June 3rd, 2010 Dr. Carli
The excess of fat is burned by HCG to produce daily energy during pregnancy for the mother and the fetus. It is natural biology.
There is a lot of science behind it, as Dr. ATW Simeons explains in his literature on HCG. An Italian team, who took over after Dr. Simeons died, continued with the same success. Now, we do not just have the science, but we also have the method and the results. For doctors practicing this type of treatment, it is not a money maker since there is no procedure required but it is always a great feeling to make a patient happy.
I thought of it as a good tool to help my patients before surgery. So far the only effective treatment available for fat loss was surgery.
The surgery consists of two types:
1. The removal of fat cells through liposuction.
2. The emptying of the fat cells with some kind of GI bypass.
I was trained 35 years ago to do a small bowel bypass, which was extremely effective, but too risky. The gastric bypass came later with recent modifications and improvements.
Last to come is the Lap Band that minimizes further the surgical risk. Nonetheless, it is still surgery. By the way, for obese people considering a lap band or other bypass surgery an HCG course prior to their surgery would make it easier and less risky.
Today, thanks to Dr. Simeon’s, we have an inexpensive way to lose fat without surgery, discomfort, hunger, or risk. But it takes strong motivation and perfect cooperation on the part of the patient, even if the patient does not always fully understand. This requires a solid doctor-patient relationship.
I recommend this to anyone who wants to lose fat; especially to my patients that need or want to lose before surgery. Being overweight increases the surgical risk and compromises the result. HCG is “Thee” solution.
There is a way to lose fat without surgery or risk. The treatment is new in the United States, but has been used in Europe with great success. It started in the United States a couple of years ago and has been very satisfying to patients. People such as myself, were skeptical, but the results speak for themselves and are based on solid scientific findings. From a practical standpoint, HCG is secreted by the placenta for a good pregnancy and can be used for fat loss.
HCG sends a signal to the brain (Hypothalamus) to start burning abnormal fat. Abnormal fat is consumed first (overweight). Fat is called abnormal when it causes overweight and /or changes in body shape. By opposition normal fat is the little reserve of energy we carry. The third type of fat is structural fat, meaning fat in and around our organs.
In other methods, the abnormal fat goes last, after normal and structural fat. This explains the emaciation of the face and other parts of the body, while the patient still has abnormal fat around the abdomen, and extremities.
Women that have morning sickness should normally have signs of malnutrition. It is not the case. HCG uses the fat of the mother to nourish both fetus and mother regardless of the morning sickness. It is well known that during war time, pregnant women can be starving, and still have a normal baby. HCG is the reason.
So, the placenta is a pregnancy gland, secreting HCG in order to trigger abnormal fat burning through a center located in the brain (hypothalamus).
We knew the placenta was a pregnancy gland secreting HCG. Dr. Simeons discovered how and why along with the fact that HCG can be used for anybody willing to lose fat medically and not surgically.
HCG is extracted from the urine of pregnant women and injected to any fat person, male or female, because it is not a sex hormone as thought before Simeons. That’s why HCG does not masculinize or feminize and anybody can benefit from it.
There is no risk and the results are consistent. Besides, it is also the least expensive weight loss program.
TREATMENT RATIONALE
The placenta is a gland that secretes a hormone called HCG. This hormone has a direct effect on centers located in the brain, such as the center of fat metabolism. For a long time that center was placed in the thyroid and/or other glands. It is actually in the brain (hypothalamus).
Everything works like the placenta forms a pregnancy gland, secreting HCG to ensure the best pregnancy for the fetus and the mother.
The original paper written by Dr. Simeons is available online. I strongly recommend reading it.
HCG is injected subcutaneously, meaning under the skin as opposed to intramuscularly (in the muscle), which makes it easier and less expensive for the patient.
During the treatment you live off the burning of your abnormal fat. Your blood is saturated with calories, explaining the lack of discomfort and hunger.
The treatment lasts up to 40 days, depending upon how much the patient wants to lose. Prolonging it over 40 days could cause immunity to HCG, which would preclude repeating the treatment. That’s why we don’t prolong the course over 40 days.
After the first course, patients have to wait six weeks before doing another course in order to avoid the risk of immunity.
The average daily loss is one pound a day.
Six weeks later it can repeated as needed or desired. Each time the treatment will give you the same benefits, provided you adhere to the regimen as prescribed.
In between courses, as well as during menstruation, patients can eat normally but with no starch or sugar in any form.
TREATMENT
It consists of two parts that can not be separated. The first is HCG and the second the HCG diet.
And extract of Human Chorionic Gonadotropin (hormone produced by placenta of pregnant women), called HCG, is injected under the skin of the thigh very simply without pain. The injections are done for a period of three consecutive weeks, except during PMS and menstruation. During this time of the cycle, the treatment must be discontinued. Meanwhile the patient can return to a normal diet with no starch or sugar.
