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...

Let's talk about liposuction ....again.  If you didn't see this spot on the 40/29 Fayetteville, Arkansas news, have a look!

http://www.4029tv.com/news/30406524/detail.html

Remember "smart lipo"??  Well, it is still around but there have been improvements.  Smart lipo is when a laser is used to destroy fat cells in problem areas.  It has been touted as being less traumatic and with faster recovery times.  It became available in 2007 and was all the rage for awhile.  I was in my cosmetic training at the time and we were the first ones in Oklahoma to have a machine and we taught courses on how to use it for Cynosure, the manufacturer.  The idea was that the laser energy destroyed the fat cell and the remains were resorbed by the body.  The skin would contract and you would have a new contour.  What we found (and what many studies have shown) is the results were not as good as traditional liposuction because the volume of fat destroyed and removed was not adequate.  What has been shown is that the heat generated by the laser does cause the skin to contract better than with traditional methods.  The take home message is this...liposuction is best for removal of fat and contouring the body.....the laser energy works to heat the skin and cause it to contract to its new position.

So what is "lunch time" lipo??  It is combining liposuction, laser liposuction, and tumescent anesthesia to treat small problem areas without sedation or other anesthesia.  The key word is SMALL.  We all know, through intuition, that a procedure that involves treating a large area or multiple areas cannot be done without some recovery time AND for larger areas we sedate you for comfort and to make it a good experience.

At Total Body Surgical our Laser liposuction is done a little differently.  I use the CoolTouch laser that has a slightly different wavelength, the major difference is the cannula we use.  With traditional liposuction the fat is removed with a hollow cannula.  If the Smart Lipo is used, the laser cannula is then used to heat up the skin causing contracture of the skin.  With our machine the cannula is combined.  This allows me to liposuction and laser simultaneously, saving time with better results.

Come see us for a complimentary consultation and I will cover options with you.  What is a "small area" that would qualify for the lunch time procedure??  It would be a single area such as the neck, saddle bags, inner thighs, lower abdomen, hips.  You would arrive at the office and we would mark the problem area in question.  We would numb the area with tumescent solution and make a small incision in the skin.  The cannula is inserted and the laser turned on.  The fat is removed and the skin heated simultaneously.  You may drain from the areas for about 12 hours and we would want you to wear a "spanks" garment for 3-4 weeks.  You may have some bruising and some minor discomfort for a few days.  Please see my portfolio page to see some pictures of my patients before and after photos.  See our lipo specials too...we have great deals for the spring. 

Last week I began the discussion on surgical options for obesity.  This week, the topic will remain the same but more In depth.

First, however, I would like to tell you about the AACS approved conference I just attended in California.  The conference was held in the Sacramento area and covered Liposuction, Tummy Tucks,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      Butt implants and Augmentation with fat.  I gave lectures on difficult tummy tucks and combining tummy tuck with other surgery.  I also gave a lecture on how to avoid blood clots that can sometimes occur around the time of surgery and lastly I lectured on advanced liposuction techniques.  The course was a roaring success and afterward we all spent the day in Napa Valley trying out some California wines.   The course was attended by physicians from as far away as Viet Nam….pretty cool.  I always learn good stuff at courses too, even if there in a teaching mode and this time was no different.  I learned some new and cool ways to shape butts and make them larger with both fat and implants or both.  I have had a fair amount of experience with these techniques but I learned some new tricks.  Now is the time to hit me up if you need a rear end overhaul!!

Now, back to obesity surgery. 

