Plastic surgery helps patients complete transformation after weight loss

Sue Thoms | By Sue Thoms | sthoms1@mlive.comThe Grand Rapids Press on September 29, 2014 at 7:00 AM, updated September 29, 2014 at 11:07

GRAND RAPIDS, MI – When Dr. Ryan Mitchell was in his plastic surgery residency, he developed an interest in a growing area of practice – body contouring for patients who have sustained a major weight loss.

The surgery to remove the excess skin left behind is becoming more in demand, as obesity rates rise and bariatric surgery becomes more common, he said.

Mitchell, who recently joined the Bengtson Center in Grand Rapids, pursued a fellowship to specialize in the treatment.

“It became my passion,” he said.

His draw to the specialty is the chance to address quality-of-life and physical needs of the patient. Many of the patients he has met, although they have lost in the range of 100 pounds and are much healthier, experience a bit of “buyer’s remorse,” he said.

Bengtson before and after.jpgBefore after photos show a patient of Dr. Bradley Bengtson after body contouring surgery. Dr. Ryan Mitchell, a surgery specializing in body contouring after major weight loss, recently joined Bengtson’s practice.

Even with diet and exercise, they can’t lose the excess, sagging skin.

“People have said I look worse now than I did before. One patient said when she was larger, she was just the largest person on the beach. Now when she goes to the beach, she feels she gets looks and attention because she doesn’t fit into either mold,” he said.

Body contouring procedures often target the belly, arms, legs and buttocks area.

The problems caused by excess skin are not all cosmetic. There also are functional problems, particularly with the skin around the belly. That area is prone to rashes and infection. And for some patients, the excess skin on the thigh prevents them from wearing slacks.

While health insurance sometimes covers removal of the overhanging skin on the abdomen, patients usually must pay out of pocket for contouring procedures on other parts of the body.

Mitchell said the cost of surgery varies depending on a number of factors. But as a general range, the cost to patients can run from $14,000-$16,000 for abdominal surgery and $6,000-8,000 for arms, including surgical and hospital fees.

A dual U.S-Canadian citizen, Mitchell received his medical degree in plastic surgery from the University of Manitoba. He did his fellowship in body contouring and reconstructive surgery at the University of Pittsburgh Medical Center.

To undergo body contouring surgery, patients must meet certain criteria, Mitchell said.

“They have to be weight stable for about 12 months,” he said. “In some of them, their weight tends to fluctuate. Once they have reached their plateau, that’s when they are optimized for surgery.”

Because some post-bariatric patients are at risk of malnourishment, patients must be on a high-protein diet to improve wound healing, he added.

He cautions patients that there will be scars. He can often hide abdominal scars in the area that would be covered by undergarments or bathing suits, but scars can’t be hidden on upper and lower extremities.

“Almost every surgeon has the ability to do what I do,” Mitchell said. “The question is whether they are passionate in order to do it or comfortable to do so. What I specialize in are the larger cases.”

He cites research showing that plastic surgery can help a patient maintain weight loss. A study in the October 2013 journal Plastic and Reconstructive Surgery found those who underwent body contouring regained an average of 11 pounds, compared with 50 pounds for those who did not undergo surgery.

The plastic surgery may be “the final hurdle to get somebody to the place they’ve always wanted to be,” Mitchel said. “To me, that’s the rewarding part – to be able to be involved in someone’s life and to be able to make that final difference.”

Séminaire CoolSculpting- le 1er Octobre – Cosmedica 514-695-7450


Coolsculpting – Now at Cosmedica – Maintenant chez Cosmedica


Dites Bonjour à CoolSculpting ® & Dites Adieu à votre graisse tenaces. Retrouver votre corps, juste à temps pour l’été


SayHelloto CoolSculpting® & Say Goodbye to Stubborn Fat.  Reclaim your body just in time for summer


Bill McElligott, Delivery Truck Driver, Has Severe Sun Damage On One Side Of His Face (PHOTO)

The Huffington Post Canada Posted: 06/06/2012 11:12 am Updated: 07/06/2012  9:06 am

This man’s face is possibly the most compelling argument for wearing sunscreen. Every day, all day, and lots of it.

