Total Body Surgical Blog

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

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

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

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

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

To re-cap..

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

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

You can't beat that anywhere!

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

Today I am going to give you a test.  Fun, huh!!  No grades will be given, thank you.  Hopefully you can learn something from this and if you like it, let me know here and I will come up with some similar ones for other common procedures.

Today the test is going to be about liposuction and tummy tucks....when is one appropriate and not the other and vice versa. Good luck!!

#1.  ....what do you think??  Tummy tuck or lipo?

  We start with an easy one.  If you said tummy tuck, you would be right.  There is no doubt there is a lot of fatty tissue present and liposuction COULD be considered, however, the hanging skin would only become worse.  A tummy tuck with associated liposuction of the waist would be the appropriate choice.  The tummy tuck would remove the excess skin and stretch marks below the belly button and liposuction of the waist would accent and renew the shape of the sides of the abdomen.

#2.  Which is it, tummy tuck or liposuction?

  This one is a little tougher.  When you look at this abdomen what do you see?  As far as fatty tissue goes, there is only a problem area in the mid abdomen and a lower abdominal pooch.  Normally, this would be a perfect abdomen for liposuction, however, you always must evaluate the skin quality too.  The skin in the lower abdomen is riddled with stretch marks.  For this reason, I would recommend a tummy tuck.  The tummy tuck removes a majority of the stretch marks, tightens the remaining ones and moves them below the pant and swim suit line.  Of course if she presented not caring about skin quality after the procedure, a liposuction procedure could be selected.  I would doubt the level of satisfaction after liposuction alone.

#3.  Which one??

  Not exactly a clinical photo, but, it makes a point.  This girl is the perfect example for liposuction.  Perfect skin, nice shape overall, and just a small area of fat in the lower and mid abdomen....what a pallet!!  I could make this abdomen look amazing.  I would use a small cannula, remove the fatty tissue and give her some definition.  I would then use the cool touch laser to tighten the skin more.  It would look fantastic.

#4.  The last one...Tummy tuck or lipo....this one is a little tough so take your time!

  This abdomen is a little tougher.  The skin looks pretty good.  The shape is fair with some fatty pockets that could easily be removed with liposuction.  Liposuctioning the waist would also improve her shape into a more hourglass look.  BUT, what about the C-section scar?  It is a point of adherence that liposuction will not address.  I would recommend a mini tummy tuck with liposuction.  This would allow me to tighten the lower abdominal skin, remove the C-section scar, and liposuction the waist.  I would not make an incision around the belly button but remove some skin that will make it look better.

Good job!  I hope you enjoyed our little quiz.  Remember to let me know on facebook, twitter @jeffswetnam, or here if you like it.  I can come up with some more I think you will like.

Here are a couple of pictures of my work....

Don't forget our laser hair removal special...$50.00/treatment/area...amazing.  Also, our breast augmentation special for silicone and saline.  Lap band specials as well.

Welcome to Trish, our new RN.  An amazing girl that we are very proud to add to our Total Body Surgical Staff.

Last week I tried to explain, in easy to understand terms, how lasers work.  Of course this is a very complicated subject involving physics and science so I tried to make it simple.  What you should try to understand is this....with lasers in Cosmetic and vein surgery, what we are trying to accomplish is using the right wavelength of light to excite or remove a certain color or tissue.  Over the next few weeks, I will attempt to help you understand what is possible using lasers.  I hope I am successful.

Today I am going to discuss how we use lasers to remove tattoos. 

When I was a kid....a long time ago....tattoos were one of the things that were considered very exotic.  You only ever saw them on merchant marines, sailors, WWII vets, etc.  I'm not sure when they came into vogue, but today, they are more than common.  Whether good or bad, they have also become much more complicated.

  (Typical WWII era tattoo...single color, small in size, shallow depth of ink)

Todays tattoos have multiple colors, can be very large, and use technology that puts the ink in the skin with more uniformity and depth. 

(new tattoo...larger, more colors, broad spacing, deeper pigment)

The other thing we see is that the inks are mixed to create some of these colors which makes it more difficult to remove.

People get tattoos for various reasons and they usually get them when they are young.  Later in life, as skin changes and we age, they may become less attractive...and...styles change.  Some designs may fall out of vogue.  Another problem is employment.  Visible tattoos that are difficult to conceal may become a problem with some job seekers.  They were put on without regard for the future.  We run into this often.  Individuals want to advance in a job but cannot because of policies against visible body art.  For these reasons, many people want them removed.

