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High heels:Grow your own collagen

Discussion in 'USA' started by Cameron, May 5, 2008.

  1. Cameron

    Cameron Well-Known Member

  2. Mart

    Mart Well-Known Member

    Jeeze I had already buried this in the back of my brain. I read this in my weekend Globe last night and cringed, believe it or not this is one of Canada's better newpapers. No doubt I will get plenty of enquires over the coming weeks and turn down lots of opportunity to bank $500 cheques and bore people with mechnical reality . . . . .. or am I missing something worthwhile here?

    more skepticaly than usual :eek:

    Martin


    The St. James Foot Clinic
    1749 Portage Ave.
    Winnipeg
    Manitoba
    R3J 0E6
    phone [204] 837 FOOT (3668)
    fax [204] 774 9918
    www.winnipegfootclinic.com
     
  3. Akbal

    Akbal Active Member

    Mart,

    You are missing out of something useful, I treat patients with fillers, most don't wear heels and find a dramatic difference in their quality of life. In eldery men and women this treatment can offer a great deal of mobility, much more than callous reduction and orthotics.

    My website is www.pillowsforfeet.com and although the marketing is geared towards those with heels I generally see patients who don't wear heels and don't care to either they just want to be able to walk across their living room without pain.

    Regards

    Akbal Randhawa
     
  4. Mart

    Mart Well-Known Member

    Hi Akbul

    Thanks for reply.

    I take your point regarding possible benefits of treatments which can address problems associated with fibro-fatty pad atrophy although your website if heavily weighted towards the “fashion consciously impaired” and my understanding is that the deleterious short and long term effects of women’s fashion shoes on forefoot function are widely accepted (though I stand to be corrected).

    I am interested in learning more about this procedure and am ignorant about the treatment mechanisms which are implied in your promo website.

    If you are able to substantiate or point me towards literature so that I could understand this better I would be very grateful.

    My initial response was mostly a reaction to my distain for celebrity culture and disappointment in my favorite national newspaper seemly being complicit in encouraging readers to buy into this without looking beyond the view seen in a “podiatrist to the stars” monocle. This is probably not the place for broader discussion on the nature of encroaching Western celebrity culture (although it is one of my favorite “old fogies” rants with anyone interested). I’d be interested in Cameron’s (or anyone else) sociological/medical perspective in this kind of promotion both from the bias of what the patient might reasonably expect in advice from a healthcare profession regarding offsetting the injury caused by an seemingly unconcerned fashion industry, and the professionals reasonable response to requests for help to wear injurious foot-wear.

    Look forward to hearing from you

    cheers

    Martin

    The St. James Foot Clinic
    1749 Portage Ave.
    Winnipeg
    Manitoba
    R3J 0E6
    phone [204] 837 FOOT (3668)
    fax [204] 774 9918
    www.winnipegfootclinic.com
     
    Last edited: May 6, 2008
  5. Dieter Fellner

    Dieter Fellner Well-Known Member


    Hello Akbal,


    Interesting post and website. Let me say from the outset I have no issues with new treatments, and the debate about cosmetic versus clinical need is wide and variable. We live in a consumer society, and since this treatment is non NHS, the consumer can exercise the right to choose and pay.

    I have looked in the past at this form of treatment for medical applications but had problems sourcing the product. What exactly is the product that you are injecting ?

    The injectable silicone seem to be inaccessible but there has been a proliferation in the application of the hyaluronic acid products, of which Restylane is one.

    First approved for use in eye surgery, in viscosupplementation the substance is also now injected into arthritic joints - e.g. in the knee though some placebo controlled studies have cast doubt on the efficacy of hyaluronan injections, and hyaluronan is now recommended primarily as a last alternative to surgery.

    In 2003 the FDA approved hyaluronan injections for filling soft tissue defects such as facial wrinkles. I can find no evidence it was ever approved for use in the foot, but I accept I could be wrong. I simply cannot find the information.

