Total Body Surgical Blog

Let's have some fun today.  It's been a little while since we had a little audience participation and I think it is time to change that.  Sooo, it's test time again!! 

Here are the rules:

1.  Look at the picture and see what you think would help.  (those of you who come here often will find it easy...you are educated!!).

2.  The choices will be between using Botox, a Filler of some sort, laser, or a surgical procedure.

You may elect to combine the use of these tools and that is OK.  I do it all the time.  Today though, let's not get too complicated.  In my analysis of the patient I will give you some ideas on what other things would be good for the patient.  I need to feel useful in some way!!

Always remember, there is no right answer, because, in Cosmetic surgery everything is elective.  You can always choose to do nothing.  However, there are wrong answers.  Wrong answers are when you plan to do more than the patient needs or wants.  My job is to steer people away from unecessary procedures and only do what's needed or desired...today, that's your job.  Good luck!!

Example #1: 

Here we have a 40'ish female with no other medical problems.  She complains that she looks "old" and wants a face lift or something to help her look the way she feels.  Look at her closely.  What do you think??

What would you recommend:

1.  Botox  2.  some type of filler  3.  laser  4.  a surgical procedure

Example #2:

40'ish young lady who complains about the lower part of her face sagging.  Her friends have told her that you have helped them and she should come talk to you about what could be done.  You would recommend???

  Your recommendation??

1.  Botox  2.  a filler of some type  3.  laser  4.  a surgical procedure

Example #3:

A 54 year old lady who is disgusted with her neck and just thinks she looks OLD!!  She says that cost is no obstacle and wants it all fixed, or injected, or something! 

 And the winner is....

1.  Botox  2.  some type of filler 3.  laser  4.  a surgical procedure

Example #4:

28 year old female who states her boyfriend says she has "wrinkles around her mouth".  She is concearned about this and wants to know what you think....

  Here she is...

1.  Botox  2.  Some type of filler  3.  laser  4.  surgical procedure  5.  get a new boyfriend!

Example 5:

A 65 year old widow comes to you and says she has finished mourning the loss of her husband and wants to look younger so she can "get out there".

  Very nice lady....funny too....what would you recommend??

1.  Botox  2.  some type of filler  3. laser  4. Surgical procedure  5.  Birth control

Well, let's see how you did.  On number one if you said Botox, that would be a great start.  Most people want to start small.  Botox would get rid of the lines around the eyes and in the upper face.  She will eventually probably want a brow lift to eliminate the lines and the cause of them but Botox is fairly cheap and less invasive.

On number two, I would say Botox and some type of filler.  This combination is great for softening wrinkles in the upper face and getting rid of nasolabial folds as this lady has.  She has good facial structure and her skin is in good shape.  This will make her very happy and not cost a fortune.

On number three, I would recommend a surgical procedure or two.  Looking at the "hooding" over her eyes, she would benefit greatly from a brow lift.  It will take years off of her appearance.  She also has the "turkey gobbler" neck and jowling but her neck is not heavy.  I would recommend a mini lower face and neck lift as well.  She will be very happy!

On number four....get a new boyfriend of course.  We see people like this sometimes and my job is to DO NOTHING.  She needs to be told how beautiful she is and just how silly it would be to do anything to change that.  Unfortunately, in many cases, these people will find someone to mess things up.  It's sad.

Number five would need a brow lift, upper eyelids, face lift, and I would also recommend full face laser to treat the discolorations and fine lines on the rest of the face.

I hope you did well on the quiz today, and enjoyed using your own evaluation skills.  If you like, let me know how you scored and if you have anything you would like addressed, send that too.

Call us at 918-786-7780 or 1-877-weight-0 to make an appointment.

Possibly more changes on the horizon for weight loss surgery are in the making.   

These changes will have an effect on the entire landscape of bariatric surgery in the U.S.  First, a little history....

When bariatric surgery first started (weight loss surgery) there were few regulations and a multitude of procedures that were tried.  All procedures were done through a large incision and most of the patients are high risk due to their weight and many other additional medical problems brought on by the weight, i.e., diabetes, high blood pressure, heart disease, sleep apnea, etc.  This combination led to a high complication rate and high mortality.  What has changed in the past several decades to make these procedures much safer is the innovation of laparoscopy.  This allows us to do the procedure with tiny incisions, fewer wound problems, much less pain, and shorter hospital stays.  Other changes that have happened are the standards that were set for bariatric centers. These standards were fairly rigid and the procedures done were made more standard.  What we have learned is the bariatric patient needs a higher level of pre-operative evaluation and post-operative care than the average patient.  Because of this, the American Society for Bariatric Surgery was formed and guidelines were created to improve safety and "centers of excellence" were created.  Centers of excellence were formed based on criteria set for pre and post op care, and a minimum number of cases done in a year. 

