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.
 

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.

Plastic Surgery Procedures (Body Contouring) After Weight Loss

Most patients who undergo gastric bypass, or some form of gastric banding procedure, do lose weight. Many lose a lot of weight. But this massive weight loss brings problems of its own.
Typically patients are left with large folds of excess skin, along with loose muscles and sometimes localized pockets of unsightly fat tissue. In such cases, bariatric plastic surgery procedures, body contouring procedures and lipoplasty (liposuction), can help to reshape the normal structures of the body in order to improve appearance and self-esteem.
Plastic surgery is not an easy option. Mostly, it involves exchanging one cosmetic problem (eg. loose skin) for another (scars).
Plastic Surgery Procedures to Remove Loose Skin and Fat
For patients suffering from morbid or malignant obesity, choosing bariatric surgery to reduce calorie intake may offer them a passport to a healthy life. But even if such surgery causes them to lose substantial amounts of weight, they may face new problems which may necessitate further operations.
Plastic Surgery to Remove Loose Skin
When bariatric surgery (eg. gastric bypass) leads to dramatic weight loss, excessive amounts of skin can accumulate and hang in various areas, including face, neck, breasts, upper and lower abdomen, flanks, armpit, back, buttocks, arms, forearms, thighs, legs, and calves. This surplus skin can cause considerable hygienic problems, skin irritation, skin breakdown, pain and infection.
Plastic Surgery Procedures to Remove Excess Residual Fat
In addition, even though the patient might have experienced massive weight reduction, this weight loss may not be evenly spread around the body. This also depends on the patient’s type of obesity condition (whether gynoid or android). Body Contouring procedures can help to reduce these fat deposits, either by surgical excision or lipoplasty.
Cost of Plastic Surgery Procedures
The price of bariatric-related plastic surgery procedures can vary significantly, depending on several factors.

  • Patient’s condition
  • Complicating factors
  • The plastic surgeon
  • The hospital chosen
  • The type of anesthesia
  • Complications arising

Patient’s Needs
The full cost of your plastic surgery procedure is unlikely to become clear until after you have been examined by your surgeon, and your individual requirements and needs ascertained. Even then, you may need follow-up procedures after your plastic surgery.





Body Contouring Surgery Options

  • Abdominoplasty (tummy tuck)
  • Arm Lift (brachioplasty)
  • Body lift (Circumferential Panniculectomy)
  • Breast Lift (Mastopexy)
  • Breast Reduction (Women)
  • Buttock Lift
  • Face Lift
  • Forehead Lift
  • Male Breast Reduction (Gynecomastia)
  • Liposuction (Lipoplasty)
  • Thigh lift (Thighplasty)

Dr. Bishara will discuss these and other treatment options with you during your consultation to determine which procedures are right for you. 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. Please call our office at (817) 473-2120 for more information or to schedule a consultation or visit our website at www.MarkBisharaMD.com for more pictures of body contouring patients.

Weight Loss Surgery, How Do I Get Started?

Taking the first step is often the hardest when it comes to weight loss, so True Results provides some easy-to-use tools and free services to help you get informed and get started on your journey.
In North Texas, True Results has teamed up with Baylor Health Care System to provide innovative weight loss solutions for life.
True Results provides a comprehensive program and an expert medical team that’s with you every step of the way. They have specialized bariatric centers in DallasFort WorthHoustonSan AntonioAustinPhoenixTucson and St. Louis.
True Results opened the nation’s first state-of-the-art outpatient surgery center to be recognized by the American College of Surgeons as an Accredited Outpatient Bariatric Center.
Losing weight is about more than just looking good. It’s about being healthy. Bariatric patients who lose a significant amount of weight typically improve or resolve weight-related co-morbidities including Type-II diabetes, hypertension (high blood pressure), sleep apnea, joint pain and asthma.

Quick Weight Loss with Bariatric Surgery


If you are overweight and are looking for quick weight loss, then a surgical weight loss procedure may be the right approach for you. True Results has excellent quick weight loss centers in Dallas, Fort Worth, Houston, San Antonio, Austin, Phoenix Tucson and St. Louis. Their centers are specially designed for outpatient bariatric procedures.  True Results specializes in the Lap Band and Sleeve Gastrectomy surgeries, and both can be performed in outpatient centers.  Lap Band procedures and the Sleeve Gastrectomy are available in all Texas and St. Louis markets.
To help you understand the differences in the Lap Band Procedure, Sleeve Gastrectomy Surgery and Gastric Bypass Surgery, this page provides a brief overview of each procedure.

