A facelift, technically known as a rhytidectomy (literally, surgical removal of wrinkles), is a cosmetic surgery procedure used to give a more youthful appearance. It usually involves the removal of excess facial skin, with or without the tightening of underlying tissues, and the redraping the skin on the patient's face and neck. The first facelift was performed in Berlin in 1901 by Eugene Hollander. In 2004, the facelift was the fifth most popular cosmetic surgery performed after liposuction, rhinoplasty, breast augmentation and blepharoplasty (eyelid surgery).

In the traditional facelift, an incision is made in front of the ear extending up into the hairline. The incision curves around the bottom of the ear and then behind it, usually ending near the hairline on the back of the neck. After the skin incision is made, the skin is separated from the deeper tissues with a scalpel or scissors (also called undermining) over the cheeks, chin and neck. At this point, the deeper tissues (SMAS - fascial suspension system of the face) can be tightened with stitches, with or without removing some of the excess deeper tissues. The skin is then pulled upwards and backwards and the amount of excess skin to be removed is determined by feel. The excess skin is then removed and the skin incisions are closed with sutures and staples.

Facelifts work best in women with thin skin and good bone structure. They are best for eliminating loose skin folds in the neck and wrinkles in the cheeks. The areas not well corrected by a facelift include the nasolabial folds and marionette lines which are more suitably treated with injectable fillers. A facelift leaves long scars. However, the portion of the scars in front of the ear are usually inconspicuous. The scar behind the ear is hidden from casual view. Hair loss in the portions of the incision within the hair-bearing scalp can occasionally occur. In men, the sideburns can be pulled backwards and upwards, resulting in an unnatural appearance. Furthermore, the thicker, hair bearing skin common in men does not tend to drape well, often resulting in an overly taught appearance. In women, one of the telltale signs of having had a facelift is an earlobe which is pulled downwards and/or distorted. If too much skin is removed (as was common many years ago), the face can assume a pulled-back, "windswept" appearance.

Facelifts are commonly combined with eye surgery (blepharoplasty) and skin resurfacing (chemical peels or lasers). They are typically performed under general anesthesia or deep twilight sleep.

The most common complication is bleeding which usually requires a return to the operating room. Less common (but graver) complications include damage to the facial nerve and necrosis of the skin flaps.

Contraindications to facelift surgery include severe concomitant medical problems. While not absolute contraindication, the risk of postoperative complications is increased in cigarette smokers and patients with hypertension and diabetes. Patients should abstain from taking aspirin or other blood thinners before surgery.

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Fine tuning sexual functions with amino acids

Version 3.0, December 2004

A number of amino acid supplements have been promoted for improving sexual function, primarily arginine, tyrosine, and phenylalanine. While their effects have not been claimed to be as dramatic as the effect of Viagra or tongkat ali, I seriously doubt that they have any use at all, at least for the purpose of sexual enhancement. I am meanwhile convinced that their promotion really is just quakery.

As I have a keen interest in sexual enhancement, and as amino acids would be a cheap solution if they were any good, I have tested them thoroughly. I do believe in the connection between arginine, nitric oxide, and ease of erection, but swallowing amino acid supplements is, based on my experience, not the way to go. I have never noticed any difference from any amino acid capsules or powders I have tried. Period.

Sure, the body synthesizes nitric oxide from arginine, and nitric oxide functions as neurotransmitter in causing erections. There are numerous studies, which have shown that blocking nitric oxide will result in a failure to have erections.

However, the fact that arginine is a precursor to nitric oxide, and that nitric oxide functions as neurotransmitter in causing erections does not mean that arginine capsules would cause better erections, or make sex any better than it were without. It may just be the case that so little arginine is used to synthesize the nitric oxide needed for causing erections that our normal diet already provides more than enough of it.

My careful self-observation suggests that arginine supplementation even in the amount of several gram simply has no effect whatsoever on erections or other sexual functions.

While arginine probably has no benefit when it comes to erections, there is sufficient reason to suspect that arginine supplementation actually interferes with sexual pleasure by having a role in the outbreak of herpes episodes.

