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Imagine this. A young teenager, 17, years old, who is fully developed. Now imagine this, the same teenager has a fully developed extra set of limbs and a pelvis. That extra set of pair is attached with chest artery. But, how can this happen?
While it is extremely rare, and has a chance of less than one case occurring per 100,000 births. Such things do happen. This is called parasitic twin.
It is an extremely rare type of cojoined twin where a baby is born with an underdeveloped twin attached to its body. This condition is also known as vestigial twins. The condition is very closely related to conjoined twins, where babies are connected at birth and share organs. However, the main difference is that in conjoined twins, there are two developed babies, whereas in parasitic twins, only one is fully developed, other one is underdeveloped and non functional.
In such a case, the twin who is developed is medically known as the autositic or the dominant twin. The dominant twin is healthy in most aspect but may have extra tissue, organs, or limbs from the parasitic twin.
The parasitic twin may be attached with the dominant twin through several places. The common joints are at the head, torso, chest, pelvis, buttocks, or back. In these cases, the parasitic twin is not alive and they die either in the womb or during the childbirth.
Now, let's go back to the case we referred to, where a young teenager had an extra pair of limbs attached to chest. The teenager who has not been named is from Uttar Pradesh's Unnao neighbourhood, and was treated in AIIMS, Delhi. The team of doctors successfully removed the extra set of limbs from his body.
Dr Asuri Krishna, who led the team of specialist who surgically removed the extra limbs told the BBC that only 40 to 50 cases of parasitic twins have been documented in world medical literature, and in those cases, the surgery had been attempted on children. The doctor said that without much medical literature to guide them, the team of doctors depended on "intuition, skill and knowledge".
The doctor shared that the child had two fully formed legs, buttocks and external genitalia, which weighed around 15kg "protruding from his abdomen".
The doctor shared that first they identified how interconnected the parasitic and host twins were. The doctors took scans and found that parasitic twin was attached to the teen's breastbone. The blood was being supplied from a vessel in his chest. However, "there wasn't much connection with other main organs like the liver or kidneys," said Dr Krishna. The team also found a large cyst in the teen's abdomen.
Then the surgery was performed in two stages. In the first stage, the parasitic twin was removed. Then the cystic mass was extracted from the surrounded area. The entire surgery was completed in two and a half hours and the team of doctors included radiologists, anaesthetists, and plastic surgeons.
The biggest challenge was when the teen's blood pressure dropped as 30 to 40% of his blood flowed to the parasitic twin, however, the doctors were prepared for it and they stabilized him.
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The boom in GLP-1 weight loss drugs is not only affecting the obesity market but also reshaping the beauty industry. Changes in consumer behaviour among those who use GLP-1 drugs is evident as people may see differences in their appearance after drastic weight loss. This phenomenon has prompted global beauty companies to explore products for people experiencing changes in their appearance after losing weight.
French cosmetics giant L’Oréal is among the companies exploring this emerging market segment. Its CEO, Nicolas Hieronimus, said the increasing use of these medications was affecting beauty and skincare consumption, compelling the company to explore products that address concerns like sagging skin after extreme weight loss.
“The rise in their (GLP-1 drugs) use was having an impact on beauty consumption and skin care consumption in particular,” Hieronimus said during an investor call on October 22, after the company's third-quarter results came out.
The development mirrors an important shift in the beauty industry as weight loss medications like Ozempic, Wegovy and Zepbound become more widely used for weight management.
Amid the growing market for these drugs, companies are now seeing increased demand for treatments that help changes in facial volume, skin firmness and elasticity after weight loss.
However, the science behind ‘Ozempic face’ is far more complicated than the name suggests. Experts say these changes are generally associated with losing facial fat during weight loss, especially when it happens rapidly.
‘Ozempic face’ is an informal term for facial changes that occur after rapid and substantial weight loss. It is marked by hollowing around the cheeks and temples and more noticeable wrinkles or sagging skin.
GLP-1 medicines, including semaglutide and tirzepatide, act on appetite regulation, helping people feel fuller for a long time and reducing their calorie intake. As a result, some people lose a substantial amount of weight over a short period.
Apart from L’Oréal, Swiss skincare company Galderma and Brazilian cosmetics group Natura are also seeing similar demands from consumers experiencing changes in their facial skin after medicated weight loss.
L’Oréal has said that it is testing products on people using GLP-1 medications. Its SkinCeuticals range also has products intended to address concerns such as skin sagging, according to Hieronimus.
“We have products in SkinCeuticals that are made to work alongside GLP-1 drugs and address their side effects, such as skin sagging and other related issues. It is very integrated,” he said.
Galderma, in which L’Oréal holds a 20% stake, has assessed some of its existing aesthetic treatments for changes due to GLP-1 use. Its portfolio includes Sculptra, an injectable that stimulates collagen, and Restylane, a range of hyaluronic acid-based dermal fillers.
Anne-Cecile Chevrier, Galderma's global head of injectable aesthetics, described the concerns that experts are seeing among consumers. “Sagginess is a concern, loss of firmness is a concern, some hollowness can be of concern and dullness can be a concern,” she said.
The expansion of this market does not necessarily mean that skincare products can reverse facial changes due to rapid weight loss.
The skin has several layers, and topical products act on the skin's surface. Facial fat loss happens when fat accumulated beneath the skin melts off. Skincare products cannot simply replace this process.
Dr Graeme Glass, a plastic and craniofacial surgeon and aesthetic director at British beauty brand LYMA, explained the limitations of topical treatments. “They can't reposition the deep fat pads of the face. There is a limit to what these things can do,” he said.
Moisturisers and other products may help improve hydration, texture and the appearance of fine lines. But these benefits should not be confused with correcting sagging skin.
