Total Body Surgical Blog

What are Varicose Veins? Total Body Surgical Cosmetic Surgery

Posted by Jeff Swetnam, MD on Sun, Jan 27, 2013 @ 10:07 AM

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Varicose Veins....an ugly term for an ugly and troublesome condition.  Almost everyone remembers a relative that had or has hideous looking legs.  When they show them, the kids run for the hills.  Today, I would like to discuss why the problem occurs and what can be done about it.  Also, a little history to show you how things have changed.....they are a whole lot better today!!

Varicose veins are a wastebasket term for chronic venous insufficiency.  Both are big descriptions for a complex problem.  The issue can range in severity from small spider veins, which most people have a smattering of, to the big ropey veins, to swelling in the lower legs, skin color changes and even leg ulcers that won't heal.

spider veins  A picture of spider veins.

large varicose veins  Picture of large varicose vein.

To be nice, I won't show an ulcer, they are ugly!!

The cause of these problems are usually hereditary, but can occur from leg injuries, clotting in the legs, and other factors.  They are made worse by working conditions, pregnancy, but usually not caused by them.  Of course, the human vascular system starts with the heart.  It pumps blood rich in oxygen to the rest of the body.  The blood travels around and exchanges oxygen for CO2 (the byproduct of the cells working), it then must get back to the lungs for the exchange of CO2 for new oxygen and the process repeats.  The veins don't have the heart to pump the blood, so, the musculature of the extremities compress the veins and make the blood move towards the chest and lungs.  In the normally functioning vein, there are valves present that allow the blood to only go towards the chest....up....against gravity that wants it to go down.  In the diseased vein, these valves don't work and the blood pools and stays in the leg or arm.leg veins  These pictures are a good visual for how this works.

leg veinsIf the valves do not work properly, pressure builds.  This is reflected in the branches of the larger veins and they enlarge over time creating the large varicose veins we have all seen.  These become painful as they stretch the surrounding connective tissue and the pressure, combined with the lack of flow causes the iron from the blood to break down in the skin.  This can lead to rust colored changes in the skin, rashes, and eventually skin breakdown. 

 

Treating this problem has changed significantly in the last decade or so.  Since the problem is usually the saphenous vein (kind of an intermediate vein in the leg), we used to remove it surgically and called it stripping.  Many have heard horror stories about removing these veins, having general anesthesia and the recovery time required.  With modern ultrasound and laser technology we can now remove this vein from the circulation without stripping, without general anesthesia, and without a long recovery time......great news!!  We do them in the office, patients walk, in then walk out. There is almost no down time...if any.

laser closure

For the large, tortuous, ugly branches, we remove them through tiny incisions, as small as the end of a pen.  Because we have stopped the flow into this vein by lasering the saphenous vein there is very little blood loss and again, almost no down time.  The little incisions heal nicely and are not noticed after a few months.

Most of the time, if you are having symptoms of pain, swelling, skin color changes and have a visible varicose vein, insurance will pay for the procedure...after jumping through a few hoops.  Spider veins are considered cosmetic and are not covered though we can treat them with injections or laser.

So if you have vein issues, come see us today at Total Body Surgical where we can help.  Our goal is to try to make your legs look and feel as normal as possible. Call 918-786-7780 today!!

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Topics: Gastric Sleeve Surgery, spider veins, cosmetic surgeon, weight loss, sclerotherapy, laser liposuction, Laser vein therapy, Total Body Surgical Lap band

Veins...at Total Body Surgical Cosmetic Surgery and Vein Center

Posted by Jeff Swetnam, MD on Sun, Nov 04, 2012 @ 09:41 PM

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Winter time is vein time a wise man once said (that's me ya'll)!!

 

Why is winter time the time to worry about those pesky leg veins??  Well, it's because you are already wearing pants.  In spring and summer we want to wear shorts, or other more revealing clothing, it is then too late to conseal any ongoing treatment.  In winter, the healing process can take place under your clothing and people won't ask too many questions.  Now is the time to treat spider veins and larger varicose veins.

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Spider veins are small areas that most of us get as we age.  These are pesky and ugly but usually do not indicate any major underlying problem with the larger venous system, although they can be an indicator.  They look like the skinny legs of a spider, thus the name.  They can also look like a bruised area that doesn't go away.  Spider veins progress with time and can be made worse by certain occupations..standing, etc.  They usually cause little concern except for their ugly appearance, however, they can become large enough to bleed if traumatized and an episode like this can be very frightening. 

What do we do for spider veins??spider veins  The best way to handle them is with sclerotherapy.  Now that may sound scary but really it is pretty simple.  We inject the veins with a chemical that causes them to stop working.  Sometimes a small clot forms in them and over time, your body resorbs the clot and vein eliminating the problem.  The process is fairly easy, quick, and causes minimal pain.  We have you wear a tight (compression) stocking for about two weeks after the injections and after that....nothing.  You may have some areas of pigmentation in the area for a few months and this usually resolves without further treatment.  Because this problem is superficial, most insurances consider this treatment Cosmetic and will not cover it under the usual policy.  We charge $350 per treatment and a treatment consists of two vials of the solution we use which is the safe amount at one sitting.  If more treatments are required, we usually wait about 6 weeks before re-treating.  Small areas usually require only one session.  Big, or multiple areas may require several sessions.

