A Botox Day Helps Keep the Scalpel Away.

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Botox and Fillers are all excellent non-surgical procedures which can help delay the need for plastic surgery. As a surgeon I love “hot lights and cold steel” as much as the next, but I think it is so important to remind patients of what regular maintenance can do to delay the need for surgical intervention. Although this concept is applicable for all patients, I find that it is even more important in my patients of color who have more melanin, or patients who have been genetically blessed with genes that make them age more like vampires than humans. If you are one of these people regular maintenance with Botox and Fillers is an excellent option for you! Facial Aging

  1. What Causes It?

 As we age our skin looses its elasticity and collagen content and of course day-to-day damage from the sun and smoking are also major factors in the aging of skin. The amount of melanin in your skin determines the darkness of your skin tone but most importantly confers a certain level of in built sun protection that can help to decrease aging changes.  Now this doesn’t make you exempt from sunscreen, but it certainly helps. Because of the increased melanin many of my patients of color are lucky to age more slowly, which means that with just a little bit of regular maintenance surgery may be delayed for decades to come!

Common signs and causes of aging.

Common signs and causes of aging.

  1. What Are the Warning Signs?

 iStock_000015868296XSmall-300x232_FotorAs we age we all start to notice early signs such as fine lines on the forehead and around the eyes. Those occur because the skin is connected to the underlying muscle; over the years that crinkle around your eyes as you smile, those lines between your brows as you frown, and that wrinkle your forehead as you question gradually cause fine lines then wrinkles. The other culprit is volume loss. As we age we gradually lose volume in our faces. Common areas involved are around the eyes and lips, and between the nose and the mouth (nasolabial folds), and the mouth and the jaw (marionette lines). As this volume loss occurs and the skin loses elasticity we develop wrinkles, shadows, and folds. 

  1. Prevention

A little can go a long way in terms of prevention. I strongly recommend treating those fine lines with Botox before they become deep wrinkles, and restoring that volume loss with filler to help prevent deep folds. This type of maintenance may delay the need for eyelid surgery (blepharoplasty) and face lift surgery for years to come. You are already accustomed to doing it for our hair and nails, but how much more important is maintaining the health and youthfulness of your face! So what can you do?

  1. Botox    

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Botox is simply one brand name for a family of neurotoxins that have been used for medical treatment since the 1980s. It works by blocking the signal facial-muscles-and-wrinkles_Fotorbetween a nerve and its target muscle resulting in decreased muscle activity. As the muscle activity is inhibited fine lines and wrinkles become less visible and actually may fade with time. Botox rules for the upper part of the face; it is great for forehead lines, frown lines between the eyebrows (the “11s”) and around the eyes (Crows feet). The effect can be seen within 1-2 weeks and lasts for approximately 3-4 months. I believe in a softer natural look that allows you to still show facial expressions but without all those pesky lines. The good news is that regular preventative maintenance with Botox can be helpful in counteracting permanent wrinkles and who doesn’t want that?

Common side effects: mild tenderness at the injection site, temporary bruising and swelling.

2. Fillers

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There are many different types and brands of fillers including Belotero, Juvederm, Juvederm Voluma, Restylane, Radiesse and Sculptra. Many of these fillers are temporary but a few are cosmetic-fillers1_Fotorpermanent. As you may have guessed from their name fillers function by “filling in” the lost volume which causes the folds and deep wrinkles on your face. Fillers are useful for many parts of the face such as the tear troughs which causes some of the shadows and the tired look under the lower eyelid. It is great for the volume loss many of us see over the cheeks, the nasolabial folds, and the marionette lines. The effect can be appreciated immediately and on average lasts for 9-12 months for most of the temporary fillers and at most 2 years for Sculptra a great new product for volume enhancement of the cheeks.  

