Plastic Surgery after Dramatic Weight Loss

Weight loss, either through bariatric surgery or diet and exercise, is truly a life changing event. You look and feel better. You are healthier. You are engaging in activities that you were never able to before. While most of the changes that accompany weight loss are positive, unfortunately, loose skin is a concern for many patients. Hanging skin can affect both comfort and self confidence, and can be a daily reminder of past obesity.

Predicting who is going to have problems with hanging skin after weight loss is hard to determine, but a majority of patients undergoing weight loss will have some complaints. How your body looks after weight loss is directly related to the elasticity of your skin. In general, skin in regions of your body that are most stretched from the weight gain tend to be less elastic. Elasticity also decreases with age, sun exposure, and cigarette smoking, and is affected by genetic factors.

Almost all parts of the body can be affected by loose skin after weight loss. The most common area that people are concerned with is the belly. An overhanging apron, called a “pannus,” can cause a fold of skin on the front of the abdomen. In addition to preventing clothes from fitting well, a pannus can cause symptoms of rash and skin irritation. These symptoms tend to be worse in hot weather. An extremely large and heavy pannus can interfere with exercise and even normal activities, as well as cause problems with lower back pain.

While the belly is definitely the hot spot for problems with hanging skin, rashes and irritation can occur in folds of skin under the breasts, and on the thighs and back. Excess skin on the upper arms can be bothersome to many patients. Skin rashes are less common in this area, but the hanging skin may cause discomfort during physical activity and embarrassment, especially in young women.

Plastic surgery can help with hanging skin problems after dramatic weight loss, but are you willing to make a trade? There is one simple rule of body contouring surgery: you can’t take away excess skin without having a scar. Scars tend to fade with time, but they will always be there. In most procedures, the scars are hidden in places that are covered by clothes, such as along the waistline. In some procedures, such as arm lift (brachioplasty), the scars can be visible. Your plastic surgeon can inform you of all of the options that are right for you.

If you live in the Las Vegas area and are considering weight-loss surgery, schedule an appointment with Dr. Shawn Tsuda. He and his expert team can explain all of the procedures that could be right for you.

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Appendicitis – Causes and Treatments

The appendix is a three to six-inch long pouch-like structure in the lower right area of the abdomen. It is attached to your intestines. The function of the appendix is not entirely clear. It contains lymphoid tissue and may help the body fight infection. Other organs take over the infection-fighting work of the appendix after it is removed.

Appendicitis occurs when the appendix becomes infected or inflamed. When the appendix becomes inflamed and swollen, bacteria can quickly multiply inside the organ and lead to the formation of pus. This buildup of bacteria and pus can cause pain around the belly button that spreads to the lower right section of the abdomen. Walking or coughing can make the pain worse. You may also experience nausea, vomiting, and diarrhea.

It’s important to seek treatment right away if you’re having symptoms of appendicitis. When the condition goes untreated, the appendix can burst and release bacteria and other harmful substances into the abdominal cavity. This can be life-threatening.

Appendectomy is the standard treatment for appendicitis. An appendectomy is a surgery to remove the appendix. Once an appendectomy is performed, most people recover quickly and without complications.

There are two types of appendectomy:

  • Open
    • A surgeon makes one incision in the lower right side of your abdomen.
    • Your appendix is removed, and the wound is closed with stiches.Appendix pain
    • This procedure allows your doctor to clean the abdominal cavity if your appendix has burst.
  • Laparoscopic
    • A surgeon accesses the appendix through a few small incisions in your abdomen.
    • The laparoscope is a long, thin tube with a high-intensity light and a high-resolution camera at the front.
    • The appendix is tied off with stiches and removed.
    • This is usually the best option for older adults and people who are overweight.

The type of surgery your doctor chooses depends on several factors, including the severity of your appendicitis and your medical history.

If you are in the Las Vegas area and need a surgeon, contact Dr. Heidi Ryan. Her specialties include bariatric surgery, LINX surgery for GERD, and appendectomy.




Navigating the Challenges After Weight-Loss Surgery

Weight-loss surgery is not a cure for obesity, but rather a tool to help you lose weight to live a healthier, longer, and more fulfilling life. Successfully maintaining your weight loss depends on your ability to follow guidelines for diet, exercise, and lifestyle changes after surgery and for the rest of your life. Life after weight loss surgery will be a 180 degree turn from what you are used to.

