Total Body Surgical Blog

To continue our discussion about weight loss, I wanted to cover, a little better, the procedures we are offering.  As you know, not every procedure is the right choice for you.  If you come in for a consult and we don't offer the one that is appropriate, we will send you to get the right one.  The roux en y bypass, we will NOT be doing.  This procedure is a great one for those who need rapid weight loss due to urgent complications of being massively overweight.  We also will not be doing the so called mini gastric bypass as this procedure is unproven and not recognized by the Bariatric community.

The two procedures we will be offering are the gastric sleeve and the lap band.

The gastric sleeve has been around for some time now with great success and very low maintenance.

The gastric sleeve decreases the amount of food that can be consumed when eating a meal.  It also decreases the amount of the hormones produced by the stomach that causes hunger and the desire to eat.  This is a proven procedure that is done through the laparoscope with an over night stay in most cases.  The weight loss is dramatic with no adjustments. 

The lap band is for those people that can afford to lose weight in a slower fashion, and desire a procedure that does not change the anatomy in a permanent way.  The band is also done through laparoscopes and generally does not require a stay in the hospital.  Weight loss is slower with this procedure and it does require adjustments.

This photo shows the difference in the two procedures.  The gastric band and the sleeve compare well at 5 years as far as weight loss is concerned, however, the speed of the weight loss is much faster with the sleeve procedure.

As the INTEGRIS bariatric program matures, we may offer the more aggressive roux en y but for now we are not. 

We are striving to become a center of distinction in bariatric surgery and will take a little time.  Until then we will not be able to treat medicare or medicaid patients as this is their requirement.

Dr Miller and I both are also fellowship trained Cosmetic Surgeons so once your weight loss stabilizes, if you desire any of the post weight loss body contouring procedures, we can help there as well.  The most common are tummy tucks, breast lift with or without augmentation, arm reductions, thigh lifts, and butt lifts.  Facial procedures are also common with face lifts being the most common.  We are both very excited to offer these services.  It is rare to find qualified bariatric and Cosmetic surgeons, not to mention in a small town, and in the beautiful Grand lake community. 

Our plan is to start bariatric seminars within the next month in Rogers, Fayetteville, Bentonville in Arkansas and Joplin in Missouri.   We will also have seminars in Grove and in the Tulsa area.  The seminars will be informative and are required for insurance coverage of bariatric procedures.  We will also discuss cosmetic procedures briefly at the seminars to give you an idea of what is available.  You will be able to schedule appointments to start the process at the time of the seminars.

We are really looking forward to meeting many of you and hope that if you have any friends or family that are interested in weight loss procedures you will send them.  I will send a schedule, as soon as we get it figured out, by email.

Don't forget our other special pricing on laser hair removal ($50/area/treatment), breast augmentation, liposuction, and nail fungus treatment.  Press on the bubbles to see them.  Schedule today to see Dr Miller or myself...918-786-7780.

Sorry for the hiatus!  Finally moved in and most of the boxes are unpacked.  We are now official residents of the Grove community!!  Time to get down to business.

I have written here a few times about obesity and the problem just keeps getting bigger and bigger (no pun here).  The consequences of this supersizing phenomenon are going to be serious for society at large and for those individuals that are involved.  Rates of diabetes, high blood pressure, sleep apnea, joint failure, and high cholesterol are all on the rise.  Probably the biggest casualty of obesity is the loss of quality of life and productivity.  There is an untold psychological effect that cannot be measured.  We are seeing our children getting bigger as well, the problem is becoming world wide.

At Total Body Surgical, we offer weight counseling and have medical and dietary solutions for those who need help.  For some, these methods can be very effective.  Unfortunately, most people with a significant weight issue have been down this and many other roads on numerous occasions and have been unsuccessful. 

At Total Body Surgical we also offer the Lap Band for those that can afford to lose weight on a slower basis and are willing to pay attention and work a little to drop the weight.  Surgical options are great for the times when diets and medication fail.

