Radio Transcript 2

Chris: I had lap band surgery a year ago, and I've lost 30 pounds, and I wanted to find out how much more I should bank on losing before I get a tummy tuck?

Dr. Workman: Sure, I guess I would talk with you, depends on your height/weight, I would check with your lap band surgeon and see what their recommendation is based upon on your body. And normally we like to have you get to a, kind of a, stable point for probably 3-6 months to make sure your not fluctuating.

Chris: Okay, like I said, I had surgery a year ago, I've lost 30 I ideally want to lose another 70. But I want the tummy tuck to be worthwhile.

Dr. Workman: Right, I think in general, the more you can lose ahead of time the better the job we can do. We can take out more skin.

Stephanie: So, I have a question about, so if I'm going in for a hysterectomy soon, how long after would I have to wait to do liposuction?

Dr. Workman: Well, depending on how the hysterectomy went, probably a week or two weeks, I think there's sometimes there's sometimes a risk of getting blood clot if you have a number of big surgeries at the same time. Occasionally we'll do it at the same time depending on if it's a little hysterectomy or a big one, so there's another option for you.

Stephanie: I didn't know you could do that at the same time.

Dr. Workman: Yeah, make sure it's all right with your gynecologist, and then check with a plastic surgeon. And sometimes that can be done at the same time, or often times, you can do one and then a week or so later do another one because a person is planning on being off for 6 weeks or whatever, so you get 2 recoveries in one.

Host: Hi, Anna! What's your question for Dr. Workman?

Anna: yeah I was just actually wondering I just had a baby a couple months ago and I have that really dark brown line on my tummy, and I was wondering that going to go away on its own? Or is there something I can do, a procedure to get rid of it?

Dr. Workman: I would give it up to a year. Stay out of the sun. It may lighten. I mean, the only procedure we would do is excise it. But it may well go away by itself. I would give it a little time, stay out of the sun.

Host: So is that a stretch mark? What is that?

Dr. Workman: Well, it not a stretch mark per se, it's a discoloration of the skin associated with the hormonal changes of pregnancy.

Anna: It hasn't lightened at all in the last couple of months so I was kind of hoping that it would start to lighten soon. But there's really nothing you can do in the office to lighten as far as lightening it with a laser or anything like that?

Dr. Workman: Well, there are things... but I mean, I'd give it a little more time it may well take care of itself.

Anna: Okay, that sounds great

Host: Thanks Anna! Our guest is cosmetic surgeon Dr. Michael Workman. Liz, you're next, what's your question?

Liz: I was wondering if you had stretch marks after having a baby, or while you were pregnant, and you go get a tummy tuck and you tighten that skin back up, are you more or less likely to get stretch marks again in the future?

Dr. Workman: Very unlikely... in fact, I have done over 1000 of them and I think I have seen that once. In essence, your skin has been pre-stretched initially. The entire abdominal skin has been stretched out so it's highly unlikely it will form stretch marks again.

Liz: That is good news!

Host: What is that in the background?

Liz: That's the cause of the stretch marks!

Host: OH! Congratulations! Sounds like a parrot, or a monkey

Dr. Workman: a monkey!

Host: Do you have a monkey?

Dr. Workman: Monkey woman there...

Liz: Yes, there are two of them running around screaming!

Host: Alright, thanks for your call.

Liz: Thank you!

Host: Hi Lauren! How can Dr. Workman help you? What's your question?

Lauren: Hi! I had. Before I had children, I had liposuction of the upper/lower stomach and hips and now I've had 4 children. In relation, you know, you gain weight, approximately 20lbs per child, which I did and now, I'm in the process of losing weight but I'm really interested in having a [breast] reduction but I'm afraid they're so, saggy of course, that just a reduction might not do it. I mean, I don't know if I'm going to have to have just a reduction, if I'm going have to have an implant also? Should I be at my goal weight? If I have a little more to go, should I wait? I'm kind of just...

