Posts Tagged gastric bypass

Brachioplasty – Arm Lift – The Truth

Posted by admin in Dr D's Patients, Dr D's Truth on April 15, 2013

Brachioplasty surgery has been called the “Arm Lift” and it kinda does “lift” the arm. The areas treated in the upper arm have been called amongst other things “Bat Wings.” Surgery tightens the skin around the upper arm which can hang unattractively in those who have lost a good deal of weight. This varies of course.

Traditional brachioplasty surgery is performed through an incision (and leaves a scar) from the arm pit to the elbow. Care is taken to try to make the scar fall into a less often seen area when the arms are at the sides. The scars from surgery take a year or more to mature and are often not the prettiest even when efforts are made to make them so at surgery.

Short scar techniques have come around, but in many cases either fail to fix the problem adequately or bind the arm to the chest in a disabling manner.

The bottom line on brachioplasty is that the “short scar” methods are probably more risky than they are worth and the scars from surgery take a year or more to mature in many cases. Still for the gastric bypass patient these operations are occasionally desirable.

Best Regards,

John Di Saia MD

Related:

A Nice Breast Lift/Implant and Arm Lift “Before & After” from the practice

Originally posted 2011-07-27 07:30:28.

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Gastric Bypass Complications – A Hospital Dilemma

Posted by admin in legal medicine on September 21, 2011

At a Department of Surgery meeting at a hospital at which I operate, the issue of gastric bypass complications and emergency department visits came up. It seems that a general surgery group working in the emergency department has been getting hammered with gastric bypass complications on cases originally operated by outside surgeons. These patients come to the emergency department and the general surgery group is consulted.

The problems this raises are multiple:

(1) Managing surgical patients operated by other surgeons exposes the new surgeon to liability risk from the original surgeon.

(2) Gastric bypass surgery is a sub-specialty of sorts and for a general surgeon to operate upon such a patient is an even greater liability.

(3) This particular general surgery group does not have malpractice coverage for gastric bypass patients. By the terms of their malpractice policy, this is considered an added expense. Since the group does not do gastric bypass surgery, they do not pay that additional premium.

(4) These patients frequently have no insurance coverage, so this is truly uncompensated liability. Cash pay emergency patients rarely if ever pay their bills. I know this from painful experiences learned when I used to cover more emergencies in years gone by.

So who should care for these emergencies?

Apparently the general surgery group has an agreement with the hospital to see all consultations, so at present they are seeing them. They are doing so possibly without malpractice coverage.

Ideally, these patients should be cared for by their original gastric bypass surgeons. One of the things patients who pay cash for their gastric bypass do not always work out its what they might do if such an emergency occurs. There is no practical way to make that happen however.

In the case of a patients without health insurance, emergency departments have a very difficult time transferring them to other hospitals. What hospital or doctor after all wants to be forced to contend with yet more red ink and liability as well.

Best Regards,

John Di Saia MD

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Gastric Bypass Study Results

Posted by admin in Medicine in the News on March 21, 2011


Women have an easier time than men after gastric bypass surgery, a new study shows.

In a study of nearly 38,000 laparoscopic bypass patients University of Nebraska researchers found that women were almost five times less likely to die after the surgery, according to a report presented at the annual meeting of the American Society for Metabolic & Bariatric Surgery. Women also had 25 percent fewer complications and were one third less admissions to intensive care units.

Experts weren’t surprised by the results.

“Generally if you’re comparing a man and a woman of the same body mass index, the surgery will be easier to do on the woman,” says Dr. Amir Mehran, director of bariatric surgery at the University of California, Los Angeles. “That’s because women tend to carry their weight on their hips, buttocks and chest, whereas men tend to carry all their weight in their belly, which makes the surgery more difficult.”

Source: www.msnbc.msn.com/id/37902869/ns/health-diet_and_nutrition

The post weight loss plastic surgery is easier on the women as well. Men are larger cases and take more post-operative care. Women adjust better.

This study also found that patients did better when they had the gastric bypass along with someone else in the family:


The difference, Slotman says, is the encouragement people get from a family member who is going through the same thing. The support makes it easier to make dramatic changes in lifestyle and eating habits to keep the weight loss going.

My wife and inlaws have all had gastric bypass surgery. It is easier to undergo what seems like an ominous feat with family around who are going through it or have been through it.

Best Regards,

John Di Saia MD

Related:

Dr Di’s Post-Gastric Bypass Plastic Surgery Website Section

Originally posted 2010-06-28 07:30:47.

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Ajay Rochester Cops to Cosmetic Surgery Makeover

Posted by admin in celebrity plastic surgery on March 1, 2011

WHEN a bikini-clad Ajay Rochester turned up looking fab on the cover of a women’s magazine last year, suspicions were instantly raised – was her svelte appearance down to tricky magazine airbrushing or a tummy tuck? What followed was a war of words between the mags and an avalanche of speculation until finally the airbrush was credited with the overhaul. But now we see that a thick-skinned Rochester has invited yet another women’s magazine into her world – the result of which is a revealing look at the tummy tuck and boob lift she had in November.
Source: heraldsun.com.au/entertainment/confidential/biggest-loser-ex-host-ajay-rochester-comes-clean-on-plastic-surgery-on-belly-and-breasts/story-e6frf96o-1225827044771

With images like these floating around what would be the point of denying it? Then again look at Octomom.

