Dr Vee Vee https://drveevee.com Dr V Sun, 28 Apr 2024 15:25:20 +0000 en-US hourly 1 https://wordpress.org/?v=7.0 https://drveevee.com/wp-content/uploads/2024/04/DR-Vee-Site-Favicon-150x150.png Dr Vee Vee https://drveevee.com 32 32 The Bang Behind Botox™ https://drveevee.com/2024/04/28/the-bang-behind-botox/ Sun, 28 Apr 2024 15:17:04 +0000 https://drveevee.collectiveshift.co.za/?p=511

April 28, 2024

The Bang Behind Botox™

Categories:

Cosmetics & Dermatology

Most of us have heard of Botox™, the well-known aesthetic treatment that has been around for more than 3 decades, popularized by Hollywood. But what is it, what does it do and will you look fake? The following questions are answered in the short blog post below.

A cosmetologist makes anti-aging injections against wrinkles on the forehead on the face

Botulinum-Toxin

Onabotulinum toxin A, aka Botox™, is one of 3 neurotoxins on the South African market all used for the same purposes- to cause non-permanent muscle relaxation and in turn, reduce the appearance of wrinkles. It is also widely used by Neurologists to treat spasticity, and migraines associated with bruxism. Botox is also used as an effective treatment option for excessive sweating, or Hyperhidrosis.

Botox works by inhibiting muscle contraction, specifically through inhibiting presynaptic acetylcholine release.

With a track record of over 3 decades, Botox™ is one of the most popular and safe non-surgical aesthetic treatments to helping achieve a refreshed look.

On-label aesthetic indications are for:

  • Frown line treatment
  • Forehead line treatment
  • Smile line (crows’ feet/ periorbital wrinkles) treatment
  • Excessive sweating

But can be used for a host of other wrinkles, which can be discussed at consultation.

Man getting cosmetic injection at cosmology clinic

Will you look fake?

NO. The Frozen Face that is commonly portrayed in Hollywood is achieved through inappropriately high dosages. With the right dosages in the right areas and in the right hands, being treated with Botox produces natural and highly satisfactory results. After 4-5 days, the effects is noticeable and full effect is achieved after 2 weeks. You can expect reduced wrinkle appearance, smoother skin texture and an all round refreshed look for 4 – 6 months. With regards to bruxism and hyperhydrosis, treatment usually lasts 6-9 months, perfect for a Spring introduction.

Ok, so what does the procedure entail?

After a thorough consultation on your desired outcomes and having discussed a treatment plan, the actual procedure takes about 15 minutes. Medical grade numbing cream can be applied beforehand, ensuring a pain-free experience. Small injections into specific areas are made and voila! You are free to go back to doing life as there is no downtime. There are some things that need to be avoided post procedure, such as laying down for 4-6 hours after, strenuous exercise, makeup application and massaging/ facials. As mentioned above, muscle relaxation takes around 4-5 days to show and the full effect is visible after 2 weeks.

What are you waiting for?

Quick, safe, effective and with a very high satisfaction rate, Botox™ can help you look younger, happier and more rested. 

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]]> To fill or not to fill? The keys to knowing when it’s time to visit your Aesthetic Doctor. https://drveevee.com/2024/04/28/to-fill-or-not-to-fill-the-keys-to-knowing-when-its-time-to-visit-your-aesthetic-doctor/ Sun, 28 Apr 2024 15:08:42 +0000 https://drveevee.collectiveshift.co.za/?p=496

April 28, 2024

To fill or not to fill? The keys to knowing when it’s time to visit your Aesthetic Doctor.

Categories:

Cosmetics & Dermatology

It’s Tuesday morning, you’re in another Zoom meeting and suddenly you notice those lines next to your mouth, that weren’t there before.

Lines that are deep, lines that stay there even when your face is rested, lines that you remember your mom and aunties having when you were little. The nasolabial fold lines.

You’re aging, and you want to do it gracefully. No Hollywood blow up doll, but no wrinkled fiasco that gives away those late restless nights looking after your new born, working on that project or maybe even those 24 hour calls in the ER.

