Dr. Abhay Gupta

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Everything posted by Dr. Abhay Gupta

  1. breast implants

    You should wait until your weight is completely stable for a few months before proceeding with any body contouring plastic surgery.
  2. Bariatric Surgeon and Plastic Surgery

    Hi AngelStorm, Sorry to hear about your experience but thanks for your question. Given your incomplete surgery follow-up, I recommend you first seek consultation with another bariatric surgeon to make sure you are doing well with no complications and get cleared for the reconstructive surgery. Then you can seek consultation with a board certified plastic surgeon to discuss your reconstruction options and any possible insurance coverage. Good luck! Sincerely, Abhay Gupta, MD, FACS.
  3. Breast reconstruction after WLS

    Hello VicWytch, Thanks for your question. Yes I have encountered your situation before. I agree with your breast surgeon's recommendation. You are correct that enough fat is crucial for a good result with autologous (tissue flap) reconstruction and that available fat is significantly diminished after massive weight loss, which usually means implant reconstruction is a better option. But your plastic surgeon will be the best person to make that determination after he/she has a chance to consult with you and examine your tissues. Good luck with your surgeries. Sincerely, Abhay Gupta MD, FACS
  4. FINDING A SURGEON

    Hi Grandma, Thanks for your question. Age is not a factor if you are healthy. What is more important is what other medical problems you have, such as diabetes or heart disease. To find an experienced plastic surgeon, I would first start with your bariatric surgeon. Dr. Kim has likely worked with a few plastic surgeons in your area or sent his other patients to them, and he may have a recommendation to help you choose. Check with family and friends who may know of someone else who has had the surgery and can recommend a good plastic surgeon. Otherwise just consult with a few board certified plastic surgeons in your area and ask them about their experience with bariatric reconstruction and review their before and after photos to help make your decision. Good luck! Sincerely, Abhay Gupta, MD, FACS.
  5. Insurance

    Hello Grandma, Thanks for your question. Every insurance company is different regarding coverage for reconstructive surgery after weight loss. This is also highly variable depending on location on the body. I recommend you seek consultation with a board certified plastic surgeon who can discuss your surgical options with you and then submit to your insurance company to see which procedures, if any, they would cover. Good luck! Sincerely, Abhay Gupta, MD, FACS
  6. Plastic surgery at non ideal weight

    Hello rds, Thanks for your question. For the best results from weight loss reconstruction, it is best to wait until your weight is stable for several months. You are the best judge of when you are at a comfortable weight that you can maintain long term. Any fluctuation in weight after your reconstructive surgery can significantly compromise your result and most plastic surgeons would therefore not perform any surgery until your weight is stable. Sincerely, Abhay Gupta, MD, FACS
  7. Best Way to Have Two or Three Procedures

    Hello Madison2015, Thanks for your question. I do not see any problem with combining your breast and tummy procedures if you have no other medical problems. This is something that is routinely done by most experienced plastic surgeons. If you are otherwise healthy then there is no significant increased risk from a 5-hour procedure compared to a 2-hour procedure. Age is not a factor if you have no significant medical problems. But I would recommend that you have the procedure done by an experienced Board Certified plastic surgeon who uses a Board Certified anesthesiologist to manage your general anesthesia, for the most safety. I personally limit my procedures to 6 hours so I would recommend doing the thigh lift at a separate time, preferably about 2-3 months later once you have recovered fully from the other procedures. Thigh lifts are great at reshaping the medial thighs but the incisions usually take longer to heal and the scar is not as thin or well-hidden as that from a breast or tummy procedure. Good luck with your surgery! Sincerely, Abhay Gupta, MD, FACS.
  8. Tummy Bulge

