| BODY CONTOURING | PEER-REVIEW


NPs. This induction is mediated by NPR-A, cGMP, and PKG. Studies22–24


have revealed the physiological


relevance of this pathway during physical exercise in normal-weight young men, in obese men and women, and during head-down bed rest. An important source of energy during exercise is NEFAs originating from adipose tissue. In addition to catecholamines, ANP has an important role in the control of lipid mobilisation and NEFA availability in adipose tissue.


Hormonal rebalancing Bioidentical hormone replacement therapy (BHRT) has been used in increasing numbers, particularly over the last 10 years, in many parts of the United States and Canada25–28


. Subcutaneous pellet implants in men and


women are gaining popularity due to convenience of application, dosing intervals, a low incidence of side-effects and reported success among users. Testosterone therapy has been used to treat men and women of all ages diagnosed with testosterone deficiency. Subcutaneous oestrogen and testosterone therapy delivered by pellet implant has been used with success since 1938. BHRT uses hormones that are identical to the hormones manufactured by the body and has transformed the healthcare of men and women as they enter the second half of their lives. Pellets or implants are made up of hormones


(testosterone or oestrogen) that are pressed or fused into very small solid cylinders. These pellets are similar in size to a grain of rice. BHRT is often called ‘natural hormone therapy’ because the bioidentical hormones act just like the hormones produced by the body. With ageing, the body no longer produces adequate levels of oestrogen and testosterone, the hormones required to maintain the body. Subcutaneous pellets can replace the hormones that are lacking. Pellets deliver consistent, healthy levels of


declining oestrogen and testosterone in women, and testosterone in men. Numerous studies in the literature25–28 have reported positive scientific evidence in regard to hormonal benefits, effectiveness, safety with minimal side-effects and convenience of use and application. The delivery system and formulation has also proven superior when compared to synthetic compounds and other delivery systems.


Manual lymphatic drainage Manual lymphatic drainage (MLD)29–30


is an essential


complementary therapy for cellulite. It should be gentle and non-traumatic in order to provide improved tissue metabolic homeostasis. Manual lymphatic drainage follows Foldi’s and Leduc’s teachings. It consists in a series of gentle touches and compressions over specific lymphatic system sites aimed at emptying congested ganglia and improving lymphatic flow by removing lymph from tissues. The rules of MLD:


■ Stimulate the microcirculation to improve oedema and cellular nutrition


■ Do not produce pain during the massage ■ 30–40 minutes is needed to perform good MLD ■ Do not produce skin redness during the MLD ■ Do not use creams ■ Only use the hands and the correct techniques to mobilise the lymph


■ The aim is to move lymph and high protein from the interstitial into the small lymphatic vessels.


Remember, the softer the tissues, the lighter the pressure. Among the important


hormones for 3–4 months in women and 4–5 months in men. Pellets have shown to be superior for relief of menopausal symptoms i.e. hot flushes and night sweats. Pellets do not increase the risk of blood clots, strokes or heart attacks unlike conventional or synthetic hormone replacement therapy. In studies, when compared to conventional hormone replacement therapy, oestrogen and testosterone pellets have been shown to increase bone density and muscle mass, restore sleep patterns and improve sex drive, sexual response, and overall well-being. Symptoms of low testosterone in women may include dysphoria (sadness, depression, anxiety and irritability), insomnia, decreased libido, hot flushes, decreased bone loss and muscle mass, and difficulty staying in shape. Subcutaneous hormone


treatment with pellets is a safe, effective, and convenient method of hormone delivery for symptoms of


substances used in ‘anti-cellulite’ supplements, bioflavonoids substantially help with microcirculation.


Platelet-rich plasma Platelet-rich plasma (PRP) is an autologous high concentration of human platelets in a small volume of plasma measured as 1,000,000 platelets per mm3


or two to three times the


native concentration of whole blood at a pH of 6.5–6.7 (whole blood pH is 7.0–7.2)31


. PRP is made up of the fundamental protein


growth factors which have been proven to be actively secreted by platelets to initiate all wound healing31


.


As PRP is a concentration of platelets, it is also a concentration of the seven fundamental protein growth factors proven to be actively secreted by platelets to initiate all wound healing.


These growth factors include: The three isomers of platelet derived


growth factors Two of the numerous transforming growth


factors (TGF1 and TGF2) Vascular endothelial growth factor (VEGF) and


epithelial growth factor (EGF). All these growth factors have been documented to exist in platelets32,33


. The biologically active signal peptides released


from local tissue or blood products (particularly the platelet fraction) play a critical role in


prime-journal.com | January/February 2015 ❚ 45


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