 

So you ask yourself, to fill or not to fill? Well, let’s start with the basics- how do we age? What is filler? How can it assist the aging process? What are its alternatives?

The aging process

With life span and health expectancy on the rise, we live in a privileged time of being able to age. Aging is an insidious process, caused by a multitude of factors relating to decreased collagen and elastin production in the skin, atrophying (shrinking) muscles, skeletal regression and fat pad repositioning.

In their groundbreaking, evidence based article on aging, swift et al (https://pubmed.ncbi.nlm.nih.gov/33325497/) approach facial aging according to the various layers of the face.

These are:

  • Bone changes
  • Soft tissue changes (fat pads and muscle)
  • Skin changes

Changes in each of these layers don’t occur in isolation but in correlation and continuum- each layer depending on the other, each undergoing an aging process, which ultimately leads to what can be seen with the eye.

When we think of the aging face, we think of course and lax skin texture, a dry appearance with sun spots or areas of pigmentation, telangiectasias (small blood vessels), amongst other things, and of course, wrinkles.

Which leads us back to our Zoom call dilemma- to fill or not to fill?

What is Filler exactly?

Filler is a colourless, gel-like substance comprised of highly cross linked hyaluronic acid. It is used to plump the skin, fill wrinkles and provide facial fullness associated with youth. 

Fillers come in various densities, for various purposes. For example, in lip augmentation (beautification) a low density, soft filler is used for good tissue integration and to avoid lumps, whereas for structure in the mid face eg cheekbones, a high density filler is placed as a scaffold for overlying skin and other soft tissues. 

In terms of the aging process, it can be used to provide structure for overlying skin, and fat pads in strategic positions in the mid face eg cheek bones, temples. It can be used to provide symmetry and profile balancing eg jaw line, chin, and even the nose. Or it can be used to fill wrinkles such as the nasolabial folds and chin crease. 

Depending on the filler used (I like Allergan’s Juvederm range for facial structuring and volumisation, and Restylane’s kysse for luscious lips), they last anywhere between 9-24 months. Areas with a low density filler, and lots of movement will have a shorter life span eg the lips, whereas areas requiring a high density product and with very little movement such as the temples, will tend to last longer.

For the nasolabial folds, a mid-density filler is used, but chasing these lines isn’t an ideal nor holistic treatment plan. The face is a whole, and if we are to age gracefully, all of the aging factors mentioned above must be treated and considered in a 3D approach. Let’s work our way outside in.

Skin health

Good skin quality is not an overnight event, nor exists there a single solution for flawless skin. However, there are a few basics that, when consistently applied, can give you that healthy, youthful glow. These are outlined below:

1. Stay hydrated- you’ve heard it, read it and known it for so long. Now just do it. 30mL/kg per day on an average day. If it’s hotter or you’re exercising, add on 500mL.

2. Drink collagen- from the age of 25 onwards, our body does not produce enough collagen to meet the demand. Our skin is made up mostly of collagen fibres, and so to age gracefully, simply supplement.

3. Use sunscreen- please? No matter what your skin type or tone, from Scandinavian pale white, to Nigerian dark skin, every tone can benefit from daily, repeated use of SPF 50, or more. One that prohibits UVA, UVB and visible light is key. Photo damage by these light sources is one of the leading exacerbators of premature aging. My personal favorite brands are Isdin and Heliocare. Both have a great texture, don’t leave a white residue and don’t leave the skin oily.

4. Invest in good products- there’s a saying in Afrikaans that I love, “goedkoop is duur koop” which can be loosely translated as, “cheap purchases are actually expensive “. I 100% stand by this, especially for skin health. When you try take shortcuts or price cuts, the expectation is never met and you end up buying the more expensive product later, anyways. We are fortunate to have exceptional, South African medical grade skin care solutions, in practice and online. The initial cost should be seen as an investment into your skin, that will help your Botox, fillers, peels etc look better and last longer. And no, dove soap doesn’t fall into this category, so stop using it.