    The explosion in cosmetic consumption generated from this technology is inevitable but it is accepted the 'filler' effects for wrinkles tends to last around 6 months. With the exception of such folk as cage fighters (who probably will not want hyalurone) most probably will not subject their face to the same mechanical pressures as compared to the sole of the foot. One has to ask how long can the filler be expected to help, if it can help at all ? Ignoring the immense mechanical pressures on the foot degradation is assured by one of at least seven types of hyaluronidase-like enzymes present in humans. Is this explained to the client? In itself nothing wrong with the temporary nature of the treatment - cross reference this with other cosmetic treatments e.g. Botox

    Since there is little or no research about this, are you doing your own audits to help evaluate efficacy ? If so can you share this information.

    What training is required to administer this treatment ? Who provides the training ? Is the treatment covered by professional insurance and what is the fee for this temporary service?

    The use of hyaluron is not recommended in those who have received blood medication in the last 5 years or the elderly, as there was some mild concern about associated memory loss.


    Thanks!
     
  6. Akbal

    Akbal Active Member

    Dieter,

    Please feel free to send me a private message on the website or call the number on the website leaving your details I am happy to speak with you, I am not using HA, not only does it not last very long it is very uncomfortable for the patient in my experience. The filler I am using seems to last around a year, there are other fillers that may last longer, and varying the methodology may also bring longer lasting results according to some evidence in the litrature.

    I am doing a talk for the cambridgeshire branch on the 21st of may, you will need to contact them to get details of venue as i have not got them to hand.

    I am sure that I will be able to present some good data some time next year and maybe run a course.

    Akbal
     
  7. Dieter Fellner

    Dieter Fellner Well-Known Member

    Inspired to delve a little deeper there are now quite a few products used for cosmetic augmentation. Applications seem geared mostly at the unhappily wrinkled and thin lipped.

    As an aside, is it just me or is there a problem with lip augmentation? Anytime I see one of those voluntary 'victims' the lips look so puffy, like they got a bad beating. Sure don't look attractive. Why do women want puffy lips anyway?

    I counted about 15 generic compounds marketed under various brand names !

    And there is no shortage of (mostly) commercial information, with the exception of products for foot applications; for this there is nothing.

    Is the technique falling out of favour in NY? When clicking on the 'Pillows For your Feet' link (http://www.institutebeaute.com/dr_levine.htm) instead of the anticipated marketing for injectabe fillers you get directed to :

    :confused:

    If it is still on offer, this must be the most subtle marketing technique ....
     
  8. Elizabeth Walsh

    Elizabeth Walsh Active Member

    Dieter,

    I am also a bit fascinated with this subject,
    There is more on this topic in the thread 'injectable implants for feet'

    My concern is that over the length of the year that the patient is trodding down on the dermal filler,
    where does the filler eventually go?
    Into the footwear, or does it lodge itself in the system?... am I making sense?

    Why do women want puffy lips anyway?
    :D, lol!!
    They probably admire big lips in certain individuals and acquire them on their own faces
    not thinking about the fact that it might not correspond with the dimensions of their own features.
     
  9. Akbal

    Akbal Active Member

    Almost all of the fillers used today are metabolised. This is not silicone that is being used.

    As far as the puffy lips go, quite frankly most of the results I have seen in faces look very natural and i think most people would be hard pushed to be able to tell if someone has had this type of procedure undertaken. There are so many differnt types of fillers with appliactions specifiaclly suited to the formulations the use of these fillers in teh aesthetic medicine requires quite alot of knowledge of teh market and the working of teh chemicals used.

    Aesthetic medicine is not just about being vain, an awful lot of people in the world today are not as confident about the appearance as some of the podiatrists on this forum and choose this avenue to aid them, and it can be life changing, so I would not dismiss it quite so lightly.
     
  10. Mart

    Mart Well-Known Member

    Hi Akbul

    I take your point and am not so naive to think there is an easy short term fix.

    What do you say to the arguement that as podiatrists, we need to be careful about being complicite in encouraging people to conform to the often poorly considered and deliterious effects which the fashion industry seems to create to its followers health?