Then the treatment is resumed with a daily injection and a 500 calorie daily diet without fat, sugar, or carbohydrates. It is essential to adhere to the instructions in order to obtain the desired result. It takes motivation. The 500 calorie diet a day also lasts 3 weeks. It sounds “terrible” but actually it is very easy because HCG has triggered the fat burning. That fat burning, in turn, provides nutritional needs and suppresses the feeling of hunger. Furthermore, the skin becomes fresh. We don’t see the facial wrinkles seen with other methods of reducing, such as amphetamines or medical diuretics.
Medical diuretics compound the problem by adding dehydration to overweight. Amphetamines work only as long as taken, with immediate regain when stopped, besides the cardiovascular risk.
HCG, as it does happen during pregnancy, triggers the center of the fat metabolism located in the brain (Hypothalamus) in order to utilize the fat as a source of energy. That is Dr. Simeon’s central discovery.
It works for all people that have too much fat. Fat excess increases surgical risk and can even preclude the surgery. In cases such as tummy tuck, facelift, or a breast lift, the patients do better without the fat.
When the patients try to lose the fat on there own, 1 of 3 scenarios occur:
1) It is time consuming to try to lose through diet and exercise taking many months or longer and delays the surgery that they wanted sooner.
2) They may not lose the weight and return months later discouraged and wondering what they can do.
3) They have a goal in mind, which might be losing 20, 30, or 40 pounds. Some weight is lost, but they are unable to reach their goal.
Today, thanks to HCG, their goal can be achieved without a long wait or difficulty.
REGIMEN
HCG INJECTIONS:
The number of injections and courses will depend upon your goal. Our office will give you syringes and needles all prepared for you to use. Each injection will contain 125 to 250 IU, making that vial good for 40 daily injections. After 40 injections, usually the patients lose over 30 pounds.
The injections are very simple and painless. Our office will help and show you how to do it. After a few times you will be able to do it by yourself.
EATING
On the first 3 days of the treatment, you need to eat at full capacity to make your first week of injections easier on you. You load your organism before HCG starts working by the third injection.
During these 3 days you will gain at least a few pounds due to water retention generated by the “gorging” of these first 3 days. Do not panic. It is normal.
On the fourth day you start a 500 calorie diet with just protein from meat, poultry, fish, vegetables and fruits. Caution with fruits; if you eat more than two fruits daily, it would be like some sugar (fructose). A little alcohol is okay. However, the people on HCG don’t feel the need.
Anything not on the list that you are given is a “no-no”. The 100 grams of meat or fish must be weighed. For fish; eat fish that is not farmed. Exclude herring, tuna, salmon tuna, eel, and other fish with high fat content, as well as all dried, smoked or pickled fish.
I recommend purchasing online an excellent guide “Phase II of HCG”, published by Christine and Jayme Hunt in 2010. They did the HCG treatment and made a book of 100 recipes to help other HCG patients
If you take vitamins you may continue to do so. Injections are discontinued on day 21, but the 500 calorie diet is continued for three more days. HCG keeps working for three days after the last injection. For these three days the blood is still saturated with food from abnormal fat. It explains the need to stay on the 500 calories diet for these 3 days.
You need to drink a good two liters a day of fluids, such as water, mineral water, tea or coffee, to avoid straining the kidneys. No sugar but sweeteners are ok.
CONCLUSION
For surgery patients it can be used pre and post-op without contra-indications. To the contrary, it helps wound healing.
The patient must adhere to the regimen. That is the only condition. The course of the treatment is very detailed. The details are not optional. You must check your weight every morning after bladder emptying and before breakfast. Any minimal weight gain must be corrected immediately.
All these details make the treatment work. Without a strict adherence, it won’t work.
These details are beyond the scope of this pamphlet. They are covered in another pamphlet, for overweight people willing to do that method.
The patient’s participation is not, by any means, passive. Full cooperation is key. Indeed, the treatment is not just injecting HCG.
The main indications are loosing weight without surgery, either because the patient doesn’t want surgery or is a poor surgical risk. It is an excellent way for people that don’t need to lose a lot and want to minimize the financial expense and the difficulty to attain their goal.
Once the weight is lost, it is easy not to regain fat with the usual recommendations such as no sugar and no starch in addition to a “turn off fat switch” that consists of simple inexpensive medications taken by mouth. Our office will help you during that transition.
