Dr. Thomas Haas' Blog Archive – November 2006
Tags: Excess skin after weight loss, cosmetic surgery, breast augmentation, liposuction, facelift, tummy tucks, on-q pain pumps, in-office surgery suite, JCAHO, weight loss surgery.,
You’ve lost the weight...what now?
After someone loses a significant amount of weight like fifty to a hundred pounds or more, a new problem arises. You now feel better and you can finally fit into those jeans you haven’t had on since college, but now excess skin is hanging…everywhere! We are seeing more of this every day as weight loss surgeries become more popular, along with diet and exercise. Some amount of excess skin will ‘pull back’ and look acceptable automatically after a massive weight loss. However, a large amount of extra skin such as that on the abdomen, arms, and neck can only be improved with surgery.
Like a lot of cosmetic procedures, surgically removing the excess skin is the only real solution. I tell this to my patients...you can either live with what Mother Nature and life has given you, or you can choose to have a surgical procedure. No amount of lotions, potions, lasers and pills will do the trick. If you want perkier breasts, removal of unwanted areas of fat, a flatter tummy, or to lift your jowls and tighten your neck—nothing is as dramatic and as proven as surgery.
Once we have gone over the patient’s medical history and physical, we (the patient and I) have to decide if it’s a good trade—improved contour and appearance for the scar they will have. This is an important part of any discussion in cosmetic surgery but should be obvious to the patient. It should be a no-brainer that the scar is much better than their current problem. Scars are hidden and will fade with time, but will be permanent to some degree. We show patients before and after photos of previous patients and draw lines on them to let them know what to expect.
We also take pictures of removed skin after surgery to show the patient later, once they are well on their way to recovery. The largest paddles of skin and fat are routinely removed from the abdomen. These can measure 20-30inches x 6-10inches and be 1-2 inches thick. These do not weigh as much as you think. A typical amount is in the range of 4-8lbs. But the improvement in contour is dramatic!
We routinely perform these procedures in our JCAHO-accredited in-office surgery suite, as we do all our breast augmentation, liposuction, facelifts, tummy tucks,...any cosmetic surgery. The same nursing staff and anesthesia team assure you of a very comfortable, private experience. The patient’s comfort is our priority. Less pain post-operatively is our goal and utilizing the ON Q pain pump greatly decreases discomfort. It is inserted during surgery and for 72 hours, the patient is virtually pain free in the designated area.
Some patients need multiple areas improved like the abdomen, arms, neck, breast, thighs and buttocks. For these people, sometimes we recommend staged procedures. We work on their areas of greatest concern first—for example the abdomen and arms. We let them recover for a few weeks or months, then work on the other areas
Another area of concern for patients is financing. We work with a few companies that exclusively finance cosmetic surgery*. Depending on your credit score and income, monthly payments are very affordable.
This is a very satisfying surgery to perform. After having lost a large amount of weight, it is incredibly rewarding for the patient to realize that their new outer appearance now matches their new and improved inner person.
* Financing companies:
Combined Acceptance www.surgeryloans.com 1-888-502-8020
CareCredit www.carecredit.com 1-800-365-8295
M-Lend www.mlendfinancial.com 1-888-474-6231 ext. 129
"I don't have to worry about folds of skin or rolls of fat hanging over my clothes" -C.L.
"Dr.Haas and his staff are wonderful! I cannot be happier with my results. I truly feel blessed to have found this office. A sincere thank you to you Dr.Haas." -L.U.
"For so long my arms were such an embarrassment to me and now I feel confident and comfortable enough to wear sleeveless tops and dresses." -W.V.
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Tags: cosmetic surgery, breast augmentation, breast implants, silicone implants, saline implants, financing cosmetic surgery, JCAHO, in-office surgery suite, facelift, tummy tuck, liposuction, eyelids, body lifts, Oprah, Connie Chung,
Good news on silicone implants!!! The FDA has finally approved their unrestricted use!! And it only took 14 years!!!
Seriously, this issue has been 'government wisdom' at its worst. Study after study has shown silicone implants are safe. No, they do not last forever. Yes, there are women who have terrible medical problems who also have silicone implants, but the science repeatedly tells us that these two facts are unrelated. Despite what Connie Chung or Oprah say.
I have been in the silicone implant study for years and have tons of experience with them. Saline implants are fine, but the feel, and sometimes the appearance, of silicone is awesome...they are the gold standard. If you ask plastic surgeons around the world, they have used silicone all along and most have never even done a saline implant...they think the US is crazy...crazy with lawyers and junk science. Duh.
We do all our breast implants, and all our cosmetic surgery (breast augmentation, liposuction, facelifts, tummy tucks, eyelids, body lifts) in our JCAHO-accredited in-office surgery suite. This approval should allow the free market to drive down the price of this procedure, making financing cosmetic surgery easier.
Anyway...what a rare treat, and a great way to start the weekend, to see good news in the morning paper...the triumph of truth!
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Tags: acne, aesthera ppx laser, in-office surgery suite, JCAHO, breast augmentation, liposuction, tummy tuck, facelift, cosmetic surgery, Cutera, Titan,
The field of non-surgical skin care and rejuvenation is really growing. Imaage has the latest in technology for these services.
Imaage has had the Cutera Titan machine for almost 2 years now. We have more experience than anyone in the area. We know what this machine can and cannot do. The Titan will provide some lift and firming of the skin because of its heating of the underlying collagen. Titan does not give as much lift as a surgical facelift, but it has no downtime. Combining Titan with Genesis and IPL allows us to do a 3-D treatment to all the layers of the skin. All of us over 30-40 know that our skin is not getting any younger. The sooner you start taking care of your skin and maintaining it, the longer your skin is going to look as good as possible.
