Total Body Surgical Blog

Don't miss the last days of the spring breast augmentation special at TBS...$3500 until April 30!! What this means is that you must consult with one of us, get an official quote, and then book your procedure by the 30, not have the surgery.  We will honor the quote for 60 days, so it's NOT TOO LATE!! Hit the button below for details...

This weeks article, by Dr Miller covers a great deal about how we do liposuction.  We are kicking off another springtime, body improvement, get in shape for summer deal, this time with great pricing on liposuction...the smart way.   

LIPOSUCTION: FACTS AND MYTHS

GENETICS

Liposuction, like all cosmetic procedures, is a combination of skill and artistry.  It sounds hokey, but just as each person is taught they are a snowflake in grade school, every individual requires a very personalized approach when addressing areas of fat.  Now, typically speaking, many women usually tend to focus their problem areas as being the lower abdomen, flanks (the dreaded muffin top), and arms.  Meanwhile, guys tend to focus on their chest and belly.  Obviously, crossover does occur regarding areas; and to be perfectly honest, it all depends on how we pick our parents! 

AM I A CANDIDATE?

Many people will begin to notice collections of fat, post baby, (men included) that they just can’t get rid of.  Others will turn to liposuction when they have pesky areas that just won’t disappear,  no matter how much exercise and dieting they do.  Still others want extra help in appearance for a wedding or class reunion coming up.  Whatever the case, liposuction is a spectacular avenue to help someone on the  road to the body that they envision.

JUST A TOOL

It should be emphasized that liposuction is only a tool.  Specifically, it is NOT a weightloss technique.  Without a doubt, one will lose weight from the procedure, but its main focus is actually to shape by removal of fat. In addition, once a person has  liposuction, that area where fat is removed means that it is gone for good.  However, this doesn’t mean you’re free to go and gain weight- quite the contrary!  In fact, weight gain will go to other areas of your body, making it look abnormal.  We encourage our liposuction patients to utilize this opportunity as a complete jumpstart to a new and healthy lifestyle. From a very positive point of view, if fat is removed by liposuction from problematic areas, this also means that calories burned by diet and exercise in the future will then be focused on other areas, rather than those where fat has been removed. 

WHAT IS THE PROCESS?

STEP 1

Essentially, the way liposuction is done at Total Body Surgical is a 3 step process.  Though it is not commonly practiced outside of the East and West Coasts, our liposuction is usually performed with what is called the  tumescent technique.  It has also been termed, “lunchtime lipo”, “Smartlipo”, or “laser lipo”.  Patients remain awake throughout the procedure, receiving local anesthesia in the areas of treatment. This allows the patient to communicate with the physician throughout the procedure. It also helps physicians provide great results by allowing them to easily position the patient in the best way possible to treat each area. For those that may be concerned about being awake during the procedure, patients are provided medications to assist in their relaxation and comfort.

In addition, the tumescent technique allows the patient to avoid the general anesthetic that is so hard on your health.  Many times, the recovery from a surgery is not so much related to the procedure, but rather to the administration of the general anesthetic.  Essentially, tumescent technique cuts your recovery time by at least 50%.  Meaning, it is a quicker return to work and your daily activities (typically 3-7 days). 

STEP 2

After getting the patient numb, the second step of the process begins.  Many people have heard the term, “Smartlipo”, or “laser lipo”, which is essentially the utilization of a laser to melt the fat in the  problematic areas being addressed.  Utilization of the laser also decreases swelling, bruising, and also helps to speed recovery.  This is especially true when compared to the old way that liposuction has traditionally been performed. The micro-laser is so tiny that it can contour small areas that were more difficult to treat in the past, such as upper arms and under the chin. This technique smoothes out the work done with the power-assisted micro cannulas and stimulates collagen formation which can help the skin tighten, producing a smooth final appearance to the treated areas.

