How Kojic Acid Annihilates Hyperpigmentation

Do you have a skin blemish caused by sun damage, aging, melasma, or inflammation? Would you like to make your skin clear, glowing, and beautifully even-toned? Or do you want a potent alternative to hydroquinone?

Enter, Kojic acid.

Kojic acid is derived from several types of fungi. It is also a byproduct of fermented rice wine and soy sauce. It is a highly effective natural skin brightening ingredient applied topically to treat hyper-pigmentation.

Due to its ability to penetrate the skin rapidly and to quickly inhibit melanin production, the chemical reduces dark spots and brightens the skin in no time.

When compared to tranexamic acid (8-12 weeks) and retinol (4-6 weeks), Kojic acid provides one of the quickest (2-3 weeks) spot lightening effects.

How does Kojic acid work?

Kojic acid provides a powerful melanin-blocking effect that helps prevent all kinds of hyperpigmentation, whether sun-induced, age-related, or post-inflammatory.

Melanin is the natural body pigment that gives the skin, hair, and eyes their color and is produced when melanocytes convert the protein tyrosine to melanin with the help of the enzyme tyrosinase.

Kojic acid can inhibit tyrosinase, the enzyme responsible for the production of melanin. By stopping tyrosinase activity, the chemical blocks tyrosine from forming, which prevents melanin synthesis and results in less skin pigmentation.

Since hyper-pigmentation tends to occur when melanin is produced in high concentrations and then becomes clumped, diminished melanin production effectively prevents dark spots, sun spots, and age spots. It also limits pigmentation after sunburn, stops the formation of freckles, and clears melasma.

What are the benefits of Kojic acid?

  1. It helps fade spots. Kojic acid inhibits melanin production, hence lightens sun spots, pigmentation, and marks left by pimples or acne scars.
  2. It helps to brighten the skin. Kojic acid protects against ultraviolet light, keeps the skin safe from sun damage, and ensures brighter and glowing skin.
  3. It relieves melasma. After pregnancy, many women have melasma—a condition characterized by dark patches on the body and face. Kojic acid is effective in eliminating the patches.
  4. It inhibits the future appearance of scars. Kojic acid works on superficial scars and prevents their resurgence.
  5. It prevents skin infections. Kojic acid has antibacterial and antifungal properties. It prevents bacterial infections such as acne and fungal skin infections, like athlete’s foot, ringworm, and yeast infections of the skin.

Who should use Kojic acid?

Kojic acid is ideal for anyone looking for a naturally occurring ingredient to lighten dark spots and provide a more even complexion.

You can use it when:

  1. You have an uneven, pigmented complexion
  2. You are battling a skin pigment of any kind, such as post-inflammatory pigmentation, sun damage, melasma, and dark spots after acne or injuries
  3. You want to improve your under-eye circles due to hyper-pigmentation
  4. You want to treat mild wrinkles and photo-damage
  5. You want to treat and prevent bacterial infections of the skin, such as yeast infections and athlete’s foot

Is Kojic acid safe?

Kojic acid has mild antioxidant, antimicrobial and exfoliating properties. It is a safe and well-tolerated skin-lightening product for the face and body, even on sensitive skin.

Kojic acid is an ideal option if your skin can’t tolerate ingredients like hydroquinone or retinoids.

You can use a serum or pad infused with Kojic acid once or twice a day, depending on the concentration of Kojic acid and the product’s other ingredients. It is safe for topical application in concentrations of up to 1% in skincare products.

But you should not use it for longer than three months at a time. Use it only in smaller doses, particularly if your skin borders on the more sensitive side.

Excessive application of Kojic acid can irritate the skin, resulting in contact dermatitis—a surface-level red rash.

Plus, Kojic acid should be used for fade discoloration, not complete lightening of the complexion of the whole skin.

Kojic acid can be applied in small amounts for fade discoloration to eliminate spots, such as age spots, sun spots, and obnoxious post-breakout marks.

Never apply kojic acid to broken or irritable skin.

Always remember to apply sunscreen in the morning also to help protect the skin.

Whenever you notice adverse effects, stop the use and consult your doctor immediately.

How do you prevent dermatitis when using Kojic acid?

Kojic acid is not suitable for sensitive skin, with dermatitis as its most common side effect. It can cause redness, irritation, swelling, itchiness, and pain when it causes a flare-up.