The simple fact is that tattoos are by nature associated with scar tissue which can never be removed.  For this reason, the skin can never be returned to its pristine, pre-tattoo state... but we can get close... most of the time.  In comes the q-switched laser (see last weeks blog for information on what this means).  The ink in a tattoo is deposited in the layers of the skin in "globs".  These packets of ink are a foreign body and our immune system is constantly eating away at them.  They are large though and this takes time....lots of it.  If you look at an older tattoo, the color is not as vivid, real old tattos may fade completely, and this is why.  By choosing the right wavelength of laser light and firing it at the ink there is a percussive effect that breaks up the "globs" into more manageable smaller deposits.  The body can handle these quicker and easier.

The easiest tattoos to remove are the black and red ones.  The q-switched 1064nm yag laser hits black very well and the q-switched 532 nm hits red.  When fired at the ink, there is a pop as it is dispersed into smaller packets that the immune system can handle.  The idea is to break up the ink without creating a lot of heat.  Too much heat can cause a burn and create a tattoo shaped burn scar.  The harder colors are greens, blues, and pastels.  For these we have to use blended wave lengths or pulsed dye lasers that have less quality and power.  Black and red tattos can usually be removed in several treatments 6-9, the other colors can take years to remove.  The other factor is the quality of ink used.  Some inks are easy and others are not.  Some inks contain iron oxides that are impossible to treat without creating heat AND resulting scar tissue.  Fortunately we see these inks infrequently.  That is what makes tattoo removal difficult and somewhat unpredictable.  There is a movement to standardize ink and this would be good.  It would make the removal process much more standardized as well.  Ethnic skin adds a whole other dimension to removal as pigment in the skin also attracts the light and changes in skin color can occur after removal that may be permanent.

Tattoo removal without local anesthetic is not without discomfort.  We usually use topical anethesia at a minimum and injected local on most.  Treatments are usually quick and done at 6 week intervals to allow the body to catch up absorbing the ink.  Removal can be costly due to the number of treatments and the expense of the laser equipment.  Q-switched lasers are not cheap and it takes multiple devices due to the different wavelengths required.

That's it...tattoo removal in a nutshell.  It is much more complicated but I don't want to overwhelm. Come see us at Total Body Surgical for a no cost evaluation and estimate if you want your tattoo removed....Call 918-786-7780 for an appointment to see our tattoo removal specialist or fill out the contact form and we will call you!!

Don't forget our special pricing on liposuction, lap bands, and nail fungus too.

The past two weeks we have discussed the common and uncommon uses for Botox and similar neurotoxins in the management of facial and neck wrinkles.

The next question is "what are my options when Botox doesn't work"??

The next easy step to correcting a wrinkle that is too deep for Botox is a Dermal Filler.  Traditionally, fillers are used for diminishing nasolabial folds as pictured here....

These are lines that form from the lower edge of the nose to the lateral edge of the mouth.  They occur as fat is lost from the mid face and the skin begins to sag.  Lipoatrophy, or fat loss occurs with age and hormonal changes in us all.  This volume should be replaced, and that is what dermal fillers are used for.

The second most common area is the oral commissure or Marrionette line at the lower lateral edge of the mouth.  In this picture there are many other areas shown and fillers can be used for most of them with glabellar lines, perioral lines, and lip augmentation rounding out the most common uses.

What are fillers anyway?  Dermal fillers have been around for some time.  They have gotten progressively better with time, the biggest improvement has been the length of time they last.  Most modern fillers stay around for a year or more and some are made to stay around forever.

One of the most common fillers is Juvederm.

It is made of hyaluronic acid (a normally occurring substance in the body) that has been cross linked to make the molecule very large.  This makes it hard for the body to digest it so it stays around longer...up to 12 months.  It also has a numbing agent within the product to ease the discomfort during injection.  Juvederm and other hyaluronic acid fillers can be used almost anywhere in the face including the lip.

Another common filler is Radiesse Radiesse is made of Calcium hydroxylapatite in a sugar base that promotes collagen development when injected.  It cannot be used in certain areas of the face but is a great product for the more common areas except lips.  It is mixed with lidocaine to make injections nearly painless as well.

I think both of these products are very good and at Total Body Surgical we use them both, sometimes in combination. 