Dr. Workman: Yeah, general rule is, and I assume your talking about your breasts, the
general rule is you want to be within 10-15 lbs of your goal weight or a weight you think you will achieve. I think you need to be examined by someone who does this a lot and often times like you said, the skin has stretched out and we've lost volume so often times, we'll remove some of the skin, i.e. give you a lift and augment the breast with a small implant.

Lauren: What I'm afraid of after losing weight and having a reduction which would in turn be a lift, I don't know if there's enough tissue to make it full enough to be even a B or C cup. I've had a couple, my mom and sister both have had surgery but they did not opt for an implant and they are probably just a B. Which being on the heavy-chested side my whole life I don't know if that's enough. But I only want to go in there one time.

Dr. Workman: Right... see... you, I suspect your going to need an implant to get that perkiness. Most women want that perkiness. That upper "pull, pop" so to speak, and you really probably will need an implant to achieve that.

Lauren: Okay, and so just to prepare for that, do you have an estimated cost when were thinking about things like that?

Dr. Workman: It varies... probably $6000-8000 dollars. I'm guessing for a full lift and augmentation with a gel implant. Ball park for that in the Portland area.

Ashley: Hello Dr. Workman! I'm actually a previous patient. My question is, I'm 31 years old. I've had 3 children and I'm slender, but the tone of my skin, especially my thighs and in my lower stomach has changed. And I don't think I'd be a good candidate for liposuction, but laser I've heard a lot about that lately and I'm wondering what options does somebody have to kind of increase the tone and texture.

Dr. Workman: Yes, there's the million-billion dollar question. There's a lot of work on a lot of work on lasers that will help contract the skin, but there's nothing really good out there. Although there may well be in within a couple of years.

Ashley: So, would liposuction do that do that on more slender people? Just to kind of decrease that cottage-cheesy look?

Dr. Workman: Yeah, I think, yeah clearly it sounds like you may well have some localized area of extra fat which in that case we could go and just remove that. I think it sounds like your skin is in pretty good shape so it would contract. It doesn't tighten the skin but it can give you a much curvier, prettier figure when you're just standing.

Ashley: Like smoother lines?

Dr. Workman: Yes it can, it can definitely help create smoother lines. It doesn't help the cellulite though or the cottage cheese texture, but if you have like lumps of fat or areas where you kind of roll out like a saddle bag it definitely help that.

Host: Marley, your next! What's your question?

Marley: Oh hi, I don't really have a question. I just want to say that this guy, Dr. Workman is a miracle worker! I had breast augmentation by him about 9 years ago and he gave me the best boobs ever.

Host: Wow, cool. Send pictures to Ted...

[laughing...]

Marley: But yeah, if anybody's thinking of that, this is the guy to go to!

Host: Well, that's very sweet of you to call!

Dr. Workman: Oh, thank you very much!!

Marley: Well, you're welcome!

Host: Hi there! Patrick, what's your question for Dr. Workman?

Patrick: Hi, I actually have lost about a hundred and twenty pounds.

Dr. Workman: congrats!

Host: Congratulations! Everyone is going to ask, "How did you do it?" Don't say diet and exercise.

Patrick: Actually. MediFast and exercise.

Host: MediFast... okay, I'm writing that down. Got it. Go ahead Patrick

Patrick: Okay. Basically what I'm wondering... I'm pretty certain I'm going to need to have skin removed but I'm also thinking I'm going to need liposuction. And I've heard a lot about tourism for those types of surgeries and wondering if you had any advice or recommendations?

Dr. Workman: You mean going to a different country? Is that what you mean?

Patrick: Yes.

Dr. Workman: I think that's kind of a hot topic right now. I think that if you go to a reputable board certified physician who does it a lot in a certified facility you're probably alright. However, there's the issue should you develop a complication... I mean it can be problematic if one doctor overseas operated on you and I see patients frequently who have had problems overseas.

Host: Wow.

