Tuesday, January 17, 2012

Surgery After Massive Weight Loss

Now that the New Year is here, and everybody is accomplishing their resolutions.  We will deal with the effects of losing a substantial amount of weight.  Losing weight will improve your health and mental disposition in many ways. Just losing a small amount of your current weight can make a difference in the way you feel and look. Some weight loss benefits include increased energy level, lowered cholesterol levels, lowered blood sugar, reduced  blood pressure,improved mobility.  It can also help with sleep apnea so you wake up more refreshed and with more energy. Also it has been shown to decrease depression and can be as effective as antidepressant medicine. With enough of a weight loss you might be able to significantly reduce or elimanate many of the medicines you are taking as well. 

Once you reach your weight loss goals you may find you do not have the fit and healthy body image you expected.  After moderate to massive weight loss, the skin and tissues that have been stretched over the years, lack elasticity and cannot snap back into the new, smaller size of the body.  As a result, sagging pockets of skin may form around the face, neck and jaw line, at the upper arms, back, the abdomen region and around the hips, buttocks, groin area and thighs. 

The surplus, sagging skin that is left behind after weight loss, can cause considerable hygienic problems, skin irritation, skin breakdown, pain and even infection. This loose, sagging skin can look abnormal and potentially gets in the way of normal activities or movement.  Aging, pregnancy, some genetic skin conditions, also can result in severe hanging skin.  This excess skin for some people is far worse than having the excess weight. The excess skin will not go away by itself. Therefore surgical correction of the excess or sagging skin is the answer.

Some typical post weight loss surgeries are Abdominoplasties(tummy tucks), lower body lifts, Total Body Lifts, Brachialplasties(arm lifts), breast lifts or reductions, face/neck lifts and Thigh Lifts.  An Abdominoplasty will remove the excess skin from the front of the abdomen, tighten the abdominal wall muscles and make you much flatter.  The tummy tuck can have liposuction of the sides and or back added for additional body contouring.  For patients who have lost significant weight and have excess skin on the sides and lower back a beltectomy might be the best addition to the abdominoplasty.  The beltectomy removes excess skin from the lower back and side.  It also helps lift up the butt to give a higher and more youthful back side.  A lower body lift will combine an abdominoplasty and beltectomy with or without liposuction or other procedures. It is very common to add a breast lift with or without breast augmentation at the same time.
 If you have lost a lot of weight then you might need to get an arm lift and or thigh lift.  Generally speaking the thigh lift is done to remove excess skin from the mid to upper thighs.  The arm lift will help with “batwings” that some people get after weight loss. The thigh lift is commonly done at a different time then the tummy tuck.  This can decreases the risks of some complications for some patients.  The arms can be easily done with the tummy tuck.
For those patient that have lost a tremendous amount of weight then I commonly recommend my signature procedure the Total Body Lift.  The Total Body Lift is a procedure that is commonly done on patients that have lost 70 -200 lbs or more.  These patients have severe sagging skin. It can be on their upper and lower abdomen, back, bra rolls, also breast or chest (depending if male or female) arms, thighs.  These patients need a complete change of their bodies.  The Total Body Lift can include some or all of  the following: abdominoplasty, a reverse abdominoplasty, corsetplasty, beltectomy, bra roll excision, breast lift with or without implants, and brachiaplasty.  The thigh lift is done 4-6 weeks later or when the patient chooses along with any touch ups.  This procedure in my hands takes 3.5-5 hrs on average depending on the size of the patient and number of procedures.  No blood is transfused and the patients are done as an outpatient. The patients are also walking around within several hours of the completion of the operation. They are usually back to light work in 10-14 days.
The Total Body Lift is not done by many surgeons due to various factors.  If you are a candidate for this procedure please make sure this is a procedure that your Board Certified Plastic Surgeon does on a regular basis.  Most surgeons elect to break up the Total Body Lift into 2-4 surgeries instead of one.  Therefore ask the surgeon how she/he does the procedures, how many surgeries will you have, how often do they do the procedure, etc. Do they use various state of the art techniques and instruments to decreases blood loss? What type of facilities do they use for the surgery?  This should not be done in an office based facility.