    This extends behond the mechanical effects of foot-wear but I see that as part of the equation. How often to you hear your patients who perform what amounts to self mutilation say, that in effect, they could not possibly wear shoes which don't injury their feet because "what would other people think" or even deny that this is even happenning? I also see what I consider as huge amount of money being wasted on items which on the surface, to an uninformed eye, provide plausable ways to offset injury caused by poor foot-wear choices, the same kind of added value which the dieting industry benfits.



    cheers

    Martin

    The St. James Foot Clinic
    1749 Portage Ave.
    Winnipeg
    Manitoba
    R3J 0E6
    phone [204] 837 FOOT (3668)
    fax [204] 774 9918
    www.winnipegfootclinic.com
     
  11. Akbal

    Akbal Active Member

    Hi Mort,

    I fully understand the position that we are in a podiatrists how encouraging the wearing of ill fitting shoes and providing relief are not the same thing at all.

    The same arguement can be made that if you treat a callous or corn as a result of ill fitting shoes you are also encouraging the wearing of that ill fitting shoe. I can assure you that I will always advise on shoes to the extent that i have to my knowledge lost several patients because 'he keep's going on about my shoes' now I warn my patients that I will advise them about their footwear at every visit regardless of whether they are going to change their shoes or not.

    This arguement is had in various areas of medicine, should treatment be provided to treat the effect of smoking, obesity or alcholism all self inflected damage. I could just as easily say to some of my patients 'loss weight' 'stop eating so much' and your plantar fasciitis may improve, instead many podiatrists(and others) all over the world will treat an obese patient with orthotics that may provide less relief than losing weight. Should we not treat these patients?

    Do you treat running injuries or other sporting injuries all again self inflicted damage should we stop treating those patients or tell them to stop these damaging activities?

    Food for thought
     
  12. Elizabeth Walsh

    Elizabeth Walsh Active Member

    Akbal,

    You have still left some questions unanswered in these threads.
    You say the fillers you are using are not Restylane, but you will not say which ones that they are.

    I was hopeful about your treatment, my sympathies go out to rheumatoid patients in particular, however,
    as I do not even believe in using such seemingly benefical products such as talc or baby oil, I contacted the author of the book 'The chemical maze' and this was his response regarding Restylane.



     
  13. Akbal

    Akbal Active Member

    Elizabeth,

    Feel free to send me a private message I am quite happy to discuss what I use and anything else you want to know over the phone.

    If you want a list of some of the fillers on the market, here is a short list of trade names, active ingredients and what they are normally used for and how long they normally last (this is not a comprehensive list and the primary use is in the face.)

    You will notice that there are alot of HA's and collagens,

    Achyal
    Hyaluronic acid

    Few days?


    AlloDerm
    (implanted)
    Human tissue




    Aquamid
    Hydrogel
    Click here
    long lasting


    Artecoll
    Round PMMA beads in a bovine collagen
    Nasal labial folds
    Lips, Wrinkles and scars
    long lasting


    Bio-Alcamid
    Poly-Alkyl-Imide
    Facial defining and improving scars
    long lasting
    Bio-Alcamid

    Cymetra
    Human tissue




    Dermalive
    Irregular PMMA beads in hyaluronic acid
    Lips and fine lines and wrinkles
    Several years


    Dermalive Deep
    Irregular PMMA beads in hyaluronic acid
    Nasal labial folds (nose to mouth lines) and deep wrinkles
    Several years


    Dermalogen
    Human tissue
    Lips
    Nasal labial folds



    Dermaplant
    (implanted)





    Evolence™
    Collagen




    Evolution
    Polyacrylamide copolymer gel
    Nose to mouth, lips and other lines
    Permanent


    Hylaform
    Hyaluronic acid
    Nose to mouth lines and lines at the side of the mouth.



    Hylaform
    Fineline
    Hyaluronic acid
    Delicate lines


    Hylaform Plus
    Hyaluronic acid
    Deeper folds and lips



    Juvéderm
    Hyaluronic acid


    Newfill
    Polylactic acid




    Outline
    Polyacrylamide copolymer gel
    Nose to mouth, lips and other lines
    18months to
    5 years


    PermaLip
    Silicon
    Lips
    permanent

    Radiesse
    CaHA micro spheres
    See their web site link



    Restylane
    Touch
    Non-animal, stabilised
    hyaluronic acid
    Fills in acne scars and imperfections. Lip stick lines and sleep creases
    6 months


    Restylane
    Non-animal, stabilised
    hyaluronic acid
    Wrinkle correction
    Thin superficial lines around eyes, mouth, forehead and smile lines. Lip enhancements
    6-9 months


    Restylane
    Perlane
    Non-animal, stabilised
    hyaluronic acid
    Facial contours such as cheeks and chin.
    Deep folds.

