Board Certified
Plastic Surgeon
Since 1989

Health Risk Misconceptions in Plastic Surgery

Health risk misconceptions are often fueled by limited information on the web and anecdotal information by persons who have experienced or heard, negative outcomes in surgery. In this interview Dr. Widder guides patients to seek complete information from their doctor as well as the American Society of Plastic Surgeons who can explain that risks in cosmetic plastic surgery are no greater than other forms of surgery.

shlomo widder

Q: As the “DC Butt Doctor,” do you receive many questions about the safety of cosmetic surgery procedures?

I actually get questions of this nature often.  Sometimes patients come to my office and have heard rumors about cosmetic surgery health risks.  They may be very eager, for example, to undergo surgery for buttock enhancement or some other procedure, but are hesitant because of complications they’ve only heard about.

Q: How do you respond to these questions and concerns?

I try to ease their minds by letting them know that there is no exceptional danger associated with cosmetic surgery.  As with all surgeries, there are risks, but that is not increased in the case of cosmetic enhancements.  I direct those who are still unsure to take a look at what the American Society of Plastic Surgeons has to say about preparing for a safe plastic surgery experience.  The recommendations are remarkably similar to prepping for any kind of surgery.

Q: Is the extra concern about cosmetic surgery due to the idea that it involves elective rather than necessary procedures?

Yes, I think that is what people believe sometimes.  But the truth is that plastic surgery is not always done for vanity’s sake, and can sometimes actually improve health.  Sometimes health issues require the help of a cosmetic surgeon.  For example, rhinoplasty can greatly improve the life of someone who finds breathing difficult because of obstructed nasal passages or breast reduction can alleviate back pain etc.  Even when surgery is for purposes of appearance, the risks are still not greater than when there is a medical objective As long as it is being done in an accredited surgery center by a board-certified plastic surgeon.  I encourage potential patients to learn all the facts about the procedure that is of interest.  Fear, especially without facts, is not helpful in making a good, confident decision.

Q: What is your general advice for those beginning to think about cosmetic surgery?

Always have the surgery in a surgery center accredited by a reputable organization like the American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF).  Make sure your surgeon is board certified.  Finally, it is very, very important to make sure to disclose any and all existing health conditions you may have and get cleared by your internist for any medical issue or if you are over age 45.  Anyone interested in more information about safety and preparing for a procedure can find it on my website and also at the site of the American Society of Plastic Surgeons.

Dr. Shlomo Widder, the “D.C. Butt Doctor,” offers premium services to fit every cosmetic surgery need in Northern Virginia, the Washington, D.C. metropolitan area, and beyond.  As the only plastic surgery center in the area offering buttock implants, other services include rhinoplasty, facelift, facial implants, otoplasty ear tuck, Botox and facial fillers, cheek, chin, and eyelids surgery, liposuction, breast lift, breast augmentation, breast reduction, gynecomastia surgery, pectoral implants, and calf implants.  Consultations are free of charge.

To find out more about the Widder Cosmetic & Plastic Surgery Center, stop by during office hours: 9 – 5 pm, Mon – Fri, or visit our website at: www.widderplasticsurgery.com.

Multiple Plastic Surgery Experience and Outcomes

Multiple plastic surgeries is not an uncommon experience for people who are very satisfied with their initial outcomes. Stories and experiences of plastic surgery patients in Northern Virginia, D.C. and Maryland are shared in this most recent interview with Doctor Widder of Widder Cosmetic and Plastic Surgery Center in Vienna, VA.

multiple plastic surgeries

Q: How common is it in your practice for patients to request multiple plastic surgeries?

 Lots of people do it. Many people lose a lot of weight as a result of gastric bypass surgery.  One of the consequences is a lot of loose skin.  Sometimes after gastric bypass, people are interested in further surgeries for the abdomen and the breasts.  Then they may want me to take care of the arms, the thighs, and sometimes the face and the neck.  I always remember one particular patient who had gastric bypass surgery.  I gave her a tummy tuck after the gastric bypass surgery.  The tummy tuck went well, so she did breast augmentation with a lift after that. She was so happy with that surgery that she sent me a picture – the picture was of her breasts and on it, she wrote: “Thank you, Dr. Widder!”  That’s a funny one.