After gaining experience and analyzing a ton of data, it was discovered that the center of excellence really does not change outcomes.  What this means is you can have a procedure done at a center of excellence or a non-accredited center and have just as good an outcome.  The net effect of the center of excellence has been to limit access for medicare and medicaid patients with no real benefit.

After joining forces, the American College of Surgeons and the American Society for Bariatric Surgery are trying to change (in my opinion for the better) the center of excellence guidelines.  Here is what the proposed changes will look like:

1. Three divisions will be set up, the first being band centers, where only lap bands will be performed.

The Gastric Band on the stomach.

The second division will be "low acuity" centers of excellence.  These are smaller facilities "like INTEGRIS Grove hospital" that have qualified surgeons but limited ancillary services.  These centers will be able to do staple procedures on "lighter" individuals with few other medical problems. In other words, healthier, lighter patients will be able to have their procedure done on a more local basis and not have to travel to big centers.

Sleeve gastrectomy                                               Gastric bypass

In these lower acuity centers, the work up is the same and all of the patients are tracked by a National Data base.

The third division is the high acuity center.  This is where heavier and more complicated patients will have to go, usually in the larger regional hospitals.

This is the proposal that was sent to the CMS (Medicare).  However, they have different ideas about the whole thing.  CMS, looking at the data, thinks that possibly communities would be better served if the whole center of excellence thing was just eliminated.  They do have a substantial amount of data that shows there is no improvement in outcomes.  Now the Politics come in.  What politics?  Well, current centers of excellence don't want any change and centers that want to gain this distinction can't because the number of cases that must be performed, under the current rules, cannot be reached.  The number of people needing the surgery continues to grow and many cannot get to a current center of excellence for care.  My feeling is that if you have a qualified surgeon and a program in place....what difference does it make.  People that need the surgery should not have to travel hundreds of miles, and according to the data, it makes no difference.  Hopefully, a reasonable compromise will prevail....and soon.  Many programs, ours included, are sitting on go, waiting for some sort of direction.  In the mean time, we are limited to private pay patients and private insurance patients currently.  We are looking for some type of decision in 2014 and are hoping for good things.

   Of course the changes will mostly only effect Medicare and Medicaid patients but some private insurance as well.

So that is what's on the horizon...better access.  We hope to be a low acuity center in the very near future as Dr Miller is fellowship trained, certainly qualified, and ready to go!

Our cash prices are pretty good too (see below) and you don't need to travel to Mexico either!!

So come see us today!!  Cosmetic consultations are always complimentary!! The spring laser liposuction special is going on so act now to reserve your time!  918-786-7780 or 1-866-weight0.  And don't forget our low prices on breast augmentation either!!!

Keep an eye out for the news reports on the sleeve gastrectomy!!!

Winter time is vein time a wise man once said (that's me ya'll)!!

Why is winter time the time to worry about those pesky leg veins??  Well, it's because you are already wearing pants.  In spring and summer we want to wear shorts, or other more revealing clothing, it is then too late to conseal any ongoing treatment.  In winter, the healing process can take place under your clothing and people won't ask too many questions.  Now is the time to treat spider veins and larger varicose veins.

Spider veins are small areas that most of us get as we age.  These are pesky and ugly but usually do not indicate any major underlying problem with the larger venous system, although they can be an indicator.  They look like the skinny legs of a spider, thus the name.  They can also look like a bruised area that doesn't go away.  Spider veins progress with time and can be made worse by certain occupations..standing, etc.  They usually cause little concern except for their ugly appearance, however, they can become large enough to bleed if traumatized and an episode like this can be very frightening. 

What do we do for spider veins??  The best way to handle them is with sclerotherapy.  Now that may sound scary but really it is pretty simple.  We inject the veins with a chemical that causes them to stop working.  Sometimes a small clot forms in them and over time, your body resorbs the clot and vein eliminating the problem.  The process is fairly easy, quick, and causes minimal pain.  We have you wear a tight (compression) stocking for about two weeks after the injections and after that....nothing.  You may have some areas of pigmentation in the area for a few months and this usually resolves without further treatment.  Because this problem is superficial, most insurances consider this treatment Cosmetic and will not cover it under the usual policy.  We charge $350 per treatment and a treatment consists of two vials of the solution we use which is the safe amount at one sitting.  If more treatments are required, we usually wait about 6 weeks before re-treating.  Small areas usually require only one session.  Big, or multiple areas may require several sessions.

