Radio Transcript

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!

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!

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!

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.

More from Dr. Workman on the Daria, Mitch, and Ted radio program