Body contouring is a general term that refers to any surgical procedure that alters the shape of different areas of the body. Body contouring after massive weight loss refers to a series of procedures that eliminate and/or reduce excess skin and fat that remains after previously obese individuals have lost a significant amount of weight, in a variety of places including the torso, upper arms, chest, and thighs.
Obesity is in epidemic proportions in the US and many parts of the world. It is defined as a condition where a person’s body mass index (BMI) is 30 or greater. BMI is calculated by dividing the patient’s weight in kilograms by their height in meters, squared. Normal weight individuals have a BMI that ranges from 18 to 25. Overweight people have a BMI from 26 to 30, with 30 and above people considered obese. Once the BMI reaches 35 and above, patients are considered morbidly obese. From a BMI of 30 and above a person’s life span is shortened. In addition, obesity negatively affects the economic health of a society as well as other aspects of adult and child health, often for life. Childhood obesity is on the rise in Europe as well.

The Facts About Body-Contouring Surgery

When you lose 100 pounds or more, what happens to the extra skin? For many, the answer lies in body-contouring surgery.

Body Contouring: Is It For You? continued…

Short of surgery, there is really nothing that can help. Exercise won’t tighten it, and skin creams and lotions won’t do a thing to help.

7 Things to Do Before Having Surgery

If you are considering body-contouring surgery, here’s what you should do before surgery:

  1. Stabilize your weight — at your goal — for at least three months, and be sure to correct all nutritional deficiencies (which are common after weight loss surgery).
  2. Establish a reliable support network of family and friends to help you during recovery.
  3. Make sure you can get enough time off from work to recover. It will take 4-6 weeks depending on the procedure.
  4. Understand that everything is a trade-off between removing skin, getting a contour, and having a scar. Scars are permanent. They do get lighter, but don’t disappear over time.
  5. Prioritize your body according to the area that bothers you the most, and concentrate your surgery there first. You may find you don’t need additional procedures.
  6. Prior to surgery, stop smoking (to reduce complications) and increase your protein intake to 50 to 70 grams per day to speed healing.
  7. Choose a surgeon who is board-certified in plastic and reconstructive surgery — not just a board-certified doctor.

At the office of Dr. Mark Bishara and The Paragon Plastic Surgery & Med Spa our treatment plan is specifically designed for patients who have recently undergone bariatric surgery and are left with loose, sagging skin as a result of the extreme weight loss. Cosmetic surgery after massive weight loss includes procedures such as facelift and neck lift, breast lift, abdominoplasty, arm lift, thigh lift, body lift, and abdominal hernia repair.  Please contact our office to ask more about body contouring procedures at (817) 473-2120 or visit our website at www.MarkBisharaMD.com.
 


Breast augmentation surgery may be a surefire way to get the breasts you ultimately desire, but when it comes to making decisions, there are a variety of factors to take into consideration. A properly trained plastic surgeon should be able to guide you through your decision-making process. One of those decisions will be if your implants should go over or under the muscle. So, what’ the difference?
Subglandular: Over the Muscle
The upside: Since the implant is placed over the pectoral muscle and below the breast tissue, recovery time is usually shorter because there is fewer traumas to the underlying tissues. Placing the implant over the muscle can also give a slightly lifted look.
The downside: The implant sits closer to the surface of the skin, making it more detectable through touch and more visible if your skin is thin. In a mammogram, additional views may be necessary.
Silicone implants allow for more patients to have their implant placed subglandularly (in front of the muscle) because there is less rippling and visibility with silicone.

Submuscular: Under The Muscle
The upside: Positioning the implant below both the pectoral muscle and the breast tissue allows for the implant to be less visible and act as an internal bra, keeping the implant in place. The implant is also only partially covered by muscle, so it’s less likely to cause problems with mammograms.
The downside: It’s a more painful recovery because the internal anatomy of the tissue behind the breast is hanged more.
Placing the implant under the muscle is good for those who are thin because it provides extra coverage over the implant, which gives a more natural look.

Breast augmentation helps women with small or unevenly-sized breasts achieve a fuller, firmer and better-proportioned look through the placement of breast implants. Women may elect to undergo this procedure for many different reasons, including balancing breast size and compensating for reduced breast mass after pregnancy or surgery.
During your breast augmentation exam, Dr. Bishara will examine your breasts and perhaps take photographs for your medical record. Dr. Bishara will then examine the size and shape of your breasts for Breast augmentation surgery, the quality of your skin and the placement of your nipple and areola. Also, a breast lift may be recommended with the breast augmentation.  Please call our office at (817) 473-2120 or click on the link below.  You can also visit us on our website at www.MarkBisharaMD.com and our Facebook page at Paragon Plastic Surgery and Med Spa at www.facebook.com/pages/Paragon-Plastic-Surgery-and-Medspa

 


Your Choices of Breast Enhancement
Breast surgery has been around for more than a century. Each year an increasing number of women opt for cosmetic breast surgery, mainly augmentation (to enlarger size) surgery.