Dr. Workman: And its tough to tell from over here if the doctors good or not

Host: I'm certainly not an expert. But I know most things in life, you get what you pay for.

Dr. Workman: Yes, often times, especially in terms of follow up.

Host: Yeah! So, be careful. Good luck!

Host: Christy, your next. What's your question?

Christy: Hi! I have what I think is maybe is a damaged blood vessel on the bridge of my nose. It's like red, and if you were to slightly expand the skin and it disappears and then it will reappear when you let go. I'm wondering if you know what I'm talking about... I'm wondering if there's anything that can be done to fix that?

Dr. Workman: There probably is. It's hard for me to know without seeing it. I probably would check with Dr. [Lee] Robinson, the nose guy, for that.

Host: DrLeeRobinson.com. That's his website.

Dr. Workman: He could look at you and give you a much better answer I would guess.

Christy: Okay, alright. Thank you!

Host: Hi Katie! What's your question for Dr. Workman?

Katie: Hi Dr. Workman. Hey, you know. You actually did implants for me. You did an awesome job and this was about 2006. And I didn't ask this...

Host: You're getting a lot of repeat clients calling! That's great! Go ahead Katie...

Katie: What was that?

Host: Well, we've have several of his past patients call in and pat him on the back.

Katie: Oh yeah, he was awesome. And I did a ton of research and he was great. Anyways, I didn't ask this question at the time cause it wasn't going to be a factor. But now it is. I'm pregnant... and I'm wondering if it will affect nursing? If I'm going to have a problem with it?

Dr. Workman: Yes, 90-95 percent chance you won't have a problem because when you think about it, the implant is placed underneath the breast. And it's underneath the relationship between the nipple and the breast glands. So, normally it's not an issue at all. It would be really unusual.

Katie: Okay. So, how often do you see women return to say "Hey, I need this fixed now, again."

Dr. Workman: Probably twenty percent of the time. A lot of it depends upon how big your breasts get... I mean I think that's really important. I mean, if they get really large they tend to stretch more and droop more afterwards. So, a lot of it depends on how much weight you gain.

Katie: Okay, gotcha. So, wait and see huh?

Dr. Workman: Yeah, wait and see. You want to wait usually three to six months after you quit breastfeeding cause they will kind of return to a steady state.

Katie: So, don't panic until about six months

Dr. Workman: No, don't panic. There are things we can do to sometimes just removing a little skin, tightening the skin around the nipple, rather then doing some big procedure will take care of it for you.

Host: And again, if you need a second pair of eyes just send pictures to...

Dr. Workman: Stop it! Stop it!

Katie: Right... right. Gotcha. Okay. Thanks a lot!

Host: Congratulations on your little baby Katie. Alright, thank you.

Mitch: 101.5 The Buzz, it's Daria, Mitch, and Ted, joined in the studio now by Dr. Michael Workman. Hello Sir!

Dr. Workman: How's it going?

Mitch: Fantastic, good to see ya!

Dr. Workman: Excellent, good to be here.

Daria: So, Dr. Michael Workman is a plastic surgeon who specializes from the neck down. He does all sorts of tucks, lifts, enhancements, increasing sizes, decreasing sizes. And this is sort of a little ludicrous of me on the heels of me saying that I'm cutting down on expenses but I have actually talked about it extensively with Dallas. My mom, I happen to know for a fact, is listening online right now because she's texting back and forth with Mitch about colonics.

Mitch: Yes, she and I are going to have a colonic together.

Daria: So she's going to have a little bit of a heart attack when I say this here, but I have been talking with Dallas extensively about it. And we agree that when I'm done having children and when I'm done nursing those children. That could be years and years and years. Not the having children part... but the nursing. I'm going to go ahead and have a combination tummy tuck and breast augmentation. I don't know if I'm going to need to have them filled back up, I don't know if I'm going to need them lifted? I still sort of have the opinion that they are going to stay full and luscious like they are right now.

Mitch: Well, they are superior breasts!

