Health Check: Melt Away Your Fat Just In Time For Spring

Author: S. Manjula Jegasothy MD

The information discussed by the hosts and guests on this talk show is meant to be informational only listening or calling in to ask questions for our guests does not create a patient doctor relationship rely on your own doctor or healthcare providers medical advice to treat or diagnose any conditions you may have nothing disgusting miss talk show is meant to replace your doctor's medical advice you should never stop your current medical treatments or delay getting medical treatment because of anything presented in this program if you want more information about a medical condition or treatment discussed on this program talk to your doctor it's time for health Jack with Heidi Gutman a daily dose of health and wellness information call or text ID your question and 373 1220 that's 37 312 running and now here's Heidi Gutman everybody welcome to health check I'm Heidi Godman hope you're doing well on this fabulous day we have a very very interesting program lined up for you today it is Monday and so on mondays we like to do our weekly brain boost and that means later on in the program we are going to be speaking with prominent neurologist Dean sutherland dr dean sutherland great friend of mine and he's on the show every monday and we talk about some really interesting things today it's going to be something that may be sort of a game changer in the world of ADHD now this is sort of an umbrella term for a number of different conditions that can fall under this it's the official name is attention deficit hyperactivity disorder ADHD but you may just have an attention issue when it comes to to focusing and things like that you may have a hyperactivity issue or you may have both so we're going to be speaking about ADHD you should sometimes if you just had that the attention issues sometimes just used to be called a DD but we're going to be talking about a new study that suggests people with ADHD have differences in their brain and in the brain structure and this is really important because a lot of folks who have kids with ADHD the parents are accused of will not parenting well or the child is accused of being lazy this has happened in our own family we have two kids in our family my nephew and my son Chris and these kids have ADHD two very different cases of it my nephew has a different kind than my son but if if they weren't working with teachers or people who really were familiar with their conditions sometimes there was a real tendency for people to just say well you know it's this or blame this or that not everybody understands a lot about ADHD and some people just are likely to chalk it up to something else and as health reporters my husband and I have been fighting this fight for a long time but now there is a new study the beans going to be talking about in our weekly brain boost that suggests again but these are brain changes structural changes to five different regions of the brain so we're going to find out about that and we're going to find out what kind of difference that makes and what this might mean we're also going to be talking today about some developments in the world of aesthetic dermatology and cosmetic dermatology so we're going to be talking about lasers that can melt fat we're going to be talking about ways to grow hair using plasma platelet-rich plasma and you may have heard of this PRP and people say that it's great for all kinds of conditions and one that we're going to talk about today is hair growth we're also going to be talking about lip line filler now those would think you should give a try is there any risk to them what about all of these things today of side effects is it too expensive what does it mean should you do this is it really just a cosmetic thing or does it go a little bit deeper we are going to find out more about that and joining us is my good friend Dr. Manjula jega Sophie she's founder of Miami skin institute she's an aesthetic dermatologist trained at Harvard and Yale and she's also an associate professor of dermatology at University of Miami med school med school of medicine and she is here with us today how are you doing mention thank you I'm doing great Heidi happy Presidents Day yes and to you too so so glad that you are here with us today so we are talking about some very very interesting things today and the first one we're going to talk about I kind of like it in the in the terms of a gadget because when I was a TV reporter I always loved going into the operating room and and getting to show our viewers the latest and greatest cool thing so anytime I hear the word laser I think that's super cool and then when you know you put fat melting in front of the word laser I think that's really great but we've actually had you know I think of Star Wars but it's not like that at all and we've actually had lasers for quite a while right yes and this machine actually is one of the newest it's literally only three or four months old and each is radio frequency so remember we had that discussion I think on our last show that the difference between radio frequency machines which we call them devices which are in the light spectrum so this is actually a device and it is kind of Star Wars II because you fit under this sort of hand piece but the u-shaped almost like a it literally looks like a hand and it uses the radio frequency to melt the fat and it never touches you that's amazing so how does it melt the fat does the fat come back do you feel anything I'm so many questions I'm sure so it sends the radio system system EU shape it basically sends the radio waves in a crisscross fashion that bends and you place it about an inch away from the patient's skin so basically what that does is that they would sort