Total Body Surgical Blog

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!!

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!!

Mommy Makeover.....what's that??  Well, the definition changes for different parts of the country, but here in Oklahoma it usually means a breast lift (with or without augmentation) and a tummy tuck (with or without liposuction).

As most women know, after having children, the ole body has a tendency to change a bit.  The hormones of pregnancy cause skin to stretch and in many cases, it never returns to the pre pregnancy tightness.  The connective tissue under the skin also stretches, leading to the end of that flat tummy.  We all see the movie stars that have babies and shortly after...LOOK GREAT!!  Unfortunately, most of us have to work for a living and cannot spend our days at the gym or in a spa pampering our skin and re-toning our musculature.  Even if we could do that, in many cases, our genetics make it impossible to shake the effects...in many ways, it's the luck of the draw.

To get back on point, after babies and breast feeding, the breast, which enlarged during milk production, shrinks and in many cases sags.  The nipple position that used to be perky now points in a more Southern position and can lose volume.

Here is a picture that shows the different degrees of ptosis or droop.  A or "normal" is perky, high and tight.  After children, all bets are off as to where you will end up.  My experience is that if you start off with little or no breast tissue, the post pregnancy changes are less dramatic than if you start off with a large amount of breast tissue.

Other issues can also occur with shape and in some instances breast abnormalities that have been present since birth.  As you can see in the pictures below, chest wall shape, breast size, breast development, and nipple shape can all play a roll.

With all of this in mind, we try to help you return to your pre-pregnancy state if possible.  This may or may not include implants, but what it does do is re-position the nipple and lift the breast tissue that is hanging.  Some of this tissue may get removed if it is well below the fold where the breast hangs over the chest wall.  My personal experience is that most women desire implants to increase the fullness in the upper pole of the breast.  The incisions can differ depending on how far the nipple needs to move but usually they are in the form of an anchor or "lolly pop".  The nipple is not "removed", it is rotated into its new spot conserving the nervous innervation and blood supply.  These incisions have a tendency to heal very well and after 6-12 months they turn into little white lines.  Implants, saline or silicone, are placed through the same incisions and usually under the muscle so they stay in place over time.

Now for the tummy.....   We see stretch marks, sagging skin, bad c. section scars, bulging, hernias...you name it.  The way to remedy all of these things is with the tummy tuck.

A tummy tuck is done through an incision in the lower abdomen a few centimeters above the labia.  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.  Once this is done, the loose muscle and underlying connective tissue is tightened back up to make the abdomen flat.  The skin is then pulled down and the extra is removed.  A new opening for the belly button is created.  The smooth, non stretch marked skin from above the belly button is pulled down and stretch marked tissue, scars, etc. are removed.  The incisions are closed and within 6-12 months they become thin white lines.  Some can get away with a mini tummy tuck which removes a small amount of sagging skin (below the belly button) only.

Liposuction can be added to either procedure to remove problem areas in the hips, under the arms, thighs and saddle bags.

The great thing is this.....at Total Body Surgical, we can do both procedures at the same time, saving time and money.....one anesthetic, one recovery time.  How can we do this??  Because we have two fellowship trained Cosmetic Surgeons that work very well together.  We can do both procedures in under three hours and usually as an out patient.

Get your pre baby body back....come see us today!!

Call 918-786-7780 for a complimentary consultation!

We have special spring pricing to help you get back in shape for summer!

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

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

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

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

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

To continue our discussion about weight loss, I wanted to cover, a little better, the procedures we are offering.  As you know, not every procedure is the right choice for you.  If you come in for a consult and we don't offer the one that is appropriate, we will send you to get the right one.  The roux en y bypass, we will NOT be doing.  This procedure is a great one for those who need rapid weight loss due to urgent complications of being massively overweight.  We also will not be doing the so called mini gastric bypass as this procedure is unproven and not recognized by the Bariatric community.

The two procedures we will be offering are the gastric sleeve and the lap band.

The gastric sleeve has been around for some time now with great success and very low maintenance.

The gastric sleeve decreases the amount of food that can be consumed when eating a meal.  It also decreases the amount of the hormones produced by the stomach that causes hunger and the desire to eat.  This is a proven procedure that is done through the laparoscope with an over night stay in most cases.  The weight loss is dramatic with no adjustments. 

The lap band is for those people that can afford to lose weight in a slower fashion, and desire a procedure that does not change the anatomy in a permanent way.  The band is also done through laparoscopes and generally does not require a stay in the hospital.  Weight loss is slower with this procedure and it does require adjustments.

This photo shows the difference in the two procedures.  The gastric band and the sleeve compare well at 5 years as far as weight loss is concerned, however, the speed of the weight loss is much faster with the sleeve procedure.

As the INTEGRIS bariatric program matures, we may offer the more aggressive roux en y but for now we are not. 

We are striving to become a center of distinction in bariatric surgery and will take a little time.  Until then we will not be able to treat medicare or medicaid patients as this is their requirement.

Dr Miller and I both are also fellowship trained Cosmetic Surgeons so once your weight loss stabilizes, if you desire any of the post weight loss body contouring procedures, we can help there as well.  The most common are tummy tucks, breast lift with or without augmentation, arm reductions, thigh lifts, and butt lifts.  Facial procedures are also common with face lifts being the most common.  We are both very excited to offer these services.  It is rare to find qualified bariatric and Cosmetic surgeons, not to mention in a small town, and in the beautiful Grand lake community. 