Many if not most gastric bypass and extreme weight loss patients consider plastic surgery. Most start with a tummy tuck or extended tummy tuck.

Best Regards,

John Di Saia MD

Related:

Plastic Surgery After Gastric Bypass / Extreme Weight Loss

Originally posted 2010-02-16 07:30:04.

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1-800-GET-THIN, 2 Dead and Lap Band Scrutiny

Posted by admin in time sensitive on December 19, 2010

A second death linked by a coroner’s report to the weight-loss surgery performed at a Beverly Hills clinic may prompt state regulators to take a closer look at the procedures marketed by TopSurgeons. The tragedy of Ana Renteria’s life was in the way it ended: her body ravaged by infection 10 days after she had the Lap-Band weight-loss operation advertised on those billboards and radio spots bearing the phone number 1-800-GET-THIN.

Source: latimes.com/health/la-fi-hiltzik-20101219,0,854041.column

Lap-band surgery is heavily marketed. 1-800-GET-THIN is just one service blanketing the airways with promises of weight loss to an overweight public hungry for weight loss.

While I do not know the particulars of this case, I do know that morbidly obese patients pose high risks for surgery. They need to be carefully screened to prepare them and reduce that risk. Surgical talent varies amongst surgeons. You are not buying a car but a surgical service. Like in plastic surgery, getting a Lap-Band by one surgeon is not exactly the same as having the operation performed by another surgeon.

One of the touted benefits of Lap-Band surgery when it was first devised was that it is smaller scale surgery (than a formal gastric bypass) and therefore should present lower risk. Don’t be confused though. Operating on a morbidly obese clientele is going to have casualties and now we are seeing some of them.

Think about any operation before you have it. See your family doctor and discuss your risk and what you can do to minimize it. Find the best surgical talent you can if you do decide to have surgery. Carefully review the risks and benefits and resist the temptation to believe advertising bits. They are only hooks to get you in there.

Best Regards,

John Di Saia MD

P.S. I am not against bariatric surgery. My wife and in-laws have all had successful Roux-en-Y operations. The truth is that these operations have risk associated with them. That is the point.

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Carnie Wilson Shops Like She Hasn’t Had Gastric Bypass

Posted by admin in Other Celebrity News on October 14, 2010

With all the paps around, you can’t hide much…like your shopping habits. Carnie Wilson was caught at the local supermarket with a ton of food. It would be interesting to see what she eats to undo the benefits of her gastric bypass surgery. She has gone up and down on her weight after her surgery and this is an uncommon problem. My extended family includes three gastric bypass patients and they have not seen large weight gains after their operations.

If people are determined enough, no surgery will keep their bodies as designed. We know that in plastic surgery all too well.

Source: tmz.com/2008/07/28/carnie-wilson-binge-shopper

Best Regards,

John Di Saia MD

Originally posted 2008-08-14 07:30:00.

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John Goodman Looks Great – Gastric Bypass?

Posted by admin in Weight Loss on June 14, 2010


He’s made his name as an overweight, larger-than-life character throughout his Hollywood career.

But the pounds have been falling off portly actor John Goodman as he showed off a slimmer physique at an awards ceremony in Los Angeles last night.

The 57-year-old, who was rumoured to weigh 28 stone 18months ago, looked almost half the man he was just under a year ago as he attended the AFI Life Achievement Award party.

DailyMail

John Goodman looks great! For those who are curious, I’d say here is a very high chance that he had a bariatric operation. This is not to minimize his accomplishment. He probably just added ten years to his life. I hope he quit the cigarettes too. On whether or not he has had plastic surgery afterward, it is hard to tell from the images at DailyMail. My practice involves a fair amount of this post gastric bypass body work, but we need to see more of him to know much.

Best Regards,

John Di Saia MD

Related:

Dr D’s Post Gastric Bypass Plastic Surgery Page

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Star Jones Bikini and Laparoscopic Gastric Bypass

Posted by admin in celebrity plastic surgery on January 9, 2009

Just Jared

Star Jones flaunts her bikini body in some sparkly white threads while vacationing in St. Bart’s earlier this month.

Star did get bagged by one of my favorite irreverent bloggers for gaining weight again, but I doubt you would have seen her in a bikini before her surgery. Improvement is improvement. A common pattern of laparoscopic gastric bypass scars can be seen here for those interested. Her bikini may be hiding a body lift scar too but it too well-placed to tell for sure.

Best Regards,

John Di Saia MD

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Carnie Wilson After Gastric Bypass – Weight Gain?

Posted by admin in Other Celebrity News on March 23, 2008

AOL

In 1999, Carnie Wilson underwent a bariatric operation (there are many types). She subsequently lost a great deal of weight and likely had plastic surgery. This release features a story about how she gained a whole lot of weight again.

These cases are fascinating as patients really aren’t able to gain this much weight after these operations, at least not very often. Does anyone know who did her operation or what type she had? The question of how weight loss surgery patients do after these operations is an experiment in evolution.

Best Regards,

John Di Saia MD

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Cosmetic Surgery After Gastric Bypass I YouTube Video

Posted by admin in tummy tuck pre-op tutorial on March 19, 2007

This is a part of a presentation I am giving to a gastric bypass support group a few times this year. It has been converted to a video and put to music. We start with the tummy.

Best Regards,

John Di Saia MD

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