If you have thought long and hard about breast augmentation and have decided you want it, then you will next need to decide on what form of augmentation. Here there are two particularly popular forms of implants which are explained below:
Implants (Silicone or Saline)
Implants are perhaps the more common form of breast enhancement. These involve implanting a foreign object into the breasts as ‘fillers’ to pad these out. These implants can be placed wither directly below the skin, or can be ‘submuscular’ (which is recommended for those who already have larger breasts) and this will make some difference to the appearance. At the same time there are different types of implants that can be used, though most often silicone implants are used. While saline implants (bags filled with a mixture of salt and water) can also be effective and have their own advantages, these are more prone to aesthetic problems which can include rippling and other problems.

History of cosmetic breast surgery
Breast augmentation surgery involves placing of a silicone gel-filled implant in the intrices of breasts with the aim to enhance size.
Implants made of different materials have been tried in the past; use of silicone implants began in 1962. The commonest kind of breast implants used today are saline and silicone implants.
• Saline implants – as the name suggests, these are filled with sterile salt water which is either pre-filled or can be filled in at the time of the procedure. Saline implants requires a smaller incision (as compared to silicone implants) – this is usually taken under the crease of the breast or the armpit and thus is very hard to detect.
• Silicone gel-filled implants – are made of a silicone gel and come only in pre-filled variety. Although, these require a much larger incisions, they are much safer than the saline ones – chances of an infection greatly decrease with silicone based implants.
This information is brought to you courtesy of Dr. Mark Bishara and The Paragon Plastic Surgery & Med Spa
 
 
 
 

Background

Although men do not face the same hormonal changes with aging that women do, the male biological clock still ticks, and over time changes in a man’s appearance can lead to a negative self-image, which can take a toll on mental and physical health. Today, men are turning to cosmetic surgery in an effort to help break the cycle of interaction between appearance and negative self-image. Because of this emerging trend, more male patients will be asking their trusted primary care providers for advice in navigating the potentially treacherous world of cosmetic surgery.
Whether in the public eye or leading a more private life, many men put forth energy, effort, and income to maintain a healthy, youthful appearance. Increasing access to more affordable, innovative, and less invasive forms of cosmetic surgery has resulted in more men turning to cosmetic procedures in an effort to look and feel younger. In fact, the American Society of Plastic Surgeons 2010 Report of Plastic Surgery Statistics indicates that of the 12.6 million plastic surgery procedures conducted annually, over 1.1 million were performed on men — a dramatic increase from the 225,009 procedures performed on men in 2000. Demonstrating their cost-effectiveness in these challenging economic times, minimally invasive procedures, such as botulinum toxin injections (Botox) and fillers, were up more than 9% from the prior year in 2010-2011. The more costly operative procedures that men undergo in large numbers include robotic hair transplants, nose reshaping (rhinoplasty), liposuction, cosmetic eyelid surgery (blepharoplasty), and facelifts, as well as surgery to correct male breast enlargement (mastopexy).
The ideal cosmetic plan maintains a life-stage balance of facial and body appearance that allows one to look their best throughout adult life. At earlier stages in life, avoiding excessive sun exposure, toxins from smoking, and recreational drug use will help to stall the progression of environmentally related aging changes. Later, avoiding significant weight fluctuation minimizes the development of loose or flabby skin. Body issues unrelated to such lifestyle factors as diet and exercise are best addressed once bone and soft tissues have reached maturity. For some, a time may come when surgery is considered for body issues unrelated to lifestyle, and plastic surgery may be the best option to help maintain a healthy self-image.
When selecting a plastic surgeon, patients should be sure to consider expertise and board certification. It is important to do the research and be patient with the selection process, because it can take some time. Patients should consider the procedure carefully and discuss with the surgeon whether a procedure is the right step to help meet their goals; this is an important part of the process because cosmetic surgery is not the answer for everyone. Patients should consult with their physician so that they can ask the correct questions in order to move forward appropriately.
A plastic surgeon will help identify patients whose body image goals and objectives may not be met with an operation alone. Postponing surgery with referral to a nutritionist, exercise trainer, or internist may be the appropriate outcome of the initial consultation. For surgery that is entirely elective, all patients should be close to their ideal health before having an operative procedure. If lifestyle choices and habits are not addressed preoperatively, the results of most cosmetic surgeries will be transient and therefore ultimately not worthwhile.
The following is a guide to help men look and feel their best throughout the lifespan.