To prevent dermatitis, Kojic acid should be paired with soothing ingredients to keep skin happy and side-effect-free.

For example, you can pair it with azelaic acid, green tea extract, and resveratrol. It used to be paired with hydroquinone to increase potency, but hydroquinone is in the process of being phased out.

 As a rule, buy Kojic acid-containing products only when you know when and how to use them, and then strictly follow your plastic surgeon’s or dermatologist’s instructions.

Trustworthy plastic surgery advice

Are you looking for freedom from dark spots, sun spots, age spots, or stubborn, post-breakout marks and just don’t know how? Would you like to put your best complexion forward and enjoy enhanced self-confidence but not know the best product for your skin?

At Politis Plastic Surgery, we can help and guide you on nourishing your skin to achieve even-toned, glowing skin.

For years, Dr. Effie Politis has been helping women become their best selves, regaining their confidence over their bodies and skin. She is well equipped with the knowledge and experience to help you.

She has recommended Kojic acid as an ingredient for clearing dark spots and skin pigmentations. That is because Kojic acid is a well-studied ingredient with high safety and tolerability profile.

Come in and speak with Dr. Effie Politis today to determine if Kojic acid or any other skin brightening ingredient is ideal for you.\

You can also discuss other procedures such as breast augmentation, breast implants, breast lift, buttock lift, facelift, liposuction, tummy tuck, lip augmentation, rhinoplasty, dermabrasion, and other forms of plastic surgery.

Benefits of PRF over PRP

PRF and PRP are both regenerative processes offered by plastic surgeons. These procedures are for patients who want to improve the appearance of their skin, combat tissue damage and overall rejuvenate their complexion.

Both are non-surgical procedures. However, the process of obtaining PRF differs a bit from that of PRP. It is also a more prudent choice of procedure, the benefits of which are explained below.

What is PRF?

PRF stands for Platelet-rich Fibrin. It is a plastic surgery treatment used to treat areas in the face showing signs of aging to give the skin a softer, younger look. The PRF platelet concentrate is achieved by extracting blood from the patient and then centrifuging it. The fibrinogen converts into fibrin after making contact with the thrombin in the blood, and the platelets are preserved in the meshes of fibrin. No anticoagulant is used when the blood is processed.

What is PRP?

PRP stands for Platelet-rich Plasma. It is also a process in cosmetic surgery; however, it requires more blood to be extracted from the patient than PRF does and then spins it at a higher speed in the centrifuge. This process causes the layers of the blood to disperse, with the white blood cells and stem cells gathering at the bottom of the test tube, separated from the platelets and plasma left at the top. The slower spinning of PRF means that the healing white blood cells and stem cells remain with the platelets used as filler.

Why PRF is a Better Choice than PRP

  • PRF is a multifunctional treatment proven to help with texturing, wrinkles, and bringing in stem cells. By repairing damaged skin cells, fostering collagen production, and boosting stem cell rejuvenation, PRF fillers improve the skin’s texture and brighten the face’s complexion.
  • Skin treated with PRF looks tighter and brighter because PRF contains approximately ten times the platelet concentration that the body has due to the centrifugation process. PRF can also be used for treating hair thinning and enhancing fat graft volume retention.
  • The retention of the white blood cells and stem cells in PRF gives it more healing factors than PRP. The slower spinning in the centrifuge stage causes less trauma to the individual blood cells overall.
  • PRF can be used as a filler by itself or blended with Sculptra (an injectable cosmetic filler) to form plasmasculpt.
  • PRF is less processed than PRP, has gentler centrifugation, and no anticoagulant is used.
  • The benefits of PRF and PRP are the same. Still, PRF releases more growth factors over time, so it continues to work for you even after the procedure is complete. These growth factors aid skin rejuvenation and increase skin volume.
  • Platelet-rich fibrin is a natural, less processed alternative to PRP. The anticoagulant used in PRP is acid citrate dextrose, which stops the blood from clotting too quickly. The lack of anticoagulants in PRF allows the fibrinogen in our blood to convert to fibrin, creating a matrix that holds the platelets for the slow release of growth factors. This process avoids bringing external cosmetic substances into the procedure. It starts the tissue healing process in the skin using only the patient’s blood cells.
  • PRF is a beneficial, non-surgical cosmetic procedure that anyone thinking about getting fillers should consider.

