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www.ReviveMagazine.ca

Winter 2009

THE REVIVE MAKEOVER Phase 3

What’s New in the World of Beauty Therapy

Kevin & Dina

The Bonnie and Clyde of Morning TV, Stealing the Hearts of Hundreds of Thousands Every Morning

Ron White The Sole King A Walking Empire

Move Over Niagara, Here Comes the Grange


Look as GOOD as you FEEL! As seen on TV shows Skin Deep and Plastic Makes Perfect.... Dr. Sproule is a member of the Royal College of Surgeons with more than 20 years of global experience and accredited by the Canadian Association for Accreditation of Ambulatory Surgical Facilities. He and the accredited staff of anaesthetists and experienced nurses of Plasticos are equipped to provide a complete range of cosmetic surgery procedures including: • Facial plastic surgery including Rhinoplasty • Breast enhancement and lifts as well as tummy tucks • Specializing in body contouring for clients that have achieved substantial weight loss • Injectables and Fillers For your convenience we have a private, fully staffed overnight suite to care for you.

For private consultation call: 416.439.1766 • www.plasticos.ca 3030 Lawrence Ave. E, Suite 507 (SGH Medical Mall) Scarborough, ON.


Combating Acne The Natural Way . . . . 104

Anti-Aging & Beauty Planning Your Rhinoplasty . . . . . . . .

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Build Your Inner Strength . . . . . . . . 106

The History of Breast Implants . . . . . .

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Fashion

Hair Myths: Busted!

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The Cause of Hair Loss Fact and Fiction .

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The Finishing Touch

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The Cellulite Solution

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I Got My Daddy’s Nose . . . . . . . . .

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Makeover Madness . . . . . . . . . . . 108 My Experience with Artecoll Injectable Filler For Facial Soft Tissue Augmentation . . . . . 120

Health & Wellness Does Low Self-Esteem Ever End? . . . .

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Who is God? . . . . . . . . . . . . . .

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No Gym Required . . . . . . . . . . .

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Natural Remedies For Sports Injuries . . .

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Dental Health . . . . . . . . . . . . .

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Natural Treatments For SAD . . . . . . .

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The Mouth is The Window to The Body . .

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Polycystic Ovarian Syndrome . . . . . .

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The Grange Vineyard - P. 34

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Revive Men’s Top Fashion Five

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Revive Women’s Top Fashion Five . . . .

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Picking The Right Accessories . . . . . .

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5 Steps to the Perfect Bra

Top Ten Recommendations To Shine For The Holidays

Holiday Glamour; How Much is too Much? .

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The Sexy Side of Sleepwear

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Features Move Over Niagara Here Comes The Grange . . . . . . . . . . . . . . . . . . . .

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The Bonnie & Clyde of Morning Television .

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The Revive Makeover . . . . . . . . . .

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Ron White: The Sole King . . . . . . . .

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SlimLipo: Want to get Slim? . . . . . . .

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A Smile Makeover with the Man Behind Revive . . . . . . . . . . . . . . . . . . . .

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Ask An Expert Dr. Andres Gantous Board Certified Facial Plastic Surgeon

Breakfast Television - P. 48

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REVIVE Makeover Phase 3 - P. 73


Korby Banner Celebrity Makeup Artist . . . . . . . . .

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Dr. Bill Middleton Board Certified Plastic & Facial Surgeon

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Hair Restoration Surgeon . . . . . . . .

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Dr. Mark Korman

Tanya Wylde Naturopathic Doctor, Certified Personal Trainer & Fitness Instructor . . . . . . . . . . .

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Dr. Richard Rival Board Certified Facial Plastic Surgeon

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36 Dr. Fred Weksberg General & Cosmetic Dermatologist . . . .

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Dr. Dan Hagi Cosmetic Dentist . . . . . . . . . . . . 118 Dr. Christopher Tsang Holistic Dentist . . . . . . . . . . . . .

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Dr. Gregory Pugen Medical Doctor . . . . . . . . . . . . .

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Dr. Robert Sleightholm Board Certified Plastic Surgeon . . . . . 102 Dr. Sheldon Herzig Medical Director of The Herzig Eye Institute

Ron White The Sole King - P. 88

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Cover: Kevin Frankish and Dina Pugliese Makeup & Photography: Korby Banner Hair: Jason Gordon Stylist: Patrice McDonough Casey Wardrobe & Accessories: Korry's Clothiers, Freda’s, Paul Magder Furs, Only Accessories, Ron White

5 Steps to the Perfect Bra - P. 110

Sexy Side of Sleepware - P. 115

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Editors

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he holiday season is here and I find myself reflecting back on our first year here at Revive. When we first launched our inaugural issue of Revive back in September 24th 2008, it was our plan to try and bring a new creative edge to a magazine that would inspire readers and to provide you the very best content of health, beauty, fitness and fashion. We firmly believed a reputable resource that educates the reader was needed. We wanted to make sure you had content with substance and most importantly from only the most reputable professionals and companies available. Judging by your feedback and our first full year we are truly happy and appreciative that you see and understand our vision and what we are trying to accomplish. It is refreshing to hear stories from you, readers comments and thoughts on how much you have learned by reading Revive and how it has helped with some decisions and choices in your lives concerning your health, beauty, fitness and fashion journeys. From our three generation makeover to informative articles and features there is something for everyone in Revive. Be sure to check out the Revive website where you can find bio's and links to all our writers and experts along with the newly added Instant Makeover Tools, Videos from Live with Revive, contests and announcements for our upcoming events!

President: Craig Charity Editor: Tracee Sheldrake Publisher: Hi-Octane Publishing Sales/Marketing: Mark Leeder

In the new year we will be launching Revive Web TV with our very own internet based show and many other interesting events like our Fitness & Longevity Retreat, information nights, seminars and mini trade shows where you can talk and get more information from the proper professionals regarding everything to do with health, beauty, fitness and fashion. We hope you enjoy your winter issue of Revive featuring the very talented Kevin Frankish and Dina Pugliese on the cover in a very unique Bonnie & Clyde inspired theme. I have to say they both were fantastic to work with and the result was amazing, this by far was our most creative and fun photo shoot that we have done to date. A special thanks to Producer Kevin Forget of Breakfast Television for understanding our vision for this shoot and his support. To Kevin & Dina you both are fabulous and it was an absolute pleasure working with you. Jason did a fantastic job with the hair and Patrice sourced the perfect clothes for the shoot. Korby Banner a brilliant make-up artist and photographer and made sure our vision came across with his photos and with the perfect make-up for Kevin & Dina to truly capture the concept of this shoot. Well done to all of you! We have just recently completed a Revive Magazine Facebook page and YouTube Channel. Visit www.facebook.com and search

Art Contributor: Carmine Napolitano Account Manager: Laura Greenspan Art Director: Gary Charity Copy Editor: Susan Charity

For all advertising and editorial inquiries contact Director of Sales & Marketing Mark Leeder at 905.591.1996, Cell: 416.473.6202 or email at mleeder@revivemagazine.ca

For all other business inquiries please contact Craig Charity at 905.591.1996, Cell: 416.898.4479 or email at craig@revivemagazine.ca


Note Revive Magazine to become a fan, post your comments, ask us questions and socialize with us! You can also watch us on YouTube! Watch us on YouTube at www.youtube.com/revivemagazine as we explore the industry and report on what's new and hot! Enjoy your winter issue and keep an eye out for our March issue as we have many exciting surprises for you. Thank you for your interest, loyalty and support and we sincerely hope that

we have been able to answer your questions and educate you! Keep your letters, stories and inquiries coming. We love hearing from you and wish you and your families all the best this holiday season.

Sincerely,

Tracee Sheldrake

The Revive Advisory Board HD Bryce Wylde - Homeopathic Doctor, Clinical Nutritionist & Host of Wylde on Health Dr. David Ellis - Professor, Department Otolarynogolgy-Head + Neck Surgery Bruce Krahn - Certified Personal Trainer & Author of The Fat Fighter Diet Dr. Ihab Matta M.D. Cosmetic and Weight Loss Specialist Dr. Philip Solomon M.D., FRCSC Facial Plastic Surgeon Dr. Fred Weksberg - General & Cosmetic Dermatologist Dr. Zoltan Rona - Medical Doctor & Clinical Nutritionist Dr. Kevin O'Grady - Plastic & Reconstructive Surgeon Cara Smith - Aesthetic Consultant and Trainer Dr. Ron Goodlin - Cosmetic Dentist Dr. Sol Weiss - Cosmetic Dentist

REVIVE magazine assumes no responsibility for unsolicited material. Opinions expressed herein are those of contributors, sources quoted and advertisers and do not necessarily reflect those of the publisher. Contents of REVIVE magazine are copyright 2009; all rights are reserved and may not be reproduced in whole or part by any means without written permission of the publisher. REVIVE magazine is published 5 times a year. Live with Revive Videographer: Tom Marasovic - Longfield Films Revive Photographers: Steve Apost - Studio Six Photography / Marcia Leeder - Marcia Leeder Photography


Does Low Self-Esteem Ever End? By Dini Petty he majority of us come from dysfunctional family backgrounds. If you take into account drug addiction (legal and otherwise), alcoholics, extreme mental/ physical religious or philosophical problems, dire poverty, mental, verbal, physical or sexual abuse; that includes a lot more than fifty percent of us. My family were always contenders for the bronze medal in the dysfunctional family event and like many other families we put on a good public show. So I grew up with and have suffered from low self esteem all my life. I was fifty before I realized that constant criticism of myself was low self esteem and that in order to handle it, I had to learn one of my most difficult lessons. Taking care of me "first" with food, water, rest and exercise and as long as I did those things my inner critic was quiet. But, the moment one of those things goes out (with me its water first, then food, rest and then exercise that falls by the wayside) and once it does, the low self esteem critic attacks. Low self esteem becomes a habit and because we've done it most of our lives it's always there, just waiting for the opportunity to return. The bottom line is that somewhere along the way you learned to disrespect yourself from either living in a dysfunctional family, "You're so stupid, so fat, never does anything right, what's wrong with you etc. etc. etc." You were treated with disrespect and at some point you learned how to and began to disrespect yourself. "I am stupid, I am too fat, too thin, can't do that etc. etc." and your low self esteem was created. Now if you came from a fully functional family

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where you were treated with respect but you were different; too tall, too short, too thin, too fat, the wrong color, have a physical difference or your sexuality is different; chances are your classmates taught you how to disrespect yourself. There is a difference between self confidence and low self esteem; self confidence is achieved through repeated actions. Examples: the first time you make a new recipe, drive a car, do your make up, try a new hairdo, you’re not very good at it but by the 50th time you no longer use the recipe, driving gets easier and your makeup and hair do are a paint by number kit. Most of us learn low self esteem from one or both of our parents, we copy it unconsciously as your children copy it from you. It's the gift that keeps on giving, generation to generation. Which is why, if you have young children you want to take care of yourself first by keeping your basics of food, water, rest and exercise in and have your children copy a good productive habit. Because once your children are teenagers with low self esteem it’s an ingrained behaviour that they have to sort out for themselves but even then if you start taking care of yourself, you set the example. So, self confidence through repeated actions leads to “I can do this” where as low self esteem is the value you give yourself, “I’m not worth it, I'm not good enough” etc. etc. and by taking care of yourself first you eventually realize “Yes I am worth it, I am good enough” - this is high self-esteem. My Grandmother had a saying, "Take care of yourself love, because if you don't, no one else will." A few years ago when I turned 60 and decided I was old enough to give advice, I wrote this: Take care of yourself love, continued on next page revivemagazine.ca


continued from page 8 - Low Self-Esteem

Because if you don't No-one else will. My Grandmother's advice, Edith Petty, born 1900 - 1978 To which this granddaughter, Dini Petty 1945- to who knows when Adds Throw yourself at the world, Seize every moment and opportunity. When you fail, and you will fail, Drop gracefully to the ground, Lie there for a moment or five And do whatever you have to do. Then get up, dust yourself off And go at it again, again and again Until life itself sings through your soul. Seek out the beauty in all things and in all beings and remember that, "by their actions you shall know them." Learn through stones and arrows, Ask every question that crosses your mind; follow every thought that seems right to you. Love every man worth your love. Take a moment or two for every Tom

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Dick, Harry and Jane And a hundred thousand more moments Just for you. Enjoy those dreams that do come true And endure But Whatever you do Where ever you go... Take care of yourself love, Because if you don't, No one else will. Take care of yourself love With the best hairdresser, accountant, lawyer and financial information you can find seek counsel from those you respect but in the end make your own decision based solely on what's good for you. Let people earn your trust, Don't give it away And let them earn your respect Every single day. But Take care of yourself love Because if you don't, No one else will.

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Planning Your Rhinoplasty By K. Conrad, M.D., F.R.C.S., F.R.C.S.C., F.A.C.S. lastic nasal operations are among the most complex and intricate cosmetic surgical procedures performed on the human body. Rhinoplasty is a popular operation and requested by both women and men regardless of age. It is performed on patients usually not younger than 16 years but under some circumstances it can be carried out on females 14 years young. My oldest patient was a 76 year-old widow who had a desire to change the size and shape of her nose all her life but was prevented from it by her husband. She remarried 6 months after her rhinoplasty, which not only rejuvenated her emotions but also her appearance. The nose is the central feature of a human face. Its size and character have profound impact on our appearance. Men may look quite handsome even with a large, strong-looking nose suitable for their body frame, especially if it is well balanced with other facial features. On the other hand, regardless of the changeable trends in fashion, women have always preferred a delicate, well-shaped and elegant nose emphasizing their femininity. This esthetic preference has been documented by a recent survey carried out at the University of Toronto, Facial Plastic Surgery Section of the Department of Otolaryngology. The decision to undergo a nose refining operation must be made by a mature, realistic individual prompted by strictly personal analysis and desire for self-improvement. First, you research surgeons according to their special training, board certification and compare their results with others. Word-of-mouth, your family doctor or Internet are usual sources of information. Remember, some of the pretty photographs seen in the advertisements are models and not examples of surgical outcomes. The

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results of nasal refinement where you can see either a subtle improvement or a dramatic change must have a natural unoperated appearance. In most instances you will not see enough examples on the Internet. If you arrange a consultation, the surgeon who has been performing many of these procedures should be able to show you numerous examples relating to your particular concerns. Here too you will be able to compare your own idea of a desired result to that of the surgeon's. Computer imaging serves well to stimulate your imagination but by itself does not reveal the surgeon's talent in visualizing the details to be created during the operation. Furthermore, you are not buying the computer image; you are relying on the surgeon's ability to apply appropriate surgical technique to create the most natural possible outcome. The desired appearance is best planned carefully, allowing your own input to make drawings using the surgeon's hands and mind - "the tools" he or she will need for reproducing the agreed contours during the operation. Hand drawing of the suggested final result with superimposing it on your preoperative photograph serves an important purpose. It will not only help you to visualize the degree of the proposed difference, but also will reveal the surgeon's intention and ability to make judgement regarding the extent of alterations in various areas of your nasal anatomy. Utilizing this information, you should see 2 or 3 surgeons who you think have the highest qualifications, experience and the results you like best to make your final choice. Some surgeons irrespective of the complexity of the operation perform a rhinoplasty using the "open" or "external approach" with an incision between the nostrils. Others reserve this method only for complicated revision cases and routinely use incisions totally inside the nose. Most rhinoplasties today are performed under general anaesthesia with the patient totally asleep. A specially equipped, accredited facility is needed to assure safety of such operations unless it is done in a public hospital where accreditation is obligatory. continued on next page

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continued from page 10 - Planning Your Rhinoplasty

Information about the facility, anesthesia and the specialist who will administer it, as well as details about the surgical approach should be available during your consultation. Postoperative recovery time needed for all the bruising and swelling to disappear varies slightly with the surgical technique and the individual tendency of the patient. Usually it stretches from 10 days to 3 weeks. The goal of the operation is not limited to the improved nasal appearance but to improve or preserve the nasal breathing capacity. A good assessment of nasal function together with the aesthetic analysis should take place before the surgery. Your surgeon must have the ability to assess your nasal function and aesthetics and address these issues skillfully at the same time during the operation. Surgical fees differ with the surgeon's experience, the type of facility and the way the operation is performed. Usually fees are higher for revisions of previous unsatisfactory results. Every rhinoplasty surgeon, no matter how experienced, accomplished and talented, must be prepared, and so must be the patient, for an occa-

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sional possibility of a small, postoperative adjustment. This additional "touchup" is due to the unpredictability of tissue healing. The financial implications of this must be explained fully by your doctor before the original surgery. A skillfully performed rhinoplasty with good aesthetic sense and good scientific understanding of nasal function is likely to lead to a most satisfying experience for both the patient and surgeon. Dr. Kris Conrad is certified by the American Board of Facial Plastic and Reconstructive Surgery, Royal College of Surgeons of Canada and Royal College of Surgeons of England. He is Associate Professor in the section of Facial Plastic Surgery, Dept. of Otolaryngology, Head and Neck Surgery, University of Toronto. He has lectured worldwide and authored numerous scientific publications. He holds an appointment at Mt. Sinai Hospital, Toronto and York Central Hospital, Richmond Hill. He is the Director of the Nasal and Facial Plastic Cosmetic Surgery Institute, 131 Hazelton Ave., Toronto (416-9612053) and 9955 Yonge St., Richmond Hill (905884-6998). www.drkconrad.com

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The History of The Breast Implants By Dr. Kevin O'Grady, BASc, MHSc, MD, FRCSC ave you ever wondered where breast implants came from and how they're made? How did they come about and why did mankind invent such a device? Well, this article attempts to tell the story of the modern silicone breast implant as we know it. The idea of increasing the size of the female breast is a fairly new one (the subject of male breast augmentation is an entirely different discussion left for another time). In the late 1890s, the first breast augmentation was performed by Czerny who transplanted a benign fat mass, known as a lipoma, into a position underneath the breast in a women desiring a larger breast size. Other such transplants, or fat grafts, were subsequently performed, but the results were unpredictable and the appearance was poor. Complications such as the fat dying, chronic, draining wounds as well as the fat masses being absorbed by the body plagued these initial attempts and they fell by the wayside. Shortly after Czerny tried his fat transplant, the first attempt at augmenting the breast with foreign materials (substances not produced by the body) was made. In 1899, injections of paraffin wax were performed - with disasterous results. Persistent swelling and inflammation, death of tissue (necrosis), chronic draining wounds and even blindness resulted. This was followed by insertion of glass balls in the 1930s and polyvinyl alcohol sponges in the 1950s. Glass balls had the obvious problems of breakage and the sponges degraded, causing breasts to become hard, distorted and painful. In the early 1960s, liquid silicone was injected into the breast, with complications similar to those of paraffin wax injections. Note that this procedure

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is still practiced by unscrupulous practitioners in some parts of the world, most notably Southeast Asia with the same complications as in the 1960s. It is mainly done by those individuals who cannot afford a breast augmentation from a reputable Plastic Surgeon. NEVER, EVER, consider this as a means of breast augmentation! The silicone breast implant as we know it was first used in 1962 and officially introduced to the market by Dow Corning in 1963. It consisted of a thick silicone rubber shell with a thick, viscous gel filler. It was extremely well made and almost indestructible - breakage rates were almost zero. However, because the shells were so thick, these implants were very prone to high rates of capsular contracture. Capsular contracture is a term used for the shrinkage of the scar that naturally forms around all breast implants. When the scar shrinks, it deforms the implant and can cause a considerable amount of pain. These types of implants, known as the First Generation Implants, were in use from 1963 to 1972. In an effort to reduce the rate of capsular contracture, the Second Generation Implant was introduced in 1972 and continued in production up until 1987. These implants had thinner shells and had a less viscous gel to give a much more natural feel. Texturing or roughing of the implant surface was also introduced in the mid 1980s to help reduce contracture. The rates of capsular contracture decreased dramatically, but there was a price for this. The shells were too thin and this generation of implants was plagued by a significantly increased rupture rate. Some studies showed that 90% of the implants ruptured at 10 years after implantation. A happy medium was needed and the Third Generation of breast implant was developed in 1988 and is still in use today. The silicone shell is thicker and much stronger. Shells of Mentor continued on page 14 revivemagazine.ca


continued from page 12 - History of The Breast Implant

implants, for example, are made of three layers of elastomer to reduce rupture rates and prevent silicone from leaking out. Some implants have a fourth layer added - these are textured implants which have demonstrated lower rates of capsular contracture. Failure rates have significantly decreased and the problems of the earlier generations appear to have been solved. A very recent study has shown that rupture rates are as low as 1.1% in patients after 6 years of implantation. As well, the shell of these implants seems to have reduced the incidence of inflammation around the implants and the capsules appear to be thinner, thus reducing the potential for capsular contracture. The latest advance in silicone breast technology has been in place for about 10 years now and has become the standard for silicone breast implants. The newest implants have a cohesive gel filling, which means that even if the implant breaks, the filling remains intact and is much less likely to leak out. Consider cutting two implants - an older gel implant and a cohesive gel implant. When one cuts into an older gel implant, thick, syrup-like gel oozes out of the implant in a sticky, gooey mess. A cohesive gel implant, when cut into, retains it shape, with the filler similar to that of Jello or a gummy bear (some people call these gummy bear implants). Thus the filler in a cohesive gel implant is much less likely to ooze out in a sticky mess and retain its shape, even if ruptured. This offers obvious advantages, the most prominent being that if these implants are ruptured, they may go years before actually needing to be replaced. One would think that the manufacture of sil-

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icone breast implants would be a highly advanced, automated process. While highly advanced and quite ingenious, modern silicone breast implants are remarkably almost completely hand made. I recently toured the Mentor breast implant factory in Leiden, the Netherlands and was quite fascinated to see how the implants were made. Essentially, the shells are made by dipping a form into liquid silicone and allowing them to dry. The shells are taken off the forms by hand and are left with a hole about the size of a quarter in the back. The shells are then stretched and a fourth layer of texturing is added to the implants, again all done by hand. After patching the hole in the back of the implants by hand, the implants are cured in an oven to "weld" the patch in place. A small needle is then placed though the patch, and the gel is inserted into the implant. A technician closely watches this and removes any air, once again by hand. The small needle hole is then patched, and the implant is placed into an oven overnight for a final cure. The implants are then packaged and a final sterilization is performed. Quality control is strict and data on each inidividual implant is kept right from the start to final processing. Quite impressive. I hope that this article has been informative and you have enjoyed a brief description on the evolution of the silicone breast implant. A great deal of time and research has gone into perfecting the implant and improvements continue to this day. As always, breast implant surgery is best done by a Plastic Surgeon and I encourage anyone interested in this procedure to contact a qualified Plastic Surgeon before embarking on this surgery.

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Hair Myths: Busted! By Luigi Di Tacchio ver the many years of being a hairstylist, I've heard countless stories of hair myths or urban legends. Just like any rumor, these stories get stronger and stronger the more people talk about them. Like a hurricane brewing in the ocean, once it hits land, all hell breaks loose. Here's a list of some the myths that we hear standing behind the chair.

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If you shave your head, your hair will grow in thicker. Whoever made this one up should be shot. I've been shaving my head for 17 years and trust me it isn't any thicker then the first time I did it. What happens is your hair grows in one length and at the same time. This gives the illusion it's growing in thicker. Sorry boys!

Split ends can be repaired without cutting. False. There's only one way to repair split ends. Sorry, you have to cut it! There may be products that can temporarily put a bandage on them. The problem is that it will only last until the next shampoo. It might be tempting to cut them yourself, but please let a trained professional do it! If not done properly, you could only make things worse. Also if you think that split ends don't travel, think again. If uncut, they can travel through the hair shaft towards the roots. I've also seen split ends so bad that the split ends had split ends.