Common side effects: mild tenderness at the injection site, temporary bruising and swelling    

Your plastic surgeon can help you customize your very own maintenance regimen. Because a Botox day…you know the rest…

Waist Training, Liposuction or Tummy Tuck: What happens during surgery? (Part 2)

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Many of us male and female alike can remember those years in our teens and twenties (30s if you are lucky) when our tummies were flat and we didn’t have to worry about that extra “pouch” under the belt line. At that time you did not have to answer the over or under question: Do I put my belt over or under this pouch? With increasing age fat tends to want to deposit in certain areas of our body, the lower abdomen in particular is one of the usual suspects. We all want to be narrower in the mid section, so how can it be done? Our last conversation exposed the truths and fallacies on waist training and exercise waist training (it does not give you long-term results) and who is a candidate for liposuction or tummy tuck procedures. If you missed it check out Waist Training, Liposuction or Tummy Tuck: What really works (Part 1). Liposuction and tummy tuck procedures provide surgical options for narrowing that waistline. If you are considering liposuction or a tummy tuck procedure you should learn more about what the surgery entails.

What is Liposuction?

 Liposuction is a cosmetic procedure that can be used to reduce specific areas of fat that are resistant to diet and exercising. Common areas of concern are the abdomen and love handles; but the chin, back, hips and thighs are other areas which can also be addressed.

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Liposuction Animation Video – ASPS: Click on photo to view.

  1. Tiny incisions are made in the skin to give access to the underlying fat
  2. A fluid solution is infiltrated into the fat. This fluid consists of IV fluid, epinephrine to decrease bleeding, and sometimes local anesthetic for numbing.
  3. Liposuction cannulas are used to suck out the fat.
  4. The incisions are closed.
  5. After surgery most patients return to work in 1 week.   Patients wear a snug “spandex style” compression garment over the area of surgery to help decrease swelling and speed up the healing process

What is a Tummy Tuck (Abdominoplasty)?

A tummy tuck (abdominoplasty) is a cosmetic procedure that improves the appearance of your abdomen. There are 6 steps:

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  1. We make a lower abdominal incision that can be easily hidden by your favorite undergarment or bathing suit.
  2. We lift the skin and fat above the abdominal muscles all the way from your lower abdomen to your rib cage.
  3. We repair the rectus diastasis by tightening the abdominal muscles, similar to lacing up an internal corset.

    Tummy Tuck Animation - ASPS: Click on photo to view.

    Tummy Tuck Animation – ASPS: Click on photo to view.

  4. We pull down all the excess skin and fat and remove it.
  5. We bring your belly button out through a new hole in the skin (it remains attached to the same place on theabdominal wall)
  6. We do a beautiful plastic surgery closure.
  7. After surgery most patients take two weeks off from work. There will be some swelling and bruising which will temporarily mask the final shape of the abdomen, but the final shape can be seen at 3-6 months after surgery.

 

Is a Panniculectomy the same as a Tummy Tuck?

No. A panniculectomy is a reconstructive procedure that is done for improvement of symptoms like severe rashes, skin infections, and difficulty with daily activities such as walking due to a large amount of overhanging skin and fat. This procedure is done most frequently for people who have had massive weight loss, think celebrities like Al Rocher and Star Jones. Unlike a tummy tuck this procedure may be covered by health insurance. There are 3 steps:

  1. We make an incision just above your lower abdominal fold.
  2. We remove all the excess tissue and skin that is hanging over that fold, nothing more. The belly button is not brought out through a new hole in the skin; it remains in the same position. This means that the belly button may end up close to the incision, or even be removed if it is hanging over the fold.
  3. We do a beautiful plastic surgery procedure.
  4. The recovery is similar to the tummy tuck (look above).

Don’t forget that you can eat your way right back out of your tummy tuck; after we have done our part to give you a flat tight tummy you still have to do your part to maintain it. So protect your investment by watching what you eat and hitting the gym. To learn more about what to expect after tummy tuck surgery visit us at Morehousehealthcare.com.

Waist Training, Liposuction or Tummy Tuck: What really works? (Part 1)

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Patients are always asking me about the effectiveness of waist training; Jessica Alba, Brooke Burke and Khloe Kardasian swear by it, but recently after Kim Kardashian posted an Instragram photo showing herself all cinched up in a waist trainer it seems like the questions have really been flying. Does waist training really work? What can I do to narrow my waistline? Here are the facts.