Our plan is to start bariatric seminars within the next month in Rogers, Fayetteville, Bentonville in Arkansas and Joplin in Missouri.   We will also have seminars in Grove and in the Tulsa area.  The seminars will be informative and are required for insurance coverage of bariatric procedures.  We will also discuss cosmetic procedures briefly at the seminars to give you an idea of what is available.  You will be able to schedule appointments to start the process at the time of the seminars.

We are really looking forward to meeting many of you and hope that if you have any friends or family that are interested in weight loss procedures you will send them.  I will send a schedule, as soon as we get it figured out, by email.

Don't forget our other special pricing on laser hair removal ($50/area/treatment), breast augmentation, liposuction, and nail fungus treatment.  Press on the bubbles to see them.  Schedule today to see Dr Miller or myself...918-786-7780.

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!!

Laser days at Total Body Surgical!!!!  We know have the Cutera laser full time in Grove...VERY exciting.  The Cutera laser is one of the most comprehensive lasers, IPL combinations on the market.  The system can nearly do it all, and do it well.  I have many years of experience using this system and it is great at treating a large number of problems.  Let's itemize them:

1.  Laser hair removal.  With the Cutera system we use the ProWave 770.  It is an IPL (intense pulsed light) that can treat large areas and do it very effectively.  In a pinch for smaller areas that are difficult, we have the 1064 YAG which most of the older systems are based on.  Laser hair removal is very popular and has, in the past, been cost prohibitive.  For a limited time, we are offering an exceptional deal...$50.00 per area per treatment.  This will be good through the summer so don't miss it.  Usually facial hair takes about 9 treatments and body hair 6.  This means you can get your underarms done for $300.00.  Take advantage of a great value!

2.  Facial or body dyschromias.  Age spots and redness become a problem as our skin ages.  The IPL Limelight system is great for treating a variety of discolorations on the face, arms, and hands.  This usually requires a series of 3-5 treatments and we usually like to have you on the Obagi skin care system to prevent further damage or recurrence.

3.  Facial veins.  We use the 1064 YAG to treat small viens that occur at the base of the nose, on the cheeks and chin.  The laser targets the pigment and closes the vein, removing it on a permanent basis. 

4.  Leg veins.  We use the 1064 YAG to treat small areas of leg spider veins as well.  For larger areas we usually inject with a sclerosant.

5.  Laser skin resurfacing.  We have the Pearl laser for resurfacing.  This helps with reducing pore size, improving skin color, fine lines, and wrinkles.  The great thing about the pearl is the short recovery time and similar results to the CO2 laser.  Recovery times are about 4 days with great results.  Some may require a series of 2-3 treatments about 2 months apart.

6.  Laser treatment of Hemangiomas or cherry spots on the body or face.  These require only one treatment in most cases and they are eradicated.

7.  Laser Genesis for treatment of acne, to reduce pore size and improve skin tone and texture.  This works exceptionally well with no down time.

8.  Titan treatments for skin laxity in the neck and face using Radio Frequency with no down time.

We are very proud to have such great technology in Grove.  Our pricing is unbeatable and results are outstanding.  Our nurses, Janet and Trish are very skilled at suggestions and advice and are very good at treatments.  We also have the Zimmer system that provides comfort during treatment sessions.  

Come see us soon to arrange YOUR treatment plan and schedule.  Call 918-786-7780 to arrange today.

I guess the test last week was not so good judging from the response.  A few people really loved it so I may consider doing another in a few months....maybe on breasts...lift vs augmentation alone....or....faces, mini vs. full face lift....we'll see.

Today I want to discuss the Pearl laser.  Lasers have come a long way in the past 10 years.  We have gone from a technology looking for a procedure to actually being able to make a huge difference in a number of skin issues.  The great thing is that recovery times and safety have jumped in leaps and bounds. 

There are many reasons to choose laser skin resurfacing.  What resurfacing can do is:

1.  Reduce facial skin discolorations such as brown "age spots" and other discolorations.  These are caused by sun damage and age.

2.  Reduce fine lines and wrinkles in the face, neck, under the eyes, and crows feet.

3.  Shrink pores that are enlarged.

4.  Improve acne scarring.

5.  Improve skin color and texture.

6.  Improve vertical lip lines.

Why the Pearl??  The Pearl laser is fairly new technology that is similar to the CO2 laser.  What makes it good?  There are a number of reasons the pearl is superior.  First is recovery time.  The recovery time from the average treatment is only about 4 days.  This means that new skin reforms quickly, much quicker than the CO2.  Second is cost.  The cost of the Pearl treatment is $1200.  Compared to the CO2 this is less than half.  Third, you don't need general anesthesia.  We usually do the procedure with some mild oral sedation and topical anesthesia. 

The Pearl is made by Cutera..hit this link for more technical information.  Here is also a video from The Doctors that talks more about it.

www.youtube.com/watch?v=8OBi5AcQwWQ

Come see us and you won't be sorry....your youthful skin awaits.

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.

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