Beautiful. Medicine.

Approved by the Food and Drug Administration, a number of fillers containing lidocaine hit the market this spring and are quickly coming into fairly widespread use.

Whether one of our experienced members of our medical team  is doing serial punctures or using a lattice technique, they will move from one area to an adjacent area, leaving enough time for the lidocaine to take effect. It actually takes several minutes for the lidocaine from the first injection to help anesthetize the area. The patient will definitely feel that first injection. Although, as with fillers in general, if it is injected slowly, it always hurts less.

There are different methods used to placing the injected material, so you can return to the area around the first injection site and have some anesthetic in the surrounding area. Even more important than reducing a patient’s pain from the individual injections is the benefit to the patient following the procedure. The greatest advantage comes after treatment, because, whereas in the past, people’s lips were really sore, they now have the benefit of a half-hour longer anesthetized vermillion area.

In terms of aesthetic results, the results from these new fillers are exactly the same as the ones without lidocaine. The pain relief is the only difference.

Unless a patient has a very high pain tolerance, a topical anesthetic is applied for 20 to 30 minutes before the first injection. This makes the patient more comfortable. This topical anesthesia, combined with a filler that comes with lidocaine, makes the visit throughout the procedure and beyond.

Allergan’s Juvéderm Ultra and Juvéderm Ultra Plus and Medicis’ Restylane and Perlane all come with the lidocaine now. The MIAMI Institute uses both products, as they have slightly different properties.

Facial aging around the eyes starts to develop early in the mid- to late thirties with excess skin, crow’s feet, and lower eyelid bags for some. Aging continues through the 40s and 50s. This process makes the focal point of the face appear tired. Correction of those tired eyes through blepharoplasty (eyelid) surgery is a very common plastic surgery procedure. Not looking so tired is the main reason why patients consider blepharoplasty surgery.

Blepharoplasty (eyelid tucks) can make a significant difference in reversing that tired aged appearance since it is the focal point of many human interactions. Removing a little excess skin and fat can really clean up your eyes and make you look less tired and more vibrant, making a blepharoplasty the best value of all the facial aging procedures. It causes the greatest positive change in your appearance.

One of the more interesting things about blepharoplasty is that there is little discomfort. Yes, there is some noticeable swelling and bruising around the eyes but remarkably, there is usually no pain. Recovery is relatively easy. For some patients, they are not concerned about their appearance and they are out in public again in 3 to 5 days. Full return to the public eye may be closer to 7 to 10 days for a more conservative patient.

In 10 - 14 days, you will look ‘non-operated’, even though there is still some small amount of swelling and perhaps some line of bruising along the lower eyelid. By 3 weeks after surgery, you will be able to enjoy the full benefits of your blepharoplasty surgery! You will look more refreshed and that will undoubtedly be noticed…even though your co-workers and friends will never figure that it was due to eyelid surgery.

The MIAMI Institute’s specialist, Dr Rhonda Fine, brings a unique combination of specialized training that represents both the physical, social and psychological aspects of weight loss.

Unhealthy eating and weight gain are the result of poor decisions and habits. Our thoughts are the genesis of these actions, therefore it becomes necessary to challenge and restructure these thoughts in order to consistently make good choices without feeling cheated.

Hunger is biological. It is the body’s request for healthy food. Appetite is psychological; it is the minds desire to eat for pleasure. A diet will attempt to change what you eat.
Exercising will increase your body’s strength and shape.

Before one starts a Weight Loss Program it is important for a professional to assess your Beliefs regarding Fitness and Weight as well as your Relationship with Food. These core beliefs will serve as the foundation of a Custom Weight Loss Program. This program will investigate and identify the Behaviors and Patterns that have led to your Weight Gain and have prevented you from achieving your weight loss goals.

Developing Individual Strategies for success must also include your specific Emotional Triggers, reasons for Stress Eating and quiet Emotional Eating. Personal Weight Loss Programs must include Motivation, Education, Realistic Goals, and Strategies for Maintenance and a genuine Desire for better Health and Fitness.

It requires the right attitude not just the right program.
The desire to lose weight must come from within.