A good candidate for a body lift are patients in good health who underwent bariatric surgery (Gastric Bypass Surgery, Sleeves, Lap Bands), or anyone who has lost 30 or more pounds leaving them with excess skin.  Previously obese people experience a marked loss in skin elasticity due to the prolonged periods of stretching while they were putting on weight over the years.  People who have medical problems can be a candidate for the procedures with the assistance of your primary care doctor. 
Normally post bariatric surgery patients have some residual medical problems.  The Board Certified Plastic Surgeon should prepare the patient for the rigors of surgery along with the primary care doctor.  Some of the methods we use are iron supplementation and other techniques to alleviate the chronic anemia very common with these patients.  My team also utilizes protein supplementations and other nutritional aids to help minimize the malnutrition that post bariatric patient have.  I also require that the patient walks twice a day for at least 30 minutes or once a day for 45 minutes daily.  The reason for this is that walking after surgery prevents or minimizes the vast majority of significant complications. Therefore the patient needs to build up their exercise tolerance prior to surgery.

As with any surgical procedure whether it is a simple tummy tuck or a full scale Total Body Lift you will experience some pain, bruising, and/ or swelling.  This is normal and will subside quickly.  Remember it can take a year to see the final results from a body contouring surgery.  While you may not be able to stand fully upright, it is important that you begin to walk for 5-10 minutes per hour the day of surgery to facilitate blood flow in your legs and decrease the chance of lung issue. Your absorbable stitches will dissolve with time. However non-dissolving stitches will be removed in approximately one-two weeks.   Most patients are able to return to work in one to three weeks, however, it may take six to eight weeks before you feel able to return to full normal activity including heavy lifting and strenuous exercise.  After surgery, with a proper diet and exercise, the results from a body lift can be maintained for many years.   
In closing, a body contouring procedure can safely help patients restore normalcy to their life, it enables them to make lasting changes to their looks so they can regain confidence in their image and feel comfortable in their body again.  Good luck with your New Year Resolutions!



About the author
 Anire Okpaku MD FACS is a Board-Certified Plastic Surgeon and the Medical Director of Ocean View Plastic Surgery, serving the needs of Florida as well as a national and international clientele. He specializes in cosmetic plastic surgery.
He is an active member of the Bayside Medical Center at Mercy Hospital where he performs most of his surgeries. He also holds privileges in several other South Florida Hospitals.
Dr. Okpaku graduated from the prestigious Jefferson Medical College in Philadelphia, relocating later to Miami to where he completed his general surgical residency at Jackson Memorial Hospital University of Miami. He went on to complete a Plastic Surgery Fellowship at the University of Texas Health and Science Center, in San Antonio.



1900 Brickell Avenue
Miami, FL 33129
Phone : (305) 856-9566
Fax : (305) 856-9567
Site :
www.DroBodies.com

Friday, December 9, 2011

Plastic Surgery Safety and You

Plastic Surgery Safety and You


There has never been a better time to consider plastic surgery than today. With better techniques in plastic surgery and new and evolving technologies, it is becoming safer than ever before to improve your appearance. Today there are many choices for cosmetic surgery, both surgical and non-surgical. In many cases there is little or no hospital down time! The best way to ensure your peace of mind and minimize risk is to do some homework BEFORE you make a choice of doctor or facilities. 