Daria: But I'm breastfeeding! There's stuff in there right now. It's like a walk around water bra.

Mitch: You definitely don't need the tummy tuck.

Daria: Well, except that I have skin now, it's not like flapping in the breeze. I wear stuff that hides it pretty well.

Mitch: You look great.

Daria: And I'm sucking in. I took Pilates a long time ago. I don't have the effects of the Pilates on me anymore but I do have the ability to suck in and up. Therefore flattening the stomach down. It happens when some women, myself included, get older. Men get it in the face. They get "spread head" sometimes.

Mitch: Yeah, my face is gigantic.

Daria: And I'm getting it in the waist area. It's just expanding. And since I had a baby, I do have. Its not really chubby... I'm feeling it right now. Below the belt, and above the little pants thing here. Yeah, I've got puffy upper area... I've got P.U.V.

Mitch: Well that's not good!

Daria: So, at some point in the future, I'm going to have it done. Obviously I'm going to have it done, permission waiting, from Dr. Workman. Because I know him the best, and I trust him the best. I've been to his seminars. I've seen the before and after and I know he's done hundreds and hundreds and hundreds and knows his stuff. Like you see these before and after pictures and you're like "That's for me! That's what I've got now, and that's what I want then!" So can you explain what happens with a tummy tuck? What the actual procedure... I'm assuming I won't be awake for it..."

Dr. Workman: Gosh no!

Daria: But, while I'm sleeping, what's going on?

Dr. Workman: Sure, what we do with a tummy tuck is we bring you into surgery and we put you all the way under so you're totally out. And the procedure takes about an hour and a half. And in essence we're going to remove or cut out all of the skin from your belly button to each of your hipbones down to your hair level, so there's going to be an elliptical piece of skin.

Daria: Surprise, you're going to have trouble finding that level. Let's just say the hip level.

Dr. Workman: The hip level. Excellent, excellent. So lets just go ahead and remove that big piece of skin, and on you it won't be that big of course Daria. That little extra bit of looseness that you have there. We'll throw that away, and do you remember the corsets that women used to wear in the eighteenth century? We're going to put one of those on with sutures. Okay, we're going to put sutures all the way down from your rib cage down to your pubic hair level, on the muscle, and it's going to tighten you up like you wouldn't believe. It's going to flatten your tummy, and that's what pulls those hips back, that gives you the waist again. It just pulls you in as if you had a really, really, really tight corset on.

Mitch: Boy it seams like that would be painful, the recovery...

Daria: Not really!

Dr. Workman: Well, not as painful as the three million Pilates you'd have to do to get the same result.

Daria: There we go! You're telling me to forget about the Pilates. You know what I mean, it's been long enough now since I've had a baby to where the skin part is clearly not going anywhere. It's shrunk back a lot. I'm really, really, really lucky, thanks mom, but there's still stuff there that's not fat, that is skin that's diddly-diddly-diddly, that's not really a good description. That I want gone, and I don't see another way to get rid of that skin short of sucking in, sucking in, sucking in.

Dr. Workman: In essence you've got more skin than your body needs relative to the size of the rest of your body. You've got too big of a skin shell, so we're taking part of your shell of skin off.

Daria: That makes me feel sexy, talking about it that way.

Mitch: Is this the procedure, Dr. Workman, that you have to do a new belly button? Does the belly button go?

Dr. Workman: Yeah, we actually keep your old belly button right where it is and we cut it right at the top where it intersects the skin. It stays there, and we pull the new skin down over it and then just pull it straight through. So it does not move in most cases, it just stays there.

Daria: Will there be a little scar around the belly button, where you sew the skin around it?

Dr. Workman: Yes there will

Mitch: Is it tab A into slot B?

Dr. Workman: Like all scars, it will fade with time. Often times it will be six months to a year before it goes away. But it always will be a little teeny tiny scar.

Mitch: And what's the other procedure you want to do?

