Friday, May 2, 2014

Coffee Effects on Breast Size

Coffee Intake Influences Breast Size  by Stef De La Cruz

More cups of coffee lead to smaller "cup size"
Women are having second thoughts about sipping their cup of joe after a study linked coffee intake to smaller breasts. A 2008 study published in the British Journal of Cancer went viral as it connected coffee intake with breast size.
One enzyme is related to both coffee and estrogen metabolism in some women, specifically those born with a specific variant of the CYP1A2*1F gene. Armed with this fact, a group of Swedish doctors led by Helena Jernstrom investigated the relationship between caffeine and breast size in 269 women with a high risk for breast cancer.
Ironically, even as coffee decreases breast size, it also decreases a woman's risk for losing her breasts altogether. But what exactly is present in coffee that influences breasts in the first place?

Coffee compounds that shrink breasts
Although best known for its caffeine content, coffee actually contains other compounds that can influence hormone activity. For instance, it is rich in phytoestrogens that are capable of blocking estrogen receptors in breasts.
Estrogen is a hormone that regulates breast tissue growth and development. But with coffee phytoestrogens beating estrogen to the punch line, estrogen cannot do its job.
Coffee metabolism is linked to an enzyme regulated by the CYP1A2 gene. Coffee drinkers carrying a specific variant of this gene have a higher enzyme expression, leading to higher levels of a “weak form” of estrogen.
Simply put, when a weak estrogen binds with the estrogen receptor, it leads to less significant breast changes. High levels of this weak estrogen, therefore, have a significant relationship with small breast size.
The above effect is seen most especially in women positive for the genotype who drink at least three cups of coffee. The more coffee they drink, the smaller their breasts are.

Bigger breasts, bigger problem
Although many women secretly dream of being one or two cup sizes bigger, a generous chest comes with a price: It may increase one’s chances of having breast cancer in the future.
Breast tissue density is a known breast cancer risk factor. In a study involving over 600 women published in Cancer Causes and Control, the incidence of breast cancer rose proportionately with a woman’s breast size.
Coffee lowers breast cancer risk
Even as coffee seems to shrink the breasts of women with the above genotype, it actually protects them from breast cancer.
The same gene found in women that leads to smaller breasts actually leads to lowers levels of 16╬▒-OHE1, a hormone known to contribute to estrogen-negative breast cancer. Estrogen-negative breast cancer is a type of cancer with fewer treatment options, making this finding an important steppingstone in formulating a holistic and prevention-centric regimen for high-risk females.
Word of advice to women: Don’t ditch coffee just yet. With moderate coffee consumption, you will barely notice any change in the size of your breasts – and you are less likely to lose them to cancer.

Dr. Stef dela Cruz is a health blogger and columnist. She is nominee for the PKKP Media Recognition Awards to be presented by the Department of Health

How much does liposuction cost ? That is the question

Friday, April 25, 2014

Potential Complications of Dermal Fillers, such as Restylane & Juvederm

Dermal Filler Complications (Restylane/Juvederm)        

There are several facial filler materials that have been approved by the Food and Drug Administration for use in the United States that have been employed by physicians for the past several years.  These dermal fillers are very effective and popular cosmetic treatments for today's anti-aging and facial rejuvenation for aesthetic patients.  One of the dermal fillers include hyaluronic acid, which is a ubiquitous carbohydrate polymer normally found as a major component of skin where it is involved in tissue repair.  Hyaluronic acid injections temporarily smooth wrinkles by adding volume under the skin, with effects typically lasting for six months.  Although they seem to be simple procedures, dermal filler complications may potentially occur.
Woman Getting a Botox Injection: Photo Courtesy of Ambro /
       These complications may include intraarterial embolization of hyaluronic acid (Juvederm & Restylane) which can have disastrous consequences.  The dermal filler may be injected accidentally into tiny vessels if not performed properly by a trained medical professional.  Intraarterial embolization of hyaluronic acid may lead to superficial to deep necrosis of the skin (premature death of cells and living tissues.)  This will then lead to ulceration and severe deformity of the face.  Embolization of dermal fillers may also lead to blindness, which is a rare complication.

How common is the facial necrosis complication from a dermal filler injection?
This complication is rare.  The incidence of facial necrosis of the skin from a dermal filler injection (Zyderm/Zyplast collagen injection) was reported to be 9 in 10,000 cases.  Facial skin necrosis may occur secondary to either intraarterial embolization or external compression of the small vessels of the skin by the dermal filler. 
Necrosis of the tip of the nose from dermal filler injection into the nasolabial fold
Complication from a dermal filler injection into the nasolabial fold

How can one treat intra-arterial injection of hyaluronic acid? Progression of the skin necrosis can be further prevented by injection of hyaluronidase (Amphadase) into the area of previous injection site.  Thus, ask your provider if they have hyaluronidase in their office just in case a complication may arise.

How can one recognize this complication?  One of the first few symptoms of intraarterial embolization of a dermal filler would be sharp pain and erythema (redness).  The area of skin involved may vary from the local injection site to areas specifically supplied by the arterial vessel involved.  This can be further recognized clinically by a bluish discoloration of the face that may eventually progress to necrosis and/or ulceration of the face.

How can one avoid these potential dermal filler complications?
It is very important for the medical provider performing these dermal filler injections to have a solid knowledge of the anatomy of the face to avoid injecting the dermal filler into the tiny vessels where embolization may occur.  Moreover, the dermal filler should be injected into the correct plane and not deep enough to penetrate into the vessel.  The level of injection is dependent on what one is trying to accomplish whether to improve a tear trough deformity or reduce perioral rhytids (wrinkle lines).