It is vital to make sure that you completely understand the process before booking an appointment, which means seeking advice from a specialist.

Dr. Effie Politis conducts her practice Politis Plastic Surgery in Tampa, Florida. She specializes in plastic and reconstructive surgeries, including PRF.

Check out her website for more in-depth information about this procedure.

Renuva Injections in Tampa, FL

Have you lost youthful volume in some areas of your body or face? Do you feel unhappy about your appearance? Would you like to restore a smooth and natural appearance through a potent anti-aging injectable that stimulates your own body to improve over time?
 
Renuva adipose matrix might be perfect for you.
 
At Politis Plastic Surgery, we offer Renuva anti-aging treatment in Tampa, Florida, as an option for age-related fat loss. The injection ensures gradual replacement of lost fat. It adds volume, fills up wrinkles, and reverses signs of aging.
 
What is Renuva?
 
Renuva is a tissue complex made of the same protein components, growth factors, and collagen subtypes that are found in the body’s adipose tissue. It is designed to provide a supporting framework that promotes the repopulation of fat cells wherever it is injected.
 
Upon injection, Renuva stimulates the body’s stem cells to divide and grow, bring in more blood around the treated area and generate new fat cells. With the steady production of fat cells, lost fat is replaced and unwanted volume deficiency is corrected. The Renuva adipose matrix will then eventually be replaced with the body’s fat cells.
 
What are the benefits of Renuva treatment?
  1. Quick, safe and effective non-surgical procedure
  2. Restores lost facial and body volume and clears out depressions
  3. Covers up and camouflages textural irregularities
  4. Restores youthful fullness to the cheeks
  5. No downtime—you resume routine activities on the same day
  6. Reduces acne scars, fine lines, and wrinkles
  7. Provides long-lasting results that last upwards of 10 years after treatment
  8. Induces natural fat formation using your own body’s natural processes
  9. With Renuva, there is usually no need for liposuction.
  10. Renuva components are eventually replaced by natural fat cells.
 
Are you a candidate for Renuva treatment?
 
You are a good candidate for Renuva if you are a healthy individual who desires a more youthful skin appearance.
 
It can help you fix:
  1. Aging skin
  2. Minor skin defects
  3. Skin lacking in volume
  4. Scarring from previous procedures
  5. Fine lines and wrinkles
  6. Dimples caused by uneven cellulite
 
Where is Renuva injected?
 
Renuva is excellent for areas on your face that naturally have fat cells. It can give a lift to your temples, chin, cheeks, jawline, jowls, and nasolabial folds (smile lines). Once injected, it helps to replace the fat loss in these areas and restores their volume and youthful appearance.
 
The injection can also be used in other areas of your body—such as the abdomen, buttocks, breast, hips, and thighs—to correct irregular depressions. For example, if you develop depressed scars after a liposuction procedure, Renuva can help correct these irregular contours by plumping out the soft tissue to give you a smoother overall contour.
 
Renuva can also repair areas with small indentations or irregularities after surgery. It improves appearance post-surgery by building fat volume and collagen. It erases cellulite dimples, clears liposuction irregularities, and enhances augmentation results.
 
How is Renuva injection done?
 
Renuva is a simple, quick, and safe outpatient procedure done in less than half an hour depending on the location and size of the treatment areas.
 
At b, your treatment begins with an initial consultation. Dr. Effie Politis will assess your skin concerns and discuss your cosmetic goals to design the perfect treatment plan that meets your aesthetic goals and concerns.
 
After consultation, the doctor will mark out the treatment areas to prepare you for the procedure. The treatment areas are strategically chosen to target areas that have an age-related loss of volume.
 
The surgeon will apply a general or topical anesthetic during the procedure to numb the injection site and prevent you from feeling pain during treatment. The procedure uses thin needles to insert the Renuva allograft tissue under your skin. But the number of injections depends on the body’s needs and the desired results.
 
Once the injections are complete, Dr. Politis will clean and sanitize the treated areas to minimize the risk of infection. You will spend a few minutes in the recovery area before you are discharged. There is no downtime, and you can return to your regular activities on the same day.
 
Quick, amazing results
Renuva injection mimics fat injections without the invasive procedure. You will enjoy an enhanced appearance without post-injection swelling, pain, or other risks that come with liposuction.
 
