As we get older our body also starts producing less hormones. These substances are produced by our glands that are part of the endocrine system and vital in maintaining our homeostasis or hormonal balance. They control every function in our body. Any deviation from this balance may result in changes to our body systems or organs. Invariably this can result in many symptoms.
The most important hormones associated with our daily well-being are testosterone, oestrogen and progesterone. With the normal ageing process all of these decline to a certain extent.
Balancing and replenishing these hormones is vital to maintaining a healthy lifestyle, positive mood and energy. They are also essential for healthy skin, alert brain function, skin rejuvenation and cardiovascular health. This goes for males and females although the levels will vary between genders.
HRT (Hormone Replacement Therapy) is usually associated with menopause and has received bad publicity in the press for being associated with increased risk of breast cancer and gynecological malignancies. Classically HRT was produced from synthetic materials which are very dissimilar to the naturally occurring hormones and thus have other side effect profiles.
Bio-identical Hormones are sourced from naturally occurring Mexican yams and are identical in structure to the human hormones. They are 100% identical in chemical structure and thus have the same effect on the endocrine system. This also means that they do not have the deleterious negative associations mentioned earlier.
The most common indications for Bio-identical HRT are adrenopause (low testosterone), menopause, PMS, postnatal depression, menstrual irregularities.
You may have had your hormone levels tested at the GP and they have come back within normal ranges, but they may have been on the low side. As they are within the normal range the GP may have reassured you that the levels are all good. Having slightly low testosterone or progesterone may have an affect on your daily mood, sleep pattern, energy levels or metabolism and although you generally feel ok, re-balancing these levels may make you feel GREAT. It may just mean replenishing the progesterone or testosterone by a small amount, but this may make the difference between feeling energised or lethargic.
We will check your levels and discuss the possible options in replenishing them. Regular follow-up visits will allow us to check the effects and possible need to teak the treatment.
We work hand-in-hand with a compounding pharmacy who manufacture the correct dosages of your required hormones.
BHRT can be taken in various forms such as creams and lozenges prepared to the patients' individual requirements.
Symptoms that may indicate a hormonal imbalance:
low energy (fatigue), lethargy, deminished libido, erectile dysfunction, irritability, skin changes, mood swings, hot flushes, unable to lose weight, breast tenderness, depression, memory loss.
(these are some examples and there are many more, these may certainly also be part of other medical conditions and are not exclusively predictors of hormone imbalance)
Tuesday 13 September 2016
Tuesday 26 July 2016
Gynecomastia, male chest reduction, gland excision, VASER liposuction
Many of my male patients have some form of male breast enlargement. Not all decide to have that area treated as it does not bother them that much. However, the patients that seek to have treatment for this particular area frequently ask about the other options available. If they dont ask it is part of my consultation process to inform them of the other options available that are suitable.
In this day and age most patients opt for the non or minimally invasive procedures as they carry less risk and the down-time is less and recovery is faster.
In some cases though it is not appropriate to perform the non-invasive techniques and the surgical ones are more indicated. It is then also imperative to inform the patients of the associated risks with the surgical options. Although you may get a better result, you may also put yourself at more risk in terms of complications and side-effects. It is thus important to balance the risk to benefit ratio.
We want exactly the opposite of what is depicted in this image.
If the wrong technique is used then the risk of adverse outcome is also higher.
The options are really 1. doing nothing 2. weight loss and losing some fat deposit in the area (if the bulk is glandular tissue then weight loss will not help at all) 3. traditional liposuction 4. VASER tumescent liposuction 5. Micro-cannula tumescent liposuction 6. surgical excision
Any of these can of course also be combined. The most conservative is obviously 1. and 2. These may certainly not be an option if the situation is causing distress, clothing limitations and self consciousness.
Patients coming to us will have started doing some research on the various techniques available and generally come with some idea of what may be required.
3. is old style technique and usually performed under general anesthesia (completely asleep). It has its limitations and works well if there is mainly fatty tissue and little breast gland.
4. targets the gland and the fat and can be performed under local anesthesia (only the treatment area is numbed)
5. targets the gland and the fat - suitable with smaller amounts of bulk.
6. suitable for large gland excision and often skin excision in combination. This is always performed under general anesthesia (completely asleep). It comes with a variety of different risk factors and longer recovery period.
The important factor is that not too much of the tissue is removed and leaves fibrotic scar tissue that is visible when the chest muscle contracts. This may leave you with an indented nipple or nipple that gets sucked in when you contract your chest muscles (see pictures below)
These are patients that have presented to me after surgical excision that have had too much removed. The scar tissue attached to the underlying muscle now causes the nipple to get sucked in when contracting the chest muscles.
Hence I always leave some tissue behind which can be felt as a small disc of hard tissue just behind the nipple complex.
Seen on the left is a common male chest diagram with representation of enlargement of the gland component (right). This may appear in various degrees - some having more fat or some having more gland. We obviously want to remove as much as possible, but also prevent the nipple retraction.
www.DrWolf.com
In this day and age most patients opt for the non or minimally invasive procedures as they carry less risk and the down-time is less and recovery is faster.