For a little larger veins we call reticular veins, we still use the sclerosing solution.  Sometimes it is used in a higher concentration and we use an instrument called a vein light. 

The vein lite allows me to see the larger veins under the skin that fill the small spider veins on the surface.  This instrument produces a very bright, circular light that produces no heat and is very good at showing reticular veins as you can see from the picture above.  I can then inject them with the sclorosing solution, stop the blood flow, and with time, the vein is eliminated by the body.  I usually try to find and eliminate any of these veins at the time I do the routine sclerotherapy.  Again, stockings should be worn for two weeks after the therapy and strenuous exercise is avoided for two weeks as well.  This helps in preventing future spider veins originating from this one source at least.  

Maintenance may be required when treating spider veins.  They usually sneak back into your life after a few years, even if all of them are eradicated along with the reticular veins.  I like to recommend that less is more....in other words, if we treat a large amount the first series of treatments, it is a lot easier to keep up by treating small areas as they arise.  Don't let them get out of hand again.

Varicose veins treated the modern way, with laser, require minimal down time and are done in the office.  It usually takes about 3 months to get insurance approval so you need to start now.  If you have varicose veins that are ugly, hurt, cause leg swelling, and create embarrassment....come see us to get started on effective, easy treatment today!!!

varicose veins.

Call 918-786-7780 or 1-877weight0.

  If you have not looked at this offer in the red box....you may be missing out on the opportunity of a lifetime!

What does skin cancer have to do with you?  Quite a bit actually.  Skin cancers are the most common cancers and that is when compared to ALL other cancers.  There are 3.5 million skin cancers diagnosed each year and another 77,000 cases of melanoma.  The incidence of all types of skin cancer are on the rise for an unknown reason.  One can speculate however, i.e., tanning beds, less coverage of skin with modern fashion, changes in our atmosphere, etc., etc.  But nobody really knows why.

As you can see from this graphic, this is a common problem.  Of course, there are several types of skin cancer that are common.  There are types that are not as common.  Then there are very rare types that are beyond the scope of this discussion.

Let's talk about the most common types first.  Basal cell carcinoma's are the most common types of skin cancer.  As the name suggests, this type of tumor arises from the basal layer of skin and is associated with UV or sun exposure.  This type of skin cancer comprises about 2.8 million of the 3.5 million skin cancers occurring in 2012.  These tumors very rarely spread to lymph nodes or other organ systems.  They start off small...

 are often ulcerated with raised edges.  Like a sore that never goes away.  They usually only spread locally and can become quite large if left alone...

  They can locally invade through bone and can require extensive surgery to remove.  It is therefore wise to seek advice while these lesions are small and easily removed.  We usually remove them surgically but they can also be removed by a Moh's procedure.  After complete removal the tumors rarely come back unless there are multiple areas involved (multi-focal tumors).  Also, the sun damage that caused the original tumor is also present on other exposed areas.  Therefore, once one is removed you must be diligent to identify and remove other tumors.

The second most common tumor, accounting for about 700,000 cases, is squamous cell carcinoma.  These tumors arise from the superficial layer of the skin and are also associated with sun exposure.  Squamous cell carcinomas involve the most superficial layer of skin.  They are usually scaley, thinner tumors in sun exposed areas.  Unlike basal cell cancers, these tumors can spread to lymph nodes in about 2-3% of cases.   This is why removal of these tumors early is a good thing. 

The big daddy of skin tumors is the melanoma.  It arises from the pigment cell in the skin called the melanocyte.  These tumors can be nasty.  About 70,000 of these tumors were diagnosed in the U.S. last year and it seems that it is on the rise.  Melanoma can spread about anywhere.  From the brain to the eye, spread of the disease is a tough problem.  These tumors can occur any place in the body that has pigment cells.This picture is pretty classic for a nodular type melanoma, irregular, varied color, and a nodule.  They can, however, look like a normal mole.  Any pigmented lesion on the skin should be watched for change or increase in size.  Treating melanoma early is critical to survival and recovery.  Early treatment means less chance of spread to other places.

There you have it, a quick primer on common skin cancers you need to look out for.  Come see us for these problems and we can help.

918-786-7780 or 1-800-weight-o.

