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Cosmetic Surgery Check List by Dr. Mark Bishara, MD

describe the imageDr. Mark Bishara is Harvard Fellowship trained in Aesthetic & Reconstructive Plastic Surgery
If you are one of millions considering cosmetic or plastic surgery, then you may want to review this list, and check it off before having a procedure. Here is a list that can help you prepare before your procedure and during your consultation.
Make sure you do your homework to better understand the benefits, know what to expect from the procedure, recovery time, and associated complications and risks.
Research your surgeon: review plenty of before and after picture of patient cases, and look for consistent outcomes. Make sure your surgeon is experienced, qualified and certified to perform your procedure.
Develop realistic expectations: it is important for patients to have realistic expectations. Discuss your goals in detail with your surgeon to understand what you should expect, anticipated downtime and side effects to reduce disappointing results.
Medical history and evaluation in advance: share your medical history, medications and any health issues in advance. Some surgeries require blood work, and medical imaging results to make sure you are a good candidate for the procedure.
Associated Fees: Cost is a big issue for most patients. Find out if the fee is all inclusive. Anesthesia can make a difference, depending on if the surgeon is using a local or general anesthetic to perform the surgery. Also, most procedures are “outpatient” surgeries performed in accredited surgical suites, within the surgeon’s office or clinic.
doctor at desk
Here is a list of questions to ask during your consultation:

  • Are you licensed in the state where the procedure is being performed?
  • How many of these procedures have you performed?
  • Do you have hospital and/or surgery center privileges? Is your facility accredited?
  • Am I a good candidate for the procedure?
  • What are the possible risks and side effects?
  • What technique would you recommend to get optimum results?
  • How long will the surgery take and what can I expect during the recovery process?
  • How much time should I take off work?
  • How much will the procedure cost, total? Do you have finance options and payment plans?
  • Do I have the right physical features to get the desired results from this procedure?
  • Do you provide detailed instructions to follow, before and after the procedure and in the case of an emergency?

Cosmetic and plastic surgery procedures are a big step. To get the best from this experience, patients who do their homework, ask the right questions and develop realistic expectations are happiest with their results.
Please call the office of Dr. Mark Bishara and The Paragon Med Spa and we would be happy to discuss any questions you may have regarding cosmetic surgery.  Our phone number is (817) 473-2120 or please click on the button below.
 

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Gastric Bypass Should Include Body Contouring- by Dr. Mark Bishara

Body contouring surgery to remove excess skin improves long-term weight control in patients after gastric bypass surgery, reports a study in the October issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).
Patients with body contouring present better long-term weight control after gastric bypass, according to a study at University of Geneva, Switzerland. Since maintaining weight loss to reduce long-term health problems is the key goal of bariatric surgery, the researchers believe that body contouring should be considered reconstructive rather than cosmetic surgery for patients who have achieved massive weight loss.
Better Long-Term Weight Control after Body Contouring
The researchers compared long-term weight outcomes for two groups of patients who underwent gastric bypass surgery. In 98 patients, gastric bypass was followed by body contouring procedures to remove excess fat and skin. A matched group of 102 patients with similar characteristics underwent gastric bypass alone, without body contouring.
Body contouring surgery usually consisted of abdominoplasty (“tummy tuck”), often with other procedures to remove excess skin and tissue from the breasts, legs and upper arms. Within two years after gastric bypass, the patients had lost an average of nearly 100 pounds. In subsequent years, patients who underwent body contouring regained less weight: an average of just over one pound per year, compared to four pounds per year for patients who had gastric bypass only.
Seven years after gastric bypass, patients who underwent body contouring surgery achieved an average weight of 176 pounds, and those with bariatric surgery alone, 200 pounds. Patients who underwent body contouring had regained about four percent of their initial body weight, compared to 11 percent for those who had gastric bypass only. After accounting for the weight of excess skin removed, average weight regain was about 14 pounds in patients who had gastric bypass plus body contouring, compared to nearly 50 pounds with gastric bypass only.
Body Contouring Should Be Considered Essential Part of Bariatric Surgery
Bariatric surgery produces fast, massive weight loss in morbidly obese patients. Unfortunately, many patients regain much of their body weight in the years after gastric bypass, putting them back at increased risk of obesity-related health problems.
A recent study in Plastic and Reconstructive Surgery reported significant improvements in quality of life for patients who underwent body contouring after gastric bypass. The new study shows that patients who have body contouring surgery are also more likely to keep weight off after gastric bypass. Because of this improvement in long-term weight control, bariatric surgery is more likely to be considered an effective procedure – from the standpoint of reducing obesity-related health risks – if followed by body contouring.
Colleagues believe this study adds to the argument that body contouring should be considered an essential part of successful bariatric surgery and, because of its favorable effects on patient health, should be covered by insurance plans. The researchers conclude, since plastic surgery after massive weight loss is mandatory for quality of life improvement and weight loss maintenance in many patients, body contouring must be considered a reconstructive surgery for those who have achieved massive weight loss.
Dr. Mark Bishara provides a wide range of cosmetic procedures, including body contouring, to help patients look and feel their best. These procedures are designed to improve the appearance of the face and body through minimally invasive techniques that provide highly effective results. Many of these procedures can be combined in order to achieve your desired appearance. Please call our office for more information at (817) 473-2120 or click on the button below
 