So what's new??  INTEGRIS, the Grove medical community, and Total Body Surgical are committed to serving the Grove community and the surrounding communities in Joplin, Tulsa, Fayetteville, Bentonville, Rogers and any areas between.  We are getting serious about weight loss by increasing our committment.  The most consequential thing we are doing is bringing in a fellowship trained bariatric surgeon.  Dr. Nate Miller will be joining the practice next month and we are very excited to have him on board.  He is a very skilled young surgeon who is board certified in general surgery, has completed a Cosmetic surgery fellowship, and just completed a Bariatric surgery fellowship in Houston.  He will bring his expertise to Grove to help get our official bariatric surgery program going.  Not only will we be able to do Lap Bands, but now we will be able to offer gastric sleeves for those that need to lose the weight quicker.  The gastric sleeve has minimal maintenance too.  Another addition is Danny Ludwig, RN.  He is our new bariatric coordinator.  He is there to help you walk through the process.

With the addition of Dr Miller, we can now offer the full service of medical and surgical weight loss, then help you remodel the body by removing the excess that comes with massive weight loss.

We are stepping up our game by bringing you the most qualified people and offering the best in Bariatric, Cosmetic, and Vein surgery.  We are also constantly trying to give you the best experience available.  Our team, Mekala, Trish, Janet, myself, Danny, and now Dr. Miller are always striving to make your experience the best it can be.  Of course, with the addition of new staff and a new Doctor I am sure there will be some growing pains, but we will do our best to keep them minimal.  We are all very excited to serve your needs with great service AND competitive pricing. 

Come see us today for a weight loss consult or to get your new look on. 918-786-7780  And don't forget our ongoing special pricing, click on them to see...

"Should I be scared of silicone implants?"  I hear that question quite a bit.  Nearly every consult I see for breast implants raises this question.  Here is the skinny, and a video that will show what the new implants are all about....opened up for all the world to see.  First of all....the video...

http://youtu.be/kceaEMmi7pA

Now that you've seen it, you know that the gel in these implants is very cohesive.  It wants to stay together.  The old silicone implants were filled with a more liquid silicone substance that would leach through the cover slowly.  This allowed it to enter the lymphatic system and after much legal hooplah, numerous conditions were blamed on this phenomenon.  The old implants were taken off of the market in about 1991 and the new ones were engineered and released for general use in 2006.

What is the advantage??  Some say they feel more natural. 
Some say they look more natural.  I have even heard they are "warmer" than saline. 

The fact is that they do ripple "wrinkle" less but can still do it.  They are a lower pressure implant and cannot be over filled, therefore, saline implants, when overfilled, can be made to look like implants.

Are they safe??  To date, there is no evidence to the contrary.  I think they are safe and look great.  Saline implants are also very safe and look great.  The choice is a personal one. When you come to Total Body Surgical, we will help you choose saline or silicone and choose size too.  I won't try to talk you into one or the other, just give you the facts and a range of size that is best for you.  Come see us today!!  Cosmetic consults are complimentary...918-786-7780

Legs are often overlooked in Cosmetic Surgery.  However, think about how much of your "person" is legs???  We all want to work on our faces, abdomens, and breasts but often forget about one of the larger parts of our body.  What can be done??

Here are the common problems:

1.  Lost tone and shape of the butt.

2.  Saddle bags or outer thigh enlargement.

3.  Inner thighs becoming large and "rubbing" together.

4.  Weight gain in the anterior or front of the thigh and knees.

5.  Spider veins.

6.  Varicose veins.

These are the most common complaints I hear from day to day.  These complaints are due to hormonal changes and the process of getting older.  Also, genetics can play a role in how we all gain weight.

First, the butt.  What can you do when the shape of the area is lost?  The most common problem is not that the shape is lost, it has become hidden.  Most of us gain weight in the hip or love handle area (the muffin top) and in the outer thigh or saddle bag area.  When these areas enlarge, the but area becomes smaller in comparison.  So how can this be fixed??  What I usually recommend is liposuction.  Liposuction of the outer thigh and hip area makes them smaller and the secondary result is a more shapely butt.  We can also take the fat from these areas (which is usually high quality) and transplant it into the butt.  This will increase the volume of the buttocks and after liposuction of the surrounding areas, you can have the shape you are looking for.  In this photo, you can see the improved shape of the buttocks after liposuction.  It looks bigger because the surrounding areas are smaller.