Daria: Oh, something with my boobs, just to make them big. I don't want, I've had big boobs since third grade, so when I'm done nursing, I'm told, that they will not be looking like they've looked, pretty much, since puberty.

Mitch: That we've all grown accustomed to, and love.

Daria: Yeah, so when I look in the mirror, I don't want to see, when you have a pair of nylons, and you put them on, and you walk around and you take them off and hold them up. I don't want boobs like that. So I don't know exactly what procedure I need to have done, or want to have done. I'm going to have a consultation with Dr. Workman and his nurses and I'll find out what would be most recommend to go from how I am now, to how I am then, back to how I am now again. If you have questions for Dr. Michael Workman on tummy tucks, breast lifts, breast reductions, anything of that nature, basically from the waist on down.

Mitch: Neck on down we should say.

Daria: Oh yeah, what did I say? Did I say waist?! Yeah from your "head waist." Your neck on down, he's here to answer them for you, right here in studio, right on the spot. 888-733-5105, your questions for Dr. Michael Workman, and the doctor's responses when we come back.

Mitch: 105.1 the Buzz with Daria, Mitch, and Ted, in the studio with cosmetic surgeon Dr. Michael Workman.

Daria: Dr. Workman, we have an e-mail here form a listener who doesn't want her voice recognized and wants to remain anonymous. But she has a fairly straightforward question and here it is, "I have DD 48 breasts at 22 years old. I feel like I should be out running, jogging, enjoying an active lifestyle, but I'm too self-conscious. I also have lower back pain. I was hoping that you could tell me approximately how much would [breast reduction surgery] cost to go down from a DD 48 to at least a B cup?"

Dr. Workman: It'd be roughly about $5,000 plus or minus, and yeah, I think we could get you down to about that size.

Daria: There's the e-mail answer. Let's take some calls at 888-733-5105.

Mitch: Hi, Liz, what's your question for Dr. Workman?

Liz: Hi there, I'm a 38 year old woman, who has just finished breastfeeding two months ago. I have a great deal of breast cancer on my mom's side of the family and have always been interested in prophylactic surgery to remove the breasts once I was done using them. I have called around to some plastic surgeons who did not do that, and so I am wondering if I need to go to a cancer specialist, though I do not have cancer to have prophylactic surgery done. And if I were to have reconstructive surgery done if it can be done all in one swoop or is it done like a cancer mastectomy?

Dr. Workman: Well that's a very good question. Number one I'd probably go to OHSU myself. You want to go to a specialty center for this because it's a little bit controversial to remove the breast prior to having a cancer, or any problem with them. However, if there's a high likelihood that you will develop cancer, it's not an unreasonable thing to do. You want to talk with an oncologist, you want to talk with the surgeon, you want to talk with the plastic surgeon, and really get the whole team on board. So I would go to a breast center at either a major university, or any of the hospitals that have a coordinated breast unit.

Liz: Okay, I greatly appreciate that. Thank you.

Dr. Workman: You're very welcome.

Mitch: Christina, what's your question for Dr. Workman?

Christina: This is in regards to my mother, not me, I've only had one child. But, what is the typical price-range for a tummy tuck around Portland? Can that be financed over time or is it one lump sum before surgery?

Daria: Yeah, that's a really good question.

Dr. Workman: Yeah, I think it varies depending on how much needs to be done, but probably anywhere from $5,000-8000. Normally it has to be paid for up front, although most plastic surgeons offer some sort of financing plans. If she is interested, a number of the doctors offer complementary consultations, where she can find out exactly what needs to be done, and can find out what the financing options are that are available.

Christina: Alright, thank you.

Mitch: Our guest is cosmetic surgeon Dr. Michael Workman, David you're next. What's your question, sir?

David: Hey, my question is, my fiancé actually had her breast reduction about a year ago. She went from about a G to a D basically, or a G to a C. Her self-confidence went down a little after that. I had to reassure that she was still attractive. Is this common with women having breast reductions?

