The way we breathe is often an overlooked aspect of our lives. For those of us who can breathe normally, when we have a temporary loss of our nasal breathing either through a cold, trauma, or allergic rhinitis we respect the importance of nasal breath. For those of us who have never been able to breathe through our noses, we may not appreciate how breathing can impact us.
Yoga plays a particular relationship between the mind-body connection. Breathing is called swara and is the essence of breath. The relationship between breathing and the mind and body is strongly associated within Yoga.
The left nostril is called Ida and is associated with mental energy, while the right nostril is called Pingala and associated with physical energy. According to some yoga gurus, if the left nostril is dominant, we tend to be more emotional, feminine, and compassionate. If the right nostril is more dominant we tend to be more masculine, dynamic, and aggressive.
Although I don't personally prescribe to the personality changes which occur with nasal dominance, both by observations of patients and personality traits, I do believe there is a strong mind nasal connection. This relationship is gaining further traction in the medical community. My own anecdotal evidence of many patients after corrective nasal surgery suggests that patients who have improved breathing will often discuss have less stress and feeling less anxiousness. However, the body and mind are both complex and this, like many things in medicine, is definitely not an absolute.
Restoring balance to nasal breathing has many important physiologic benefits and perhaps some hidden benefits as well.
While the word Botox, may seem like a relatively new treatment, its history is long and well detailed. Botox has been used clinically for over 50 years.
Botulinum toxin comes from a bacteria called Clostridum botulinum. This bacteria was first identifed in 1897 by Emile van Ermegen. In 1928 Sommer and Snipe isolated the toxin from the bacteria. The mechanism of action of botox was then found in 1949 to decrease acetylcholine release. Acetylcholine is released from nerves to stimulate muscles to move.
The first clinical use of botulinum toxin was around 1968 by Dr. Scott ad Schantz who used it in strabismus. Rather than perform surgery for this condition, the innovators injected botulinum toxin into the muscles.
The cosmetic use of botulinum toxin was noted after patients reported improvement in their lines from injection of the toxin as a side effect. Dr. Carruthers (husband and wife) first described the us of botox toxin in a study in 1992. After exhaustive testing, Botox was approved by the FDA for cosmetic use in 2002. Later on, Dysport and Xeomin were similarily approved for cosmetic use.
1895 Bacteria Identified
1928 Sommer and colleagues purify type A toxin
1949 Burgen identifies Botox decreases Ach release
1968 Botulinum type A toxin used for strabismus
1992 Botulinum toxin type A use for glabellar lines
1989 Botulinum toxin approved for distribution
2002 Botox Cosmetic approved for glabellar lines
2009 Dysport Approved for glabellar lines
2010 Xeomin approved for glabellar lines
Facial fillers are some of the most popular plastic surgery procedures. This has created newer products on the market, each with its own specific qualities. One way clincians try to define the "feel" of a filler is through its physical properties.
One way fillers are quanitfied by their "feel" is their G prime or elasticity. The G' (G prime) or elasticy describes how the filler is able to retain its shape when a force is applied. G primes are firmer to palpate, more contour stable, and lift tissue better. Fillers with lower G primes are softer, spread through tissues easer and move with the face better. For a nasal labial fold or smile line, a firmer product will be a better choice due to the amount of movement and need for contouring. Along the lower lid of the eye, a lower G prime may be better suited. An analogy of higher G prime product would be Jello versus a lower G prime product of pudding.
Another property measured for filler is the viscous nature of the filler. The viscocity is related to the flow of the filler and how spreadable the filler is. The more viscous filler is able to keep its shape better while a thinner filler will conform to the underlying tissues better. Keep in mind there is an artistic element to fillers where experience with fillers not quantifiable with a number. The following chart demonstrates the properties of fillers as a general guide.
So what facial filler does Dr. Shah recommend? He choses facial fillers based on patient's individual anatomy and goals and customizes the product to better suit a specific area and places the product in an artisic manner.
|Radiesse + lidocaine||554||143,100|
|Juvederm Ultra Plus XC||139||32,152|
|Juvederm Ultra XC||11||27,034|
|Juvederm Ultra Plus||75||17,699|
Table taken in part from data from Sundaram H, et al. Dermatol Surg 2012;11(8 suppl)S12-24.
Citrus fruits, in particular lemons and limes, contain limonene. This substance can give some people watery eyes and a burning senstation in the nose. Some people are sensitive to just touching it. The medical community is becoming more aware of irritants and allergic substances that were previously considered safe.