Of the permanent fillers, I like Silikon 1000.  Silikon 1000 is made to use in the eye but due to its high quality, it can be used as a filler if used carefully.  Of course it is off label and not FDA approved.  I like to use it to volumize lips and to treat some acne scars.  It works great when done properly and is permanent.  This can be very economical over time.

Next week I will talk about the more unconventional uses for fillers....some you may not have thought of.

Come see us today at Total Body Surgical and take advantage of our special offers.  Call 918-786-7780 where Cosmetic Consultations are complimentary!

NOW UNTIL THANKSGIVING....BUY ONE FILLER (Juvederm or Radiesse)AND GET THE SECOND ONE AT HALF PRICE!!!!!

Last week we discussed (and hopefully dispelled) many of the myths about the use of Botox.  The FDA  has approved the cosmetic use of Botox in the  Glabellar region or the area between the eyes and forehead.

However, off label uses for the medicine have become common place.  I like to use it around the eyes to elevate the brow, treat crows feet, and to open the eye to show more of the iris or colored part of the eye.  Botox is VERY effective in these areas and due to the small size of the muscles, it requires only a very small amount.

  Notice the "crows feet" around the outer aspect of the eye and the hypertrophy or enlargement of the muscle below the eye.  Botox works extremely well to smooth these areas creating a more youthful look.

Another area that can be improved is the neck.  Many men and women develop banding of the muscles that lead to wrinkling of the skin.  Botox relaxes the muscles that cause the banding and the skin smooths very well.

A third area is around the mouth.

Many people start to form lines around the mouth due to the pursing motion of the muscles around the lips and loss of volume.  Smoking, using a straw, pursing the lips all create the lines.  When used carefully, Botox can help smooth these areas.  Add some volume and the mouth appears much younger.  Be warned that it may create some temporary weakness and this should be expected.  The chin area can also be smoothed with botox.

Another off label use is for Masseter muscle enlargement.

This can occur due to genetics or teeth clenching.  Botox can weaken the muscle and allow it to shrink giving the face a less angular look.

Botox can also be used to treat hyperhydrosis or excessive sweating.  The best area to treat is the under arm but it is also effective on the palms and feet.  Many people have this problem that cannot be resolved with anti-perspirants.  A simple test done at the time of treatment shows where the sweating is most profuse and small amounts of botox are injected.  It is very effective and seems to have good longevity....6 months to a year.

These are just a few of the off label uses for Botox.  There are many others and more are tried all of the time. 

Next week I will discuss volume replacement with dermal fillers and other things such as fat or implants.

Be sure to check our liposuction, nail fungus, and lap band offers.  Many are taking advantage of them, saving significant money, and getting GREAT results!!

Cosmetic consultations are complimentary so call today 918-786-7780 or fill out our contact form!

Watch this video for a little laugh....

http://youtu.be/nB7wtLMsm5c

This little cartoon displays many of the myths about botulinum toxin and its use in making us look younger.  Botox, made by Allergan, and Dysport, made by Medicis, have been around a long time.  Other similar products are on the horizon and these newer products will be just as effective and may drive down the cost.

For this blog I will refer to all of them as Botox as it is the most notable. 

Botox was originally marketed for muscle disorders that caused spasm, disfigurement, and pain.  It worked very safely and very well.  As time went on, many of us realized that wrinkles in the face were caused by common muscles of expression that, over time, cause the skin that overlay the muscles to crease.  The areas most commonly noticed are in the forehead, between the eyes, and the crows feet around the eyes.  They are caused by us raising our brow as if surprised: forehead wrinkles, looking concerned: the "elevens" between the eyes, and smiling or squinting in the sun: crows feet.  It was noticed that when these muscles are weakened with Botox, the wrinkles were markedly reduced.  Over time, FDA approval was requested and granted for Botox use in these areas for cosmetic reasons. 

Treatment with Botox started off being only for the "wealthy" as the cost was high.  Also, there were many misconceptions about the complications that could occur and fear due to rumors of deaths from the proper use of the product. 

Here are the facts:

1.  Botox and other similar products are very safe.  The amount injected by qualified injectors is so small that there is essentially no risk of any serious complication.  As with any other injection, there is the small risk of bruising and if the medication is injected into the wrong muscle group there could be some brow droop or eyelid droop that is self limiting.