Re-do what?  I have lots of patients that ask about how long a cosmetic procedure will hold up or "last".  I think that is a fair question in most instances.

First, the face.  When people ask me the question before a facial procedure, the analogy I like to use is daylight savings time.  When you have a facial procedure, basically, we are resetting the clock on your appearance.  You will continue to age, just like time continues to tick away in daylight savings time.  In other words, the change is permanent, but aging continues to change your appearance.  The procedure most often repeated is eyelid surgery.  Eyelids move constantly, the skin is very thin, and the eyelid skin is exposed to a great deal of sun.  The nature of the skin is to stretch and when used a great deal, it will stretch more.  Upper and lower eyelid surgery, the second time, is usually less traumatic than the first time because the fatty tissue has already been removed.  That means that only the skin is removed in the second procedure.  The second procedure most often repeated is the facelift.  Again, after the first procedure, as we continue to mature, the skin continues to stretch and the floppy neck or jowel may return after 15-20 years.  A second face lift is easier because of scar tissue that forms gives us more tissue to work with so sutures hold better and dissection is less involved.  The procedure that holds up the best is the endoscopic brow lift.  Since the low brow is usually heredity related, once the brow is lifted it tends to stay put.

Second to discuss are body procedures.  Tummy tucks seldom need re-doing unless you have severe changes in weight or have a pregnancy after the initial procedure.  That is why we encourage women to be done reproducing before considering a tummy tuck.

The same is true of most other body procedures, thigh or butt lifts, arm reductions, etc.  Liposuction is seldom repeated in the same area except for touch-up prodedures since most of the fat cells in that area have been removed.  Of course, if you do gain weight, it will appear in other areas and the repeat procedure will be in that area instead of the old site.  In other words, if you have your abdomen done then gain 20 pounds, you may notice that your arms or thighs are where the weight is going.  The reason is, the fat cells that used to store fat in the abdominal wall are gone or greatly diminished in number and fat can no longer be stored there...it must go somewhere else.

The third is the breast.  This is a whole other animal sorry to say.  The breast is somewhat unpredictable.  For breast augmentations, they look great in younger women and generally hold up well with two caveats....pregnancy and weight changes.  Most women look fantastic with their breast implants... until pregnancy.  Then, in some, the wheels come off.  The breast inlarges during and after pregnancy, breast feeding occurs, and for some, the process repeats itself over and over.  After several pregnancies and several years the breasts start looking sad.

They droop over the implants or sometimes take the implants with them.  In these cases, the only solution (after a tubal or vasectomy) is a breast lift, removing the old implants, and deciding whether to replace the implants or not.  The only way to get fullness in the upper part of the breast in this situation is with an implant so it just depends on the final outcome you are looking for.  Of course implants can always be placed later.

Hope this helps answer your questions and don't forget all of the special pricing we have going on with hair removal, tummy tuck, and weight loss surgeries!!

Call for complimentary cosmetic consultation 918-786-7780 or 1-877-weight-0.  We can't wait to hear from you!

  Do you ever feel like this?  What is a brow lift and when do I need one?  How do you know if it's the eyelid or the brow?  This week I hope to give you the information you need if you have these questions, or know someone who does.

  Many people show up to the office wanting their eyelids done.  The eyelids droop, look bad, and sometimes even effect their vision.  The question is..this, is it the brow, the lids, or a combination of the two?

If you look closely at this picture, what do you see?  First, it looks like her lids are drooping.  On closer inspection, the problem is a little more subtle.  If you look at the brow position, it is very low.  There is a hood over the outside of the eyelid and out over the outside of the eye.  This is a tell-tale sign....lateral hooding.  The second thing you notice is how low the eyebrow is in relation to the eye.  In females, the normal position should be above the boney rim of the upper eye and should have an arch to it that is highest at about the outer iris (colored part of the eye).  Her brow is far from being in the proper position...it is very low.  She may come asking to have her eyelids fixed, and without further examination, she may be right, but the primary problem is her brow.

Brow ptosis, or droop, is a problem that can be multi-factorial.  It is partially hereditary and is added to, as a problem, by facial fat loss.  It can cause cosmetic issues, making you look older, tired all the time, and causes wrinkles in the forehead due to over-use of the muscles in the area so you can see.  Brow ptosis can also cause visual field problems.  Our peripheral vision is dependant on a clear field of vision, up, down, medial and lateral.  What the droop can cause is an occlusion to the vision.  Once the brow falls significantly, it is like having blinders on a horse, you can only see straight ahead!

