Saturday, November, 28, 2015

Plastic Surgery Part of Aftercare Following Extreme Weight Loss

KANSAS  CITY – The Journal of the American Medical Association’s internal medicine edition just published an article stating that more than 67 million Americans over age 25 were obese. This startling figure is based on data collected between 2007 and 2012 as part of an ongoing study conducted by the Centers for Disease Control and Prevention.


It is not surprising that thousands and thousands of people in the United States are turning to bariatric surgery to address their morbid obesity.  In 2013, 179,000 Americans had weight-loss surgery, according to the American Society of Plastic Surgeons (ASPS). Forty-two percent of those procedures involved a gastric sleeve. Thirty-four percent had Roux en-Y (RNY) – or gastric bypass surgery, and about 14 percent chose gastric banding.

Over time, the majority of bariatric patients lose a massive amount of weight. In the process, they must create new eating habits, be diligent about exercise, and address the emotional and psychological changes that follow extreme weight loss. Follow-up care often includes plastic surgery to remove excess skin and to surgically sculpt specific areas of the body – for example, brachioplasty, an arm lift to remove “bat wings.”

“It is not uncommon to see extreme weight-loss patients at Premier Plastic Surgery of Kansas City a year after their surgeries,” says Dr. Federico Gonzalez, a board-certified plastic surgeon. “They’ve lost the weight, but excess skin in the upper arms, chest, belly, thighs and face is left behind. The extra skin may cause discomfort or problems in getting clothes to fit. My colleagues and I can address these issues.”

According to ASPS, the world’s largest organization of board-certified plastic surgeons, thigh lifts and upper arm lifts were the most popular surgical procedures selected in 2014, following significant weight loss. Breast lifts increased 10 percent, and the number of tummy tucks jumped 4 percent. ASPS began specifically tracking procedures related to bariatric surgery in 2009.

“A person’s troubles are not over once they’ve had weight-loss surgery,” says Dr. Moore. “In fact, that’s just the beginning of the process. The weight loss is great, but sagging skin can be painful, unsightly and discouraging. Resistance training for muscle growth helps support some of the tissue, but more often than not follow-up surgeries are warranted.”

If you have had – or are planning to have – bariatric surgery and need a board-certified plastic surgeon as part of your aftercare team, please call the office of Dr. Federico Gonzalez at (913) 782-0707 between the hours of 9 a.m. and 5 p.m. Monday-Friday. Premier Plastic Surgery of Kansas City’s suite is No. 370 in Doctors Building No. 1 at 20375 W. 151st Street in Olathe, KS, 66061.

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Will Diabetes Affect Cosmetic Surgery?

KANSAS CITY – We see a lot of good surgical candidates walk through the doors at Premier Plastic Surgery. They are healthy, physically fit, well-nourished and psychologically sound. Unfortunately, we consult with many men and women who are less than optimal patients for elective cosmetic procedures. They are looking for answers like anyone else, but come in with a lot of added risk factors.

A triad of problems tops the list of things that could potentially compromise surgery and healing:

  • Poor medication management
  • Smoking
  • Diabetes

diabetes-cosmetic-surgeryIt’s vital that patients fully disclose their medical history and current lifestyle habits. This includes all health conditions, as well as use of alcohol, drugs, tobacco, homeopathic products, over-the-counter medications, and prescriptions. Many of these items compromise blood clotting, anesthesia, organ function, blood pressure and wound healing. To do their best work, Premier’s board-certified plastic surgeons – Dr. John B Moore, Dr. Brad Storm and Dr. Federico Gonzalez – need to know everything. This facilitates case management and risk reduction.

Smokers must cease their habit several weeks pre- and post-operation – if not permanently. Diabetics must have their blood sugar strictly under control before surgery and afterward. Smokers and diabetics are notoriously poor healers, so these cases must be managed closely to promote satisfactory outcomes.