There are a multitude of in-clinic therapies that can be employed to assist with improving skin quality, texture and tone. These include but are not limited to mesotherapy, micro-needling, chemical peels, Biostimulators (e.g. profilho), PRP facial (vampire facial), fractional laser (Nd:YAG), and Carboxytherapy.

Soft tissue

Overly strong muscles cause dynamic wrinkles. A prime example that is universal, is the frown. It looks good on no one and only makes one appear sad, mad, bad or tired. It’s one of the first areas we tackle in aging and is best treated with botulinum toxin (Botox). This causes a non-permanent muscle relaxation and an inability to frown. Voila.

Other commonly treated areas include the forehead lines, crows feet (peri-orbital lines), bunny lines of the nose, gummy smile and the chin. Botox can also be used as an alternative to filler in the lips, as a lip flip. This specialized technique helps the lips to turn out, without a drop of filler, resulting in a totally natural, ‘untouched’ but full look.

The various fat pads that shift, atrophy or hypertrophy require a little bit more invasive procedures such as dermal filler, fat transfer and threads. These techniques are used to reposition fat pads to their Once youthful position. As for the boney elements, a high G prime filler is definitely the answer, or plastic surgery implants (eg for chin Augmentation).

To fill, or not to fill?

Taking all of the above into consideration, my best recommendation would be to start with the basics of skin health. Consistent application produces consistent and significant results.

 

Fortunately, aesthetic medicine is very personalized medicine and there is not a, “one-size fits all”. Whether you decide to fill or not fill, make sure you find a good, certified aesthetic doctor, build a trusting relationship with them and, consistently apply the basics. Future you will thank you.

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]]> Struggling to lose weight? This one’s for you. https://drveevee.com/2024/04/28/struggling-to-lose-weight-this-ones-for-you/ Sun, 28 Apr 2024 14:58:12 +0000 https://drveevee.collectiveshift.co.za/?p=482

April 28, 2024

Struggling to lose weight? This one’s for you.

Categories:

Lifestyle, Women's Health

This is one of those topics that hit very close to home and personal health journey- how can we lose that stubborn weight? And are there any natural supplements that aid in weight loss? As an adult that struggled with childhood, adolescent and adult obesity, I hear you loudly and clearly. In this post, focus a gut health and feeding your gut microorganisms through things like apple cider vinegar, prebiotics and fermented foods to lose weight and discuss a recently published question, is a calorie a calorie? I am super excited about this topic as I believe it can add immense value to your life so without delay, let’s jump right into it!

Measure tape for weight loss concept

The weight loss industry is worth 260 billion USD and is estimated to be at 532 billion USD by 2032. Each shareholder always postulates that their product is the best and that a silver bullet- usually their product- can solve all our problems. Now before we get into the juice of this I need to make one thing clear- there is no silver bullet, no one solution that causes permanent and significant weight loss.

Even bariatric surgery has a long term failure rate of 10%. In other words, even the surgery where a portion of the stomach is cut away forever is not a silver bullet. But with the emerging evidence surrounding gut health, there are a lot of promising solutions. Before we get there, let us discuss two macronutrients we know and desperately try to avoid (wrongly so) on our weight loss journeys: Fats & Carbohydrates.

So calories in versus calories out? YES. BUT, a calorie is not a calorie.

Dr Robert Lustig a neuroendocrinologist professor in the USA and he has published research that shows the calories you consume are not all absorbed. A fat is not a fat.

A good example he has made famous is regarding 9 calories of Fats. 9 calories of omega 3 is cardiopreotective, neuroprotective and is directly absorbed into the blood stream. Versus 9 calories of trans fats which is a highly processed form of fat commonly found in easily accessible foods which our bodies CANNOT process because we do not have the enzyme required to break down the molecule and turn it into energy. This then accumulates in our arteries, brains and hearts and is directly linked to atherosclerosis and cardiovascular disease.

With regards to CARBOHYDRATES- a sugar is not a sugar.