For a little larger veins we call reticular veins, we still use the sclerosing solution.  Sometimes it is used in a higher concentration and we use an instrument called a vein light.  vein light

The vein lite allows me to see the larger veins under the skin that fill the small spider veins on the surface.  This instrument produces a very bright, circular light that produces no heat and is very good at showing reticular veins as you can see from the picture above.  I can then inject them with the sclorosing solution, stop the blood flow, and with time, the vein is eliminated by the body.  I usually try to find and eliminate any of these veins at the time I do the routine sclerotherapy.  Again, stockings should be worn for two weeks after the therapy and strenuous exercise is avoided for two weeks as well.  This helps in preventing future spider veins originating from this one source at least.  

Maintenance may be required when treating spider veins.  They usually sneak back into your life after a few years, even if all of them are eradicated along with the reticular veins.  I like to recommend that less is more....in other words, if we treat a large amount the first series of treatments, it is a lot easier to keep up by treating small areas as they arise.  Don't let them get out of hand again. 

More about varicose veins next time.  Don't forget our special pricing and come meet Dr. Miller, he knows veins too!!!

Topics: lap band at Total Body Surgical, varicose veins, spider veins, Breast Augmentation, cosmetic surgery, Laser vein therapy, Total Body Surgical Lap band

Getting Ready For Summer?? Total Body Surgical Cosmetic Surgery

Posted by Jeff Swetnam, MD on Sun, Aug 26, 2012 @ 09:52 AM

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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.Click me

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!!

 

 

Topics: breast, breast implants, laser hair removal, Laser treatments with fractional lasers and pearl, lap band at Total Body Surgical, Liposuction, varicose veins, tumescent liposuction, Breast Augmentation, augmentation, cosmetic surgery, tummy tucks, laser liposuction, Laser vein therapy, Total Body Surgical Lap band

Obesity surgery at INTEGRIS Total Body Surgical Cosmetic Surgery

Posted by Jeff Swetnam, MD on Mon, May 30, 2011 @ 07:16 PM

 

 

Lap Band Surgery at Total Body Surgical Cosmetic Surgery

Total Body Surgical Cosmetic surgery

At INTEGRIS Total Body Surgical Cosmetic Surgery we are a dedicated Lap Band facility.  This means that we have chosen to only offer the lap band for our patients who have failed diets and are at risk for developing complications of obesity.

Obesity in America is at epidemic proportions.  Look at this from the CDC

Literally every state has an issue with people being over weight and in many states.....severely.  All we need do is walk down the street to see how bad it is.  The question is what to do about it??  This question deals with numerous issues that are difficult to quantify.  We are victims of our own prosperity and it is rapidly spreading around the globe.  We now have readily available food.  Our activity levels continue to decline.  The food is processed in ways that may be detrimental to our bodies.  Bad habits are passed on to our children and this is perpetuating the problem.  Obesity is becoming an issue globally.  Many will say "so what", I am fat and hurting nobody, why should you care??  What we see is the rising cost of the care that is required as we get older and fatter.  When people are young, their bodies can compensate for their weight by producing more muscle to haul the excess weight around.  They can produce more insulin so blood sugars don't rise.  Young hearts can beat more efficiently to send oxygen to the excess.  BUT, as we age, our skeleton is not capable of carrying all the excess and begins to fail.  Our pancreas cannot keep up and the fat causes insulin resistance.  Arteries become clogged with fat causing atherosclerosis, starving the heart, losing efficiency.  We then have joint breakdown, hypertension, coronary disease, adult onset (type II Diabetes), and the inability to increase activity.  These chronic problems are an expensive drain on the medical system and it effects all of us.  Not to mention all of the man and woman power we lose as a nation.

Diet and exercise of course is the way to combat the problem in the ideal world, however, this is not always a realistic solution.  Sometimes alternative methods are required.  Medical supervision is the next step using supervised diets and in some instances, medication to curb appetite.  When all of these methods fail, the next step may be a surgical alternative. 

There are many surgical procedures available for weight loss today and I will talk about the main ones briefly.  First of all, who qualifies for weight loss surgery?  Obesity is measured by body mass index or BMI.  Though not perfect, it is a way to measure a persons weight and index it for height giving us a number to use to gauge a persons weight.  To calculate your BMI, use the calculator on this site 

http://www.nhlbisupport.com/bmi/

New FDA guidelines consider a BMI above thirty to be of concern.

They consider a BMI over 40 to be morbidly obese. 

The three most commonly performed surgeries for obesity today are the Roux-en-Y gastric bypass, the gastric sleeve, and the Lap Band.  The Roux-en-Y is a good procedure for those who are very heavy, with diabetes, and need to lose weight quickly.  This bypass is good for more rapid wight loss and is better for controlling blood sugar.  This procedure is both restrictive (making a smaller stomach) and causes some diminished absorption.

The Gastric sleeve also causes more rapid weight loss.  It is restrictive by making the stomach smaller but does not have as many absorption issues.

Both of the larger surgical procedures have a short and long term complication rate.  .19% death rate and a complication rate of between 5 and 10 percent for the gastric sleeve.  For the gastric bypass the death rate is somewhere between .2 and .5 % with complication rates being 10-15% short and long term.  For the lap band, the death rate is .09% and the short and long term complication rate is 1-3%.

Next week we will focus on lap band surgery, how it's done and what you can expect...we'll have video too!!

Remember our Breast and Hair removal offers and get ready for the introductory offer on the Lap band!!!!

Very exciting!!

Breast augmentation special

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

Topics: tummy tuck., Breast Augmentation, cosmetic surgery, Total Body Surgical Lap band