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Q&A with Dr Rick Silverman: Botox and Tummy Tucks!

RickSilverman I’ve thought about a tummy tuck since I had my second child, who left me with a C-section scar, a bunch of stretch marks, and a wider mid-line between my rectus muscles, but I was warned as a female bodybuilder that I might not like the results. Why is that?

Women bodybuilders can benefit from tummy tuck (abdominoplasty) surgery, but there are a few considerations that surgeons must be aware of that are less important in many women who have this procedure. A tummy tuck usually does two things. First, it removes extra skin and stretch marks, generally including the skin between the lower abdomen (where you may find a scar from a C-section) and the belly button. To accomplish this, the skin is lifted off of the underlying muscles, exposing the rectus abdominus muscles and their overlying fascia. This allows the skin to be pulled down toward the feet, and the extra can be cut off. A mini-tummy tuck won’t remove as much skin, since it doesn’t usually do anything (or very little) for the area above the belly button.

Satellite Cells, Myonuclear Domains, And a la Carte Regulatory Factors for Muscle Growth-- Part 2

SatelliteCells2Muscle damage following resistance exercise is characterized by a loss in plasma membrane integrity, release of intracellular constituents, and myofiber degradation.  As described by Dr Connelly in his interview with Heavy Muscle Radio, a localized source of functionally-competent stem cells called satellite cells, restore myofiber formation and muscle architecture through a highly-regulated process.  Toward this end, growth factors released from injured fibers, connective tissue, and infiltrating immune cells engage a diverse array of receptors located at the surface of satellite cells.  This process promotes an ordered process of satellite cell activation (release from a quiescent state), migration to sites of damage, and fusion with each other to form new myofibers.  As the ratio of myonuclei/sarcoplasmic volume is fixed, this process of satellite cell fusion re-establishes the myonuclear domain in growing myofibers.


Q&A with Dr Rick Silverman: Rhinoplasty and Gynecomastia!

gynecomastia_20091220_1740181053Have you ever performed areola donut pexy or do you not like this practice? If you do perform it, is the scarring always permanent or can it heal???

This inquiry relates specifically to male breast reduction or gynecomastia surgery, where there is an excess of skin, frequently in combination with a large areola.  And the answer is, yes, I do perform skin resection when necessary as a "donut pexy."   I have a number of patient examples of this procedure, but one that is particularly appropriate to accompany a reply on this website can be found on my site at:


Satellite Cells, Myonuclear Domains, And a la Carte Regulatory Factors for Muscle Growth-- Part 1

SatelliteCellsMyofiber size is dynamically regulated, increasing, and decreasing depending on muscle use.  Hypertrophy is defined by increases in myofiber cross-sectional area and mass, as well as myofibrillar protein content. During muscle growth, cell surface receptors, relay signals from extracellular growth factors, hormones, and cytokines through cell surface receptors into the interior of the myofiber. These signals are then distilled through a myriad of signaling pathways to regulatory compartments known as nuclei within the myofiber.  Therein, "myonuclei" harness growth factor-induced signaling into transcriptional signatures, protein synthesis, and notably, muscle growth. Myofibers contain many hundreds of nuclei each of which has a nuclear domain


Dr. Silverman's World of Plastic Surgery: Breast Implants!

rick_silverman_headshot"One of my friends who got breast implants last year just competed, and I didn't think her implants looked very good.  Her surgeon told her that since she's a bodybuilder, the implants had to be above the muscle.  Now that I'm planning to get mine, I'm not sure what to do-Above or below the muscle?"

Placement of breast implants in bodybuilding women presents a unique challenge for plastic surgeons and women bodybuilders.  When I first started to do breast implant surgery in the early 1990s, silicone gel implants were only available for limited use, and as a result, nearly all of my early experience was with saline implants



Greg Panora: “I Want to Win More Than Anyone!”

SC_GregPanora175I've been to Westside Barbell, the epicenter of all things powerlifting about a dozen times, going all the way back to their old location next to a pizza place where the window was spray painted black to keep lifters from daydreaming about Spring lilies or girls in string bikinis in the Summer. Each trip brings the unexpected.

In earlier visits I have witnessed the entertaining ball-busting of Dave Tate, goading the walking house Mike Ruggiero between sets, much like matadors stab an enraged bull before entering the arena. I have seen lifters whose photos I had yet to see in Powerlifting USA lifting National record breaking poundages IN TRAINING and women squatting and deadlifting weights that would crumbled the spine of men in most other gyms. In each visit to Westside, I have left humbled, inspired and reeducated on all things to do with strength and lifting.


The Rise and Fall of Gym Equipment: Hardcore Prevails!

Nautilus45Leg PRessFree weights aren't the only thing that's hardcore....

Most lifters will tell you that the most hardcore piece of gym equipment is a power rack.  I would agree.  And when you're young and invincible, tossing around free weights in or out of a power rack is a wonderful thing.  Not too many of us use free weights exclusively though.  Modern weight lifting machines are an excellent adjunct to your free weight training and can provide a tremendous variety to any training program. For instance, many believe squats are the foundation to a serious leg building campaign, however, leg presses, extensions, curls, hacks, etc., also have their place


Best Short Man Crossword Puzzle!

DDICrosswordEnjoy this Crossword Puzzle that refers to
competitors in our Danny Devito
Invitational. If you have been
following the contest, then many
of the clues below were mentioned
in the character bios or posted
comments. They may be listed here
by first name, last name, nickname
or any combination of the above.


The Ole' Double Whammy!

Weak bodyparts?  No problem.  This "one-two punch" for correcting muscle imbalances is simple and effective!

His eyes glanced away for just a second, and that was all I needed.

I darted through the doorway without a sound, trying to make myself invisible. Instantly adopting the gait and carriage of someone that belonged there, I switched from the condition of sharpened alertness I needed outside the door to a calm, composed state of being. "Blend" - that is the key and, I have to modestly admit, I was a master chameleon.


Iron Subculture #3: Namat, Rychlak, Storch, and Dreimann

2008Curiosity doesn't always kill the cat; sometimes it just REALLY pisses him off.

Like many of you, I enjoy checking out hardcore warehouse gyms and independent physique-centric nutrition stores. On this occasion, I wish I hadn't made a hopeful detour into one particular store since it only served to aggravate me for most of the day. We had some time to kill so I had my girlfriend pull her car into the lot of a nutrition store we drove past so I could check it out.