“One of the best features of Renuva is immediate results,” says Dr. Politis.
 
“Since the fat is injected directly into your body, your skin will look fuller and feel firmer right away,” she adds.
 
The treatment helps add volume to your skin for concerns such as cellulite, areas of depression, volume corrections, contour irregularities, liposuction irregularities, and other minor aesthetic imperfections. In turn, your skin texture and appearance continue to improve over the next few months, with full results realized in 3-6 months. The new fat cells can thrive longer, giving results that last at least ten years.
 
At Politis Plastic Surgery, we provide safe and effective Renuva injections in Tampa, Florida, to help you be at your best and feel more confident in your body. We ensure that your treatment is uniquely personalized to meet your goals by including you in all decisions concerning your treatment. You will know what to expect before, during, and after the procedure.
 
You will love the compassion and professionalism of Dr. Effie Politis and her entire staff. To learn more about Renuva adipose matrix treatments, schedule a consultation today.

6 Innovations to Know About From 2021’s Biggest Aesthetic Meeting

The year 2020 was like no other for the regenerative industry. With lockdowns imposed to curb the COVID-19 pandemic, cosmetic surgeons and clinics could not conduct procedures for months. Neither could plastic surgeons hold in-person meetings, spend time together, learn from each other, and share knowledge on innovative techniques.


But the demand for cosmetic treatments was never curtailed by the lockdowns. On the contrary, many Americans felt compelled to recommit to improving their appearance and wellbeing.

Unimpeded growth and popularity

When the lockdowns were lifted, the demand for cosmetic treatments skyrocketed, partly due to patients who had missed their appointments, but also because of many first-time patients interested in undergoing cosmetic enhancements. 2020 gave us the “Zoom Boom” and a rise in the demand for treatments.

The trend is set to continue in 2021, with millions of people in the United States reportedly interested in improving their appearance.

Takeaways from the 2021 Aesthetic Society Meeting

With the lockdowns lifted, the top aesthetic experts recently gathered in Miami for the 2021 Aesthetic Society Meeting—their first in-person conference since the COVID-19 pandemic hit the globe. The meeting provided doctors an opportunity to understand how each of them has coped with the pandemic, reflect on the positive changes they have implemented since the pandemic struck, and build on techniques that are working.

So what are the biggest takeaways from the conference? And what can prospective patients expect for the future of cosmetic surgery?

1. Combination therapies
The 2021 Aesthetic Society Meeting affirmed the combining of surgical and non-surgical technology as the future of plastic surgery. The doctors agreed that blending surgical and non-surgical techniques allows for more efficient treatment plans, ensures natural-appearing revitalization, improves the overall result, and minimizes bruising and swelling after surgery.

For instance, with the rise in global obsession with eliminating dark circles, enhancing cheekbones, uplifting eyebrows, reducing wrinkles, and overall smoothing of facial skin, the 2021 meeting asserted the need to make facial injections a core part of cosmetic therapy going forward.

So it was agreed that when developing personalized treatment plans, surgeons should couple invasive with non-invasive treatments. Mainly, they should consider dermal fillers and botulinum toxin type-A, which are among the most sought-after procedures.

The other non-invasive treatment that is going to be part of combined therapies moving forward is laser resurfacing. Lasers are a non-surgical add-on to plastic surgery procedures that already require a considerable recovery period, such as facelifts or eyelid surgery. Apart from enhancing the facelift result by boosting the texture of newly lifted skin, laser during surgery prevents extra downtime.

After surgery, most patients tend to stay out of sight for at least a week. Hence, adding deeper laser resurfacing, which leaves the skin red and raw, saving the patient from two rounds of downtime. Post-operation, they stay home and recover from both the surgery and the laser treatment simultaneously.

2. Fine-tuning of Rhinoplasty

The 2021 Aesthetic Society meeting recommended various techniques to enhance the outcomes of rhinoplasty. For example, the conference affirmed the value of frequent pairing of lip fillers and nose jobs.
When paired, tweaking the lip shape helps balance the new proportions of the face and gives better rhinoplasty results. Also, an injection around the mouth is quite painful, so doing it when the patient is under anesthesia helps prevent extra discomfort.

