All posts by DS

Allergies, Health and Wellness, Nose

Introducing SLOW-TOX!

Post nasal drip from allergiesAre you tired of the endless sniffles and embarrassing nasal drips that escape during important meetings and romantic dinners? Do you long for the day when you can breathe freely without reaching for a box of tissues? Well, we have exciting news for you!

SLOWtox is a medical treatment that involves injecting small amounts of Botox into your nasal cavity. While the idea of injecting Botox into your nose may seem bizarre, it’s actually a medically sound approach.

If you are thinking, how on earth does Botox dry up a drippy schnoz? Well, here’s the science behind the medical miracle of SLOWtox: tiny amounts of the toxin are injected into strategic areas in your nose, targeting the very glands responsible for producing excessive mucus. By temporarily paralyzing these glands, the release of a chemical called acetylcholine is blocked as are the nerve impulses to the glands that produce mucus. This treatment temporarily puts an end to the relentless waterfall that can flow from your nostrils, allowing you to face the world with your nose held high!

In a world where Botox seems to be the answer to all of life’s problems—facial wrinkles, excessive sweating, migraines, and even overactive bladder—Botox has also been shown to be effective in reducing nasal secretions in people with conditions such as allergic rhinitis and chronic rhinosinusitis.

If you are considering SLOWtox, Dr. Yagoda suggests that you should first consult with a qualified ear, nose and throat surgeon to address any structural problems that may contribute to your symptoms. If SLOWtox is right for you, you will need a trained physician to determine the appropriate dosage for your individual needs.

Like any medical treatment, SLOWtox isn’t without its potential risks and side effects. Some people may experience mild pain, swelling, or bruising at the injection site, while others may experience temporary changes in their sense of smell. However, these side effects are generally mild and temporary, and most people are able to resume their normal activities immediately after the procedure.

Face & Cheeks

Buccal Fat Removal: Miracle or Mistake?

A buccal fat procedure removes fat from the cheeks through an incision in each side of the mouth in order to allow for better definition of the cheekbones and jawline, and to result in a more slender face.

If you have been thinking: “I wish my cheeks were a little more defined” then you may have more in common with celebrity A-listers than you think! Chrissy Teigen has admitted to having had it done. Madonna, Demi Moore, Bella Hadid and recently Lea Michele look like they have had it done.

Buccal Fat Removal: Too Good To Be True?

Buccal fat removal is all over the news and it is purported to be an innovative new fat removal procedure that will give your face the look you’ve always wanted. Can you trust the media? Well, there’s this….

The buccal fat removal procedure was first described in 1802. It initially had it’s moment in the spotlight, but sculpted cheeks soon morphed into hollowed ones that were gaunt, unappealing and untreatable. Understandably, the procedure fell out of favor. But as with all things fashion and beauty, prior trends get recycled and what was old (pun intended) can become new again!

So, how do you know if buccal fat removal is right for you? How can you predict if it will leave you looking like a masterpiece or a mistake?

  1. Consult with a trusted surgeon to understand your unique anatomy.
  2. Understand the risks. The immediate risks include infection, bleeding, scarring, and a rare but real risk of damage to the facial nerve that can result in temporary or permanent partial facial paralysis, regional numbness and/or loss of taste. The longer-term risks of this procedure include changes in facial symmetry and appearance as the face ages. These changes may not be immediately apparent after the procedure, but may become more noticeable as the individual gets older. Because this procedure is not reversible, the long-term risks and potential consequences should be carefully considered before making a decision.

Your beauty is an external reflection of your internal health and wellness. Dr. Yagoda believes in and promotes an integrative approach to help you feel and look your best.

ENT

What you CAN do if you lose your sense of smell from COVID-19

Sudden loss of smell was recognized as one of the earliest and most reliable predictors of COVID-19. In fact, over 75% of those afflicted with COVID-19 experienced complete or partial smell loss.

Imagine for the moment that you have no sense of smell. At first, you might consider it a minor annoyance. You wouldn’t be able to smell a flower garden or the bouquet of your favorite pinot noir. But losing your sense of smell isn’t just a quality of life problem. Having an impaired sense of smell can be dangerous. How would you smell a gas leak or a house fire? How would you know if the milk you were about to pour on your cereal was sour?