Once this complication occurs, can my provider fix the problem?  
Once necrosis/ulceration of the face occurs, injection of hyaluronidase into the previous injection site may prevent its progression.  Once the necrosis has demarcated, your plastic surgeon may need to perform a plastic surgery procedure, such as debridement of dead tissue and possibly a reconstructive facial procedure.  Whether you need a plastic surgery procedure or not is dependent on the severity and location of the ulceration/skin necrosis of the face.

Other Potential Complications of Dermal Fillers

  • Bruising -for patients with no history of heart attack, stroke or blood clot, it is recommended to discontinue taking aspirin and other medications that can cause bleeding (NSAIDs such as ibuprofen; gingko biloba; ginseng; garlic; fish oils; and Vitamin E.)
  • Nodule formation (lumps) of the skin - incidence varies, depending on the dermal filler used.
  • Allergic reaction - rare, especially with hyaluronic acid dermal fillers.

I recommend that one should ask one of your Houston plastic surgeons for these potential complications from injectible dermal fillers, such as Restylane and Juvederm, prior to undergoing such procedures.   One should also ask their plastic surgeon that if such complications arise, what can be done to minimize and correct the adverse outcome that can potentially happen.  Being able to recognize, prevent and treat these potential complications are essential, even for a minor procedure such as a dermal filler injection.

I recommend reading about Botox for dynamic wrinkles.

Other Recommended articles:

"To create something exceptional, your mindset must be relentlessly focused on the smallest detail."
~ Georgio Armani

The Aesthetic Meeting 2010 by the American Society for Aesthetic Plastic Surgery 
Bailey S., Cohen J., and Jeffrey Kenkel. Etiology, Prevention, and Treatment of Dermal Filler Complications. Aesthetic Surgery Journal January 14, 2011 vol. 31 no. 1 110-121
Glaich, et al. Injection necrosis of the glabella: protocol for prevention and treatment after use of dermal fillers. Dermatol Surg. 2006 Feb;32(2):276-81.
Grunebaum, et al.  The risk of alar necrosis associated with dermal filler injection. Dermatol Surg. 2006 Feb;32(2):276-81.
Hanke, C. W., Higley, H. R., Jolivette, D. M. et al. Abscess formation and local necrosis after treatment with Zyderm or Zyplast collagen implant. J Am Acad Dermatol. 25: 319, 1991.
Inoue, et al.  Arterial embolization and skin necrosis of the nasal ala following injection of dermal fillers.  Plast Reconstr Surg. 2008 Mar;121(3):127e-128e. 
 Lemperle, et al. Avoiding and Treating Dermal Filler Complications. Plast Reconstr Surg. 2006 Sep;118(3 Suppl):92S-107S.  
Other articles related to dermal fillers:

Date article updated:  4/21/2011

Thursday, March 27, 2014



A multicenter, prospective randomized controlled trial in 2012 recently showed that the VASER-assisted liposuction resulted in a statistically significant improvement in skin retraction of 53 percent relative to the traditional regular liposuction (17 percent per liter versus 11 percent per liter, p = 0.003). Moreover, the VASER-assisted liposuction group also resulted in a statistically significant reduction in blood loss of 26 percent relative to the traditional liposuction (p = 0.019 with n = 20 using a two-tailed t test).
Figure 1: Before & After Photos of Abdominal Liposuction (VASER Liposuction 1 Month after the Procedure.) Procedure performed by Houston Plastic Surgeon, Dr. Emmanuel De La Cruz. Note: Skin retraction after VASER Liposuction peaks at 4 months, and thus results will continue to improve 1 month after the procedure.


• The VASER-liposuction method demonstrated improved skin retraction compared with traditional/conventional liposuction.
• The VASER-liposuction method demonstrated reduction in blood loss compared with traditional liposuction.
• No serious complications reported in a clinical study involving VASER liposuction in over 70,000 VASER liposuction procedures.
• No burn complications, contour irregularities or prolonged swelling seen in one clinical study.
• No revisions needed after a VASER liposuction found in a multi-center pilot study.


• Single procedure results with speedy recovery times
• Less bleeding & more skin retraction
• Improved body contouring over traditional liposuction
• Refines and accentuates appearance of muscles
• It’s the RECOMMENDED type of liposuction for treatment of gynecomastia in men

Emmanuel De La Cruz MD, PLLC

Houston Cosmetic Surgeon | Breast Surgeon

Call NOW at 832-520-1844
Clinic Locations: The Galleria in Houston, TX & The Woodlands, TX

Thursday, February 6, 2014

Before & After Photos of Plastic Surgery Houston

Before & After Photos of Plastic Surgery in Houston

Before and after liposuction 
Emmanuel De La Cruz MD, PLLC
Woodlands Plastic Surgeon

Saturday, January 11, 2014

Before & After Photos of Plastic Surgery Houston

Before & After Photos of Gynecomastia Surgery performed by Houston Plastic Surgeon, Emmanuel De La Cruz MD, PLLC

Before & After Photos of Lip Enlargement/Augmentation performed by Houston Plastic Surgeon, Emmanuel De La Cruz MD, PLLC

Before & After Photos of Tummy Tuck (Abdominoplasty) with VASER Liposuction performed by Houston Plastic Surgeon, Emmanuel De La Cruz MD, PLLC

Before & After Photos of VASER Liposuction performed by Houston Plastic Surgeon Emmanuel De La Cruz MD, PLLC

Before & After Photos of Arm Lift or Brachioplasty performed by Plastic Surgeon in The Woodlands, Emmanuel De La Cruz MD, PLLC

Before & After Photos of Chin Augmentation performed by The Woodlands Plastic Surgeon Emmanuel De La Cruz MD, PLLC

Before & After Photos of Rhinoplasty or Nose Surgery performed by Plastic Surgeon in The Woodlands, Emmanuel De La Cruz MD, PLLC

Silicone Gel Breast Implant or Saline Breast Implant?