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

:welcomeB: to LBT!!!!

I worked with Garth for years at UM (his residency) and miss him like the dickens! Please tell him Faith the rotund redhead from Trauma Burn says hi!

That is, if you see him. (I admit I don't watch Big Medicine so I don't know if you ever work together or not-not home at night much.)

Dang it! The Welcome banner doesn't work anymore! That should have been a neat flashing rainbow colored banner that said welcome. I think you get the idea.

Glad to have you here!

Hi Dr. JLo and welcome to LBT! I'm a huge fan of Big Medicine and I have seen your work on the show. Thanks for your willingness to answer our questions. I still have a long way to go, but I know I am going to need skin removed. How close to goal weight should I be before considering plastic surgery?

I am definitely leaning towards the LBL. Does the LBL take care of the inner thighs and pubic area too? Also, can you take fat from one part of the body and implant it into another, such as the buttocks?

Thanks for your time, I really appreciate it!

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.

Thanks Dr. JLo! I believe I have that episode recorded on my DVR, I just haven't gotten around to watching it yet. Thanks

Hi DrJLo-

I love LOVE love the show and had decided that I would like for you to be my physician for my TT and to remove the "wings" from my arms. I was wondering what the recovery time would be for the excess skin removal from my arms would be. I work in an office so there is no heavy lifting.

I would probably have to do the TT at a later time because money is an issue unfortunately.

Thanks for coming here to answer our questions!

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.

Most of my excess skin seems to be the inner thigh. Have you ever done just the inner thighs without the LBL? Does the scar typically go all the way done the leg? I was wondering about thermage for the arms- I really worry about the scarring. Thanks so much for being available to answer our questions.

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.

Hi Dr Lo,

Welcome aboard and thanks so much for taking the time to come on and answer questions.

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? I have already been told that underneath all the fat and skin I have really good abs so I wont be having MR.

One more question 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?

Thanks in advance for all your help.

Nina

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

Hi Doc! Great to meet you! I was wondering about having lipo in my ankles,calves, and knees. Even at a smaller size , I never had the shape we call them" Baby legs" lol. what would be the approx cost and recovery time for this?

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?

Also, I have large areola's (HUGE) what happens to them when the extra skin is removed and your nipples are replace? I've always hated how big they are, and my breast feeding days are behind me... so is it an issue for them to be removed as excess skin? The more I watch PS shows the more I've had this question.

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? 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?

Any information would be appreciated.

Thanks,

Sherri

Dr. JLo, do you recommend that your patients reach goal before considering PS, or that they just get close to it? 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?

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 !