Brushing your hair causes hair loss. False! This is a huge statement. Many people believe that brushing hair can lead to hair loss or thinning. If you use a quality hair brush and are gentle, there is no reason for hair loss. Hair brushes help remove debris from the hair, help distribute natural oils the scalp produces and help stimulate the blood flow to the surface of the scalp. This helps in nourishing the roots of the hair, where all life takes place. If you brush your hair excessively, then it may lead to breakage. Also, please never pull or rip through tangles that could be in the hair.

If you pluck one grey hair, two, seven or ten will grow back. If this were true, I'd be plucking whatever I could find. I'm hair folliclie challenged and I need all the help I can get. And who really cares if they grew back, you can always color them.

Another common myth is do products stop working if you use them all the time? What? Is your hair on an episode of survivor and just won the immunity idle! People say if they use a shampoo or conditioner on a regular basis it doesn't have the same effect that it used to. Most shampoos and conditioners are designed for a certain purpose. Once the hair has accomplished its goal it might feel like it's not working any more. Not true! It might mean your hair needs a different shampoo or conditioner. Example: your hair type is dry/brittle and flat. Let's say you want to control the dry, brittleness of your hair. You'll need one shampoo. Once that's been taken care of and the quality of your hair is restored, then you can use a shampoo for volume for the flatness. Also, some products can leave a build up in the hair that needs to be cleansed before another shampoo could work in it.

How about this one: cutting hair will make it grow faster. No! Hair only grows about ½ inch per month. Maybe a little quicker in the summertime because of vitamin D or hormonal changes. Regardless what you think, that's all it grows. Cutting hair promotes healthy hair. So if you want long, healthy hair you must maintain it by visiting the hairstylist regularly. Home cocktails with vodka, mayonnaise or beer are great for the hair. Wrong! This might be the start of a great party, but if these ingredients were good for the hair, don't you think the companies that spend millions of dollars on research would have used them by now? 16 - REVIVE Magazine

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Q & A with Dr. Andres Gantous Dr. Andres Gantous is a board certified Facial Plastic Surgeon that has been in practice in Toronto for fifteen years. He is internationally known for his work in rhinoplasty and facial rejuvenation surgery. He is an Assistant Professor in the Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head & Neck Surgery of the University of Toronto. Please visit www.torontofacialplastic.com for more information or email your questions to askanexpert@revivemagazine.ca

Q: I am over forty and see my face aging compared to my body. I want some work but I like my looks and do not want them to change, only to look more youthful but am afraid due to what I see happens to other woman! They have the same look big lips and cat like. A: You do not have to worry about looking "done" or abnormal after having facial rejuvenation procedures. It is important that you convey your wishes and goals to your surgeon and have an open dialogue with him regarding your expectations. A range of different procedures can be offered to patients your age who are looking for an improvement in their looks without changing them. It may be as simple as using different types of available fillers for subtle volume replacement and Botox or Xeomin for treatment of some facial wrinkles and lines. At times, minimally invasive surgical procedures can be used to achieve these goals. In my practice, the goal is always to try to achieve a

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Dandruff is contagious? No. We all have the micro organisms that cause dandruff. In some people they aren't as active. A dandruff shampoo will help control it. Dandruff usually flares up with the change of seasons or stress. But be careful with sharing brushes or combs. Although dandruff isn't contagious there are other parasites and lice that are. So please be careful! Blow drying hair can cause it to smoke. Not true. This myth has been told in many different ways and for many years. On a rare occasion hair "smokes". This is caused by evaporarevivemagazine.ca

natural look that is age appropriate when performing rejuvenation surgery and procedures. Q: I am unhappy with the size and shape of my ears feeling they are too big and my ear lobe has an odd shape to it. I am interested in surgery in order to alter the shape and size of my ears. Is this possible? And what would be some of my options available? A: An otoplasty is the name of the procedure we use to reshape ears. There are many variants of otoplasty and it can be tailored for the individual case. I am the first surgeon in Canada performing incisionless otoplasties for the correction of protruding ears. This allows us to correct the ear deformity with minimal healing time and discomfort. When dealing with very large ears, cartilage cutting techniques may have to be used in order to make the ear smaller. The ear lobes can be easily altered when necessary in most cases. tion of moisture in the hair. Also, certain styling products can have the same effect. So don't worry; your hair isn't on fire. Standing on your head cures hair loss. Absolutely false!!!! Yes it's true that hair follicles need blood flow to grow. But come on, the only thing this might be good for is some gymnastic move that might impress your partner in the bedroom. So if you heard a hair myth, do your research and ask a hair expert if there is truth to this. A hair expert isn't your best friend or your wise old grandmother; it's your hairstylist of a trichologist. Your hair deserves the truth and the best.

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Who is God? By Dr. Ihab Matta hile it may seem overwhelming, it doesn't stop many of our readers and much of humankind from asking that same question. One might wonder what this article is doing in a magazine that is focused on beauty, health and fitness. One of the essential components of human health is spirituality, either the presence or absence of it. So hopefully this article will be useful to many of our readers. This article is not meant to offend anybody's existing beliefs or lack there of. Instead the goal is to inspire discussion, and help the individual reader to find their own spiritual path that serves them best. Throughout much of human history, there has been a longing to understand our role in the world. Whether it was driven from a fear of death or higher mental ability, it is difficult to say. Some argue that man's fear of death lead to the development of early religions, while others would argue that man is spiritual to begin with. It is at this early point that we should discuss the difference between spirituality and religion. Most dictionaries relate the two very closely, but people tend to have their own personal definition. Many would say that spirituality relates to the existence and communication with "God". The compact Oxford dictionary defines it as "relating to or affecting the human spirit as opposed to material or physical things". Religion includes spirituality with a set of fixed beliefs and rituals. There are those that question the whole purpose of this discussion and prefer to go about their day to day lives either adhering to the belief system passed on to them by their parents or just not believing in a "higher power" altogether. There is a popular movement of atheism now, with no belief in a God at all. Many others are

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agnostic, which most people define as "I don't know". The age of science and critical thinking has allowed mankind to move forward from primitive explanations of the gods to explain natural phenomena, such as the sun rising and setting each day. There are many different ideas of what God is; without getting into a serious theological discussion about it, I will mention the most common schools of thought. Deists believe that God created the universe and all the physical laws that govern it, but is not involved in the day to day management. Theists believe that there is a personal God, who did all of the above but also listens to prayers and is involved in day to day details and hears one's prayers and may or may not intercede. Pantheists generally consider God and the Universe the same thing and don't attach a "supernatural" aspect to God. It isn't a lot different than atheism. Others have a concept that God is a Universal Energy, from which all things have come forward. It is interesting that atheists usually use science to debunk the idea of the existence of God. While science has been able to disprove many fixed false beliefs over the history of mankind, to prove either the absence or existence of God is rather a futile attempt. Since the discovery of quantum physics, the concept of interconnectedness of objects has created great angst for scientists. A concept called quantum entanglement says that two particles separated by a great distance can affect each other in real time, faster than the speed of light. Einstein stated that nothing can travel faster than the speed of light. In fact, Einstein called it "spooky action at a distance" and tried for more than 30 years to fight the ideas of quantum mechanics which he himself discovered, all because it didn't make sense to him and he thought that it contradicted the heart and soul of physics. While humankind has discussed and debated the existence of God for thousands of years, we still don't have a clear understanding like we do the physical laws of our world. With hundreds continued on next page revivemagazine.ca


Q & A with Korby Banner Korby Banner is an internationally published photographer, who appears daily on the hit TV show, Style by Jury on W Network, as key make-up artist. His resume includes A-List Hollywood talent , Cd covers, billboards, advertisements and magazine editorials from fashion, cosmetics and lifestyle. For more information visit korbybanner.com • info@korbybanner.com or email your questions to: askanexpert@revivemagazine.ca

Q: How important are make-up brushes and warm water, rinse, apply hair conditionfor daily application? Anna M. er, rinse them well in luke warm water, flick A: An investment in a set of brushes is a off excess water, and lay flat on clean facecloth to dry overnight. wise step in acquiring a professional look. For smooth smokey eye-shadow blend- Q: What basic eyeshadow colors suit ing it's essential to use brushes. blue eyes if blue eyeshadow is such a Contouring is "no no". Pamela nearly impossible L. without a great A: Dove or steelangle brush. grey eyeshadow is Blush and bronzgreat, as it's blueer apply easily ish but does not with a large compete with the rounded brush. natural eye color Now that mineral like blue eye-shadpowder base is ow would. Any fast replacing liqneutral like taupe, uid base, a good brown or charcoal foundation brush will contour the is a must for most eyes and add women. dimension. Plum If cared for violet is also great properly brushas it echoes the es will last a lifeblue and adds time: zing. Every 6 weeks, Try a warm Model: Christine MacGibbon from Sherrida clean your brushbuttery color highes by swirling Models lighter like eggshell them in a mug on brow-bone to with shampoo add luminescence. continued from page 18 - Who is God?

of different religions, each believing that they are right, it seems likely that the details will never be agreed upon, but the main belief in a higher power seems to be a consistent feature. The "power of prayer" and the general health benefits and improvement to ones general well being if they are spiritual is well known. The analysts and skeptics would say that it is simply the power of positive thought triggering biochemical reactions in the body that strengthen the immune system and acting like a placeborevivemagazine.ca

effect. The faithful would say that if you don't believe, then you can't understand it. Is it a placebo effect? Is it spooky action at a distance, in which one manifests a change in subtle energy? Is it God intervening? The answer will ultimately depend on your belief system.

For more information or to contact Dr. Matta, please visit www.drmatta.com or call: 905.790.6644 REVIVE REVIVE Magazine -

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Q & A with Dr. Bill Middleton Leading edge cosmetic surgery requires years of advanced surgical training with an artistic appreciation for the human form. Dr. Bill Middleton has been expertly trained to manage a wide variety of aesthetic problems related to the face, body and breast. He is frequently quoted in the media and has been featured on such television programs as Style By Jury, Plastic Makes Perfect, ET Canada, Skin Deep and Cityline. Dr. Middleton is a Fellow of the Royal College of Surgeons of Canada. For more information please visit www.middletoncosmetic.com or email your questions to askanexpert@revivemagazine.ca

Q: Not knowing who is who in the cosmetic world, I have been a bit stand offish with getting any cosmetic procedure done. After reading Revive for a while now I feel more comfortable. I have been very interested in the content and feel that I may be ready to finally do something about my neck. I have very little volume in my neck along with a fair amount of sagging and excess skin. I am in my mid fifties and would like to know what procedures may be available to me? Because of my age would I have a greater risk for complications? A: Necklifting surgery is a common procedure amongst patients in their fifties and it is an excellent way to treat the loose sagging skin of the neck, often referred to as a "turkey Neck" or a "waddle". Utilizing incisions that are discreetly placed below and behind the Ear and underneath the chin, the neck muscles are tightened and the excess skin and fat is excised and removed. The remaining skin is then smoothly draped across the neck, and the incisions stitched closed, resulting in a naturally rejuvenated look that can take years off of your appearance. I would not be concerned that your age is a factor, as 50 - 55 is an excellent age for necklifting surgery, and complications are rare amongst healthy patients. Most patients return to work in two weeks or less and report very little pain associated with their procedure. Q: After taking time to think things through, I have decided that I would like to have breast implants. However my husband and I would like to have a child and I would like to have my implants before children. I am concerned about breast feeding! Will I be able to breast feed if I have implants? 20 - REVIVE Magazine

A: Breast augmentation has recently surpassed liposuction surgery as the most popular procedure performed in my office. The operation takes between one and two hours, and is performed on an outpatient basis with women frequently returning to work within days. It appeals to a wide variety of women of all ages, including younger women who still plan on having children and breast feeding. It is widely accepted that women can still breast feed following this procedure with no evidence that implants affect breast feeding in an adverse fashion. The surgical approach, however, can be customized to optimize successful breast feeding. The choice of incision site is important because although breast feeding is still possible, incisions placed around the nipple and areolar complex can disrupt the milk ducts. The type of implant that is used may also play a factor, as trace amounts of silicone have been found in breast milk secondary to silicone gel bleed in older implants. There are no known detrimental effects to infants associated with ingestion of this milk; however, if the perspective patient wants to feel perfectly reassured; a saline implant should be employed. The Saline fluid that fills this type of implant is the same as that given intravenously during surgery and is perfectly harmless in the event that implant does ever leak. I usually recommend placing the saline implant submusculary using either the transaxillary (underarm), transumbilical (belly button) or inframmary (below the breast) incision approach. Regardless of a woman's stage in life, the decision to pursue Breast Augmentation surgery can safely and positively enhance her self-esteem, confidence and outlook on life. revivemagazine.ca


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Is over-dressing a crime? he Holiday season always creates a fashion buzz with the possibilities of office parties, evening functions and of course, the New Year's Eve bash. Along with endless options of what to wear to each event, we are faced with a varying amount of "dress-stress" in the form of the following: • What will I wear to each event? • Have I been seen too many times in that outfit? • How can I go from work to the party without lugging around shoes and wardrobe all day? But perhaps the most nagging and recurring holiday question is; How can you make a great impression without risking being overdressed and looking like you try too hard, or being over made-up ending up looking like you are insecure and hiding behind a cosmetic mask, or worse, being the only one in slacks at a long dress function and feeling like a misfit? The answers to these social challenges lie in the ability to look in the mirror and say with conviction that you are dressing strictly to please yourself; then believe it! The guidelines I will outline may help you along the way. • First and foremost, always dress figure and age appropriate. Elegantly simple is always simply elegant. A year-end party is no time to experiment with a formula. If you are heavier than your ideal, this is not the time for sleeveless backless cocktail dresses or busy patterns that multiply your dimensions. A sheer blouse or a shrug over your bare skin is an excellent solution to cover-up a bit. • Have your colors done so whatever you wear will suit your natural tones. For example freckled red heads are considered warm undertones so usually should avoid hot pink or fuchsia as they are blue based colors which clash with their skin. Black is excellent for most, but for some olive skin tones, it can drain all your radiance and color. Even over-dressed but still in your native tones will always create a harmonious presence. • Short skirts and plunging cleavage are fine for younger ladies or fit types, but remember, the office party is still a business affair not a hot date. • A cocktail jacket is the answer to keep an executive profile until the dancing starts. If you arrive and realize that you are the only one in high fashion attire, go to the washroom and remove the necklace and/ or earrings and store them in your clutch. Then forget about it, have fun and be yourself. Do not mention to anyone there how you felt when you arrived. It relaxes others when you are un-self-conscious, and in most cases, it is better to be over-dressed than under-dressed. If you can not inquire ahead from the host or hostess what the dress code is, then take some bling in your purse. With the right shoes and blouse, even jeans can be pulled off with a stunning neck-piece and glamorous earrings. • Many times if your make-up and hair look modern and well applied, only you would remember the clothes. Make no excuses unless someone brings it to your attention. If someone does, make light of it and say, "It's recession chic or, the maid borrowed my Chanel, or I left the garment bag in the 'copter, or the chauffeur sped off with my Louis Vuitton, or I could only find one of my glass slippers!" Then change the subject with a laugh.

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• Life is not a fashion competition so make sure your warm personality and humor keep you in the spotlight and on next year's favored guest list. • Make-up and hair should be appropriate too. An updo is such a fast way to set an evening tone to your look. Shimmery lipstick, liquid eyeliner on the top lid, more mascara, and few individual eyelashes on your outer top lid is a fast way of glamming up an office day look into red carpet territory. • Fashion is an art form that allows us to express our individuality and personality so decide if you are the classic type, the trendy one, or the woman who can do it all. When we go out it gives us a chance to explore who we are, and attract new people, so dress for yourself first and foremost. The truth about judging a book by its cover applies. If you are sophisticated then being overdressed is never a fear. That is really you, just like the sporty tomboy is not really the prissy-frilly dress-type so a lacy cocktail dress and high shoes that stop her from walking with confidence are a sham. • The holidays are a time to heal the world, so start with yourself first and treat yourself to one new item that will give you that extra zing that says, "I'm worth it!; then believe it." • And when it's time to go out, remember that the best fashion accessory is a charming smile and kindness in your eyes. Korby Banner Credits Make-up and photography: Korby Banner korbybanner.com • info@korbybanner.com Hair and hat creations: Jason Gordon jasondhrty@yahoo.co.uk Model: Christine MacGibbon/ Sherrida Model www.sherrida.com • mgmt@sherrida.com

Korby Banner is an internationally published photographer, who appears daily on the hit TV show, Style by Jury, as key make-up artist. His resume includes A-List Hollywood talent , Cd covers, billboards, advertisements and magazine editorials from fashion, cosmetics and lifestyle. www.korbybanner.com • info@korbybanner.com


Q & A with Dr. Mark Korman Dr. Korman has extensive experience in cosmetic and reconstructive surgery. Following board certification in Canada and the U.S., he completed advanced fellowship training in hair restoration. Dr. Korman is a member of the Canadian Academy of Facial Plastic and Reconstructive Surgery and the International Society of Hair Restoration Surgery and continues to travel internationally to enhance his approaches with cutting-edge techniques from around the world. Please visit www.kormanmedical.com or email your questions to askanexpert@revivemagazine.ca

In past Q&A columns, I have addressed questions about medical and surgical treatments for hair restoration, as well as questions about the modern hair transplant experience and the undetectable results that we can achieve. Recently, I have fielded some questions about when the right time is to consider treatment for hair loss. Q: When should I start medical treatment with Propecia or Rogaine? A: This is a great question because barely a week goes by when a patient doesn't tell me how much they regret not starting medical treatment sooner. Minoxidil, sold as Rogaine is applied directly to the scalp and is effective for both men and women. Finasteride, sold as Propecia is a daily pill that is generally prescribed only for men. Propecia has been shown to stop or stabilize hair loss in about 90% of men who take it and like Rogaine, is most effective in the crown area of the scalp. I encourage my patients to think of their hair as a non-renewable natural resource. Hair transplantation can achieve impressive cosmetic results by redistributing hair from areas where there is an abundance (like in the back) to areas where there is a need (like at the hairline). What hair transplantation cannot do however, is to create new hair. Consequently, what can be accomplished with transplantation is limited by the supply of donor hair that is available and the area of bald or balding scalp that needs to be covered. Given the above, it makes sense to stop ongoing hair loss early in order to preserve existing hair and conserve natural donor reserves. We are fortunate to have proven and safe medical treatments including minoxidil and finasteride at our disposal. Starting medical treatment early may eliminate the need for a transplant in the future, or limit the area that requires transplanting, thereby allowing us to maximize coverage 24 - REVIVE Magazine

and density. In those patients who ultimately undergo a transplant, medical treatment gives us a more "stable canvas" to work with by limiting progressive balding. I recommend consideration of medical treatment to stop ongoing hair loss at the soonest possible time even if surgical treatment is not currently an option. Remember that by the time an area has a thinned appearance, 50% of the hair in that area has already been lost. Q: When should I consider a hair transplant? A: Men and women who have visible hair loss, are healthy, and in whom there is no underlying medical condition requiring further investigation or treatment are candidates for hair transplantation. While I do not have an absolute cutoff for age, I am cautious about recommending hair transplants to very young patients. It is sometimes very difficult to predict what the eventual extent of hair loss will be in patients presenting in their teens and early 20's so I often recommend at least a year of medical management to stabilize the situation before considering a transplant. If a transplant is undertaken on a relatively young patient, I create a very conservative hairline that will continue to look natural even if the patient continues to lose the surrounding non-transplanted hair over time. Sometimes I have to spend a long time managing the expectations of younger patients who ask me to restore the hairline that they had when they were in high school. Taking the above into account, the right time to consider a hair transplant is when you look in the mirror, or at a photograph of yourself, and the hairline that you see does not reflect the way that you feel or the image of yourself that you wish to project to the world.

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No Gym Required How to get fit at home By Bruce Krahn s a personal trainer with more than 15 years experience I am often asked "what is more important to getting in shape- exercise or diet?" This question has been hotly debated on many a forum but recently science has weighed in on the matter and the answer was quite surprising. While most folks have long believed diet to be the key to losing (and keeping off) the pounds it turns out this is incorrect. In a recent study looking at successful "losers" researchers discovered that people who exercised were far more likely to lose weight and, most importantly, keep the weight off over the long term. The non-exercisers had a much higher recidivism rate and in many cases regained any weight lost plus a few extra pounds. Getting in some gym time is clearly one of the most important investments you can make. In today's post-recession, "work 2 jobs to pay off the bills" world many people are looking for alternatives to expensive gym memberships that require several hours of commitment each week. The prospect of working out at home becomes very appealing especially when you consider the amount of time and money needed to purchase and actually use a gym membership. What prevents many people from working out at home is the belief that in order to get a great workout you need rows of expensive machines and cardio equipment. The following workout is a perfect example of what can be accomplished in your own living room with some basic equipment and good old fashioned hard work; Warm up Preparing the body for movement does not necessitate the use of a treadmill or bike. Here are 3 movement drills that will warm up your joints and prepare you for action: 1. Jumping jacks 2. High knees 3. Leg swings

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4. Arm circles Workout When working out with minimal time and equipment it is best to train the whole body as opposed to following a traditional "split" routine. The following exercises can be done for reps or for time. Remember, there is no law saying that you must do "three sets of ten reps". Be sure to vary your repetition range each workout and change your workout frequently. This variety is the key to your success. Follow this routine or create your own program using these fantastic exercises: 1 a) Y squat 1 b) Mountain climber 2 a) Spiderman push up 2 b) Medicine ball slam 3 a) Renegade row 3 b) Burpee 4 a) Spiderman crawl 4 b) Standing high knees Complete this routine on 3 non-consecutive days per week. Perform exercise "a" for 10-20 repetitions and exercise "b" for 30-60 seconds. Repeat each pair of exercises 2-3 times resting no more than 60 seconds in between. This workout should take less than 30 minutes including warm-up. Follow this for 2-3 weeks before progressing to using more resistance. Don't be surprised when you feel muscles that you never knew existed before! One of the advantages of workouts such as this is there is no need for any post workout cardiovascular exercise- it's already built in. For many people a workout such as this is all that is needed to drop several pounds of fat in very little time.

Bruce Krahn is a personal trainer and the author of the Fat Fighter Diet. He has consulted with many well known celebrities including Nelly Furtado, Criss Angel and Tom Cochrane. You can download his "Lose 5-50 inches Fat Loss Report" absolutely free by visiting ebodi.com today.

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The Cellulite Solution Tips and Techniques to lose the lumps By Anna Gabriele veryone has written on cellulite - here are a few quick and direct ways to tackle this chronic condition. Whether we like it or not - cellulite will come and visit most of us at some point in our lives. Many women will develop some degree of cellulite on various parts of their body. There are various tips to deal with or delay the onset of those unwanted lumps and dimples that creep up on us. If you have joined the group already - or it is creeping up on you - don't despair this article will help you to deal with it. Cellulite if left unattended becomes an unsightly skin problem. Most women will be exposed to it - even the skinny ones. One main reason is hormonal imbalance and the reason why most men don't get it. Another important cause is the imbalance between how much we eat and how much we burn off. Most of us eat more calories daily than we need and we don't burn enough of the calories off by days end. Our fat cells store the unused food and swell sometimes to 100 times their original size. The roadmap of bumps and valleys that we see on the surface are basically caused by poor circulation and water retention. This is caused by fat cells that are so swollen they create - in simple terms "a traffic jam". Fat cells by the hundreds come closer to the surface of the skin due to the weakening skin structure and therefore become more visible. "The orange peel effect". This most commonly occurs in the hip, thigh and butt areas. You might also notice "SMILING" knees due to the loss of elasticity. For those of you that feel exercising will eliminate this problem - think again. It is true that burning more calories helps to reduce the chances of fat cells swelling.