STEP 3

After the fat is melted, then the fun part begins.  Meaning, all of the melted fat is then gently  removed  by a very small suction tube.  This is where inches are lost, and new waistlines are formed.  The majority of the time during the procedure is spent on this stage.

Am I A Candidate?

Most importantly, you must be in good health. Ideally, not having any active diseases or significant pre-existing medical conditions is best. 

Make sure you  have realistic expectations of the outcome of liposuction. Open communication is absolutely imperative! You have to clearly understand what your desired results are and be able to convey  this information to your surgeon.  Then, discussion of your goals with your surgeon to determine what can feasibly be done to reach all or part of this goal will be essential.

Further, the elasticity of your skin plays a huge role in whether you are a good candidate. You should have good elasticity, so that your skin is able to shrink  back to its former tightness once the fat is removed. As we get older, have babies, and yo-yo diet, our skin loses its elastic property.  Think of it this way:  if you took a brand new pair of underwear out of the package and stretched out the elastic waistband for 2 hours, then let it go, it wouldn’t snap back to the way it was when you took it out of the package brand new, would it?  Our skin is much the same.  In addition regarding your skin, if you had a 10 pound sack of potatoes and you took out 8 pounds, you’d have quite a lot of sack left over, right?  Obviously, we want that sack to shrink up. Analogously, when you take a large amount of fat out of an area, you’ll have the tendency to have extra skin.  This is where using the laser comes into play. Utilizing the laser (remember stage 2 of the procedure) optimizes the chances that this will happen.  However, the overwhelming factor of whether or not this skin will shrink back  is by far and away your genetics.  How we picked our parents plays a huge roll in this life!  The presence of stretch marks is a flashing neon sign that your skin is not what it used to be, and may not shrink up as tight as it would have when you were 18.  However, many patients really just desire to look better in clothes.  Having extra skin after removal of fat will not effect this.  Again, discussion of realistic expectations between you and your surgeon is a must!

Hit this button to see the great offer we have going until May 30!!

What does Bravo have to do with gastro-esophageal reflux disease??  Well, let's investigate it a little.

What is GERD (gastro-esophageal reflux disease)?? Here is a good definition: 

GERD is characterized by symptoms and/or tissue damage that results from repeated or prolonged exposure of the lining of the esophagus to acidic contents from the stomach and occurs when the lower esophageal sphincter (LES) does not seal off the esophagus from the stomach.

The two most frequently reported symptoms of GERD are heartburn, which can be described as a burning discomfort that begins behind the breastbone and radiates to the neck and throat, and acid regurgitation, which is characterized as a bitter, sour tasting fluid. One out of five people experience heartburn or acid regurgitation on a weekly basis and two out of five people experience heartburn or acid regurgitation at least once a month.

This is a good depiction of how reflux occurs.  The esophagus is not prepared to handle the exposure to acid that the stomach is.  The "heartburn" that can occur is normal on occasion, but if it occurs frequently, it can cause changes in the lining of the esophagus... esophagitis. Besides the symptoms this can cause, I.E. heartburn, chest pain, hoarseness, coughing, bad breath, inability to sleep, it can cause strictures in the esophagus, difficulty swallowing, and changes in the cellular lining that can be dangerous.

Fortunately, today, we have medicines that are very effective in reducing the acid and the symptoms that it causes.  These medications are readily available, even over the counter, but, they are not meant to be used for a long time.  They also have a dark side.  PPI (proton pump inhibitors) like prilosec, nexium, etc., when taken for the long term can cause calcium leaching from the bone leading to osteoporosis or thinning of the bones.  They can also cause changes in the lining of the stomach leading to polyp formation.  They can also be very expensive!!

