By Dr. Pier Albrecht

After a couple has lived together for some time (from 18 to 36 months), the passion starts wearing off gradually. Shortly afterwards, they become comfortably accustomed to one another or the relationship becomes a heavy burden to both and, then, one of them drifts apart and opens up their heart and mind to a new adventure, trying to feel free and independent again. Although the other person may not be satisfied, he or she will often try to continue the relationship because he or she thinks that it will be impossible to find someone better or for fear of being alone. This is what happened in most of the cases I have come across. One gave up on the relationship before the other. However, after some time, both of them felt happier and more liberated. They acknowledge that the relationship was like being in jail -a sometimes nice prison, but a prison after all.

Therefore, some couples stay married almost all their lives, but they have to overcome crises to that effect. This is not the general case and there may be a secret to their success. Sometimes it is a moral or religious point of view, according to which one has to devote oneself to a single person in order to be happy or to give happiness. This sounds nice, ideal, something out of a fairy tale, and with some advantages to it. You are sharing your whole life with someone who will always be at your side, to support you and give you tenderness. In my opinion, this is not better or worse than the other solution. But only a few individuals can make it.

I have a different point of view in this regard. For me, human life is a developmental experience, an opportunity to learn from each other. When I was a kid, I always wanted my friends and I to share our experiences in order for us to gain a better understanding of life and to live a happier life. The same holds true for a couple. In my opinion, it is all about sharing experiences and helping each other. The personality and wisdom of our loved one should help us improve our awareness of life. Loving your partner is nothing but wishing that they find the greatest peace and happiness possible.

But in order to carry this relationship in happiness, both individuals need to clearly know that there is no use in making it last longer than necessary. I don’t see the point in going beyond all means to try to extend the good times. When you have given all you can give and taken all you can take, sometimes you have to be strong enough to acknowledge that it is time to move on to the next phase in your life. Both need to adopt a positive attitude about it, knowing for sure that it is not only the happy experiences but also the painful ones that teach us lessons in life. Your life is not over when a relationship comes to an end. Sometimes you may think: “I will never find someone like him or her, I will never fall in love again, and so on…” You need to ask yourself how many times you have said one of these phrases, how many boyfriends or girlfriends you have had after a painful break up. We should always remember the saying: “that which does not kill you makes you stronger.”

But I also believe that there is a certain person with whom we will share the last years of our lives. This may be the “love of our lives”, since it is the most mature and tolerant one.

Broken Heart

There’s a saying that goes: “You can’t really love unless you’ve been brokenhearted.” This is a profound truth, since our heart is like a nut, it is full of love and generally protected by a shell. The only way of letting it out is by breaking the shell. Unfortunately, most of the times, it is through suffering that the shell breaks open. It is hard to admit it but I know it’s true. We would all love to live our lives with no suffering, just full of pleasure and beautiful moments. We all try to avoid bad experiences and suffering. We hide, we ran away from any potentially painful obstacle we may find in our way.

It is a pity, because pain makes us better and stronger. I’m not saying that we should pursue a life of hardship and pain, but rather that we should not try to avoid it, since we would be missing the opportunity to break open the outer shell of our hearts that keeps our love locked in it.

There are different degrees of suffering, some more tolerable than others. A broken heart can sometimes kill you. The loss of loved ones, such as children, is a type of pain that is nearly impossible to overcome, and which will stay in our hearts forever. Studies were made not only of the loss of a relative, but also of emotional stress in general, with very interesting results.

Dr. Llan Wittstein, a cardiologist of the John Hopkins School of Medicine in Baltimore, United States, directed a research team who studied 19 patients admitted to hospital with a left ventricular dysfunction after sudden emotional stress. All patients had a coronarography and repeat ECGs performed. Five of them underwent endomyocardial biopsy. Plasma catecholamine levels of 13 patients with myocardial dysfunction were compared with those in seven patients with Killip class III myocardial infarction. All the patients studied were women except for one, with a median age of 63, that is to say, postmenopausal women. According to Wittstein, the symptoms included chest pain, pulmonary edema, and cardiogenic shock, and had they not been treated, some of the patients would have died. In many cases, the patients had just been informed of the death of a relative.