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However, once you are already victim to swollen fat cells, increasing muscle size will simply push the bumpy fat cells closer to the surface of the skin. Exercising is making it look worse. Now that we know a little about the make up of cellulite, let us get to some tips, tricks and techniques on dealing with it. There is no magic PILL you can take - sorry. To deal with it you need to do some of the things we really don't like to do (oops I'm saying "adopt a cleaner and healthier lifestyle"). Yes ladies we need to get with the program. Eat healthy (more fruits, vegetables and whole grains -increases elimination and rebuilds the skins structure) and participate in a regular fitness regimen. Add to this the application of circulation boosting creams, heat, massage and vitamin B12 and you are on your way. The "eat clean" topic is one I could elaborate on extensively. The first step which should be taken to resolve issues affecting your body, in my opinion, is investigating which foods help your body stay healthy. The purpose of this article is not to discuss the benefits of eating clean however, I guarantee that once you investigate the topic further you will see that it does apply. It is my belief that you should deal with the source of the issue and not the effect. Although some creams may work, they are topical. Health and nutrition starts from within. The body is your primary source of nutrition. You are what you eat. Eat healthy and your body will be healthy. Let's not kid ourselves we all love to cheat once in a while however, the bottom line is that it catches up to us. Below is a list of important tips: • Find a way to drop some weight. This will shift the cellulite issue to a possibly more manageable factor. • Muscle building exercises can boost your metabolic rate and help you burn more body fat - the result is less cellulite. continued on next page revivemagazine.ca


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• Crash diets may make cellulite more visible beware - losing weight quickly does not allow enough time for the fat cells to shrink. • Daily skin brushing (dry skin brushing) or massaging can help soften and smooth out orange peel thighs (that dimply effect). • Ionithermie is a no nonsense clinic therapy that involves sending rhythmic electrical pulses through your bottom - it's not torture, but some swear by it. • If you are looking for a non-clinic approach, jogging is one of the best exercises for cellulite busting.

swollen fat cells. • Professional massages will boost circulation and kick start your lymphatic drainage system. • Cigarettes and alcohol contain toxins that wreak havoc on your skin. A dose of clean living might keep the dimples at bay. • Protein helps to build muscles which boost your metabolism - cellulite hates it. The following are some high tech treatments that can help zap cellulite away: • Endermologie • Radio Frequency • Infrared light

• Slow but steady - build as you go - even walking works wonders.

• Vacuum sucking

• Clinical trials show that endermologie - a deep massage therapy - can minimize lumps and bumps and reduce thighs by inches.

• Mesotherapy

• Keeping skin hydrated can reduce the visibility of those dimples. Therefore moisturize, moisturize and moisturize!! • Magic happens when you rub goo (seaweed and algae) all over your body - i.e .those famous body wraps. It creates heat - rebalances your metabolism and circulation, relaxes your muscles and heals the skin. • Marine products help with cellulite by boosting circulation and encouraging fluid loss from your skin. • Cut back on bad fats and you will reap massive rewards on your butt and thighs. • Beware - caffeine can dehydrate and age the skin - this can make cellulite worse. • The daily intake of water can help reduce those orange peel thighs and help flush toxins that are stuck in the fluid in between the

• Heat treatments with caffeine • Endomesotherapy As you age your metabolism slows - more body fat and sagging occurs - combat this with new strategies to combat this natural chemistry. If you can't beat it, the recommendation is to hide it with a FAKE tan. If you take care of your body, your body will take care of you. Once you have addressed the important lifestyle issues discussed and have formed a plan of action; there is one more tip I can give you. Depending on your budget, learn what to wear to make the most of your assets. Be a mistress of disguise. Anna Gabriele Certified Skin Care Aesthetician Co-Owner Lasair Laser & Advanced Skin Care Medi-Spa

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We want to hear from you. Send us your letters, comments and suggestions. You can mail us at Revive Magazine, 5-18 Ringwood Drive Suite #414, Stouffville Ontario L4A 0N2 or email us at letters@revivemagazine.ca. All submissions become the property of Revive Magazine and will not be returned; they may be edited and may be published or otherwise used in any medium. Fashion questions can also be submitted to fashion@revivemagazine.ca. Have a question for a Revive expert email to: askanexpert@revivemagazine.ca

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The Cause of Hair Loss Fact and Fiction By Dr. Mark Korman umerous medical conditions can cause temporary or permanent hair loss however for the overwhelming majority of people who seek hair restoration, the cause of the problem is what is known as male pattern hair loss or female pattern hair loss. This is also know as androgenetic alopecia (AA). "Alopecia" means "hair-loss" and "androgenic" ref ers to male sex hormones or androgens that are responsible for progressive miniaturization and loss of hair with age. In genetically susceptible males, pattern baldness is caused by the action of the hormone dihydrotestosterone (DHT). The hormone testosterone is converted to DHT by an enzyme called 5-Îą reductase and it is now understood that DHT is responsible for beard and body hair growth as well as for scalp hair loss. The medication Propecia (finasteride) prevents androgenic alopecia by blocking 5-Îą reductase. The effect of androgens on the male hairline can begin as early as the teenage years and most men will have experienced some degree of pattern hair loss by the time they reach their fifties. The pattern typically begins as recession of hair in the temple areas and in the crown and can gradually progress until only a thin rim of hair is left around the edge of the scalp. It can be very difficult to predict the ultimate extent and pattern of hair loss for any individual patient. In general, the horseshoe shaped area of scalp hair starting above the ears and extending to the back of the head is resistant to the effects of DHT and so is not lost with male pattern baldness. The resistance of these hairs to DHT is retained even when they are relocated to other areas of the scalp and it is this property that makes modern hair transplantation possible. Predisposition to male pattern baldness is

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thought to be largely inherited however the genetic process is complex and poorly understood. It is a myth that the "baldness-gene" is inherited from the maternal grandfather. Other myths include that poor scalp circulation, caps or hats, or shampoos cause baldness, although certain products such as strong relaxants can damage hair. Women are also subject to hair loss and while this can be particularly upsetting and can have a devastating impact on self-esteem, in many cases it can be effectively treated. As noted above, there are numerous medical conditions that can cause hair loss in women and hair loss can be associated with other factors such as recent pregnancy or long-term pulling of the hair in pony-tails or tight braids. As in men, the most common cause of hair loss in women is inherited androgenic pattern baldness however the pattern is generally different from what is seen in males. While female pattern hair loss can start early, it often begins later than the male variety and is more frequently, but not always, associated with a diffuse thinning effect over the entire scalp sparing the frontal hairline. Many women complain that the part in their hair seems to get wider. While female pattern hair loss is extremely common, many women do not realize that treatment is available and effective and so continue to suffer with the embarrassment and anxiety that frequently accompany thinning hair. In addition to androgenetic alopecia, there are numerous other conditions that can lead to temporary or permanent hair loss. Such conditions include thyroid or other hormonal imbalances, low iron, nutritional deficiencies, autoimmune disorders, medication side effects, trauma to the hair or scalp, stress and many others. General medical factors tend to be more of a consideration for women than for men and many female patients require blood tests or other investigations to rule out an underlying medical cause prior to proceeding with hair restoration.

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Q & A with Tanya Wylde Tanya Wylde is a Naturopathic Doctor (ND) with a special interest in Weight Loss, Fertility and Perinatal Health. She worked for many years as a certified personal trainer and fitness instructor while training to become an ND because she believes that physical activity is one of the fundamental requirements to a healthy body and soul. For the last 4 years Tanya has been working in a very busy eclectic practice in Vaughan Ontario with a team of health care experts including Bryce Wylde. Please visit www.homeopathicdoctor.ca or email your questions to: askanexpert@revivemagazine.com.

Q: I keep seeing "gluten-free" on labels on products in the grocery store. What is gluten? What's the difference between gluten free and wheat free? A: Gluten is a protein found in grains. The following grains contain gluten: Wheat, Barley, Rye, Spelt and Kamut. The following grains are gluten-free: Rice, Amaranth, Quinoa, Buckwheat and Millet. Wheat has the most gluten compared to the other grains. Oats are usually gluten free but are sometimes contaminated with gluten so if you are gluten intolerant or sensitive it's best to get gluten free oats. "Wheat-free" doesn't mean gluten-free since wheat free products often have gluten containing grains. People with celiac disease can't tolerate any gluten at all since it destroys their intestine when they eat it and causes major intestinal discomfort, diarrhea and malabsorption. People with gluten sensitivity but who aren't celiac usually get gas and bloating with wheat but can eat the other gluten containing grains that have less gluten(such as rye and kamut). In addition to avoiding gluten if you are sensitive or intolerant, try the product "Digest Gluten Plus" by Genestra or Gluten Defense by Enzymatic Therapy when you are dining out to avoid gastrointestinal distress.

A: Lactose intolerance is when a patient lacks the enzyme lactase to break down the sugar in dairy called lactose. This can cause major diarrhea and intestinal discomfort. People who are lactose intolerant may be able to eat small portions of cheese or yogurt with a lactase enzyme since there is less lactose in yogurt and cheese compared to milk. People who have allergies to dairy are allergic to the proteins "casein" or "whey" found within dairy. This means that they react to all forms of dairy including milk, cheese, butter and yogurt and have to read labels to avoid foods that contain casein or whey. If someone is allergic to dairy the reactions are more serious and include throat closing, vomiting or serious full body eczema. People who have sensitivity to dairy have less serious reactions such as mild to moderate eczema, skin itching, runny nose, phlegm and mild to moderate stomach discomfort. If you have allergies to dairy you should completely avoid dairy. If you are sensitive to dairy or have lactose intolerance you should avoid dairy most of the time but when you have small amounts of cheese or yogurt on occasion you can take an enzyme like Digest Dairy Plus by Genestra to help you digest the small amounts of dairy you consume.

Q: What is the difference between dairy sensitivity, dairy allergy and lactose intolerance?

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New wine region just south of Belleville has come of age visited The Grange of Prince Edward County, a vineyard just south of Belleville, Ontario where I met with Caroline Granger, the CEO, and an outspoken advocate of the wines of Prince Edward County , which surprisingly consists of more than a dozen wineries. Caroline is also a member of the board of the Canadian Vitners Alliance and The Wine Council of Ontario. My visit was during grape harvesting time which I later discovered was the worst and best time of year to visit. A passion for life has guided Caroline Grace Granger through a wide spectrum of experiences, everything from working at her parent's cattle farm to being a successful international model and travelling to Paris, New York and Tokyo. Today you can find her working diligently on that same farm harvesting and bottling some of Ontario's finest wines. Caroline explains, "This is an exciting time for us, how often do you get a chance to experience the infancy of a new wine region". I was surprised to learn that the grape harvest for the entire year for PEC wines lasts only 5 weeks, but it is a long 5 weeks, in fact Caroline doesn't sleep much in those 5 weeks. The Grange has 60 acres of grape vines which is a small amount compared to their counterparts in Niagara so the grapes at the Grange are all handpicked, which is unique only to this county. The wineries of Niagara, Pelee Island, and Lake Erie North Shore, all use machines to pick their

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grapes. No sleep for the ‌‌ 5 weeks of harvest time. During harvest there is little to no sleep at The Grange. Caroline explains, "There are such rich oxygen levels during harvest from the grapes that you can feel the energy and well being just from being on this farm during this magical time. The air is so full of oxygen, it is incredibly invigorating." Aside from the gruelling work schedule of picking grapes, Caroline is kept awake from the constant threat of frost, birds, and especially racoons. She explains, "We found out the hard way in 2003, and later learned that racoons can eat almost 3 tons of grapes in a single weekend". Growth at the Grange has been astronomical! In 2003, they produced 1,600 cases of wine but in 2007, they produced 10,000 cases of wine. Obviously as the vineyards matured so did the production. Wines from the Grange are bottled under the Trumpour's Mill Label. These wines were the first from Prince Edward County to win medals at provincial and national competitions. Caroline explains "Awards are important for consumers learning about your wines, it gives them confidence in selecting what they're going to try". Caroline's passion includes a strong focus on buying locally and supporting Ontario's authenticity. I was shocked to learn that the LCBO is the largest retailer and purchaser of beverage alcohol in the world, and The Grange Wines have to compete on par with those of France, Italy, and Australia. "The Ontario market is a


great place to sell wine because it is the largest market but this also makes it very competitive", e x p l a i n s Caroline. "Local wines are now competing with the world's most well-known brands. Ontario is definitely making a global name for itself when it comes to wines". Caroline explains the importance of looking for the "VQA" symbol at the LCBO, "It stands for Vitners Quality Alliance and means that if you buy wine displaying the VQA symbol, the grapes are 100% grown and processed in Ontario, also growing our local economy." In fact, for every litre of VQA wine produced in Ontario there is an economic value of $11 before taxes towards the economy. A definite advantage of being in Prince Edward County "The climate is similar in both regions of Niagara and PEC, but the soils are shallower here. Both Niagara and the PEC regions are on limestone but PEC's limestone is easy to break so the roots of the grapes can penetrate through for more nutrients." explains Caroline, "these rocks absorb heat from the sun which keeps the

vineyard well drained and also keeps the ground warmer during the frosty nights." The economy has suffered but the Grange has weathered the storm "Most wineries like Niagara have the Americans to thank for a lot of their revenue so they really felt the dip in the economy south of the border, but PEC never relied on the Americans because they are not located near us, unlike the wineries on the border of Niagara". Caroline's great aunt once gave her some great financial advice, "You have to invest in alcohol companies because no matter how bad things get, people will always drink!" It looks like Caroline's great aunt was right.

HEALTH BENEFITS OF WINE A moderate level of alcohol consumption is considered to increase the body's production of high-density lipoprotein cholesterol (HDL). HDL is known as the "good cholesterol" and helps eliminate bad cholesterol from the body, reducing plaque build-up in arteries, therefore decreasing one's risk of heart disease. Red wine includes pigments that make grapes deep red, blue or purple. These pigments act as antioxidants and decrease the tendency of blood to clot, which could save one's during a heart attack, and decreases the ability of LDL (low-density lipoprotein) cholesterol to stick to plaque in the arteries. continued on next page


Q & A with Dr. Richard Rival Dr. Richard Rivals practice is devoted to facial plastic surgery. His expertise in rhinoplasty and other procedures has been recognized academically and in the media. He sees patients in Newmarket and his two Toronto offices. Dr. Rival is on the teaching faculty at the University of Toronto Department of Otolaryngology-Head and Neck Surgery in the division of Facial Plastic Surgery. For more information please visit rivalcosmeticsurgery.com or rhinoplastytoronto.ca or email your questions to askanexpert@revivemagazine.ca Q: It's been two months since my chin implant and I think it is too large, my profile isn't bad but from the front my face is longer and my smile is different. My bottom teeth used to show when I smiled and now they barely do, it's lopsided and both my top and bottom lips are still tight. I am concerned; I didn't think my smile would change. If I have it removed will my smile return. A: When a chin implant is placed the surgeon must separate and then repair certain muscles to gain access to the jaw bone. This creates swelling and stiffness of these muscles that can last for months after the procedure. The placement and shape of the implant can of course also affect the result. It's important to return to your surgeon to make sure the implant has not shifted or changed position. Overall though I would suggest waiting 2-3 months to allow all the swelling and muscle stiffness to go away. If you are still not happy then you may want to consider having the implant removed and possibly repositioned or replaced. Your

INTERESTING FACTS - 1 tonne of fruit yields between 600-675 litres of wine or 800-867 bottles of wine - There are 140 tonnes of grapes in the 60 acres of The Grange. - It takes 6-36 months for PEC grapes on vines to become bottles of wine for sale on LCBO shelves, depending on the grape, style of wine, and vintage year. Quite a difference from the 5 weeks it takes for the bottle your own wine at VinBon! 36 - REVIVE Magazine

smile is likely to return to normal either way with time. Q: How do I know if I need neck liposuction or a facelift or both? A: Excess tissue in the neck is usually a combination of loosening of the main muscle of the neck known as the platysma, excess fat and sagging skin. Neck liposuction is ideal for those patients that have mostly excess fatty deposits in the neck but also have relatively tight skin and muscle. In this situation when the fat is removed the skin will usually contract down and leave a nice smooth surface. This is typically seen in younger patients (40s- early 50s). In patients that have significant sagging skin or visible bands at the front of the neck a more formal face or neck lift is appropriate. Liposuction alone in these patients may in fact make the sagging skin look worse. Ultimately it would be important to seek the help of a surgeon who specializes in Facial Plastic Surgery to sort out together which procedure is right for you.

The Grange Wines have won the following awards to date: SILVER METALS Trumpour's Mill 2007 Pinot Noir VQA and Trumpour's Mill 2007 Cabernet Franc VQA BRONZE METALS Trumpour's Mill 2007 Chardonnay VQA, Trumpour's Mill 2007 Pinot Gris VQA and Trumpour's Mill 2007 Gamay Noir VQA revivemagazine.ca


Natural Remedies For Sports Injuries by Dr. Zoltan Rona, MD, MSc

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ennis elbow, knee ligament strains, ankle sprains and different forms of tendonitis can be a real nuisance to athletes at any level. If you are one of those people who suffer from frequent or recurrent musculoskeletal injuries, consider using some natural remedies for both prevention and to speed healing. While none of these nutritional supplements is an alternative to standard medical, physiotherapeutic or chiropractic care, they can help these treatments work better and more quickly. The best-documented nutrients in this category are: Protein - (1 gram of protein per pound of lean mass or more daily) is required for maximum muscle strength and growth as well as to prevent muscle deterioration and loss of lean body mass to energy requirements. It is most natural to get your protein from real food rather than supplements. In that respect, the highest quality proteins, in descending order of quality based on amino acid composition, are: lactalbumin (from hydrolyzed whey protein concentrate) egg albumin (from egg white) beef, fish, poultry casein (from milk) soy protein vegetable protein (half the muscle building protein quality of lactalbumin). The ion-exchange whey protein supplements (90%+ ion-exchange whey protein by weight) are good alternatives for those with limited cooking skills or an affinity for the kitchen. L-Glutamine - 4000 mgs. before and after exercise. L-glutamine is an amino acid which is vital for anyone who exercises a lot and is a favorite of most serious body builders. As a nitrogen donor, glutamine helps build proteins and repair the muscle, as well as help build up more mus38 - REVIVE Magazine

cle. This, in part, may be due to its ability to induce the release of growth hormone. For those taking prescribed anti-inflammatory drugs, Lglutamine will help prevent damage to the lining of the gastrointestinal tract, ulcers and blood loss. If you are injured, L-glutamine will speed your recovery from virtually any sports injury without side effects. Broad spectrum multiple antioxidant (1-3 capsules or more daily) - should contain at least the following nutrients: vitamin A, beta carotene, B complex vitamins, vitamin C, E, zinc, copper, manganese, selenium and N-acetyl-cysteine, a precursor for glutathione. The minerals zinc, copper and manganese are important cofactors in the body's production of superoxide dismutase, considered to be the most potent of the body's protective enzymes. Antioxidants are free radical scavengers or neutralizers that also prevent the formation of free radicals in the first place. MSM (Methyl-Sulfonyl-Methane - 6000 mgs. or more daily) - a naturally occurring organic source of nutritional sulfur found in ever diminishing quantities in fresh fruits and vegetables, commonly lost during storage and cooking. MSM is a stable metabolite of DMSO (dimethyl sulfoxide), a substance popularized in the 1970s and 80s for its ability to reverse pain and inflammation in arthritis and other degenerative diseases. DMSO can be used as an enhancer of both nutrient and drug absorption into body cells. Unfortunately, the use of DMSO causes individuals to develop a severe garlic odor to the breath and body. MSM has all the same properties of DMSO but is odorless and and has no side effects at any dosage. Sulfur is a critical component of many important amino acids contained in cellular proteins, enzymes, hormones and other body structures. In high doses, MSM is a powerful free radical scavenger, improves circulation, boosts nutrient absorption, reduces inflammation and helps reduce lactic acid build-up, the chemical causing muscle soreness and fatigue after strencontinued on page 40 revivemagazine.ca


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uous exercise. In addition, MSM fights fatigue, helps hair and nails to grow faster and has been shown to be anti-parasitic. The efficacy of MSM is enhanced by vitamin C supplementation. The beneficial effect of glucosamine sulfate in the reversal of osteoarthritis is thought by some experts to be related to its sulfur component, something which can very effectively be delivered to the body by MSM. Vitamin C (3 grams or more, depending on bowel tolerance daily) has been shown to reduce muscle damage after working out and aid in muscle recuperation by reducing cortisol levels after intense exercise. Growth hormone, testosterone and insulin are all, to various degrees, dependent on an adequate supply of vitamin C. The value of vitamin C as an antioxidant as well as a crucial nutrient in bone health is well documented. Vitamin D3 (10,000 IU daily) not only speeds healing from injuries but also has been proven to boost athletic performance. We are talking steroids here. Yes, vitamin D is really a steroid. Few, however, believe that it is a performanceenhancing steroid too. Like testosterone, it is manufactured from cholesterol and it is a hormone in the same way that growth Hormone (GH) is a hormone. According to Dr. John Cannell of the Vitamin D Council: "Steroid hormones are substances made from cholesterol that circulate in your body and work at distant sites by setting in motion genetic protein transcription. That is, both vitamin D and testosterone set in motion your genome, the stuff of life. While testosterone is a sex steroid hormone, vitamin D is a pleo- morphic steroid hormone." Many performance enhancing drugs and food supplements are banned from athletic competitions. Presently, vitamin D is allowed and may make a big difference in the performance of many athletes. In the 1960s and 70s when German and Russian athletes seemed to win just about every Olympic medal, Germany and Russia coincidentally published the most convincing studies on the athletic performance enhancing effects of vitamin D in their medical journals. Vitamin D supplementation will definitely improve athletic performance in vitamin D deficient people (which is just about everyone, it seems). Studies do show that taking vitamin D will make you faster, stronger, better coordinated and mentally tougher as an athlete. One more recent study by a Dr. Ward in 2009 found that vitamin D helped young teenaged 40 - REVIVE Magazine

girls jump higher. Vitamin D supplementation increases the number and size of fast twitch muscle fibers which are needed for optimal athletic performance. In order to achieve improved athletic performance your vitamin D blood levels must be at least 75 ng/ml. Get your blood levels checked. Coenzyme Q10 (ubiquinone) - (100 - 200 mgs. daily) protects against exercise-induced muscle injury and fatigue caused by exercise. Many reports also indicate that coenzyme Q10 is an effective remedy in the treatment of Chronic Fatigue Syndrome and other immune system diseases involving damaged cellular mitochondria. It's value is limited by its high price. Glucosamine sulfate (1500 - 2000 mgs. daily) supplementation may speed healing of recurrent joint injuries such as chondropathia patellae and thus prevent the development of osteoarthritis. MSM coupled with an adequate protein intake eliminates the necessity of supplementing this nutrient. Proteolytic enzymes (3 or more capsules daily) trypsin and chymotrypsin, usually considered as enzymes that break down dietary protein in the gastrointestinal tract, also have been shown to promote the healing of many exercise damaged tissues. Bromelain (from pineapple stalks) and papain (from papayas) have been reported to have similar beneficial effects. Creatine Monohydrate - (20-30 grams a day for a week for muscle saturation, then 5-10 grams per day for maintenance) is a natural, tasteless and safe nutrient found in animal protein (about 5 grams per 2.2 pounds of steak, salmon, tuna, lobster or lamb). It has ATP (adenosine triphosphate) enhancing effects that dramatically increase muscle strength. Creatine monohydrate is especially popular with competitive body builders who can look about 5-10 pounds more muscular because creatine attracts water into the muscles. This should not be confused with the bloating and fluid retention caused by allergies, congested organs or other suboptimal states of health where the fluid accumulation is outside the muscles. Creatine monohydrate converts in the body to creatine phosphate, an energy supply for muscles providing greater strength and stamina. Creatine also acts as a buffer against the buildup of lactic acid and neutralizes the free radicals produced by heavy exercise. L-carnitine - (1000 mgs. or more daily) - has a protective effect against exercise caused pain continued on page 42 revivemagazine.ca


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and damage. This appears to be primarily related to its vasodilatation property which improves the energy metabolism of damaged muscle. Acetyl-L-Carnitine (1-2 grams before you workout and at bedtime), an L-carnitine derivative, has been shown to reduce the high catabolic cortisol levels in the blood after intense exercise. If you are just beginning a supplement program, do not expect instant results. All the nutrients discussed above take time (at least 3-6 months) to show noticeable improvement since it takes that long to grow the several billion new cells incorporating the new influx of nutrients. The best times to take supplements are 1 hour or so before and immediately following an exercise session and at bedtime. For more information on nutrient supplementation, see your natural health care provider. REFERENCES Alive Research Group; Gursche, Siegfried, Publisher; Rona, Zoltan P., Medical Editor. Encyclopedia of Natural Healing. Vancouver:Alive Books, 1998. Bรถhmer D et al. Treatment of chondropathia patellae in young athletes with glucosamine sul-

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fate, in N Bachl, L Prokop, R Suchert, Eds. Current Topics in Sports Medicine. Proc World Congress of Sports Med, Vienna, 1982. Urban & Schwarzenberg, 1984. Giamberardino MA et al. Effects of prolonged L-carnitine administration on delayed muscle pain and CK release after eccentric effort. Int J Sports Med 17:320-4, 1996. Kim MC, Ames BN. Ubiquinol-10 is an effective lipid-soluble antioxidant at physiological concentrations. Proc Natl Acad Sci U S A 87:4879-83, 1990. Kleine M-W. Systemic enzyme therapy in sports medicine. Deutsche Zeitshrift fur Sportsmedizin 41(4):126-34, 1990.

