Dr.JLo

Hi Jacque. PM sent.

Hi. The implants rupture most commonly from folds or ripples that rub on each other, so the rate of rupture is much higher if you have capsular contracture, which "squishes" the implant and causes folds. The chance of rupture on most implants is around 7% at 7 years, so it's overall low. Rupture for most reasons will get you a lifetime replacement from the 2 major companies, and they will pay amounts towards surgery and anesthesia too.

There is a lot of planning needed for PS, so I advise an early consultation to get the facts and begin looking for the best PS. Its easy to get tied to the scale as a measure of how "successful" you are, but the scale is only a part of the story. A stable weight, where your diet and excercise mesh comfirtable wiht your lifestyle is far superior than starvation to satisfy some number on the scale. I have seen patients (often bypass or DS) thin to the point of Protein malnutririon who will not heal properly from their PS and so I need to get them built up for a safe procedure.

The organization doing this calls it their Living Skin Donation program. Musculoskeletal Transplant Foundation Of course, by law nothing of value can be traded for human tissue.

I find that many patients do not appreciate the fact that they have a circumferential excess of skin. Doing a limited procedure like TT does not give the best results. Most patients who have lost over 90lbs, are over 35, and have had children are going to need a circumferential procedure. Best wishes, John LoMonaco, M.D., F.A.C.S. Plastic Surgery Houston, Texas www.DrLoMonaco.com www.BodyLiftHouston.com

The hernias are usually not a probem but I get a CT scan on my preop patients who've had them. Sometimes we find another one or a recurrence ! Im board ceertified in general and plastic surgery so Im comfortable fixing most of them but each PS differs on this. Best wishes, John LoMonaco, M.D., F.A.C.S. Plastic Surgery Houston, Texas www.DrLoMonaco.com www.BodyLiftHouston.com

Hi. Every bariatric surgeon will have their own preference here, but for the larger PS procedures like LBL I prefer them left open (unfilled) as patients need the extra nutrition after surgery. John LoMonaco, F.A.C.S. Plastic Surgery Houston, Texas www.BodyLiftHouston.com www.DrLoMonaco.com

Sorry Ive been away for so long...been busy plus it's fishing season n galveston! The event I will be attending is this weekend in Dallas at Crowne Plaza: Ryd Obesity Project - to help others conquer obesity Hope to see you there... Dr L.

I know Dr. Newall and he is a surgeon of impeccable reputation and training. It is a good idea to see several docs prior to surgery, do your homework, and select based on your reasearch. best wishes, John LoMonaco, F.A.C.S. Plastic Surgery Houston, Texas Bodylifthouston opening movie

I have been giving free information seminars in Houston at University General Hospital for 6 months or so. Typically they are Thursday nights from 7-9. My staff comes too, and can answer questions about anything from insurance, financing, recovery, etc. In fact, my manager's mom was on the show Big Medicine and she took care of her so she has a lot of helpful advice ! Anyone interested can give us a call at 713-526-5550 to check the schedule. Im also planning a big obesity related event in Dallas for May with lots of patients telling their stories, various professionals, vendors and surgeons coming too. Let me know if you'd be interested and we can get you a pre-registration discount. Yours truly will be the "MC" and there will be plenty of evening activities at the nearest local dance hall.

Hi BrandyK, Congratulations on your progress so far. I do agree with coming in early for a consult even if you are not at goal. There is a lot of planning involved when it comes to these procedures, and I am booked several months in advance. Check into our free seminars on Thursdays too...they are a good chance to get to meet my staff and I in a nice setting with 10-15 other people.

Hi, tightening the muscles is called a platysmaplasty, and that is done if it's needed (like everything else in PS!). Sometimes the issue is excess skin, sometimes its excess fat, or excess muscle laxity...or a combination. I tailor the procedure to correct the problem issues. I usually do the face very last..after the body work...as changes in wieght (i.e. loss) after the body procedures is common and it will really show on the face.

Here are the national averages from the American Society of Plastic Surgeons. These are just the surgeon fees, not the hospital and anesthesia. And remember some docs include soem areas of lipo within the cost of tummy tuck like I do. http://www.plasticsurgery.org/media/statistics/loader.cfm?url=/commonspot/security/getfile.cfm&PageID=23761

Every doc is different on this, but unfilling the band allows better control of reflux and nausea which sometimes happen after surgery. For larger cases, I do want the patients getting a few more calories to facilitate healing, so having the band open helps with this.

Congratulations on your accomplishments! We know that most lap band patients take 2 years to get down to their best weight. Continued loss after surgery will result in loose skin so I do tend to wait a bit longer in this group. Once a person has reached a healthy and stable weight, they can be candidates for PS.

Hi. Drains are a personal preference...I do not use them on my brachioplasty or inner thigh lifts. Your doc should show you pics of dog ears and tell you when/how he will correct them...again, everybody has a different approach here.

Hi Nina, Well this is a little out of my area of expertise so I cannot make a recommendation...other than to say you need a general and a plastic surgeon to talk to you about the downsides of the procedure compared to any benefit you may have. I agree that you may be at high risk and the procedure is something to consider. JL

"Be smart about looking good" The training and experience of your doctor are critical, and are the most important factors in getting a good result. Surgeons certified by the American Board of Plastic Surgery have undergone plastic surgery training at accredited programs and have been formally trained in liposuction. Board-certified plastic surgeons can be found at American Society of Plastic Surgeons: The resource for plastic and reconstructive surgery I might add that liposuction of any kind in weight loss patients often has limited results (I personally have never performed it) as the problem here is mainly excess skin not excess fat. Of course, be sure you look at numerous before and afters of patients who look like you so you can see what your results will look like.

Hi. There is a lot of debate over this. Carriers of the BRCA gene may be candidates for prophylactic mastectomy (the skin and nipple can be spared) but a careful analysis of the risk and benefits must be done. The BRCA risk is manifested by the development of cancer in a first degree relative (mom, sister, or daughter) at a young age. A genetic counselor can probably get you more complete answers here.

Sorry for the embarassment you experienced. My standard (and wise) practice is to always have a female staff member present when doing an exam or photos that involve any kind of exposure or nudity. Im sure the doctor you mention has a policy on this...his manager may want to be made aware.

Hi I think Drs. Scott Kasden and Jeff Kenkel are excellent surgeons for post-weight loss plastics. Give Jill in my office a call too as we have a nice program for out of town patients.

Hi. Ultrasonic lipo is not the same as smart lipo. Smart lipo is a newer technique and uses a laser to melt the fat. As I mentioned, both techniques supposedly melt fat and tighten the skin. Im not sure I have ever seen a convincing photo of this but that is the claim.

Hi. What was your opinion on the posts and links I posted above? It seems to me that most patients who have had the procedure were farily clear about their results.

Thats great...seems like they are getting away from what THEY deem as "medically necessary."

That's a great provision !...I wish we had that down here in Texas, where we rarely get coverage unless there are 6mos of documented medical problems from the excess skin. We still attempt insurance coverage, and continue to have a lot of delays and claim denials. Insurance companies settled for around $2 billion for unfair business practices such as these, with BCBS contributing around $128 million. These settlements were for an "alleged scheme to defraud doctors." Worth reading for those who wonder why some physicians may be reluctant to take insurance these days... http://www.hmosettlements.com/settlements/bluecross/BCBS-pressrelease.pdf