A woman had been held at gunpoint during a bank robbery. Another one had experienced a great fright when 70 people shouted “surprise” at her during a party held in her honor. Unlike the other patients who suffered from real heart diseases, these patients were discharged after 2 or 3 days with their hearts in perfect condition.

Wittstein and Coll believes that stress following a great emotional shock may, depending on the family history, cause an exaggerated increase of some neurochemical components produced by the body, such as adrenaline and noradrenaline, which will reach the heart and sometimes kill you.

With the exception of these extreme cases, most of us survive emotional shocks. But they do affect us deeply and transform us every time they take place. In my opinion, every heart ache allows us to love better and become more compassionate.

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Editorial: Dr. Pier Albrecht, Dr. Pierre Albrecht, Dr. Pierjean Albrecht,

Dr. Pier Jean Albrecht, Dr. Pierre F. Albrecht, Dr. Pierre Frank Albrecht,

Dr. P. Frank Albrecht, Dr. Pierjean Frank Albrecht, Marbella Clinic

By Dr. Pier Albrecht

I will not try to rewrite a thesis about happiness; I will just share my experience and thoughts about some topics that are sometimes addressed at my practice.

The hope of finding true love, getting married and having a family is universal. Almost every culture and civilization has considered marriage to be one of the pillars of social stability, individual and community happiness.

Individually speaking, there are two individuals that love each other, long to share the same life and start a family. They want to share every aspect of their lives with their soul mate, have tenderness, support and guaranteed sex. Generation after generation, people fail to realize that their parents went through difficult times, sometimes unbearable, and want to reproduce the image of ideal family they have. In the best case scenario, those parents who have suffered throughout their marriage for ages hope that life will be better for their children. Otherwise, parents just want their children to move out so that they will not have to feed them any more.

Socially speaking, it is in the community interest that individuals live together to have a peaceful life and achieve development. Firstly, this may be due to economic reasons: Family favors wealth creation. Second, there may be reasons of civil peace and balance: If relationships are developed within a legal framework, men and women cannot exchange each other (theoretically speaking) at will, preventing conflict with high economic impact: When we are fighting, we do not work. Thirdly, there may be public health reasons: With steady relationships, sexually transmitted diseases are less likely to spread like a plague. Finally, there may be religious reasons: To prevent people from living in sin.

These schemes were discontinued at the end of the twentieth century. These days, couples start dating and split up so easily that marriage is not even justified. In other words, people keep on liking the idea of getting married; however, they are often conscious that it may not be for good.

Living together can be considered the paradox in a relationship, for it may lead to divorce or separation. I repeat that I am considering general ideas in this book, for I know perfectly well that there are exceptions. However, the evolution of the past few decades has provided us with extraordinary material to analyze many aspects of our lives.

When a couple lives apart and only shares some moments, it is like living for hours or days in a loving and happy bubble. Their working lives are left aside; they only share the best of themselves. They feel a burning desire. They have missed each other for a while. Each individual wants to project the best image. Every time they meet is like a having party.

HAPPINESS, LOVE & COUPLES

When they begin to learn more about each other, the desire to live together gradually appears. If they decide to take the step to live together, they discover new things about each other, things not related to desire or love but to the most practical aspects of their daily lives. One is too fast and the other too slow. One loves watching the news at the same time everyday, the other thinks it is a silly thing to do. One takes a one-hour-shower, the other only takes a five-minute-shower. One is stingy, the other throws the money away. One does the washing-up perfectly, the other leaves froth and soap. These details start to gradually affect the couple’s life until they both begin to think: “How can he live that way? I believe it is impossible, foolish or ridiculous”.

Those details mark the beginning of the deterioration of the relationship, but the end comes quickly when lovers begin to say: «You shouldn’t do this that way; I don’t like it that you are always following me, and so on.” Daily life commingles with feelings and the result is usually negative. Love dies little by little.