And while we are not aware of scientific studies showing that arginine supplementation would cause better erections in healthy men, there is ample scientific evidence that tilting the arginie-lysine balance in favor of lysine will make herpes episodes less frequent and less severe.

Tilting the balance towards lysine does not necessarily mean that one has to swallow (and purchase) supplemental lysine in the form of capsules, powders, or designer foods. Physicians usually just recommend that one consumes foods rich in lysine, and avoids foods rich in arginine.

I guess that anyway, the "pure" amino acids in capsules and supplement powders and drinks are all inferior to the amino acids found in protein food. Apart from amino acids, wholesome food contains many co-factors, which may be important for the proper utilization of amino acids.

On the other hand, amino acids in capsule form are probably great for the placebo effect. Even though they are, in my opinion, useless, a lot of people believe in them, and those who do will likely experience a sexual boost. And, amino acids do have the clear advantage of not being drugs, so side effects are not much of an issue.

One can have a definite improvement of one's sex life with tongkat ali or yohimbe. While side effects on tongkat ali are usually mild (hot-headedness), one often does get more than what one has been bidding for with yohimbe. For many people who try yohimbe, there will be an interruption to normal sleep cycles. Heart palpitation and general nervousness are other common side effects. Even if one finds these side effects of yohimbe manageable, one will still feel that one has taken something.

This is unlikely to ever happen with any amino acid supplement. One may have great sex after having taken specific amino acid supplements, but in my opinion, this is just a placebo effect.

Apart from arginine, the amino acid histidine has also been touted for sexual enhancement. The body uses the amino acid histidine as building material for histamines; histamines are chemical substances, which are responsible for quite a number of physiological processes, such as inflammation in case of infections or allergies. They also play a part in ejaculation. Doctors typically prescribe anti-histamines for inflammations and allergies, usually without telling male patients that they can expect some interference with orgasms. They may be more difficult while on anti-histamines.

One man's side effect is another man's cure. Those suffering from premature ejaculations (an annoying condition, indeed) may find that they can withhold ejaculation easier when having ingested anti-histamines. On the other hand, older men, or those having general difficulties to reach orgasm, may find themselves no longer capable to finish off.

Unfortunately, while some people who sell amino acids have theorized that ingesting histidine may have a positive effect on achieving orgasm, I myself have never noticed any difference from ingesting histidine, nor have I seen any scientific study proving it useful in any way.

Those who have read through a number of my sexual enhancement articles are probably aware of the connection between dopamine and libido. The body uses phenylalanine to manufacture tyrosine, and tyrosine is the precursor to the neurotransmitter dopamine.

For physicians, dopamine is of interest primarily because its age-related depletion is the cause of Parkinson's Disease. And it has long been known that medications used to treat Parkinson's Disease, such as bromocriptine (Parlodel) can make patients become romantically agitated. Love affairs among the elderly treated for Parkinson's Disease have been recorded as an occasionally embarrassing side effect of these medications, though a more modern line of thought considers this a blessing rather than a disturbance.

Tyrosine and phenylalanine are not used as medications in the treatment of Parkinson's for dopamine enhancement. Why? Because there is no indication that they would raise dopamine levels in any way. As other amino acids, tyrosine and phenylalanine are constituents of any normal, protein-containing diet. In general, the human physiology is tuned in a manner that normal constituents in food do not affect brain function, including dopamine levels.

Bromocriptine, which is derived from the ergot fungus that befalls grains, is of course not a normal constituent of food, but a poison in more than very small amounts. The member area of the sexual function package gives guidelines for the use of bromocriptine and other Parkinson's Disease medication for sexual enhancement.

Better avoid spending any money on any amino acid supplement. If you feel that you should supply your body with more amino acids, eat a steak or a good slice of Gorgonzola. That's cheaper, and tastes better.

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Plastic and cosmetic surgery

Plastic surgery is a medical specialty that uses a number of surgical and nonsurgical techniques to change the appearance and function of a person's body.[1] Plastic surgery procedures include both cosmetic enhancements as well as functionally reconstructive operations. In the former case, where aesthetics are considered more important than functionality, plastic surgery is also referred to as cosmetic surgery. Most procedures involve both aesthetic and functional elements.