Thankfully, you don’t have to figure out this new post-bariatric-surgery life alone. Follow-up care, including a support group, dietitian services, and continuing education are imperative to help you achieve long-term success. Your chance of maintaining a healthy weight will increase if you have a network of family, friends, and professionals who can offer encouragement and help you stay on track. Even though it can be difficult at times, most patients say it was the best decision they have ever made.

In addition to weight loss, bariatric surgery may improve or resolve conditions often related to being overweight, including:

  • Gastroesophageal reflux disease
  • Heart disease
  • High blood pressure
  • Severe sleep apnea
  • Type 2 diabetes
  • Stroke

Healthy lifestyle infographics. Compare of fat and slim man silhouettes. Color flat illustrationDespite all of these positive outcomes, you’ll need to develop permanent long-term habits in order to maintain your weight and health goals.

If you let your post-surgery habits slip and find yourself putting weight back on, you’ll be more likely to experience a recurrence of your former health problems. For example, most patients with diabetes experience a complete remission of the disease following bariatric surgery, but one out of five of these patients see their diabetes return, due in part to having a higher body weight as time goes on following surgery.

Get ready for some significant changes to both what you eat and how you eat, but don’t be discouraged! It may not be as hard as it sounds. Many patients find that their unhealthy food cravings completely go away, plus your new stomach will cause you to feel full much sooner than before surgery.

If you live in the Las Vegas area and are considering bariatric surgery, schedule an appointment with Dr. Shawn Tsuda. He and his expert team can find the right treatment for you.


(Healthy) Breakfast in Bed for Father’s Day

With Father’s Day coming up this Sunday, you may be thinking of making Dad his favorite breakfast in bed. You aren’t doing dear ol’ Dad any favors, though, if you are serving up a big plate of fat and cholesterol. Don’t be disheartened! (Pun intended!) You can still serve up yummy comfort food without sacrificing Dad’s heart health.

Fancy, rich, and usually a big hit with dads, Eggs Benedict is the perfect main course for your breakfast tray. This recipe allows him to enjoy all the gold, gooey goodness of a traditional Eggs Benedict and save calories for any other indulgences that might be planned for the day.

Eggs Benedict at a restaurant can set you back over 1000 calories and 57 grams of fat. This version has less than half the calories, way less fat, and is free of butter.


1 Whole Wheat English Muffin
2 Strips of Turkey Bacon*
2 Eggs
2 tsp. White Vinegar

For the “Hollandaise Sauce”

1/2 C. FF Greek Yogurt
1 Egg Yolk
1/4 of a Lemon
1/2 tsp. Yellow Mustard or Dijon
1 tsp. Dill


  1. Fill a large sauce pan and a small saucepan with 2/3 water. Bring the large to a boil, the small to a simmer.
  2. Mix together the Greek yogurt, egg yolk, and lemon in a small heat-safe bowl.
  3. Once the small sauce pan is simmering, place your bowl with the yogurt mixture in the water. Heat and stir occasionally until the sauce thickens – about 10 minutes.
  4. Toss your turkey bacon in a pan sprayed with olive oil and cook for about 2-3 minutes per side.
  5. Drop your English muffin in the toaster.
  6. Now that the large pan of water is boiling, stir in 2 tsp. white vinegar. Carefully crack each egg into the water. Use a spoon to push the white portion of the egg toward the yolk if it appears to be coming apart.
  7. Turn the heat off and cover the pan, cook for 4 minutes.
  8. While the eggs are cooking, assemble your benedict. Top each muffin half with a strip of bacon, then add the egg.
  9. Your hollandaise should be done now too. Carefully remove the bowl from the saucepan and add the remaining ingredients.
  • Top the benedicts with the sauce.eggs benedict and breakfast in bed image1 (2).JPG
  • Serve to Dad and wait for the oohs and aahs!

Total Calories: about 480 for the whole recipe
*Feel free to swap the turkey bacon for smoked salmon, crab, or anything else you like!

Find more healthy breakfast recipes here:

Happy Father’s Day from Dr. Ryan and her team. If you are considering bariatric surgery in the Las Vegas area, call today to make an appointment!


Weight-loss Maintenance after Bariatric Surgery

One of the greatest fears of patients seeking weight-loss (bariatric) surgery is the fear of weight regain. This is understandable considering that it is common for a surgical candidate to relate stories of losing 10 pounds, 20 pounds, sometimes even 50-100 pounds with dieting attempts, only to see the weight return over time.

