Total Body Surgical Blog

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

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

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

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

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

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

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

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

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

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

Why Botox???  Well, look at my picture...see any lines??  Do I look fake or funny to you??  I don't feel funny!!  The best way to summarize the answer to the Botox question is...it makes you look younger.

If that's what you want, Botox is the medication for you.  As we age, the muscles of facial expression work day after day.  Our surprised look, our concearned look, our mad look, and squinting from the sun or when trying to read all lead to eventual wrinkles in the skin.  We get crows feet, lines in our forehead, elevens between the eyes and so on.  This happens to everyone whether we like it or not.  As these lines appear, sometimes as early as the 3rd decade of life, they start to show our age with only a glance.  These lines are difficult to hide with cosmetics and may not only show your actual age but may make you look older than you really are.
  Don't be depressed, have a low self esteem, and lose your confidence, DO something about it!!

What we have today is a whole armamentarium of therapy to make you look your best every day.  Botox is the product I want to talk about a little.  First of all it is very safe.  It is next to impossible to have a severe complication from Botox.  The safety profile is excellent.  It has become very affordable as well.  Usually the cost for treatment of the upper face is around $300.00.  This will generally get the forehead, the elevens between the eyes and the crows feet.  It is very quick and simple to do.  We use the smallest needle we can find and use the highest concentration so that bumps after injection are usually non-existent.  There is very little discomfort and it takes about five minutes.  About the worst that can happen is a small bruise which is rare unless you are taking aspirin or ibuprofen.

  After injection we have you briefly hold pressure on the areas and exercise the muscles we have treated.  In 3-5 days or less the wrinkles will soften and many will disappear.  The effect usually lasts for 3-6 months and for this time, the muscles are weakened and cannot crease the skin as badly.  It does not paralyze the face or make you look "funny" if done properly.  You will look refreshed and younger as the wrinkles fade.  When the strength in the muscles creating your wrinkles starts to return, you will notice the change in the skin and then return for re-treatment.  Most people have 2-3 treatments per year.  After you quit paying for wrinkle creams that do not work and cosmetics to hide the wrinkles that are marginally effective, it is a good investment.  If kept up with, you can go wrinkle free for years and if you keep up with good skin care as well, you will be miles ahead of the game.

Come see us today at Total Body Surgical, we are specialists at Botox and all other aspects of Cosmetic Surgery.  Also Click on any of the flags to see specials.  Mention this blog and get Botox for $9.00/unit.  Call 918-786-7780 for a visit today!!

Breast disease for men???  What the heck you say.  Well, it does happen even though breast problems and Cosmetic breast surgery IS much more common for women. What kind of problems would a guy have is a question you might ask.  Well, there are several, but today I want to address a problem called gynecomastia.  Gynecomastia is a word that means puffy nipples.  Gynecomastia normally occurs during hormonal changes in the life of infants, adolescents, and men.  The first time in life it occurs is in infancy.  After birth, estrogen from the mother is high in the infant and breast tissue develops that rapidly disappears.  It also occurs in elderly males as the hormonal changes of aging take hold.  Many medications can also cause the breast tissue to increase.  Other causes are beyond the scope of this installment.  I mostly want to focus on the adolescent occurrence.  In adolescent males, gynecomastia can develop in as high as 80% of individuals.  Again, its the hormones that occur normally and in those who use anabolic steroids.  Unfortunately, in up to 30%, it doesn't go away this time.  Gynecomastia during adolescence is made of fatty tissue with a bud of breast tissue under the nipple.  By the early 20's it should be gone, if not, it may become a real problem.  The problems it causes are not generally physical but psychological.  Wearing normal clothing becomes an uncomfortable situation for a guy that has breast tissue and makes one very self conscious.  Working out to develop pectoral muscles can often times only make things worse...so what's a guy to do??  First of all, be patient.  It is hard to do but fortunately, in a majority of cases the problem resolves after hormone changes settle down.  In cases that don't resolve, we can take care of the problem.  Usually, in the normal case, I will liposuction the chest and remove the "bud" of breast tissue.  I do this through a small incision in the arm pit to liposuction the chest of excess fatty tissue.  I then make an incision through the nipple to remove the small bud of breast tissue.  We do this in the office procedure room using some IV sedation and tumescent local.  It takes less than an hour and can be life changing.  We have you wear a compression shirt for about 3 weeks and from that point on, normal clothes can be worn without the worry of those two little reminders poking through.  The incisions heal very well and go unnoticed after a healing time of a few months.