Left: Classic tight laced corset style  Right: Malaysian Bengkung belly binding

Left: Classic tight laced corset style Right: Malaysian Bengkung belly binding

First of all waist training is really nothing new, it harkens back at least to the 1500s when corsets first came in vogue and maybe even further back in Asian and African traditions of pre-natal and post-natal belly binding.

 

Left: Exercise Waist Trainer (Spandex with hook-and-eye closure)  Right:  Corset Waist Trainer (Metal boning structure and lace up closure)

Left: Exercise Waist Trainer (Spandex with hook-and-eye closure) Right: Corset Waist Trainer (Metal boning structure and lace up closure)

Secondly, there is a difference between exercise waist training (the latest rage) and waist training. Exercise waist training involves wearing the equivalent of the Incredible Hulk of spandex around your waist during exercise. Actual waist training involves lacing yourself up in a corset with metal boning and laces for several hours daily and gradually reducing down to smaller corsets over time.

Waist Training

Illustration of the changes that occur to the internal organs during the corsetting process.

Illustration of the changes that occur to the internal organs during the corsetting process.

1.  If you stop your waist will pop (back out to its original size that is).

True waist training must be continued on a daily basis in order to maintain the result. People may begin to see “semi-permanent” changes with >4 and up to 23 hours of corseting 7 days a week. Several changes occur when you wear a corset, your internal organs are displaced lower down into your abdomen allowing tightening around the rib cage and the waistline. The ribs have some level of bendability, so with enough continuous pressure the ribs may begin to angle downward and inward and the bone and cartilage begin to remodel. However, as soon as corseting is stopped the tissues will all return to their normal pre-corseted shape. If you are only laced up for a few hours a day the changes will only last a few hours, if you are laced up for longer periods the changes may last for a few months. Bottom line is that the changes are not permanent.

 Exercise Waist Training

2.  There is no permanent waist reduction that occurs with wearing an exercise waist trainer during your workout.

The manufacturers of these products cite core compression, increased perspiration, and targeted fat burning over the abdomen thereby reducing the waistline. This practice does not increase fat loss over the abdomen. You will see some temporary reduction in inches due to compression and increased perspiration, quite simply water loss. The only way to burn fat is by increasing your aerobic exercise reducing calories and eating clean. This leads to fat loss all over your body. Remember, the formula to seeing changes in your body is 30% exercise and 70% diet.

3.  There are risks to exercise waist training. If the garment is worn too tightly it inhibits your ability to breathe at a time when your breathing rate is increased to satisfy your body’s need for increased oxygen. Oxygen is part of the fuel your muscle uses to create energy to function during a workout. Some women wear their waist trainer so tightly they actually faint during their work out due to lack of oxygen.

4.  Liposuction and Tummy Tuck procedures are surgical ways to achieve a whittled down waistline.

You may find that in spite of having a healthy diet, engaging in regular exercise, and maintaining a healthy body weight, you may still have love handles or some resistant fat and skin over the abdomen. This is true in particular for many women after child birth, as we discussed before in Erasing the Tiger Stripes: 3 Steps to Restoring Your Pre-baby Body there can be some post-pregnancy changes that the gym and certainly the exercise waist trainer cannot fix. Diastasis-RectiFor example, many women also develop a rectus diastasis after pregnancy. A rectus diastasis occurs when space develops between the two rectus abdominus muscles (six-pack muscles) as a result of being stretched during pregnancy causing the abdomen to protrude. Although core exercises will strengthen the muscle and improve the overall abdominal shape they cannot mend the gap; the abdomen will always be wider than before. Exercise waist training will certainly not improve this problem but liposuction or a tummy tuck can.

5.  Liposuction can achieve targeted fat reduction over the abdomen.

6.  During a tummy tuck we actually do tighten the muscles, creating an INTERNAL CORSET. If you have a rectus diastasis part of the tummy tuck procedure involves bringing the muscles back together thereby tightening the abdomen and narrowing the mid section.

 

Are you a candidate for Liposuction or a Tummy Tuck (Abdominoplasty)?