I always advise my friends not to forget the reasons why they have loved their partners. I further suggest them to try to imagine what would happen if they were to meet their couples again today: wouldn’t they love them again? Focus on the essential. You cannot expect your loved one to have all the qualities that made you fall in love with him/her and yet try to gradually change him/her to become more like yourself.

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Editorial: Dr. Pier Albrecht, Dr. Pierre Albrecht, Dr. Pierjean Albrecht,

Dr. Pier Jean Albrecht, Dr. Pierre F. Albrecht, Dr. Pierre Frank Albrecht,

Dr. P. Frank Albrecht, Dr. Pierjean Frank Albrecht, Marbella Clinic

>>> Over my long years of professional experience I have come to see that my patients, by improving their appearance, hope to find happiness. Because of this, I have decided to write about this subject and present it, in chapters, to the readers of Transform Magazine.>>> Today we will analyze how to differentiate happiness from pleasure. I hope these lines will help you in your quest for happiness.

Happiness & satisfaction

From childhood we are aware of the tyranny of our desires. From the moment when we cry, asking for mother’s milk, and we are soothed when we are given it, we are aware of that feeling of satisfaction that causes us to confuse it with happiness.

To be able to achieve what we desire seems to alleviate our suffering and the tension that this produces. If we spend our life placating our desires, we will never achieve happiness. Quite simply because as soon as we satisfy the first desire, another one will appear in one form or another. It is a mistake to think that we will feel happy after obtaining something. We will only be temporarily comforted.

Happiness & pleasure

The very essence of pleasure is that it does not last. Pleasure is related to a beginning and an end. The strongest physical pleasure, an orgasm, is very short. It is the peak of tension, followed by deep relaxation. Any kind of pleasure can be defined as an outof- the-ordinary condition, with an increase of endorphins in the brain and sometimes more adrenalin in the body. Man tries to achieve the maximum moments of pleasure during the course of his, or her, life and often believes that the happiness level of his life is related to the number of moments of pleasure: how many orgasms, how many delicious meals, how many concerts, how many dances, how much travelling, etc…

We live in a time that is so centred on multiplying those moments that young people spend most of their time with earphones, listening to their favourite music. Many enter an unreal, digital world in front of a Playstation that permits them to live a virtual life that is not theirs. They spend the rest of the time sending text messages (SMS) on their mobile phone.

When they eat or drink, they prefer sweet, fizzy drinks like Coca Cola rather than water and soft food, like pasta, chips, hamburger buns, etc. It is obvious that the new generation is no happier than the previous one, quite the contrary.

The absence of motivation and ideals condemns the new generation to pay attention only to their pleasures and the way in which to achieve them, which usually means through money.

This is really the modern ideal. The modern western democracies have already attained all the freedom possible. They know that people can now think as they wish, speak, write, sing, film, criticize, dress and move as they wish. There is nothing more to fight for. The only thing remaining is what’s left once you have achieved all of the above : pleasure. The problem is that an excess of pleasure kills off the pleasure itself, and then more and more stimulation is needed in order to feel good.

Modern life consists of obtaining the maximum pleasure possible, whether physical, intellectual, emotional, in primitive or in higher forms. The fact is that daily life might seem to us to be easier, but the effort is not so much physical, but mental. People suffer from a mental overload that prevents them from being happy. Pleasure can be the enemy of happiness.

On the other hand, happiness is not the enemy of pleasure. Once we achieve a stable condition of happiness – based essentially on a feeling of internal peace and joy, and after several years of conscious efforts to attain this – we develop a capacity to be able to feel pleasure with a minimum of stimulation. Nature, the birds singing, contemplating the sky, the clouds, the sea, the children, these are situations that will bring us moments of intense pleasure and happiness. A dense, fluid pleasure that lives in the heart and in the flow of energy and emotion through our body.

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Editorial: Dr. Pier Albrecht, Dr. Pierre Albrecht, Dr. Pierjean Albrecht,

Dr. Pier Jean Albrecht, Dr. Pierre F. Albrecht, Dr. Pierre Frank Albrecht,

Dr. P. Frank Albrecht, Dr. Pierjean Frank Albrecht, Marbella Clinic

By Dr. Pier Albrecht

In our last issue we talked about the concept s of happiness, joy and inner welfare. We started to raise the issue of how the quest for happiness evolved along man´s history. In this chapter we deal with the vision of some philosopher s and how different civilizations give happiness a different meaning.