    6-9 months


    Restylane
    Sub-Q
    Non-animal, stabilised
    hyaluronic acid
    Facial contouring and sculpting. Cheek & chin definition and mid face lift
    12-15 months


    Restylane Vital
    Non-animal, stabilised
    hyaluronic acid
    Skin rejuvenation after sun damage. Can be used on backs of hands and décolletage
    Around 9 months


    Restylane Lipp
    Non-animal, stabilised
    hyaluronic acid
    Lip enhancement
    Estimated around 6-9 months


    Sculptra
    Polylactic acid
    Nose to mouth lines, corners of mouth,cheeks & chin, sunken cheeks, scars.



    Surgiderm
    Hyaluronic Acid




    Teosyal
    Deep Line
    Hyaluronic Acid
    Nasal furrows



    Teosyal Global
    Action
    Hyaluronic Acid
    Marionette Lines



    Teosyal Kiss
    Hyaluronic Acid




    Teosyal Meso
    Hyaluronic Acid
    Neck and Cleavage



    Teosyal
    TouchUp
    Hyaluronic Acid




    Teosyal
    Ultra Deep
    Hyaluronic Acid




    Zyderm 1
    Bovine collagen
    Fine lines and wrinkles
    Varies 1-4 months


    Zyderm 2
    Bovine collagen
    Moderate lines
    Varies 1-4 months


    Zyplast
    Bovine collagen
    Deeper lines and lips
    Varies 1-4 months
     
  14. Dieter Fellner

    Dieter Fellner Well-Known Member

    Elizabeth,

    Akbal will indeed happily chat with you about this - at length, and then some !

    I have and the discussion about Restylane is redundant.

    As concerns Akbals riposte about the psychological impact of cosmetic procedures - this is hugely complex. And PLEASE, my comment about the rubber lips was tongue in cheek. I cannot pretend I am expert at spotting those who have and those who have not. Akbal seems to know about it though. Good enough for me.

    There is an entire shoe industry which can exist on account of aesthetics and the dedicated shoe aficionado often will care little about possible or actual damage - every mother tells their daughter about wearing 'sensible' shoes. Hey, someone else can fix that, right? He is of course right in that much of what we do has, for that reason, a cosmetic angle, to varying degrees. When I correct a hallux valgus deformity, often I know the patient could be made much more comfortable simply by addressing footwear e.g. with bespoke shoes. But of course it is not that simple and that in itself does not address all their needs. Certainly I have my own patients talk about a positive life changing event from their surgery. Very humbling indeed. The rights and wrongs can be debated endlessly. And at the end of the day, money talks.
    And to a good degree I sympathise with those folk - we live in an age when political correctness and the 'nanny culture' from the state and society in general has reached the point of rude intrusion and pervasiveness in almost everything we do. Personally I see the fashion conscious shoe follower in the same light as to the rebel motorcyclist, (I personally prefer the bikes) in their own way they are sticking up a finger at Orwellian oppression. And it hardly amounts to much of a crime. Are they not simply enjoying what life has to offer ?
     
  15. Elizabeth Walsh

    Elizabeth Walsh Active Member

    Akbal,

    Thanks for the further info
    Could you message me just to tell me what fillers you are using
    and why Dieter said that the discussion about Restylane is redundant, is that because you are not using it?

    Dieter,

    Your remark about puffy lips, just made me laugh,
    it appealed to my sense of humour that's all, then rubber lips gave me another laugh!!!