Truck driver Bill McElligott, 69, has unilateral dermatoheliosis, according to The New England Journal of Medicine. Essentially, ultraviolet A (UVA) rays transmitted through the window of his delivery truck have severely damaged the skin on the left side of his face during the 28 years he has spent driving on the job.

As a result, the left side of McElligott’s face looks roughly 20 years older than the right, the Toronto Star reports. The difference between the two sides of his face is so pronounced, even medical experts were shocked.

bill mcelligott sun damage“We are used to seeing photo damage by the sun, photo aging, every day, but I was taken aback when I saw how one-sided this was,” said Dr. Jennifer Gordon, a dermatology expert who treated McElligott, in The Daily Telegraph.

Driving has been linked to an increased risk of skin cancer due to sun exposure through the windows, which do not filter UVA rays. A study in the Journal of the American Academy of Dermatology concluded more cases involved the left arm and left side of the face, according to the CBC.

McElligott’s photo surfaces as Sun Awareness Week heats up in Canada, throwing the spotlight on the dangers of UV damage and indoor tanning, particularly for minors. The Canadian Dermatology Association estimates 5,800 new cases of melanoma will be diagnosed this year, causing 970 deaths, the CBC says.

The doctor’s orders for McElligott? Sun protection, topical retinoids, and skin cancer monitoring. Car windows can also be tinted to protect against harmful UV rays, although each province in Canada has its own regulations.

Christine Janus, executive director of the Canadian Skin Patient Alliance (CSPA), also suggests prevention is essential. For more sun damage prevention tips, see below.

Wear Sunscreen — All The Time

  • “Wear sunscreen constantly,” says Christine Janus, executive director of the Canadian Skin Patient Alliance (CSPA), an organization that provides support for those with skin conditions. Janus recommends wearing about three quarters of a shot glass full or as much as you need to cover exposed skin. She also says we should reapply the lotion every four to six hours if you’re going in the water or working out.

    Don’t Take Risks — With Your Skin

  • “If your skin looks or feels different, rough like sandpaper for example, get it checked — don’t wait,” Janus says. Treatments for skin cancers exist, but the the more you expose your skin, the higher your risks are, she says.
  • Limit Exposure

    “Limit your time outdoors and during peak hours when the sun is up,” Janus says.

  • Wear A Hat

    Make sure when you’re outside you wear a hat. “Men should be wearing hat as well. The top spots for skin cancer for men is on their head and back,” Janus says.

  • Try UV Clothing Or Umbrellas

    Ultraviolet clothing is also another level of protection, Janus says. There are now companies that manufacture specialized items that have a built-in UV layer. She also recommends an umbrella.

Hands giving away your age? Plastic surgeons have the answer

Shari Rudavsky 7:12 PM, Jul. 19, 2012…

If you want to guess someone’s age, look at her hands.

Exercise and the right clothes can make our bodies look more youthful. Makeup and anti-wrinkle cream can keep our faces young. But for the most part, our hands have had little to protect them from the ravages of time.

Until recently. Cosmetic surgeons now offer a number of treatments to give aging hands a youthful appearance. People are taking advantage of them, too, particularly those who have cosmetic work done on other parts of their bodies.

“A lot of folks realize that the hands give them away,” said Dr. Janet Turkle, a plastic surgeon in Indianapolis. “If they have a face-lift and they get all prettied up, all of a sudden, they’re looking at hands that don’t match.”

It’s a dynamic that Indianapolis plastic surgeon Bruce Van Natta expects will only increase over time. He, too, has patients who invest in a face-lift, then suddenly notice their hands.

“I think it’s something we’re going to see more and more as the boomers age,” he said. “They’re a little more attuned to this.”

For Eileen Bewley, the wake-up call came in the treble voice of a child.

A few years ago, the 53-year-old Northwestside resident was sitting on an airplane, chatting and laughing with the little girl next to her, when the girl looked down and asked, “Why do you have old-lady hands?”

