Abdominoplasty & Panniculectomy at RoxBariatric

The post-bariatric body contouring surgery program at the Roxbury Clinic & Surgery center continues to grow with more patients enrolling in post-bariatric body contouring procedures.

Patients present to our office and are very excited about having their body contouring procedures done at either the Newport Beach or Beverly Hills, CA surgery centers.

We encourage all patients who desire to have post-bariatric body contouring procedures to bring their insurance cards with them during their consultations. It is a great time to utilize health insurance plans to undergo lap band procedures. Typically after patients undergo their lap band operation they return for their post-bariatric body contouring surgery within 9 months to one year. Patients are very happy after having their panniculectomy and abdominoplasty surgeries and greatly look forward to having their mastopexy, breast reduction, brachioplasty, or medial thigh lift.

Performing post-bariatric plastic surgery is very gratifying for the patient and physician.

Brian P. Dickinson, M.D.

www.drbriandickinson.com

Rox Bariatric: A Team Effort

The Rox Bariatric program continues to grow. I was very fortunate today to hear some excellent feedback from one of our patients who is recently post-op from her panniculectomy and medial thigh lift.

She was very thankful for her results as well as to have had an excellent team of surgeons tend to her care. This group of surgeons not only pays close attention during her surgery, but also to the post-operative care that is so important to ensure proper healing.

I was truly thankful to hear how highly our patient spoke of our team of doctors. Specifically, the patient expressed her gratitude to Dr. Jay Calvert, Dr. Anita Patel, as well as the USC plastic surgery resident Dr. Joe Carey was so helpful during our case.

Dr. Patel has been taking a great interest in post-bariatric body contouring surgery and post-bariatric patients. Together with Dr. Patel, Dr. Shafipour, and the help of the USC residents we are able to provide complete and excellent care to these great patients who have lost massive amounts of weight. I am very proud of how hard our patients work to achieve their goals.

Brian P. Dickinson, M.D.

www.drbriandickinson.com

RoxBariatric. More Body Contouring. More Patients Enroll for Lap Band.

The Rox Bariatric program continues to gain significant traction. We are seeing many patients return for the second stages of their operations. I continue to be impressed by the power of panniculectomy to facilitate weight loss.

Not only does the removal of the abdominal pannus seem to allow patients the ability to workout and exercise, but also significantly motivates them to loose weight through appropriate dietary measures.

Today in the operating room I was truly impressed with a patient who returned for her bilateral mastopexy and bilateral brachioplasty after she continued to loose weight after her panniculectomy a few months ago. I continue to be very proud of how hard our patients work to improve themselves and their health.

Brian P. Dickinson, M.D.

http://www.drbriandickinson.com/

RoxBariatric:Putting Patients First

The RoxBariatric program continues to grow as more patients enroll for the lap band procedure. Upon enrollment patients meet with Bariatric Medicine Specialists who calculate their BMI.

BMI stands for body mass index which is in units of (kg/m ^2)

BMI (kg/m2) = Weight in kilograms/Height in meters ^2.

People with a BMI below 18.5 are Underweight.
People with a BMI between 18.5-24.9 are Normal.
People with a BMI between 25-29.9 are Overweight.
People with a BMI above 30 are Obese.

Many insurance companies will authorize lap band surgery if patients meet the following indications:
1. An individual has clinical severe obesity, BMI >40, or BMI> 35 with co-morbidities such as heart disease, diabetes, hypertension, sleep apnea, or degenerative arthritis.2. An individual has suffered from morbid obesity for at least five years. 3. An individual has failed non-surgical attempts at weight loss over the years.4. An individual is at a high-risk for obesity-associated morbidity or mortality. 5. An individual is motivated and has an acceptable operative risk.

Once individuals have had their lap band surgery, they are usually candidates for post-bariatric body contouring surgery 9 to 12 months after. I stress to the patients in our program the importance of adequate protein intake prior to their body contouring operations. For the post-bariatric body contouring patients, it is important to eat 1-2 mg of protein for every kilogram of ideal body weight (IBW) provided they have normal kidney function.

When pre-operative labs are drawn before surgery, it is optimal to have serum albumin levels between 3.5-5 g/dl. It is optimal to have serum pre-albumin levels on the high end of normal levels 17-40 mg/dl. Pre-albumin has a half-life of 1.9 days compared to the half-life of albumin which has a half life of 21 days. Therefore pre-albumin levels tend to be more reflective of the more recent nutritional protein intake.

Brian P. Dickinson, M.D.

Surgery After Weight Loss: RoxBariatric

http://www.drbriandickinson.com/

The RoxBariatric post-bariatric plastic surgery program continues to grow and expand. Post-bariatic body contouring surgery is becoming very popular as we are seeing patients not only from Southern California, but now patients from the Midwest who travel to Beverly Hills and Newport Beach to have their post-bariatric surgery performed. More patients are coming to the RoxBariatric Center to meet our team of plastic & reconstructive surgeons and then be introduced to a bariatric surgeon who will perform either a lapband procedure or gastric bypass procedure.

Occasionally, in patients who undergo bariatric surgery or simply loose weight through a bariatric diet, they develop excess of overlying abdominal skin termed a “pannus”.

Patients are coming to the RoxBariatric Plastic Surgery Program from out of state to have their panniculectomy or body contouring surgery performed by our team of plastic & reconstructive surgeons.

Insurance companies will pay for patients to have a panniculectomy performed or removal of this overhanging skin as long as certain criteria are met that deem the procedure medically necessary. These criteria include:

1. Panniculus hangs below the level of the pubis; and
2. Patients have chronic intertrigo (dermatitis occurring on opposed surfaces of the skin, skin irritation, infection or chafing) that consistently recurs for a period of over 3 months while receiving appropriate medical therapy, or remains refractory to appropriate medical therapy over a period of 3 months.
Frequently patients with subcostal scars present for these operations. Subcostal scars are normally right sided scars used to remove the gallbladder. We have seen many patients who have been turned away for abdominoplasty or panniculectomy operations due to the presence of these scars.

These operations can be performed, but need to be performed carefully by plastic & reconstructive surgeons who have demonstrated experience in these operations to ensure proper wound healing. When addressing panniculectomy or abdominoplasty in these patients it is important to respect the remaining blood supply to ensure rapid healing and prevent infection. Adequate nutrition is paramount for proper wound healing.

Brian P. Dickinson, M.D.

http://www.drbriandickinson.com/

RoxBariatric Health & Lifestyle Program

The RoxBariatric program continues to grow with as the most recent five patients who underwent lap band procedures continue to loose weight. We are starting to see not only significant reduction in weight of these patients, but ancillary physical signs improve as well. Notably one patient has lost a significant amount of weight in his neck and no longer snores at night. Not only has this improved his sleep patterns, but also those of his spouse.

Bariatric patients often loose greater than 100 lbs of weight over the course of six months to one year post surgery. Not only do these patients desire body contouring surgery, but also rejuvenation of their face and neck. I have found that facelift and necklift techniques provide a significant change in the facial aesthetics and be quite rewarding to these patients.

Traditionally when body contouring and facelift procedures, our patients stay over one night at an aftercare facility where they are examined by a physician that evening and the next morning at the aftercare facility or at the office.