Glucose is the energy of life. Every single one of our ten trillion cells burns glucose for energy. Our brains are solely reliant on glucose to perform its functions @ 5grams per hour. Our bodies desperately need glucose so if we don’t consume enough, our bodies will make it from the foods we consume, particularly free fatty acids. We also need glucose for hormonal balance and the formation of hormones. Glucose causes increase potency of hormones, including thyroid hormones, oestrogen, progesterone and testosterone.

Fructose, on the other hand- also a carbohydrate- is the enemy of life. This extremely sweet molecule is found in 73% of all foods in the food industry. It is an addictive sugar, and activates the nucleus accumbens or reward centre for the brain, in the same way that cocaine, heroine, nicotine do. We do not need it. What is an astonishing fact is that since the beginning of the last century, our consumption of fructose has increased by 25 fold.

 

Not only is it addictive, but ironically, it inhibits energy production. Fructose inhibits 3 enzymes that enable normal mitochondrial function. For those that did not have biology in high school, mitochondria is the energy producing organelle of a cell. So in other words, what was previously thought to provide energy to cells, especially because it is a carbohydrate, actually inhibits energy production. Worse of all, fructose has a cumulative effect. So one packet of a highly processed food isn’t going to kill you. But a decade worth of consistently consuming these foods will increase your co-morbidities such as diabetes, hypertension, high cholesterol etcetera.

 

Just to touch on the macronutrients protein- why were a fan in term so of weight loss efforts is…

 

10% of everything we eat goes to maintaining normothermic temperatures.

 

When we consume protein dense foods, more energy is required to convert it into ATP and maintain normothermic temperatures. So when we eat high protein dense foods, we burn more energy turning it into usable energy than carbohydrates.

 

Also protein in terms of muscle in the body is more metabolically active, so it burns more energy than fat. If you are actively building muscle and struggling to lose weight, please keep going. Muscle weighs more than fat and is more metabolically active so energy burning than fat. Exercising to build muscle has incredible long term benefit. This is sort of the thought behind muscle centric medicine which has incredible long term anti-aging and pro health benefits.

Young Women Exercising In Nature

One of the hot topics in medicine and the media at the moment is this thing called gut health.

 

As we pivot from the calories we consume onto our gut health, I really do want to address and answer the question- what supplements can we take to aid in weight loss?! Not just any, only those that are actually effective and have evidence to back their use. Most of the emergening research is focusing on gut health. So say we’ve been on a high protein, low carbohydrate diet and it worked well at first, then we plateau. Why?

 

Well, it mostly has to do with the change in our gut microbiota. If you are not actively using that protein as in weight lifting and strength improving exercises, that protein remains unabsorbed in your gut where it disturbs and disrupts trillions of microorganisms that are collectively known as microbiota.

Green detox smoothie, concept of healthy nutrition and healthy lifestyle

These microorganisms need to be fed and kept alive, almost like a tamagotchi (for any of my millennial friends listening). These little organisms are responsible for absorbing nutrients, creating immune function and even creating hormones that influence our mood such as serotonin and dopamine. Around 70% of our mood hormones are formed in the gut. They are also responsible for our metabolism, along with various other controls. So if we aren’t feeding them and keeping them healthy, we’ll end up with things like leaky gut syndrome, depression, weight gain and fluid retention, amongst other things.

 

The bad news is most of the food we consume, even when low calorie, do not feed these organisms, and they get upset and will either cause us to maintain our weight OR gain weight. So in order to lose weight, we need to nurture and take care of these organisms.

 

How do we support these organisms for weight loss?

  1. Increase fibre intake- if we had to bring a favourite meal to your tamagotchi microorganisms, it would contain just fibre.

  2. Diversify the diet

  3. Implement probiotics

  4. Add fermented foods

  5. Limit alcohol, sugar and processed foods- the natural killers for good gut health

  6. Prioritize sleep and stress management (more on sleep coming soon…)

Pills box for daily intake of vitamins and medicines.