Dr. Zoltan P. Rona practices Complementary Medicine in Toronto and is the medical editor of "The Encyclopedia of Natural Healing." He has also published several Canadian best selling books including "Return to The Joy of Health". For more of his articles, see mydoctor.ca/drzoltanrona

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REVIVE Men’s Top Fashion Five By Mara Wood From H&M to Helmut Lang, the MILITARY-INSPIRED looks are what we'll be seeing in stores this year. TAILORED PREPPY CLASSICS with cuffed slim pants, cardigans to layer with and the classic polo shirt with a new twist, extra long! LEATHER BOMBERS with interesting t-shirts, always a classic, but now a MUST HAVE! DESIGNER JEANS You can wear them almost everywhere! With prices

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Dental Health 101 By Dr. Charles Botbol BSC, DDS

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here are 4 main disease processes that are treated in dentistry. These categories also represent the top four ways in which we lose teeth as adults: 1) decay (cavities) - a bacterial infection of the hard tooth structure. This is the major cause of tooth loss in children and the major cause of root canal infections in adults. 2) Periodontal (gum) disease - a bacterial infection of the soft tissues surrounding the tooth (gums) and the supporting bone (the tooth socket). This is the major cause of bad breath, bleeding gums and tooth loss in adults. 3) Traumatic occlusion (a bad bite) and bruxism - grinding, clenching of the teeth and an uneven bite can generate forces across the teeth can range from 100 to 600 pounds per square inch leading to premature tooth loss. 4) Trauma - such as motor vehicle accidents and blunt force trauma. Accurate diagnosis is the only way to identify these disease processes early and treat them preventively. The diagnostic skills of your dentist are very important to your short and long term dental and overall health and appearance. A simple start is having regular hygiene visits to your dental office. The average number of times can vary from two to four times per year, depending on your current dental health. Your dentist should be able to recommend the correct frequency for you and explain why he has recommended it. It is critical that patients understand, however, that the absence of pain does not indicate the absence of disease. If you take your 46 - REVIVE Magazine

automobile in for regular maintenance and oil changes, it is highly unlikely that you will have any unexpected problems, such as transmission failure, which can be frustrating and costly. It is for this same reason why it is so important to be examined approximately twice per year by your dentist at your "maintenance" or hygiene visits. Since your hygienist will usually spend on average anywhere from 40 to 90 minutes with you, she should be able to clearly communicate any concerns to your dentist, who can then discuss options with you so you can make an informed decision. This will reduce the likelihood of any problem progressing to a point where you have pain, discomfort, lost time at work and fewer, if any options to save the tooth or teeth in question. Ensure that your dentist and his educated team take the time to be thorough and have the ability to see problems "early". As a patient it is also important to always communicate your own concerns about tooth or gum sensitivity, bleeding gums, grinding or clenching, pain, bad breath, as well as esthetic concerns that can affect your everyday life.

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Bruxism, whether at night or during the day, is a loosely used term that refers to an incessant grinding and clenching of the teeth, intentionally or unintentionally, and at inappropriate times. Unfortunately, "bruxers", or people who grind or clench their teeth, are often unaware that they have developed this habit, and often do not end up seeking treatment until damage to the mouth and teeth has been done. Similarly, a tooth that is not properly positioned within the dental arch absorbs more of that biting pressure than it should. An uneven bite is also associated with bruxism and studies have shown that this as well as bruxism, can greatly accelerate the painless loss of bone support for the teeth with existing gum disease, tooth loss due to excess forces, as well as early failure of implants, crowns, bridges and veneers. Occasional bruxism may not be harmful if treated early with a simple bite guard or night guard. When it occurs regularly and it is not diagnosed or treated, it may be also associated with moderate to severe headaches, shoulder and

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neck pain, facial pain, and disturbed sleep. Sometimes, patients may "adapt" and not have any "problems", even in advanced bruxism. Then, something as simple as increased stress, takes them beyond their adaptive capacity, leading to serious pain and other associated problems The primary focus of your dentist is the prevention of oral diseases, maintaining of healthy teeth and gums, and treatment of common oral health problems as well as helping you understand the link between oral health and general health. Your dentist will work with you to develop a customized dental hygiene plan that incorporates a complete dental examination, diagnostic x-rays and use of other diagnostic equipment to prevent, uncover or treat problems as early as possible. Your dentist may also incorporate a variety of restorative procedures in the development of a treatment plan that will help prevent decay or disease of the teeth, mouth and gums.

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The

Bonnie & Clyde

Of Morning Television

Stealing the Hearts of Hundreds of Thousands Every Morning


Catch Kevin & Dina on Breakfast Television airs Weekdays at 6am ET on CityTV Photos Courtesy of Korby Banner

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Q & A with Dr. Fred Weksberg Dr. Fred Weksberg is recognized as a leader in the field of Cosmetic Dermatology focusing his practice on Botox Cosmetic, Injectable Fillers, Fraxel, Thermage and Sclerotherapy. He is committed to excellent patient care and ongoing research and education. He teaches locally and abroad and is often quoted in the media. Please visit www.drweksberg.com or email your questions to askanexpert@revivemagazine.ca

Q: I have Melasma pigmentation on my face that has been resistant to conventional therapy. What are my options? A: Melasma is a common facial skin condition that causes brown patches. The cheeks, ridge of nose, forehead, chin, and upper lip are places where melasma is most likely to form. It also can develop on the forearms and neck. Most melasma occurs in women. People with darker skin tones, including those of Latin, Asian, Indian, Middle Eastern, Mediterranean, and North African descent, tend to have melasma more than others. What causes melasma is still unknown. People with a family history of melasma are more likely to develop this skin condition. Pregnancy, birth control pills, hormone therapy, phototoxic drugs (make the skin more susceptible to light damage), antiseizure medication, and sun exposure often trigger melasma. Melasma is so common during pregnancy that it is often called chloasma, or the "mask of pregnancy." Sun exposure can trigger melasma because the pigmentproducing cells in the skin (melanocytes) are stimulated by ultraviolet (UV) light from the sun. This production increases when stimulated by light exposure or rising hormone levels. Just a small amount of sun exposure is the main reason melasma returns after fading. Irritating the skin also may trigger melanocytes in dark-skinned people to produce more pigment. This is why using a skin care product that irritates the skin may worsen melasma. The first action in the treatment of melasma is avoidance of the aggravating factors. It is important to stop birth control pills or homones if possible. Avoidance of sun is crucial. Creams containing hydroquinone (2-5%) are usually prescribed. Hydroquinone blocks the formation of 56 - REVIVE Magazine

melanin, the pigment produced in the skin responsible for this condition. There are many resistant cases where these creams do not work. In resistant cases one could try a series of Fraxel laser treatments to reduce the discoloration. Some patients would prefer a cream approach. A new peptide (protein) is available called Lumixyl. This cream is applied twice daily. The treatment can be enhanced by a Lumixyl SilkPeel. This is a microdermabrasion where Lumixyl is infused into the skin during the procedure. Hopefully these 2 extra procedures will help the patient with resistant melasma. Q: The winter is approaching and my skin is getting dry. How do I look after my skin? A: With the change in seasons to winter there is a drop in temperature and humidity. The skin responds by becoming dry, scaly, and itchy. The first important thing is to ensure that you have a humidifier at home in order to increase the humidity. Furnaces push out a lot of warm dry air. It is also important to moisturize daily. Try to select purfume free moisturizers, as these are more hypoallergenic. Water based moisturizers are less likely to cause problems. There are hundreds of moisturizers available. Everyone will have a personal favorite. Some moisturizers are light (such as cetaphil lotion) and are good for the face. Thicker moisturizers could be used for the body, hands, and feet (glaxal base, Lubriderm). I personally carry a line of medical grade skin care products and like to assess each patient to see their skin and recommend a solution . Many times dry skin requires prescription creams as they can develop into eczema. Book an appointment with your dermatologist if you are experiencing extreme dryness. revivemagazine.ca


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The Finishing Touch By Jason Gordon he holidays are nearly upon us again and it's time to get your hair into its best possible condition. Hair is more a fashion "accessory" than ever before and it really is the crowning glory of any look, the finishing touch in fact, so choosing the right hairstyle and colour is vital. Your haircut should suit your face shape foremost, but your lifestyle and the time you spend styling it should always be discussed with your stylist. In these coming winter months light changes everything including the look of your hair colour so keep your colour tone warmer to compensate, keeping your complexion enhanced. If you want a more multi-tonal effect without the maintenance try adding a few hi-lights underneath your natural parting and back from your hairline. This way there is no obvious re-growth and is easily covered when changing your look. This year the hairstyle trends were cropped bobs and pixie cuts which unfortunately don't suit everyone, so find a balance with your own style, even by shortening your layers to give that choppy effect that creates a shorter feel. Colourwise, warm tones of red are very "in" which range from a strawberry blonde to an auburn brunette, enhanced with a few contrasting golden pieces throughout to add texture and dimension. Hair trends, like fashion come and go, but always stay with what works for you, your lifestyle and most importantly, what you feel comfortable with. There are also many parties to attend around this time of year so be adventurous and try something different. Try an 'updo' by simply adding some curl texture with a curling iron and lightly pulling it back from your face and creating a low twist at the nape of your neck. Secure with a few bobby pins but keep a few pieces of hair around your face to soften the look. Natural is always better and remember to keep the style frizz-free, so spritz with a shine spray to give it that glamorous healthy lustre. HAIR TIPS • For easy styling, invest in a round ceramic

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brush to aid smoothing the hair. Continuous rotating motions along with a hairdryer flattens the cuticles increasing shine. The size of the brush depends on the length of hair and volume desired. • Completely drying curly hair with a hairdryer can cause frizz so scrunch dry until it's still damp and leave the rest to dry naturally. To minimize frizz further, mix mousse and serum together and apply evenly to hair before you start to achieve both hold and shine without that 'crunchy' feeling. • Use professional hair care products for your appropriate hair type, as they do ensure the right needs for your hair, maximizing colour vibrance and its overall general condition. • When choosing a base colour stay either one level above and below your own natural colour to have a more natural blending effect on your re-growth and avoid a solid row of roots. • If you happen to have no colour in your hair but lack lustre, then most salons carry a clear colour/ gloss which will not change or affect you own natural hair but add intense shine to dull hair. This lasts for weeks! • Regular hair trimming will keep your hair in order while removing any damaged split ends and keeping it healthy. • Blondes need to be more careful with the treatment and the brushing of their hair so apply a leave-in conditioning spray and always start brushing from the bottom and work your way up. Born in Ireland, Jason started hairdressing nearly a decade ago and has not looked back. Since then, he has worked on various movies, magazine photo cover shoots and fashion shows both here and in Ireland. Before moving here a year ago, he was also a member of the Irish Hair Team and has competed in Paris and Norway where he won various awards for his creative work with hair sculptures. Jason has recently created hair-styles for the Toronto LG fashion week August 09 and currently works at Salon Daniel in Yorkville.

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REVIVE Women’s Top Fashion Five By Mara Wood "BOYFRIEND BLAZERS" still a continuing trend for 2010. What's a boyfriend blazer you ask? Basically an oversized blazer that's too big for you, like you stole it from your boyfriend! With rolled up sleeves to show off your sexy wrists! A GREAT PAIR OF JEANS ripped, torn and patched up denim are definitely all trendy this year, but let's not forget the basic dark denim, skinny jean. Paired off with a great heel or boot, very impressive, always in style! OVER THE KNEE BOOT they can be flat, wedged or sexy high heel. The only thing that matters is that you get a pair! CAPES or what I still call "poncho" is back, except this time keep it simple and high-end. Choose a basic black or camel cashmere, put on your tights and over the knee boots and walk right off the runway!! The LEATHER BOMBER with a twist. Higher collar, more fitted, large lapels and interesting zippers are all things to look for in the trendy new bomber. It's always a great wardrobe staple. Model photo provided by: Cartise www.cartise.ca

Boot photo provided by: Ron White www.ronwhite.ca 60 - REVIVE Magazine

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Picking the Right Accessories… By Karen McClintock resentation is everything, or at least that is what they say. And in the world of fashion, nothing rings truer. Like the icing on a cake, accessories can take an outfit from plain to fabulous. Accessories come in many varieties, such as scarves, belts, hats and of course jewellery! They can work their magic and bring to the forefront what you want people to see or distract from what you want to hide. The right accessory can bring out the colour in your eyes, move focus away from your waistline or make an old blouse seem new again. Working with jewellery, I see time and again, that the old clichés no longer apply. Such as the rule that petite women cannot wear chunky necklaces. Much like the old rule of not wearing white after Labour Day, this is no longer the case. I often tell the story of a very petite older woman who wore one of my chunkiest pieces to a charity event. I can't tell you how many people stopped her to say how stunning she looked! A smaller, more delicate necklace would have been lost on her. I believe women should try to bring out their best features: what stands out is what the eye is drawn to. For example, coloured shoes. If you were to wear black pants and a black top, but had red shoes on, that is what the eye will be drawn to. Do you want people looking at your feet, or looking at your face??? Recently, a friend of mine came to me to accessorize her for a gala event. She had a plain white blouse on but she is blessed with the most beautiful blue eyes. She put on a piece from my new Spring 2010 Collection that was the perfect complement to her eyes.

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Suddenly, her look went from classic to drop dead gorgeous!! The piece, shown here, brought the focus to her face and away from the rest of her body. Balance, balance, balance… The key word when working with accessories is balance. One mistake that I often see with outfits is that there is too much detail or in some cases, not enough. For example, wedding dresses can be very elaborate, with beautiful beadwork and detailing . Especially with strapless styles, the eye is drawn to the center of the bride. But she should draw focus to her face. There has to be something that will bring the eye up to where you want it to go. Many people choose simple jewellery that really does nothing for the overall look. What you want to do is balance it. Detailed dresses may not need a necklace, but can benefit from substantial earrings, such as drop or chandelier styles. Or you could wear an elaborate necklace, perhaps with a strapless style, but then have on very understated earrings. The same principles work with heavily-patterned clothing. Again, go with the rule of where the eye should go. If you want to wear patterns, keep it on the upper part of your body, instead of drawing the eye to your lower half. Accessorizing this look will only require earrings and not include a necklace. Picking a beautifully coloured earring, that brings out hues in the blouse, but is not overly detailed, is an excellent way to keep the focus on your face. I recently saw a woman buy a beautiful black cashmere winter coat at a store where I was doing a trunk show. What surprised me was her determination to buy coloured gloves! To me, the focus should be on having a scarf that would bring colour to the overall look and again, keep the focus on the face. Why would you want to have people see your continued on next page revivemagazine.ca


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hands before your face? Updating your look without breaking the bank‌ I love working with accessories and I can't think of anything that can work better in our struggling economy. Instead of replacing core pieces in your wardrobe, investing in a piece that can be worn with different colours can go a long way. Take the piece shown adjacent-top. This necklace can be worn with white, black, brown, beige etc. Working with natural stones that have different colours running through them, allow the piece to be incredibly versatile. Note that the earrings shown with this necklace are much smaller and blend, but do not compete with this larger piece. Another way to gain versatility is to invest in a piece that can be worn different ways. I will often make larger pieces that have detachable strands, so that a necklace can be worn as a one, two or three strand necklace. In some cases, my necklaces have detachable bracelets so they can be a necklace or necklace and bracelet. Size is not everything!!! Going back to the principle of drawing the view-

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er's eye to where you want it to go. A simpler, yet detailed necklace, as shown, may be the answer to keeping the focus on your upper half so as not to overwhelm your overall look. Simpler, lighter necklaces can add whimsy to your look yet give onlookers a focal point, especially if you are trying to draw the eye away from something else. Picture an easy, flowing white linen outfit of pants and loose top with this light, oceaninspired necklace of sea foam greens and sterling coral. Interesting and eye-catching but in the same spirit as the overall lighter look. Simply put, think of your accessories as the icing. Remember that your outfit is not just a jacket; or a dress, but rather a total look. You have to pay attention to every detail and ask yourself "What do you want people to see?" For more looks, go to karenmcclintock.com

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Top Ten Recommendations To Shine For The Holidays By Dr. Fred Weksberg, MD, FRCPC(C) ith the holidays fast approaching, one look in the mirror is causing many of us to scramble for the phone to get an appointment with our dermatologist. With the upcoming parties and social events most of us want to look our best! What I suggest is all non-invasive solutions to help keep us looking and feeling our best while maintaining a natural look. You can choose one or multiple treatments depending on your desired outcome and budget. Here are my top 10 suggestions for the upcoming holidays.

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#1-PREVENTATIVE MEDICINE- USE YOUR SUNSCREEN One of the most important ways to protect your skin, minimize sun damage, reduce the risk of skin cancer and maintain youthfulness is the regular application of sunscreens. Get into the habit of applying your sunscreen to freshly cleaned skin first thing in the morning. After applying your sunscreen you should continue your skin care regime with quality products that will further help preserve your skin. Applying sunscreen should be done on a regular basis. Look for a sunscreen with an SPF (sun protection factor) of 30 or higher. In addition make sure the label says that it protects against both UVA and UVB light. It should be applied 30 minutes before going out and should be reapplied if sun exposure is prolonged as sunscreens do wear off with time. Don't be fooled by wintery weather, you have the same sun exposure and UV Index as in summer and it can be even worse with the reflection off the snow. Remember, the only way this works is if you use it!

#2-THE ULTIMATE QUICK FIX- BOTOX Botox is an effective agent for the treatment of frown lines in the glabella, (between the eyebrows), the crow's feet (outside corners of the eyes) and forehead lines. It is very effective in cases where patients have deep frown lines secondary to overactive facial muscles. Botox is a purified protein that temporarily relaxes muscles. After injection one sees a gradual relaxation of these frown lines; giving the patient a calm, youthful appearance. By causing certain muscles of the face to soften, many of the lines and grooves in your skin begin to disappear. In the doses that are used it is an extremely safe product. The procedure does not take very long, in the order of fifteen minutes. A tiny needle is used to make the injections therefore patients feel little if any discomfort. Beneficial results may be seen in several days but the maximum effect may not be seen for up to two weeks. The trick as a doctor is to do this treatment without having the patient look stunned or overdone. I take pride in creating a very natural and relaxed look for my patients. The overall improvement is temporary. In order to maintain the beneficial results retreatment is necessary. Retreatment is generally done every four months although the interval varies with each patient. Gradually the treatments may be required less frequently. #3-IMMEDIATE RESULTS- HYALURONIC ACID FILLERS Over recent years, Hyaluronic Acid (HA) has emerged as the miracle compound for filling in wrinkles, scars, and replenishing lost volume on the face. Hyaluronic Acid is a major component of skin tissue, maintains local moisture content, and is gradually reabsorbed with time. Highly purified Hyaluronic Acids are injected to improve depressions, lines, wrinkles, and continued on next page

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scars. With aging, our lips shrink and deflate. These fillers help to reverse these signs of aging and restore the lips to make them look younger and more sensual. HA's can also be used to treat the border of the lips. This can add definition to the lip line for those who desire a fuller look to the lip. This will also help to stop lipstick from running into the fine lines around the lip edge. HA's are available from many companies, however I have chosen to use tried and true products that demonstrate the safest and most effective types of HA's. These products include the Juvederm Ultra/Voluma and Restylane/Perlane family of HA products. Juvederm Ultra and Juvederm Ultra Plus are available with added Lidocaine (dental freezing). These Juvederm products with lidocaine help make the injections less painful. These HA's have an excellent safety profile, they are of non-animal origin, they do not require any prior skin test, and are highly biocompatible. JuvĂŠderm Ultra, Voluma, Restylane, and Perlane are sterile, transparent, and bioresorbable gels based on cross-linked hyaluronic acid. They are not made from any animal or human material. The injected filler can enhance the natural structure of your skin and improve lines, wrinkles, and folds. Lips may also be augmented with these agents. Many clients see an improvement in skin resiliency and smoothness after just one visit, while others will require multiple treatment sessions. While your treatment will typically last four to ten months, you may require touch up treatments to maintain the correction. With this variety of fillers we successfully treat superficial fine lines, prominent lines, and effectively fill forehead wrinkles, glabellar (frown) lines, mild to moderate nasal furrows, smile lines, cheek wrinkles, and improves scars. These fillers are used to add definition to the border of the lip and augment the lip for those who desire a fuller look. We have great success with treating the deeper wrinkles, deeper folds, and scars. The denser products are excellent for adding volume back to the face and giving a more youthful fresher appearance.