Another recommendation from the meeting is the preservation of the natural dorsum to reduce the nasal hump. The technique may not manage most noses, but it simplifies the rhinoplasty procedure in many minor or uncomplicated humps. And while the practice is more than a century old, it has recently been applied by only a few practitioners—hence why it was given prominence during the meeting to renew it.

3. Refining Botox technique

Botulinum toxin injections are always the number one non-invasive treatment. However, the existing brands have usually required retreatment every 3-4 months. There is a new toxin (doxibotulinum Toxin A), expected to get FDA approval in 2021, which promises a longer-lasting effect.

With this in mind, the 2021 Aesthetic Surgery Meeting encouraged surgeons to continue finding creative ways of coupling Botox and invasive cosmetic procedures. The experts considered the possibility of using topical Botox, but because the information on the technique is still inadequate, it was agreed that there is still a need for more data before implementing it.

4. Using fat grafting with other procedures

The conference recognized the increasing value of nano-fat grafting in combination with other procedures to boost volume. For instance, the meeting encouraged doing breast augmentation with breast implants and fat grafting.

Plus, fat grafting can be done as part of the facelift procedure. A good example is when treating festoons under the eyes—which cannot be corrected by traditional lower blepharoplasty or facelift alone—due to the need for mid-lifting.

5. Safety of breast implants

The 2021 Aesthetic Society Meeting discussed the issues facing breast implants, particularly breast implant illness and BIA-ALCL. The surgeons agreed on the need for excellent, well-designed research to deliver true, evidence-based answers to the questions on breast implant safety.

The conference acknowledged ongoing studies by leading surgeons and scientists around the world. It also encouraged plastic surgeons to continually use information from these studies to deliver safe, effective breast implant surgery.

6. Updated safety protocols post-pandemic

The meeting was an opportunity for surgeons to compare their safety protocols. The experts were able to look at various measures, including masks for staff, patients, and visitors, facility cleaning and disinfection, hand sanitizer usage, screening of patients for COVID-19 symptoms, and visitor restrictions.

There were also discussions on special floor markings and furniture arrangements to encourage social distancing and keep patients with respiratory issues away from the rest.

The need to vaccinate all staff members and use e-visits and e-check-ins to limit exposure was highlighted. In the end, the conference affirmed the value of keeping some of the positive changes in place post-pandemic.

At Politis Plastic Surgery, we are proud of our unparalleled commitment to innovative cosmetic and restorative procedures. We have been ahead of the curve in using the latest technology and techniques and already offer the procedures highlighted during the 2021 Aesthetic Society Meeting.

Dr. Effie Politis and her extraordinary team offer safe, high-quality, and compassionate care. You can be confident that you will enjoy the best possible aesthetic outcomes from our unique blend of surgical and non-surgical treatments.

Dr. Effie Reacts to Chicago-Based Influencer’s Botched Botox

Last April, Chicago-based influencer and blogger, Whitney Buha, shared about an unfortunate experience with a cosmetic procedure gone wrong.

What exactly happened and what can be done about it?

I shared my thoughts about it in this quick video.

Also, I talked a little bit of what I do with regards to using Botox in my own practice.

What do you think about this incident? As a fellow plastic surgeon, as a patient, or as someone who is considering this procedure?

Why do women undergo breast explantation?

Hi everyone it’s Dr. Effie Politis and I’d like to talk about a great article on the April edition of the PRS called

“Contemporary Strategies in Breast Explantation Surgery”. So what is explantation surgery? It is a surgery in which someone proceeds with removing their implants and not replacing them. I’m seeing quite a few patients that are interested in the surgery for various reasons. We all know that implants are man-made devices.

The first reason that women would opt to undergo the surgery is because of implant rupture.

I tell women that breast implants are not a one and done device. They are prosthetics that are placed in your body, so you need surveillance and you likely will need one or several surgeries in the future if you opt for breast implants. There is a small chance of them rupturing, we can discuss more on the differences between saline and silicone ruptures in the future. 

Is breast implant associated with ALCL

This is a rare lymphoma associated with texture implants, which I do not use, so it’s not really an issue with my practice but I do see patients with prior history of textured implants. 

Is breast implant illness?

This is a large topic that’s often discussed on social media. It’s the name given to patients for a wide range of symptoms. The current data shows there’s no cause and effect relationship between implants and the symptoms. However we certainly are proponents of what women want to do with their body, so if they want their implant removed they certainly have the right to have that done. However, the data based on long term studies does not show whether explantation surgery reliably reduces these symptoms. 