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What is Breast Augmentation? What are Breast Implants?

Augmentation mammoplasty, or breast augmentation is a surgical procedure to increase the size, shape or fullness of a woman’s breasts. The surgeon places silicone, saline or alternative composite breast implants under the chest muscles or breast tissue.
Breast augmentation is done to:

  • Enlarge breasts that are naturally small.
  • Restore breast size and shape after pregnancy, weight loss or breastfeeding.
  • Restore symmetry when the breasts are asymmetrical
  • Restore the breast(s) after surgery as treatment for breast cancer or some other condition or event that affected the size and shape of the breast.

Breast enlargement can boost self esteem- women usually experience a significant boost in self-esteem and positive feelings about their sexuality after undergoing breast enlargement.
98% of women who underwent breast augmentation surgery said the results met their expectations. Women also reported improvements in quality of life and self-esteem after their procedure.
A study, involving 225 women who were followed for five years, found that:

  • Patients said they were “back to normal” within 25 days of their surgery
  • 85% said their new breast size was “just right”
  • 13% said a larger size would have been better
  • Less than 2% would have preferred a smaller size
  • 1% were not happy with their scars, which are usually in the crease under the breast
  • 75% thought their breast firmness was “just right”
  • 98% said their results met with their expectations

What are breast implants?

A breast implant is a medical prosthesis that is placed inside the breast to augment, reconstruct or create the physical form of the breast.
The outer layer of breast implants is made of firm silicone. The inside of the implant is filled either with salt water (saline solution), silicone gel, or a composite of alternative substances. Makers of breast implants say they should last for at least ten years.

Saline breast Implant
Breast implants filled with saline solution

There are three main types of breast implants:

    • Saline implants – filled with a sterile saline solution (biological-concentration salt water 0.90% w/v of NaCl, ca. 300 mOsm/L.) which is held within an elastomer silicone shell. These implants can be filled with different amounts of saline solution, which may affect the feel, firmness and shape of the breast.If this type of implant leaks, the solution will be absorbed and expelled by the body naturally.

 

Breast implants in hand 01
A breast implant filled with silicon gel
    • Silicone implants – filled with a viscous silicone gel which is held within an elastomer silicone shell.If a silicone-filled implant leaks, the gel will either stay in the shell or escape into the breast implant pocket. A leaking silicone-filled implant might not collapse. Patients choosing this type of implant should carry out more regular checks with their doctor compared to those on saline solution implants. The condition of the implants can be determined with an MRI or ultrasound scan.

What happens during the breast augmentation procedure?

Anesthesia

The patient may have a choice of general or local anesthesia. Under local anesthesia the patient is awake and only the surgical area is numbed. However, in most cases the procedure is done under general anesthesia.

The incision

The surgeon and patient should discuss incision options. The doctor should explain which are most suitable for the patient and her desired outcome.
The following incision options are possible:

  • Inframmammary incision – in the crease under the breast.
  • Transaxillary incision – in the armpit (axilla)
  • Periareolar incision – around the nipple

The choice of which incision to use depends on several factors, including the degree of enlargement, the patient’s anatomy, the type of implant, and surgeon-patient preference.

Inserting and placing the breast implant

Breast Implants
1. Breast after subglandular augmentation.
2. Breast after submuscular augmentation.

The breast implant is inserted into a pocket. Today, there is a choice between two types of placements:

  • A submuscular placement – under the pectoral muscle. When placed here the patient may take slightly longer to recover, compared to subglandular placement, and may also experience a little more post-operative pain.
  • A submammary (subglandular) placement – behind the breast tissue, over the pectoral muscle.

Techniques used today for placing breast implants have significantly improved recovery times.

The incisions are closed

The surgeon closes the incisions with layered sutures (stitches) in the breast tissue, and with skin adhesives, sutures and surgical tape to close the skin and keep it closed.
Initially, there will be evident incision lines. These will fade with time.