Second, the Saddle Bag.  These are the areas that not only "shrink" the butt, but also create a problem when trying to get into jeans and dresses.  I hear it all the time, "I cannot buy jeans that fit my waist and thighs at the same time"!!  Liposuction is what I use to attack these areas.  It can be an amazing transition when you can drop 2-3 pant sizes with one in office procedure.  Other procedures that are advertised may or may not work for you...this one is guaranteed.  You can see from this photo that indeed, you can drop a significant number of pant sizes and regain your shape.

Third is the inner thigh area.  I hear it all the time...."I hate that my thighs rub together".  We can actually lump three and four together, the inner thigh, anterior thigh, and knee areas.  Again, what we use is liposuction.  These areas are fairly easily done and the recovery time is short.  All of the areas can be done together to re-shape the entire upper leg.  Small incisions about the size of the end of a pen are used in the groin area and in the fold at the base of the buttocks.  Within a few weeks the difference will become visible and you will need to find some new pants...but don't, because, it will continue to get smaller for 4-6 weeks.

The next complaints are of veins.  Spider veins and varicose veins are ugly.  They are also, sadly, very common.  Caused by heredity, trauma, child birth, and life style, they come and stay.  They trap many people in long pants making it embarassing to wear anything else.  Spider veins are considered a cosmetic problem.  They are the small, blue veins that are very close to the surface of the skin.  Treating them requires professional evaluation to make sure no other bigger problems with the veins exist.  Once other venous problems are ruled out, they are treated by injecting small amounts of a substance to obliterate the vein.  It does cause some inflammation and this procedure, called sclerotherapy, is best done in the fall and winter....NOW!  It may take several treatments to get rid of them all, and may require maintenance.  We charge $300 per session, very competitive.  Varicose veins are a different story.  They require more extensive evaluation and treatment.  Much less than in the past however.  Getting rid of these veins, when symptomatic, is done as an office procedure and is usually covered by insurance.

Come see us NOW to get ready for next summer....remember your legs....they need attention too!

Remember our specials...

Get ready for summer???  What!!  That's right, this summer for all intents and purposes is OVER, it is now the time to consider what changes YOU want, and do them before it is too late for the next go around.  There are things that you can do in fall and winter to be ready for lake, swim suit, and beach wear.

The first thing to consider working on are things you have a hard time hiding.  Spider veins or varicose veins are two of the big things.  I will talk more about options for treatment in the coming weeks, but, to have a great result and be ready for shorts and skirts, it takes time.  The areas have to heal and may require several treatments.  During fall and winter, long pants conceal treatment in progress....now is the time to start.  Call to schedule..918-786-7780.

The second thing to consider is your complexion.  Now is the time to get started on a good skin care regimen to reverse summer sun damage and keep that skin glowing through the winter.  We love the results we see with the Obagi line of skin care and for those that need an extra kick, we use the Pearl laser and IPL to get rid of dark spots, fine lines, and wrinkles.  The Pearl laser is fantastic for fine lines, wrinkles, and improving skin tone, color, and texture.  It also comes with one of the shortest recovery time of all ablative laser treatments.  Treatments in the winter will get you ready for next year...call today 918-786-7780.

The third thing, the second concerning lasers, is hair removal.  With the lowest prices in the 4 state area, now is the time to get that unwanted hair GONE.  Start now and stop shaving those sensative swim suit areas for good.  With our pricing, you'll make money not buying those expensive razors....call today 918-786-7780.

Fourth...breast augmentation.  Even though recovery time is fairly short for an augmentation, it is nice to get that over in the less active winter time.  We can get you the look you want at a very fair price with short booking times.  Call today for your consultation and book your time early.  Restore your confidence next summer in swim wear...918-786-7780.

Fifth...liposuction.  Have that abdominal pooch, love handles, or are you unhappy with your thighs?  For the right people, liposuction is life changing.  Problem areas that won't go away with exercise and diet can be sculpted into the form you are looking for.  We have laser technology that can tighten skin as well.  It takes time for the skin to tighten after laser liposuction so now is the time to get going.  Consults are complimentary so call today..918-786-7780.