So, what can be done about this!!  When I see a patient with symptoms of reflux, the first thing we like to do is document any changes to the baseline by looking with a scope...an EGD.  This allows us to look and biopsy to establish any changes.  The procedure takes about 15 minutes under sedation...pretty easy.  We then start a trial of medication which usually works.  It is recommended that the trial is relatively short...a few months...  If symptoms persist we will then schedule for a BRAVO pH monitoring test after being off of the meds for about a week.  This allows us to rule out other causes for the symptoms you are experiencing.  The Bravo is a small monitor that adheres to the esophagus for a few days and monitors the acidity.  You keep a journal of symptoms while we monitor...symptoms and acid=a positive test. 

With a positive test, changes in the esophagus, and symptoms on the medication, we recommend a laparoscopic repair.  This is called a Nissen Fundoplication (hiatal hernias are also repaired at the same time).  If the medications alleviate the symptoms, and you have been on them a long time....we have to decide if surgery is appropriate.  Considering the fact that the medications can cause problems, if you are healthy, patients usually opt for fixing the problem to get off of them medication.

The success rate for the Nissen is about 90%, as reported in the literature....there are not many treatments that have statistics that good!!  You will usually spend one night in the hospital and are back to normal in a couple of weeks with only small (1/4 inch) incisions.

So, the Bravo is a great test to help us figure out if the symptoms you are having are actually caused by your GERD....that's important.  The worst thing we can do is fix your reflux and later find out your symptoms are from something else!!

Come see us today if you have reflux that does not respond to medications, or, if you have been on the meds for some time and cannot live without them...WE can help.  We do EGD, Bravo pH testing, AND Nissen Fundoplication, Total Body Surgical!

Call 918-786-7780 or toll free 877-weight0 today for an appointment!!

Don't forget our special pricing on breast enhancement surgery until April 30..what a deal!! Just click on the breast button to see what it's all about.  AND our liposuction special pricing too, look great for summer!!  Cosmetic consultations are always complimentary!!

Thought ya'll might like a break from the breast this week!  I guess you can have too much of a good thing, BUT, don't forget about our spring breast deal...hit the button above to check out our offer, it's a good one!

After a cold winter of intermittent goody indulgences (think Christmas and New year) and less sporadic exercise, the question is..... are you going to be ready for Summer?  Would you like a jump start to a new and healthy lifestyle?  Are there areas on your body that despite all the exercise and dieting in the world, simply will not go away?  You can blame that on your genetics, baby.  Unfortunately, we can't pick our parents, so what options does that leave us?

Thin girl with "saddle bags"...genetics in action.

The answer to that question is liposuction.  You may also hear the term "body contouring" , the terms are interchangeable.  Many of our patients who undergo liposuction body contouring improve not just their confidence, self esteem, and overall quality of life; but also comment on their new and increased volition to exercise and maintain their body in a positive fashion. At a far more drastic end of the spectrum, we have had others comment that a simple body contouring liposuction procedure has allowed them to experience and achieve goals that their appearance or body shape has prevented them from achieving in the past. 

love handles...spare tire

Men often collect and store their fat over their abdomen, breasts, and neck, whereas women will collect it in their waist (the dreaded muffin top), their abdomen, arms, and thighs.

"Muffin top"...funny but true.

So you're asking, what does this entail?  "I've seen it on TV and it looks soooo rough and painful."  Guess, what?  Things have changed.  Drastically. At Total Body Surgical, we use a technique that was popularized around 2005 on the West Coast called, laser lipo, lunchtime lipo, smartlipo, etc.

CoolTouch laser used at our facility.

