Total Body Surgical Blog

Hey everyone!!  Hope ya'll are avoiding the flu bug...bad deal!  People are dropping like flies around here.  The epidemic should be over in a couple of weeks and we'll all be feeling better.  In the mean time, drink plenty of liquids and keep the tylenol handy.

What I want to talk about today is the other epidemic we face in Oklahoma, and essentially the entire country....obesity.  As most of you know, we are in the process of becoming a center of excellence for bariatric surgery.  The new guidelines are out for review and if accepted in the current state, we should be there this year.  What that means is, we will be able to accept Medicare, Soonercare, and most other insurances.  This is good news.  Our goal is to provide quality care locally, big city care with a small town twist.  We are also committed to giving great value, the best pricing around.

We are in the process of doing seminars in multiple towns in the area.  The schedule has been set, but not finalized.  The first one was in Grove this past week and it was a great success.  They last about an hour and cover weight loss surgery, post weight loss cosmetic surgery, and a little about veins.  It's a great opportunity for us to meet you and for you to see what we are about.  It also gives you the chance to start the ball rolling to the new you.  With the lap band, or the gastric sleeve, you can expect to lose a substantial amount of weight and in doing so, correct many of the problems associated with that weight.....hypertension, type II diabetes, joint breakdown, sleep apnea, cholesterol issues, and others.  For those with insurance, we can start the process for you at the seminar (in fact, the seminar is usually a requirement).  For those without insurance, we are working up something special to give you the best price available anywhere.  This will be a limited offer so if you need help, or know someone who does, keep and eye out here...you don't want to miss it.  Of course our current lap band offer still stands and is a great one.

The communities we will be coming to soon are, Vinita, Pryor, Tallequah, Joplin, Miami, Grove, Claremore, to name a few.

We look forward to meeting you and helping you get on track.  Of course you can call for an appointment at any time....918-786-7780

“Please help me.  I’ve tried every diet out there.  I exercise.  I just can’t get rid of my weight, and it’s literally killing me.”  These are the words I hear all too often in my clinic here at Green Country Bariatrics in Grove, OK.  You see, obesity has become a problem in our United States, and it’s not going away- not even close.  In fact, recent studies of the population show obesity increasing exponentially throughout the world with the USA leading the way.  More specifically, Oklahoma is ranked 7^th, with Missouri close behind at 11^th.  It is truly a staggering statistic to consider  that 30% of our nation is now considered obese.

Why am I overweight?

What is the reason that I continue to be unable to get rid of my excess weight?  Unfortunately, this is not an easy question to answer in a simple way.  Multiple reasons and theories abound, though most likely, it is a combination of more than one of the following explanations:

1. Psychological

Certainly, overeating can be a reason why you’re overweight.  However,
let’s be honest: eating makes us feel good, right? Many eat not just because they are hungry, but rather a result of feeling lonely, bored, or depressed.

2. Anti-Depressants and Other Medications
Did you know that weight gain is a somewhat common side effect of many antidepressant medications?   By slowing down your metabolism or increasing your appetite, they make you gain weight.  Other common medications that cause weight gain in some form or another are Beta blockers and anti inflammatory steroids (corticosteroids).

3. Sleep Deprivation
Look, we all know that we are living in a busy world.   Fitiing in a normal life around work, kids, and various other responsibilities can be difficult.  Did you know that 63% of Americans feel that their night’s sleep is not meeding their daily energy needs?  Scientific studies prove that people who sleep less than eight hours a day gain more body fat that those who sleep more. Why?
Sleep deprivation causes the hormones that control our hunger to get out of control.  What else do you do during the day when you feel sluggish and tired? Yes, that’s correct. You guessed it: we grab that high calorie soft drink, candy bar, or whatever catches our eye in the vending machine to give us a “pick me up”.

4. Slow down!
Did you know that the part of our brain that helps to govern our hunger (the hypothalamus) shuts down after 25 minutes into a meal?  Slow down.  Chew your food.  You’ll find that you won’t consume quite as much.

5. How we picked our parents
Your genes may be causing you to have trouble fitting into your jeans.  According to research, metabolic rate and where your fat is deposited on your body has been linked to genetic inheritance.  Are one or more of your parents heavy? If so, you’ll have a higher risk of gaining and retaining weight.