1.  Do you have a normal body weight?

A tummy tuck or liposuction does not replace weight loss. These procedures are for contouring and shaping. If you are more than 20% above your normal body weight or more than 50lbs overweight you are not a candidate for surgery. Remember removing the fat over the abdomen does not decrease the internal fat around your organs that is responsible for the increased risk of heart disease and diabetes.

2.  Is your weight stable?

You must have a healthy diet and regular exercise regimen to maintain a stable weight. If you are still gaining weight you need to get that under control first.

3.  Do you have extra skin and fat over your abdomen?

If the extra skin and tissue hangs over causing a fold on your abdomen you are likely a candidate for a tummy tuck. If you have extra fat but no extra skin, liposuction may be a better option.

4.  Have you finished having children?

You can still have liposuction if you are planning another pregnancy, but if you are interested in a tummy tuck you should wait until afterwards. Of course if you are a man or are using a surrogate you do not have any of these worries!

Don’t forget that you can eat your way right back out of your liposuction or tummy tuck. There is no trade off for a healthy diet and regular exercise. After we have done our part to give you a flat tight tummy you still have to do your part to maintain it. So protect your investment by watching what you eat and hitting the gym. Learn more about what to expect before, during and after liposuction or tummy tuck surgery.

‘Bottoms Up’: New documentary explores cultural obsession with big butts

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It continues to be interesting to see the ongoing trend and discussion about butt augmentation. It seems that the directors of the new movie “Bottoms Up” have done a great job in framing the discussion, providing information and being honest about the dangerous and dark side of this phenomenon particularly with women seeking out black market injections. As a plastic and reconstructive surgeon, and genetically curvaceous woman myself I advocate for and believe in empowering women to make choices about their body and to make choices for THEMSELVES, choices that make them feel happier and more confident. Under no circumstances however should a woman put her life at risk with black market injections like mineral oil or fix-a-flat in order to fulfill someone else’s expectations. It is important to be educated and to seek the assistance of a trained plastic surgeon to help you achieve the enhanced shape that you desire. Check out my blogpost “Demystifying Butt Augmentation” to learn more. http://wp.me/p4t7Am-f

From Gynecomastia to Gladiator: Overcoming Male Breast Enlargement

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Summertime equals skin time; not just for the ladies but for the men who want to be liberated from their shirts and feel the sun on their chest. Many men do this without even a thought, but for many others doing so causes self-consciousness, embarrassment and discomfort. The first thing that is important for you to know if you are suffering with this problem is that you are not alone. Many of my male patients come in with concerns about enlarged breast tissue. Luckily social media provides a platform for sharing and removing the sense of isolation which sometimes accompanies this problem. I applaud people like Chris Pineda for making this video to share his struggle.

Normal Male Chest vs. Male with Gynecomastia

Do I have gynecomastia?

☑︎Do you have excess breast tissue?
x Are you obese?

If you are a male with excess breast tissue and you are not obese you most likely have gynecomastia. Gynecomastia consists of increased breast tissue and some fat. There are varying grades of severity of this enlargement.

 

Grade I Minimal increase in breast tissue, no sagging/extra skin

Grade II Moderate increase in breast tissue, no sagging/extra skinGynecomastia: Grades of Severity

Grade III Moderate increase in breast tissue, with moderate sagging/extra skin

Grade IV Severe increase in breast tissue, with moderate or severe sagging/extra skin

 

What causes gynecomastia?

Short-term causes:

Some causes of male breast enlargement are transient and resolve on their own. Male breast enlargement is very common during certain stages of life: infancy, adolescence, and mature-age. The thought is that this is caused by an imbalance in hormone levels between estrogen (the female hormone) and testosterone (the male hormone). During pregnancy a male infant is affected by the estrogen from their mother’s blood causing an increase in the breast tissue. After birth the estrogen levels decrease and the gynecomastia resolves. As many as 66% of all male adolescents experience gynecomastia of one or both breasts at some point. So if you are a teenage male experiencing this problem remember that it is quite common. The teenage years are full of shifts in hormone levels, an imbalance between estrogen and testosterone for a limited amount of time can cause breast enlargement. As the hormone balance returns the breast enlargement usually resolves within 6 months to 2 years. Mature age unfortunately is the only exception here, the imbalance in testosterone and estrogen that comes with age ( > 65 years) does not resolve.