Sixth...toe nails.  Many people are embarassed by their feet....toe nails in particular.  Many of us have nail fungus that makes the nails thick, yellow, brittle, and discolored.  Medications are 50% at best for curing the problem but come with many risks your liver.  Laser Genesis has been FDA approved to treat the problem and is over 80% effective with only two treatments.  It does take time for the sick nail to grow out.  Do it now and get your two treatments out of the way, new nails...next summer....sandals!!!  Call today 918-786-7780.

Of course there are many other things that you can do and it is always better to recover in the winter, tummy tucks, eyelids, facelifts, and more.  The other thing that you can do to re-invent yourself is the lap band.  If you are overweight and diets continue to fail, the lap band may be for you.  If you do it soon, you could be fifty or more pounds lighter by next summer...would that be amazing or what!!!  Book today 918-786-7780.

So there you have it!!  My advice is to start preparing for next summer NOW.  Don't wait or you'll miss it.  We want to help and we have the skills and people to make it happen.

Call today 918-786-7780!!

Sorry I've been out of the box for a couple of weeks.  Selling a house, preparing to move, AND the 4th tend to eat up the time.  Back to it today though and we're going to talk about your complexion.  It's easy to find great looking skin when youth is on your side.  How does she do it??
I have a few suggestions.  We start with good skin care and recommend Obagi products for damaged skin and Skinceuticals for good skin to maintain.  The next thing we do is laser treatments.  We like to pre treat with retinols and lightners to calm down the dark pigmented areas that occur from sun and hormones....why??...because treating these areas without pre treatment can cause them to recur with a vengeance.  Pre treatment is not a guarantee that they won't come back but it significantly reduces the problem. 

The next thing we do is recommend laser treatments or IPL.  The laser we use is the Cutera XEO.  For people that have significant sun damage, fine lines and wrinkles from the sun, and pigment issues, we use the Pearl laser.  The Pearl does a number of things well.  First, it helps eliminate skin discolorations.  It helps to create a more uniform skin tone and color.  It helps reduce rough patches that occur from solar injury and it can help reduce fine lines and wrinkles.  Treatment take about an hour using topical anesthesia, some mild oral sedation and the Zimmer which blows cold air on the treatment areas.  Recovery time for most people is about 4-5 days until make up can be used to cover the healing skin.  The skin will stay pink for a few weeks after treatment and gradually get to the uniform color you expect.  Remember that laser treatments take time.  We are stimulating new collagen formation and it doesn't happen over night.  It takes several months.  The newer lasers are less destructive too, so, be prepared to need more than one treatment months apart.  The results are worth the time though.

We like to maintain, after the treatments, with continued good skin care and peels.  We use low concentration glycolic acid peels that can be applied periodically at home to keep the skin looking good.

For pigment issues only we use IPL.  This is Intense Pulsed Light that targets specific colors in the skin, brown spots and red hues.  These treatments, also called photo facials, are effective in causing brown spots to disappear and red areas to decrease.  These treatments also take about an hour with topical anesthesia and the Zimmer chiller.

To recap:

1.  Good basic skin care to heal, maintain, and protect.

2.  Pearl laser treatment to rejuvenate the skin color and texture.

3.  Photo facials with IPL for those with pigment issues only.

4.  Continued good skin care and sun protection.

5.  Periodic maintenance with peels if needed.

There you have it!  The Total Body Surgical plan to keep your skin young looking and vibrant.  Our goal is to make you look good.

Don't forget our specials on breast augmentation, lap band, hair removal, liposuction, and toe nail fungus treatments.

Happy Father's day to all the dads out there and the dads of the future!

Today I'd like to share an offer that will make dad happy and also the moms out there.  I frequently talk about things that make women happy but often neglect the men.  Not today!

Men usually don't need much.  Some food, some sports to watch on tv, a little beer, and every now and then....well, you know.  We usually don't like to make much of a fuss about ourselves but today I want to talk about how to rid yourself of a common problem....hair.

We get hair on our chests and back and abdomen that we don't like.  Not only us, but the women in our lives don't like it either.  They want us to shave it, or worse, wax it...ugh!!  We have a much better solution.  Six treatments or so and guess what...no more hair to mess with.