In many cases, the brow droop is accompanied by upper lid laxity (blepharachalasia) as well.  When this happens, we try to address both problems at once.  For older patients with visual problems, we establish the problem exists first by doing a "visual field" test.  This establishes if your vision is actually effected by the extra or low tissue.  Then the lid or brow is taped out of the way and the test repeated.  This allows us to tell if removing eyelid tissue or elevating the brow is indicated, or if both are indicated.(Visual field testing.)

 This is a great example of an eyelid problem only.  If you look closely you see that the brow position is exactly as we discussed.  The brow is in a good position as far as it relates to the boney part of the eye socket, and it is arched nicely.  Also note that there is no lateral hooding present as we saw in the previous picture.  It is the eyelids that are the problem and a simple blepharoplasty is sufficient to fix this.  This is a great result by the way, off of google images.

 A blepharoplasty means removing skin from the upper eyelids and often a small amount of fat.  This gives you back the lid platform for eye make-up, makes you look less tired, and is very rejuvenating, knocking several years off of your appearance.  I usually do these in the office, mostly under local.  It takes about 45 minutes or so, you go home after, there usually is no more than minor bruising, and after healing several months, you can't even see the scar.  It is a great procedure.

When a brow lift is done for cosmetic purposes.  I do them using a scope and a camera.  Some people still make a large incision on the scalp but I think the scope gives great results without significantly moving the hair line and without a big scar.

This picture depicts where the small incisions are placed for a brow lift.  We shave no hair, the hair line stays the same, and the results are just as good as the old big incision.

This shows a nice result from a brow lift.  She looks much younger and the hoods that she had before are now gone.  The brow position is arched and good...no surprised look.

If you are dealing with these problems, come see us today at Total Body Surgical.  We can help...call 918-786-7780 or 1-877-weight-0.

I hope everyone had a great 4th....time to get back at it. 

One of my friends asked me to address those unsightly veins that show up on the face.

  Here is a good example of what I'm talking about.  These are from a condition called rosacea that causes inflammation and eventually the larger veins that appear on the cheeks and around the nose.  The problem is usually made worse with heat (i.e. working in the yard during summer) or consumption of red wine.  It can occur in all ethnic groups but is much more visible in the lighter skinned groups. Rosacea is treated with topical medications, oral medications, and light therapy which will be covered later. 

 Rosacea can also have a deleterious effect on the color and shape of the nose.  Known as "rhinophima", the nose becomes red with acne like lesions that eventually cause the nose to become misshapen.  It can also cause very large veins to become visible.

 The veins that appear at the base of the nose are very common as we age.  Some people have them worse than others of course, but lighter skin tends to allow them to show up more prominently.  They can occur with or without rosacea.

 Here is another example of a facial vein that sometimes bothers people.  This is known as a facial reticular vein.  They can occur around the eye and temporal area.  They are present in young and old alike.

 In some instances, instead of visible veins, just a "redness" is seen.  This probably is just early rosacea and should be treated as such.

How do we treat these problems?  The treatment depends on what the cause is and how severe the problem has become.  With rosacea, we treat it topically and sometimes with low dose antibiotics when it is early and large venous areas are not present yet.  Once outbreaks are controlled, the redness usually subsides.  If it does not, the next step would be to use Intense Pulsed Light treatments to close the small capillaries that are flushing and causing the skin to turn red.  These treatments (also known as IPL) use bright flashes of light of a certain wave length to damage and close the small vessels that are causing the problem.  Usually several treatments are required, sometimes up to 5.  These treatments will controll the problem for some time after, but usually not permanently, so treatments may be required every few years or so.

For the larger veins, in the cheek, nose, and base of the nasal area, we use the vascular setting of the Cutera 1064 YAG laser.  Using a very small spot size, the veins can be closed and they are no longer visible.  In some cases, we will use both the laser, and the IPL in combination.  This treats the redness that is generalized and the larger veins that are too large.  The treatments are generally pretty quick and the discomfort is tolerable.  We use numbing cream for most as well as the Zimmer chiller that blows cold air over the treated areas.  For larger treatments we will call in Valium if needed.

Reticular veins around the temples or eyes are also treated with the YAG laser.  They may be a little sore after treatment for a few weeks until the body resorbs the vein and some bruising is possible though not very common.

The nasal effects of rosacea can be severe if left untreated.  The laser is used to control the venous problem and it helps with the sebaceous problem as well.  Left alone, the nose can turn into a trunk so treatment is necessary.