Essentially, the process involves three steps.  The first part is the hardest step and takes the longest time.  What happens is numbing medicine (lidocaine with saline mixed) is placed into your areas of concern.  Once you are numb, the next portion involves using a laser to go in and melt the fat.  The laser also serves another really beneficial purpose... it helps to shrink down the skin.  Ok, that being said, we need to take a side trip and discuss this whole saggy and loose skin thing.  Picture a  10 pound sack of potatoes.  If you took 9 pounds of potatoes out of the bag, you'd have a heck of a lot of sack left over, right?  This is the same concept with your body and liposuction.  If we go in and remove a batch of fat from an area, it's inevitable that you're going to have some extra skin.  Now, whether or not that skin is going to snap back depends, once again, on your  genetics.  We only have so much elasticity to our skin.  As we get older, have babies, and yo-yo diet, all these factors act to decrease the amount of give and elasticity to our skin.  It's kind of like your favorite pair of socks that ends up around your ankles at noon time because the elastic has given up.   The laser helps to counteract this somewhat.  As I stated already, the overwhelming factor of whether your skin will shrink down or not completely depends on your genetics, but the laser certainly helps to optomize the situation.  Lastly, the third and final step to the procedure is the fun part.  This is where we insert a tiny tube underneath your skin and suck out all the melted fat.  This is where you lose your inches and get rid of that darn fat deposit.

Now, take into account that you will retain water and be swollen enough to not allow you to see your final appearance for about 12 weeks.  That means, getting ready for Summer and planning ahead is essential.  Make no mistake, Spring is peaking its head above the covers, and Summer is just around the corner!

Beside the breast augmentation special we have going this spring...we always have great deals on liposuction!  Check it out by hitting the lipo button.  Remember that Cosmetic Consultations are complimentary, so what have you got to lose???  Call 918-786-7780 TODAY.  Financing also available.

This is a great article that was written for a magazine in NW Arkansas.  I also wanted to mention our 2013 spring time special on Breast enhancement.  You must act now though as it is on only until April 30.  Click on the button below to see the great pricing!!

Green Country Bariatrics: There IS a Light at the End of the Tunnel!

By Nathan G. Miller, M.D., board-certified general surgeon, fellowship trained bariatric surgeon and cosmetic surgeon

“Please help me. I’ve tried every diet out there, I exercise, I can’t get rid of my weight, and it’s literally killing me.” These are the words I hear all too often from my patients. You see, obesity has become a problem in the United States, and it’s not going away – not even close.

I often see patients at their wits’ ends. They have tried everything to lose weight, and nothing works. Rest assured, there IS light at the end of the tunnel! The surgical solutions of today are unparalleled to those of the past. The complications and problems of old have been minimized, and weight loss is now maximized. And in addition to pounds lost, many patients see up to an 85% resolution rate of their diabetes issues and 50% resolution of high blood pressure problems. Several are able to get off medications altogether.

At Green Country Bariatrics, we work very closely with another fellowship-trained bariatric surgeon in the region, Dr. Josh Roller. We consult frequently about patient care and our areas of expertise. I specialize in sleeve gastrectomy and lap band, whereas Dr. Roller concentrates on gastric bypass.

What is possible?

Lap Band - A fully adjustable collar that is placed around the top of your stomach, the lap band causes you to eat less and feel fuller, faster. It is nonpermanent, and is typically done on an outpatient basis. Patients return to our clinic to tighten or loosen the band as needed, depending on weight loss and hunger. With this technique, we often see a 50 percent maximum excess weight loss, meaning, if the patient was carrying an extra 100 pounds, he or she would typically lose nearly 50. Most patients are able to return to work within a week. 

Gastric Sleeve - The gastric sleeve is an operation where 80 percent of the stomach is removed, including the hormone center for hunger. In addition, this surgery also removes the part of the stomach where food is stored, sometimes referred to as the reservoir. While this is a permanent procedure, the patient’s anatomy is not rearranged as it is in the gastric bypass or mini gastric bypass. With this technique, we often see a 70 to 80 percent excess weight loss, meaning, if the patient was carrying an 100 extra pounds, he or she would typically lose around 80. Normally, this procedure requires one to two nights in the hospital. It is less associated with malnutrition, dumping syndrome, ulcers, and internal hernias than other bariatric procedures, and it is usually performed through six tiny holes in the abdomen. Return to work is often within two weeks, and many insurance companies now cover this procedure (including Medicare).