In some cases though it is not appropriate to perform the non-invasive techniques and the surgical ones are more indicated. It is then also imperative to inform the patients of the associated risks with the surgical options. Although you may get a better result, you may also put yourself at more risk in terms of complications and side-effects. It is thus important to balance the risk to benefit ratio.
We want exactly the opposite of what is depicted in this image.
If the wrong technique is used then the risk of adverse outcome is also higher.
The options are really 1. doing nothing 2. weight loss and losing some fat deposit in the area (if the bulk is glandular tissue then weight loss will not help at all) 3. traditional liposuction 4. VASER tumescent liposuction 5. Micro-cannula tumescent liposuction 6. surgical excision
Any of these can of course also be combined. The most conservative is obviously 1. and 2. These may certainly not be an option if the situation is causing distress, clothing limitations and self consciousness.
Patients coming to us will have started doing some research on the various techniques available and generally come with some idea of what may be required.
3. is old style technique and usually performed under general anesthesia (completely asleep). It has its limitations and works well if there is mainly fatty tissue and little breast gland.
4. targets the gland and the fat and can be performed under local anesthesia (only the treatment area is numbed)
5. targets the gland and the fat - suitable with smaller amounts of bulk.
6. suitable for large gland excision and often skin excision in combination. This is always performed under general anesthesia (completely asleep). It comes with a variety of different risk factors and longer recovery period.
The important factor is that not too much of the tissue is removed and leaves fibrotic scar tissue that is visible when the chest muscle contracts. This may leave you with an indented nipple or nipple that gets sucked in when you contract your chest muscles (see pictures below)
These are patients that have presented to me after surgical excision that have had too much removed. The scar tissue attached to the underlying muscle now causes the nipple to get sucked in when contracting the chest muscles.
Hence I always leave some tissue behind which can be felt as a small disc of hard tissue just behind the nipple complex.
Seen on the left is a common male chest diagram with representation of enlargement of the gland component (right). This may appear in various degrees - some having more fat or some having more gland. We obviously want to remove as much as possible, but also prevent the nipple retraction.
www.DrWolf.com
Thursday 21 July 2016
Lipoedema treatment - tumescent liposuction, VASER
I was fortunate enough to attend the Lipoedema conference on the 24th June in Reading this year. It was well attended and very informative for networking and sharing experiences with other professionals.
It was re-iterated that not much information was available for patients with the condition and still many GP are misdiagnosing the condition as obesity. The training course offered by Lipoedema.co.uk has however had overwhelming response from GPs in getting the word out.
Many GP are now recognizing the condition and referring patients in the right direction.
Some interesting data were produced by a German clinic on the success of tumescent liposuction including VASER and the treatment of Lipoedema. It remains the only real way of preventing the condition from worsening especially when caught in the early stages (stage I or II).
Stage III requires more interventional treatments such as skin excision and reconstruction.
The key is to diagnose it in the early stages and manage it appropriately. This includes MLD and wearing hosiery.
www.Lipoedema.co.uk
www.MLDuk.org.uk
http://www.lipedema-simplified.org
Henrietta@MLDLondon.co.uk
It was re-iterated that not much information was available for patients with the condition and still many GP are misdiagnosing the condition as obesity. The training course offered by Lipoedema.co.uk has however had overwhelming response from GPs in getting the word out.
Many GP are now recognizing the condition and referring patients in the right direction.
Some interesting data were produced by a German clinic on the success of tumescent liposuction including VASER and the treatment of Lipoedema. It remains the only real way of preventing the condition from worsening especially when caught in the early stages (stage I or II).
Stage III requires more interventional treatments such as skin excision and reconstruction.
The key is to diagnose it in the early stages and manage it appropriately. This includes MLD and wearing hosiery.
www.Lipoedema.co.uk
www.MLDuk.org.uk
http://www.lipedema-simplified.org
Henrietta@MLDLondon.co.uk
Thursday 23 June 2016
VASER 360 degree legs (circumferential)
We have had a resurgence of requests for the circumferential treatment of legs/ thighs. Our success rate has been really good.
With the majority of patients also having mild lipoedema we always work hand in hand with MLD therapists.
Some of the excellent practitioners we refer to are Henrietta Cassar from MLDLondon , Julie Bradford and Petra Erving, Kimberley Harrington, Helen Fox
It really is vital to find a good therapist that will see you through the recovery period.
Obviously the more fatty deposit there is the more impressive the results will be. We can however also make smaller thighs look more shapely by making them more proportionate.
The important factor is the skin texture and elasticity. If this is not ideal then any removal of tissue may result in loss of skin turgor and resultant laxity. Then one would need to consider a thigh-lift which is more complex and involves excising skin and pulling the remaining tissue tighter by stitching it back together.
We would certainly recommend this option if the VASER liposuction is not suitable.
In all cases it is important to maintain realistic expectations. We are not magicians and cannot create something out of nothing.......
In most cases we can create something more shapely that will fit much more comfortably in clothes especially around the hips and thighs.