View the results

Please view our website at www.markbisharamd.com for even more before and after pictures of some of our patients.
Breast augmentation results are visibly evident straight away. There will be some swelling caused by the surgery, which will resolve within a couple of weeks. As the swelling dies down and the incision lines fade, the patient will have a better idea of whether the procedure met her expectations.
Dr. Mark Bishara provides a wide range of cosmetic procedures to help patients look and feel their best. These procedures are designed to improve the appearance of the face and body through minimally invasive techniques that provide highly effective results. Many of these procedures can be combined in order to achieve your desired appearance.  Please visit our website for before and after pcitures of patients at www.markbisharamd.com.  Please call our office to receive more information at (817) 473-2120.
 
 

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VI Peel at Dr. Bishara's office in Mansfield and Southlake

 
Fall in love with your skin all over again! Join us in September and October for Fall Skin Rejuvenation. Until October 31, 2013 we are running the following special:
VI Peel for $199 (Value of $250)
VI Peel is a facial peel for ALL complexions.  It helps improve the appearance of acne, unwanted pigmentation and melasma.  It is the only peel of its kind to contain synergistic blend of TCA, Retin-A, Salicylic Acid, Phenol, and Vitamin C.  It gives great results in as little as one treatment.
The VI Peel contains a synergistic blend of powerful ingredients suitable for all skin types. This peel provides dramatic results with virtually no pain, no skin preparation and little downtime. Why wait weeks or months for results? Enjoy radiant, younger looking skin in about a week with the VI Peel.
The VI Peel will improve the tone, texture and clarity of the skin; reduce or eliminate age spots, freckles, and hyper-pigmentation, including melasma; soften lines and wrinkles; clear acne skin conditions; reduce or eliminate acne scars; and stimulate the production of collagen, for firmer, more youthful skin. Vi Peel also works well in conjunction with lasers, injectables and post procedure.
At the office of Dr. Mark Bishara and The Paragon Mede Spa, we offer many cosmetic and med spa services to help patients look and feel their best.  Please Call 817-473-2120 today to make an appointment.
 
 
 

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Breast Cancer Awareness-by Dr. Mark Bishara, MD in Mansfield & Southlake

October is Breast Cancer Awareness Month


To Honor our Breast Cancer Survivors, the office of Dr. Mark Bishara & The Paragon Med Spa offer Breast Cancer patients Free Radiation Tattoo Removal. For patients who have undergone breast cancer surgery and have completed radiation therapy, we offer free tattoo removal for their radiation tattoos. Please call our office to schedule your appointment at (817) 473-2120.
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Understanding Your Breasts

Many changes will occur in your breasts during your lifetime. Yet, many women do not know much about their breasts unless they breastfeed or they have a problem. Learning about breast structure (anatomy) and how the breasts function can help you understand which changes are normal and which are not. This is a good first step to find out about breast cancer and benign (not cancer) breast conditions.

The breasts are made up of fat and breast tissue, along with nerves, veins, arteries and connective tissue that helps hold everything in place. Throughout puberty and menopause, the look, structure and function of the breasts change.

Age and Breast Cancer

The two most common risk factors for breast cancer are:

  • Being female
  • Getting older

All women are at risk for breast cancer. The risk of getting breast cancer increases as you age. Most breast cancers and breast cancer deaths occur in women aged 50 and older.
No matter your age, you should know how your breasts normally look and feel. If you notice any changes, see your health care provider. Learn about the warning signs of breast cancer.

Warning Signs of Breast Cancer

Warning signs lumpWarning signs swelling
Warning signs change in size or shapeWarning signs dimpling or puckering
Warning signs nipple rashWarning signs pulling in of nipple
Warning signs nipple dischargeWarning signs pain

Due to the increased use of mammography, most women in the United States are diagnosed at an early stage of breast cancer, before symptoms appear. However, not all breast cancers are found through mammography.  The warning signs of breast cancer are not the same for all women. Below are more organizations

Organizations
Susan G. Komen® — promises to save lives and end breast cancer forever by empowering people, ensuring quality care for all and energizing science to find the cures.
For information and support, call 1-877 GO KOMEN (1-877-465-6636), www.komen.org
American Cancer Society — provides medical information, treatment decision tools, news updates and support resources. 1-800-ACS-2345, www.cancer.org
American Society of Clinical Oncology — has goals of improving cancer care and prevention and ensuring that all patients with cancer receive the highest quality care. 1-888-282-2552, www.asco.org
Food and Drug Administration Breast Implant Information — answers questions about breast implants. www.fda.gov
Living Beyond Breast Cancer — offers programs and services to women affected by breast cancer, caregivers and health care providers. 1-888-753-LBBC, www.lbbc.org
This information is brought to you courtesy of Dr. Mark Bishara & The Paragon Med Spa


 

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