The question did not completely take Bewley by surprise. Fit, with blond hair and a self-described tendency to “act goofy,” Bewley frequently found herself mistaken for someone younger. Then her hands, which she described as being “skinny and wrinkled and veiny” would give her away.

Prompted by this little girl’s tell-it-like-I-see-it question, Bewley decided to do something about her hands. She had Dr.Turkle inject Juvederm, a filler, to plump out her hands and give them a more youthful appearance.

Interest in so-called “hand lifts” has increased in the past five years, said Dr. Michael Fiorillo, a plastic surgeon in New York City, with people staying in the work force longer. They may take pains to keep their faces youthful, but their hands stand out.

“You see men in a business suit and the only thing showing in a business suit is your face and the back of your hands,” he said.

In Indiana, Dr. Turkle sees mostly women seeking treatment on their hands, presenting problems that range from thin skin such as Bewley’s to dark, telltale age spots.

All of the same unseemly things that happen elsewhere as we age also transpire in our hands. They can wrinkle, develop age spots and lose fat. Mix in sun damage — after all how many of us remember to spread that sunscreen down to our digits? — and you have a recipe for granny hands.

Fuller looking

That’s where plastic surgeons enter the picture. If your hands’ thinned appearance bothers you, you can rejuvenate them in various ways. A doctor can inject a filler such as Radiesse or Juvederm. This makes the veins less prominent, not unlike blowing up a balloon, Dr. Fiorillo said.

“You can kind of plump up the back of the hand. A lot of times you see the veins and tendons, and that makes the hand look a little older,” Dr.Turkle said. “A youthful hand is a little fuller and plumper. If you look at an older hand, you see a lot more veins.”

In the past five years, filler use has taken off, Dr.Turkle said. Fillers are used in many places, including earlobes that some people feel look too thin and wrinkly. Using filler on hands would probably cost about $900 for both hands, assuming each requires one filler. Typically, these fillers last six months to a year, and the more times you have this done, the longer each treatment seems to last, Dr.Turkle said.

For some, the filler effect can last even longer. Elaine Shaw had her hands done three years ago and has not returned. Shaw, 68, did only one hand for starters.

“I had the one done first, to see if I liked it,” she said. “You could really tell the difference when you had them side by side.”

Today, her hands still look younger, with the veins more concealed. Her face had always looked younger than her years, thanks to a sunscreen habit, and now her hands match, she said. She treats herself to manicures, and the combined effect draws comments.

“A lot of times I will be signing a credit card or at the bank and they will say, ‘Oh you have pretty hands,’ ” she said.”For me that’s a reaffirmation that they look nice.”

Not everyone, however, is a fan of fillers.

Van Natta, a plastic surgeon with Meridian Plastic Surgeons, prefers to use about an ounce of a person’s own grafted fat as a filler. Not only does this method last indefinitely, it also produces a better appearance, he said. However, it takes longer — about 21/2 hours — and costs $4,500 to $5,000.

Age spots

For many people, it’s not just a matter of thin skin but also sun-damaged skin with freckles and sunspots. Lasers and other techniques can help with that.

“Probably the ultimate treatment would be to do both — one is providing volume and the other is treating the surface of the skin to make the texture better and to get rid of some of the pigmentation and uneven appearance to the skin,” Dr.Van Natta said.

In fact, much of what you can do to improve your face, you can do to your hands, Turkle said. Microdermabrasion will stimulate the collagen, removing the top dead layer, and giving the skin a healthier appearance. Lasers will help erase brown sunspots and other discolorations.

Years ago, when Susan Norton tanned, she never thought about what all those rays might do to her hands. As she hit her 40s, though, her hands started to display dark age spots. She hated them. She would often cross her arms or hold them down to hide what she considered her unsightly hands.

“It really bothered me to the point where I would cover up my hands a lot,” said the Fishers resident, 55. “I was so self-conscious of my hands. My mom’s 86 and her hands look better than mine.”