With the majority of patients also having mild lipoedema we always work hand in hand with MLD therapists.
Some of the excellent practitioners we refer to are Henrietta Cassar from MLDLondon , Julie Bradford and Petra Erving, Kimberley Harrington, Helen Fox
It really is vital to find a good therapist that will see you through the recovery period.
Obviously the more fatty deposit there is the more impressive the results will be. We can however also make smaller thighs look more shapely by making them more proportionate.
The important factor is the skin texture and elasticity. If this is not ideal then any removal of tissue may result in loss of skin turgor and resultant laxity. Then one would need to consider a thigh-lift which is more complex and involves excising skin and pulling the remaining tissue tighter by stitching it back together.
We would certainly recommend this option if the VASER liposuction is not suitable.
In all cases it is important to maintain realistic expectations. We are not magicians and cannot create something out of nothing.......
In most cases we can create something more shapely that will fit much more comfortably in clothes especially around the hips and thighs.
Thursday 19 May 2016
3000 VASER liposuction procedures!!!
I am pleased to be able to share with you that I have just recently performed my 3000th case of liposuction using the VASER.
Due to patient confidentiality we could not share this publicly, but the patient was pleased to be able to celebrate this milestone with us.
We did however take a celebratory "Team" photo.
Looking forward to the next 1000!!!
DrWolf.com
DrDennisWolf.blogspot.co.uk
YouTube DrWolf.com channel
Monday 23 November 2015
The healing process after Vaser lipo or Micro lipo
The healing process can take varying amounts of time. As each person has their own genetic make-up, lifestyle, diet and exercise routine the recovery pathway in each case is different.
Hence it is difficult to give concise time frames. On the whole though it would take 5-6 months. Even after that the last 10-15% of healing is not visualised externally. This all takes place under the skin and is microscopic. Occasionally one may have certain sensations such as itchiness, pulling sensation, electric shock type sensation, hypersensitivity or even mild lumps that appear and disappear.
Every person is different and that is normal.
If you have any concerns it is best to see your treating doctor.
Wednesday 11 November 2015
Exercise after VASER lipo and Microlipo
After your surgical procedure you will need to let your body rest and recover. In addition your nutrition will need to be balanced to help with the healing process.
Most patients who are active prior to the procedure get really itchy feet in the first week or two after the procedure as they feel lethargic and get the unfit feeling.
Stretching is very important every single day. You want to get your body out of its comfort zone and break up the scar tissue. Try touch your toes, flex to the right and the left and try and touch your knees. If you feel any "knots" massage them with firm pressure. These may come and go. The more you stretch and massage the quicker the lumps and knots will disappear. Remember that you will also feel numerous types of sensation - itchiness, hypersensitivity, numbness - all these are normal and indicate that the healing process is progressing.
Exercises you can start doing immediately after the procedure are hill walking and treadmill low impact, high incline walking. You will prefer not to do any impact work such as running or jogging. You can also go swimming after all the incision points have healed - generally a week after the procedure.
Obviously areas that have not been treated can be exercised with caution and if it feels comfortable then continue and build up the levels. Your body will remind you what can what cant, or should not be done.
If any doubt just speak to your Doc.
I find it really helpful wearing a heart rate monitor as this can give you an idea of how many calories you are burning. There are various types on the market. Best to get one that determines the calories from the heart rate. Ideally you want to get to heart rate ranges of 160bpm. If you can sustain this for 40 seconds and then have a 10s rest and repeat the process about 4 times, would be good. Your fitness levels will soon improve.
After 4 weeks you should be able to get back into a fairly normal routine. Build it up slowly. Don't jump straight into "Insanity". Use a week to get back up to speed.
Most patients who are active prior to the procedure get really itchy feet in the first week or two after the procedure as they feel lethargic and get the unfit feeling.
Stretching is very important every single day. You want to get your body out of its comfort zone and break up the scar tissue. Try touch your toes, flex to the right and the left and try and touch your knees. If you feel any "knots" massage them with firm pressure. These may come and go. The more you stretch and massage the quicker the lumps and knots will disappear. Remember that you will also feel numerous types of sensation - itchiness, hypersensitivity, numbness - all these are normal and indicate that the healing process is progressing.
Exercises you can start doing immediately after the procedure are hill walking and treadmill low impact, high incline walking. You will prefer not to do any impact work such as running or jogging. You can also go swimming after all the incision points have healed - generally a week after the procedure.
Obviously areas that have not been treated can be exercised with caution and if it feels comfortable then continue and build up the levels. Your body will remind you what can what cant, or should not be done.
If any doubt just speak to your Doc.
I find it really helpful wearing a heart rate monitor as this can give you an idea of how many calories you are burning. There are various types on the market. Best to get one that determines the calories from the heart rate. Ideally you want to get to heart rate ranges of 160bpm. If you can sustain this for 40 seconds and then have a 10s rest and repeat the process about 4 times, would be good. Your fitness levels will soon improve.
After 4 weeks you should be able to get back into a fairly normal routine. Build it up slowly. Don't jump straight into "Insanity". Use a week to get back up to speed.
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