    Hello mmb5370, Thanks for your question. Based on your weight loss achievement, I imagine you probably have a significant amount of excess skin on your abdomen anyway, and likely also have some weakness of your muscles. In that case, I would recommend a tummy tuck as your best option. But I would still recommend you first seek consultation with a board certified plastic surgeon experienced in weight loss reconstruction, to discuss your treatment options. Sincerely, Abhay Gupta, MD FACS.
  9. Excess Lower Back Fat

    Hello paxriversandy, Your plastic surgeon will most likely remove a large pannus of skin from each lower back/flank area similar to your abdominal surgery but I believe your specific questions can best be answered by him/her after your plastic surgeon has had a chance to examine the area. Just a word of caution: your primary doctor probably got approval for a consultation to see the plastic surgeon, not the actual surgery. Only the surgeon can get that authorization, but not before seeing you in consultation. Although your consultation is covered by insurance, the actual surgery may not be. I hope it goes through insurance approval for you but just wanted to make sure you didn't get your hopes up just to be disappointed later. Good luck! Sincerely, Abhay Gupta, MD FACS.
  10. Hello Cupecake, Thanks for your question. Congratulations on your weight loss achievement! It is normal to feel quite anxious about your upcoming reconstructive procedure. I recommend you contact your plastic surgeon to discuss all of your concerns and recovery questions to your satisfaction. Good luck with everything! Sincerely, Abhay Gupta, MD FACS.
  11. unhappy with lejour reduction

    Hi ccma, Sorry to hear your surgery results - albeit very early in healing - have not met your expectations. I recommend you speak with your plastic surgeon directly about each of your concerns and the surgical revision options to address them. Sincerely, Abhay Gupta, MD FACS.
  12. Hair Transplant

    Hello Calmclear, Thanks for your question. Sorry but I do not have any experience with hair transplantation and therefore cannot answer your questions. Sincerely, Abhay Gupta MD FACS.
  13. Can everything be done at once?

    Whichever area you would most like to correct first.
  14. Can everything be done at once?

    Hello Smallbites, Thanks for your question. The quick answer is No you should not have all of those procedures done at the same time. That would involve several hours of general anesthesia which has a high risk of significant complications. Also, your recovery would be exceptionally difficult given the multiple areas of healing all at once. I recommend you seek consultation with a board certified plastic surgeon in your area who can meet with you in consultation and discuss the safest and most effective surgical plan to address your areas of concern and achieve your goal. Sincerely, Abhay Gupta MD FACS.
  15. Male plastic surgery post-VSG

    Hello Herealways, Thanks for your question and congratulations on your achievement. The best time for your plastic surgery reconstruction after weight loss is once your weight is stable within a 5-10 pound plateau. If you anticipate gaining a significant amount of weight with further weight training then I would recommend delaying surgery until you have finished building muscle mass. Otherwise I believe the time is right for you to consult with your plastic surgeon to discuss your surgical options. Good luck with everything. Sincerely, Abhay Gupta, MD, FACS.
  16. Breast lift without implants

    Hello ccma, Thanks for your question. A breast lift without an implant can always be done. If the breast tissue is still firm then it will hold shape well and the breast will be full and round. But if the breast tissue is very thin and fatty then it will not hold shape very well and the breast will still be very saggy (ptotic) with poor fullness up top and in the cleavage. For these breasts, an additional implant is often recommended to achieve the desired breast shape. Your plastic surgeon will be able to advise you which category you fall into after consulting with you and examining your breasts. Hope that helps. Sincerely, Abhay Gupta, MD, FACS.
  17. When is it time for surgery?