The laser works to stop hair production at its source, the stem cell.  First, we either have you shave the hair off or we will help do it for you.  Then we use the Cutera Prowave to treat the areas in question.  We count the chest as one area, the abdomen as an area, and the upper and lower back as two areas.  Some want the groin area treated as well and this can be done.  Body hair is usually thick and dark, thus making the treatments very effective and requiring around six treatments to reduce the hair growth to almost zero.  These treatments are done with topical numbing cream and are associated with only minor discomfort.  The treatments take about fifteen to twenty minutes after about 30 minutes of numbing.  We recommend a touch up after a year or so if need to get any straglers.

To re-cap..

  upper and lower back...$50.00/treatment times 2 areas times 6 treatments = $600.00

  chest....$50.00/treatment times 6 treatments = $300.00

You can't beat that anywhere!

Make your appointment today, you don't need to see me, we have nurses that are well versed at laser hair removal and can squeeze you in about any time.

Last week we discussed how Botox can be used to prevent some wrinkles and soften others.  It is a great product and is now more affordable than ever.  Today I would like to briefly discuss what to do about those wrinkles that won't go away with Botox or those that Botox is not appropriate for....what can we do with them??

The most common complaints I see about facial appearance AFTER Botox have to do with residual wrinkles or sunken spots around the mouth.  Here is a common picture that shows and labels the areas we are discussing.  As we age, the face loses volume..ie fat.  We get it where we don't want it and lose it where we'd like to keep it....go figure!

When the volume is lost, of course the skin falls a little creating a hollow area.  When not too severe, these areas can be helped tremendously by replacing the volume with either harvested fat or some other material.This picture demonstrates a before and after of a nasolabial fold filled with Radiesse....Nice result I think.  The area is softened quite nicely.  This is done in the office with very little discomfort and an immediate result.  We could also use Juvederm in this area.  Both fillers last a year or more and there are few problems with them.

Another area commonly complained about is the Marrionette line area.

  Here we see in the before picture how the nasolabial folds are prominent and the marrionette lines are too.  These lines are present at the corners of the mouth and cause the lip corners to turn down.  When filled, the result is pretty amazing.  You get a much more youthful appearance with no surgery and no recovery time.

  A third area complained about is the glabellar area.  Botox works to soften this area but when the lines persist, it is a great place to fill.

These three areas are the most commonly treated spots that we use fillers on.  At Total Body Surgical I use Juvederm and Radiesse.  I think they both work very well.  As I said, they both work for about a year.  We do injections in the office and it takes very little time.  There is no recovery time and the worst problem that can arise is a bruise. 

At Total Body Surgical we have a great deal of experience with many fillers.  For the remainder of the summer we will offer a special on fillers.  If you pay full price for one syringe you get the second one at half price.  That means you get two syringes for $775 and Botox for $9 per unit if you mention this blog.  I use Botox with fillers as it helps them last longer.

We look forward to seeing you soon.  Call 918-786-7780 to set up your time!!

Click on one of the buttons to see other specials currently running.

Why Botox???  Well, look at my picture...see any lines??  Do I look fake or funny to you??  I don't feel funny!!  The best way to summarize the answer to the Botox question is...it makes you look younger.

If that's what you want, Botox is the medication for you.  As we age, the muscles of facial expression work day after day.  Our surprised look, our concearned look, our mad look, and squinting from the sun or when trying to read all lead to eventual wrinkles in the skin.  We get crows feet, lines in our forehead, elevens between the eyes and so on.  This happens to everyone whether we like it or not.  As these lines appear, sometimes as early as the 3rd decade of life, they start to show our age with only a glance.  These lines are difficult to hide with cosmetics and may not only show your actual age but may make you look older than you really are.
  Don't be depressed, have a low self esteem, and lose your confidence, DO something about it!!

What we have today is a whole armamentarium of therapy to make you look your best every day.  Botox is the product I want to talk about a little.  First of all it is very safe.  It is next to impossible to have a severe complication from Botox.  The safety profile is excellent.  It has become very affordable as well.  Usually the cost for treatment of the upper face is around $300.00.  This will generally get the forehead, the elevens between the eyes and the crows feet.  It is very quick and simple to do.  We use the smallest needle we can find and use the highest concentration so that bumps after injection are usually non-existent.  There is very little discomfort and it takes about five minutes.  About the worst that can happen is a small bruise which is rare unless you are taking aspirin or ibuprofen.