Q: After the tummy tuck, why did she choose breast augmentation?

When women who have gastric bypass and/or a tummy tuck and lose a great deal of weight, the breast size goes down.   The breasts are made of breast tissue and fatty tissue.  The breast tissue doesn’t change after those operations, but the fatty tissue does.  The breast can become deflated – It will appear as loose skin without a significant amount of volume.  You can take care of it with just the lift procedure. I usually use the keyhole mastopexy.  It will improve the shape of the breast, but then she’ll have about an A cup.  For some women, an A cup is ok.  I had a largely breasted patient who wanted to be an A cup, so I gave her a breast reduction. But the majority of women want to be in the C range.  Maybe a small C or full B if they are athletic, or a full C to small D if they aren’t athletic and just want to look good in their clothes and bathing suit.  I had a woman patient who had an A cup size breasts before surgery, so she requested the implant and I combined it with the mastopexy or keyhole lift.  It’s called the keyhole lift because the incisions take the shape of a keyhole: there is around incision around the areola,  a vertical incision, and a horizontal incision at the crease area.  With that technique, you remove all the excess skin and achieve a very nice shape. You get a perky, beautiful breast.  To add the volume, I use the implants.  So her situation was a common one; it is very rare that a patient with such small breasts will go for just a lift.  Most of them do also want implants.

Q: Since you specialize in buttock augmentation, would you say there is an additional operation that tends to go with that?

Well, the butt augmentation can go very naturally with liposuction to enhance its shape.  Liposuction is more common with the fat injection procedure. Unfortunately, the fat injection to the butt does not last beyond 6-12 months.  With the butt implants, the change stays intact, so those patients look very good permanently.  As a result, I don’t do as many liposuctions associated with butt implants.

I do sometimes see patients that have me redo a procedure they already had done by someone else previously.  One woman came in for a redo tummy tuck and breast augmentation with a lift.  You can imagine how unhappy she must have been if I had to redo the surgery, because the tummy tuck surgery, in particular, isn’t a walk in the garden.   Yet, she was motivated to go through it again.  She was very, very happy with those procedures, so next, we moved on to liposuction of the thighs.  She was so pleased with the liposuction that the week after next we were doing the butt implants. The whole sequence has been at a very fast pace, all done in only six or eight months.  After the butt implants, she wants to do liposuction of the hips and waists.  She seems ecstatic with the changes – you can hear it in her voice.

Q: Do you have any other memorable stories about two or more surgeries?

 Yes. There is a woman who works in my office – she’s on my staff.  She has had multiple surgeries and looks phenomenal.  She’s a 65-year-old African-American woman, and she’s beautiful.  She looks like she’s 40.  I’ve done her tummy tuck, breast lift, eyelids, chin augmentation, liposuction in multiple areas, and calf implants.

Q: Which one started her journey with plastic surgery?

She started with the tummy tuck.  She just came in as a patient.  She had a very nice result and we at the practice thought she had a nice personality, so we offered her a position in the office.  Once she joined the team, we continued with the process of improvement.  After the tummy tuck, I gave her the calf implants.  Her breasts were a nice size naturally though droopy, she chose to go for a breast lift next.  These were followed by eyelids surgery,  chin implants, then liposuction of the abdomen, hips and waist, and finally liposuction of the thighs.  I think we did 8 or 9 surgeries in all.  She looks fantastic.

Widder Cosmetic & Plastic Surgery Center provides multiple plastic surgery options as well as single procedures for those looking to improve their appearance in one area. Stop by during office hours: 9 – 5pm, Mon – Fri, or visit our website at: www.widderplasticsurgery.com. Office Phone: 703.506.0300.

Plastic Surgery Implications for Weight Loss | Tummy Tuck and Liposuction

Weight Loss and Plastic Surgery

A welcome side effect of plastic surgery is that many people who have a tummy tuck or liposuction experience additional weight loss.  Dr. Shlomo Widder discusses this natural phenomenon and why it is important to maintain healthy eating habits post surgery.