    Dear Shadow6, Thanks for your question. The best time to see a plastic surgeon in consultation to plan your surgical reconstruction is once you are at your personal goal weight and your weight has been stable for at least a few months. This means after you are done losing your excess weight and after you have finished having kids (and the associated weight fluctuations). The plastic surgeon will then be best able to discuss your surgical options after he/she is able to assess your skin elasticity and pannus size. These options might change if you continue to lose weight after your consultation and might change the proposed surgical plan. Hope that helps! Sincerely, Abhay Gupta, MD, FACS.
  18. Blood work

    Hello K-dog. Thanks for your question. There are many different possible causes for those ECG changes but combined with a very high C-reactive protein level, your surgeon will probably ask you to see a cardiologist for consultation and possible treatment prior to proceeding with your surgery. Good luck with everything! Sincerely, Abhay Gupta, MD FACS.
  19. Blood work

    Hello sln05270, Thanks for your question. If your prealbumin level is a true test of your nutritional status then yes, that low level may affect your healing from surgery. It would be wise to improve your nutrition prior to surgery to decrease healing complications. Also, if you have less protein in your blood, then fluid will tend to shift out of the bloodstream and into your tissues which can result in seromas after surgery. But prealbumin is not always an accurate indicator of nutritional status because it can be affected by a number of other factors. Therefore, other blood tests are sometimes ordered at the same time to help interpret the prealbumin results. I recommend you discuss this issue with your plastic surgeon to see if he/she wants to do any further testing prior to performing your surgery. Sincerely, Abhay Gupta, MD, FACS
  20. Butt Implants

    Hello, Thanks for your question. Buttock implants are made of either solid silicone or firm cohesive silicone, both of which are much firmer than the more liquidy silicone gel in breast implants. They feel much firmer to the touch than an implanted breast, just like a strong buttock muscle would feel like. The implants are usually placed underneath the buttock muscles to camouflage them and also protect them. You don't actually sit on your buttock implants when you sit down. When you sit, you are actually sitting mostly on your posterior thighs and the lower part of your buttock area. The buttock implants are placed above this area so they are not damaged when you sit down. As for pricing, there is always a huge variance in plastic surgery pricing across the country, depending on multiple factors. There is probably even vast pricing difference within different practices in the same city. I recommend you seek consultation with a few different surgeons in your area to discuss your options and pricing. Hope that helps. Sincerely, Abhay Gupta, MD FACS
  21. Won't drain seroma

    Your surgeon and I manage seromas very differently. It is not normal to have a lot of excess skin come back only 6 months after a tummy tuck. But it's hard for me to comment without seeing any pictures or examining your tissues. I really think you'd benefit from another opinion with a different plastic surgeon who can examine you and discuss options. Sincerely, Abhay Gupta, MD FACS
  22. Won't drain seroma

    Hello Thanks for your question. Seromas can be quite a nuissance after body contouring surgery and are best treated early. The longer a seroma stays, the more gelatinous the fluid becomes and evenutally gets replaced with scar tissue. If you are not happy with your plastic surgeon's management of the seroma, even after you have expressed your concerns to him, then getting another opinion would be very reasonable. Here in Southern California most plastic surgeons offer complimentary consultations including second opinions, but I do not know if this is true in Louisiana. An ultrasound is a very useful tool in determining whether or not you have a seroma and if it is still drainable. Hope that helps. Good luck. Sincerely, Abhay Gupta, MD FACS.
  23. recovery time

    Hello alynnstrong, Thanks for your question. The recovery time really depends on the amount of skin removed and the locations from where it is removed. Usually the recovery is between 2 and 6 weeks depending on these factors. Sincerely, Abhay Gupta, MD FACS.
  24. Flatulent gases

    Hello sunflower28, Thanks for your question. I believe your question would be more appropriate for Dr. Callery. He is a bariatric surgeon with expertise in multiple bariatric procedures and all possible complications folllowing these procedures. You can post your question to his forum at: http://www.thinnertimesforum.com/forum/121-ask-dr-callery/ Sincerely, Abhay Gupta, MD FACS
  25. Seroma?

    Hello createchange, You have a seroma. Your surgeon will drain it, and might even leave a drain in if there is a large amount of fluid. You will definitely feel much better after the seroma is drained. Your surgeon will discuss strategies for further seroma prevention. Sincerely, Abhay Gupta, MD FACS.