The word "plastic" derives from the Greek plastikos meaning to mold or to shape; its use here is not connected with the synthetic polymer material known as plastic. Plastic surgeons typically mold and reshape the following tissues of the body: bone, cartilage, muscle, fat, and skin.

The history of plastic surgery reaches back to the 700s BCE. Physicians in ancient India including Sushruta were utilizing skin grafts for reconstructive work as early as the 8th century BC. In his work Sushruta Samhita describes rhinoplasty and otoplasty. This knowledge of plastic surgery existed in India up to the late 18th century as can be seen from the reports published in Gentleman's Magazine (October 1794).[2][3]

The Romans were able to perform simple techniques such as repairing damaged ears from around the 1st century BC. In mid-15th century Europe, Heinrich von Pfolspeundt described a process "to make a new nose for one who lacks it entirely, and the dogs have devoured it" by removing skin from the back of the arm and suturing it in place. However, because of the dangers associated with surgery in any form, especially that involving the head or face, it was not until the 19th and 20th centuries that such surgery became commonplace.

Up until the techniques of anesthesia became established, all surgery on healthy tissues involved great pain. Infection from surgery was reduced once sterile technique and disinfectants were introduced. The invention and use of antibiotics beginning with sulfa drugs and penicillin was another step in making elective surgery possible.

Chopart in 1791 performed operative procedure of a lip using a flap from the neck. Joseph Carpue in 1814 successfully performed operative procedure in a British military officer who had lost his nose to the toxic effects of mercury treatments. Carl Von Graefe the German surgeon in 1818 published his major work entitled "Rhinoplastik." Carl Von Graefe modified the Italian method using a free skin graft from the arm instead of the original delayed pedicle flap. In 1845 Dieffenbach wrote a comprehensive text on rhinoplasty, entitled "Operative Chirurgie." He introduced the concept of reoperation to improve the cosmetic appearance of the reconstructed nose. In 1891 John Roe, an American otorhinolaryngologist presented an example of his work, a young woman on whom he reduced a dorsal nasal hump for cosmetic indications. In 1892 Robert Weir experimented unsuccessfully with xenografts (duck sternum) in the reconstruction of sunken noses. In 1896 James Israel, a urological surgeon from Germany, and In 1889 George Monks of the United States each described the successful use of heterogeneous free-bone grafting to reconstruct saddle nose defects. In 1898 Jacques Joseph, the German orthopaedic-trained surgeon, published his first account of reduction rhinoplasty . In 1928 Jacques Joseph published Nasenplastik und Sonstige Gesichtsplastik.

The U.S.'s first plastic surgeon was Dr. John Peter Mettauer. He performed the first cleft palate operation in 1827 with instruments that he designed himself. The New Zealander Sir Harold Gillies an otolaryngologist developed many of the techniques of modern plastic surgery in caring for those who suffered facial injuries in World War I. His work was expanded upon during World War II by one of his former students and cousin, Archibald McIndoe, who pioneered treatments for RAF aircrew suffering from severe burns. McIndoe's radical, experimental treatments, lead to the formation of the Guinea Pig Club. Plastic surgery as a specialty evolved tremendously during the 20th Century in the United States. One of the founders of the specialty - Dr. Vilray Blair - served as the first chief of the Division of Plastic and Reconstructive Surgery at Washington University in St. Louis. In one of his many areas of clinical expertise, Blair treated World War I soldiers with complex maxillofacial injuries, and his paper on "Reconstructive Surgery of the Face" set the standard for craniofacial reconstruction. He was also one of the first non-oral surgeons elected to the American Association of Oral and Plastic Surgery (later renamed the American Association of Plastic Surgeons) and taught many surgeons who became leaders in the field of plastic surgery.

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L-carnitine supplementation in the dialysis population: Are Australian patients missing out? (Review Article).

Sansom Institute, University of South Australia, Adelaide, South Australia, Australia.