Long-term causes:

Some causes of male breast enlargement may be idiopathic, meaning inherent to the person with no specific cause. Others are due to medications, drugs, and illness.

What to watch out for:

Medications
Many medications can cause this problem for example Zantac (cimetidine), Prilosec
(omeprazole), Aldactone (spirinolactone), Vasotec (enalapril). Changing your
medication may be an option.
Drugs of Abuse
Drugs of abuse such as marijuana, heroin, anabolic steroids can cause breast enlargement, so remember that as you light up or shoot up you may be increasing that breast tissue.
Thyroid Abnormalities
High or low thyroid levels can also contribute to this problem.
Liver Failure
Alcohol abuse and hepatitis are common reasons for liver failure. If you start noticing
yellowing of your eyes of skin you may be in serious danger of liver failure which can
lead to breast growth.
Testicular Tumors
Tumors of the testicles can release hormones causing an upset in normal hormone
levels and increasing breast growth.

 

How do I get treatment?

It is important that you visit your PCP so that they can rule out medication side effects or severe illness.

1. See your PCP
Your PCP will review your medications, examine you including performing a testicular exam, send off any necessary labs, and possibly send you for some imaging studies as well.

2. Get a referral to a Plastic Surgeon
If all the possible causes of gynecomastia have been eliminated or there is no improvement within 1 year of removing the offending agent it means that you require surgical treatment for gynecomastia.

 

What is the Surgical Treatment?

1. Liposuction

This is the most common method of treatment for gynecomastia and can be used for most grades. One or two tiny access incisions are made and then liposuction is performed to remove the breast tissue. Even for those patients who have some sagging and extra skin we often start with liposuction alone and allow 6-12 months to allow for healing and shrinking of the skin. If additional skin needs to be removed or the nipple needs to be elevated that can be done during a second short surgery.

2. Direct Removal of Breast Tissue

At times there is very dense/thick breast tissue which cannot be removed with liposuction alone. In these instances a small incision is made under the skin of the areola and the breast tissue is removed directly through that incision.

 

What about Insurance?

Although it is the best method of treatment insurance companies do not cover the use of liposuction for treating gynecomastia. Some companies will however cover the costs for direct excision. Consult with a plastic surgeon to find out your options.

Erasing the Tiger Stripes: 4 Steps to Restoring Your Pre-baby Body.

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Kerry Washington at her baby shower.

Kerry Washington at her baby shower.

You are a gladiator!! Like Kerry Washington (Miss Olivia Pope) and her other celebrity friends Megan Fox, Ciara, Kim Kardashian and of course her Royal Highness Duchess Kate (all new moms) you have been through the battle and come out victorious on the other side.  You have definitely earned each and every one of those “tiger stripes” required to carry a child through pregnancy and then nourish and care for them afterwards.  Although you would never change one moment of motherhood, many of you may be unhappy with some of the differences in your new post-baby body. You are not alone, many women experience deflation, sagging or enlargement of their previously perky breasts, and excess abdominal fat and skin over that previously flat abdomen.  2012 statistics from the American Society of Plastic Surgery (ASPS) show an increase in breast augmentation, tummy tucks, and liposuction among “mom-aged” women, with very high satisfaction rates for the results.

A few of my patients remarked on the frustration they feel about hours spent in the gym without being able to change those problem areas.

Her Royal Highness Duchess Kate and Kim Kardashian pre and post pregnancy.

Her Royal Highness Duchess Kate and Kim Kardashian pre and post pregnancy.

They wonder how Duchess Kate and Kim Kardashian are able to get back into shape so quickly.  Well first of all don’t beat yourself up.  Though there are many things that can be addressed with exercise and a good diet, not everything can be.  Also, do not forget that most celebrities have a big team behind them to help them to reach their goals.  So, how can you restore that firmer more sculpted shape that you had pre-pregnancy?  Here are some steps to reaching that goal.