Anosmia or loss of the sense of smell can have even more profound implications. Your sense of smell is closely linked to your sense of taste. If you can’t smell your food, you can’t enjoy it or even identify it with any certainty. For many, being cut off from the intimacy and companionship that comes with eating, cooking, and feeding, is a profoundly difficult loss to bear. Furthermore, parosmia (smell distortions that many patients experience as the sense of smell “re-wires”) can interfere with appetite, and further alienate people from food. For those who have a smell/taste disorder from COVID-19, and the nearly two million Americans who suffered from it prior to COVID-19, the world becomes a less joyful and far more dangerous place.

While many may recover spontaneously within weeks or months, some do not. For 10% to 20% of people, their smell loss is persistent, and it can be months before they even begin to recover. So, for those who do not show early signs of spontaneous recovery, the question is, what can be done? Luckily, the olfactory system has the capacity to regenerate. Dr. Yagoda recommends “smell training” for all patients with anosmia. This significantly amplifies (and often doubles) the rate of recovery. Guided olfactory training is a deliberate, active, contemplative smelling process used to support the regeneration of olfactory neurons, forge new neural pathways and reinforce existing ones.

Dr. Yagoda also recommends a novel olfactory therapy conceived of by her patient, Leah Holzel, who was a trained culinary professional, food journalist and researcher. She personally suffered anosmia in 2016 after an upper respiratory infection, and began a smell training program recommended by Dr. Yagoda immediately thereafter. She later become an expert in one-on-one counseling to help others navigate the loss of sense of smell. This intervention advocates a culinary approach to anosmia that supports a positive reconnection with food in the absence of flavor, and/or during the challenges caused by parosmia. This approach was extensively researched and peer-reviewed by two flavor scientists, Alexander Fjaelstad. M.D and Robert Pellegrino, PhD, and by Professor Thomas Hummel, one of the world’s leaders in both basic and clinical olfactory research. (A publication and cookbook on smell loss and the flavor system currently is in contract with Columbia University Press.) Dr. Yagoda can connect those suffering from loss of smell with Ms. Holzel for one-on-one counseling.

Loss of the sense of smell can be a presenting sign of COVID-19 infection. If you’re experiencing an altered or diminished sense of smell or a complete loss of sense of smell, your first step should be to call an otolaryngologist like Dr. Yagoda, who specializes in the care of the ear, nose, and throat. Dr. Yagoda has been committed to educating and empowering you and to providing you with outstanding health, wellness, safety and beauty advice, goods and services for the last 25 years. There is good reason that Dr. Yagoda is the one other doctors choose when they want the very best. Call us at 212.434.1210 or email us at info@DrYagoda.com to schedule your telemedicine consultation. And, read this article for ongoing research.

Additional resources:

Health and Wellness

Moderna mRNA vaccine needs to do an about face!

Didn’t anyone tell it to target COVID-19 not facial filler!

Yes, you heard it right. The Moderna vaccine has distinguished itself from the Pfizer vaccine yet again. But, after gaining a point in the competitive scoring for easier storage and transport, it lost a point in side effects. Recently, Moderna noted that there were three reports of facial swelling in the area of facial fillers–two patients who had filler six weeks before their vaccine, and one who had filler two days after the vaccine. All were treated for the facial swelling with either steroids or non-steroidal anti-inflammatories (think Advil, etc.) and symptoms fully resolved. So, no big deal, right? All’s well that ends well?

Well, maybe. But, to assess that, you might want to understand what exactly caused the reaction. Prior vaccines worked by giving a teeny-tiny dose of the actual virus to the body and letting the immune cells figure out on their own, how to launch an attack. Moderna and Pfizer’s mRNA vaccines work differently. They each send specific information into the body in advance that directly teaches the immune responder cells how to attack the COVID-19 virus. Shortly after the information is received, the body’s immune cells begin to practice launching an attack.

Herein lies the problem. After the vaccine, the immune system is on high alert. It is looking for an enemy to attack. And, Moderna’s vaccine has in very rare instances prompted the immune cells to find and attack the harmless but foreign facial filler. All things considered, the risk of serious side effects of COVID-19 infection is both more common and more grave. Overall: It’s simply a scary but thankfully not serious case of mistaken identity!

Health and Wellness

Why Women Sabotage Other Women

Women sabotaging womenWe all know it happens. But, at the pinnacle of success, it seems even more incomprehensible. Sabotage by another woman? Why? We trained hard. We are that good. We’ve even earned the respect of male colleagues. So why the full-on strike in the face?