The Asian Era .

As the modern man does, ancient civilizations almost certainly attempted to find happiness. In India, China and Japan, the ancient world of the Orient defined a series of principles related to spirituality – not to find happiness – but rather to evolve, improve and attain a state of serenity. The basis for this search was not materialist. It was centred on strict rules and techniques, the purpose of which was to maintain the body healthy and the mind concentrated on spiritual matters.

In India

For many centuries, the greater part of India lived with the belief in reincarnation: the journey of the soul through time, bodies and lives, with the objective of becoming more perfect and evolving towards liberation from this cycle of earthly life, based on suffering. Due to this, they felt it was unnecessary to change the social organization of the castes as, according to them, the soul is born where it has to be born in order to be able to continue its journey. Throughout the course of a man’s life, he should not struggle to change his caste, but to live the best way possible, so that in the next life he may be born again, in a higher caste. For this reason, in India, as in other ancient societies, earthly life was not aimed at increasing material happiness, but towards a better spiritual life and future reincarnations.

The Era of the Egyptians

The Egyptians, like the majority of Asian civilizations, led a material life aimed at a spiritual life. Their life on earth was completely dedicated towards attaining eternal life. In this sense we could say they were not looking for earthly happiness in itself, as it was considered to be a phase that would lead us to eternal life, after death. Of course, as with all ancient societies, the problems of material or spiritual happiness were strictly for the elite, as the greater part of the population had to contend with problems of a more practical nature, like survival.

The Greek Era , after Socrates .

Socrates spoke of the philosophy of happiness and takes it to be a supreme asset. It is hardly surprising that this appears in Greece, in the 5th century before Christ. This philosophy tries to bring together the maximum happiness with the maximum virtue. In other words, a life full of pleasure, joy and satisfaction, together with a life that is just, wise and virtuous. Two visions of happiness are put into contrast : the mortal vision, through virtue (which is within reach of the common people) and the immortal vision, through meditation (within the reach of the scholars and the mystics).

The Happiness of Epicurus

Later on, Epicurus made the basic affirmation that man should “enjoy to the maximum and wish for the minimum”. His message has been altered since then and nowadays people make the mistake of using the word “Epicurian” to express the concept of having to enjoy everything to the maximum.

Quite the contrary, Epicurus teaches us that to be happy, we have to increase our pleasure and reduce the motives that are the source of that pleasure. That is to say, we should know how to distinguish between what will bring us happiness and what makes us search indefinitely for that happiness, which in the end becomes a source of dissatisfaction.

Epicurus continues by categorizing three types of desire : Desires that are natural, like eating, drinking, having clothes and roof over our head, friends and being able to philosophise, so that we can achieve a better understanding of ourselves, of other people and of life.

Desires that are natural but not necessary, such as sexual desire, desire for the aesthetic, good food, things that can be enjoyed, but taking care to not become dependent upon them. Desires that are unnatural and unnecessary, like the desire for glory, fame, riches and power. He considered these desires to be unlimitable, because we will never be able to achieve all of them and therefore, according to him, they will not be able to make us happy but, on the contrary, they only serve to complicate our lives.

Epicureanism is therefore the art of enjoying the simple things, like bread, water the beauty of nature, instead of indulging in excesses of food, alcohol or sex, which only creates a sensation of repugnanceand dissatisfaction. We could almost say it is a form of asceticism, but not as an end, only as a means.

After the birth of the religions known as “religions of the book”, such as Judaism, Christianity or Islam,the notion of religious happiness appeared, as could be enjoyed in the Garden of Eden after living a life ofvirtue, organized on a religious basis. In France especially, during the 18th century, the philosophers conceived a political organization of happiness, based on the art of life, of communicating, sharing, within the games of love and sex, food, etc. An ideal world where we would all be equal. But while the philosophers were launching their ideas, the aristocrats were enjoying themselves, taking advantage of the sweat and toil of the poor.