Diabetes and Plastic Surgery

Diabetic surgery patients have a particularly challenging road, depending on their age, fitness, circulation, kidney health, current treatment protocol, immune system condition, and their ability to strictly control diet and blood sugar levels. Surgery involves a degree of physical and mental stress, which impacts hormone levels. In the diabetic, these changes can contribute to lower insulin secretion, increased insulin resistance, reduced cellular glucose uptake, and a buildup of acidic ketones in the bloodstream.

High urinary output may make diabetics prone to dehydration. In post-op surgery patients, excessive urination takes vital fluids away from cells trying to heal and may cause other complications. Hydration, electrolyte levels, and renal health must be watched closely in diabetic patients.

Nerve damage, fragile skin, cardiovascular inflammation, and an increased risk of infection and tissue death are also concerns for plastic surgeons considering surgery on clients with diabetes. Wounds take longer to heal, exposing incisions to contaminants for a longer period of time. Following wound care instructions is of utmost importance. Weighing a potential patient’s ability to comply with post-op protocol is a vital part of the consultation process.

Reducing Risks before Cosmetic Surgery

  • Keep blood glucose within target zone
  • Eat a nutritious, protein-rich diet
  • Maintain hydration
  • Avoid cigarettes, alcohol and drugs
  • Exercise
  • Keep stress levels low
  • See your family doctor regularly

By following the aforementioned lifestyle routine, you will become a better surgical candidate. Needless to say, non-insulin dependence is the goal, whether you are considering cosmetic surgery or not.

If you have diabetes and would like to consult with one of our physicians about the possibility of having a breast lift, nose job, or liposuction, please call our office at (913) 782-0707. We’ll weigh the benefits and risks together. And, don’t forget that we offer a wide range of non-invasive cosmetic procedures and products in our Premier Skin Care Center.

VECTRA 3D Imaging Enhances Plastic Surgery Consultations

Vectra-StandingKANSAS CITY – To provide potential plastic surgery patients with a more accurate portrayal of cosmetic outcomes, the board-certified physicians at Premier Plastic Surgery of Kansas City have added VECTRA® M3 imaging and “Sculpt My Dream” simulation technology to their patient services. These tools allow patients to visualize surgical options and give doctors the means with which to explain procedures and show cosmetic choices.

In the past, viewing before and after photos of other people was the only way to show clients their options.  However, all patients are different and pre and post op photos have limited value and may allow patients to develop unrealistic expectations. While the doctors at Premier Plastic Surgery encourage clients to look through the photo galleries on this website, they were excited to adopt the latest consultation-enhancing technology.

Drs. Moore, Storm and Gonzalez have partnered with Fairfield, New Jersey’s Canfield Scientific, Inc., a leading provider of clinical imaging systems in the United States. The surgeons now are using Canfield’s VECTRA® M3 system. Incorporating multiple cameras, VECTRA takes a series of high-resolution photos of the patient from different angles. These simultaneous images are used in conjunction with a patient’s personal information, resulting in a customized, three-dimensional virtual model of the patient.

vectra-pt-docWhile VECTRA is useful for planning cosmetic surgery of the head and neck, rhinoplasty surgery for the nose, chin implants and body lifts, the program is especially beneficial in determining whether a breast lift is needed and what size and style of implants best suit augmentation candidates. Uneven breast size and positioning are common. This new 3D software allows surgeons at Premier to pinpoint asymmetry and show patients a surgical plan to address the unevenness.

Canfield’s “Sculpt My Dream” simulation also delivers a dose of reality. It allows our surgeons and clients to manipulate physical traits and rotate the model, so they can visualize potential surgical outcomes. A ghost image can even be overlaid with original physical traits to help the client “project into the future.” The enhanced communication maximizes understanding during consultations and helps clients make more informed decisions.

Premier Plastic Surgery believes that when combined with accurate medical history, a healthful lifestyle, and strict attention to post-surgical after-care, VECTRA and the Sculpt My Dream technology pave the way for long-term patient satisfaction.  If you think you are ready to weigh the possibilities, please call (913) 782-0707 to set up a consultation with Dr. John B. Moore, Dr. Brad Storm or Dr. Federico Gonzalez.