  After injection we have you briefly hold pressure on the areas and exercise the muscles we have treated.  In 3-5 days or less the wrinkles will soften and many will disappear.  The effect usually lasts for 3-6 months and for this time, the muscles are weakened and cannot crease the skin as badly.  It does not paralyze the face or make you look "funny" if done properly.  You will look refreshed and younger as the wrinkles fade.  When the strength in the muscles creating your wrinkles starts to return, you will notice the change in the skin and then return for re-treatment.  Most people have 2-3 treatments per year.  After you quit paying for wrinkle creams that do not work and cosmetics to hide the wrinkles that are marginally effective, it is a good investment.  If kept up with, you can go wrinkle free for years and if you keep up with good skin care as well, you will be miles ahead of the game.

Come see us today at Total Body Surgical, we are specialists at Botox and all other aspects of Cosmetic Surgery.  Also Click on any of the flags to see specials.  Mention this blog and get Botox for $9.00/unit.  Call 918-786-7780 for a visit today!!

Let's talk about a common problem that we can help with.....acne.  Acne vulgaris is a common problem in adolescence that can continue or leave long lasting changes through adulthood.  It most commonly occurs on the face and back but can cause problems almost anywhere.  It occurs in these places most commonly because of glands that produce a large amount of oily material.  The pores become "plugged" with this thick, oily material and bacteria (germs) get in the mix causing inflammation and pimples.  It occurs when hormonal levels are peaking, thus the high rate during adolescence but adult acne is also a common problem. 
Certainly, acne is not a life threatening condition but it can ruin self esteem and lead to life changing and permanent skin damage.  It can cause scarring and pitting of the skin that will carry through life in severe cases.  Many of us have mild and sporadic breakouts that are only a minor problem, but for some, acne is a curse that can ruin social interactions and make us very self conscious.

At Total Body Surgical we take a systematic approach to the treatment of acne.  I like to evaluate at the initial visit how severe the problem is and what potential for permanent skin damage there is.  If the problem is not severe, we start with a good skin cleanser that contains salicylic acid to remove the oil the skin is producing.  I like the clarifying cleanser made by Skinceuticals.  We also like benzoyle peroxide products for a topical kill of bacteria. Retinol or tretinoin is also used topically to help the skin turn over quicker.  This is usually our first line of treatment for even the worst cases.  For more severe problems I will add a topical antibiotic gel or start treatment with an oral antibiotic at low doses to decrease the inflammation and lower the bacteria count.  These steps will usually make the condition improve a great deal, at least enough to make it tolerable.  If not, the next step we use is the Cutera 1064 laser.  The laser genesis treatment is painless and quick with no down time.  We use the laser to gently warm the skin to a temperature  that eliminates the bacteria causing the problem.  This is usually very effective and allows the other treatments to take hold.  It is also a good way to get ready for special events...treat a week or so before and have a clear face!!  These treatments can be done at 4-6 week intervals and are very affordable.

Now for the severe cases...the dreaded Accutane!!!  I am very careful when I choose patients to use this medication.  They must be reliable and have good supervision from a parent.  The i-pledge program must be followed as well which gives good counseling about pregnancy prevention while on the medicine.  Accutane IS a great drug...it works almost universally.  It can, however, have some severe side effects that are not very common (regardless of what the lawyers on TV portray).  It can cause depression leading to suicidal thoughts, headaches that can be severe, birth defects if you become pregnant or make someone pregnant while on the drug, very dry lips and skin, dry eye....and the list goes on.  Most treatment regimens start at full dose and after clearance of the acne we switch to a lower dose program which seems to be effective.  Any of the above problems that become severe may require a stoppage of the medicine. 

I have found that most individuals will require a minimum of 6 months of Accutane and some may need more than one course of the medicine.

For those with permanent acne scarring we offer the Pearl laser.  You must be off of Accutane for a minimum of 6 months to qualify but these resurfacing treatments help tremendously to soften the scarring.  Down time is around 4-5 days and treatments can be repeated to desired effect.

If you need help with acne...give us a call at 918-786-7780...we'll be glad to give you the help you need.  Don't forget our laser hair removal...$50/treatment/area special too!!