Here are a few things to watch for when considering plastic surgery and choosing a surgeon:

• The first thing is go to a REAL Doctor. Never have anything injected in your body by a non qualified professional. Do NOT have surgery by the “doctor from another country” who flies in once a month to perform surgery. Anybody who is willing to come to your house to perform a procedure or surgical treatment BEWARE . Unfortunately these are not jokes but daily occurrences here in Southern Florida. Remember if you choose to use a non licensed practitioner and you get a complication. The complication could severely disfigure you. It will also be very hard to find a doctor to treat you. It will most likely costing you many times the original fees you paid to the unlicensed person. A bill more than $100,000 for hospital for a botched surgery is very common

• Find out the qualifications of the surgeon; is she or he Board Certified by the American Board of Plastic Surgery (ABPS)? The ABPS is the only board recognized by the American Board of Medical Specialties. Do not be confused by people who say they are “cosmetic surgeons”. Plastic Surgeons who are board certified have at least 5-8 years of post medical school training. A “cosmetic surgeon” can call themselves that without any training.

• Make sure the doctor has privileges for performing the procedure that you want in a hospital. Even if you choose not to use a hospital setting. The standards of a hospital must be met prior to that doctor having hospital privileges.

• Check the surgeon’s FL State medical license; has it been suspended, any other issues? You can check for the license here: https://ww2.doh.state.fl.us/IRM00PRAES/PRASLIST.ASP . Most states have a web site where you can access your doctor’s license records. It can be scary what you might find out.

• If you will be having anesthesia ask to see the credentials of the anesthesia provider. They also should be board certified.

• Take a tour of the facilities prior to surgery, check the layout, and make sure you feel comfortable with the size, age and condition of the building. Is the building clean? Does the facility have adequate and up to date equipment? What accreditation does the facility posses? Remember in Florida a Doctor can operate in any place they deem fit within the zoning guidelines? There are unfortunately, less then scruples doctors and businessmen, who operate in non licensed facilities in violations of codes and laws all over Florida and the country.

• Find out if the facility has proper recovery rooms and service. What happens if your recovery runs long? Will they ship you to the ER or another facility?(with an attached large bill) What staff do they keep late in the day. What will happen if you have an emergency? Check out the staff, they should have a registered nurse in the recovery and operating rooms. Is there a limit to how long you can stay in recovery, will they end up moving you to another facility you haven’t researched?

To sum it up, if you aren’t comfortable with your doctor or the facilities, DON’T get your surgery there. Do your research; the patient that could be saved from dreadful results, could be you.


Here are some things to consider before surgery day:

• Make sure you know your risk of surgery, do you have any pre-existing conditions such as a heart or lung condition, as some illnesses may increase your risk dramatically. Please be honest with your doctor and other medical specialist who are getting you prepared for surgery.

• You should not smoke prior to surgery! Minimize or stop alcohol prior to surgery.

• You should keep a good nutrition, keep hydrated, and drink plenty of liquids, no starvation diets prior to surgery.

• Increase your exercise tolerance. You should walk 30 minutes twice a day or at least 45 minutes once day at minimum to be able to tolerate elective cosmetic plastic surgery. If you can’t walk or are severely limited by injury or illness this needs to be discussed prior to your surgery.

• Don’t take any aspirins, ibuprofen, or any blood thinning products prior to surgery unless directed by your surgeon 1-2 weeks before your surgery. Many natural or herbal products have blood thinning properties.

• Discuss with your surgeon all medications, or any over the counter and herbal products you are taking.

• Start taking a multivitamin each day and Vitamin C (1000 to 1500 mg) a day and continue taking through your recovery. The healthier you are, the quicker your recovery will be, but NO mega doses of Vitamin E.

• Be extra careful about hygiene and make a habit of washing your hands frequently, and make sure you report signs of cold, infections or any other problems prior to surgery.

The day of surgery and after:

• Follow you doctor’s guidelines explicitly.

• Do not take additional medications that your doctor did not approve for you.

• Do not smoke!!!

• Do not drink alcohol.

• Walk, walk and more walking. You need to walk the day of surgery. This can help greatly decrease multiply complications. It will help reduce the risk of blood clots, pneumonia and other serious problems. I have my patients walk for 5-10 minutes every hour when awake after surgery with assistance the day of surgery. This then increases to 10 minutes of walking an hour the next day.