The last reason why women want their implants removed is for non-medical reasons, like the effects of aging, weight changes, pregnancy and shifting perspectives in aesthetic beauty. 

As we know there is a movement towards a smaller breast. So women seeking explantation surgery just need to be aware of the risk and benefits and any adjunct surgeries that can be done to enhance their breast. We look at each woman on an individual basis. It’s a woman’s choice to have her implants removed and we consider the patient’s risk profile, patient preference as well as safety when guiding them on whether explantation surgery is the right surgery for them. I would advise you all to always consult with a board-certified plastic surgeon with a specialty in breast surgery when considering these types of procedures. You can always DM me or look at my website, I’ll have more information. Thank you so much 

Lip Restoration and Shaping

On achieving lower facial optimization This patient displays typical age-appropriate changes in lips: maxillary retrusion leading to lack of bony support, elongation of upper lip unit, loss of philtral definition, architectural changes (loss of fascia/ligamentous support), deflation of the vermillion, as well as dynamic peri-oral rhytids. I typically have patients animate and evaluate them while talking. I also evaluate their lip tooth ratio while in repose and while smiling. I evaluate the chin and mentalis muscle as well as mandibular support. The correct analysis helps me make recommendations for surgical correction versus volumetric enhancement. This patient passed my criteria for volumetric enhancement with filler to restore youthful contours and ratios. This patient received only I cc Revanesse Versa lip filler. I like this filler because it is prehydrated, meaning, less swelling and a softer appearance. I also like RHA2 in lips and Restylane Kysse for my younger patients. If I need more border definition I often go to a Restylane Refyne or Defyne. Sometimes I combine fillers to optimize different rheologic properties. I massage lips and apply moisturizer. Expect bruising and swelling to subside at 5-7 days. More to come on surgical correction or lip lift

Renuva a Great Alternative to Autologous Fat Transfer

Renuva is great alternative to autologous #fattransfer and #facial-rejuvenation . Given the well documented fat loss starting in our late 30’s and accelerated in the 40’s and 50’s… this is a good volumizer that recruits your own fat cells into a honeycomb lattice that lasts! Your own fat is recruited over 3 months to replace the shelf fat in syringe. No downtime and great for those with #fillerfatigue or those wanted a more lasting, natural look. What’s better than recruiting your bodies own fat? Call or DM our office for more info!

What Is The Fat Transfer Procedure?

Autologous fat grafting, or fat transfer, is a procedure that allows your surgeon to transfer your own fat from one area of your body to another. Fat transfer is often used for aesthetic and reconstruction procedures to: • Enhance volume and fullness of body areas with soft tissue loss or deficiency • Contour or reshape body areas • Improve overall symmetry and fine-tune body proportions In fat grafting, fat tissue is removed from other parts of your body — usually your thighs, belly, and buttocks — by liposuction. The tissue is then processed into liquid and injected into the breast area to recreate the breast. REVOLVE™ System is designed to remove localized deposits of excess fat through small incision and subsequently transfer the tissue back to the patient. Use of this device is limited to those physicians who, by means of formal professional training or sanctioned continuing medical education (including supervised operative experience), have attained proficiency in suction lipoplasty and tissue transfer. (source: revolvefatgrafting.com) If you want to know more, ask a #boardcertifiedplasticsurgeon for a FULL-BODY CONSULTATION to discuss the benefits of fat transfer.

What is PRF Treatment?

PRF is now one of the most highly sought out cosmetic non-surgical procedures.

It is an all-natural solution that can treat areas in the face that show the first signs of aging, like under-eye hollows, deflated cheeks, and scalp for hair restoration.

This has platelets, fibrin, and white blood cells, which help achieve wound healing, collagen production, and improved overall elasticity.

As for its benefits, I will talk about it more in a future post!

Stay tuned!

And if you have some questions, comment them down below, and we will address them in our next post!

If you are interested in this procedure,
⁣⁣⁣⁣⁣
Call us: (813) 542 – 2587⁣⁣⁣⁣⁣⁣⁣⁣
Check our website: politisplasticsurgery.com⁣⁣⁣⁣⁣⁣
Visit us: 5016 West Cypress Street, Suite 200, Tampa, FL 33607