Dr. Workman: It happens occasionally. Probably, depending on the amount that is removed, it sounds like she had a fairly large reduction. We do see it. I would say, probably 5% of the time after we do a reduction, we end up coming back later and putting in a small implant. The reduction gets rid of all that droopy, big, hanging tissue. And then we put an implant in and it kinda restores that youthful perkiness.

David: Okay, perfect. That's all I was curious. Thank you.

Mitch: Hi, Mary Jane, what's your question for Dr. Workman?

Mary Jane: I'm actually a CNA, and I have quite a few friends considering breast augmentation. I just saw an eighty-year-old woman, and what those look like afterward and I was wondering if it was commonplace. Nature takes place and her breasts sag down a little bit. Yet she had those insertions up-top with no nipples on them, just two big bumps. It took me a second to figure out what was going on. And then realized it. Is that commonplace? Do people have to come in and get reconstructed as they age? I'm just kinda wondering how the process works later in life.

Dr. Workman: Yeah, that's really unlikely. Most women who have implants put in end up dying with them. I think that if, for one reason or another, if your skin...

Daria: Why don't you say, "Keeping them their whole lives?" I really like the image of that a little bit better.

Dr. Workman: ...Sorry about that. So anyways, most women end up having them for their entire lives. It's usually not an issue. If a person has gained a lot of weight and lost a lot of weight, or if they've really drooped excessively. Yeah, you can run into problems. Normally it's not a big deal, later in life, to remove them. Often times it can be done under an IV sedation, should a person want that, but usually isn't required.

Mary Jane: Well it's just that her nipples were underneath pointing straight down. The skin had sagged down, but the implant hadn't.

Dr. Workman: Were they hard?

Mary Jane: Yeah

Dr. Workman: Okay, probably what happened there is about 3% of the time, breast implants form more scar tissue around them than we would like, it's called capsular contracture. And that can push the implant up and make it harder, more like a ball. A little bit of that is probably good, that's why they came up with the Victoria's Secret Wonder Bra. It pushed the implants up and you get a little bit of perkiness.

Mary Jane: Huh, I was just wondering. It was the first time I've come across a woman in her eighties who had had that done.

Dr. Workman: Sure.

Mitch: Hi there Nicole, Dr. Workman's ready for you. What's your question?

Nicole: Hi Dr. Workman, I was listening to you talk about the procedure on the tummy tuck. I am a very short person, I'm just barely 5' tall. I lost 65 lbs., which is great. My problem is, no matter how much I work out, I just can't get rid of that love handle area. If I go in for a tummy tuck, do you work that area also? Do you do liposuction? Do you include that area in the tummy tuck? Do you wipe all that out and pull it together? Or is that a different procedure all together?

Dr. Workman: No, oftentimes we can do some liposuction at the same time we do the tummy tuck depending on your anatomy. Sometimes if it's more an issue of extra skin we'll end up making your scar a little bit longer but that enables us to get rid of that extra skin. If it's more an issue of extra fat then we just go ahead and primarily do liposuction in that region.

Nicole: I had a hysterectomy about ten years ago. Now would you use the same scar line to do the tummy tuck?

Dr. Workman: Yeah, most likely we would, and what we would do is go below that scar and get rid of that one for you and give you a nice new one.

Daria: So the hysterectomy scar would actually disappear?

Dr. Workman: Yes it would.

Nicole: Perfect. And you're in Portland right?

Dr. Workman: I've got a Lake Oswego office and a Vancouver office.

Daria: The website is linked from our website, Daria Mitch and Ted at 105.1 the Buzz, or you can always just go DrMichaelWorkman.com.

Nicole: Perfect, thank you so much for your time.

Dr. Workman: You're welcome.

Daria: And that's all the time we have today for Dr. Michael Workman. He'll be back here in two weeks, or you can check him out online as we just mentioned it's DrMichaelWorkman.com and we'll see you back here in two weeks. Take care of yourself.