What do I do?

Fortunately, we live in a day and age of new techniques and  technology to help those with weight issues resolve them.   Did you know that 98% of people who lose weight through diet and exercise alone eventually regain their weight? I have seen countless people at their wits end and frustrated, suddenly find hope.  There IS a light at the end of the tunnel!   Our main focus at Green Country Bariatrics is on YOU.  That being said, our way of getting there is surgery.  We specialize specifically in adjustable gastric bands (lap bands) and gastric  sleeves.  What if I told you that I could help you lose 70-80% of your excess weight?  What if I told you that I could give you a >50% chance that we could cure your diabetes and get you off of your blood pressure meds?  That’s EXACTLY what we offer at Green Country Bariatrics.

Tell me more!

Lap Band: This is a fully adjustable collar that is placed around the top of your stomach.  In a nutshell, it causes you to eat less, and makes you feel fuller, faster.  It is nonpermanent, and is usually done on an outpatient basis.  Occasionally, a patient will need to stay overnight due to their insurance mandate.  A patient will visit our clinic to tighten or loosen the band when needed. A 50% maximum excess weight loss is often seen. Return to work is usually within a week.

Gastric Sleeve: This is an operation that removes 80% of your stomach.  In doing so, we remove the part of the stomach that houses the hormones that cause you to feel hungry.  In addition, we are removing the part of the stomach where you store your food.   It should be noted that it is much safer and quicker than the traditional gastric bypass.  Many of the complications often seen with the traditional gastric bypass (ulcers, internal hernias, dumping syndrome, etc) are NOT seen with the gastric sleeve.  In addition, the anatomy is not rearranged as it is in the gastric bypass or mini gastric bypass.  However, the weight loss is very similar with both giving approximately a 70-80% excess weight loss.  All the perks, but fewer of the hassles!  It is a permanent procedure, and will require 1-2 nights in the hospital.  Return to work is often within 2 weeks.  Many insurances now cover this procedure.

Green Country Bariatrics

We are here for YOU.  We want to tailor your weightloss surgery to fit your needs and personality.  Certainly, we here at Green Country Bariatrics understand your challenges with weight, and want to provide whatever support we can in order to help you accomplish these goals.  Please note that in treating our patients, we want to see you reach your maximum weightloss potential and keep it off!  In doing so, we help you get started with our nutritionist to teach you how to eat, and make better food choices.  We also encourage participation in a support group for camaraderie, accountability, and just being around others who have been through the process.  A contact with a trainer in your area for post surgical exercise can also be arranged.  Lastly, in beginning the new you, many of our patients desire to have reconstructive surgery to lift and remove excess skin after the wight has been lost.  This is completely optional, but we find that the majority of our patients opt for this to complete the transformation process. All of our surgeons at Green Country Bariatrics are fellowship trained in this particular type of reconstructive surgery.

"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

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.

New blogs starting after the new year.

Let's hope 2012 will be a great one and that things actually do "change".

Look for some of the same offers this year AND some new ones.

Thank you all for making our year a very good start here in Grove.

I want to spend some time discussing lasers and how we use them today.  Lasers have been around for some time.  In the past, at least as far as medicine is concerned, they have been a technology looking for an application.  In the past several years, improvements in technology have made them much safer and applications have greatly increased.

  Austin Powers....demonstrated his ignorance of laser technology.  Lasers have been a mystery to most!! 

Laser and intense light or flash lamp therapy are both based on concentrated light.  Let's talk about lasers first.

Lasers are concentrated light that can be used for multiple applications.  They have been used in industrial applications for years. Medical lasers have numerous applications as well.  We use them to to clear up and make skin look prettier.  We use them to remove tattoo's.  They are used to treat veins and vascular problems on the body and face, even varicose veins.  We can remove unwanted hair, laser fat cells, make skin contract, use them to cut skin, and now we can treat toenail fungus which has been a nagging problem.

Pulsed light therapy is based on a bright flash of light shot onto the skin.  Also called a flash lamp, this technology has been used for other applications, photography, etc.  In cosmetic surgery we use it to treat spots and different pigments on the skin of the face or body.