The revolution was the immediate consequence. This arose as an attempt to allow everyone a chance to enter this new world of happiness and equality. It has reached our times converted into sick democracies, due to the failure of the Communist and Socialist utopias. In effect, happiness has not always been an ideal in life for everyone. Sometimes Man has preferred to seek love or wisdom, as happens in India, Tibet, Japan or China. In the West we chase after success, money or beauty, whilst in the East they pursue serenity, peace or harmony. The paradox of our era is that we are aware of and promote inner happiness, but at the same time we develop more and more consumer products that are mere playthings and tools for pleasure.

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Editorial: Dr. Pier Albrecht, Dr. Pierre Albrecht, Dr. Pierjean Albrecht,

Dr. Pier Jean Albrecht, Dr. Pierre F. Albrecht, Dr. Pierre Frank Albrecht,

Dr. P. Frank Albrecht, Dr. Pierjean Frank Albrecht, Marbella Clinic

By Dr. Pier Albrecht

The natural diet comes from a long natural health tradition of the twentieth century. A large number of natural health gurus have promoted this way of eating. The Diamonds wrote a best-seller entitled “Young Again” explaining the key concepts of such “dietary philosophy”. I find it interesting for people who seek to find “their” own diet. It is one of the most serious diets and it enables you to keep fit through a long term weight control program.

Respecting Natural Cycles

This diet is based on respecting the natural physiological cycles of the body. I have not been able yet to find out how these cycles were discovered. There is no clear explanation of this hypothesis in the book by Diamond. I admit that it does make sense and going on this diet is not bad for your health. You can try going on this diet and observe its effects on your health and vitality.

From noon to 8 pm it is the appropriation stage (eating and digesting). It is supposed to be the only time of the day in which we should eat. Our body can take new food. The machine is ready.

The assimilation stage (absorption and use of nutrients) goes from 20 pm to 4 am. Throughout this stage, food goes through the stomach and every segment of the intestine. Food is reduced to essential elements called nutrients. This is the stage in which the digestive machine is in operation. The fibers are broken, proteins are dissolved by digestive enzymes and acid in the stomach. What we have eaten moves along the intestine, and is transformed, allowing for the use or assimilation of nutrients: amino acids, fatty acids, glucose, vitamins and minerals. The products of digestion enter the blood stream and move where needed.

The elimination stage (of food waste, toxins and organic waste) goes from 4 am to noon. At this stage we should not eat to allow our bodies to focus all efforts on eliminating waste. One of the interesting ideas of this diet is that if we do not let our body eliminate waste, it will accumulate it. If we start a new cycle before the previous one comes to an end, we prevent our bodies from performing at its best. In that sense, this diet is in line with every tradition. You should eat at fixed timetables to improve your health. I do not know whether the exact time spans of the three stages of this natural diet are true, however, I think it makes sense to at least respect a regular schedule when having our meals.

Respecting the Metabolic Balance:

Anabolism, catabolism and toxemia.

Anabolism is the building up of some elements of our body such as cells and muscles. Anabolism is the process that begins with essential elements found in the Catabolic process.

Catabolism is the breaking down of elements such as cells, fat and sugars leading to the so called toxemia, i.e., the overall human waste.

There are two types of toxemia:

• Metabolic toxemia: from 3 to 8 billion cells are eliminated and replaced everyday. These dead cells are toxic and must be eliminated.

• Food toxemia: this is wrongly assimilated and digested waste that must be eliminated as well.

Knowing this, we should remember that our body has its own pace and we should try to respect it to allow all processes to be completed.

High Water Content Food:

The natural diet recommends the intake of fruits and vegetables for their water content is similar to that of the body. The intake of this food should represent 70% of our meals. Water provides for the transport of nutrients and is vital to cleanse the body. In addition, it is organic and would be easier for our body to use and absorb because it has already been in a live organism, say, fruit or vegetables. When you eat a lot of fruit and vegetables, the intake of water is not necessary. Supposedly we should not drink a lot of mineral water since our bodies cannot assimilate it that easily. Another advantage of the natural diet is that it is similar to the raw diet in that high water content food is live food. When we eat high water content food, we are drinking water indirectly. Moreover, we are assimilating organic minerals instead of accumulating inorganic minerals as we do when we drink mineral or tap water. Those inorganic minerals favor the development of atheromatous plaques, which are linked to cholesterol.