Replacing lost facial volume is of major importance in facial rejuvenation techniques. As one ages the entire face gradually shrinks and deflates (think of a deflated balloon), adding to the appearance of aging. By refilling the cheeks, chin, and jawline the patient's youthfulness is revived. The jowls are significantly reduced. The appearance of the face in some patients can be almost as good as a face lift. The overall result will be far superior when the facial volume loss is treated as well. The improvements Before Juvederm are seen immediately. and Botox Figures 1 and 2 illustrate the beautiful effects of Juvederm and Botox used together. The duration of benefit from HA treatment varies from person to person and depends on many factors such as the structure of the skin, lifestyle, age, as well as on the degree After Juvederm of correction desired and Botox by the individual. That being said, these HA's typically last six to eight months, and in some cases up to one year. #4-SKIN REJUVENATION WITH NO DOWN TIME- IPL (Intense Pulsed Light) Photorejuvenation is a laser-like procedure based on Intense Pulsed Light (IPL) and electrical energy. This procedure removes the many skin imperfections secondary to sun and aging, including brown patches, facial veins, red patches and Rosacea. Other benefits of this treatment include reduced pore size, scar improvement, and textural improvement. This leads to a more youthful, smoother skin. Another major advantage of this technique is how gentle it is on the skin, allowing patients to continue with their normal daily activities with no downtime! The pulsed light passes through the outer surcontinued on next page

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face of the skin and penetrates into the lower layer of the skin known as the dermis. Cells called fibroblasts are stimulated into producing more new collagen. Over several treatments, the collagen smoothes and softens the appearance of your wrinkles, pores, and textural irregularities. During your consultation your doctor will meet with you to review your history and plan a course of treatment based on your individual needs. Most patients require 5-6 treatments to achieve maximum optimal aesthetic skin rejuvenation. Our patients tell us that the procedure is virtually painless. There may be a slight tingling but very little, if any discomfort. Some people may find that when treating sensitive areas such as the nose, there is momentarily an uncomfortable feeling, a slight pinch or "zap". Most patients return to work or regular activities immediately following their treatment. You may experience minor redness, puffiness, or a tingling sensation which typically dissipates in 1-2 hours. Makeup can be applied immediately following your treatment. Bruising is very rare, however, if it does occur it is usually very mild and fades within 5-10 days. Photorejuvenation is a very safe and successful cosmetic procedure. #5-SKIN IMPROVEMENT WITH MINIMAL DOWNTIME- FRAXEL Fraxel is a laser treatment that is used for improving fine lines, wrinkles, skin texture and tone on the face, neck, chest, forearms and hands. This laser works below the skin to repair from the inside out. With this treatment you will see improvement of surgical and accidental scars, acne scarring, lentigines (brown patches from the sun), as well as melasma. It is also useful for improving the skin elasticity and brown discoloration on backs of hands, chest, dĂŠcolletĂŠ, and horizontal neck lines. Typically your doctor sees you for a consultation to determine an appropriate treatment plan. An effective regime consists of 4 to 6 sessions, spaced about 3-4 weeks apart. Results are immediate as well as progressive. After treatment you will feel a mild sunburn sensation for about an hour and then virtually no 66 - REVIVE Magazine

discomfort. You may apply a moisturizer and makeup soon after treatment. Men can continue to shave. There may be some mild swelling which generally subsides in several days. Over the next three to fourteen days, your skin will have a bronzed appearance and will then exfoliate. Sunscreen with 30SPF or higher must be applied twice daily during healing and then for several months after treatment. After your treatment you will experience a radiant glow and more youthful looking skin. #6-THE NEXT BEST THING TO A MINI FACELIFT!- THERMAGE Thermage is a non-surgical approach to create forehead, eyelid, eyebrow and neck skin tightening. Firming of the jowls and neck as well as body areas are also successfully achieved with Thermage. Thermage is a unique use of computerized radio frequency that allows for tightening of collagen and elastic tissue, creating a smoother texture and firmness by using a uniform controlled pattern. The treatment may take anywhere from 15 minutes to 2 hours depending on the size of the area treated. Results occur in phases: Phase I: During the first 30 days contraction of collagen and elastic tissue creating a firmer looking zone to the treated area. Phase II: Over a 6 month period there is new collagen and elastic tissue formed, causing gradual improveBefore Thermage ment. The treated areas have improved firmness and contour. The improvement from Thermage can be seen in Figures 3 and 4. In those patients that have very loose skin early results may be seen within the first 4 weeks. However, After Thermage the best results are continued on page 68 revivemagazine.ca


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gradual and may take up to 6 months to be seen. For some patients 1 treatment session is sufficient, others require more than 1 treatment. I believe that all procedures should be as comfortable as possible, therefore I occasionally use mild oral sedatives prior to this treatment and patients must arrange to be driven home. Thermage may be used on its own; however at our centre combined treatments are the wave of the future. Usually patients will have a combination of procedures: Botox, Hyaluronic Acid Fillers and Intense Pulsed Light (commonly known as Photorejuvenation) are very commonly combined with Thermage to produce the best improvement. Other body parts that can be successfully treated include the abdomen, thighs, areas above the knees, and upper arms. Patients that are good candidates exhibit mild to moderate elasticity and/or crepiness of the skin. After Thermage treatment the skin appears tighter and more contoured. Thermage is not a treatment for fat reduction or for removal of large areas of loose skin. #7-ULTIMATE FACIALS AND MORESILKPEEL AND MICRODERMABRAISON MicroDermabrasion is a non-invasive, gentle procedure used to exfoliate the skin. Micro crystals are delivered across the skin resulting in a polishing effect of the skin's surface. These crystals and dead skin cells are then vacuumed away in one easy motion. This procedure is used for acne scarring, hyperpigmentation, sun-damage, uneven texture, fine lines and age spots. The procedure is easily administered with minimal discomfort producing an overall fresh healthy glow. It is effective for all skin colours and types and normal activities can be resumed immediately. It is a short "lunch-hour" procedure with no down time. The SilkPeel速 system is a safe and highly effective microdermabrasion treatment for simultaneous exfoliation of the skin with delivery of a topical formula to target a specific dermatological condition. Exfoliation promotes the reduction of fine lines, wrinkles, minor scars, acne, stretch marks and sun damage. It also regenerates the epidermal cell structure resulting in skin elasticity and more youthful, pliable, 68 - REVIVE Magazine

smooth skin. Topical formulas penetrate the skin to treat specific conditions such as acne, hyperpigmentation, photodamage, environmental stress, dehydration and fine line wrinkles. The SilkPeel速 treatment is available in 4 different formats: 1. Hydrating and anti-inflammatory with hyaluronic acid for dry skin 2. Clarifying with salicylic acid and aloe for acne patients 3. Lumixyl infusion for treating areas of brown pigmentation 4. Vitamin C type for providing an anti-oxidant function for sun damaged skin. Immediately following this procedure your skin will have a fresh pink glow. Improvement continues throughout your treatment program. The number of treatments and time between treatments varies on individuals. Most patients need one treatment every two weeks for a total of six treatments. Patients will notice considerable improvement in the smoothness and color of their skin. #8-REMOVING MARKS WE DON'T LIKE TO SEE- MOLES AND SKIN TAGS As we age we accumulate many moles and skin tags. For most patients these are bothersome on their face, neck, and armpit areas. These can be easily and successfully removed in most cases without scarring. The removal can be as simple as a liquid nitrogen (freezing) spray, or may require actual removal. These procedures are done in minutes and require almost no downtime. #9-UNDER THE LIGHT- PHOTODYNAMIC THERAPY AND BLU-U LIGHTS Photodynamic therapy (PDT) is a special treatment performed with a topical photosensitizing agent called Levulan (5-aminolevulinic acid or ALA) activated with the correct wavelength of light. This procedure is also known as "ALA PDT or ALA BLU-U treatment". These treatments remove sun damaged pre-cancerous areas called actinic keratosis. Sun damage, fine lines, and blotchy pigmentation are also improved with the positive effect of Levulan and the light treatment. PDT also has the unique ability to effectively treat stubborn Acne. Acne continued on next page revivemagazine.ca


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patients improve with two to four treatments, performed at three week intervals. Patients with severe sun damaged skin manifested by actinic keratoses, texture and tone changes, including mottled pigmentation and skin laxity may see excellent results. Active acne can improve dramatically. This treatment may eliminate the requirement for oral antibiotics or Accutane. To achieve maximum improvement of precancerous (actinic keratoses) areas, a series of three treatments 2-4 weeks apart is the most effective. Some patients with only actinic keratoses are happy with just one treatment. Following PDT, the treated areas may appear red with some peeling for 2-7 days skin. PDT is well tolerated (essentially painless) and noninvasive (no needles or surgery required). It has an excellent cosmetic outcome, particularly in cosmetic sensitive areas such as the face.

very helpful in reversing sun damage and restoring skin aging. One of the most common antioxidants is Vitamin C, but there are many others. There are many products available in the market, but in my office I chosen two medical grade product lines; SwissTEC and DCL. These are excellent hypoallergenic product lines with antioxidant properties. Most cosmetically oriented doctors offices carry excellent skin care lines. Your doctors office will provide you with a skin care program individualized just for you. Staff typically require extensive training to understand how each product works and how they work together to maximize your skin renewal and maintenance. So now you have it! These are my highly recommended pick-me-up solutions for great skin care and healthy looking skin. Enjoy the holidays- here's to putting your best face forward!

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#10- PROTECT YOUR INVESTMENT - you only have one face to last you your lifetime SKIN CARE PRODUCTS In addition to sunscreens, anti-oxidants are

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I Got My Daddy’s Nose By Dr. David A.F. Ellis M.D. FRCSC

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his is the comment that many of my young female patients state when they come into my office wishing to have their nose reduced in size. Many have an ethnic background from Italy, Spain, Eastern European, and the Middle East and many of the men in these areas tend to have larger noses. Some of these patients are very young and come in with their mothers, others are in their 20s and don't like the size of their nose. The question is how much to reduce the nose as most want to preserve their genetic heritage, but still wish to have an attractive nose which will fit and flatter their face. Hence there must be a dialogue between the surgeon and the patient about how much to reduce the size of the nose. Giving an Italian young lady a short retrusĂŠ, turned up nose would be wrong! This style of nose is very popular in France, but not Italy. There are classical aesthetic measurements concerning nasal-facial proportions. Successful rhinoplasty depends on careful analysis of both the nose and the surrounding facial features. From the front, the width of the nasal base should be approximately the same as the distance between the eye (See fig 1). The width of the bony sidewalls should be 75% of the ideal nasal base width. The nasal tip has two tipdefining points that represent light reflection from the skin overlying the domes of the nasal tip cartilages. (See fig 2). The width of the nasal tip is perceived as the Figure 1 distance between 70 - REVIVE Magazine

the tip-defining points. There are no established parameters for the ideal width of the nasal tip and a surgeon must use aesthetic judgment to determine if the tip is too narrow or wide in a given Figure 2 patient. Viewing the profile from the side, the distance of the nasal tip from the face should be approximately 60% of the nasal length. The nasal dorsum should lie at or slightly behind the line drawn from the nasal starting point to the nasal tip. The nasolabial angle refers to the angle between the columella (the fleshy skin between the nostrils) and the upper lip and determines the need for superior or inferior tip rotation. The ideal angle for men should be 90-95 degrees and for women 95-115 degrees. (See fig 3). The columella should be visible below the nostril margin by 2-4 mm. These are ideal concepts for the Caucasian nose. Other ethnicities want their noses to be augmented along the dorsum or bridge of the nose to give it some height and Figure 3 wish the width of their nose narrowed at the nasal base. Most large noses will have a boney and cartilaginous bump as seen on the side view; however others will have a great big huge ball on the tip of the nose. Others will have a nasal tip that is pushing too far forward from their face (over projected). Some will have the angle between their upper lip and their nose less than 100° which will give the appearance of a "hook" to continued on page 72 revivemagazine.ca


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the nose. Once the general concepts of the surgical procedure have been discussed, the next stage is for patients to be imaged. During this imaging session, Dr. Ellis can make specific changes to their nose on a computer and put things in proportion according to the patient's wishes and the facial features. During this imaging session, Dr. Ellis plans which surgical procedures he will use to get the best cosmetic results for the patient. How much reduction does the patient want? Does the patient want the tip of the nose moved closer to the face? Does the tip need to be rotated upwards so that the angle between the lip and the nose is greater than 100°? Looking from the front view, what is the cause of the ball at the end of the nose? Is it because the tip itself is too wide? Or is it a question that the bottom part of the tip hangs too low (hanging columella]? During the imaging session all these questions must be answered so that a proper operation can be performed. Once the patient has decided to proceed with the surgical procedure, blood tests will be taken as well as a history of the general health. Most candidates opt for the type of anesthesia that is often called "conscious sedation". During this type of anesthesia, the patients are somewhat responsive and may wake up if their name is called, but fall back to sleep within seconds. They do not feel pain during the surgery and afterwards, remember very little about the surgery. After conscious sedation, patients rarely have nausea and vomiting and generally feel very good compared to general anesthesia. A few patients opt for what we call "TIVA anesthesia" (Total IV Anesthesia). This is very similar to a

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general anesthetic, but there is no tube that goes into the breathing passage through the mouth and patients wake up very quickly following this type of anesthesia. Postoperatively the patient will need a responsible adult as a care giver, but no nursing care is needed. That evening the patient can watch television sitting up and should use ice packs around the eyes for the next 48 hours to minimize the swelling and bruising. Because no nasal packing is generally used, 25% of my patients have not taken pain medication. Patients may feel blockage inside their nasal passages due to swelling, dried blood, and mucus. As the swelling settles, the nasal airway will rapidly improve. The purpose of the nasal cast is to decrease swelling so any time after the third day the cast can be comfortably removed with minimal if any discomfort. When the cast is removed, there will be swelling but the nose will look better than it did preoperatively. In two weeks, 80% of the swelling has gone and the bruising has disappeared in 99% of the patients. There are small exceptions in patients with very thick skin. At 2 weeks the patients will be "socially acceptable". Over the next year the swelling gradually goes down and the final result can be seen. See rhinoplasty pictures showing noses made smaller. (See fig 4, 5, 6).

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The Revive Makeover

The Next Level in Beauty Therapy Phase Three

The third phase continued from the Fall Issue of REVIVE

Sponsored by:

A REVIVE MAKEOVER Phase Three:

Hello all, the holidays are fast approaching and our makeover is in full swing as we are finishing phase 3. We would normally show you progress photos with each participant along with their recent measurements. However, phase three is a very interesting stage of the makeover and the girls have begun some of their surgeries so this issue we will not be showing their progress but still will give you updates. The media has lead many people to believe that going through a “makeover” is easy. From television programs to magazine features we almost always see the same thing- the “unhappy” before picture followed by the exuberant after shot. But what about the time inbetween? This is where the real story and struggle lies. Rarely do we get to see the participants actually going through the surgeries, workouts and lifestyle changes. For many the struggle is too much to bear and they quit before making it to the final reveal of their new and improved selves. Others grit their teeth and push through doing whatever it takes to achieve the goal they have set for themselves. Here is how our 3 makeover participants are fairing as they move into the next phase of their makeover journey.


Meet the Women:

Laura is 36 years old and a mother of three young children. She is a smoker and married to a workaholic entrepreneur. About 3 years ago, Laura experienced a sudden increase in weight brought on by a prescription medication. She has since come off the medication but the weight remains. At the present time Laura hates exercising and her diet consists mainly of refined foods, coffee and unhealthy snacks. Wendy is a 43 year old registered nurse. She has dedicated her life to caring for others and recently has been under a tremendous amount of emotional stress due to the passing of her mother from cancer. Because of her medical background Wendy believes that she eats a healthy diet and is very mindful about how the amount of food she eats. Because of her hectic work schedule Wendy believes that she does not have time to exercise. Helen is a 53 year old professional woman. She has a very high stress job and works long hours. She is a smoker. Helen is menopausal and has a very hard time losing weight. She does not exercise and her diet consists of eating whatever she can whenever she has the time.

Grilled Salmon Recipe from Bruce Krahn: Try this classic dinner recipe! Ingredients: Long-grain brown rice

1/4 cup

Wild Salmon

3oz

Lemon Juice

1/4 fl oz

Extra-virgin olive oil

1/4 tbsp

Asparagus

3 spears

Garlic cloves, chopped

1

Herbal seasoning

1/4 tsp

Cook rice according to the package instructions. Cut the salmon crosswise into 1 inch slices, then place them in the lemon juice, turning a few times. Top with some of the chopped garlic. Set aside. In a large skillet, heat half of the olive oil. Add asparagus and the rest of the garlic and stir until they are coated with oil. Cover and cook for five minutes until almost tender and set aside in a serving dish, cover, and keep warm. Grill salmon and serve with the rice and asparagus. Top with herbal seasoning. Enjoy!

Laura Bruce Krahn: Laura’s progress has been excellent. She continues to lose both pounds and inches while making improvements to her definition, strength and flexibility. Once Laura has fully recovered from her surgeries we will be able to take things up a notch in terms of workout intensity. I am expecting some great things from her and I know that she will deliver. Dr. O’Grady: Laura recently underwent her Smartlipo procedure of the abdomen. A total of 650 cc of fat was removed, which is a fairly significant amount. As is typical of women who have had multiple pregnancies, her tissues were very fibrous which made the surgery a bit more difficult than normal. Regardless, she tolerated the

procedure very well and should have a significant result. She is still quite swollen and it will take several more weeks to catch a glimpse of what the final result will be. As with any liposuction procedure, the final results will not be truly seen until 6-12 months after the surgery. I am planning to perform her arm lift at the end of January next year. Dr. Dan Hagi After undergoing some tooth whitening and initial gum work we are ready to transform Laura’s smile. At this point the dental implants are ready to be placed and we are ready to begin the preparation of her teeth for her porcelain veneers. The misalignment on her lower jaw will be fixed initially with state of the art invisible braces. Once preparation of the teeth has taken place we will be ready to proceed with the facial work.

Sponsored by:

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Wendy

Bruce Krahn: Wendy has seemed to hit a plateau. Her overall interest in the makeover procedure has diminished and she has come to the realization that the process is not easy. In order to reach her goal Wendy will have to rededicate and refocus her efforts. There can be no more skipping workouts or slacking on the diet. We are down to crunch time and the next several weeks will make all the difference in the world.

Dr. O’Grady: Wendy has decided to proceed with her augmentation. Being in the healthcare field, she had a few more reservations than normal regarding the surgery. As with all of my patients, I encouraged her to think about the surgery and schedule it when she was ready. After a week or two of thinking about it, she is excited to proceed. I have scheduled her procedure for early in the new year.

Dr. Dan Hagi: Wendy’s transformation is taking shape. We managed to preform a gingival grafting procedure to restore gum tissue that has receded from one of her back molars. In addition we were able to restore some of Wendy’s lower molars with onlay restorations. Our next step will be to comy smile by rejuvenating her upper teeth. plete Wendy’s

Wendy has decided to go ahead with a cohesive gel silicone breast implant, also known as the “gummy bear” implant (see my article elsewhere in this issue). She has a bit of asymmetry, so I am planning to perform an asymmetric augmentation. This means that I will be placing implants of different sizes in each breast. This will help compensate for her natural asymmetry and give her a more even look.

Helen

Dr. Ellis: A long way has come since we last met with Helen for her last consultation. Consideration had to be made for Helen’s surgery and the recovery time due to her demanding work schedule. In order to achieve optimum results with Helen’s limited schedule we proceeded with the Endoscopic forehead lift, upper and lower blepharoplasty (eyelid lift) and a Smartlifting procedure for her neck and jowls. The Smartlift procedure will melt the excess fat along her neck and jowls and tighten her skin from the inside. Helen will achieve what she is looking for, a natural rejuvenated look to match her personality.

were taken and Dr. Ellis reviewed her surgical options and answered her final questions. Surgical markings were done. Tammy, our surgical nurse, prepped Helen for the operating room. Intervenous Conscious Sedation was used to make the surgery comfortable and pain free. The total surgical time was approximately 2 hours and 45 minutes. The surgery went very well and Helen went home with her friend with compression dressing and tensor bandages.

In follow-up, we saw Helen the following day, three days, 6 days and 10 days after her surgery and she is healing as expected. She has the typical swelling and bruising associated with her surgery. Helen is On November 6th at 9 am, Helen arrived at Art of happy with her immediate post-operative results and Facial Surgery, a little nervous which is common is looking forward to showing off her rejuvenated look and normal with all patients. Pre-operative pictures to her colleague and friends. Stay tuned…

Helen Pre-Op (Day of Surgery)

Day 1 (After Surgery)

Day 3 (After Surgery)

Day 6 (After Surgery)

Day 10 (After Surgery)


Helen

Bruce Krahn: Dr. O’Grady: Helen has been a pleasant surprise. In the Helen is close to attaining her beginning I was not sure if Helen really weight loss goals and is currently recovwanted to go through this but I now think ering from facelift surgery. She will be reotherwise. For the first time in her life Helen assessed this month to see if she is still a is working out and making better food choices. The candidate for a body contouring procedure. hardest part with Helen has been the food- her job does not allow for frequent eating! We are making some adjustments to help her with this and she will continue to see results week after week.

Watch for the March Issue of

REVIVE

To follow the progress that our three participants have made as they continue their journey and enter phase four.

Presenting The REVIVE Makeover Team Trish Stratus www.stratusphereyoga.com

Dr. Ihab Matta MD www.drmatta.com

Dr. Sol Weiss DDS www.dentistryatelements.com

Dr. Dan Hagi DDS, FAGD, FICOI www.thornhillsmilecentre.com

Dr. Kevin O’Grady BASc, MHSc, MD, FRCSC www.drkevinogrady.com

Dr. David Ellis M.D. FRCSC www.artoffacialsurgery.com

Bruce Krahn CPT www.ebodi.com

Dr. Ahmad Nasri MD (Dom. Rep.), HD, MFS www.nasri-integrativemed.com

Tanya Wylde B.Sc., CPT, FIS, ND. www.homeopathicdoctor.ca

Korby Banner www.korbybanner.com

Dr. Philip Solomon M.D., F.R.C.S. (C) www.solomonfacialplastic.com

Dr. Fred Weksberg MD, FRCPC(C) www.drweksberg.com

You can also log on to www.revivemagazine.ca to track their progress, updates and video blogs.