What about supplements we can take with proven weight loss benefits?

The first one is commonly found in most of our kitchen cupboards- apple cider vinegar.

Apple cider vinegar

Causes delayed gastric emptying, increased utilization of glucose, and increased lipolysis- which is the breakdown of fat. It has no side effects, and effective weight loss and fat loss results are seen with as little as 5mL per day.

Fulvic acid

Fulvic acid is a compound that forms when foods break down. It might block reactions in the body that cause allergy symptoms with its interaction with histamine release and prevents water retention ands swelling. It has natural antiviral, antibacterial and anti fungal effects, is a major anti-oxidants that scavenges free radicals, so can effectively treat fatigue, and most importantly ito our talk today, it supports gut health. Depending on which brand and where you are getting it, 15mL: or two capsules are the recommended daily dose.

Prebiotics

Is often a specialized fibre that promotes the activity, growth and health of gut microbiota. E.g. inulin, pectin, beta-glucans.

Probiotic

These are the Friendly, good and healthy bacteria that are killed when taking antibiotics. So if you have a severe infection necessitating antibiotics that your Dr has prescribed, please always take a probiotic at the same time.  Synbiotic is the combination of a pre and pro biotic.

Collagen

Is the most abundant protein found in the human body and production thereof, as we know, starts decreasing from age 25. Collagen is essential for skin structure, bone structure, joint health and cartilage. Our favourite supplement also helps the gut heal.

Collagen has essential amino acids acids that assist in repairing the gut lining damaged by the foods mentioned earlier. Best of all, it feeds the gut microbiome by providing essential nutrients. Thus our gut microbiota is able to effectively absorb nutrients, process foods, maintain glycemic control and helping us lose that weight we have been struggling with

 
 

There you have it. I wish I knew this twenty years ago, but that is the joy of medicine and how the research keeps evolving and enlightening us to natural solutions. It would mean the world to me if you could share this with people in your world that it might help. I love love love hearing from you! Please send me a comment and let me know what other topics you’d love to know more about. Till then, take care. 🙂

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]]> Is Male Menopause a Thing? Spoiler Alert! Yes, it is. https://drveevee.com/2024/04/28/is-male-menopause-a-thing-spoiler-alert-yes-it-is/ Sun, 28 Apr 2024 14:10:03 +0000 https://drveevee.collectiveshift.co.za/?p=399

April 28, 2024

Is Male Menopause a Thing? Spoiler Alert! Yes, it is.

Categories:

Men's Health

The past few weeks I’ve noticed an increasing amount of an undiagnosed condition that we just don’t speak enough about. For many people- men and women alike- male menopause is a myth. In this week’s blog post I would like to bust this myth and introduce you to SUCH an important topic that you, or your male friends and family member might need to hear more about- Andropause aka Male Menopause.

Attractive fit man running fast along big modern bridge

What exactly is Andropause?

Andropause is the result of decreasing and insufficient Testosterone levels in men and usually presents from 40 years old and onwards. 90-95% of all Testosterone produced in men occurs within the Leydig cells in the testes and as men age, this production subtly and gradually decreases resulting in the clinical syndrome of Andropause

What is important to note is that Testosterone receptors are found all throughout the body, including in the brain, and as such, this hormone is responsible for multiple functions including memory, sleep, motivation, energy levels and sex drive amongst other things. Andropause is often considered an unavoidable consequence of aging and that’s not true- there are multiple ways to treat Andropause and help you get your groove back.

“Male menopause, often overlooked and misunderstood, is a real and treatable condition. Recognizing and addressing Andropause can restore vitality and improve quality of life, proving that men’s health issues deserve attention and care.”

Free Vs Bound Testosterone

Now, to activate these testosterone receptors one needs free testosterone. Free testosterone is any amount of testosterone not linked to a binding protein, usually 1-2%. Like most other hormones coursing through the body, most (98%) Test. Is transported by two major proteins- Sex hormone binding globulin (SHBG) and Albumin. As we age, our SHBG naturally increases which means it binds more testosterone, leaving less free testosterone to work on receptors and achieve its function. When we look at treatment modalities for Andropause later, this will become important.