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March 2nd, 2010 Dr. Carli
“CAPSULE” – A NON-SURGICAL APPROACH:
Capsular contracture, or more simply “capsule”, is the most common complication of breast augmentation. Once a capsule has formed, the treatment is surgical. Little can be done to prevent or predict this complication. The nation-wide incidence is 11%, which is lower than 20 years ago. In my practice, this incidence has continued to go down over the past 18 years, and is now about 2-3%. Like all plastic surgeons, I tried and used different techniques to avoid the problem with more or less success; always looking for some type of new technique or technology. However, by combining several ways I have noticed some definite improvement in prevention and non-surgical treatment of an early capsule.
PREVENTION:
In 1995, Jaime Planas, a well known plastic surgeon from Barcelona, Spain, presented a large series of cases using ultrasound for three to four weeks, twice a week after each capsulectomy (surgical excision of the capsule) to minimize the risk of capsule recurrence.
His result was encouraging. He finished his article saying that he had started doing the same regimen after each breast augmentation, and felt it was promising. He said that he would wait until he had a very large service before publishing his result in regards to the use of ultrasound status post breast augmentation.
Five years later, in 2000, Jorge Planas, the son of Jaime Planas, a plastic surgeon like his father, published an article showing that the routine use of ultrasound after breast augmentation can lower the incidence of capsule formation. I had started in 1995, after his first article, and had the same impression. Our practice does not charge for this service.
The same year, in 2000, Andre Camirand, a renowned plastic surgeon from Montreal Canada, published a series of more than 3000 breast augmentations, all treated with a compression strap for the first two to three months status post surgery. He explained the mechanism of that treatment, based on elementary knowledge of scar tissue formation. Though somewhat bothersome, I use the strap on my patients. Again, I noticed less capsule formation. I also use the strap after a capsulectomy, and notice fewer capsules as well.
In 2003, Schlessinger, from Honolulu, Hawaii, published another large series minimizing capsule formation by giving Accolate to his patients after a breast augmentation for two to three months. His rationale was that one cause of capsule formation is inflammation, which can be partially controlled by Accolate; a medication for the treatment of asthma. The only contraindication is a liver condition since Accolate can be hepatotoxic. Accolate is now used nation-wide, and seems to be effective.
These three modalities combined have resulted in a positive result. At my Riverside Plastic Surgery practiceI rarely see a capsule in patients who follow these instructions. Combined, they do prevent capsule formation; however I cannot determine which helps the most. If a patient seems to form an early capsule, in spite of that combined technique, I prolong the treatment.
In April 2008, a new tool became available. Claude LeLouarn, from Paris, France, published a new approach; again based on the theory against inflammation. Schlessinger uses Accolate, a systemic medication, to fight inflammation. Le Louarn thought of using Flector Tissue Gel, which is an anti-inflammatory patch that delivers the anti-inflammatory agent via a percutaneous bioadhesive impregnation system. These patches measure 10 X 14 cm and contains 180 grams of diclofenac-epolamine, which is the active substance.
The whole breast needs to be covered by one or two patches, depending upon the size of the breast. It is kept on 24 hours per day and changed daily for three weeks. There is no toxicity, and it can be covered by insurance, as Accolate can be. Without insurance, the cost is still minimal. Within the past two years, I used it in three patients with an early capsule that had formed within three months after surgery.
According to LeLouarn, there is no response if Flector is used on a capsule that is already six months old. At this point the inflammation process is complete and the scar tissue has formed.
In conclusion, there are non-surgical ways to prevent and treat an early capsule.
Surgery may still be indicated, but it is a last recourse and much less necessary than in the past.
Feel free to contact us about Capsular Contracture in Riverside, Inland Empire at (951) 688-8660.
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March 24th, 2009 Dr. Carli
Silicone vs. Saline
Since 1992, when it was banned, we could no longer offer silicone to our patients. I switched to “saline” and wrote an article on the subject, deploring this ban.
Not familiar with saline, after using it for a few years, I discovered its advantages over silicone.
These advantages are:
1. Saline allows a better size symmetry. Indeed, silicone cannot be as close because it is prefilled and goes by 30-40 cc increments. This precludes more accurate size adjustment during the surgery.
2. This incidence of capsular contracture is somewhat higher with silicone. This is due to two reasons:
Reason 1: The so-called “low bleed” of silicone gel through the envelope of the implant. Though minimal in new implants, it can be a problem.
Reason 2: The new silicone implants have silicone gel that is more cohesive than the old ones in order to leak less. This has made the “armpit” (transaxillary approach) no longer possible, because the implant is no longer soft enough. We must go through the “nipple” or “under the breast” to insert the implant. The main advantage of the armpit is minimizing the tissue trauma caused by the other two techniques. The less the trauma, the lower the incidence of hematoma (bleed), seroma (serum fluid collection), and the less the risk of capsular contracture.
3. If a problem results from a breast implant, it is usually more difficult to treat if the implant is silicone versus saline. The silicone gel can contaminate the pocket, with formation of silicone granuloma (mass of scar tissue).
