Dr.JLo

If you have documented medical problems from the excess skin, you may be able to get insurance to help. Hernias can be fixed at the same time, but have no relation to excess skin and the insurance companies go to great lengths to provide the research that shows this on their websites: Abdominoplasty, Suction Lipectomy, and Ventral Hernia Repair AETNA and most of the other companies adgere to these guidleines. "Aetna considers panniculectomy experimental and investigational for minimizing the risk of hernia formation or recurrence. There is no adequate evidence that pannus contributes to hernia formation. The primary cause of hernia formation is an abdominal wall defect or weakness, not a pulling effect from a large or redundant pannus." Because I am double board-certified (in general surgery and lpastic surgery) I will repair the hernia while I do the tummy tuck. The hospital will agree to seriously discount the fees they charge my patients for the tummy tuck, and the overnight stays are also covered. In this manner, a hernia may "help" you receive a tummy tuck at a discounted price. Realize that a "panniculectomy" is NOT an abdominoplasty and does not provide a result that I consider favorable...so beware of a physician who will do a "panni" and call it a "tummy tuck." "Panni" photos are at PictureTrail John LoMonaco, F.A.C.S. Plastic Surgery Houston, Texas www.Bodylifthouston.com John LoMonaco M.D., P.A.

Hi. I really cannot give you medical advice about your condition as I was not your surgeon and cannot even examine you. These are questions best answered by a physician who can see you. Glad you enjoyed the TV show. It's the second season of "Big Medicine" and my patients will be featured on most of the weekly episodes. Best, John LoMonaco, F.A.C.S. Plastic Surgery Houston, Texas Bodylifthouston opening movie

I'm more than happy to answer questions and usually get online every 2-3 days. My practice is quite busy, so I'm sure you'll understand if I can't get you an immediate response. The best way to get a question to me is to include my name in the Title (i.e. "Question about TT recovery for Dr. JLo") Tha way I can see it and others interested in that topic can refer to it and earn too!

During surgery using meticulous and gentle technique, not using surface stitches (we use glue), and closing the skin under minimum tension may help prevent HTS. Afterwards, silicone gel sheeting, steroid injections, and even laser therapy may be helpful. Best John LoMonaco, F.A.C.S. Plastic Surgery Houston, Texas Bodylifthouston opening movie

Hi. I think most PS offices offer discounts for multiple procedures, non-financed payments, and will include other things at no charge. I cannot comment on the price for LBL because it is defined so many different ways, but when I do it I perform a tummy tuck, pubic lift, muscle tightening, outer thigh lift, buttock lift, new belly button, and all liposuction needed. The general price range for this is $10 - $20,000. Hope this helps, Dr LoMonaco

Paulax ... Join Date: Feb 2006 Posts: 1,167 What if anything can be done at the time of surgery for skin that tends to form hyprotropic scares? OR Is this something that is dealt with post surgery with injections? Honestly, I have no idea, but we hear of surgeons who are specialists dealing with hypertrophic scaring or true keloid patients. Thanks in advance. I have hypertrophic scaring from my breast reduction 3 years ago and one of my band incisions is still red and rope like, 2 years out. I am considering a tummy tuck. __________________ banded July 21-06 280 fill 1 Aug 21 - 1.65cc 255 fill 2 Oct 23 - 2.2cc 245 fill 3 Feb 15 - 2.5cc 228 fill 4 Apr 2 - 3.0 218 fill 5 Oct 22 - 3.2 195 280------177------175 HYpertrophic scars (HTS)....raised, red, thick, and itchy scars form around 3 months from surgery and are usually unfavorable in appearance. Most will settle down in a year but some persist. If you have these elsewhere, you may also develop them on a tummy tuck. In patients who I know are at high risk for unfavorable scarring, we do a preventative program as soon as the wound is healed. Even so, HTS can still be a problem so I place the scars very low so they can be concealed. Best wishes, John LoMonaco, M.D., F.A.C.S. Houston, Texas opening movie Bodylifthouston

Hi. Flattening of the buttock comes first from loss of fat in that area, if the skin sags and is then lifted by an LBL there will be even more flattening. An example is case #11 at John LoMonaco M.D., P.A. If a patient wants to avoid this, I will transfer fat fat from the hips to the buttocks as a "flap" (also called "autoaugmentation") and also I may inject fat from liposuction (a "brazilian buttock lift") to 'round out' the buttocks. See case #13 at John LoMonaco M.D., P.A. Remember that the gluteus is the biggest muscle in the body and you can build it up with excercise to offset some of the flattening. Best wishes, John LoMonaco, M.D., F.A.C.S. Houston, Texas opening movie Bodylifthouston