Why does it go undiagnosed?

Some of the common symptoms of Andropause look a lot like clinical depression, and include tiredness, lack of motivation, irritability, poor sleep quality, withdrawal from usual physical and social activity and weight gain or difficulty losing weight. Both of these conditions have a subtle and gradual onset, and both often have no identifiable stressor that triggered these feelings. Both should also not be taken lightly and require diagnosis by a medical doctor. It is usually in blood tests that they are differentiated.

There are other common symptoms that accompany Andropause such as a decreased capacity of physical endurance. This is directly related to decrease muscle mass and strength that accompanies Andropause. There is also an accumulation of fat around the waist (hello, beer belly), with thinning arms, a flattened bum and male patterned baldness. Think Homer Simpson. Underlying the outer changes is also a weakened bone structure and density, resulting in osteoporosis.

Feeling off?

Because of the natural decline in Testosterone occurring over a decade, it can be hard for men to pin point as to why they feel, “off”. This then leads to trying to compensate for this phenomenon and cue the “midlife crisis” of excessive spending and risk taking behaviour, trying to regain a sense of normality and masculinity. This is another area that is greatly affected by Andropause and usually the only way low testosterone levels are diagnosed- sexual symptoms.

These include lack of sex drive, erectile dysfunction that is inconsistent and intermittent (I.e. not permanent), along with a lack and decreased intensity of climax. Now these symptoms of can also be caused by other conditions such as diabetes mellitus, high cholesterol and high blood pressure so if you identify with any of the symptoms above, please go see your doctor.

Thoughtful man standing by window

Getting diagnosed

First things first, if you can relate to the above symptomatology (or known someone that meets the above criteria) you can complete an A.D.A.M. Questionnaire which stands for, “Androgen Deficiency in Aging Males”. If you answer yes to Questions 1,3 and 7, there is a strong correlation with Andropause, with high sensitivity and specificity. Please go see your doctor who will then do further blood tests. I recommend an annual check up for every person over the age of 40 where most chronic diseases start rearing their heads for preventative and curative health.

I have Andropause, what now?

So glad you asked. Remember that SHBG we spoke about earlier on with free and unbound testosterone? Something that naturally increases testosterone levels by reducing SHBG is Nettle Root, a totally natural adaptogen that can assist with Andropause.

Testosterone can be safely and effectively replaced. When we speak about testosterone, it is not to be confused with the bulking hormone used illicitly in gyms and locker rooms around the world. Those are anabolic steroids, that are uncontrolled and unregulated when they are produced, meaning they are unstable and have an unpredictable response. They usually cause bodily nodular acne, mood swings, and aggression. They are to be avoided, especially during Andropause.

Bioidentical Testosterone is the replacement I am referring to, which is molecularly identical to the natural testosterone found in humans. There are various forms it can be taken, including weekly injections, injections every 3 months, gels, creams and even patches. I have found the 3 monthly injections and creams to be the most effective, but please ask your doctor for an individualised treatment plan.
 
Andropause, treated
 
Benefits of treating Andropause are fairly obvious, you get your life (and mojo) back! This means increased energy levels, improved motivation towards work, social life and relationships. Replenishing testosterone helps with improved muscle density (size) and strength; it could also assist with getting rid of that belly weight you’ve been trying to lose. Bone density, red blood cell count and overall vigour for life improve with correct dosing intervals and the correct mode of treatment.
Portrait, hug or mature men in workout gym, training exercise or healthcare wellness in success cel

Male menopause feels like one of those taboo subjects that nobody speaks about, and thus, so many men go untreated. Personally, I find this devastating, because I know the solution to be simple and effective. I have seen the amazing life effects of properly treating Andropause in my patients, which affects every area of a mans life (especially in the relationship area). Relationships can be restored, and the “kefi” for life restored through proper diagnosis and treatment of Andropause. 

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