In addition to this, the findings of studies on food energy show that raw or slightly cooked food has higher energy levels than cooked food.

As regards the vegetarian vs. carnivorous diet dilemma, the natural diet claims that animals eat raw food (save for pets). Most animals have vegetarian diets and do not have overweight problems. Most carnivorous animals usually eat herbivorous animals exclusively. When they attack their prey, they begin by eating their digestive organs, such as the intestines, which are filled with predigested vegetables. After that, they eat the vital organs, drink the blood which is full of water, and finally, they eat the muscles.

There are many other sound arguments, for instance, the fact that the length of the intestines of carnivores is only three times the length of their torso. Whereas the length of the digestive system of vegetarians and herbivores is twelve times that of their torso. Such is the case of humans.

Another point to bear in mind is food cooking. In order not to destroy the nutrients of food, it is advisable to cook food at a temperature not higher than 55 degrees Celsius. The raw diet theory recommends raising the temperature to 112 degrees Celsius and dehydrating food instead of cooking it.

The last argument in favor of the natural diet is Longevity. Apparently, those cultures that have a diet similar to the natural diet, enjoy a much greater longevity than others.

For example, the Abkhazians of Russia, the Vilacabambans of Ecuador, and the Hunzukuts of Pakistan live to be 100 years old without any serious illnesses. As with any other diet, we should try it for a while to see if this diet suits our bodies and lifestyles.

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Editorial: Dr. Pier Albrecht, Dr. Pierre Albrecht, Dr. Pierjean Albrecht,

Dr. Pier Jean Albrecht, Dr. Pierre F. Albrecht, Dr. Pierre Frank Albrecht,

Dr. P. Frank Albrecht, Dr. Pierjean Frank Albrecht, Marbella Clinic

Having been since ancient times an outstanding symbol for femininity and fertility the female breast has always been a central part of the visual image of any woman, and despite the many historical changes that image underwent during the last centuries, there was at any given cultural period a quite well defined image of the ideal breast which inspired artists, fashion and society.When we take in consideration western society’s actual idea of an ideal breast, we experience the recreation of a more female look and style. A full breast is considered as sensual and beautiful and fashion and media are competing to visualize this image day by day.

Therefore, breast augmentation is more and more sought after, especially by young women, to approach their individual image of the perfect breast. But something which is not covered in most features covering aesthetic surgery of the breast is the fact that there are even more women suffering from very big or very saggy breasts who are searching for the possibility to get a smaller and beautiful shaped breast.

This misinformation about the possibilities of modern plastic surgery combined sometimes with the perception of the unfavourable results of some ancient techniques still keeps many women suffering their whole life from their big breasts; with this article we want to provide this missing information by explaining modern techniques of breast lifting and breast reduction and to offer you solutions to this common problem.

From a plastic surgeons view, there are distinctive measurements which define a perfect breast, but aside from those more academic definitions a woman’s feeling regarding her breast size and shape should always be our individual guideline. A breast which may be perfect for a woman looking for a more female and seductive appearance can be much too large for a small-framed woman who loves to do sports and has a more girl-like image of herself.

So the surgeon will consider your personal feeling regarding the size and the form before talking with you about any reduction or lift. After this has been thoroughly discussed the surgeon can evaluate if the adequate technique is a lift which removes only excess skin to achieve a firm and uplifted breast or if a removal of glandular tissue is necessary to meet the patient’s expectations.

A breast lift, sometimes also called a mastopexy, is a procedure which consists of removing excess skin without any removal of glandular tissue to lift up a sagged breast while keeping its original volume. If the sagging and the loose skin are less important the so called Benelli Lifting Technique can be performed removing skin only around the areola. In this case the resulting scar will be only around the areola and is barely perceptible after one year because it is placed exactly on the border of the pigmented areola. If the sagging and consequently the excess of skin are more important, a skin resection of the lower breast pole combined with a resection around the areola is necessary to achieve the desired lift. The result is the circular scar described above and a vertical scar descending to the fold under the breast.