The scale is only part of the story here...if you are at a stable and healthy weight, you may be ready for plastic surgery. For lap band patients, this is often a year or more out from their band. Emotional stability and a healthy environemnt in which to heal are also important considerations. A plastic surgeon can help determine how much fat you have left, and I do an anaylsis in my office. Patients often have less fat and more excess skin than they think. Best wishes, Dr. LoMonaco Plastic Surgery Houston, Texas opening movie Bodylifthouston

Hi. Congratulations on your accomplishments! What you would like improved is largely a matter of personal choice. What bothers you most ? If there are several areas, you may consider combined procedures. I have found that liposuction rarely benefits weight loss patients as they have lots of skin and very little fat. Look over my website photos at patients who may look like you, and you can get an idea of what is possible. John LoMonaco M.D., P.A.

Hi, Dr. John LoMonaco here. Some of you may know me from the "makemeheal.com" or "obesityhelp.com" forums. I'd be glad to help anybody who has questions I can answer. I will say that it is hard for me to answer emails in a timely manner, and many questions are really best left for your PS to answer but I'll help if I can. I do prefer to answer via the forums since everybody can see the answers that way! Some of my patients are featured on TLC's Big Medicine and many have agreed to be available to help others contemplating plastics should any of you care to contact them through me. Best wishes, John LoMonaco, M.D., F.A.C.S. Houston, Texas

Ill answer as many of these ??s as I can, although for the future its best to post your questions as separate threads so all can choose which ones to read, and I won't miss any! I am going for a High Lateral tension tummy tuck in 3 weeks and I am worried that with the lipo that I will be having to my thighs and hips that I wont acheive as much of an hourglass shape as I want ( the one advantage to having a big butt is that it makes my waist look smaller!) Is there any way to avoid the straight up and down and get more definition to the waist? A lot of this depends on your basic anatomy, hip-to-chest ratio, etc. Muscle tightening plus lipo can go a long way to get the more curvy shape. See case #21 at http://www.drlomonaco.com/tummy.htm I am having a breast lift/augmentation in May but I am worried about the scarring round the nipples and the change in sensations, also I have seen someone on this board who had a wedge lift that didnt involve the scar running down from the nipple.Is this a common procedure and how successful is it? Do only certain people qualify for it? No way to tell without seeing you what is best, and your PS has to give you his own numbers and experience on nipple sensation. I do a LeJour lift (lollipop shaped scar) and rarely have sensation loss. DR!!!!!!! THANK YOU SO MUCH FOR JOINING THIS FORUM I am a huge fan of the show. I really appreciated the visual on Claudia last week with her port. I know ps is in my future as my stomach is fast deflating.. I've ALWAYS had arm issues, so I would love to get them done first...... My question. Is is normal to get a breast lift and the arms done at the same time? Hi. I often do the "upper body lift (arms, bra roll, and breast lift) as one stage. Also, I have large areola's (HUGE) what happens to them when the extra skin is removed and your nipples are replace? They can be downsized if you like... Hi Dr. JLo, I live in Toronto, Canada and know I will be needing plastic surgery (minimum of BL & TT). How do I find a really good PS in the Toronto area? Do WL patients pose a special challenge to a PS? Im not too familiar with the board certification up there, but find the F.R.C.S. website and see if they list plastic surgeons. This certification ensures they have the proper credentials. Are you aware of anyone in Toronto who specializes in PS on WL patients or anyone whose work stands out as really good? Other than board certified PS, what else should I look for? A dedicated interest in post-bariatric plastic surgery, lots of good referrals from other patients, and an extensive library of "before and after" photos. Dr. JLo, do you recommend that your patients reach goal before considering PS, or that they just get close to it? I recommend early consultation (even before goal) so you can learn about the procedures, costs, and plan your time off work/school. Also, do you recommend that if a women is getting a breast lift and thinking about augmentation, she should get the breast lift first and let it heal before augmenting, or do you recommend the lift and augmentation as one surgery? Highly variable....I will not augment a paient wth a very long breast. I do a lift first, then the implants 3 months later. Hope these help ! Let me say I rarely return to older posts and if you post as a separate thread, Ill have a better chance of getting to it plus others who ahve the same question can also see it and learn. Many folks have the same questions !

Hi. As I'd mentioned in another post, it is illegal to sell human body parts or trade them for anything of value...like free surgery. There is a foundation that offer information about this: Musculoskeletal Transplant Foundation.