Sponsored by:


Natural Treatments For SAD Seasonal Affective Disorder By Bryce Wylde B.Sc., RNC, D.H.M.H.S., H.D t's that time of year again! The drastic change in temperature is typically preceded by the chaotic mad dash to the malls for last minute Christmas shopping. And yet many of us who feel particularly down at this time of year, when quite frankly the holidays should have us feeling better regardless of weather , is a paradox which involves S.A.D. S.A.D. is an appropriate acronym for Seasonal Affective Disorder. It is a recurrent mood disorder that can take the form of depression in all ages. But the interesting thing is it is limited to the months where sun and light is all but non-existent. Symptoms of S.A.D. include a depressed mood which is typically worse in the evening, usually with certain characteristic features, namely incessant sleeping, extreme lack of energy, depression, and increased appetite, often with carbohydrate craving and weight gain. Other than the direct tie-in to the sun connection, the cause of seasonal affective disorder is not fully understood. One important factor to consider is where you live in the world. Latitude is one of the most predictive factors as those who live at high or low points on the earth's hemispheres are far more predisposed to S.A.D (as well as vitamin D deficiency) due to less overall sun (and therefore light) exposure. In cases of S.A.D, there is also a family history of mood disorder, usually depression, in about 50% of people. The condition is twice as popular in women as it is in men, the average age of onset is 23 years old, and stress seems to precipitate acute episodes of S.A.D. The condition regularly recurs during fall and winter nearly and spontaneously remits during spring and summer. One very common oversight is that thyroid dysfunction (hypothyroidism) may be an underlying

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condition. (Ask your doctor to run the necessary blood work to rule this out). Ensure you speak to your family doctor if you have these symptoms • Depressed mood: feelings of hopelessness predominate. The future looks black, and life may not seem worth living. Normal activities and interests hold little pleasure. Sometimes depression is worse in the evenings (the reverse of classic depression). Depression is usually mild to moderate, but can be severe with risk of suicide. • Irritability and anxiety: these are common, and may cause interpersonal and work difficulties • Fatigue and lethargy: increased somnolence during the day and increased sleep duration at night • Decreased libido • Increased appetite: carbohydrate craving and, very often, substantial weight gain

But here is the good news. People with SAD respond very well to light therapy (phototherapy) and vitamin D supplementation as well as other forms of natural medicine. Light Therapy: 70% of patients with mild-to-moderate symptoms respond to light therapy from a light box at 2500 lux 2h/day or 10,000 lux one hour/day, within 1-2 weeks where about 50% achieve complete remission. "Lux" is a unit of illuminance or luminous emittance from a light source. The latest research suggests that the intensity of the light exposure is more important that the spectrum or wavelength. So, avoid getting lured in to buying one of the very expensive units which profess having a "special" wavelength that "mimics the sun". Vitamin D: It used to be suggested that 400iu vitamin D was enough in order to maintain good bones. continued on page 80 revivemagazine.ca


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That dose and that use of vitamin D is now considered very one dimensional. Vitamin D (in the D3 form known as cholecalciferol) should be taken by Canadians, on average, at 12000iu/day. Blood levels can be regularly assessed by your doctor using a simple blood test known as serum 25OHD. Vitamin D3 is now known to be useful for not only bone health, but also immune system health, inflammation, against all forms of cancer, and of course mood. Herbal Supplementation: The conventional pharmacological treatment of S.A.D includes the class of drugs called Selective Serotonin Reuptake Inhibitors, or SSRI's. These drugs are postulated to work by keeping serotonin - a feel good brain chemical "alive" longer to induce "feel good" messages in the brain. But, in natural medicine it is commonly believed that in the case of S.A.D., people don't produce enough serotonin to begin with (or run out of stores in the winter months). Grifonia seed contains a high amount of an amino acid called 5-HTP which can be supplemented orally in order to increase the amount of available serotonin in the brain to contribute toward improved mood (rather than to prevent the breakdown of a suboptimal amount - as in the action of drug SSRI's). Simply put, 5-HTP increases the production of serotonin and has been used successfully to treat depression and S.A.D. Homeopathic Dilution Medicine: Homeopathic medicines used for mood balancing can be very effective, but it is always

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advisable to seek a professional's advice when selecting the right remedy for your condition. Aurum metallicum can be used if you are experiencing a depression and loathing of life after having worked through the holidays (high stress) and are aggravated mostly at night. Arsenicum should be taken when you have deep-seated insecurities with restlessness and anxiety, extreme weakness, fear of being alone, and you are really chilly with frequent thirst for small quantities and a strong craving for bread and other carbohydrates. Pulsatilla may be your best bet if you are emotional, overly sympathetic, and cry easily because of a feeling of being forsaken (and where many symptoms you experience could be related to hormonal fluctuations). Nat-mur is administered for extreme emotional vulnerability leading to introversion. It is a great remedy for symptoms of ailments from grief and an intense craving for salt. To maintain a healthy mood, it is also important to maintain a healthy diet with lots of dark green vegetables, nuts and seeds, and mangoes. A natural chemical constituent found in mangoes actually increases good mood. In addition, supplement with a good vitamin B complex (high in B6, B12, and folic acid), and magnesium. Take no less than 5 grams of omega-3 essential fatty acids daily. Last but not least, remember to exercise - high intensity - during the winter months. And, at this point, it should go without saying, you should exercise under bright lights to offset the lack of the golden summer sun.

REVIVE

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The Mouth is The Window to The Body By Dr. Dan Hagi

f the eyes are the windows to the soul then in the the mouth is most definitely the window to your body's health. The state of your oral health can offer lots of clues about your overall health. Oral health and overall health are more connected than you might realize. In recent years much evidence was found for the relationship between oral health and many diseases. Some of these causal relationships have not as yet been proven with scientific certainty. However, evidence is mounting to support the idea that periodontal disease and its resultant inflammatory reaction in the oral tissues can cause or exacerbate many common medical conditions. The mouth is normally teeming with bacteria. We can keep these bacteria under control with good oral health care, such as daily brushing and flossing. Saliva is also a key defense against bacteria and viruses. It contains enzymes that destroy bacteria in different ways. But harmful bacteria can sometimes grow out of control and lead to periodontitis, a serious gum infection. When the gums are healthy, bacteria usually don't enter the bloodstream. However, gum disease may provide bacteria a port of entry into your bloodstream. Invasive dental treatments can also allow bacteria to enter your bloodstream. Medications or treatments that reduce saliva flow or disrupt the normal balance of bacteria in your mouth may also lead to oral changes, making it easier for bacteria to enter your bloodstream. Some researchers believe that these bacteria and inflammation from the mouth are linked to other health problems in the rest of the body.

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Here's a look at some of the diseases and conditions that may be linked to oral health: Cardiovascular Connection A relationship between periodontal disease and the atherosclerotic mechanism responsible for cardiovascular disease and stroke is now generally accepted. Several studies have shown that people with periodontal disease may be more likely to have coronary artery disease than people with healthy mouths. Scientists have two possible explanations for this association. One is that the bacteria that cause periodontal disease can release toxins into or travel through the bloodstream and help to form fatty plaques in the arteries. These plaque deposits can block blood flow. They can lead to serious complications, such as blood clots. The other explanation is that these bacteria cause the liver to make high levels of certain proteins. These proteins inflame the blood vessels. This inflammation eventually could lead to a heart attack or stroke. It is also important to note the cardiovascular disease and periodontal disease have similar risk factors such as obesity, diabetes and smoking. Dentists now routinely screen for atherosclerotic risk factors. Cardiologists and medical professionals are vigilant in referring patients with poor oral health. Reproductive Health During pregnancy most women notice changes in their gums. Some women notice that their gums look redder and bleed when they continued on page 84 revivemagazine.ca


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brush their teeth. Some women have severe swelling and bleeding. All of these changes are referred to as "pregnancy gingivitis." The level of progesterone in the body can be 10 times higher than normal during pregnancy. This may enhance growth of certain bacteria that cause gingivitis. Also, the immune system may work differently during pregnancy. This could change the way the body reacts to the bacteria that cause gingivitis. A pregnancy granuloma is a growth on the gums that occurs in 2% to 10% of pregnant women. It is also known as a pyogenic granuloma or pregnancy tumor. Pregnancy tumors are misnamed. They are not actually tumors and are not cancerous. They are not even dangerous, although they can cause discomfort. The exact cause of pregnancy granulomas is unknown, although poor oral hygiene is a primary factor. Trauma, hormones, viruses and blood vessel malformations have also been suspected as co-factors. Women with these growths usually have widespread pregnancy gingivitis. Taking good care of one's gums while pregnant is important not only for the mother but also for the baby. For many years scientists have known that maternal periodontal disease is linked to several serious conditions. Maternal periodontal disease has been linked with preterm (before 37 weeks) and low birth weight(less than 5.5lbs) babies. This happens because the pervasive periodontal bacteria enter the placenta and amniotic fluid. It has also been shown that women with periodontal disease are more likely to develop gestational diabetes and preeclampia, a condition that includes a dangerous elevation in a pregnant woman's blood pressure. Diabetes Diabetes can affect the entire body. Whether diabetes affects your oral health depends on how well you are able to control your blood sugar. If your diabetes is under control, it should have little effect on your oral health. However, if your diabetes is not under control, the oral effects can be dramatic. The link between diabetes and periodontal disease is well established. Those who have periodontal disease are at higher risk to develop adult onset diabetes. The mechanism is thought to be similar to cardiovascular disease and is mediated by inflammatory proteins. Those who have uncontrolled diabetes tend to 84 - REVIVE Magazine

heal slower as elevated blood glucose levels tend to slow down the body's healing. This in turn can severely hamper the health of the gums when attempting to control the oral infection. The result is usually more cavities, gum disease, tooth loss and fungal thrush. Kidney Disease The jury is out on this one but recent research has shown that subjects with periodontal disease and those with missing teeth were nearly twice as likely to have chronic kidney disease (60 percent and 85 percent, respectively) compared with those without these risk factors. As more studies examine the role of periodontal disease in chronic kidney disease, data will accumulate to support or refute the inclusion of periodontal therapy to reduce the growing number of those with kidney disease. People with kidney problems may have a bad taste in their mouths. They often have bad breath (halitosis). This occurs because the kidneys fail to remove urea from the blood. The urea breaks down to form ammonia, which has a foul smell. Bone changes also can occur because the body cannot absorb calcium properly. People with kidney problems can lose bone from their jaws. Their teeth may become loose and painful. Respiratory Health Our oral cavity is used when we breath. Small particles from the mouth may be aspirated into the lungs. It stands to reason that a person that has more bacteria in their mouth, like that of a person suffering from periodontal disease, will aspirate more disease causing bacteria leading to more frequent lower respiratory infections and exacerbating existing lung conditions. Poor oral hygiene and periodontitis often leads to more frequent respiratory disease in patients with chronic obstructive pulmonary disease. Physological Health It is on this area that our profession has focused so much. Cosmetic dentistry or making a patient happy about the way their smile looks and is perceived. It has been estimated that 53% of people with even minor dental problems suffer from low self esteem. Missing teeth or continued on page 86 revivemagazine.ca


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infection can affect the way people eat and masticate, but just as importantly it affects how people interact and speak. The appearance of our teeth affects how we interact with people, covering up one's teeth when engaged in a conversation is the first sight of psycological issues rooted in a displeasure in one's appearance. Oral health and a healthy smile is very important in terms of maintaining psycological and physical well being. Cancer Oral cancers comprise over 2.5% of all newly diagnosed cancers. Your dentist is often the first to find the presence of oral cancers. Any unexplained bleeding, white or red patches, tingling, numbness or non-healing (longer than 7-10 days) open sores in the oral area should be checked out. Oral cancers are not the only type of cancer that can be found during a routine dental visit. Most of us see a dentist more often than we see other primary care physicians and as such many early signs may be noticed in the mouth. Nutritional Status A diet that is full of nutrients happens to be one that helps promote healthy gums and, conversely, many vitamin deficiencies are readily visible in the mouth. For example: Vitamin B - Vitamin B deficiency is one of the most common deficiencies with consequences for your mouth and teeth. A common oral effect of vitamin B deficiency is a burning sensation in the mouth, especially on the tongue. People with this deficiency can also have trouble swallowing. The tongue may feel swollen. The tissue of the inner cheeks can be pale and may break apart easily and slough off. Vitamin B deficiency also may increase your risk of: • Angular chelitis - A painful inflammation and cracking in the corners of the mouth. It usually is related to a fungal infection. • Recurrent aphthous stomatitis - Also known as recurring canker sores. • Chronic oral mucosal candidiasis - A fungal infection in the mouth. The Candida albicans fungus is found naturally in the mouth. It does not normally cause problems. However, poor nutrition or poor absorption of vitamins 86 - REVIVE Magazine

makes you more susceptible. • Atrophic glossitis - A condition that causes the taste buds to degenerate, making the tongue look "bald." This condition affects the sense of taste. It can occur with a severe vitamin deficiency. Vitamin C - Vitamin C is also called ascorbic acid. This vitamin aids the synthesis of collagen, the main building block for many tissues. A deficiency can lead to gums that bleed easily, and may also cause body-wide symptoms such as fatigue and easy bruising. Vitamin A - Vitamin A helps skin cells grow and maintain themselves. A lack of vitamin A can lead to delayed healing in the mouth. Vitamin D - Vitamin D works with calcium to maintain bone quality and strength. Deficiencies of this vitamin can lead to brittle bones. In the mouth, vitamin D deficiency can increase the risks of jaw fracture and periodontal disease. A deficiency early in life could affect the formation of teeth. Sometimes people with kidney disease also have vitamin D deficiency. Nutritional status and oral health are like two sides of the same coin. Most nutritional deficiencies result in breakdown of oral structures, gum disease and sores. Our ability to eat nutritious foods affects our well-being. As our diet depends on the types of foods we are able to masticate, without teeth, nutrient rich foods such as fruits, vegetables and meats are a challenge to get through and therefore many elderly patients with dentures switch to a soft diet that is rich in refined carbohydrates. This has a snowball affect on one's health, being able to have teeth that are strong and healthy and able to masticate is very important in keeping us healthy. Dentistry today has the ability to rehabilitate or replace teeth that have been harmed by the ravages of bacteria, nutritional deficiency and neglect. The main goal of the dental oral health professionals of today is to help optimize your oral health, leading to an overall healthy, and happy you.

Dr. Dan Hagi Thornhill Smile Centre - General + Aesthetic Dentistry www.thornhillsmilecentre.com REVIVE revivemagazine.ca


SPOTLIGHT: Ron White The Sole King A Walking Empire Interview and Photos

K: A great shoe is a marriage of art and technology

by Korby Banner

and you seem to image it and put it together? R: I work with companies that will use materials I

Ron White is the most suggest, rather than what they normally use. I rely celebrated and success- on the most talented designers to help execute my ful shoe guru in the coun- ideas. try, famous for high quality, ultra fashionable, yet K: What makes a classic shoe? super comfortable shoes. R: The best investment is a classic pump, toes can His shoe empire includes be snipped or a bit squared or slightly rounded, 6 gorgeous stores in the but not extreme. The heel is moderate rounded on GTA, premium worldwide distribution, and celebrity the throat and mirrored on the back in black patent fans such as Matt and Lucy Damon, Kylie Minogue, leather or black calf skin. Kim Catrall, and Sarah Ferguson; Duchess of York. K: Fashion Forecast, retro or futuristic? K: Ron, you have a background in Biomechanics R: I see a ton of 50’s influences, and a lot of the 70’s and orthotics, how did the fashion and art side blos- are back, 80’s were huge the last couple of seasons som into one?

as you might have seen.

R: I think it blossomed from the inside. It’s always been a passion and love to be involved in art and K: How many pairs of shoes do you personally own fashion. I always planned my life to be in fashion. yourself? I must have always had a sense of style because R: I had my shoe closet re-designed; it’s a wall and it even when I was very young, older relatives and holds about 80 pairs and when it’s full, I trade some friends, many of them corporate level executives, out. would ask me to be their personal shopper. K: What is the most exciting part of your career? K: Recently you launched the All Day Heel. Travel? Art and work itself ? Or some of the doors Elaborate please. that open from being a celebrity in your field? R: It took 3 years of back and forth between the R: The most exciting thing is someone that has accomfort /othopedic and the fashion factories. We cess to any shoe in the world, such as international launched this fall and already have Matt Damon’s socialite Suzanne Rogers and they try on my shoes wife Lucy, Kim Catrall, Kylie Minogue, and Sarah; and they become their favorites! the Duchess of York. It’s amazing how it’s spreading. Word of mouth has been amazing ! I keep track of the technology that they use in the orthopedic world and keep bringing that to the fashion world. Jeanne Beker came up to me and said, “These shoes are rocking my world! I use these shoes 80% of the time.” We started casual and with the demand have updated for more evening, and am launching some of the chunkier heels for the spring.


product knowledge component. If you pay more and you train more people, they have pride in working there and they perform better! K: I loved the experience of shopping in your store. It compared to Rodeo Drive. I felt well attended to by a knowledgeable salesperson without feeling pressured. How do you teach that delicate balance? R: The idea is if I could clone myself and attend to everyone myself, I would, and that is part of the training program! ( laughs ) K: You are respected and admired by your peers, not only for fashion but also for your business suc- K: How much of success is determined, when takcess. Do you manage your own career, or do you ing luck out of the equation? What percentage of it have a manager?

would be talent, drive and personality, or business

R: I manage my own career but I surround myself smarts? with experts and leaders in their fields. I have a VP R: Drive 50%, Talent 25% Business sense 25% . who runs HR and operations, who previously had But you need all to be a true success- you have to 800 staff and was top in the country, I have an really work. That drive to keep going and pushing, amazing buyer, and a brilliant PR person.

some times 7 days a week 12 hrs a day. That’s what an entrepreneur has to do; you need that focus!

K: How important is it to have a publicist in the fashion world?

K:

Wow! Congratulations Ron! Thank you from

R: Really important! We all get caught up in what everyone and from the staff and readers of Revive we are doing, and their role is to package it up and Magazine for this insightful interview. market it and give it to the mass media. Sometimes the way we see it is not the way it needs to be presented to the world. K: I shop at your store and I was astounded at the level of expertise of your sales staff. The young woman that helped me asked me to walk, she analyzed my gait, examined my arch, the width of my feet, and instantly recommended a perfect pair! To date, they are the most comfortable shoes I’ve ever owned. I can wear them all day long and never once have had a sigh of relief removing them. How do you recruit such effective talent? R: We have a 6 month training program for new staff; three parts, the last one being a footwear specialist training program which has a medical, technical, fashion component, fitting component and a


Want to get Slim? r. Sean Rice is one of Canada's premier body contouring surgeons, and is proud to be the first plastic surgeon in Canada to offer SlimLipo™. Dr. Rice and his premier body contouring surgery clinic in Toronto have been selected by manufacturers of SlimLipo™ to be the Canadian training facility for laser assisted liposuction by SlimLipo™. The SlimLipo™ procedure uses advanced technology to deliver dual wavelengths of laser light, specifically designed to easily melt fat in large areas-with less downtime, little to no bruising, and remarkable results. Unlike traditional liposuction, SlimLipo™ is an effective device for melting fat and not simply tearing through tissue structure. The result is less body trauma and significant fat removal and dermal heating. The heating of dermal tissue has been shown to have skin tightening results.

D

What is the SlimLipo™ laser? How can this help me? The SlimLipo™ laser is revolutionary because it utilizes an ideal "fat melting" laser wavelength. Via a few tiny incisions, this patented laser gently melts fat for removal from your body. With SlimLipo's superior technology, you'll experience little downtime-get ready to show off your new slimmer look!

Which parts of my body can be treated? Areas of unwanted fat-your tummy, waist, hips, thighs, knees, buttocks, arms, and under your chin and be treated with SlimLipo™.

How fast is the procedure? The SlimLipo™ procedure is fast-often under an hour for a given area. At your pre-procedure consultation Dr. Rice will perform an evaluation and go over any questions.

Is this just for women? No-the SlimLipo™ procedure is for both women and men who have areas of unwanted fat. SlimLipo™ can also be used to treat gynecomastia (male enlargement of the breast)


How many treatments will I need? Typically, one treatment is enough for a given area.

What does this treatment feel like? You may be pleasantly surprised how little discomfort the typical patient feels. Our state of the art system has been carefully designed to ease unnecessary trauma to the body-Dr. Rice

Ask us how you can get slim, lose fat the laser-assisted lipolysis way! To arrange a consultation or for more information please call 416-391-4048 or visit our website at www.slimlipo.ca or www.doctorseanrice.com


Q & A with Dr. Christopher Tsang Dr. Christopher Tsang is clinic director of Dentistry in Aurora and has incorporated a BioSafe approach to dental care in combination with lasers and high magnification to promote faster healing with less pain and fewer injections. Dr. Tsang speaks regularly to dental professionals and community groups and appears on television. Please visit www.dentistry-holistic.com

Q: Are there choices for safer more biocompatible dental materials? A: Fortunately there have been many advances in technology in dentistry over the past few decades. No longer do we need to rely on centuries old techniques of using 'silver fillings' and 'gold and other metal caps'. No one wants to flash a smile full of shiny metal! More dentists are using materials such as bonded acrylic resins, porcelains and ceramics which thankfully make the tooth stronger and more natural looking. Silver fillings actually contain up to 50% mercury, a known poison. Metal fillings and crowns together in our mineral rich saliva actually generate electrical currents which can be measured with an everyday electrician's meter. Having a battery effect in our mouth so close to our brain is not the kind of spark we want in our lives. Ask your dentist how easy it is to enhance your smile by using natural looking materials that are a healthier choice as well. Q: Is it true that it’s more dangerous to remove the mercury fillings that are

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already in my teeth and better to leave them alone? A: Yes there is a considerable amount of mercury vapour released when these 'silver' or 'amalgam' or 'mercury' fillings are drilled out of our teeth. As the amount of mercury vapour off-gassing from silver fillings is usually very small on a daily basis, it is sometimes better to not disturb them if there is nothing wrong with the fillings or teeth. For people preferring to not use their mouth as a hazardous waste depot, taking extra precautions while having amalgams removed can reduce the risk of exposure. Finding a dentist who is experienced at removing them safely is the first step. There are extra precautions that can be taken such as isolating the teeth with a rubber barrier and extra suctions for water and air that will help reduce mercury vapour levels. A naturopathic heavy metal detoxification program with specific nutritional supplements and homeopathic remedies will minimize side effects.

revivemagazine.ca


By Dr. Sol Weiss My name is Craig Charity, I am the owner and creator of Revive Magazine. For the majority of my life I have struggled with many dental issues and just never had the time or was sure what I wanted to do to improve my smile. I am at a point in my life where I was ready to make a change and to improve my smile. Fortunately for me I know and am good friends with many reputable dentists and started talking with them about my options. There are two things for sure I knew I would not do and that is jaw surgery to correct my jaw because it stopped growing when I was quite young and braces. At this point of my life I just could not take the time for jaw surgery and I knew I would not feel comfortable wearing braces. Speaking with many dentists I found they had all great ideas as far as a treatment plan but everyone insisted that I have jaw surgery and braces for a minimum of three years. Dr. Weiss was actually the only dentist that really listened to what I wanted to accomplish and what I wanted to avoid. With his experience, talents and creative thinking Dr. Weiss was able to come up with a treatment plan that worked for me! After talking with Dr. Weiss we decided to move forward and to have him perform my smile makeover. I wanted our readers to read this story, so you know with the technology that exists today and the professionals that are available there are options and anything can be done. This is my smile makeover story, I hope you enjoy it!

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re planning is the key to a great makeover. Understanding the problem that is presented, and knowing the patient expectation, the dentist has to weave a path that satisfies that expectation, but also operates within acceptable dental practices. Sometimes thinking out of the box will help the dentist reach that ultimate goal. This patient presented with a dentition in a real mess. I am not sure why he left it to deteriorate but I assume there was a lot of poor dentistry in many different countries, and a fear of what would need to be done. Also when no pain is evident, people allow things to get worse, not understanding that just because there is no pain, does not mean that there is no problem. Now, Mr. Charity is ready, so we had to make ourselves ready by gathering all necessary records. We did a tooth exam, gum exam, full set of x-rays, pictures, and models of his teeth. With all that in hand we sat down and discussed his expectations. There is no reason to come up with a plan without understanding what the patient wants!!!!!!!! Basically the expectation was that he would have a healthy natural white smile, allowing me to do what ever I wanted, and however I wanted, with two exceptions….NO BRACES, AND NO 94 - REVIVE Magazine

JAW SURGERY! Wow now that sounds simple……….! Besides all the decay and the poor dentistry, we had an issue of no space for the lower front teeth, and some teeth on the upper right side that were in an impossible position to fix without some orthodontic intervention. The lower anterior teeth were even worse. With all the records in hand and having Mr. Charity see the hygienist a few times to get his gums in good shape(always done before any other work), we discussed the framework of the plan. I decided that to reach all of our goals and to satisfy Mr. Charity's wishes, we would have to take out the teeth that are in poor position, and that are badly crowded. Teeth in those circumstances will always be a problem and the bridges we can make in those areas will beautifully help to restore the area. All the other teeth in the mouth would have to be crowned because of all the decay! The plan was accepted and we determined that the first phase will be getting a wax up of what we wanted the teeth to look like and from that we can create temporary teeth. Because they will look like the permanent, he can wear them while the extractions heal (where the teeth were revivemagazine.ca


taken out). During this time we can alter and adjust tooth shape and position so that the teeth are comfortable, the teeth work well together, and of course the teeth look great! At the first appointment we started with the lower teeth. I prepared all the teeth for crowns, changed fillings and removed any decay. The lower front teeth (4) were extracted carefully, and I proceeded to make the temporary teeth using an impression of the wax up. This process took about 4 hours. Mr. Charity had some valium which relaxed him and left him in a real mellow state that allowed me to operate effortlessly. We decided to do the top teeth the next day because I needed to adjust the bite(the way the teeth come together) and I needed to do this with all temporary teeth in place. Normally when doing this type of work, I like to do it within 2 days but sometimes we wait until the next week to prepare the opposing teeth. Never the less he was given valium, relaxed in the dental chair where we changed fillings, prepared crowns and extracted the 2 bicuspids on the upper right side. I again made temporary teeth using the impression of the wax up, and Mr. Charity was now finished phase 1. • Phase 1 is placing the patient into temporaries, so we can let phase 2 happen.

final phase in Mr. Charity's smile makeover. You can also visit www.revivemagazine.ca to see a complete step by step video of this makeover. A special thanks to Domenic Di Cianna from Styles Dental Creations for helping to make this all possible.