If a patient is suffering not only from an excess of skin but from an excess of glandular breast tissue (Macromastia) the patient’s expectations can mostly only be met by a so called breast reduction procedure. There are multiple factors which can be responsible for Macromastia, in most cases it is a combination of a genetic predisposition together with hormonal changes which can be induced by onset of puberty, pregnancy or menopause. Even without considering the aesthetical aspect, very large breasts are often the origin of serious functional problems like chronic back and neck pain, arthritis of the neck, chronic eczema of the breast fold and others.

Therefore already 2 centuries ago very large breasts represented a serious problem for many women, so the plastic surgeon’s quest for aesthetically and functionally satisfying procedures started in 1882, with the first described breast reduction by the English surgeon Thomas. In the attempt to develop techniques which provide minimal scarring combined with a safe surgical procedure at least 15 different procedures where described during the last century.

Some of those ancient techniques are still frequently used and widely accepted, others have been replaced by more modern procedures, but the basic principle of all breast reduction techniques still remains the same: a circular incision around the areola which allows for skin removal and uplifting of the nipple-areola-complex combined with a vertical incision descending toward the lower breast fold which allows for breast tissue removal in the lower quadrants of the breast. This vertical incision is necessary because any removal of glandular tissue requires a reduction of the skin envelope as well, so by tugging the remaining skin into this vertical oriented scar for suturing the surgeon can rearrange the remaining breast tissue to recreate the natural round breast mound.

Depending on the technique used the scar descending from the areola can have the form of an L, of an inverted T or just be a vertical line. The L or the inverted T shaped vertical scar techniques are the more ancient procedures, but they still have their justification in very large reductions where the single vertical scar technique can not cope with the associated excess of skin.

The more recent technique based on a single vertical scar in combination with the circular scar around the areola was described 1998 by the Belgian surgeon Madeleine Lejour. This surgical approach is based on the ability of the skin to shrink once it has been freed from the glandular breast tissue, so that large amounts of excess skin which would normally need an L or inverted T shaped skin excision can be rearranged in just one vertical scar by using a special purstring suture technique.

Offering the big advantage of minimal scarring, this technique can be used in almost all reductions except for breasts which are extremely big and sagged. Because of the reduced incisions, healing is fast and most patients can get back to normal life activities after 2 weeks. Due to the fact that this technique is based on the postoperative shrinking of the skin, the reduced breasts require 3-6 months after the operation to achieve their final position and the desired aesthetic result; during this early stage the lower half of the breasts will show some small skin folds which will smooth out gradually.

By using all the techniques available after more than hundred years of modern plastic surgery research, the modern breast lift and breast reduction procedures provide excellent aesthetic results combined with an invaluable effect on the functional problems mentioned above resulting in an important improvement of life quality.

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Editorial: Dr. Pier Albrecht, Dr. Pierre Albrecht, Dr. Pierjean Albrecht,

Dr. Pier Jean Albrecht, Dr. Pierre F. Albrecht, Dr. Pierre Frank Albrecht,

Dr. P. Frank Albrecht, Dr. Pierjean Frank Albrecht, Marbella Clinic

Neck – cheek & eyebrow lift in the temporal area

Dr. Albrecht published in the last issue of Aesthetic Surgery Journal, the magazine of the American Society for Aesthetic Plastic Surgery.

Mrs. V.B. came to my surgery nine months ago following the recommendations of a friend of hers and her hair stylist. She needed a complete face lift including a retouch of her upper and lower eyelids. My state-of-the-art facial rejuvenation technique includes lifting, injections and peeling.

The complete treatment takes 9 hours and it is performed in two days. It is an expensive procedure. Viviane told me that she was willing to spend half the quoted sum so I proposed a simpler strategy that yields very good results.

• The first step of the rejuvenation technique con-sists in lightening to the maximum extent possible the weight of the skin of the jaw line and the neck, allowing it to attach itself back to the subcutaneous muscle.