• Also please shower with antimicrobial soap prior to going to facility for your procedure.

Above all, be prepared for surgery, both mentally and physically, this will make everything go much smoother. The goal of your surgeon is to help making your operation as less stressful as possible. Your surgeon should check your medical history and current health before deciding if it is safe for you to go on with surgery. It’s important that you share any important medical information so your surgeon can better determine the risks involved. Make sure that your goals and expectation match with your doctors. Above all, enjoy the life altering experience



About Anire Okpaku, MD, FACS:
Doctor Anire Okpaku is a Board-Certified Plastic Surgeon and the Medical Director of Ocean View Plastic Surgery, serving the needs of Miami, Fort Lauderdale, and South Florida. He specializes in cosmetic plastic surgery. 

 He is an active member of the Bayside Medical Center at Mercy Hospital where he performs most of his surgeries. He also holds privileges in multiply other South Florida Hospitals.

Dr. Okpaku graduated from the prestigious Jefferson Medical College in Philadelphia, relocating later to Miami to where he completed his general surgical residency at Jackson Memorial Hospital University of Miami. He went on to complete a Plastic Surgery Fellowship at the University of Texas Health and Science Center, in San Antonio.


1900 Brickell Avenue
 Miami, FL 33129

Phone : (305) 856-9566
 Site : www.DroBodies.com

Wednesday, June 1, 2011

Dr. Okpaku Fixes Maripili's Breasts

Maripili, one of the hottest stars in spanish TV, sought Dr. Okpaku's expertise to correct her significant breast defect. Univision filmed the procedure, See the clip here:

Tuesday, May 17, 2011

Surgery After Massive Weight Loss

The Benefits Of Weight Loss
Losing weight will improve your health and mental disposition in many ways. Just losing a small amount of your current weight can make a difference in the way you feel and look. Some other ways weight loss can benefit your health include increased energy level, lowered cholesterol levels, reduced  blood pressure, it improves your mobility,  helps with your breathing and helps you sleep better to wake up more rested.

After losing the weight
Once you reach your weight loss goals you may find you do not have the fit and healthy body image you expected.  After massive weight loss, the skin and tissues that have been severely stretched over the years, lack elasticity and cannot snap back into the new, smaller size of the body.  As a result, sagging pockets of skin may form around the face, neck and jaw line, at the upper arms, lower back, the abdomen region and around the hips, buttocks, groin area and thighs. 

The surplus, sagging skin that is left behind after massive weight loss, can cause considerable hygienic problems, skin irritation, skin breakdown, pain and even infection.   This loose, sagging skin looks abnormal in most cases and gets in the way of normal activities or movement.  Aging, pregnancy, some genetic skin conditions, and major weight loss can also result in severe hanging skin.

Candidates for a surgical body lift:
A good candidate for a body lift are patients in good health who underwent bariatric surgery(Gastric Bypass Surgery, Sleeves, Lap Bands), or anyone who has lost 60 or more pounds leaving them with excess skin.  Extremely obese people experience a marked loss in skin elasticity due to the prolonged periods of stretching while they were putting on weight over the years.

Surgical options after massive weight loss
Some typical weight loss surgeries are Body Lifts, Tummy Tucks, and Thigh Lifts.   A Full Body Lift surgery can remove or reduce the loose drooping skin around the entire body. This type of surgery often involves several stages to address the sagging that occurs around different areas. Lifts are performed on the lower body, breasts, arms, thighs, and upper body areas. The general procedure involves removing the excess tissue, then sculpting and restoring the body to a more normal, aesthetically pleasing state. 

Recovery
As with any major surgical procedure, you may experience some pain, bruising, or swelling, most of which will subside in a few weeks.  While you may not be able to stand fully upright, it is important that you begin to walk for short periods soon after your procedure to facilitate blood flow. Your stitches may dissolve with time. However non-dissolving stitches will be removed in approximately one week.   Most patients are able to return to work in one to three weeks time, however, it may take six to eight weeks before you feel able to return to full normal activity including heavy lifting and strenuous exercise.  After surgery, with a proper diet and exercise, the results from a body lift can be maintained for many years.   