After three treatments with a light laser, however, Norton loves the way her hands look. When her treatments ended about two months ago, Norton decided she was so pleased with the result that she would have laser work done on her face.

After all, she figures, her face should look as good as her hands.

Try these ideas for younger-looking hands

Want to keep your hands looking young as you age? Be sure to use sunscreen on them whenever you head outside. Short of discovering the Fountain of Youth, there’s not much else you can do, experts say.

So take that sunblock seriously and ideally start long before your hands — or any other part of you — begins to age. And if you want to give your hands an extra boost, you might consider using a retin-a product on the back of the hands to improve collagen and thickness, says Dr. Bruce Van Natta, a plastic surgeon in Indianapolis. Facial products that contain vitamins C and E may prove helpful for the hands, says plastic surgeon Dr.Janet Turkle.

But for the very best protection, remember that sunscreen.

To learn more about hand rejuvenation, contact Dr.Benchetrit’s office, Cosmedica, for a free consultation at 514-695-7450

Fat Cells Don’t Return to Treated or Untreated Areas After Liposuction – New Study Refutes Previous Findings Claiming Fat Returns, Redistributes to Other Areas of the Body

ARLINGTON HEIGHTS, Ill. (July 31, 2012)

Since it made its debut in North America 30 years ago, liposuction has promised to permanently remove excess fat from stubborn areas, barring extreme weight gain. New research reveals liposuction lives up to its promise. According to a study in the August issue of Plastic and Reconstructive Surgery, the official medical journal of the American Society of Plastic Surgeons (ASPS), fat cells neither return to treated areas nor get redistributed to untreated areas of the body after liposuction.

The new study refutes a report published last year in Obesity, which concluded that fat returns to untreated areas of the body, especially the abdomen, shoulders, and arms within one year after liposuction. In a follow-up story, the New York Times featured a caricature of a distorted woman, looking trim in the lower body, but like the Incredible Hulk in the upper body. This disturbing image was widely publicized on the Internet.

The new study by ASPS Member Surgeon Eric Swanson, MD, Leawood, Kansas, evaluated 301 patients having liposuction, either alone or in combination with
abdominoplasty, using standardized photographs and computer-assisted measurements of body dimensions obtained preoperatively and at least three months after surgery. The study revealed no evidence of fat regrowth in treated areas of the arms, abdomen, or lower body. Additionally, upper body dimensions were unchanged after surgery, indicating no fat redistribution. Average reductions in hip measurements remained significant in patients followed one year or more after both liposuction and combined liposuction/abdominoplasty procedures. The average hip reduction was significant even among a subgroup of 34 patients who gained five pounds or more after surgery.

“Previous studies have evaluated small numbers of patients and used imprecise measuring techniques, limiting their power to reliably detect changes,” said Dr.
Swanson. “Our study included a sufficient number of patients and used precise measurements, making the conclusions highly reliable. Patients can be reassured
that their improvements will last and they need not worry about putting weight back on disproportionately.” Dr. Swanson adds, “Of course, liposuction does not change your ability to gain or lose weight. Its value is in permanently reducing the number of fat cells in problem areas. For any given weight you will be in the future, your proportions will be better after liposuction, barring extremes in weight gain.”

(Don’t) Like My Photo: Social Media Spurring Plastic Surgery

PHOTO: Triana Lavey, before and after plastic surgery to fix her "weak chin." Lavey, a 37-year-old television producer in Los Angeles, got the surgery because she didn't like how she looked on Skype and Facebook.Triana Lavey, before and after plastic surgery to fix her “weak chin.” Lavey, a 37-year-old television producer in Los Angeles, got the surgery because she didn’t like how she looked on Skype and Facebook. (Courtesy Dr. Richard Ellenbogen)


July 16, 2012

Triana Lavey was about to undergo a radical transformation. And she was doing it for a radical reason.

She wanted to look better online.

With the help of Beverly Hills plastic surgeon Dr. Richard Ellenbogen, she was changing her chin, her nose and the shape of her face.