If you look at statistics for all types of obesity procedures, you will find some interesting facts.  Most of these studies look at the percentage of excess body weight (EBW) lost over a set period of time.  The way EBW is measured is by subtracting maximum weight from Ideal body weight.  This gives us a number that can be measured and compared.  If you compare bypass, sleeve, and lap band procedures, in the short term time frame, the bypass and sleeve appear to work better than the band.  However, even though most people would like to lose their weight quickly, they also know that this may not be the best for them.  The lap band is slower and requires adjustment, not because it loses volume, but because the anatomy changes as we lose weight and the band loosens.  With the bypasses, no adjustments are necessary.  The interesting thing is that the studies looking at EBW at the five year and older mark are nearly the same!  There is only a 2% difference between the lap band and the more invasive procedures when losing weight.  In other words, if you are overweight by 100 pounds and we look at your progress at 5 years, if you have had a bypass you will have lost 58 lbs on average or about 58%.  If you have had a Lap Band, you would have lost on average 56 lbs, you would have just lost it a little slower.  Pretty interesting!!  Many people have knocked the band in the past for not being as successful.  After looking at these numbers, the only difference is 2% at five years, AND your anatomy has not been permanently changed, AND it can be removed if you want it gone, AND your problems with vitamin deficiency, muscle and other protein wasting will not be as severe.  What I am not saying is the lap band is for everyone as clearly it is not.  At Total Body Surgical Cosmetic Surgery, I like use fairly clear parameters for those I think it is best for.  I think it works better when the person has a BMI between 30 and 50, has few or no comorbid conditions.  Larger patients are generally sicker from their weight and need to lose it faster.  With the lap band, you will need supervision, you will need weigh in’s and volume added to the band to help you lose the weight.  You will change your personal dynamic with food. Below is a youtube showing how the procedure is done.

http://youtu.be/KPuThbFMxGg

More next week....

Remember the breast special, the laser hair removal, and vein specials we currently have going!!

http://www.totalbodysurgical.net/breast-aumentationact-now/Default.aspx?utm_campaign=Grand-on-GRAND&utm_source

-LOVE YOUR LEGS......AGAIN!!!!

-Laser HAIR Reduction....buy one area and get one F

I hear you....OK....it has been a lot of information on skin...I know.  This will be the last installment on skin, at least for a little while.  I am going to talk a little about skin color changes or dyschromias.  No YouTube this week...couldn't find a good one for ya'll.

What causes dyschromia in our skin??  The same old things...too much sun and poor skin care habits.  Added to these problems are hormone changes, rosacea, venous changes in the skin, skin thinning with age, etc.  All of these problems create the browns and reds that become apparent as time progresses.  The terminology for dark spots are poikiloderma or brown spotting that usually occurs on the chest after years of tanning and melasma or brown discoloration on the cheeks and face in a mask like distribution.  Melasma can occur in younger women during pregnancy and is certainly related to hormonal changes with pregnancy and menopause.  When the sun is added to these changes, it can be dramatic.  We also can get vascular changes in the face.  The most common areas are on the cheeks and around the base of the nose.  Here you may see visible veins, small cherry red spots, even a generalized redness.

After identifying the changes, what can we do about them?

There are many approaches and all of them begin with good basic skin care.  I recommend some type of retinol cream and a topical vitamin C along with this.  To help tame those brown spots I also add hydroquinone to turn off the melanocyte that produces the pigment.  Retinols are vitamin A compounds that help thin the "dead" layer of skin and stimulate growth of new skin.  Over time they make a big difference.  Sun screen is also crucial to help stop the damage.  At Total Body Surgical, we use the Obagi system because they are pharmaceutical grade and make a dramatic difference over time.

After taking care of the basics we can address the color issue with lasers and Intense Pulsed Light or IPL.  The IPL is a flash lamp system with wavelengths that target the pigment we want to get rid of.  The reds are diminished and the browns crust off while turning off the melanocyte.  IPL treatments are usually done in a series of 3 to 5, about a month or so apart to be successful. Vascular lasers are used to treat hemangiomas, visible veins, and larger red spots. These treatments can be combined with milder forms of laser skin resurfacing.  At Total Body Surgical we use Cutera technology.  This system has the Limelight IPL system that is good at treating multiple pigments in the skin.  We also have the Pearl which is mentioned in this segment,

http://youtu.be/0goYcY3LTqQ

The Pearl is a good way to get immediate results with the added benefit of "buffing" the skin.  This creates a new skin feel that is softer, recreating that glow that is age defying.  The treatments can be "stacked" on each other to get the benefits of both.  When used for treating pigment, recovery times are usually no more than 4 days.

Well, that about covers the face.  From facial skin care to face lifting and implants.

We have extended the breast augmentation special pricing through July so don't miss out, -Breast Aumentation....ACT NOW!!!

I am also working on a special Pearl package for the fall (you should not be tanning when we do it) as this is the perfect time to start.

Next week....tackling obesity with the Lap Band!!!

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