Gastric Bypass - This is an operation that removes a significant amount of native  stomach.  Typically, it also bypasses anywhere from 90-120 cm of the native small bowel. This causes the body to absorb fewer calories and fats. It is a permanent procedure wherein the patient often loses 80% of his or her excess weight. Many times, this is a prime procedure for brittle diabetics, or those with diabetes requiring insulin for more than five years. It is also an excellent procedure for those with extensive reflux problems and a related need for weight loss.

What happens after the weight loss?  Let’s pretend we have a 10-pound sack of potatoes.  Now, let’s also imagine that we’ve taken 9 pounds out of that sack. There’s quite a bit of sack left over, right? Such is the case with weight loss. Skin has only a certain amount of elasticity. Age, yo-yo dieting and childbearing all work to degrade that elastic property. For many on a weight loss journey, removal of excess skin is often the final destination. Men and women alike often opt for tummy tucks, and also add arm lifts, neck lifts, breast lifts or thigh lifts. Essentially, these procedures are the polishing step in the complete rejuvenation of the patient. 

Tummy Tuck - A tummy tuck is performed through an incision in the lower abdomen a few centimeters above the pubic region. The incision goes from hip bone to hip bone and also around the stalk of the belly button. The skin is raised off of the underlying connective tissue and muscle up to the ribs. Next, the loose muscle and underlying connective tissue is tightened to make the abdomen flat. The skin is then pulled down and the excess is removed. A new opening for the belly button is created. The smooth, firm skin from above the belly button is pulled down, and stretch-marked tissue and scars are removed. The result? Voila: a flat abdomen.

  Typical loose skin after weight loss surgery.

Arm Lift - An arm lift, or brachioplasty, reduces excess skin and fat between the underarm and the elbow, reshapes your arm to result in smoother skin and contours, and results in a more toned and proportioned appearance.

Sagging arm skin after weight loss.

Breast Lift - A breast lift, or mastopexy, raises the nipples and firms the breasts by removing excess skin and tightening the surrounding tissue to reshape and support the new breast contour. Implants can also be placed to fill out the deflated breast.

Loss of breast volume after weight loss.

At Green Country Bariatrics and Total Body Surgical Cosmetic Surgery, our cosmetic consultations are always complimentary. If you’ve been considering these options, call us today for an appointment at 918-786-7780.  For more information, we welcome you to visit our websites and “like” us on Facebook!  Be sure to check the breast special!!!

www.greencountrybariatrics.com

www.totalbodysurgical.net

LIPOSUCTION: FACTS AND MYTHS

GENETICS

Liposuction, like all cosmetic procedures, is a combination of skill and artistry.  It sounds hokey, but just as each person is taught they are a snowflake in grade school, every individual requires a very personalized approach when addressing areas of fat.  Now, typically speaking, many women usually tend to focus their problem areas as being the lower abdomen, flanks (the dreaded muffin top), thighs, and arms.  Meanwhile, guys tend to focus on their chest and belly.  Obviously, crossover does occur regarding areas; and to be perfectly honest, it all depends on how we pick our parents! 

The dreaded "muffin top"

  "love handles"...not so lovely

Fatty thighs...saddle bags, inner thighs, anterior thigh, and fatty knees.

AM I A CANDIDATE?

Many people will begin to notice collections of fat post baby that they just can’t get rid of.  Others will turn to liposuction when they have pesky areas that just won’t disappear,  no matter how much exercise and dieting they do.  Still others want extra help in appearance for a wedding or class reunion coming up.  Whatever the case, liposuction is a spectacular avenue to help someone on the  road to the body that they envision.