of engineered it so that then all of those Chris classes meet at a certain place that's about to about one to two centimeters below the skin surface so that you don't have any heating on the skin itself which is where all the nerve endings are and which is where you can get burns or blisters and it goes directly to the fat cells which have no nerve endings so there's no pain I mean there's no there's no burning or anything like that and it literally heats up the fat cell layer without heating up the overlying skin it's amazingly painless and you feel you know you're the fat heating up fifth time goes on the procedure takes about 45 minutes and you feel it heating up as time goes on but the skin never heats up and you never get any burning now where are we talking about using this laser so this laser you know we've talked a lot about que Bella over the last few sessions are less few toxins you know that's sort of thinner people with the BMI body mass index of less than 25 this is more for you know moderately to overweight people so and it can be used their different hand pieces I have large hand pieces for the stomach and hips I have large pieces 10 pieces for the back and then I smaller ones for the size and should be armed now is this known as laser lipo is it getting that reputation or is that something different laser lipo is a specific it's sort of the late term for a specific combination of treatments with the machine called the like both phonics machine that machine uses ultrasound but you actually are performing liposuction so that's an actual surgery where you know the surgeon makes a little hole and puts in a cannula that has this ultrasound technology and he uses the ultrasound to break down the fat cells and then that makes it easier for him to suction it out without you know having to do a lot of that gaming I don't know if you've ever seen a liposuction procedure but it's quite vigorous oh yeah it's a disturbing I would say yeah yeah yeah so the vigorous is a kind word so anyway so the lifeless onyx makes it so that the surgery is less vigorous and so you have an easier down time with bruising etc like I said before this machine is revolutionary because it's the first one that does not touch the skin at all it does not touch the patient now I do remember reporting on something about 10 years ago may be called Zerona you remember that one and that way yeah that was also didn't touch the skin maybe it worked in a different way yes but so that one has data isn't great and so it's kind of fallen by the wayside compared to the newer devices you know it doesn't an interesting machine in that kind of it early you might have remembered but you chorley had a set chef like a red light that's the low-level LED light which we're using now is really at home technology people can use it cuz after pimples at home there a lot of things like that because it's very low level but it's they didn't really give give us much results so it's kind of fallen out of favor with the aesthetic doctor but it's important to say that this uses radio frequency which is a much different technology and my higher energy levels do what about other are there any risks associated with it the only surveyed thousands of patients in their most recent FDA studies and the only risk is that you can occasionally if you had assists under the surface of the skin or an ingrown hair or pimples that can form a blister and that's the only thing that can happen and those blisters typically resolve within a week with no pigmentation issues or anything like that and that unfortunately you know we can't see if you have a deep ingrown hair or something but if you have something that's superficial then we can avoid it by adjusting the laser so it's not hitting right where that ingrown hair is ok but really cool development that you know we have ways to just melt fat how long does it last do we know how long it lasts so essentially the fat cells that this machine destroys on any given treatment that's permanent but we don't get all of the fat cells so if you gain weight if you eat a lot and gain weight the other fat cells you have will grow larger so your overall appearance might stay the same so you know obviously in all of these things we want this to be motivational for you to eat cleaner and to eat better and to exercise and to do all of those things so that you don't gain weight and then you know it's technically permanent so what would be the benefit of having this done if I mean even if if you're cheating and you could still look the same what's the benefit of getting rid of some of the fat cells I can think of a few benefits right off the bat when it comes to estrogen and different things that they secrete insulin levels to so you know destroying but say we're saying in four treatments we destroy a quarter of your fat cells in a given area studies show that then your insulin levels will be that much lower and so you're that much less hungry and so you're that much more likely to eat less on a given day and then hopefully that will become your new habit and so it changes your whole spiral of the way that your metabolism works and that you eat and you're dieting and it should even continue to you know the results should help perpetuate all right so that there could be a good start of something new for someone who is just trying to control weight and maybe is wearing worried about other chronic conditions that could develop but but what about for people who just are in this purely for the cosmetic reasons they've got to go into it it sounds like no matter what the reason thinking that you're committing to a lifestyle change yeah I mean I'm hoping that everybody is and I'm hoping that even if you're not committing to a lifestyle change this will motivate you to consider a