Q: How does the tummy tuck procedure result in weight loss?

The reason you lose weight after a tummy tuck is that the procedure is not only a tightening of the abdominal skin but also tightening of the abdominal muscles. When you tighten the muscles, you increase the pressure on the stomach, and that in turn sends a message to the brain that says, “Stop filling me up.  Stop eating.”  That’s how patients lose weight.

I always tell my patients about that; it is part of my initial talk.  I tell them that hunger is managed in two ways.  One is a chemical, which involves sugar.  When the blood sugar goes down, you feel hungry and you eat.  The other is mechanical.  When the stomach is empty, it starts contracting and you might hear all those gurgling noises.  It is saying to the brain, “I’m empty – Fill me up.”  The stomach has special cells that measure pressure, but the brain is not so sophisticated as to tell the difference between pressure from food in the stomach or pressure from the outside.  So we can fool the brain by adding pressure from the outside by tightening the muscles.

I just did a tummy tuck for a military guy.  He told me that he was constantly hungry.  He was in good shape – trim and muscular – but he hadn’t reached what he physically wanted to achieve.  His stomach muscles were loose from lifting heavy weights.  Sometimes men, due to heavy lifting, rip the attachments of the abdominal muscles and it causes this problem.  For some women, a similar thing can happen when they have children.  The pregnancy stretches the abdominals and laxity of the muscles result.  If the muscles are loose, they just extend outward when you eat.  You don’t feel satisfied, so it is easy to keep on eating.  After his tummy tuck surgery, this man I mentioned, felt full and much less hungry.  He’s already lost 10 to 15 pounds and he’s achieved his weight goal.

Q: What will occur if you get liposuction or another procedure that encourages weight loss, and then continue a habit of overeating?

It depends on the surgical technique used.  When my patients have liposuction, I tell them that they have to lose, at least, the same amount of weight that I remove from them.  If they don’t lose that amount of weight, any new fat gained can go into those sections where I did not do the liposuction.

In order to do effective liposuction, you really have to enter with the suctioning cannula from many different directions in order to remove as many fat cells as possible.  For this reason, I take a very aggressive approach and go from multiple directions.  If a surgeon goes from only one or two entries, fat cells will be left between the tracks of the cannula, the tube that is used to aspirate the fat.  Each fat cell is able to store more fat by increasing its size by 50%.  So if you leave a lot of fat cells, two to three months after the procedure, it may look as if nothing was done.  But if you go from multiple directions and are very aggressive with the fat cells removal, the number of fat cells that remain will be reduced dramatically.  Then, no fat or very little can go in those areas in the future.  However, it can go elsewhere. If a patient keeps overeating in the same fashion as before, since the fat can’t go into the liposuction area, it might go to the shoulders, face, butt, breasts, and so on. So the secret really is for me to do a very thorough removal of the fat cells and for the patient to lose the same amount of weight that was removed by the liposuction.

 Q: If a person has a tummy tuck or liposuction, how long before he or she can take on an exercise regimen?  Are there exercises you recommend in addition to a shift in dietary lifestyle? 

 For liposuction, I limit their exercise for two weeks, and then for the following two weeks, they can increase exercise in a gradual fashion. On the first week back, they can exercise at a 25% capacity of what they did before.  The following week, I advise they go to 50% of their former activity level.  Then one month after the surgery, they are free of any limitation.  For a tummy tuck, they have to wait six weeks before any physical activity or lifting.  Then as with the liposuction, they can gradually return to normal activity over a two week period.  After two months, they are back to full speed.

The main type of exercise I recommend is cardiovascular, or aerobic.  Any type of cardio can get you in good shape.  It could be a stationary bike, it could be a treadmill –all of those machines at the gym are good.  The key is to put forth at least 20 minutes of constant effort during which the heart rate is raised to two-thirds of maximal capacity.  Do this, and you’ll be burning fat and lose weight.

For a free consultation and 5% off any surgical procedure, schedule an appointment on our website! http://www.widderplasticsurgery.com/contact.php

*Individual results are not guaranteed and may vary from person to person. Images may contain models.