2.  Botox is not an anesthetic.  It does not cause numbness where injected.  It does weaken the muscles but when done correctly, they can still be moved, just not with as much force.

3.  Botox does not work immediately.  In some of the smaller muscle groups it works quickly (within a few hours), in the larger muscle groups it may take as long as a week.

4.  Botox is not permanent.  In the typical patient, it lasts about 4 months.  Some shorter and some longer.  The average patient receives Botox every 4 to 6 months.

5.  Some wrinkles may not disappear with Botox.  Deep wrinkles that have been present for some time will be softened after injections but probably will not go away. 

6.  Botox does not "fill in" wrinkles.  It simply slows down the underlying muscle strength and if the skin is able, it will smooth out by not being wrinkled by muscle contraction.

7.  Botox is now becoming very affordable.  Prices, due to increasing competition, have fallen.  Also, as new products come to market, the price of the product should fall, allowing us to charge less.  The average price of a treatment now is around $250-$300 where it used to be twice that much.

8.  Treatment with Botox usually takes less than 10 minutes.  I use the smallest needle I can get and it is essentially painless.

So, there you have it!  Hopefully these points will help dispense many of the myths that surround Botox use.  It is one of the most effective medications I have ever used and patient satisfaction exceeds any other medication when used on the right people. Like Total body Surgical on Facebook and get Botox at $9.00 per unit!!! Don't forget our liposuction special pricing and the newest treatment for toenail fungus!!

Call or fill out our form for a complimentary cosmetic consultation....918-786-7780!!!

Onchomycosis, also known as nail fungus, is a very common problem.

It is a problem that can make people very self conscious and is often very difficult to treat effectively. The cause is a fungus called tinea unguum.  The fungus infects the nail bed where it is protected, moist, warm, and has a good supply of food.  Common risk factors for fungal infection are:

• Getting manicures and pedicures using utensils that have been used on other people

• Getting minor skin or nail injuries

• Having a nail deformity or nail disease

• Having moist skin for a long time

• Poorly functioning immune system (Diabetes and smoking)

• Wearing closed-in footwear

Symptoms

Nail changes on one or more nails (usually toenails):

• Brittleness

• Change in nail shape

• Crumbling of the outside edges of the nail

• Debris trapped under the nail

• Loosening or lifting up of the nail

• Loss of luster and shine

• Thickening of the nail

• White or yellow streaks on the side of the nailThese changes in the nail are unsightly and can lead to discomfort, and to the inability to wear certain footwear due to the thickness of the nail.  Until recently, the problem was very difficult to treat.  Creams, vinegar, nail removal, were the only options.  Then came oral medications:

Over-the-counter creams and ointments generally do not help treat this condition.

Prescription antifungal medicines taken by mouth may help clear the fungus.

• You will need to take the medicine for about 2 to 3 months for toenails; a shorter time for fingernails

• Fluconazole griseofulvin, terbinafine, and itraconazole are used to treat this condition.

• Your health care provider will do lab tests to check for liver damage while you are taking these medicines.

In some cases, the health care provider was required to remove the nail. Nails grow slowly. Even if treatment is successful, a new, clearer nail may take up to a year to grow in. AND the treatment effectiveness is only about 50%.

So why am I writing this???  Well, there is a new treatment that is being used that is about 80% effective and I can give it to you.  NO blood tests, NO risk of liver damage, NO anesthesia, NO pain.  Also, very quick and usually only takes two treatments.  It is done using FDA approved laser treatment. 

The treatment is done in the office and takes about 15 minutes.  We use a 1064 YAG laser that warms the nail and kills the fungus.  We treat all 10 toes and repeat the treatment in 6 weeks.  Usually the nail re-grows and looks normal in 3-6 months.  NO anesthesia is required and can be done on the day of your first visit is you schedule.  If more than 2 treatments are required, the cost is greatly reduced.

The expense of the medications and lab work required could exceed $1000.00 and, again, was only 50% effective.  The laser treatment for all toes, both feet, two treatments is $800.00...very affordable.

Book your appointment today and tell them it is for treatment of nail fungus so we can schedule laser time.  We will have you back in open toed shoes or sandles before next summer!!!  Call 918-786-7780 or fill out the contact form and we will call you!

Don't forget out lap band special AND we are starting a new liposuction promotion until Christmas...get one area 10% off and get a second smaller area FREE!!!                          

Click on image to see lipo special offer!