"The Texas Weight Loss Surgery Summit is an exciting and educational event for those who have had weight loss surgery. There will be informative speakers addressing a variety of topics important to the weight loss surgery patient." This weekend at the Omni Hotel in Houston. I'll be there giving 2 presentations and my staff will be present with educational materials and of course our drawing for free stuff from my spa, etc. To register: </title> <meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1"> <style type="text/css"> </style> <script type="text/javascript"> /*********************************************** * Switch Menu script- by Martial B of http://getElemen Im not sure why these links look so wierd as above, but just click on it and you'll be there !

I'd really have to see you to talk about the actual surgery and scar placement...it is highly variable and depends on the location and amount of skin, your age, and condition of the skin. Thermage and all the other skin tightening systems work inconsistently for simply aged skin, so I feel their effect on the damaged skin of most WLS patients would be even less.

The skin can be used for many purposes, regardless of it's stretched out condition. Check Musculoskeletal Transplant Foundation and see if your PS participates.

Hi. Recovery from arm reduction (brachioplasty) is about a week to 10 days off most work, and the arms must be kept elevated and wrapped. Recovery also varies as to the amount of excess skin being removed too.

I have strong feelings and a lot of negative experience from patients when large surgeries are done overseas or in Mexico and there is no long term followup. The latest techniques are pioneered right here in the U.S. because we have the obesity/weight loss population that requires these advanced techniques. Add to that you have no insurance coverage, no legal protection, an invalid implant warranty, and limited long-term followup and you have a "ticket to trouble" in my opinion. Best wishes, John LoMonaco, M.D., F.A.C.S. Plastic Surgery Houston, Texas http://www.drlomonaco.com/forwlp.htm www.BodyLiftHouston.com

Smoking (nicotine more specifically) constricts the small blood vessels that are needed for healing and can result in serious healing problems after PS. Most PS will not operate on active smokers,a nd even former smokers are still at some risk. Nicotine in any form (incl. the patch or gum) is still a problem for healing so be sure and check with your PS on this.

Hi all. Thanks for the welcome. Faith, I do see Garth all the time and will tell him hello from you. Georgia girl, an LBL does fix the pubic area but not the inner thighs in most cases. I routinely transfer fat from one area to another. See if my patient Claudine (from episode 2 last week on Big Medicine) has a re-run. She had an LBL, inner thigh lift and fat taken from the back and put in the buttock.

My advice, of course, is to always seek a board-certified plastic surgeon to perform these types of procedures as ANY doctor can do lipo in their office. A list is at American Society of Plastic Surgeons: The resource for plastic and reconstructive surgery Most docs who have a lot of experience with SmartLipo (check Dr Blinski's posts at makemeheal.com) are now following SmartLipo with regular old lipo through the usual incisions. I personally am not sure that will result in the lowered swelling and downtime that some claim. Do check the messageboards though and do your research...this technique is still very new and very few docs have a lot of experience with it. A few recent posts I found: Liposuction Message Boards - HELP WITH SMARTLIPO w/ VASER - Plastic Surgery, Cosmetic, Forums, Chats Liposuction Message Boards - Failed Smartlipo. Help needed please - Plastic Surgery, Cosmetic, Forums, Chats Liposuction Message Boards - smart lipo questions - Plastic Surgery, Cosmetic, Forums, Chats Liposuction Message Boards - any point repeating smartlipo - Plastic Surgery, Cosmetic, Forums, Chats Liposuction Message Boards - Smart lipo update - Plastic Surgery, Cosmetic, Forums, Chats Anyway, it seems the reviews are mixed which keeps me using the techniques that I know work.

Hi. Sorry for youe problems. Are you a smoker or former smoker? Areas that are slow to heal often suffer from low blood flow, and will close slowly on their own. Be sure and keep your PS updated and call if there are signs of redness or excess drainage. Best wishes, John LoMonaco, M.D., F.A.C.S. Houston, Texas www.DrLoMonaco.com www.BodyLiftHouston.com

Hi. Insurance can help, but you must have documented medical problems from the excess skin. By documented I mean doctor visits and prescriptions for skin problems due to excess skin. You will also need to find a PS willing to go through the insurance process for you, and you must be prepared for out-of-pocket expenses. My websites have a downloadable document called "Tips for getting insurance approval" under PATIENT RESOURCES plus another article in the NeWeigh newsletter you may find helpful. Best wishes, John LoMonaco, M.D., F.A.C.S. Houston, Texas opening movie Bodylifthouston

It is of course against the law (and unethical) to sell human tissue or body parts, and so skin donation cannot be done for anything of value...like free surgery. Musculoskeletal Transplant Foundation lists good information about how skin donation can help others. Best wishes, John LoMonaco, M.D., F.A.C.S. Plastic Surgery Houston, Texas