Lap Band Procedure

Lap Band Surgery IllustrationGastric banding, commonly known as a Lap Band procedure, was approved by the U.S. Food and Drug Administration for safe and effective weight loss. It is a silicone band – like a ring or belt – that is placed around the upper part of your stomach.
It is designed to place a precise level of pressure on the nerves around the upper part of your stomach so they send signals to your brain that you are not hungry.  Because the band also constricts the upper portion of your stomach, you will eat less food at one time and still feel satisfied.
The Lap Band system includes a small access port that is safely placed under your skin.  The port is not visible and it is unlikely that anyone will know you have the Lap Band system, unless you tell them.
The band is adjusted by adding or removing saline through this access port with a small needle to ensure it continues providing optimum weight loss results.  True Results has the most experienced team of weight loss surgeons in America and pioneered performing this procedure in an outpatient setting.
True Results offers the Lap Band procedure at all of its specialty weight loss centers in DallasFort WorthHoustonSan AntonioAustinPhoenixTucson and St. Louis.

Sleeve Gastrectomy (Gastric Sleeve)

Sleeve gastrectomy is a surgical weight-loss procedure in which the stomach is reduced to about 20% of its original size.
Gastric sleeve is a restrictive procedure where approximately 80% of the stomach is removed, creating a small vertical sleeve about the size of a small banana.  This procedure is not reversible.
This procedure limits the amount of food you can eat and helps you feel full sooner. It allows for normal digestion and absorption. Food consumed passes through the digestive tract in the usual order, allowing it to be fully absorbed in the body.
The majority of sleeve gastrectomy procedures are performed using a laparoscopic technique, which is considered minimally invasive. This procedure can be done in an outpatient, same-day surgery center or an inpatient hospital setting.
True Results offers the Sleeve Gastrectomy throughout Texas and in St. Louis.

Plastic Surgery Procedures After Weight Loss- Body Contouring

Most patients who undergo gastric bypass, or some form of gastric banding procedure, do lose weight and many lose a lot of weight. But this massive weight loss brings problems of its own.  Sometimes the need for plastic surgery or body contouring procedures are needed to get rid of excess fat, loose muscle and fat tissue.  The office of Dr. Mark Bishara offers many body contouring procedures that help patients look and feel their best after their weight loss. These procedures are designed to improve the appearance of the body and provide highly effective results. Many of these body contouring procedures can be combined in order to achieve your desired appearance.  Please call our office at (817) 473-2120 or visit our website at www.MarkBisharaMD.com for more information.

 

Breasts

Whether you want to increase your breast size, get a lift, go down a size or have breast revision surgery, the office of Dr. Mark Bishara has the information for you to get started on your smart beauty choice.

Breast Augmentation

Also known as augmentation mammaplasty, breast enlargement or breast implants
Breast augmentation surgery increases or restores breast size using silicone gel implants, saline implants or in some cases, fat transfer. One of the most popular and frequently performed aesthetic surgery procedures, breast augmentation has a long and successful track record in satisfying women who wish to enhance, regain or restore balance to their figures.

When to Consider Breast Augmentation

  • If you want a better proportioned or more appealing figure
  • If you wish your clothes fit better
  • When pregnancy, weight loss or aging has affected the size and shape of your breasts
  • To restore symmetry if one of your breasts is smaller than the other
Also known as mastopexy and breast lift surgery
A breast lift addresses sagging and uneven breasts, decreased breast volume and drooping nipples and stretched areolas (the darker area surrounding the nipples), recreating a youthful shape and lift to your breasts. If there is too little or too much breast volume, a breast augmentation or breast reduction might be recommended in addition to a lift. Every year, thousands of women undergo successful breast-lift surgery, experience no major problems and are pleased with the results.

When to Consider a Breast Lift

  • Pregnancy, nursing, gravity, weight gain or loss, normal aging, and heredity have taken a toll on the shape of your breasts, resulting in sagging
  • If your surgeon thinks that breast implants alone are unlikely to achieve the contour you desire
  • If the tissue surrounding the nipple or areola has become stretched

Breast Reduction

Also known as reduction mammaplasty
The goal of breast reduction surgery is to reduce the size of your breasts and reshape them so that they are proportionate to the rest of your body and are no longer a source of physical discomfort. This commonly requested, predictable procedure has the dual benefits of improving your appearance while relieving the physical and emotional burden of overly large breasts.

When to Consider Breast Reduction

  • If your breasts are too large for your body frame and create neck, back, or shoulder pain
  • If you have heavy breasts with nipples and areolas (pigmented skin surrounding the nipples) that point downward
  • If one breast is much larger than the other
  • If you are unhappy and self-conscious about the large appearance of your breasts

Breast Revision

Also known as breast implant replacement
Breast implant revision surgery, which commonly involves removal and/or replacement of saline or silicone breast implants, is performed to change the size or type of your implants and to correct any complications from your primary breast augmentation. The overall goal is to restore a youthful breast contour and appearance.

When to Consider Breast Revision

  • Your saline breast implants have deflated or an X-ray or MRI suggests your silicone implant has a shell leak
  • If you want to change your implant/breast size
  • If you have tightening of the scar tissue around the implant (capsular contracture) or your breast implants have shifted in position
  • If your breast tissue has changed as a result of skin stretching or weight loss/gain

Dr. Mark Bishara, with offices in Mansfield and Southlake- 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. Many of these procedures can be combined in order to achieve your desired appearance. Please call our office for more information at (817) 473-2120 or visit our website at www.MarkBisharaMD.com.