Loss of function of mitochondria, the key cell organelle responsible for approximately 90% of cellular energy production, can result in cell death, excess fatigue, pain, and other symptoms that are common problems in almost if not all age-related chronic diseases as well as advanced age. These diseases include neurodegenerative diseases, diabetes and metabolic syndrome, cardiovascular diseases, autoimmune diseases, neurobehavioral and psychiatric diseases, musculoskeletal and gastrointestinal diseases, fatiguing illnesses, cancer and chronic infections, among others. The mitochondrial function also declines in advanced age. At the molecular level reductions in mitochondrial function occur when there is a loss of mitochondrial maintenance of inner membrane trans-membrane potential due to oxidative damage by Reactive Oxygen Species (ROS) as well as loss of critical mitochondrial co-factors, resulting in reduced efficiency of the electron transport chain and less generation of ATP.

The average life expectancy of individuals in the United States (US) has increased dramatically in the last century due to public health strategies and advances in medical treatment. It is expected that more than 20% of US population will be over 65 years of age by 2030. Older patients suffer from significant chronic medical problems including heart disease, cancer, stroke, dementia, and diabetes etc. requiring frequent hospitalizations. Almost half of the adults who get hospitalized are ≥ 65 yrs. and this proportion increases as the population ages. Hospital care costs Medicare about $149 billion per year in 2015, representing 25% of health care expenditures in the US. Hospitalization causes functional decline and increases mortality and morbidity due to confinement, immobility, diagnostic testing, and treatment especially changes in drug regimen, complications including delirium, falls, infections and death. Acute hospital care should only last long enough to allow successful transition to home care, a skilled nursing facility, or an outpatient rehabilitation program

Hair follicles are considered as alternative pathway for topical and transdermal delivery. They can contribute to absorption and uptake of large molecules and nanoparticles. Therefore, Nano carriers can potentially be an effective drug delivery system targeting at hair follicle-related diseases, such as acne and alopecia1. Adapalene is a third generation retinoid and a highly lipophilic drug (logP=8.2), which is commercially available in forms of topical gel and lotion for treatment of mild to moderate acne2. In these commercial products adapalene exists as microcrystals dispersed in the formulations. Skin irritation has been reported with topical adapalene products due to direct contact of adapalene microcrystals containing acid groups (-COOH) with stratum corneum (SC), as well as presence of alcohols and surfactants in the formulation3. We have developed a platform technology to encapsulate hydrophobic drugs in tyrosinederivednanospheres (TyroSphere) and to facilitate skin delivery4. In this study, the applicability of TyroSphere for targeted delivery of adapalene into hair follicles is assessed.

I am presenting my experience of Vaser liposuction in 200 patients with a longest follow up of one and half years. Since April 2010 Vaser liposuction was used for mega liposuctions and body contouring, breast reductions, gynaecomastia. The advantages and merits along with side effects are described. In the breast reductions especially in unmarried girls vaser liposuction is good for volume reduction of 2- 4inches and minimal mastopexy. Even in grade four where there is more than 1000 gms reduction its useful as surgical excision becomes easy to execute. The scar less breast reduction was favored by many young women. In gynecomastia post operative results are more acceptable to the patient as the morbidity of the traditional liposuction is minimal.

Centro-facial structures, such as the midface and the orbital with the periorbicular region are the main regions, in that aging with tissue weakness and depletion arise first. Early changes by aging are characterised by tissue depletion and ptosis, which are focused on orbital and the midface. Jawline is not caused by sunken lateral facial portions, but can cause down sliding of tissues from mid face towards the jawline. The result is Jawline and deepening of nasolabial folds. The skeletonisation of the lower lid and arcus marginalis give an effect of hollow eyes with dark circles which are the typical signs of midface ptosis. Objectives: The authors show the limitations of old fashioned cosmetic rejuvenations such as a classical lower lid blepharoplasty, conventional facelift or brow lift procedures. According to their experience of more than 20 years in facial plastic surgery they developed sophisticated new methods for all centro-facial portions, for the brows and foreheads, for the upper-and lower lid and for the midface too.

Three D surface technology is used to demonstrate to the patients the expected changes possible with a particular procedure. This technology has allowed the patient and surgeon to both see the expected result at the same time on the same screen. This will help the surgeon identify the patient’s expectations and be cautious about patients who have unrealistic expectations. The Surgeon can also define the steps of surgery and plan it more accurately. The goal is to improve the patient’s satisfaction with this technology and minimize the revision.The aim of this paper is to describe the author’s experience with 3DSI and 3DSM. Method: The 3D images are normally taken with digital camera with adequate lightning and then stored in a computer and images then manipulated using Software. The image can be captured with a camera or the surface can be scanned with a scanner but the latter would require the subject to be motionless for a longer time