Men in Their 30s

A man’s circulating testosterone level begins to decrease after age 30 years, with loss of lean muscle mass averaging 1% a year. Because of this, the most important thing a man can do to keep himself looking youthful is to continue building and maintaining his muscle mass. A regular program of cardiovascular fitness paired with weight training is essential to mitigate the natural aging process of decreased muscle mass. Proper hydration and attention to rest and diet are reflected in a healthier, more youthful appearance.
At this stage, age-maintenance procedures that are less invasive and are cost-effective can deliver results that look far more natural than other, more radical surgical choices. Skin care, sun avoidance, and proper use of sunblock are also crucial at this and every life stage.

Men in Their 40s

The use of botulinum toxin injection (Botox) and fillers has become much more common among men in their 40s and 50s, who are beginning to deal with the loss of facial skin elasticity. Because a man’s face has a more robust blood supply than a woman’s face, surgeons performing any personal enhancement treatments on the face must consider such factors as the depth of skin peeling, energy levels for light base treatments, and frequency of past use of topical medications.
The most common aesthetic procedure for men in this age group involves rejuvenation around the eyes. Blepharoplasty (eyelid surgery), when done well, can help revitalize a man’s face in a discreet manner, without announcing to the world that a cosmetic procedure was performed.

Men in Their 50s and Beyond

Men in this age group will typically experience increasing skin accumulation along the jawline and the neck; this is often referred to as “jowls.” Traditional approaches for face and neck lifts do not work particularly well on men because the scars cannot be hidden under the hairline, as with women. To avoid the problems caused by hairline alteration, an alternative operation to a traditional face and neck lift is performed: Using a geometric incision pattern to remove the excess neck skin hides the scar in the area between the bottom of the chin and the Adam’s apple. The presence of hair follicles in the beard also helps camouflage the scar.

Regardless of age, encourage your patients to take a planned, realistic, and conservative approach to achieving their ideal body image. Less favorable cosmetic surgery outcomes among men, such as those seen in Bruce Jenner, Mickey Rourke, and Burt Reynolds, can and should be avoided with the guidance and support of surgeons who demonstrate a clear understanding of what cosmetic surgery options are available, along with knowledge of overarching health concerns.
At the office of Dr. Mark Bishara and The Paragon Plastic Surgery & Med Spa, we provide a wide range of cosmetic procedures to help patients look and feel their best. These procedures are designed to improve the appearance of the face and body through minimally invasive techniques that provide highly effective results. Many of these procedures can be combined in order to achieve your desired appearance.  Please call our office to find out more about us at (817) 473-2120 or visit our website at www.MarkBisharaMD.com.


For those looking to improve their breast shape and/or size, breast augmentation is an option to explore. But through exploration, many women come across the same questions and concerns, leaving them to wonder what they should and shouldn’t believe. What are the most common myths regarding breast implants:
1) Saline is safer than silicone.
False. Saline implants were largely used because silicone implants were thought to cause medical problems. In scientific studies and in real life, silicone implants perform equal to or better than saline implants, which are filled with salt water. They produce more of a natural feeling. However saline implants require less surveillance and don’t necessitate MRIs.
2) Under the muscle is more natural looking than over the muscle.
False. The practice of placing breast implants under the pectoralis major muscle depends on individual breast anatomy and the type of breast implants selected. Some patients get better, more natural-looking results with the breast implants under the pectoralis major muscle, while others over the muscle. It really depends on your unique anatomy.
3) You cannot breast feed after you have had a breast augmentation.
False. When a breast augmentation is done via an incision through the inframammary fold, armpit or belly button, there is not usually a problem with breast-feeding.
4) Natural breast augmentation with fat is better than breast implants.
False. Taking a person’s own fat with liposuction and adding it to the breasts may create future problems because some of the fat transferred will perish within a year. It’s a new technology, and there is no regulatory approval in the U.S., so the technique is not yet standardized. So at this point, the procedure is very controversial, and there is concern about the long-term safety and efficacy.
5) You need breast implants for a breast lift.
False. Breast implants are not a treatment for breast sagginess. Only a breast lift (mastopexy) corrects sagginess.

For more information regarding breast augmentation, breast lift (mastopexy), or breast revision please contact the office of Dr. Mark Bishara, with offices in both Mansfield and Southlake, TX.  Dr. Bishara provides a wide range of cosmetic procedures to help patients look and feel their best. These procedures are designed to improve the appearance of the face and body through minimally invasive techniques that provide highly effective results. Please contact our office at (817) 473-2120 or visit our website at www.MarkBisharaMD.com.
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