If you or someone you know has this problem, come see us!  We can help.  Call 918-786-7780 for an appointment.  Don't forget our other specials as well...laser hair removal, breast augmentation, nail fungus eradication, and great pricing on Obagi skin care products.

                                                                                      Let's talk about eyelids for a bit.  As the old Yiddish proberb says, "the eyes are the mirror of the soul"....eyes are very important.  When we meet someone, where is the first place most people look??? the eyes.  Therefore, if we have prematurely aging eyes, they can make us look older, more tired, and cover one of the most beautiful attributes we all have.  Eyelids, though small, can change even the way we think about ourselves.  We look in the mirror and even though we don't feel tired because of the "tiredness" we see in our eyes we begin to reflect it in our actions.

Youthful eyes are wide and inviting.  The upper lid is full with few wrinkles and no excess skin present.  The lower lids are smooth with skin color that is pink.  There are no bulges, folds, or "bags" to draw our attention from the color of the iris or the pupil.  We see well as there is no abstructing skin in the way.  We look and feel great.

As the instoppable aging proces happens, eyes, are at times, the first thing to reflect it.

  Why is this?  When did it happen?  How did the first picture become the second??  Well, let's get some answers.  The eyelid skin is some of the thinnest skin on the body.  It also moves more than the other skin and it is constantly exposed to the damaging UV rays of the sun.  The other thing that happens is a loss of fatty tissue in the face.  This exposes underlying connective tissue where it is tethered to bone.  Lines and bulges that are normally window shaded by ample fat pads begin showing up when those fat pads diminish.  Fine lines and wrinkles develope from sun damaged skin, motion, and sagging of the muscle around the eye.  The process is unrelenting and over time, the sagging skin can even decrease vision.

  What we see here is a large amount of extra skin on the upper lid obstructing vision and the fat pad below the eye is protruding with severe skin changes.  Regardless of actual age, these changes can create the image of a very old person and the view of the eye is just a slit...not a very good view of the soul.

At Total body surgical we do a lot of eye rejuvenation.  It is one of the more rejuvenating procedures we do.  It is fairly simple and can take years off.  Upper lids are done with some light sedation and local anesthesia.  Lower lids can also be done with light sedation sculpturing the fat pad and either removing the loose skin or lasering it to tighten it up.  We often graft fat into the cheek to restore a more youthful look.  Recovery time for upper lids alone is quick, usually about a week and for lower lids a week or two depending on laser use.  We have great pricing on lids so be sure to check us out!  Cosmetic consultations are complimentary so call 918-786-7780 for a visit.  Also remember our other offers on the lap band, breast augmentation, hair removal, and liposuction.  Summer is right around the corner, so get ready now!!!

Today, for the final installment on lasers, we are going to discuss the use of lasers to treat veins on the face, legs and elsewhere. 

First, leg veins.  Superficial or spider veins occur very frequently on the legs.  As I have discussed before, when the areas are large, I prefer injections to the laser because I can cover much more ground and cause less dicomfort.  For small areas, however, the laser is very convenient and in most cases works very well.  The veins in this picture are perfect....why??  Remember that laser light is attracted to pigment.  The darker the pigment, when the laser light hits it, heat is generated, the small vein is injured, the flow stops and the vein is gone.  After lasering the vein it turns red and forms a clot that slowly dissolves.  I use the Cutera 1064 laser for the darker veins.  For veins that have a lighter and more red pigment we use the KTP or 536 wavelength laser.

The second area that is most commonly complained about is the face.  Adults of European descent commonly develope visible veins around the base of the nose that are unsightly.  Those with Rosacea get veins that are visible on nose, at the base of the nose, and nearly anywhere else on the face.

The nasal areas we treat with the laser to close the veins.  For Rosacea, it may require several different methods, even systemic medications on some cases. 

The results we get are very good.  In most cases, new areas will arise and will require repeat treatments from time to time we call maintenance.

A third condition that is vascular and can be treated with laser are hemangiomas.  These areas occur in the young and old and anywhere on the body.  They can be very small.  They can also be very large.  Most of these can be closed with the laser.  Larger ones may require several treatments.  They turn dark, dry up, and are usually gone.