It has been widely established that patients with end-stage renal disease undergoing chronic haemodialysis therapy exhibit low endogenous levels of L-carnitine and elevated acylcarnitine levels; however, the clinical implication of this altered carnitine profile is not as clear. It has been suggested that these disturbances in carnitine homeostasis may be associated with a number of clinical problems common in this patient population, including erythropoietin-resistant anaemia, cardiac dysfunction, and dialytic complications such as hypotension, cramps and fatigue. In January 2003, the Centers for Medicare and Medicaid Services (USA) implemented coverage of intravenous L-carnitine for the treatment of erythropoietin-resistant anaemia and/or intradialytic hypotension in patients with low endogenous L-carnitine concentrations. It has been estimated that in the period of 1998-2003, 3.8-7.2% of all haemodialysis patients in the USA received at least one dose of L-carnitine, with 2.7-5.2% of patients receiving at least 3 months of supplementation for one or both of these conditions. The use of L-carnitine within Australia is virtually non-existent, which leads us to the question: Are Australian haemodialysis patients missing out? This review examines the previous research associated with L-carnitine administration to chronic dialysis patients for the treatment of anaemia, cardiac dysfunction, dyslipidaemia and/or dialytic symptoms, and discusses whether supplementation is warranted within the Australian setting.

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Excitotoxic damage, disrupted energy metabolism, and oxidative stress in the rat brain: antioxidant and neuroprotective effects of l-carnitine.

Laboratorio de Aminoácidos Excitadores, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, México, Mexico.

Excitotoxicity and disrupted energy metabolism are major events leading to nerve cell death in neurodegenerative disorders. These cooperative pathways share one common aspect: triggering of oxidative stress by free radical formation. In this work, we evaluated the effects of the antioxidant and energy precursor, levocarnitine (l-CAR), on the oxidative damage and the behavioral, morphological, and neurochemical alterations produced in nerve tissue by the excitotoxin and free radical precursor, quinolinic acid (2,3-pyrindin dicarboxylic acid; QUIN), and the mitochondrial toxin, 3-nitropropionic acid (3-NP). Oxidative damage was assessed by the estimation of reactive oxygen species formation, lipid peroxidation, and mitochondrial dysfunction in synaptosomal fractions. Behavioral, morphological, and neurochemical alterations were evaluated as markers of neurotoxicity in animals systemically administered with l-CAR, chronically injected with 3-NP and/or intrastriatally infused with QUIN. At micromolar concentrations, l-CAR reduced the three markers of oxidative stress stimulated by both toxins alone or in combination. l-CAR also prevented the rotation behavior evoked by QUIN and the hypokinetic pattern induced by 3-NP in rats. Morphological alterations produced by both toxins (increased striatal glial fibrillary acidic protein-immunoreactivity for QUIN and enhanced neuronal damage in different brain regions for 3-NP) were reduced by l-CAR. In addition, l-CAR prevented the synergistic action of 3-NP and QUIN to increase motor asymmetry and depleted striatal GABA levels. Our results suggest that the protective properties of l-CAR in the neurotoxic models tested are mostly mediated by its characteristics as an antioxidant agent.

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Camellia sinensis

Camellia sinensis is the tea plant, the plant species whose leaves and leaf buds are used to produce tea. White tea, green tea, oolong and black tea are all harvested from this species, but are processed differently to attain different levels of oxidation. Kukicha (twig tea) is also harvested from camellia sinensis, but uses twigs and stems rather than leaves.

The name sinensis means Chinese in Latin. Older names for the tea plant include Thea bohea, Thea sinensis and Thea viridis.

Camellia sinensis is native to mainland South and Southeast Asia, but is today cultivated across the world, in tropical and subtropical regions. It is an evergreen shrub or small tree that is usually trimmed to below two metres (six feet) when cultivated for its leaves. It has a strong taproot. The flowers are yellow-white, 2.5–4 cm in diameter, with 7 to 8 petals.

The seeds of Camellia sinensis and Camellia oleifera can be pressed to yield tea oil, a sweetish seasoning and cooking oil that should not be confused with tea tree oil, an essential oil that is used for medical and cosmetical purposes and originates from the leaves of a different plant.