JUST A TOOL

It should be emphasized that liposuction is only a tool.  Specifically, it is NOT a weightloss technique.  Without a doubt, one will lose weight from the procedure, but its main focus is actually to shape by removal of fat. In addition, once a person has  liposuction, that area where fat is removed means that it is gone for good.  However, this doesn’t mean you’re free to go and gain weight- quite the contrary!  In fact, weight gain will go to other areas of your body, making it look abnormal.  We encourage our liposuction patients to utilize this opportunity as a complete jumpstart to a new and healthy lifestyle. From a very positive point of view, if fat is removed by liposuction from problematic areas, this also means that calories burned by diet and exercise in the future will then be focused on other areas, rather than those where fat has been removed. 

WHAT IS THE PROCESS?

STEP 1

Essentially, the way liposuction done at Total Body Surgical is a 3 step process.  Though it is not commonly practiced outside of the East and West Coasts, our liposuction is usually performed with what is called the  tumescent technique.  It has also been termed, “lunchtime lipo”, “Smartlipo”, or “laser lipo”.  Patients remain awake throughout the procedure, receiving local anesthesia in the areas of treatment. This allows the patient to communicate with the physician throughout the procedure. It also helps physicians provide great results by allowing them to easily position the patient in the best way possible to treat each area. For those that may be concerned about being awake during the procedure, patients are provided medications to assist in their relaxation and comfort.

In addition, the tumescent technique allows the patient to avoid the general anesthetic that is so hard on your health.  Many times, the recovery from a surgery is not so much related to the procedure, but rather to the administration of the general anesthetic.  Essentially, tumescent technique cuts your recovery time by at least 50%.  Meaning, it is a quicker return to work and your daily activities (typically 3-7 days). 

STEP 2

After getting the patient numb, the second step of the process begins.  Many people have heard the term, “Smartlipo”, or “laser lipo”, which is essentially the utilization of a laser to melt the fat in the  problematic areas being addressed.  Utilization of the laser also decreases swelling, bruising, and also helps to speed recovery.  This is especially true when compared to the old way that liposuction has traditionally been performed. The micro-laser is so tiny that it can contour small areas that were more difficult to treat in the past, such as upper arms and under the chin. This technique smoothes out the work done with the power-assisted micro cannulas and stimulates collagen formation which can help the skin tighten, producing a smooth final appearance to the treated areas.

STEP 3

After the fat is melted, then the fun part begins.  Meaning, all of the melted fat is then gently  removed  by a very small suction tube.  This is where inches are lost, and new waistlines are formed.  The majority of the time during the procedure is spent on this stage.

Fat abdomen

 Am I A Candidate?

Most importantly, you must be in good health. Ideally, not having any active diseases or significant pre-existing medical conditions is best. 

Make sure you  have realistic expectations of the outcome of liposuction. Open communication is absolutely imperative! You have to clearly understand what your desired results are and be able to convey  this information to your surgeon.  Then, discussion of your goals with your surgeon to determine what can feasibly be done to reach all or part of this goal will be essential.

Further, the elasticity of your skin plays a huge role in whether you are a good candidate. You should have good elasticity, so that your skin is able to shrink  back to its former tightness once the fat is removed. As we get older, have babies, and yo-yo diet, our skin loses its elastic property.  Think of it this way:  if you took a brand new pair of underwear out of the package and stretched out the elastic waistband for 2 hours, then let it go, it wouldn’t snap back to the way it was when you took it out of the package brand new, would it?  Our skin is much the same.  In addition regarding your skin, if you had a 10 pound sack of potatoes and you took out 8 pounds, you’d have quite a lot of sack left over, right?  Obviously, we want that sack to shrink up. Analogously, when you take a large amount of fat out of an area, you’ll have the tendency to have extra skin.  This is where using the laser comes into play. Utilizing the laser (remember stage 2 of the procedure) optimizes the chances that this will happen.  However, the overwhelming factor of whether or not this skin will shrink back  is by far and away your genetics.  How we picked our parents plays a huge roll in this life!  The presence of stretch marks is a flashing neon sign that your skin is not what it used to be, and may not shrink up as tight as it would have when you were 18.  However, many patients really just desire to look better in clothes.  Having extra skin after removal of fat will not effect this.  Again, discussion of realistic expectations between you and your surgeon is a must!