Lavey is a 37-year-old television producer in Los   Angeles. For work and socially, she spends a lot of time on Skype, Facebook and other sites. She said she didn’t like the face staring back at her from her computer screen.

“I have been self-conscious about my chin, and it’s all stemming from these Facebook photos,” she told ABC News correspondent Cecilia Vega.

The more she saw herself online, the more she said she wanted to change. “I think that social media has really changed so much about how we look at ourselves and judge ourselves,” Lavey said. “Ten years ago, I don’t think I even noticed that I had a weak chin.”

Lavey tried to change the camera angle. She even untagged herself in photos she didn’t like. But none of it was enough.

“Here is a weak-chin photo that I didn’t untag myself in … because I was working out really hard that summer, and I am pleased with everything else in the photo,” Lavey said. “But it’s my darn chin that bugs the living daylights out of me in this photo. … You keep looking and looking, and now it’s the first thing I look for in a photo. It all started with Facebook.”

Surgery was the only way to fix it. Simply cutting down her social media use wasn’t an option. “That can’t happen. … Where my career is headed and the industry is headed, I have to be on social media,” Lavey said.

Lavey is not alone. According to the American Society of Plastic Surgeons, chin augmentations have increased 71 percent in the last year. Doctors confirm that more and more patients are asking for the Facebook facelift — plastic surgery for the iPhone generation.

At Lavey’s consultation, Ellenbogen showed her what her new online-ready face would look like.

Ellenbogen explained that augmenting the chin should be balanced by adjustments to the rest of the face with procedures like fat grafting — adding a bit of fat to the face — and rhinoplasty (a nose job).

Given that social media are supposed to make life easier, did Lavey feel she was doing something extreme?

“Plastic surgery should be a last-ditch effort,” she said. “It should be after you work out, after you diet.”

“I am blessed; I can afford it,” she said. “I feel really lucky. I have worked my butt off, and I feel like if I can afford it, if it’s something I can do to feel good and feel confident, why not? It’s 2012.”

The surgery Lavey got costs between $12,000 and $15,000, Ellenbogen said. Lavey is a friend, so she got a discount.

Is our eager embrace of social media creating a culture of Internet narcissism? And can’t we just move the webcam to improve the angle from which it shoots us?

“It definitely is, and most people should do that,” Ellenbogen said, “but there are people who have tried to do that, to make themselves more attractive, and they just need a little bit of a boost.”

More than a month after her surgery, Lavey was ready to show her 692 Facebook friends her new face.

She said she felt more confident.

“It extends all the way from Skyping with people [to] having people tag me in a Facebook photo,” she said. “If the camera comes out at a party … I am fine with it. I am excited to see them. Before, I used to want to hold my chin, but now I want to show my face.”

Conversations in the treatment room

“Beauty, to me, is about being comfortable in your own skin. That or a kick-ass red lipstick.”
Gwyneth Paltrow
My lip injection.
Today is my day off from work but I’m strolling into the golden towers that house Cosmedica, Montreal’s beauty mecca, for a different reason. Scurrying through the elegant lobby, I do a mental check of my appearance; I like to keep it professionally casual in case I bump into patients… Today it’s a little challenging as I’m toting my two year old while balancing on my heels and sucking on a Freezee. At 31 years old, I’m the one sucking on the Freezee and not sharing. At the clinic, between us girls, frozen goodies are our preferred method of minimizing bruising post lip injection, and a darn good excuse to have Haagen-Dazs.


After a flurry of greetings and hugs, we gather around in Isabelle’s injection room to watch the transformation take place. With a wink and few expert injections with her Restylane syringe, Isabelle plumped my lips just the way I wanted. Her special “hydrated lips” technique only requires an economical half a syringe of product, enough to give that sleep-swollen lips look you wish would last all day, minus the puffy eyes. As our other nurse Val explains: “hyaluronic acid (Restylane) occurs naturally in the human body, it is the main component in our skin and is also used by the body to lubricate and prevent injury to our joints. Because it already exists in our tissues, there is very little risk of any allergic reactions.”