lifestyle change you know of course I think as you know as a nation we're trying to become healthier and so I don't think that people who aren't trying to eat right into exercise they're not coming to my office anyway for this treatment you know these are people who are trying in some way it might not be a successful they'd like it to be but hopefully this will give it a kick start and then also there are lots of people who are doing the best they can and still have stubborn areas you know we know as we get older especially as we're menopausal we sort of deposit fat in our stomach area due to increased cortisol levels and that felt those fat cells are very stubborn and very resistant to diet and exercise what we used to be able to accomplish in our 20s we can no longer accomplish in our 50s and so the lasers are great for things like that stubborn areas okay but then let's say that you go through a few treatments and you've gotten rid of some fat cells and you're dieting and not dieting we don't use diet but you know you've changed your diet to a healthy tinkly or if you've changed to a healthy diet and you're getting the right amount of exercise and strength training and things like that are you left fill with some faggy skin where the fat used to be now and that's why I love radio frequency at the technology in general and I prefer itself your sound for that reason is i think that radio frequency has been shown in thousands of studies of using we know multiple lasers of different brands that it tightens the skin as well even though this is a contact with laser it basically tightens the skin from the underneath because it's really hitting it at the level right below the dermis and so I'm the I've not had any patients with loose skin and neither have the studies okay alright and some people just tuning in tell us again how long does fat burning Mae West it's always permanent unless you gain weight and I'm talking significant weight you know more than 10 pounds okay so that's very encouraging now what about cost if someone is seeking out a physician to do this how much how much would you expect and also how do you find a position to do this absolutely well the easiest way to find a physician is to go on to the website but laser is called the vanquish Emmy there was an older version of the laser this Emmy version just came out in October of last year so just Google vanquish Emmy and and then it has right there find a doctor and you can find when you complete your zip code in and find a doctor the FDA studies for this machine recommended for treatments spaced about two to four weeks apart and then patients lost an average of three inches circumference in any treated areas some patients lost as much as five and six inches which is you know why I bought this laser because I think that's significantly more than other lasers we've seen in the past and they they recommend charging around 3000 for 3500 for the package of four which works out to around eight hundred dollars a treatment it all depends on where you are so it's anywhere from I'd say five hundred to a thousand dollars a treatment depending on what part of the country you are okay alright so for people who are thinking about any kind of a procedure to remove fat you know that should definitely be one that they put on their list to investigate and see if it's right for them okay very very interesting development but we have so much more to talk about going to take a quick break everybody stick around when we come back more with Dr. Manjula Jegasothy a Harvard and Yale trained aesthetic dermatologist who is the founder of Miami skin institute and associate professor of dermatology at University of Miami just so much to talk about this is health check with Heidi Godman on w sr q we'll be right back welcome back to health check I'm Heidi Godman so glad you are with us today my guest is Dr. Manjula Jegasothy so see she is a Harvard and Yale trained aesthetic dermatologist founder of Miami skin institute which you can check out by going to Miami skin institute com she's always on the cutting edge of the coolest treatments and gadgets and I love having her on because she she gives us all all different views of a particular situation and we've been talking in our last segment about fat melting lasers in the pros and cons now we're going to talk about lip fillers so there are a number of different lip fillers but why would you want to get any fillers module what is the most common cause of a need for lip fillers I mean our does everyone get those lines around the lips yes so two things you know we used to call them smokers lines but you know there's lots of people who get them just because of the way they enunciate or they use their the way they move their mouth to chew or eat or speak that gives you those vertical lines and you know even if you're not that cosmetically inclined it's terrible when your lipstick feathers or bleeds into those lines that's just you know that something people want anything done you know they can't go out in it because by the end of the night and it looked into the whole area right now sure sure and I can think of you know using a straw might give you those lines or whistling you know I remember my mom would say don't whistle talk whistle yeah you'll regret it I'll don't think your mom and grandmother told you had the real basis see how so funny the more we learn about cosmetic issues like you know the ladies who used to use the theatrical tape to tape up their necks or their you know all this stuff release it work right right well tell us a little bit about of treating lip lines because it to me it seems like it'd be very painful but how do you do it and what has the evolution of these treatments bin sure and I think what you know I want to take music st.