To have that discussion at no charge to you, call 918-786-7780 today!!  We can help and Cosmetic appointments are complimentary!!

Acne can be a terrible affliction or a very minor problem.  It can occur from the teenage years, and also as an adult.  Acne can cause problems that will be present for life, leaving cosmetic issues that may be very hard to deal with.  I want to discuss today the process of the problem and how to handle it.

First of all, what is the process behind the problem???  Acne usually starts in adolesence.  It is a familial problem that manifests during hormonal changes.  It can occur in all skin types and with different degrees of severity.    Acne can lead to social problems that may last a lifetime.  Hormonal increases in adolecense lead to changes in the output of oil in our skin, making it thicker.  This leads to the pores becoming closed, and with bacteria in the skin using this "food" source, they multiply.  The result is the inflamed cystic "comedones" that we call acne. In most instances, the blemishes are limited, resolve in a short period of time, are not severe, and, with the exception of slight embarassment, do no long term harm.  In a minority of cases, the problem is severe, unremitting, and can lead to permanent skin changes.  The changes that can occur are scarring, changes in skin pigmentation, and the resulting self confidence issues that remain. 

What can be done about all of this then?  Most manage by keeping the skin clean and using over the counter products that we see on television.  For minor cases, this is enough.  For more severe cases, these products are no match and the blemishes continue.  At this point, hopefully, parents recognize the severity of the problem and will seek other help.  That is where we can help. 

The first step usually recommend is a change in basic skin care.  We like cleansers that contain salicylic acid.  The salicylic acid in the cleanser helps to liquify and remove the oil that is the root of the problem.  We also recommend benzoyl peroxide solutions that will help reduce the bacterial load.  The third thing I like for patients to do is start a retinol topical cream.  Retinol also helps reduce oil, dry the skin, and compact the stratum corneum, the dead layer of skin cells.  If need be, I will also start an oral antibiotic to decrease the bacteria and decrease the inflammatory response that the bacteria cause.  Antibiotics are generally continued at a low dose as the inflammatory response is less while on them.

For most, these routines are effective in managing the acne.  In others, these steps may not be enough.  The next step I usually add is laser therapy.  We use the Cutera system on a setting that will heat up the skin and kill the actively reproducing bacteria.  There is no recovery time and these treatments can be repeated at 4-6 week intervals with no pain. 

After this step, if no response is noticed, we have a decision to make.  In some women we will add some other medications as hormone modulators such as birth control pills or spironolactone.  If these do not give us results, we then must consider more powerful oral medications.  The one that is the most effective is Accutane.  Accutane is a medication that works very well.  It is also capable of causing problems for some patients.  Everyone has heard of a horror story related to Accutane but few hear of the great number of successes.  The biggest problem a patient can encounter is conception while on the medication.   I-pledge is a program that was instituted to educate patients taking the drug about how to avoid pregnancy and the birth defects that can occur.  Secondly, headaches, brain swelling, depression to name a few are the other side effects than may be encountered while on  Accutane.  The biggest complaints I see are that of dry skin and cracked lips and these are very tolerable.  In most instances the results far exceed expectations and over shadow the risks.  The usual patient takes the medication for 6 months.

My personal philosopy is that the risks of Accutane, when given correctly, are very much worth it.  I am often asked to try to treat patients with scarring and pigment changes resulting from severe cystic acne....this is VERY hard work and is usually only marginally successful.  For that reason, I start off with the less problematic treatments and give them a fairly short trial...6-8 weeks.  If there is no measurable result and the acne is severe, I usually will then suggest Accutane if the patient is a reliable person and can understand the risks.

Come see us today at Total Body Surgical Cosmetic Surgery if you need help....918-786-7780.

"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.