Unfortunately, there is no single laser that can be used for all applications.  Not to get too complicated (because it is complicated) the way we choose what laser or lamp to used is based on the chromophore we are trying to treat.  A chromophore is the part of a molecule or cell that produces its color.  Each laser or flash lamp has a wave length that attacks that color.  This is why one laser or lamp will not work on all colors.  We know what colors we are trying to treat and select the laser or lamp that will work on that specific color.  This is where the art meets the science.  With some applications, we are aiming at water in the skin as the chromophore, especially when resurfacing the skin. 

The most common laser currently used in Cosmetic Surgery are the nd-YAG, the KTP, the CO2, and the pulsed dye lasers.  Each of these target a different chromophore or color.  The newest developments in the technology is the fractional and q-switched technologies.  We used to resurface skin by ablating or lasering the entire skin surface.  Since the skin recovers by healing from the hair follicle, recovery was slower than desired and this scared people.  Fractional lasers give us the ability to divide or fractionate the pulse of light from the laser.  This leaves islands of undamaged skin between the areas treated.  There are more and larger areas for the skin to heal.  The advantages are that healing is much faster and complication rates are less.  The disadvantages are that the treatment is not quite as good and may require more than a single session.  Q switching is a way to modulate the laser output to get a better "quality" of light energy, more intense output per pulse.  I will talk more about Q-switching when I discuss tattoo removal.

Flash lamps also treat specific colors in the skin.  They are used for treatment of brown pigment, red pigment, and hair in the treatment areas.  With flash lamps, we must change the wavelength of the light to treat each problem.

Now that the boring part is over, next week we will begin to explore the problems we treat and what we use to treat them.

Don't forget our nail fungus, lap band, and liposuction deals that are currently running.  We also are having multiple Botox events in Tulsa and Grove to get everyone ready for the holidays!!  Send me a message, fill out a contact form, or call 918-786-7780 to find out when and where.

After weight loss surgery, as we discussed the past few weeks, skin can become loose and not return to its pre-surgical state.  Last week we talked about tummy tucks, removing skin from the abdomen and tightening the underlying muscles.  This recreates the shape and tightness of the abdomen that is lost after weight loss.  Another common procedure that is requested after massive weight loss is the arm reduction or brachioplasty.  Many people gain excessive weight in their arms and after the weight is gone the skin can hang.  Many describe these at "bat wings".  The unsightly nature of this excess skin becomes hard to conceal and makes wearing short sleeves, tank tops, or anything other than a long sleeve top impossible.

What to do about it??  There are some non-invasive ways to tighten up the skin but these are usually inadequate after weight loss.  It requires skin removal, just like with the tummy tuck.  The up side to this procedure is the reclaimation of your original arm shape with the ability to wear more fashionable clothing and the loss of the "bat wings".  The down side, as with most cosmetic procedures is the scar that occurs on the medial aspect of the upper arm. Photos compliments of the ASPS.

Fortunately, this scar is on the inside of the arm and becomes less and less visible with time. 

Come see us at Total Body Surgical where we do ALL post weight loss body contouring.

ALSO, be sure to take advantage of the Lap band introduction at INTEGRIS Total Body Surgical, and the Breast Augmentation Special through the end of July!!

Last week we talked about who is ready for Cosmetic Surgery after weight loss surgery.  If you have not read that installment, read it first.  Today we are talking about one of the most common procedures desired after weight loss and that procedure is the tummy tuck or abdominoplasty.

After massive weight loss, either surgical or diet, many people have excess skin in the upper and lower abdomen.  This is not only unsightly but can cause to infections, rashes, and leads to the problem of where to put it in clothing etc. In a few cases, insurance may even cover the removal, but in most instances, it is considered Cosmetic and remains uncovered.  When covered by insurance, usually only the lower hanging skin is removed and this skin and fat is called a pannus.  The procedure is called a panniculectomy and is meant only to remove the skin that is hanging and prone to infection.  It is not meant to be a cosmetic procedure.

In a true tummy tuck, the entire abdomen is addressed.  The skin in the upper and lower abdomen is addressed and the underlying muscle is tightened.  The idea is to regain the appearance and shape that was lost with weight gain. 