 

1.  Avoid excessive weight gain during pregnancy.  If you are planning another pregnancy remember that “eating for two” does not mean eating twice as much.  Expert Dr. Kiwita Phillips, OB/Gyn at Morehouse School of Medicine explains that women only need an additional 300 calories (size of a small sandwich) a day to keep themselves and baby healthy during pregnancy.  She advises patients based upon the Institute of Medicine (IOM) guidelines.  According to the IOM most normal weight women should not gain more than 25lbs, women who are severely underweight may need to gain up to 40lbs, and obese women no more than 20lbs.  Dr. Phillips cautions that women who are morbidly obese (BMI < 40) may not need to gain any weight at all.

Institute of Medicine Weight Gain Recommendations for Pregnancy

Institute of Medicine Weight Gain Recommendations for Pregnancy

2.  Breast feed.  Some studies show that breastfeeding can help to reduce post-pregnancy weight as it burns 300-500cal a day.  Long term weight loss and reduction of fat in the mid-section has been noted for women who are able to breastfeed for greater than 6 months.

3.  Maintain a healthy diet and exercise.  This one is a no-brainer, you already know this.  Eating healthy is good for you and for the baby.  Lots of vegetables, fruits and water are important.  Stay away from processed foods.  There is no substitute for the health benefits of regular exercise; at least 150 minutes of moderate activity per week is recommended, check out Bikini Body Mommy for some great tips.

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4. The Mommy Makeover.  The Mommy Makeover refers to a combination of plastic surgery procedures that are individualized and tailored to restore and rejuvenate the body after pregnancy.  For most women this includes a procedure on the breasts and the abdomen but can include other areas as well.  If you are planning additional pregnancies it is recommended that you wait before doing these procedures.

Breast Lift, Breast Augmentation & Breast Reduction

Women see a variety of breast changes after pregnancy.  For some women volume loss is the problem, their breasts have deflated after breastfeeding and they require a breast augmentation using implants.  The breast engorgement during breastfeeding can stretch the skin and leave the breasts sagging.  For women who experience this problem a breast lift may be an excellent solution.  For women for whom both volume loss and sagging are a concern a combination of breast lift and augmentation may be the best option.  Finally, some women experience significant breast enlargement after pregnancy and a breast reduction is a excellent way alleviate the neck, shoulder, back pain caused by the extra weight while simultaneously lifting the breasts.

Tummy Tuck & Liposuction

Many women are most frustrated by the excess fat and stretched out skin around their midsection.  It seems like all the hours spent at the gym trying a plethora of core exercises just doesn’t seem to touch this area.  Unfortunately there really are some changes post-pregnancy that the gym cannot fix.  In spite of attaining a healthy weight women may still notice some stubborn fat deposits on the lower abdomen and love handles.  Many women also develop a rectus diastasis after pregnancy.

Pregnancy causes the abdominal muscles to spread apart, this is called a rectus diastasis.

Pregnancy causes the abdominal muscles to spread apart, this is called a rectus diastasis.

A rectus diastasis occurs when connection between the two rectus abdominus muscles (six-pack muscles) actually stretches out causing the abdomen to protrude. Liposuction is a great option to target those areas of excess fat.  A tummy tuck tightens the stretched out abdominal wall internally bringing the rectus muscles back together, and removes the extra skin and fat hanging over the lower abdomen.

 

Every woman’s body is unique and has different needs.  Your plastic surgeon can help advise you about which options are best for you.  The good news is that you can have it all, all the joys of motherhood and the more sculpted shape that you had pre-pregnancy.

7 Steps to Glowing Skin like Lupita Nyong’o

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Lupita Nyong'o

Lupita, Lupita, Lupita, it seems as though everything has been coming up Miss Lupita Nyong’o for the past few months. Why are we so in love with her? Well like most of you when I think about this woman I think about authenticity, humility and sophistication all bundled up in a swath of vibrant energy that seems to radiate off the small and large screen. As if this all weren’t enough she is clever, with a Yale-minted theatrical degree, and absolutely stunning.