    All that I am focusing on in this thread is safety to the system,
    I did not express myself very well in my first post,

    What I was trying to get at was a bit of a memory I had of the following article that I had read a while back

    Toxic Harvest Time Line
    by Dudley Nichol ATMS

    "Our skin is exposed to, cleansing, shampoo, conditioner, shaving, skin care, toothpaste and other items daily.
    Many carry ingredients harmful to humans, penetrate skin into body fluids, are carried to the brain, liver, cardiovascular system, digestive tract, lungs and more."

    The rest of that article can be found here, just click on to Articles on the home page
    http://www.quantumknowledge.com.au/Quantum.htm

    Ok then, now I am off to enjoy a bit of what life has to offer;)
     
  16. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    This is not exactly on the same topic, but is related:

    Press Release:
    Chicago Podiatrist Initiates Clinical Study to Evaluate ArteFill for Podiatric Disorder
     
  17. DaVinci

    DaVinci Well-Known Member

    Surely that is a typo and they mean 100 to count for a control group
    I wonder if they have heard of ' regression to the mean'
    With only 10 subjects; no control group; and the repeated measures/regression to the mean ...is it even publishable?
     
  18. Cameron

    Cameron Well-Known Member

    netizens

    >Why do women want puffy lips anyway?

    Apparently the psycho-social drive for puckered lips relates to the desire to emulate the gorged walls of the vulva in precoital mode. Anthroplogically this represents sucessful procreation ie continuation of the species. In humans this facial symbolism is considered cosmetically an attractive attribute to a would be partner. The origins of which can be explained by the Displacement Theory which refers to the subsequent sexualisation of the head and feet once humans began to cover up their naughty bits. This has been described in the displacement theory which highlights the sexualisation of the head and feet. In developing society the 'respectable focus' was no longer on the genitalia but on the heads and feet of individuals. At a glance you could tell the gender, of a person as well as their social and marital status. As a consequence lips took on a significance which we still see to this day with for example cosmetic rouge lipstick depicting a gorged vulva (ready for procreation).

    From antiquity all body orifices have held potential for demonic possession and careful talisman usually in the form of intricate patterns (representing magical insignia) were used to protect them. These have now become everyday things like paterned collars and cuffs., the significance of which has long been lost to most people. Lip appearance and decoration may also have 'protective' associations and hence the younger looking the lip configeration the more likely the healthier the individual.

    toeslayer
     
  19. Dieter Fellner

    Dieter Fellner Well-Known Member

    In have known about this theory ever since my O-level psychology classes - for what it's worth it was but a rhetorical question; but kudos to you for helping out ! :empathy:

    Can’t speak for everyone but I sure don't want my lady feeling compelled to engorge her lips artificially with a surgeon’s buttocks adipose tissue, or similar, to attempt to form vulva shaped facial lips, or for that matter any other form of human or other genitalia :morning:

    And what sleep deprived lonely bearded pipe smoking marijuana induced paranoid single vegan anthropologist (aged circa 38, virgin and still living at home) dreams up such weird theories?
     
  20. Dieter Fellner

    Dieter Fellner Well-Known Member

    10 - 100 - 1000 - irrelvevant. Why, is cited above ...

    OK, what are the odds the study will favour Artefill - anyone prepared to put money on this ?
     
  21. Akbal

    Akbal Active Member

    Dieter,

    Though I agreethat there is a potential for bias in this study it will still be of interest, most plastic surgeons and aesthetic practioners i know are not keen on permanent fillers, for the sole reason that if something does go wrong and there is always the potential then the filler needs to be removed surgically. However this is still very interesting and I wish them well with the study hopefully they will publish some interesting findings.

    Akbal
     
  22. admin

    admin Administrator Staff Member

     
    Last edited: Sep 22, 2016
  23. Akbal

    Akbal Active Member

    Isn't it amazing how plastic surgeons and nurses are at the forefront of this technology to treat foot pain with podiatrists still reluctant to consider these options.

    Akbal
     
  24. davidh

    davidh Podiatry Arena Veteran

    Hi Akbal,

    The situation was much the same when Pod Surgery was first introduced to the UK.
    Then much of the grass-roots opposition to us carrying out surgical procedures and even LA came, not from Medics (who were either helpful, or at worst ambivalent) but from our own profession:confused:.
     
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