Dr. Fine approaches weight loss by identifying and teaching strategies that are specifically tailored for your needs. An individualized program promotes successful outcomes. The goal is for you to maintain a healthy lifestyle, enjoy all its benefits and never have to diet again.

Dr Rhonda Fine’s individualized mind/body approach to Emotional Eating teaches you the techniques to regain control. You will learn to recognize true hunger, identify and anticipate your triggers, manage your emotions, and handle stress in a healthy way while practicing mindful eating.

Dr. Fine will help you discover why you cannot stop this self- defeating pattern of behavior. You will learn to turn emotions into constructive actions for positive change while feeling in control and relaxed around food.

Weight Management

The large majority of the people that lose weight fail to keep it off as success of usually depended on a diet of denying ones-self and an exercise program that did not flow with lifestyle. After they achieved their goal, they quickly went back to their old, sorely missed, relationship with food and inactivity.

Consciously or unconsciously people turn to food for comfort and for distraction.  Food allows us to soothe or suppress negative emotions such as anxiety, boredom and loneliness. The pleasure of eating stimulates our bodies to release trace amounts of mood elevating satisfying
hormones and neurotransmitters. This reward offsets the negative emotions leading us to consume too much high calorie sweet, salty and fatty foods, as well as leaving us with the feelings of guilt and shame.

Emotional Eating will sabotage any and all weight loss efforts. It is important to deal with the psychological and emotional part of eating. Learning how to identify and manage emotional reactions will free you from using food as a buffer for emotions and enable you to maintain the healthy lifestyle you desire and deserve.

Empowerment For Life

Experts now agree that 75% of our overeating is caused by Emotional Eating. Which means a lot of us are using food to cope with feelings.

Dr. Fine brings an innovative scientifically validated technology to The MIAMI Institute. This is an interactive program, which utilizes technology to assist her patients in being able to develop Internal Awareness, Self-Regulation, and Emotional Management Skills.

This approach to weight management focuses on how you feel not what you eat. This method has proved to be successful by people around the world and on five continents.

This program seeks to empower you to Self-Regulate, which leads to improved awareness and resiliency. It will help you replace old emotional responses with new habits. You will discover how to manage your weight for life.

Most people get their cavity-preventing fluoride from toothpaste and tap water—unless you’re a fan of black tea, often used in iced tea mixtures. Previous estimates of the fluoride level in this popular breakfast brew have been miscalculated, according to recent research.

Past studies have used a measuring technique that determined black tea’s fluoride to be between one and five milligrams per liter. Recently a new method of analysis revealed that black tea could contain as much as nine milligrams per liter.

The average American ingests approximately two or three milligrams of fluoride every day.

Although this is good news for the moderate tea drinker, it could spell danger for constant consumers of black tea. Excessive fluoride can lead to skeletal fluorosis, a painful bone disease. However, sufferers whose diagnoses have been linked to black tea are believed to have drunk over a gallon of it every day for more than a decade.

If you decide to up your black tea intake to help protect your teeth, you may also want to consider incorporating a whitening toothpaste or treatment into your dental hygiene routine, as it’s one of the biggest staining culprits.

Dear Dr. Fine,

Every time I stick up for myself my boyfriend accuses me of being aggressive. What do you think?

Lucia
Miami Shores

Dear Lucia,

There is a vast difference between assertive and aggressive behavior. Assertiveness means you can stand up for yourself while communicating clearly and with confidence your thoughts, needs, feelings and interests and at the same time respecting the rights of others. Aggressive behavior is a behavior that intends to do harm. Threatening, intimidating and humiliating behavior clearly violates the rights of others.

Being assertive can help you in build a healthy honest relationship. Aggressive behavior is destructive to a relationship. Improving communication helps to resolve conflict without resentment.Speaking up for yourself can challenge gender roles. Women often feel that it is not feminine to act assertively. Feeling comfortable to advocate for yourself has many benefits such as reducing stress, boosting confidence, self-esteem and improving communication. Recognizing that you have the right to:

Say no without feeling guilty
Express your feelings
Make mistakes
Change your mind
Be proud of yourself and accomplishments
To form and express your own opinions

Respect for yourself and your needs is a good place to start building the skills necessary to be assertive.