As a plastic and reconstructive surgeon I have the opportunity to see and celebrate so many different types of beauty, and as an African woman it is gratifying to celebrate that of a fellow African woman. One feature, which many of us have noticed about Miss Nyong’o, are the beautiful rich tones in her flawless skin. Interestingly Nyong’o herself has shared her early experiences of being “teased and taunted about her night-shaded skin”. During an acceptance speech at Essence’s Black Women in Hollywood luncheon she shared a letter from a young girl who stated that she was about to purchase skin lightening cream before “saved” by Nyong’os “[arrival] on the world map. Lupita then relayed the following about her own journey of self-acceptance:

“I remember a time when I too felt unbeautiful. I put on the TV and only saw pale skin. I got teased and taunted about my night-shaded skin. And my one prayer to God, the miracle worker, was that I would wake up lighter-skinned. The morning would come and I would be so excited about seeing my new skin…and every day I experienced the same disappointment of being just as dark as I was the day before. I tried to negotiate with God. I told him I would stop stealing sugar cubes at night if he gave me what I wanted, I would listen to my mother’s every word and never lose my school sweater again if he just made me a little lighter. But I guess God was unimpressed with my bargaining chips, because He never listened.”

And thank goodness for that. I am so glad that Lupita chose this platform to bring forward this issue.

Step 1. Avoid non-prescription skin-bleaching products.  The use of skin lightening creams is very common in many communities. Beyond the problematic social issues this practice presents many are unaware of the significant medical dangers associated with the chronic use of these products. The first challenge is that many of these products are not controlled; some are unlabeled and may contain products that are dangerous especially when applied to large areas for a long time. For example the active ingredient in some of these products is mercury, which can cause mercury poisoning. As a result patients may have kidney damage, depression, anxiety, decreased sensation in the in hands or feet, skin rashes and more. Some of these products contain high concentrations of steroids that can result in thinning of the skin and significant stretch marks, skin infections and acne.

Counterintuitively some skin bleaching products can cause dark discoloration over time

Counterintuitively some skin bleaching products can cause dark discoloration over time

Hydroquinone is another additive, when used chronically, in high concentrations, and in combination with caustic and dangerous ingredients can actually result in the unintended side effect of a dark rash called ochronosis that is incredibly difficult to treat once it occurs.

Some of these products even cause a very unpleasant rotten fishy odor due to a chemical (trimethylamine), which is excreted in bodily fluids.

So what CAN you do to get beautiful, glowing and healthy skin?

Hydration is so important for the skin.

Hydration is so important for the skin.

Step 2. Drink lots of water. Since about 55-65% of your body is composed of water, hydration is very important.  Staying well hydrated will allow your cells to remain plump, function more optimally, and will also help your body to flush out all those toxins and waste products. You need to drink at least 64 ounces a day, more if you are perspiring a lot during your daily activities (ex: outdoor work or exercise).

Step 3. Stop smoking.  If you are a smoker, please stop. Besides all the many dangers to your health smoking damages and ages your skin prematurely.

Maintaining a beautiful glow day to day.

Maintaining a beautiful glow with your daily regimen.

Step 4. Exfoliate daily.  Exfoliate using either an exfoliating brush, sponge or facial wash to remove dead skin and expose new healthy cells.

Step 5. Get a superficial skin peel 1 – 2 times yearly.  Talk to a dermatologist about superficial skin peels for a refreshed look and regular maintenance. Under the care of your dermatologist treatment with hydroquinone can be safely used to help smoothen your skin tone by targeting specific areas, not for overall lightening.

Step 6.  For more significant aging use Retin-A or a deep skin peel.  For more significant skin aging changes such as deeper wrinkles and sun related damage, Retin-A and/or a deeper skin peel by your plastic surgeon or dermatologist can help.

Step 7.  Wear sunscreen.  I know that all of you are doing this one already.  Make sure that your daily facial moisturizer contains at least 15 SPF (more if you are fairer skinned).  This is especially important if you have had a peel or are using Retin-A as the delicate new skin is more susceptible to sunburns.