Premier Plastic Surgery of Kansas City is located in Suite 370 in Doctors Building No. 1 at 20375 W. 151st Street in Olathe, KS, 66061. Hours are 9 a.m. to 5 p.m. Monday-Friday.

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FDA Approved 410 Breast Implants

Dr. Brad Storm compares the 410 Natrelle™ Silicone  Gummy Bear Silicone Breast Implants with other traditional implants. Watch the video and us today for your consultation.

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FDA Approves Allergan’s Natrelle 410 Silicone-Gel Breast Implant; Establishes National Breast Implant Registry with the ASPS

natrelle-410Based on seven years of data from 941 women, the FDA has approved Allergan, Inc.’s Natrelle 410 silicone-gel breast implant for breast augmentation and reconstructive surgery.   Allergan, as part of the FDA-approval process, has agreed to officiate over a series of post-approval studies.  These studies will assess long-term safety, and effective outcomes as well as any associated risks with rare diseases.

According to Dr. Jeffrey Shuren, Director of the FDA’s Center for Devices and Radiological Health, “Women should fully understand the risks associated with breast implants before considering augmentation or reconstruction surgery, and they should recognize that long-term monitoring is essential.”

Other conditions Allergan must  meet for FINAL FDA approval include submission of a report based on a 10-year clinical study, and participation in developing the National Breast Implant Registry (NBIR) in collaboration with the FDA and the American Society of Plastic Surgeons (ASPA).

dr-brad-storm-2“At Premier Plastic Surgery we are very excited about the FDA announcement that the 410 cohesive gel implant is more widely available.  I’ve used this implant for the last 7 years for breast reconstruction cases and the most complicated breast augmentation patients thru an FDA research protocol and I’m very happy the FDA has allowed the use of this implant for more straight forward breast augmentation cases.  In plastic surgery there are numerous situations in which the quality of the final result depends in part on the devices and technologies available.  While the cohesive anatomical implant won’t replace the round gel implant and is not appropriate for all, it will allow better final results for a significant group of patients.”  – Dr. Brad Storm.

The basis of this registry is to track cases of breast implants among women, and create a device surveillance registry to collect data on short and long-term safety outcomes associated with breast implants.  Overall, the main focus is to monitor the safety and efficacy of these devices in patients who have used them.  Since initiating the 10-year profile study, a cooperative research and development agreement has been signed by the FDA and the ASPS.  Review of historical data, discussions on the aggregation of data and validation of inquiries continue on a weekly basis.

According to Shuren, the FDA will continue to look at results from the post-approval study to rate long-term safety and effectiveness.   The silicone gel used in the Natrelle 410 implant contains more cross-linking than Allergan’s previously approved implant, resulting in an implant that is significantly firmer.  The Natrelle 410 breast implant is the fourth FDA-approved silicone gel implant to be available in the United States.

Dr. Storm Earns Top Doctor 2013 Award

Top Doctors 2013 - Dr. Brad StormDr. Brad Storm was voted as a Top Doctor by his peers in the January issue of 435 South Magazine.

More than 5,000 licensed doctors were surveyed in Kansas and Missouri and asked which doctors they would send a family member to within the area. Nominees were evaluated on the basis of the survey results, the legitimacy of their licenses, and their current standings with their state’s medical board.

“Obviously it’s very gratifying when our patients feel we’ve done a good job, but it’s particularly gratifying when my peer physicians who see a lot of work of other Plastic Surgeons voted me one of the top Plastic Surgeons in Kansas City, ” Dr. Brad Storm.

Breast Reconstruction by Dr. Brad Storm

Dr. Brad Storm interviewed on NBC News, talks about the basics a woman has to go through when deciding on her options after a mastectomy.

Migraine Surgery by Dr. John B Moore

In this video Dr. John B Moore talks about migraine surgery treatment with a patient that underwent surgery.

More information about Migraine Surgery treatment is available on the Midwest Migraine Surgery Center website.

Patients with migraine headaches, unresponsive or poorly responsive to medical management, can now be treated surgically with a 90% success rate at the Midwest Migraine Surgery Center of Premier Plastic Surgery of Kansas City.