Imaage has an exciting new acne treatment just approved by the FDA. The Aesthera PPX system is painless. The PPX cleans pores while combining the proven therapeutic qualities of broadband light. Multiple clinical studies have demonstrated impressive clinical outcomes.
All the above treatments are done daily in Imaage. None of these require the use of our JCAHO-approved in-office surgery suite. We use the in-office surgery suite for all of our breast augmentations, liposuctions, facelifts, tummy tucks, body lifts...any cosmetic surgery procedure.
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Tags: cosmetic surgery, tummy tucks, breast augmentation, liposuction, financing cosmetic surgery, fat roll, skin excess, JCAHO certified in-office surgery suite, on-q pain pumps, flat belly,
Seems like I've been doing lots of tummy tucks lately. I gotta tell ya...it is a great operation. If you've had a few children (or even one) or lost weight, or whatever, and have skin laxity in your abdomen, there is nothing like a tummy tuck to flatten your belly. You can do a million sit-ups, eat right, etc...all of which are good for you...but they won't tighten those stretched muscles and skin like a tuck.
Yes it is a serious operation. Like all our breast augmentations, liposuctions, facelifts, (cosmetic surgery), we do that here at Imaage in our JCAHO-certified in-office surgery suite. Tummy tucks take about 2-3 hours to do. We tell patients they probably need 3 weeks off work. 75% recovered at one month, and not 100% for two months. We use on-q pain pumps which help tremendously with soreness.
Of course patients need a full consult, and I like to see people twice before surgery to make sure we are communicating and understanding each other. The scar usually runs from hip to hip across the top of the pubic hair. Like everything we do, the patient and I have to decide if the scar is a good trade for a flat belly. Financing cosmetic surgery usually needs to be addressed also, along with scheduling time off for your job.
If you want that roll of fat hanging over your belt when you sit to be gone...liposuction won't do it, exercise and diet won't do it...a tummy tuck will.
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Tags: cosmetic surgery, breast augmentation, liposuction, facelift, JCAHO, in-office surgery, costs, financing, Botox, Restylane, tummy tucks,
Financing cosmetic surgery is an issue we deal with daily. Understandably, paying for these procedures is a major concern for our patients. Lots of patients seem a little unaware of options available to finance their surgery.
There is an entire cottage industry that has sprouted up just to address this. We deal with three companies...their websites are: www.surgeryloans.com, www.carecredit.com, and www.mlendfinancial.com. We are linked to their websites and it's pretty easy to apply on-line or thru their 800 numbers. To give you an idea, a breast augmentation costs about $5000, and the minimum payment is around $150/month.
We do all our procedures in our JCAHO-approved in-office surgery suite...breast augmentations, liposuction, tummy-tucks, facelifts, etc. This gives the patient a much more private and luxurious experience and allows us to control expenses better. (Smaller things, like Botox and Restylane, don't require any sedation.)
Cosmetic surgery is an investment in yourself. The patient must be comfortable with all aspects of her/his decision...with these options, there are a variety of ways to finance.
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Tags: plastic surgery, liposuction, breast augmentation, in-office surgery suite, diet and exercise, weight loss, sedation anesthesia, twilight anesthesia,
Just finished another liposuction in our in-office surgery suite (We do all our surgery in our JCAHO-accredited surgery suite...breast augmentation, faces, liposuction...under sedation, or twilight, anesthesia). There is lots in the news, as there always is, about new techniques for weight loss, injections, herbs, gels, etc. The gold-standard for areas resistant to diet and exercise is still liposuction...and it will stay the best way for the near future.
When I'm in the gym, I see people struggling on machines for years trying to get rid of saddle-bags (more women than men) and spare tires (more men than women). I fight the urge to tell them, look, liposuction is faster, probably is less sore than years of leg-lifts, sit-ups, whatever, and probably costs less if you factor in time-is-money. Everyone has areas on them that they can't get rid of, even when their weight is down to an unusual low.
I like patients to be at their lowest stable weight. Yes it is possible to eat your way out of a good result with liposuction. So we also stress adhering to a sensible diet and exercise program after liposuction. Studies show people who do this are much happier with their result years later.
Liposuction still is a surgical procedure, but it is very routine, and the results cannot be duplicated with any other new technique.
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Tags: in-office surgery suite, private surgery suite, JCAHO, safety, luxury privacy, breast augmentation, liposuction, facelift, anesthesia, plastic surgery,
Patients frequently ask me about our in-office surgery suite. Having this facility provides our patients with much more privacy and luxury, and I think it is safer than a hospital.
The American Society of Plastic Surgery mandates that all members of this society only operate in certified operating rooms. Imaage's surgery suite has been accredited by JCAHO, the Joint Commission for Accreditation of Health Organizations...this is the arm of the federal government that assures hospitals, surgery centers, etc are meeting certain standards. We must have all emergency equipment and policies in place to be allowed to operate.
We do all our surgeries here at the office...breast augmentation, liposuction, facelifts, etc. I think it's safer for a few reasons. The same staff, from anesthesia to nurses to scrub techs to recovery, are here every day. In the hospital, the surgeon never knows what staff will be in his room that day...you could have a urology nurse one day, an orthopedic nurse the next. Also, you never know if the patient in your room before you had an infection.
Our suite is certainly more private and luxurious. You don't have to go down the hall for bloodwork, then back to registration, then hope your family can find recovery, etc.
Patients have asked 'If having your own surgery suite is so great, why doesn't every other surgeon'. The answer is simple...it is very time-consuming and expensive and involves years of work, along with government oversight, to accomplish this. There is no doubt this is the wave of the future, and I'm sure you'll see more and more local surgeons building their own operating rooms.
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