All of these treatments are done in the office with little or no sedation.  The treatments alone are fairly quick, taking only a few minutes.  Usually there is only a mild amount of redness after, though there can be some areas of ulceration or skin slough.  These areas usually heal very well.  Ideally, you come in and have the treatment done, leave with a little redness, after that resolves, the veins and redness are gone or greatly diminished.  As I said before, more than one treatment is usually required and are done 4-6 weeks apart to allow for healing.

So, if any of these things are bothering you, give us a call at 918-786-7780 or 877weight0 toll free.  If you have any questions, fill out a contact form and I will try to answer it for you.

I hope this helped some of you understand a very common problem.

For the past several weeks I have taken the time to reflect.  Some of the time has been spent venting here, mostly, the time has been spent on my back deck looking at the lake and re-evaluating some things.  This week I wanted to touch on a few points that I think are important and how they relate to Cosmetic Surgery and Bariatric Surgery...namely, happiness and fulfillment.

Now first of all, I am not a philosopher.  I did take several classes in the subject in college and I have read philosophy since, but I am not a pro. 

As children, all of us start off pretty happy.  We really have no point of reference to create sadness.  Whether we are rich or poor, have good parents or not, are good looking or not as good looking as we think we should be, we are usually content with our existance.  Then society steps in to tell us all the reasons we should not be happy.  The TV tells us that if we don't have this gizmo or that, this car or that car, blah blah blah, we are inferior to others.  The process worsens in school as peer pressure takes over, and the process goes on and on as we get older. 

We all reach points in our life where we are not happy with some portion of ourself or our situation.  Maybe we are overweight, maybe there is something about our body that is making us unhappy, maybe it's our job, family, belief system, or a combination.  I personally think that it is OK to be unhappy about some things and it is OK to strive to improve them.  For instance, if you were unhappy with your employment situation, you could start investigating new career options, start taking some classes, if that is what is needed, and start a new career path.  If your marriage is not so great, you and your spouse can seek counseling sessions to find out why your compatability has waned and start communicating better.  We have all seen situations like these where people improve their lives dramatically with a little self improvement or education.

What if we are too heavy?  Of course starting off with exercise and diet may help.  Physician directed diets and medication are also accepted methods and are, for some, successful.  However, when they fail, it is also perfectly acceptable to seek a surgical option.  My philosophy is fairly simple when it comes to bariatric surgery and similar to the philosophy when treating drug abusers....if you don't get it under control, it's going to kill you, so do whatever it takes to get it under control.  For any addiction problem, it may mean drug rehabilitation and for the morbidly obese, it means bariatric surgery.  The two problems are very similar as both deal with controlling desires and changing lifestyle.  Rehab is a tool, and so is weight loss surgery.  Let me tell you, once a person loses 150 lbs, they become happy.  They realize that the extra person they have carried around for all those years has made their life miserable, socially, physically, and otherwise.  Life for these people becomes much more fulfilling because they are happier, their self image restored.  They are now able to get out of the house, socialize, play with their children or grand children, work and become better providers.  Most of all, they get rid of the stigmata of obesity that society tags them with.  I find this an exciting and life changing event.  We have one life to live so live it to the fullest.  If your weight is prohibiting this and all else has failed....what's stopping you?  Don't let those that don't have the problem dictate what you do.  Obesity is a dangerous problem that WILL shorten your life so fix the problem if you can.

Cosmetic surgery falls more into the "want to" category, but is no less important.  People that have some sort of Cosmetic problem are no less self conscious than the obese person.  Whether it is breasts that are too large or too small, stretch marks after children or a sagging lower abdomen, or facial changes that occur with age, all can cause a person to be less able to fully participate in society, be happy, and fulfilled.  We have the ability to correct these problems so why not be happy.  Of course most say that "happiness comes from within" which is a statement I believe in.  However, if fixing a Cosmetic problem gives one the self esteem to let that happiness out....I say fix it!  Again, don't allow others to dictate what will make you happy, and remember that most of them would have something done if they could.

Our lives are a gift from God.  It is our job to make the best of that life.  Live every day like it is your last, and do whatever it takes to be fulfilled and happy, even if that means fixing something.  Love deeply, laugh out loud, cry when you need to, make good friends and cherish them, treat others like they are family (but love your family a little more), hug everyone, and most of all, thank God every day for what you do have in life.  Pretty simple, but now you know my philosophy. 

Come see us....we will treat you right, and Cosmetic Consultations are always complimentary.

918-786-7780 or 1-877-weight-0.