There are two common types of tummy tuck.  The first is the full tummy tuck that is probably the most common.  The incision is across the lower abdomen and around the belly button.  I like to keep the incision as low as possible to conceal it below garments and swimwear.  The belly button stays where God put it but the skin and fat is elevated, pulled down and removed.  Before re-attaching, the muscle is tightened in the middle of the abdomen to flatten the stomach and get rid of any laxity in the connective tissue.  The upper skin is then pulled tight and sewn to the lower skin.  Finally, the belly button stalk is located and a new opening is created in the overlying skin and it is sewn in place.  A plastic tube drain is placed in the space under the skin and it stays in place until this space stops producing fluid....about a week.  During this time I advise patients to stay bent over a little until the skin stretches.  A garment is also worn for several weeks. 

Full Tummy Tuck

For people that already have an incision in the middle of the upper abdomen, an anchor abdominoplasty or Fleur Des lis tummy tuck may be more appropriate.  This can tighten the waist as well.  Here is a video that demonstrates the procedure.

Anchor or Fleur Des Lis tummy tuck

The second most common type of tummy tuck is the lipoabdominoplasty or Avelar abdominoplasty.  In this technique, the fat is removed with liposuction until the skin becomes loose.  The incisions are made in the lower abdomen and around the belly button, the skin is pulled down and removed.  A tunnel is made to allow tightening of the underlying connective tissue and a drain is placed. I could not find a good video for this procedure....guess I need to make one!!

It just depends on your specific needs and wants when choosing a technique.  Many cosmetic and plastic surgeons try to make everyone fit into one procedure.  Find one that can offer choices and be sure to look at before and after pictures AND be sure they are the Doctors work and not someone elses!!

Come see us at Total Body Surgical Cosmetic Surgery to investigate all of the options.  Don't miss out on our special pricing on a number of procedures.  Press the tabs below to see them.

Next week...the arm reduction. Thanks for reading!!

Today I want to talk about Butts.  Butts used to be maligned and frowned upon.  Things have certainly changed in society today.  After Jennifer Lopez and the Latin boom and the fame of many African American TV and Music stars, Butts are now on the front page.  Many of us were not blessed with a shapely rear compartment, and people that lose considerable weight often lose their shape as well, as muscle is lost.  One way to enlarge the area is to work hard to enlarge the gluteus muscle.  This is often hard to do and may not be possible for some people.  Fortunately, there are other options.

As we age, many of us grow "love handles" or hips.  These cause the butt to lose definition and even if it is present, it becomes concealed.  The first way to increase shapeliness is liposuction.  With liposuction of the love handle or hip area, the butt area gains more definition and appears larger.  For those with an ample hind quarter to begin with, this is all that is necessary.  For people that are still deficient, the Brazilian Butt lift may be the answer.  This procedure is done by augmenting the buttock area with fat grafting.  This is where we liposuction unwanted fat from the love handle area, abdomen, thighs, or anywhere else it is present, process the fat and transplant it into the buttocks.  Amazingly, if there is enough fat to harvest and transplant this is a great and lasting solution.  Of course, as the name portrays, it was developed in Brazil where butts are king.  Studies show that if done properly, it is very effective, and safe.

The problem for some is the lack of fat to harvest.  Some people are thin and have no fat to obtain.  For these people, implants are the solution.  Butt implants have come a long way in the recent past.  They used to be hard and could be difficult to place.  With newer silicone technology they can be made softer with the feeling of real muscle tissue.  They are placed between muscle layers and look and feel very realistic.  They also come in several different sizes to fit nearly anyone.  Recovery time is relatively short and you can go from flat to shapely literally over night.

At INTEGRIS Total Body Surgical, we offer all of these modern solutions to this age old problem.  Liposuction, the Brazilian Butt lift, and implants.  Come see us for a complimentary Cosmetic consultation to see which is the right one for you.

Keep an eye out for liposuction special pricing coming soon.  Friend us on facebook for direct notices on all special offers or on Twitter.

Also don't forget our Breast, Laser hair removal, and Lap Band Specials that are currently running....they are great offers!!!-Incredible Value on the LAP BAND!!!

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

-Breast Aumentation....ACT NOW!!!