Philip's that they're getting more and more of them approved at an increasing rate because we're starting to see that different viscosities or sicknesses of the fillers has a very big impact on how successful you will be able to treat a certain area so Val Bella is like Restylane silk or belotero in the sense that it's a very thin viscosity filler and so it's wonderful for treating very superficial lines such as lip lines are very the most superficial laugh lines and it's also great for the body of the lip because even though it's been it gives you know it gives you a nice sort of soft very natural look okay so so how does it work when you get a filler in your lip line and how do you know if your candidate so if you have any smokers lines at all you are already a candidate if you feel like you're the other thing is especially in Florida years of fun even if you you're careful about it etcetera in certain skin types particularly fair skin causes the lipstick cave in word so a lot of people simply don't have the lip shape the mouth shape that they had 20 years ago and so if that's the case for you also been your candidate for lip fillers and the way it works is pretty simple we put numbing cream on the patients on the area that we're going to inject whether it's the lines or the body itself and then we give them ice for about five minutes before the procedure now I'm including for 15 minutes ice for five minutes and then we inject in most people with the ice find it quite manageable all right so how many injections does it take i mean are you just going to each individual line and it what is that like does it take several different treatments or or is it just one time it only takes one treatment and it used to be that lip fillers only lasted about six months but with this new generation of the pillars including vole bella you can get up to a ten to twelve month longevity which is significantly better than in the past the procedure the actual body of the list I usually accomplished in four to six objection the lines yes unfortunately we do have to inject into each line to get it precisely placed so depends on how many lines you have what's an average amount do you think for an older woman now about maybe five or six on the upper lip and maybe two or three on the lower list okay that's not too bad but it's still painful to me I don't know I'm starting to get those lines but I don't think i think i'd be too chicken to get it and so so you get this and it might last for a long time up to a year but what about is there a more permanent way to get rid of these things what do you think about the future of lasers when it comes to treating those lines absolutely i think you know it's plastic surgeons love to do resurfacing laces those you know those really strong carbon dioxide lasers that we used to do in the old days where patients would look like you know they were red and like almost like a burn patient covered up in bandages for a week to two weeks that was considered the most popular way to get rid of these lines but some results aren't very natural now with fraxel improving more and more you know each each generation of fraxel is better and better i think that that's the future of these lines is that we would do fraxel and inject this filler and then you would be able to just do fraxel treatments once a year after that and be able to maintain it line free sounds like it's getting easier to manage yes much less painful to like you said okay that's encouraging all right we are going to take a quick break before we go to the break want to let everybody know that we are speaking today with Dr. Manjula Jegasothy she is a set anesthetic dermatologist founder of miami skin institute if you want to check out what she does go to miami skin institute com she's incredibly media savvy she has facebook twitter twitter pinterest link as she does all of it and and very very interesting his podcast she does all kinds of stuff and if you are interested in finding out more again miami skin institute com when we come back we're going to speak with Manjula about PRP platelet rich plasma for hair growth this is health check with Heidi Gutman on w sr q we'll be right back you welcome back to health Jack I'm Heidi Godman time now to talk about something called platelet-rich plasma now you may have heard about this using your own platelets from your own blood and doctors can sort of spin them out of your blood and then use a very thick concentration of platelets to inject them into injured tendons or ligaments or muscles or joints and the studies have kind of been mixed on whether or not it can help you reduce pain and and regenerate the healing it appears that maybe it is promising for tendon injuries and things like that but we are still trying to find out how effective it is when it comes to healing other joints but what about using platelet-rich plasma to regrow hair this is a very interesting development and I have seen and interviewed patients who've tried it and it's worked for some people my guest today is Dr. Manjula who is an aesthetic trainer Susan aesthetic dermatologist trained at Harvard and Yale she's also an associate professor at University of Miami School of Medicine founder of Miami skin institute so such a long title manjula for such a wonderful person and thank you so much for being here with us today so PRP for hair growth this is something that you're doing more and more yes as you mentioned you know PRP or platelet rich plasma i think is Cena the organic treatment of the future if lasers of the electric treatment of the future then this is the organic treatment of the future you know it's a great thing because it really harnesses the patient's own blood so there's no risk of any sort of foreign body reaction or anything you know if anybody's we we've demonstrated that Botox and fillers and all ages are very safe but this is something that's definitely faced because it belongs to you and essentially what we do is we take the patient's blood and we spin it in a centrifuge which is a machine that makes it go around very rapidly and it breaks open the platelets the platelets have all these growth factors that are in them but are not able to work until we actually need them like when you get a cut that's why when you get a cut immediately the platelets come to the scene because any of all these growth factors in them to heal the gut and so this way you think we're just opening up those platelets and then injecting them into various areas for the podiatrist they're doing it for plantar fasciitis the orthopedist are doing it into joint after joint replacement and then we're doing it as dermatologists into the scalp for hair growth because anything that the growth factor will help grow hair so that's basically the theory behind it I'm seeing typically that a lot of a lot of people scalp issues or hair growth issues or hair loss issues can be related to scalp health so at first the big thing we're doing is we're nourishing and supporting the skin of the scalp so that it's much more healthy and much more productive and more likely to grow better quality hair and that I find very