Author Bonnie Marcus wrote about women sabotaging other women in Forbes in her article, The Dark Side of Female Rivalry In the Workplace And What To Do About It. She explained that some women attack other women because of their own insecurity. They may lack confidence in their own ability and worry that they might not attain their own career goals. Other times, it is the fear that another woman will be a threat especially if that woman is both beautiful and intelligent.

Women often attack other women according to Katherine Crowley and Kathi Elster, co-authors of Mean Girls at Work: How to Stay Professional when Things Get Personal because they can’t reconcile the need to be overtly kind and nurturing, with the truth of being covertly jealous, envious, and competitive.

Author Susan Shapiro Barash in her book, Tripping the Prom Queen, points out that competition can be healthy if it is not out of jealousy. But, women have childhood fairytales stories ingrained in their minds like those of Snow White or Cinderella, in which we learn that beautiful and talented women need to be destroyed.

Like every issue that needs to be changed, the first step is recognizing that there is a problem. Women need to collaborate and mentor each other to be successful. We need to stop comparing ourselves and secretly seething. We need to acknowledge that emotional festering leads to consumption of our energy and ultimately, our loss of power. To succeed, we need to build a power network to protect our reputation by aligning with mentors, sponsors, influencers and key decision makers. We need to remember to advocate for ourselves and speak up when we see injustice. We need to build confidence, take control and document our accomplishments. And, above all else, we need to be positive role models for other women while offering praise. After all, if one of us wins, we all win.

ENT, Health and Wellness

Tongue Brushes and Scrapers

tongue brushes and tongue scrapersTongue brushes and scrapers can be used to treat physiologic halitosis. They are favored by halitophobic patients. The origin of physiological halitosis is often post-nasal drip, gastroesophageal reflux, or poor dental hygiene. If so, treatment for those disorders can reduce or eliminate halitosis.

But, for persistent halitosis, often coming from the back of the tongue, tongue brushing and scraping can be helpful. In addition, mouth rinses with homeopathic solutions free of alcohol, (e.g. Alkalol) can also be used. In general, mouthwashes containing alcohol are to be avoided because they increase the risk of oral cancer. And, chewing gum can produce methyl mercaptan, one of the principal components of oral malodour, leading to persistent halitosis.

Brow, Non-surgical Treatments

Better than Botox?

Better than BotoxCan something as good as Botox get even better?

Revance, Bonti and Evolus, three California biotechnology companies, are counting on it!

Aside from Galderma’s Dysport and Merz’s Xeomin, three new Botox offspring are about to hit the market. First up is Jeauveau by Evolus which received FDA approval on February 1, 2019. “European and Canadian studies showed a 4.4% statistical superiority of Jeauveau to Botox.” Next will likely be RT002 which promises a longer duration of action than Botox (about 6 months). And, finally, EB-001A offers a short onset of action (within 24 hours), and an associated shorter duration of action (one month instead of 3+ months) making it ideal for first time users, of for scar optimization after surgery.

Are you a member of the “newer is better” team or are do you belong to the “if it ain’t broke, don’t fix it” group? Undecided? Ask Dr. Yagoda which one is right for you. And, fingers crossed, perhaps more products will lead to more competitive pricing!

Skin

Unmask the Myth

Using Skin Masks during FacialsYou can’t skim social media or browse a beauty blog without encountering the sheet mask. But, just how valuable are they? Dr. Yagoda unmasks the myth of the sheet mask…

Despite the rage, sheet masks bestow beauty that is only “skin deep”—that is their benefits are superficial, and not true or lasting. That’s not to say that there isn’t some value in adding a sheet mask to your skin care regimen, but, you need to know that it will only work on the top layers of your skin, leaving the lower layers (where collagen and elastin hang out) untouched.

Because sheet masks don’t work in the deeper layers of your skin where collagen and elastin provide support and elasticity, your skin will not display a smoother, tighter, or more youthful appearance after using these masks. At upwards of $5 a pop, you will receive only limited and temporary moisturizing, with little to no anti-wrinkle or anti-aging effects.

Single-use sheet masks are like large soaked cotton pads with active ingredients that stay in contact with your skin for as long as you wear the mask (typically 20 minutes). But because the skin’s main task is to act as a barrier to protect you from the environment and to prevent absorption of toxins, many of those active ingredients will not get absorbed, even if you were to leave the mask on for much longer than 20 minutes!