Through cheek and jaw line liposuction, in combination with the surgical removal of the fat deposited behind the subcutaneous muscle (platisma) of the neck, the weight of the neck skin is eliminated and it adheres back to the jaw.

My face lift theory is based on the ageing of the skin, in other words, the loss of elasticity. What happens when elastic gets old? It fails to go back to its initial position when stretched and it does not bear even the minimum weight. What happens if it is stretched too far? It breaks or does not allow further movement.

The same thing happens with the skin, depending on the elasticity loss degree, which may vary significantly among people of the same age. When it loses elasticity, it fails to bear the weight of the subcutaneous fat and it drops due to the effect of gravity. However, under no circumstances is gravity responsible for the loosening of the skin of the face. If this skin is tightened trough a face lift, the facial expressions will be limited, resulting in a pulled, unnatural look.

In order to avoid this undesired effect, I always focus on the removal of fat from the skin. By removing all this fat (this is a fine surgery procedure that takes from 2 to 4 hours), the skin can go back to its original location and attach to the muscle thanks to the scar-like tissue (fibrosis) resulting from the liposuction. Curiously enough, even thin people have fat in their necks.

This is precisely what I did in the case of Viviane. Through the 3 to 4 cm incision hidden in the first wrinkle under the chin, the neck was “cleaned”. The results are always very good and amazing, taking into consideration that no skin is cut.

• The second step consists in a temporal lift (in the temple area) through a small 3 cm long incision made 2.5 cm from the hair line, slightly to the back and above the eyebrow tail. After removing skin from the lower and upper eyelids, the temporal lift allows to slightly augment the size of the eyes and to elevate the brow naturally (unlike the frontal lift, where the entire brows are lifted, resulting in a permanent look of surprise or fear). Here again there is no skin cut, it is only pulled backwards with internal sutures of the skin to the muscle.

• The third step was an injection of the patient’s own fat in the cheeks and the area around the eyes, particularly in the upper eyelid, to achieve the “full but not loose” effect typical of the youth.

Finally, it can be stated that Mrs. V.B. has achieved a significant and natural rejuvenation with only two small incisions of 3 cm each, under local anesthesia and sedation. You can learn more about this case in her interview in Transform Magazine n° 5.

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Editorial: Dr. Pier Albrecht, Dr. Pierre Albrecht, Dr. Pierjean Albrecht,

Dr. Pier Jean Albrecht, Dr. Pierre F. Albrecht, Dr. Pierre Frank Albrecht,

Dr. P. Frank Albrecht, Dr. Pierjean Frank Albrecht, Marbella Clinic

March is my favourite month, since spring is soon to come. This year it is even better because Marbella Clinic has been granted the “Essential Marbella Awards”. Marbella Clinic was chosen among 4 other clinics specialized in beauty and aesthetics by thousands of votes as the centre of excellence. We are proud of this award since it is an acknowledgement of 12 years of work and experience in marbella offering patients the best techniques, art and passion within the wonderful specialty of Plastic-Aesthetic surgery.

I may be repeating myself, but nowadays, promoting more traditional and humane life principles is as important as struggling against global warming. You can work very professionally, successfully and profitably, and still promote ethics based on allegedly outdated values. I always tell my collaborators that it is not necessary to try to be the best, but it is essential to do your best at whatever you do. If you end up being the best, all the better for you. It has been a pleasure to receive the “Essential Marbella Award”,but we were only doing our work and trying to make our patients’ lives nicer and happier. And we will continue to do so. When spring and summer are near, it is of primary interest to choose a good diet to shed the excess pounds gained over the festive season, but also to get your skin prepared for the sun. The new Mole Control unit of Marbella Clinic offers a non-surgical, state-of-the-art digital evaluation of nevuses and suspicious skin lesions

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Editorial: Dr. Pier Albrecht, Dr. Pierre Albrecht, Dr. Pierjean Albrecht,

Dr. Pier Jean Albrecht, Dr. Pierre F. Albrecht, Dr. Pierre Frank Albrecht,

Dr. P. Frank Albrecht, Dr. Pierjean Frank Albrecht, Marbella Clinic