There are other uses for lasers but that about covers the more common things and I'm worn out with it.  We have covered how lasers work, hair removal, skin rejeuvenation, abnormal coloration, and vascular lesions....we treat them all.  Something new next week.

Don't forget our specials at Total Body Surgical.  We have a few surgical spots left before the first of the year then the summer countdown begins....believe it or not.

What can lasers do for your skin??  ALOT!!!!  As time goes on and the natural aging process of the skin occurs there are many changes that occur.  Ultraviolet light from the sun, pollutants in the air, pollutants in what we eat, the loss of collagen as we age, genetics, loss of fat,....and the list goes on and on.  All of these things lead to the aging of our skin causing spots, wrinkles, enlarged pores, and even skin cancers.

Here is a comparison of young and old skin...here you see how the age spots form, the outer layer thins, and fat is diminished.  On a smaller scale we would see collagen loss as well.

    What we see on the outside is this....

  How can laser treatment alter these changes??  There are a number of effects that a good laser treatment can cause making the skin look and feel younger.  Laser can tighten the skin by causing new collagen to form as the damage caused by the laser is healed.  The outer layer of skin (stratum corneum) is also thinned and made more organized by laser treatment making the skin look and feel smoother and softer.  Dark spots (age spots) or dark patches (melasma) are not only caused by sun damage but also are aggravated by hormonal changes.  When lasers are used carefully and these treatments are combined with targeted skin care and sun protection, these spots can usually be treated and removed.

Laser skin resurfacing today is safer, cheaper, and recovery times are significantly less than ever before.  At Total Body Surgical we use the Cutera Pearl laser.  This laser is unique for a number of reasons.  It is a wavelength that penetrates well into the skin but shortens recovery time.  We have the only pearl in the area.  It gives the same results as a CO2 laser but the recovery time is only around 4 days.  This means that you can wear makeup after about 4 days but will have some redness for a week or two. 

Laser resurfacing can make a huge difference in acne scarring too.  Smoothing them and helping pigment changes they can cause. 

So if you want to get rid of age spots, melasma, acne scarring, or just tighten the skin up to look younger, come see us at Total Body Surgical.  We can get you started on the new you in 2012.  Now laser treatments are as cheap as $800....much cheaper than the big city.....schedule today!!   918-786-7780...cosmetic consultations always complimentary...

Don't forget our specials too!!

  Last week on the Total Body Surgical Cosmetic Surgery blog we talked about wrinkles and how good skin care and Botox can make a big difference.  This week we will take a look at the common fillers that can be used.

Below is one of the commonly used scales to measure and quantify the severity of wrinkles and skin damage.

Class II we would usually use Botox or Dysport because slowing the underlying muscles will usually eliminate the wrinkle as long as it is maintained.

Class III wrinkles will usually require "filling" as they are present at rest and are more or less permanent fixtures.  Filling them will not remove the wrinkle 100% but will go a long way toward making them tolerable.

There are many fillers on the market and thank goodness most of them now last a year or more.  This is in contrast to only 5 or 6 years ago when a filler would work for 2-4 months.  Many techniques can be nearly peramanant.

Hyaluronic acid fillers such as Juvederm and Perlane are great all around fillers that can be used nearly anywhere in the body.  This is because it is a naturally occurring substance in the body and is colorless.  They cause very little collagen production and the newer ones contain lidocaine which is a nice plus for the patient and injector.  These are the most widely used products.

Radiesse is another filler that is made of small calcium hydroxyapetite beads in a sugar based carrier.  This filler is limited in its use and should not be used in the lip or superficially anywhere.  It is great for larger volume fills in the cheek and nasolabial fold.  It works by causing your body to form collagen in the treated areas. It should last 12 to 18 months but will need some supplementation in that time.

Other common fillers are Sculptra which is poly L lactic acid can be used to create volume in the cheeks but this is a much slower process than the other two.

More permanent fillers are fat and silicone.  Fat harvesting and grafting has become common all over the body, but is very popular in the face.  Fat is harvested, treated and placed in areas where fat has disappeared over time.  There is some variability in the percentage of the fat that lives and therefore the procedure may need repeating. Lastly, silicone.  Silicone has received a bad name.  There are countless examples of low grade silicone used in too large a quantity to create a terrible result.  At Total Body Surgical, I have a great deal of experience with silicone.  We use only the best quality silikon 1000 that is manufactured by Alcon and made for use in the eye.  It works great for augmenting lips, filling areas of imperfection on the nose, and some acne scarring.