There is already anesthetic mixed into the Restylane so the procedure was very bearable. I’d do ten of these over a Brazilian bikini wax! Then again, who needs Brazilian bikini wax when Cosmedica offers virtually painless laser hair removal by LightSheer Duet. That’s a topic for another day…


I would like to thank Aurelie who giddily exclaimed: “ouch, I know exactly how you feel right now!” Thanks. Without Val bouncing around my two year old, this whole thing would not be possible. Thank you to Dr. Benchetrit, of course, for taking good care of us. Special thanks to my beloved colleague Isabelle, Montreal’s top injector nurse who really knows her way around a needle and helps me wear my red lipstick even more proudly!


Nadine Harvey
Medical esthetician at Cosmedica

Aurelie’s Breast Surgery Journey!



So it’s been a while now since my operation (8 days) and I’ll update you about how it’s been. 

Day 1 – Operation day – As I said, it went well, a little towards the end but due to anesthesia. Dr.B was great and really reassured me throughout the process.  All went well without any vomiting. Hospital and staff was fantastic. Big thanks to my nurse Josée.  Any transitions (to lie down or get up) is very stiff (muscle pain) and causes a lot of pressure.

Day 2 – Sore, to be expected.  Tolerable pain still feeling the anesthesia. Very itchy where the incisions are. Transitions displacement still difficult.  Can’t wait for shower.  I don’t know why (perhaps meds or anesthesia makes you sweat) but my hair is very dirty.

Day 3 – Reaction to Dilaudid (Pain medication). Vomited, very tired, stayed in bed all day, not eating but lots of Gatorade. Still itchy & pressure during transitions

Day 4 – Stomach-wise better, both breasts sore (pressure pain), no pain were incisions were done. Itchy!

Day 5 – Stomach much better (must have gotten rid of anesthesia in my system).  Bra and tape causing much itchiness. Still transition issues

Day 6- Saw Dr.Benchetrit post op to take some of the bandages off. He was very pleased with the results. I had no bruising or leaking.  The incisions look great. My nipples are in the right place. I still have Steri strips that will eventually fall off on their own.  Now I can take a shower but without touching breasts! Yay!!

Day 7 – Tired du to lack of sleep since I’m always sleeping half sitting up and still sore.  Tired o being tired and sore!!

Day 8 – So far. Back at work.  More pain on left breast than right.  Since it’s hot very itchy. Saw Dr.B again and is very pleased with result.  Incision very nice.  Swelling is going down a bit.  Asked if I was please with size and I am.  I chose 370 cc’s which a full C size.


Here are some suggestions and comments about having this surgery:

You’ll get sick of lying down on your back.  Have lots to watch on tv or dvd’s.  Calculate 4 days to doing nothing at home with a mastopexie (lift) with implants.


You won’t be sleeping well so buy yourself specialty foam pillows if you can to make sure you are comfortable and allows you to be partially sitting while sleeping


At the en of all of this, having this surgery is priceless, honestly. I would do it again in a heartbeat. 


Make sure that you choose a size that you’re happy with so you don’t regret your choice. The implant trial with the nurse is invaluable.


I’m already seeing the results in my clothes and I’m loving it.



Aurelie’s Breast Surgery Journey!

Hello everyone my name is Aurelie and I work for Dr.Benchetrit.


The reason for my blog is to let you know that I am getting breast surgery in 3 days with Dr.B. I want to share my experience before and after the surgery. I will start with the fact that I have lost almost 100 pounds in a year so my breast are really not what they used to be so that’s why I decided to get a breast lift with implants ( mastopexy with gel implants).


My surgery in on June 14th so in 3 days!!! I feel exited, nervous and I cant wait plus I know I am in great hands with Dr.Benchetrit!!!


So I will be posting my little journey of before and after my surgery and hopefully it will help some of the women out there understand better breast surgery and that you do it for you and not for anybody else! J


If ever any of you would like to ask me questions it will be my pleasure to answer them online or call me at the Clinic 514-695-7450.


Aurelie. J

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