So if you are thinking, “nothing ventured, nothing gained,” then consider this: sheet masks, in order to stay moist without drying out, contain ingredients that can harm your skin. Yep, ingredients like alcohol, butylene glycol (a delivery agent and solvent), polyethylene glycol (a preservative), and fragrance can have negative effects on your skin.

A better vehicle for moisture delivery (but still subject to limited absorption due to the skin’s barrier function) would be the serums, lotions, creams and ointments that you can buy at your corner drugstore or Dr. Yagoda’s office. Without doubt, the best vehicle for moisture delivery is an ingestible beauty supplement, in powder form, (because it does not need to be digested in order to be absorbed).

Whether choosing a sheet mask, topical products, or a beauty nutritional supplement, select one that contains all three of the active ingredients listed below:

  • antioxidants to protect the skin from premature aging and damage from free radicals;
  • peptides to help make more collagen; and,
  • hyaluronic acid to hydrate and plump the skin.

An ingestible is a more effective and affordable option than sheet masks. But if you just have to jump on the gimmicky sheet mask wagon, you’ll need to adjust your expectations to receiving little more than hydration and entertainment in order to be satisfied!

There are good reasons why Dr. Yagoda is the one other doctors choose. To find out why, schedule your consultation with Dr. Yagoda. Call 212.434.1210 or email info@DrYagoda.com.

Health and Wellness

Tastes good, and you can wear it, too!

Drinking Green Tea - Health BenefitsGreen tea and matcha lattes sure taste good. But did you know that they have aesthetic benefits, too? Epigallocatechin gallate (EGCG) is an active ingredient of green tea, a natural compound, and popular antioxidant. Antioxidants prevent the oxidative damage that comes from environmental and sun exposure. Theoretically, they can stop brown spots and skin cancers in their tracks! Unfortunately, they are less effective as anti-aging and wrinkle reducing treatments.

Antioxidant’s anti-tumor and anti-inflammatory properties make them a necessary step in the skin care regimens of redheads, freckled folk, and those with a particularly high risk for, or past history of skin cancer. Green tea is non-toxic and safe for all.

EGCG is of particular interest to product formulators because it is easy to combine with other topical ingredients because of their mutual attraction to water. However, like Vitamin C and other antioxidants it poses a challenge because it is not a stable ingredient, losing its effectiveness when exposed to oxygen and to high temperature. Recently, researchers demonstrated that EGCG is more stable when combined with alpha lipoic acid or when enclosed in nanocapsules, Although these additions add stability and enable EGCG to reach high concentrations in the skin when applied topically, they do not allow EGCG to to get absorbed systemically.

Skin

TRxUTH on TONERS

Beautiful Clean Cosmetics Woman Close Up PortraitToners are widely known as an important skin care step for people with acne-prone or oily skin. However, toners can also be used as an “added layer” of cleansing for those who wear heavy foundation or waterproof sunscreen. Or, for those who are on the run, after a workout at the gym. Toners can restore the pH of the skin after using a particularly alkaline cleanser.

The ingredients in the toner will determine its benefits.

For acne-prone skin

Use toners with salicylic acid and/or glycolic acid to get rid of excess oil, tighten the skin, exfoliate and remove dead skin, and reduce the likelihood of ingrown hairs. Toners with clay and/or charcoal can reduce shine and tighten pores in oily and acne-prone skin. Natural anti-bacterial ingredients include tea tree and rose oil. Willow bark is a natural salicylic acid alternative. Natural toners can contain witch hazel, tea-tree oil and/or rose oil as astringents. Mint, and apple cider vinegar also act as astringents.

For combination and sensitive skin

Toners with lactic acid, and/or aloe vera are great for gentle hydration.

For mature and dry skin

Toners with glycerin and/or hyaluronic acid can hydrate and smooth skin. Natural tones with honey and algae are great.

For all skin types

Toners with Co-Q 10, anti-oxidants like Vitamin C and green tea can replenish moisture and provide anti-oxidant protection.

Be wary of toners with essential oil as they can cause hypersensitivity. In addition, toners should not contain alcohol which can be extremely drying. They also should NOT include parabens, phthalates, formaldehydes, ethoxylated ingredients, polysorbates, phenoxyethanol, petrochemicals, triclosan, TEA/DEA and synthetic fragrances and colors.