procedure with autologous body fat. She answers your questions on her blog, Lipo Queen, an international resource for unbiased information regarding all of the newest developments in plastic surgery and cosmetic medicine. Her book, Lipo Queen will be available next year. Further information about Dr. Trott and her practice can be found at Drtrott.com.