useful in women who are experiencing hair loss after pregnancy or childbirth or after surgery or some sort of trauma like that a motor vehicle accident all those things that really cause metabolic disturbances and so then first thing the response to that is the hair and so I help those patients get through that sort of bump and then you know then their own mechanisms take over and they grow their normal hair again but that first year after having a baby can be rough and so I do it for that for men a lot of balding interest on 28 and so that's harder to combat with something like PRP but if we catch a guy when it's in this very early stages of their loss if we you know do the PRP maybe once a year it can sort of delay the onset or the you know the rapid balding phase by five years or so is it going to stop it now I doubt it'll stop it because as I said that testosterone mediated so we would need to figure out a better way that's how propecia works is it testosterone blocker in the scalp but we would need to find something that would do something or specifically blocked the testosterone receptors in the scalp for male pattern baldness for it to be really effective I really love PRP for all these other causes of hair loss that are not hormonal better that are really related to like I said the traumas are you know you know upheavals in the body like surgery or pregnancy or even breastfeeding which up in a metabolically very taxing for for the woman mm-hmm and don't you have to catch it you were saying and you have to get in the early stages while the hair follicle is still there and while it is actually capable of producing a thick terminal hair with men as they start to bald progressively the actual hair follicle changes it becomes miniaturized and so it is only capable of producing a miniature hair such as on the order of like smaller than an eyelash so you can't ever get that follicle to grow normal hair so that's why you need to catch them early so if you already have areas of baldness or just an it's smooth skin now and no hair there a PRP is not going to bring it back no and then knowing you said about areas of baldness so you know those patients that have alopecia areata where they have you know patches evolving I think that this can actually help those patients because they have a metabolic issue it's considered autoimmune but if we stimulate those hair follicles we might be able to overcome the immune factors that are blocking the hair growth in those places and what about postmenopausal women you know some for some of those women and it's hormonal rate related but for some of them are my little bit hastening also a body it's more see for men it's really testosterone mediated for postmenopausal women it's that all the other things that are going on in your body because of the hormonal people is causing this so it's not directly estra generated so it's more treatable with PRP I'm getting very good results in postmenopausal women yeah so that's what I was going to ask what are you seeing in your office so I'm seeing mostly p.m. Women who've just given birth and having that what that you know that post baby hair loss for the year and you're not sleeping properly all those things contribute you know so I'm seeing those women I'll do two or three treatments they grow back their hair much more rapidly and then their body takes over I've seen people who had surgery or some kind of like I said some big upheaval like a motor vehicle accident or something like that and they've they're losing hair from that or you know some people who are just you know having an incredible incredibly stressed out time in their life they lose hair for that this helps bad and then I'm seeing women who are postmenopausal we're just losing hair because of all the other things that are going on at their body does it ever not work I haven't had a patient who it hasn't worked to some degree on you know people disagree on how much they want it to work in terms of you know what they're willing to pay for it the study so far they've been I think three or four large-scale studies in the dermatology literature in the last year or so showing an average of about thirty percent hair growth in most patients so that's pretty much what i'm seeing i've had a couple of patients who've experienced as much as forty to fifty percent hair growth after two it up to two sessions I usually don't have to do more than two sessions on most of these patients who are having you know a temporary stressor in their life the postmenopausal crowds I just generally do them about once a year and you know they think it's better and they're happy with it but I haven't quantified those results sure sure but if you stop getting it then it stops working right you know that's unclear that's what's nice about it because it's not like Rogaine which opens up the the blood vessels and and gives the hair more nutrients that's kind of that concept to the insert stops working when you stop using the Rogaine here you know I've sort of Rhys up lamented your scalp with growth factors that have gone away for whatever reason and it's possible that they might hang around for a really long time we don't know that hmmm all right and what about cost for something like this I charge five hundred dollars a treatment session for the entire scalp okay all right I've heard of places where it's much more expensive than that and and you know that is happening in so many different doctors offices if you do specifically want to get it for hair loss or thinning hair you should only go to a dermatologist right I I think a board-certified dermatologist yes I think that you know here treating the hair and diseases of the hair is a really a dermatology specialty issue so the reason you want to go to a board certified dermatologist is because we can we can diagnose what is the reason for your hair loss you know it may not just be hormonal it may not just because you were pregnant and so that's why you need to do that because you may actually need some other kind of treatment and that's why I think best not to go to it to a non-physician for this turn all right well there's so much to know about it and thank goodness that you are there to give us some insight and we sure appreciate it Dr. Manjula Jegasothy thank you so much i'll give everybody your information so great to talk to you wonderful thank you i D okay I have a great day you to talk to you soon everybody again that's Dr.

Manjula Jegasothy she's an aesthetic dermatologist trained at Harvard and Yale and she's the founder of Miami skin institute you want to check out more information about her go to Miami skin institute dot-com or university of miami school of medicine the Miller School of Medicine where she's a clinical associate professor of dermatology we are going to take a quick break when we come back we are going to talk about potentially a game-changer for ADHD this is health check with Heidi Godman on w sr q we'll be right back yeah walkman birthday I'll be around the state are you to see I'm about to go and then you'll know don't leave me.

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