In closing, a body lift can safely help patients restore normalcy to their life, it enables them to make lasting changes to their looks so they can regain confidence in their image and feel comfortable in their body again. 



About the author
Doctor Anire Okpaku is a Board-Certified Plastic Surgeon and the Medical Director of Ocean View Plastic Surgery, serving the needs of Miami, Fort Lauderdale, and South Florida. He specializes in cosmetic plastic surgery.

He is an active member of the Bayside Medical Center at Mercy Hospital where he performs most of his surgeries. He also holds privileges in several other South Florida Hospitals.

Dr. Okpaku graduated from the prestigious Jefferson Medical College in Philadelphia, relocating later to Miami to where he completed his general surgical residency at Jackson Memorial Hospital University of Miami. He went on to complete a Plastic Surgery Fellowship at the University of Texas Health and Science Center, in San Antonio.



1900 Brickell Avenue
Miami, FL 33129
Phone : (305) 856-9566
Fax : (305) 856-9567
Site :
www.DroBodies.com

Tuesday, March 22, 2011

Body Contouring and Fat Reduction without Surgery

Cosmetic surgery is not for everyone; some patients are too worried or skittish about surgery or simply not a good candidate for surgical fat reduction procedures. Fortunately today there are new products and treatments which allow you to shape your body or reduce fat without going under the knife.  One quick and effective non-surgical option is called Exilis, a new technology that combines ultrasound, high radio frequencies and instant cooling, stimulating the skin’s fatty cells to quickly remove fat.
There is no anesthesia required for the treatment and no discomfort, the treatment is quick; you will be in and out of the office and you may notice changes after the first treatment.  In addition, Exilis shows marked improvement in skin tone, elasticity and texture, while it reduces wrinkles and rejuvenates the skin. 
The treatment involves massaging the desired areas using a hand held application device until the optimal temperature is reached for breaking down the fat cells; this is determined by a digital readout on the device.  You can apply the treatment to either the face, body or both.  The hand held wand is rubbed gently in circular patterns on the desired areas of the body or face.  Each treatment area takes about 10 minutes per area to perform.

The Radio Frequency produced by Exilis, penetrates the deepest skin layers and heats up the fat cells, causing them to increase their metabolism and release excess fat. It is a fairly comfortable experience and most patients get through it with no down time or discomfort. No pre-op medication is required. Numbing creams are not recommended because they change the resistance of the skin.
The Exilis treatment should not be carried out on any patient with metal replacement parts in the region to be treated (artificial limbs, kneecaps, plates in the spine).  One way to think of it; if you can have an MRI, then you can safely undergo RF treatments such as Exilis. Pregnancy and cancer are also red flags. The patient must be aware that Exilis will not produce the same results as a surgical abdominoplasty (Tummy Tuck).
If you do not wish to undergo surgery, then you are probably a good candidate for Exilis. What should you expect after the treatment?  First of all, if you maintain a good diet and stick to a reasonable exercise program, you can expect to maintain your results for a long time. Furthermore, if you maintain a good lifestyle and don’t gain too much weight after the treatments, you may only need the full treatment program once.  You should follow up with your surgeon to discuss skin tightening options once you have lost more weight. 

In closing, Exilis can be a fast and painless alternative to surgery for fat reduction or body shaping, which will provide noticeable results in most cases.  According to research, there is no harm to body organs, it is proven by biochemical testing, and is clinically tested.

About Anire Okpaku, MD, FACS:
Doctor Anire Okpaku is a Board-Certified Plastic Surgeon and the Medical Director of Ocean View Plastic Surgery, serving the needs of Miami, Fort Lauderdale, and South Florida. He specializes in cosmetic plastic surgery.
He is an active member of the Bayside Medical Center at Mercy Hospital where he performs most of his surgeries. He also holds privileges in several other South Florida Hospitals.
Dr. Okpaku graduated from the prestigious Jefferson Medical College in Philadelphia, relocating later to Miami to where he completed his general surgical residency at Jackson Memorial Hospital University of Miami. He went on to complete a Plastic Surgery Fellowship at the University of Texas Health and Science Center, in San Antonio.