Photo above shows top of mouth before. Photos below show before (left) and after (right) shots at different angles.

• Phase 2 is healing and adjusting so that patient is comfortable, teeth work and look good. All or any adjustments are made during this time. • Phase 3 is making the final permanent restorations!!! The temporary teeth actually are supposed to look good and you can continue with normal daily activities. They do pickup stain but they can be polished whenever possible! The result is fabulous….In 2 days we took Mr. Charity from a badly broken down dentition to something he can be very proud of. Watch for the March issue as we reveal the

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Q & A with Dr. Gregory Pugen Dr. Pugen is a graduate of the University Of Toronto Medical School and has been a practicing physician for over 30 years. In addition to his primary care physian practice, Dr. Pugen is also the director of his own anti-aging clinic for men and women. Dr. Pugen specializes in menopause, andropause, in combination with anti-aging treatments using natural and bio-identical treatments and hormones to improve the quality of life, allowing you to feel and act as you did in your prime. Dr. Pugen is a member of the World Anti-Aging Society, and the American Academy of Anti-Aging & also fully trained in sclerotherapy and mesotherapy, lipolysis. For more information email greg.pugen@utoronto.ca or askanexpert@revivemagazine.ca

Q: What is this Anti-aging phenomenon? A: Anti-Aging Therapy, requires the replacement of all hormones to the levels of a 30 to 40 yr old. You will never be 35 again, but you can feel and act and think as you did then. Once you are feeling better, you may decide to introduce Botox, to minimize lines, and facial fillers such as, Restylane to enhance and fill in areas of volume and tissue loss due to normal aging and lowered levels of hormones. Replacement with bio Identical hormones (BIOHRT) including estrogen, progesterone, testosterone, DHEA and other hormones to enhance both mental and physical function. Supplements and neutraceuticals and intravenous protocols at times, are added to this regimen. Q: Why do we need anything? A: As we age, our hormones lessen, until in some instances we have very little at all. Women suffer from menopausal symptoms of flushes, sweats, decreased libido, memory problems, and mood swings. Men

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become tired, indecisive, gain central fat, breast tissue, and exhibit mental slowdown, low libido, and erection difficulties. They perceive and think in an aging way, their metabolism changes, and they slow down mentally and physically leaving them unable to do what they previously did. As we age, we obviously become older, however with bio-identical hormone replacement treatments, we can feel and act much younger than our actual age, and so extend the quality of life and health well into the eighties and beyond, plus with the addition of a proper diet, regular exercise, both aerobic (cardiovascular) and anaerobic (weights), lifestyle modification, and laser rejuvenation, facial fillers and Botox, mesotherapy, we can then feel, look, work, and act decades younger, with a new rejuvenated mental outlook on life. It is not necessary to feel that once you are close to age 50 that one is in the decline of one's life, but rather in a continued activated progressive adult life.

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Polycystic Ovarian Syndrome What is Polycystic Ovarian Syndrome By Tanya Wylde B.Sc., CPT, FIS, ND. Read more to find out if you or someone you know might have undiagnosed Polycystic Ovarian Syndrome‌. olycystic (literally, many cysts) ovarian syndrome (PCOS) is a complex condition that affects the ovaries (the organs in a woman's body that produce eggs). PCOS is one of the most common endocrine disorders in women of reproductive age with a prevalence of approximately 3-5%. If undiagnosed and untreated, it may lead to infertility, type II diabetes and endometrial hyperplasia.

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PCOS exists in two forms, typical and atypical. Typical Polycystic Ovarian Syndrome is characterized by: 1. Obesity (Body Mass Index>30) or fat percentage greater than 32% 2. Amenorrhea(absence of menstrual cycle) or oligomenorrhea (infrequent periods or cycles longer than 35 days) 3. Hirsutism (Excessive hair growth in male pattern ie. on chin or chest) 4. Adult Acne and oily skin 5. Male pattern baldness/thinning 6. High male hormones 7. Polycystic Ovaries sometimes with ovarian enlargement(seen on pelvic ultrasound) 8. Cysts(immature follicles) in ovaries (more than 10 in each ovary) 9. Insulin resistance/Glucose Intolerance The atypical form of PCOS often goes undiagnosed because these patients' weights are stable, they have fewer symptoms and the symptoms they have are milder.

What causes PCOS? The underlying cause of PCOS is still unknown, but many doctors feel that it is insulin resistance. I feel that there are multiple contributing factors to this complex condition, but the most important causal factors are stress and insulin resistance. A genetic component is also likely as it seems to run in families, especially those with a history of type II diabetes. Ongoing research is trying to clarify whether there is a clearly identifiable gene for PCOS. How does weight and insulin resistance affect a woman with PCOS? Obesity exists in more than 50% of cases of PCOS. Obesity occurs due to poor lifestyle habits including overeating nutrient deficient foods, lack of exercise, improper stress management, overworking and poor sleep-wake cycles. Weight gain is often the main factor in turning on the PCOS gene. Once a woman with a genetic predisposition to PCOS becomes overweight, PCOS can manifest and progress. Once PCOS has manifested a hormone secreted from the pancreas called insulin becomes resistant to blood sugar and then it becomes even harder to lose weight. When blood sugar and insulin levels rise, inflammation levels rise. Estrogen accumulates in fat tissue and turns into the male hormone testosterone. Excess stress hormones from poor stress management and eating habits also convert to testosterone. High testosterone levels may contribute to oily skin, acne, excess hair growth (chest/chin) and scalp hair loss in male patterns. The elevated testosterone contributes to irregular menstrual cycles because it suppresses the female hormone progesterone. When progesterone is low, there is incomplete ovulation since progesterone is vital in the maturation process of follicles to eggs in the ovaries. When this process happens over and over, mulcontinued on next page

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tiple immature follicles remain in the ovaries and we call these "cysts". More than 10 cysts in each ovary is the one of the diagnostic requirements for PCOS. It's important to realize however, that you can have a healthy pelvic ultrasound with no cysts in your ovaries and still have polycystic ovarian syndrome based on your other symptoms and blood tests. This is because there are varying degrees of this condition and you might have the milder atypical form which can exist with or without cysts in the ovaries and with only a few of the symptoms rather than all of them. Women with atypical PCOS still benefit from a similar treatment protocol as the typical form. Women with atypical PCOS are not overweight, but still have to be careful of weight gain and insulin resistance because it is easier for them to develop type II diabetes and these factors could worsen their condition. If you suspect that you might have PCOS it is important that you ask your MD or ND to run the following tests in Table 1 and Table 2 at the appropriate time of your menstrual cycle to determine the current status and health of your ovaries and hormones. It is also important that the tests are interpreted properly and assessed for the correct time in your cycle. After you have initiated a naturopathic treatment plan, tests that showed up as abnormal should be repeated 3-4 months later to ensure that you are responding appropriately to the treatment. The column to the left of Table 1 and 2 represents the test to be measured. The second column explains when in your menstrual cycle (if you are menstruating) to have the test measured. The 3rd column shows you normal values and the values you should strive towards achieving with your treatment. The 4th column explains what results are often seen in patients with PCOS. Table 2 reviews further testing you should consider doing with your doctor such as pelvic ultrasound and saliva hormone tests and at home assessments such as cervical discharge tracking and basal body temperature tracking. Table 1 Lab Tests to run when you suspect Polycystic Ovarian Syndrome Blood Tests

When should test be run? *Remember that day 1 is the first day of heavy flow

Normal Values Values you are aiming for with treatment of PCOS

Often observed in patients with PCOS

LH, FSH

Day 3-5 of cycle (Follicular phase) NB: any day of month if don't have period or menopausal

LH:FSH seen in 1:1 or 2:1 ratio

LH:FSH seen in 3:1 ratio or more

Progesterone

Day 21 of cycle or 7 days after egg white vaginal discharge observed (Luteal Phase) NB: any day of month if don't have period or menopausal

3.8-50.6 nmol/L 30nmol/L-50.6 nmol/L is more ideal on day 21

Low

Free Testosterone

Same day as progesterone

1-8.9 pmol/L Midrange is ideal

Low or High

Dihydrotestosterone

Same day as progesterone

Pre-menopausal women: 83-1266 pmol/L Post-menopausal women: 50-623 pmol/L Midrange is ideal

High

Androstenidione

Same as progesterone

1.5-11.5 Midrange is ideal

High

Estradiol

Day 9

139-2382 Low to midrange is ideal

Low, High or within range

Estrone

Day 9

Within range

High

Morning cortisol

Same as progesterone

170-540pmolL Midrange is ideal

Normal or High, sometimes low if burnt out adrenals continued on next page

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DHEAS

Same as progesterone

1.8-7.7umol/L Midrange is ideal

High or normal

Fasting Insulin

Same as progesterone

40-190 pmol/L

High or normal

Fasting Glucose

Same as progesterone

6.1nmol/L or less

A fasting level of 6.16.9nmol/L indicates some degree of glucose intolerance

HbA1C (Glycated Hemoglobin)

Any time in cycle

0.040-0.060 Aim to get levels below 0.055

High normal values or higher than 0.060 (which indicates insulin resistance)

Glucose Tolerance Test

Any time in cycle

Normal blood values for a 75-gram oral glucose tolerance test used to check for type 2 diabetes: Fasting 60 -100 mg/dL; 1 hour: less than 200 mg/dL; 2 hours: less than 140 mg/dL

Between 140 - 200 mg/dL is considered impaired glucose tolerance (sometimes called "prediabetes"). This group is at increased risk for developing diabetes. Greater than 200 mg/dL is a sign of diabetes mellitus

ESR

Any time in cycle

0-20mm/hr

Normal or High which indicates increased general inflammation

hs-CRP

Any time in cycle

<1mg/L

>3mg/L (indicates increased risk of cardiovascular disease)

Thyroid panel (TSH, Free T3, Free T4)

Any time in cycle

TSH-0.5-2.00 mIU/L Free T3-2.6-5.7 IU/L Free T4-10-20 Midrange is ideal

Must rule out a thyroid problem because sometimes hyper or hypothyroid might be cause of delayed or missing period

Sex hormone binding globulin (SHBG)

Same as progesterone

18-114 nmol/L

Low levels are common and reflective of insulin resistance

*Make sure that when you test your hormones 3 months after initial treatment that the test is done at the same time of the cycle as previous test continued on page 100

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Other tests and at home assessments

Normal Values Values you are aiming for with treatment of PCOS

Often observed in patients with PCOS

Basal Body Temperature Tracking

Daily tracking of temperature. Go to www.lunafertility.com for fertility charts to help you get pregnant or avoid pregnancy the natural way

Wake up in the morning and take your temperature before you get out of bed put number on chart, you should see a rise in your temperature around day 14 of your cycle. Your temperature will remain high if you are pregnant, it will drop just before menses.

If you have PCOS you might not see may or may not see a rise in your temperature each month. This means some months you might not be ovulating.

Cervical Discharge tracking

Pay attention to the changes in discharge you see when you go to the bathroom when wiping

Between day 1-7: Blood Between 7-12: Sticky Discharge Between 12-15 Clear Egg White Discharge Between 15 and the next menses: Sticky Dicharge

You might not identify egg white discharge which is a sign that you are not ovulating You may find you have egg white discharge later in your cycle (around day 19 or later) this indicates you are ovulating late and usually a sign of low progesterone

Pelvic Ultrasound

Same time you get progesterone check

Normal size ovaries Less than 10 follicles in each ovary

2-5 fold ovarian enlargement of ovaries and the polycystic, with many small follicles scattered under the surface of the ovary (usually more than 10 or 15 in each ovary) and almost none in the middle of the ovary. These follicles are all small and immature, generally do not exceed 10mm in size and rarely, if ever, grow to maturity and ovulate.

Saliva Hormones (Rocky Mountain Analytical or Genova Diagnostic Labs)

Comprehensive test of all hormone levels relative to each other levels through entire cycle; saliva collected every 3 days from home OR 1 day assessment of all hormones done on same day (day 21 of cycle)

Ranges vary depending on hormone.

Low Progesterone High Estrone High Testosterone High DHEA High Cortisol

What are the treatment options for PCOS? Both Conventional and Naturopathic treatments for PCOS include a strict nutrition and exercise regime to balance blood sugars and improve insulin sensitivity. It's important to do this with the guidance of a naturopathic doctor or nutritionist so that nutritional regimes are customized to the individual. An additional conventional treatment for PCOS is the use of the birth control pill to suppress the excess testosterone lev100 - REVIVE Magazine

els and "regulate" the menstrual cycle. I don't recommend the birth control pill unless all other avenues have been pursued. The birth control pill is not ideal because a woman with PCOS already has incomplete ovulation. Taking the birth control pill will only suppress ovulation further. Unfortunately giving synthetic hormones in the form of birth control suppresses a continued on next page revivemagazine.ca


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women's production of her natural hormones and only masks the problem since once she stops taking it her hormonal balance remains and sometimes even gets worse. The conventional medication Metformin (blood glucose regulator) is often used to treat patients with typical PCOS who are obese. Metformin has been found to help with weight loss and improve fertility but it is very hard on the liver and it does not teach a woman how to take care of herself long term. It is a short term Band-Aid solution. The good news is that there are alternative natural therapies that can be used to treat PCOS exclusively or concurrently, if a woman decides to combine conventional medicines with natural medicines. The role of the naturopathic doctor in PCOS treatment is primarily to improve lifestyle through proper education on nutrition and exercise and secondarily to balance hormones with the use of supplements and herbal medicine. Nutrition The most successful treatments for PCOS involve nutritional changes targeted to achieve weight loss and improve body composition (higher lean body mass, lower fat mass), balance blood sugars and improve insulin response. Both the typical and atypical forms of PCOS improve significantly on a low glycemic index diet. My favourite nutritional regime is based on the low glycemic index diet and is part of the "First Line Therapy" program created by Metagenics. It works because patients following First Line Therapy lose fat mass and maintain their lean body mass which allows them to maintain a higher basal metabolic rate. The higher the basal metabolic rate, the more calories burned at rest. Patients learn the skills to eat properly and keep the weight off for the long term rather than yo-yo dieting. When a woman eats foods that are low glycemic index her insulin becomes more sensitive. When insulin becomes more sensitive, blood sugar levels decrease, the body has less inflammation, female and male hormones begin to balance, skin and acne levels improve and it becomes easier to lose weight. Exercise When resolving PCOS, exercise is just as important as following a healthy nutritional regime. Without exercise stress is higher and hormones become imbalanced. Stress increases the hormone cortisol which causes insulin resistance, elevated blood sugar levels and contributes to excess testosterone in women with PCOS. Haven't you ever noticed that when you exer-

cise, your skin glows and you feel less stressed out! That's because one of the best ways to use up excess cortisol is to exercise. If you were confronted by a big scary bear the stress hormones (adrenaline and cortisol) would rise which would cause your heart rate to go up, your blood pressure to rise and your blood to be diverted to your muscles so you could run away from the bear. If you didn't run away from the bear you'd be standing there staring at the big scary bear having a panic attack!!! If you don't exercise daily and use up the excess cortisol and adrenaline that rises from dealing with your day to day stresses like your big scary boss it's like living in panic mode all the time. Many times women with PCOS have more trouble losing weight than the average woman because of their blood sugar problems. Sometimes they struggle to lose weight even before the insulin and glucose show up abnormal on the blood. If you trick your body by changing up your exercise regime monthly and challenging your body to new limits you will bypass any weight loss plateaus you may have reached. A personal trainer is a wise choice in this case as they will guide you through your plateaus. If you can't afford to have a trainer on a bi or tri-weekly basis, hire one once monthly to give you an exercise prescription for the month so that you are constantly changing up your exercise regime. Nutritional Supplements/Herbs to resolve PCOS When a woman is diagnosed with PCOS it's important to identify and address any nutrient deficiencies such as zinc, vitamin B12, folic Acid, iron (ferritin), vitamin d (25-OH-Vitamin D). The additional tests in Table 1 should also be done to assess and address hormonal imbalances and levels of inflammation. I find that liver detoxification is a good way to initiate treatment in a woman with typical PCOS including a 4 week anti-inflammatory diet with Ultra clear Plus (metagenics product) because it helps the liver to speed up the elimination of excess estrogens, testosterone and fat soluble toxins stored in the fat. I've had a lot of success reducing excess dihydrotestosterone levels into normal range with saw palmetto and zinc and increasing progesterone levels using vitex. Once the levels of progesterone increase to normal and dihydrotestosterone normalize, the irregular cycles in a woman with PCOS become much more regular and shorter (closer to 28 days instead of >35 days). If the levels of progesterone and testosterone don't normalize with continued on next page

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Q & A with Dr. Robert Sleightholm Dr. Robert Sleightholm is a Fellow of the Royal College of Physicians and Surgeons of Canada specializing in Plastic Surgery. Dr. Sleightholm has extensive experience in surgical and nonsurgical procedures of the face and body. The more frequent procedures are breast and body contouring procedures. He is the surgical director of the Brampton Cosmetic Surgery Center and Medical Spa located in Brampton. Please visit bramptoncosmetic.com or email your questions to askanexpert@revivemagazine.ca Q: I was told that if you get a breast reduction and a lift it is covered by OHIP. Is that correct?

Q: I am very interested in liposuction! I read somewhere that liposuction can cause cellulite. Is that true?

A: Prior to breast reduction surgery a request for surgery must be submitted to OHIP for approval. Approval is determined by breast size and the medical indications for surgery. In most cases approval is granted. Breast reduction reduces breast size and lifts the breast. Breast lift as the sole procedure is considered cosmetic and is not covered by OHIP.

A: Liposuction at the present time does not reduce the appearance of cellulite. Liposuction performed too superficially or performed on patients with poor skin elasticity could increase contour irregularity. There are trials with radiofrequency (electricity) liposuction that heats the skin and subcutaneous tissue that could prove beneficial in reducing the appearance of cellulite.

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cholesterol imbalances, strokes, heart attacks, endometrial cancer (cancer of the lining of the womb; especially if there are many missed periods), infertility, hypertension, gestational diabetes. Once a woman begins naturopathic treatments for PCOS ideally her hormones return back to normal, her body composition and weight improves, her menstrual cycles normalize and she feels much calmer and less irritable with lower levels of the male hormone testosterone. Head hair growth can improve by about 30% within a few months but the hirsutism (hair growth on chin, cheeks, chest, upper lip and abdomen) takes much longer to address (6 months before any noticeable improvement and 2-3 years to achieve the maximum benefit from anti-androgens because of the length of the growth-cycle of hair.) Laser hair removal in this case is the best option. Remember that it may not be possible to change your genes but you can certainly turn them down by staying healthy with good food choices, exercise and supplementation can keep conditions such as PCOS at bay.

vitex, bio-identical progesterone should be considered as a last resort before the birth control pill is used. When HbA1C levels are high or high normal, insulin levels are high or fasting glucose levels are high or a women is struggling with weight loss it is important to consider additional fiber, chromium, vanadium, cinnamon and hormone free whey protein powder. If inflammation is an issue (high ESR or high hsCRP) omega 3 fish oils, nattokinase and or curcumin are helpful to reduce inflammation and risk of cardiovascular disease. Stress management is a key component in the treatment of this condition. An indication that stress levels are too high is high blood cortisol levels. Another indication that stress levels are too high is fatigue all the time or frequent colds and flus. In addition to exercise adrenal adaptogenic herbs like rhodiola and siberian ginseng are helpful in decreasing excess cortisol. It's important to assess and treat PCOS if you suspect you might have it since it can increase a women's risk of developing type II diabetes, 102 - REVIVE Magazine

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Combating Acne the Natural Way By Cara Smith

W

e are all EAT skim milk, cottage cheese, yogurt and familiar with avoid fatty creams and rich milks as acne aggraacne, the vation has been directly linked to fat pustules image distorting skin contained in them. Rich dairy products can play condition characterized a big part in worsening acne. When dairy is by embarrassing bumps eliminated from one's diet, immediate skin and blemishes, exces- improvements may occur. sively oily or dry skin EAT nuts, seeds and oily fish. It has been and in most cases, an proven that polyunsaturated fats found in nuts, accompanying low self- seeds and oily fish can control acne. Oil or esteem. spring water tuna have also long been recomAcne is a skin disease caused by the clogging mended as a food to eat to improve acne. Both of pores and inflammation of the sebaceous are high in omega 3 and have special benefits to glands and hair follicles. When these glands pro- the skin. duce too much sebum or oil, they become DRINK 2 to 3 litres of water a day. plugged and become whiteheads, blackheads Drinking plenty of water reduces acne by flushand pimples. Dead skin cells on the skin's suring toxins out of one's system and keeping kidface then mix with this sebum to clog pores even neys, liver and bowel functioning effectively. A more. Squeezing these sluggish digestive pimples often causes system is often a "Let your foods be your medicine pitting and scars. cause of acne. While we think and your medicine your foods as Drinking plenty of acne is just a problem nature is the healer of all diseases!" water and eating lots facing teenagers, it is of fibre in the form of a quote by Hippocrates not uncommon for fruit and vegetables adults. Surprisingly will keep your insides these days, more adults have acne than healthy and your skin supple, hydrated and lookteenagers! Acne affects approximately 50% of ing refreshed. Dehydrated skin can become dry adults between 25 and 49, compared to 25% of and flaky, causing the skin's natural exfoliation teenagers. to slow down, resulting in blocked pores and The good news is that acne can be controlled pimples. and in best cases cured by natural, drugless EAT Grapes and fruits rich in citric acid, methods and when you apply the eating tips below, this embarrassing problem could hope- one of the most important ingredients in an acne reducing diet. Lemon juice added to water is fully be avoided. highly recommended because it is one of the Foods that help to combat acne healthiest drinks for the skin and body. It fights Below are some foods to add or avoid when acne by helping with the elimination of waste, combating breakouts. the alleviation of constipation, the cleansing of EAT whole grain cereals and bread and the liver and promotes proper digestion. avoid white bread and other forms of highly EAT chicken and low fat protein. Our bodprocessed breads. In fact, avoid all highly processed foods including meats, pastas, cookies ies create enzymes that stimulate fat and oil production in skin's sebaceous glands. Formation of and everything in between! continued on next page

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these enzymes is substantially lessened when your diet is rich in low fat proteins. Less enzyme production results in less oil production that clogs pores and stimulates acne. EAT Salad. Beetroot, tomatoes, cucumbers and lettuce should be mixed together as a salad and should be eaten every night. This magical Mediterranean salad is an excellent acne eraser. DRINK fresh fruit and vegetable juices and avoid soft drinks and artificial sweeteners which are guaranteed to aggravate acne. EAT Potatoes, a filling, satisfying vegetable that can serve as a meal itself to keep you feeling full and avoiding cravings for snacks like acne causing chocolate, sweets and highly salted snacks. Vitamins, Minerals for Acne Prevention For healthy, happy skin, you need plenty of antioxidants but a diet specifically high in betacarotene and zinc can be extremely beneficial to acne. Beta carotene converts into Vitamin A in the body and helps maintain skin's health. Beta carotene is found in apricots, mangos, eggs and in dark green or orange vegetables such as spinach or carrots. Men with acne can benefit from adding selenium to their diet. Proper minerals and vitamins will also help speed up the healing process, quickly fading annoying acne spots and scarring. Internal Cleansing to Stop Spots Many people believe that any disease or disorder, including acne, is a sign of constipation or the clogging of the body tissues and improper functioning of internal organs. People with acne often have sluggish digestive systems and inefficient liver and/or kidneys and so the body eliminates its toxins through the skin. By helping your body work more efficiently to flush out toxins, your acne can fade. Therefore by consuming foods known to clean vital organs, your kidneys and liver will do the detoxing for you and your internal impurities will stop manifesting itself as acne on your face. In some cases, internal cleansing may initially result in breakouts but this is simply a sign that your body is undergoing internal cleansing revivemagazine.ca

and once impurities are released, the acne will subside. A Few Methods of Internal Cleansing There are many ways to conduct internal cleanses and your choice comes down to personal preference. I recommend doing research and consulting with a physician (a must!) about what cleansing program could work for you. Internal cleanses can be as effective as taking strong acne medications but cleansing may have long term benefits because they get at the root of the problem. A well-known method of cleansing is the juice or water fast. This is a radical discipline however, and must be undertaken with care but comes with a guarantee you'll see a drastic improvement in your skin's condition at the end of a 3 to 4 day fast. Another popular cleansing method is the colon cleanse. Cleansing the colon rids the body of fecal matter and other toxins that have built up on the walls of the colon, causing it to work improperly, possibly leading to malfunctions in other organs, such as the kidneys. Since the colon needs to be in its healthiest condition to avoid blemish problems, herbal remedies can be effective in cleansing the colon and reducing acne, without the harsh chemicals or side effects of taking certain acne drugs. Other ways of obtaining a cleaner colon include colonic hydrotherapy or irrigation, altering your diet to include more fibre and increasing exercise. Nutritional cleansing is another effective detoxification method as it is a cellular cleanse and focuses on all organs, including the largest; skin. These are usually based upon aloe vera juice, a powerful fighter of acne that boosts health at a more fundamental level, possibly preventing other health problems in the future. One popular cleansing program based on liquid aloe vera is IsagenixÂŽ. The IsagenixÂŽ Cleanse for Lifeâ&#x201E;˘ drink combines aloe vera, teas, nutrients and minerals and claims to infuse your cells with nutrients, helping you body release impurities that cause acne. With all of these points in mind, always consult your physician before making any dietary changes or undergoing a cleansing program.