Next week....we'll address pigment issues!!  Come see us at Total Body Surgical.  Mention this blog and get $10.00per unit botox....That's a good price now!!

Last week I began a discussion of common skin care complaints.  Today I will discuss one of the common complaints.....wrinkles...

Now this kid has a cure for everything.  Check out his routine!!

http://youtu.be/X5kFQW7W7_k

What causes wrinkles?  Well, that is a big question but the answer is about the same for everyone.  Time, as in aging, is the primary culprit.  We all make facial expressions that are common.  We all scowel from time to time, we smile, frown, and elevate our brow.  When young, we produce collagen at a rapid rate and elastin that keeps the skin flexible even when the underlying muscles wrinkle the skin.  Skin also produces more oil and moisture when young adding to its pliability.  At around age 30 most of us stop producing collagen at a rapid rate and we gradually develop a net loss of it.  When this happens, the skin, in response to constant pressure from the underlying muscles of expression, begins to gradually show wrinkles.  These wrinkles are seen in nearly everyone starting around age 40 but can occur much later or much earlier.  Genetics takes a part in when the process starts as well.

What can we do about them??  You can start with prevention.  This starts with a good skin care regimen.  The most important part of this regimen is sun screen to protect from UV damage.  For the remainder of the care, at Total Body Surgical Cosmetic Surgery, we recommend the Obagi line of medical skin care.  These products are fantastic at slowing the process of aging, i.e. wrinkles.  When used properly this line stimulates collagen formation and keeps the skin young longer.

When skin care is used properly, wrinkling can and eventually will continue to occur.  When this happens, the best product on the market, hands down, is Botox or Dysport.  These products are time tested, safe, and VERY effective when used properly.  We use Botox by the gallon and everyone loves it.  Wrinkles that are too deep for Botox may need to be Filled.  I will cover these products in my next chapter.

Come see us at INTEGRIS Total Body Surgical for a full line of Obagi products and Botox.  Mention this blog and get Botox for nine dollars per unit (about $300 for the full upper face).  You need to mention this blog though when you book.

Cosmetic consultations and skin care consultations are complimentary!!!

The next few weeks I will be covering, in this blog, my philosophy and approach to common skin problems.  I hope this will be helpful to some of you. As a cosmetic surgeon, we see these problems commonly.

For a good laugh with a little ring of truth. 

http://youtu.be/byTMPyzq7O8

What are the causes of skin damage, pigment issues and other skin problems?  The answer to that question is fairly complex.  We do know some of the answers but certainly do not know them all.  First of all.....exposure.

Have you ever seen a new car that was wrecked and then left out in the elements???  Over time, the paint becomes dull, faded, and if you rub it, it comes off on your finger.  This is called oxidation.  The same thing happens to our skin over time.  Elements in the air.... pollutants, and sun work on the skin from the outside making it less youthful.  The other factor that works on the skin is what we put IN our body.  To use the car analogy, if water gets into the metal under the paint, you get rust from the inside.

So, all analogies aside, our skin is effected by exposure and what we eat.  There are 3 or 4 main problems that people complain about related to their skin:  First is wrinkles...these are caused by the skin adapting, over time, to motion of the underlying muscle.  Add this to the aging process where our bodies produce less collagen (the substance that gives our skin strength) and less elastin (the substance that gives our skin elastic qualities).  This process goes on even when we remove all of the other variables unfortunately and actually has been proven to start in the late 20's age group which is not considered old to me.  These wrinkles are very predictable.  They occur between the eyes (the elevens), around the eyes (crows feet), across the forehead, and around the mouth.  They are created by frowning, squinting, pursing the lips, and elevating the brow.  The second problem people complain about are pigment issues....brown and red "spots".  These are caused by changes in pigment production and areas of blood vessel changes in the skin, usually related to UV (sun) exposure.  The third problem is "sagging" of the skin.  This is again related to loss of collagen and skin elasticity but is contributed to by loss of underlying support structures, i.e. facial fat.  The fourth problem people complain of is the developement of "lesions" or rough areas that may or may not be pre-cancerous.

In the next blogs I plan to cover these issues one by one and give you some ideas on how to deal with them.

Come see us at INTEGRIS Total Body Surgical for your skin care concearns.

Remember to check out our Breast augmentation and hair removal specials too!!!

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

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