1900 Brickell Avenue
Miami, FL 33129
Phone : (305) 856-9566
Site :
www.DroBodies.com

Tuesday, February 22, 2011

Plastic Surgery Safety and You

There has never been a better time to consider plastic surgery than today; With better techniques in plastic surgery and new implant technologies, it is becoming safer than ever before to improve your appearance. Today there are many choices for cosmetic surgery, both surgical and non-surgical, and in most cases there is little or no hospital down time! The best way to ensure your peace of mind and minimize risk is to do some homework BEFORE you make a choice of doctor or facilities. 

Here are a few things to watch for when considering plastic surgery and choosing a surgeon:

  • Find out the qualifications of the surgeon, is she or he Board Certified by the American Board of Plastic Surgery?
  • Take a tour of the facilities, check the layout, make sure you feel comfortable with the size, age and condition of the building, are they an accredited facility, is the building clean?
  • Does the facility have adequate and up to date equipment?
  • Find out if the facility has proper recovery rooms and service
  • Check out the staff, they should have a registered nurse in the recovery and operating rooms
  • Is there a limit to how long you can stay in recovery, will they end up moving you to another facility you haven’t researched?
  • Find out the qualifications of the person administering the anesthesia, is she or he board certified? Ask to see their credentials
  • Check the surgeon’s FL State medical license; has it been suspended, any other issues? You can check for the license here: https://ww2.doh.state.fl.us/IRM00PRAES/PRASLIST.ASP

To sum it up, if you aren’t comfortable with your doctor or the facilities, DON’T get your surgery there.

Here are some things to consider before surgery day:

  • Make sure you know your risk of surgery, do you have any pre-existing conditions such as a heart or lung condition, as some illnesses may increase your risk dramatically
  • You should not smoke or drink alcohol
  • You should keep a good nutrition, keep very hydrated, drink plenty of liquids, no starvation diets prior to surgery
  • Don’t take any aspirins, ibuprofen, or any blood thinning products prior to surgery unless directed by your surgeon
  • Discuss with your surgeon all medications, or any over the counter and herbal products you are taking
  • Start taking a multivitamin each day and Vitamin C (1000 to 1500 mg) a day and continue taking through your recovery. The healthier you are, the quicker your recovery will be, but NO megadoses of Vitamin E
  • Be extra careful about hygiene and make a habit of washing your hands frequently, and make sure you report signs of cold, infections or any other problems 

Above all, be prepared for surgery, both mentally and physically, this will make everything go much smoother. The goal of your surgeon is to help making your operation as less stressful as possible. Your surgeon should check your medical history and current health before deciding if it is safe for you to go on with surgery. It’s important that you share any important medical information so your surgeon can better determine the risks involved.



About Anire Okpaku, MD, FACS:
Doctor Anire Okpaku is a Board-Certified Plastic Surgeon and the Medical Director of Ocean View Plastic Surgery, serving the needs of Miami, Fort Lauderdale, and South Florida. He specializes in cosmetic plastic surgery.

He is an active member of the Bayside Medical Center at Mercy Hospital where he performs most of his surgeries. He also holds privileges in several other South Florida Hospitals.

Dr. Okpaku graduated from the prestigious Jefferson Medical College in Philadelphia, relocating later to Miami to where he completed his general surgical residency at Jackson Memorial Hospital University of Miami. He went on to complete a Plastic Surgery Fellowship at the University of Texas Health and Science Center, in San Antonio.



Main Offices at:
1900 Brickell Avenue
Miami, FL 33129
Phone : (305) 856-9566
Site : www.DroBodies.com

Tuesday, January 18, 2011