4. In the case of rupture, the saline leak is immediately diagnosed. The breast flattens down and it is very easy to correct. A silicone leak is not diagnosed clinically. There is no sign of rupture. This is why the manufacturers (Mentor and Allergan) stipulate, “It is recommended that a first MRI evaluation take place starting three years after implant surgery and then every two years after that, even if you are experiencing no implant problems”. This precaution implies a more difficult and expensive followup, since an MRI is not usually covered by insurance for this type of indication.
5. Finally, the cost can be another consideration since silicone is twice as expensive as saline. The higher cost of silicone might lead one to believe that silicone is better. It is incorrect. The silicone engineering is more costly, but the main reason is the consequence of the silicone crisis. This crisis has cost the manufacturers about one billion dollars, lost in lawsuits and compensations. That money needs to be recovered some how.
All of this said, the return of silicone is quite welcome.
It allows the women to have the choice. If they want it, it is available.
It allows me to recommend and use it when indicated. Indeed, it is definitely indicated when women have tissue that is too thin to cover a saline implant, which is rougher on the tissue than silicone. In that case, silicone is better because the saline implant may become palpable. The possibility of rippling is a little higher with silicone, but rippling is possible with both saline and silicone implants.
The patient now has the choice between the two types of implants. I hope that they understand the advantages of each type before making an educated choice. I remain at the disposal of our patients to recommend one or the other on a case-to-case basis.
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February 25th, 2009 Dr. Carli
Skin care is a lifelong commitment. Everybody’s skin is different. Whether your skin is, for example, filled with acne, pigmented, sallow, lined or lacking luster, using the right products and receiving treatments such as chemical peels is essential in correcting and preventing what ails you. Let’s face it (no pun intended) your face is the first thing people notice. With so many practitioners out there and little salons popping up, where does one turn? You want quality. You need expertise. You definitely deserve the attention and customer service. Look no further than to Dr. Carli’s Esthetics. Finding a skilled paramedical esthetician who will partner with you every step of the way is the key to unlocking what holds you and your confidence prisoner. Her name is, Erin Turner.
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February 18th, 2009 Dr. Carli
Magnolia Plastic Surgery Introduces Latisse
A New Innovation In Eyelashes
Dr Alexander Carli and the asthetic staff at Magnolia Plastic Surgery proudly introduces Latisse, the first and only prescription eyelash treatment which is approved by the FDA to grow your lashes longer, fuller and darker.
Latisse works effectively because of its active ingredient: bimatoprost. Research suggests that the growth of eyelashes occurs by increasing the percent of hairs during the growth phase. Bimatoprost helps lashes grow longer, thicker and darker because it can also prolong this growth phase.
Lattise is easy to use, FDA approved and effective. It was developed through years of research by Allergan, a pharmaceutical leader with over 60 years of expertise in prescription eye care products.
Now you can grow longer, fuller darker lashes. Let the professional staff at Magnolia Plastic Surgery provide you with more details about this exciting new product! Call Today 951 688-8660.
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February 4th, 2009 Dr. Carli
Since September 15, 2008, Plastic Surgery is almost at a standstill. Understandably so. Cosmetic Surgery being a luxury, it is the lowest priority. Though realize the crisis will not be forever, we all save.
The financial “Tsunami” is not just financial. Part of it is a psychological reaction as we have seen in the last crisis between 1990 – 1995, when companies were folding and/or leaving California.
The main question again, is how long? Nobody knows. So, should we wait or should we spend to look and feel better? We are not sure.
More than ever, the decision to go for cosmetic surgery is based on money. So is the competition among cosmetic surgeons.
We try to guess. Nothing is sure but one thing. A lot of Cosmetic Surgeons or “self-called” Cosmetic surgeons are making an all out effort to attract potential “clients” with potent promises. For example, breast augmentation for $2,999 as advertised on a billboard on Highway 60 East. The magazines and other media are used for “inexpensive surgery and great deals”.
People, once more, be careful.
“You get what you pay for” and “it is too good to be true” are time tested adages. Try to remember and don’t get fooled. These ads are false. They keep from you essential information such as the credentials of the surgeons, the type of surgical facility and the pre-and post-operative care.
You think you save money when actually you pay a high price for a second rate, at best, surgery. There are so many ways to lower a fee by lowering the quality of care.
The media are paid to claim anything. The one’s paying can be and are sometimes unscrupulous.
You think you get a deal. It is a poor deal as you may realize too late. If you don’t have the money, wait. Do not become the prey of the market. Do not add a cosmetic problem to your financial one.
In these hard times, our practice works with you. Our financial department can assist you with options that can help to make your surgery affordable without compromising the quality of care. Meanwhile, you can scrutinize every aspect of our practice, including specials, on our website http://www.magnoliaplasticsurgery.com
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