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Build your inner strength By Trish Stratus, Stratusphere Yoga Studio Proprietor Trish Stratus is a long-time yoga practitioner and studio proprietor in Vaughan, Ontario where she runs several different styles of yoga and pilates classes. One of her most popular and fastest growing classes is her prenatal classes. Offered regularly on her schedule, this weekly class offers momsto-be a way to maintain their fitness during pregnancy, which plays a significant role in having a safe and comfortable birthing process. The class also provides the support and company of other pregnant women as well as the expertise of Team Stratusphere member and instructor Lisa. Whether you are new to yoga or already an experienced practitioner, Trish Stratus shares her thoughts on prenatal yoga and why doing it is wonderful for both mother and her baby. lu season. It's here and with all the H1N1 buzz, it may seem that this season, it's going to be tougher than ever to battle through. But really, I personally will approach this season the same as I do every other and that is with a preventative mindset. The great news is all the arsenal we need is right at our fingertips. The choices you make about what you eat and how you live will ultimately dictate how you will fare against seasonal viruses. As the saying goes, the best defense is a good offence, so taking the steps to boost your immune system will give you the best chance to experience optimal health and wellness not only during flu season, but throughout the year. There are many things you can do to improve your body's ability to fight disease. By incorporating healthier patterns into your daily living, like how you nourish your body, how much physical activity you get and certain simple

F

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lifestyle changes, you can easily get those white blood cell soldiers ready to fight … and win! You are what you eat. By eating a varied and balanced diet that includes lots of fresh fruits and vegetables you prime the body's defenses from the inside out. Eating certain foods will ensure you get the nutrients that help strengthen the immune system: • Citrus fruit, broccoli, tomatoes, red, yellow and orange peppers (vitamin C) • Garlic (acts like a natural antibiotic, active components block the enzymes that lead to infection) • Whole grains (zinc and vitamin E) • Bananas (vitamin B6) • Sweet Potatoes, carrots, spinach (sources of beta-carotene, which is a form of vitamin A that helps produce white blood cells.You can also add these immune enhancing products to continued on next page revivemagazine.ca


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help prevent or shorten the duration of common colds and flu: • Vitamin D • Vitamin C • Echinacea • Goldenseal • Probiotics In addition to what you eat, certain lifestyle changes can help support your immune system, including: • Washing your hands. Wash thoroughly and often with warm water and soap to avoid both passing on and picking up cold viruses. • Getting enough sleep. At least 7 or 8 hours of sleep is recommended, any less makes you more susceptible to getting sick. • Reducing and managing stress. Long periods of stress or chronic stress can raise cortisol levels (the stress hormone) which can weaken the immune systems' ability to fight off cold or flu symptoms. • Eliminate sugar and processed foods from your diet whenever possible. Sugar consumption has an immediate, debilitating effect on your immune system. Another way to not only help ward off a cold and flu virus but also attack it is physical activity. Regular exercise appears to jumpstart the immune system by increasing the number and aggressiveness of certain immune cells. Yoga in particular provides many healing benefits that help improve immune function: • Twists and inversions stimulate the lymphatic revivemagazine.ca

system, which is rich in white blood cells and plays a vital role in your immune system • Certain poses compress the organs, this helps massage and rejuvenate immune organs and channels. • Inversions and forward bends (like downward dog) improve the flow of the sinuses and help flush mucous from the lungs. • A regular yoga practice reduces high levels of cortisol in the body which can increase the body's vulnerability to infections. • Deep breathing techniques increase the flow of oxygen into the lungs, which helps in alleviating colds, asthma, sinus congestion and allergies. • The cardiovascular work that is required in yoga helps remove toxins through sweat. This detoxification process can also be achieved by doing yoga in a heated room. All of these are possible kinds of natural, preventative approaches to help build up our natural defenses and improve overall immune health. So before you reach for the cold and flu medications remember that the solution lies in prevention instead of the cure. Let's not forget that the body has an amazing innate ability to heal itself. Years and years ago, we didn't have antibiotics or flu vaccinations - but, we did have whole foods and we did have yoga.

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Makeover Madness By Dr. Sol Weiss he holy grail of dentistry, the perfect smile, is quite special because depending on many factors it will be different for every person who walks into the dentist's office. The media portrays beauty in specific ways, and dentistry is no different. How many people do we see that have their perfect smile look like big white Chiclets that has absolutely no harmony with the persons face. The reality programs such as Swan, Extreme makeover, Skin Deep, Style by Jury, have piqued the interest of the part of society that up until now had really no ability to have these life changing procedures. It is now not only because the Jones's haveâ&#x20AC;Ś, but more people now have a chance for a significant life change that will affect the rest of their lives. What is a dental makeover, full mouth reconstruction, full mouth rehabilitation etcâ&#x20AC;Ś???? It is not simple as there is a lot of planning that needs to happen, and the dentist using all the records that have been taken will then decide upon a treatment plan that will render someone with an unhealthy dental situation, to one of those healthy beautiful smiles! Here are some examples of major dental issues:

T

Color of teeth

Multiple Missing Teeth

Major Crowding

X-bite problems in adult dentition

Worn down top and bottom teeth

These treatments include procedures such as, crowns, veneers, extractions, implants, bridges, gum sculpting, dentures, and some type of maintenance program. Cleanings with the hygienist continued on next page

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continued from page 108 - Makeover Madness

are necessary every 4-6 months to insure proper oral hygiene care. Warranty programs exist really to help the patient take care of their new investment. What is the time commitment? These treatments take time and it is not unusual for the process to take from 3 months up to a year depending on the specific services. Any treatment that includes implants can take at least 6 months more, than just regular crowns or bridges. If correction of badly broken down teeth is necessary, the patient will be in temporaries for a few months to make sure that the new position is comfortable. What records are necessary? Standard practice at my office insures that we have a complete exam with full set of x-rays (within1 year) we mark down the existing tooth condition and we also mark down the existing gum condition. It is the gum condition that will adversely affect the final result if not careful. We will take a full head x-ray if we are placing implants as well. Another important and maybe the most important record is the wax up! This record will show the patient the end result, tooth shape and position and to some degree color of the new teeth. It will also help to make the temporary restorations. These are acrylic teeth worn that represent the wax up, and can be adjusted easily. These are also worn while the permanent teeth are being made! It is during this time where input from patient is necessary specifically if there are any issues with shape, size, color, or comfort. Other stuff Know approximately what you want. Bring pictures of what you like and don't like. Bring old pictures. Make sure you understand the dentist. Make sure that the dentist listens to you, and incorporates what you want into the plan! Make sure you see a dentist that is experienced with this type of work. Treatment schedule Usually the dentist will work on the top teeth at one appointment and the bottom teeth at another appointment A final impression is necessary before the final teeth can be made. Usually this is done at a revivemagazine.ca

different appointment than the tooth preparations. During this time the temporaries cover the prepared teeth, but more importantly they give a representation of what the final teeth will look like. It is at this point adjustments are made to the bite, and to the shape and size of the teeth. These changes are incorporated into the new teeth, by sending adjustments to the laboratory! There are quite a few appointments, over the span of the treatment. Impressions are taken typically after healing of a surgical procedure. All in the entire end justifies the means!!!!!!! Before & After photo's of actual cases

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Q & A with Dr. Sheldon Herzig Dr. Sheldon Herzig is the Medical Director and co-founder of the Herzig Eye Institute in Toronto, one of the premier surgical eye centres in North America. Dr. Herzig has lectured worldwide on his surgical techniques as well as training surgeons from many different countries. He is on active staff at North York General Hospital and a Lecturer at the University of Toronto. For more information please visit www.herzig-eye.com or email your questions to askanexpert@revivemagazine.ca Q: I am considering having eyelid lift surgery and laser vision correction. I am wondering which should be performed first and how much time should elapse between the two procedures? A: It doesn't matter which surgery is done first as long as you have sufficiently recovered from the first procedure and the second surgeon is aware of the previous surgery. Usually one month between procedures is sufficient. Both eyelid and laser eye surgery can cause dryness of the eyes. Doing both procedures in close proximity can increase the risk of the ocular dryness being prolonged. Q: I am very interested in getting Laser Eye Correction but have heard some horror stories. What are the most common side effects of laser vision correction? Will I see 20/20 after my procedure and how soon can I go back to work?

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A: Any surgical procedure has some element of risk. Risk is minimized by carefully selecting patients for the right procedure and then performing the surgery with great care and skill. The most common problem after laser vision correction is ocular dryeness which is almost always temporary and can be controlled. Rare complications include corneal irregularity (ectasia) and infection. Night vision problems have been virtually eliminated with the introduction of wavefrontguided treatments 8 years ago. After LASIK most patients are at or close to 20/20 in 24 hrs. and can return to work the day after their surgery. After PRK patients have functional vision very quickly but may not be able to drive for 7-10 days so this has to be planned for. For about 30% of patients PRK is safer than LASIK.

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Q & A with Dr. Dan Hagi Dr.Hagi maintains a private practice in Thornhill, Ontario focusing on Aesthetic, Implant and Rehabilitative Restorative Dentistry. Always keeping up to date with the latest technology and innovation, Dr.Hagi's main concern is restoring a mouth into a balance of health and aesthetics. He is a published author and reviewer in dental journals and a member of numerous professional dental organizations and clubs. Visit thornhillsmilecentre.com for more information or email your question to askanexpert@revivemagazine.ca

Q: My front teeth are really short and uneven. I am 43 years old and have noticed that this is getting worse. My dentist says I grind my teeth at night, but I don't. What is causing this damage and can I fix it? A: Excessive tooth wear is a problem. I like the reference to M&M's and Tires. Tires that grip the flat road wear relatively slowly and evenly, yet if we drive on an uneven surface then the tires wear unevenly and much faster. Teeth are the same, if we have teeth that are out of alignment they tend to wear faster than teeth that are properly aligned. In addition, if we drive more on those tires then they wear more, similarly if we grind or overuse our teeth they will wear more. M&M chocolates are hard on the outside and soft on the inside, as are teeth. The enamel outside the tooth is hard yet the inside of the tooth, the dentin, is softer. Once the outside surface of the tooth gets worn, which usually takes many years, the inner part wears much quicker, which is why you may be noticing the teeth getting much shorter. In our practice we see a lot of patients that say they do not grind their teeth at night but present with a lot of wear. Many people do not realize that they are grinding, others have other abnormal or parafunctional jaw movements that damage the teeth. Worn teeth are less effective in masticating through food, can lead to spaces and therefore food getting stuck between the teeth and they are less attractive and make us 118 - REVIVE Magazine

look older. We can repair the worn teeth using advanced restorative techniques such as crowns, veneers and bonding, but in order to make sure that our repairs last we need to control the cause of the problem, which may be crooked teeth, uneven teeth, or underlying jaw issues. Q: My bottom teeth are crooked and my gums always bleed. My dentist told me I should floss more, but it doesn't help, is there anything else I can do to stop the bleeding? A: Brushing and flossing is wonderful to get our gums healthier, however, when you teeth are crooked and overlapped you are unable to properly clean the spaces between the teeth even with floss. When teeth crowd they tend to retain more food and bacteria. That's the same bacteria that often causes bad breath and gum disease. In many cases just brushing and flossing is ineffective in properly cleaning these surfaces. Gum tissues can be more easily cleaned if the teeth are properly positioned. At our office we use orthodontics and Invisalign to correct the alignment of teeth and provide better access to the areas between the teeth so that the bacteria and food debris can be properly cleaned. Once your teeth are straightened, having a proper home care regiment that includes proper brushing and flossing in conjunction with professional cleaning will enable you to stop the bleeding in your gums. revivemagazine.ca


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My experience with Artecoll injectable filler for Facial soft Tissue augmentation by Philip Solomon MD, FRCSC Otolaryngology Head and Neck Surgery-Facial Plastic Surgery Artecoll is considered a semipermanent facial filler. In Canada there are few other semipermanent fillers therefore making artecoll a relatively unique product. The injectable implant is composed of two components commonly used in both aesthetic and reconstructive surgery. 25% of Artecoll is composed of microspheres (pearls) of polymethyl methacrylate (PMMA). PMMA has had the most extensive use in dentistry and orthopedic surgery where it is largely utilized in bone cement. The majority of the product is injectable collagen. Injectable collagen has had a long track record of use as temporary soft tissue filler. In Artecoll, the role of collagen is that of a temporary carrier of the microspheres of PMMA as it is deposited in tissues. The goal of depositing the PMMA microspheres (plastic pearls) in the tissue is to elicited scar formation in the form of tiny capsules around each sphere and thereby achieves a more permanent tissue filling or augmentation. The largest experience with its use is in Europe where it appears that Artecoll has been a viable permanent tissue filler with minimal complications in comparision with other forms of long acting tissue fillers. We review our experience with the efficacy of Artecoll as a soft tissue injectable implant in four common clinical scenarios: 1) deep nasolabial folds, 2) forehead - glabellar grooves, 3) lip augmentation and 4) post-rhinoplasty nose job irregularities. Our Study Review We reviewed 129 patients of our patients treated with artecoll over seven years. None demonstrated allergic response to Artecoll on testing. 74 patients desired lip augmentation; 21 nasolabial fold augmentation and 8 patients glabellar folds augmentation, 26 patients underwent treatment of miner irregularities of the nose following rhinoplasty. Average follow up was 34 months with a range from 24 to 60 months. Of the 74 patients in the lip augmentation group, 19 patients only had upper lip injection; 11 patients, lower lip only; and 44 patients, combined upper and lower lip injec120 - REVIVE Magazine

tion. 108 of 118 lips required only 1 vial of Artecoll. The remaining 10 lips required up to 2 vials. Patients experienced mild discomfort during injection and in the immediate post-injection period. 68 of the 74 patients reported complete satisfaction with the outcome. Artecoll appeared to be semi permanent filler, maintaining good volume on subsequent follow-up for at least 2 years in all patients. On palpation, the areas injected with Artecoll appeared in most patients to blend into surrounding tissues smoothly. However in 52 of the lip augmentation group we could detect a texture to the lip which would suggest implant augmentation. However we only noted 5 patients who had exhibited localized lip lumpiness that caused patient awareness of the implant. Visible lump formations or significant palpable lip deformities were treated with massage and Kenalog injection. These measures failed in 2 patients who subsequently underwent excision of the palpable lip defect under local anesthesia. No sequelae resulted.

Courtesy of ArteSense

Courtesy of ArteSense

continued on next page revivemagazine.ca


ideal tissue filler should be easy to administer, non-immunogenic, biocompatible, predictably permanent, identical in texture to surrounding tissue, and affordable. The downside of most biological fillers is resorption over time. Hyaluronic Acid fillers and Courtesy of ArteSense Courtesy of ArteSense collagen work well but typically last from 4 to possibly 18 months. A small percentage of patients are not candidates secondary to A total of 21 patients had treatment of there allergic reactions to collagen. Fat injections can nasolabial folds. A total of 40 folds were filled. be used for longer term filler results but can Two patients required unilateral injections only. cause lumpiness and unpredictable results. We used one vial in 13 folds, 2 vials in 23 folds, Although permanent, injectable allograft and 3 vials in 4 folds. A significant number of implants like silicone can subject patients to nasolabial folds required up to 2 vials for satischronic inflammation and often leave tissue with factory improvement of the folds at the initial an unnatural appearance and texture. Silicone injection. Deep nasolabial lines subjectively did injections, which are oil based, may have a not respond as well as mild to moderate lines. greater tendency to spread beyond the intended While maintaining good volume over time, the areas of treatment. It is difficult to reverse the implants did not demonstrate an unnatural effects of silicone injection and thus, should be induration or nodularity to palpation. Overall used with caution. Finally injectable silicone is satisfaction of this patient group was 18 of 21 currently prohibited in Canada. patients treated. The three patients who were not Gortex, used in lip augmentation and filling totally satisfied all felt there was some improvefacial folds gives permanent results but can crement but had wished for a more significant ate a unnatural texture and appearance. change. These patients had deferred further Acrylic Hyrdrogels have recently been used treatment. as an alternative semipermanent injectable. A total of 14 glabellar folds in 8 patients were Products such as DermaLive and Dermadeep are injected. All glabellar folds required on average composed of hyaluronic acid and acrylic. The less than one vial for complete treatment. In 4 hyaluronic acid makes up 60 percent of the prodpatients with excessive muscular activity causuct and acts as the carrying fluid vector for the ing prominent dynamic frown lines, the glabellar acrylic. It has no collagen and therefore needs no region was adjunctively treated with botulinum allergy testing. Its use has been in Europe since toxin injection 2 weeks prior to injection with 1998 but when introduced in Canada was met Artecoll. Six of eight patients treated in this with mixed reviews. Currently this product is group expressed satisfaction from Artecoll injecno longer available in Canada. tion. The two patients who were not completely PMMA microsphere( plastic Pearls) are sussatisfied had persistent linear lines into the derpended in a gel of collagen in Artecoll. Since it mis, which was not completely effaced by the is anticipated that the collagen is resorbed, its artecoll. role is that of a vehicle for smooth delivery and Twenty six patients were treated for minor even dispersal of the PMMA spheres. PMMA asymmetries of the nose post rhinoplasty. All has a long and proven track record for use as a patients were treated at least 12 months followbiocompatible material. Since its invention by ing rhinoplasty surgery. On average, less than Rohm in 1902, PMMA has been used in orthoone quarter of a vial was needed for each patient. pedic surgery, dentistry, neurosurgery and ophAll patients in this group were satisfied with thalmology. treatment. PMMA microsphere-induced granulomatous A total of 11 patients expressed a less than reactions is a rare complication where one develcomplete satisfaction with artecoll of the 129 ops an inflammatory reaction to the injection. patients in the study group. There have been only 10 reported cases of granDiscussion uloma formation reported to the manufacturer The multitude of soft tissue fillers used for since its introduction in Europe in 1993. wrinkles and tissue augmentation attests to the continued on next page fact that ideal tissue filler does not exists. The

continued from page 120 - Artecoll Injectable Filler

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continued from page 121 - Artecoll Injectable Filler

Histological studies demonstrate that over a 2 to 3 month period, the collagen is degraded and replaced by a persons own collagen., analogous to the capsule surrounding breast implants. The maintenance of tissue filling is attributed to this "mesh" of fibrous capsular tissue encompassing these colonies of microspheres. The most extensive clinical experience with use of Artecoll as a skin and soft tissue filler comes from Europe where it has been in use for approximately 10 years. Lemperle et al. treated 2000 patients for static lines and lip augmentation and prospectively reported on the initial 100 patients. 90% of patients were satisfied with their results in long-term follow-up to 5 years; less than 2% expressed dissatisfaction. In addition to the indications reported here, Artecoll has also been used by European practioners for nipple reconstruction, tear trough or naso-orbital grooves, and chin augmentation. Other reported uses for Artecoll have been for treatment of functional problems (vocal cord paralysis, cleft palate, velopharyngeal insufficiency, urinary incontinence). Acute complications, which have been previously reported elsewhere and noted in some of our patients, include echymoses and erythema, which lasted a few days, and itching which, can take several weeks to resolve. None of our patients had an allergic reaction. The delayed complication of lump formation was noted in 5 (4.6%) patients, all of who had undergone lip augmentation. Palpable implants do not appear to be a problem for treatment of folds or dorsal irregularities. The main limitation of the use of Artecoll appears to be its cost and lip lumpiness. Placement of Artecoll in locations with thin skin, such as the periorbital region is also to be done with caution. It must be stressed to patients the indications and limitations of the product and the possible need for adjunct therapies to achieve optimal results. There has been some discussion in the medical community about the role of massage for prevention of lump formation. Some surgeons recommend use of massage of the lips over the first few days after injection. The belief was that massage would spread artecoll evenly within the subcutaneous space and avoid lump formation from initial poor technique. Others believe that 122 - REVIVE Magazine

there is a propensity for lump formation as a result of the obicularis activity pushing the implant in the clumps similar to pearl formation. Therefore massage may conteract the obicularis muscle and reduces lumpiness. Finally there have been suggestions that the adjunct use of Botox in low doses into the obicularis may reduce the clumping of artecoll and therefore be useful to prevent lumpiness. These theories are all speculative and require further evaluation. Overall, our experience indicates that Artecoll a Semi permanent injectable filling agent appears to have a high patient satisfaction. In our series Artecoll had an acceptable patient safety profile. The product had an extremely high satisfaction for soft tissue augmentation of facial folds and correction of miner nasal asymmetries after rhinoplasty surgery. The product was felt to give good long term correction of atrophic lips. The product was felt to frequently cause palpable textural change the lips in a high percentage of cases. Significant lumps requiring steroid injection was noted in a minority of cases. Significant lumps requiring surgical intervention was seen in 2 out of 129 patients. Both of these cases were patients who had undergone lip augmentation. No patient in our series formed granulomas from the product. There have been a number of long lasting or semipermanent injectable fillers on the market over the years in canada. Artecoll is the only semipermanent product that has withstood the test of time. Other competitive semipermanent products have had significan local complications and have been pulled from the market. If a patient is seeking treatment of facial folds or lip enhancement that last for years artecoll is worth offering in ones practice. The physician must have experience with its use and inform the patient of the relatively high chance of palpable textural changes to the injected site especially the lips...

Author Dr Philip Solomon MD, FRCSC Private practice Toronto Ontario Canada. Lecturer Dept Otolaryngology, University of Toronto REVIVE revivemagazine.ca


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Revive Winter 2010  

Thornhill Smile Centre article about Oral Health, Makeover update and AD.

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