Treatments like fillers and collagen injectables may address these concerns directly, but they involve different risks, costs and clinical considerations.
Avani Sinha, MD, and FACE endocrinologist and program director of the Northwell Health Division of Endocrinology, Diabetes and Metabolism fellowship told Women's Health Magazine that it is important to take care of nutrition and muscle-building to "fill up spaces where you are losing that skin laxity".
“We are what we eat, we are what we do,” she said, stating that protein intake is especially important on a GLP-1. She suggested aiming 0.8 to 1.8 grams per kilogram of body weight.
Sinha also recommended staying hydrated along with strength training to build muscle. “You build up that muscle, you're going to fill up those spaces where you're losing that skin laxity,” she said.
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US journalist Norah O’Donnell recently spoke about the importance of early skin cancer detection a decade after being diagnosed with melanoma, the most dangerous form of skin cancer.
She said her experience changed her outlook towards sun protection. She also shared advice related to skin cancer from her dermatologist, Dr Elizabeth Hale.
According to CBS News, O’Donnell recalled that it was during a routine dermatology appointment when Hale noticed two concerning spots on her back.
A biopsy confirmed melanoma, but the cancer was detected early and removed before it could spread.
O’Donnell said she now seeks shade wherever she can find, wears UV-protective clothing and regularly reapplies broad-spectrum sunscreen when spending time outdoors. She also reflected on her past exposure to sunburns and tanning salons.
Melanoma develops in the cells that produce melanin, the pigment responsible for skin colour. Although it accounts for a smaller proportion of skin cancer cases, it is responsible for an alarming share of skin cancer deaths.
Hale emphasised that early detection can make a considerable difference. “Even though it only accounts for 5% of new cases of skin cancer, it’s responsible for more than 75% of skin cancer-related deaths,” she said.
She also spoke about the importance of getting suspicious spots examined rather than waiting for them to become more noticeable and serious.
“There have been major advances in melanoma treatment, but it’s still really best to get your skin checked because when melanoma is caught early it has greater than a 99% five-year survival. But once it spreads, that survival rate goes down precipitously,” Hale said.
Speaking about skin cancer risks related to tanning beds and sunburns, Hale said melanoma cases have been increasing among women in their 20s and 30s.
“It is directly related to exposure to tanning beds and to sunburns,” she said.
According to the Skin Cancer Foundation, using tanning beds before 35 could increase melanoma risk by 75%.
Hale also warned against the growing trend of deliberately seeking a tan through prolonged, unprotected sun exposure.
“There really is no such thing as … a safe, healthy tan,” she said.
A tan is not simply a cosmetic appeal. As Hale explained, it denotes “DNA damage” that may contribute to cancer later in life.
Hale recommends regular skin examinations to nab suspicious skin changes early. She advises people to discuss their individual cancer screening needs with a dermatologist, especially if they have a family history of skin cancer.
Sun protection is another essential part of prevention. Hale recommends using a broad-spectrum sunscreen with SPF 30 or higher and reapplying it every two hours when spending extended periods outdoors.
Her advice on choosing sunscreen is straightforward: “the best sunscreen is the one you’ll actually use”.
As per the Johns Hopkins Medicine, wearing sunscreen is the easiest and the best ways to protect your skin's appearance and health at any age. It recommends to use it regularly to prevent sunburn, skin cancer, and premature aging.
While everyone needs sun exposure to produce vitamin D, unprotected exposure to the sun's UV rays can cause damage to the eyes, skin, and the immune system.
To protect, apply 1 ounce of sunscreen throughout your body. To protect your face and neck, you will need about half a teaspoon of sunscreen.
Experts also believe that as long as the sunscreen is at least SPF 30 and is water-resistant, it does not matter what order you apply your skin care products. While some people find it is easiest to work with bare skin, some do it at the end.
Protective clothing and seeking shade can provide additional protection, especially during prolonged outdoor activities.
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Arthritis is sometimes treated like a normal part of getting older. Yet it can show up in many age groups. It can also limit how freely someone moves. That can affect daily independence and overall comfort.
Some people think arthritis care always means an operation, like joint replacement. In reality, the path to care is wider. What happens next depends on symptoms, which joint is affected, a person’s age, how active they are, and their general health.
Where the disease is in its early stages or is perceived to be mild, treatment will begin in a very low-key manner. This will involve physiotherapy and exercise. Where necessary, losing excess body weight can be beneficial. Minor changes in daily activities will decrease stress. Doctors will prescribe medication depending on the situation. Here, the main objective is to alleviate symptoms and maintain function. It will not be the initial step and will only be considered where appropriate.
In case arthritis is severe, pain and stiffness will persist for a long period of time. Performing simple activities becomes difficult. Even walking will become challenging. Sleep may also be affected. When this happens, it helps to check again. Doctors can use exam findings and imaging to see how much the joint has changed. They can also review whether non-surgical care is working as expected.
Good arthritis care is about choosing the right path for the right person. Timing matters too. It begins with a close look at symptoms and a clear diagnosis. Sometimes it also means getting scans when they are needed. After that, the plan should rely on what the best research shows.
Treatment should be set up with rehab in mind. The aim is to fit the person, not just the label on the chart. One person may do well with physical therapy and simple habit shifts. Another person may need a procedure, mainly when a joint is badly worn.
The main goal is easier daily comfort and better movement. Just as important, it should help someone keep their independence. It is also not only about chasing the newest option.
People should not wait until pain makes normal life hard. When they seek help early, it can be easier to see what is driving the joint pain. It can also help show how far the arthritis has gone. With that in hand, a care plan can be built with more clarity.
When care starts early and matches the person, many can stay active longer. They may also better protect joint function and keep it working well for more time.
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