The good news is that with bariatric surgery, the weight loss seen post-operatively can be maintained over a long period of time if patients are willing to make necessary changes. However, it is important that patients keep in mind that obesity is a chronic disease that is not cured by surgery. Rather, surgery provides a powerful tool for significant weight-loss.

The key to prevention of weight regain is education and follow-up. Both before and after weight-loss surgery, patients need to be taught how to use their surgery for optimal success. This education should involve counseling in dietary, behavioral health, and exercise issues.

Maintain weight loss by:

  • following a healthy, balanced diet
  • regularly exercising every week

Sometimes, post-operative patients can become discouraged or embarrassed by weight woman on scale (2).jpggain and may not return to their bariatric surgeon, or even worse, they sometimes return many years later at their pre-surgery weight and request a revision. Instead, it is best to return to the bariatric team at the earliest signs of weight regain. If weight regain is caught in its early stages, it is easier for patients to get back on track. It is unusual, but regain of weight can be due to changes in operative anatomy and require tests to diagnose. It is more common that weight gain after bariatric surgery is caused by changes in diet, lack of exercise, or psychological issues.

If you live in the Las Vegas area and are considering bariatric surgery, schedule an appointment with Dr. Shawn Tsuda. He and his expert team can help you find the treatment that will be easiest for you to maintain and have optimal success.

Maximize the Healthy You with Minimally Invasive Surgery

If you are obese and have any of the associated health problems that go along with obesity, you may be thinking about weight-loss surgery. Weight-loss surgery can help you:

  • lose weight
  • improve or eliminate many health problems
  • improve your quality of life
  • live longer

Weight-loss surgery is definitely not the easy way out, but with innovative minimally invasive procedures available, the surgery and recovery won’t be the hardest part either. Adoption of minimally invasive procedures is increasing, with millions performed in the U.S. every year. The typical reasons are:

  • smaller incisions
  • less pain and scarring
  • fewer complications
  • shorter hospital stays
  • faster recoveries

The 3 most common bariatric surgeries are:

  • Gastric Bypass – The Roux-en-Y Gastric Bypass is one of the most frequently performed procedures for morbid obesity. It restricts food intake, utilizing restrictive and malabsorptive surgery techniques, which prevents the body from absorbing calories and nutrients. Aside from creating a smaller stomach pouch, the overall digestive process of the body is changed so that food will bypass the large part of the stomach and most of the small intestine.
  • Gastric Band – For this procedure, a band is placed around the uppermost part of the stomach, dividing it into two parts—a small upper pouch and a lower stomach. The small upper pouch can only now hold about ½ cup of food, so the patient will eat less, feel full sooner and stay satisfied for longer.
  • Sleeve Gastrectomy – This restrictive surgical weight loss procedure limits the amount of food patients can eat and makes them feel full quicker. During the procedure, a thin, vertical, banana-sized sleeve of stomach is created and the rest of the stomach is removed.

All three of these bariatric procedures can be performed laparoscopically using minimallySurgeons working on a patient invasive techniques. These innovative techniques have been scientifically validated as an alternative to conventional surgery for many patients.

It’s no surprise that more and more patients are asking their doctors about these less invasive techniques. If you live in the Las Vegas area and are considering weight-loss surgery, schedule a consultation with Dr. Heidi Ryan to talk about your surgical options.


Going On Vacation Shouldn’t Mean Taking a Break From the Healthy You

Taking time off for vacation shouldn’t mean taking time off from your healthy lifestyle too. Don’t throw away months of work for one gluttonous getaway. With a little forethought and planning, you can stay on track and still have fun.

Even if you overindulge a little on food while you are away, you’ll stave off weight gain by making sure you stay active on a daily basis.

  • Set aside 45 minutes to an hour a day for some form of physical activity.
  • Book your stay at a hotel with a gym and plan some time each day for a workout.
  • Go for a long walk on the beach or hike in the mountains with your significant other or friends.
  • Rent bikes and go exploring on a family bike ride.
  • Swim laps at the pool.
  • Bring a workout DVD and pop it in while everyone else is away.

You get the idea.  If anything, you have more options for fun exercise/activity when on vacation.

You also have exciting and often different options for foods while on vacation, and you’re definitely more likely to dine out at restaurants. However, if you just take some time active mature woman running the beachchecking out menus online beforehand, like you take time to plan which activities you want to do while on your vacation, you can plan some delicious and healthy dining-out experiences. Also, stock up on grab-and-go snacks that you can bring with you while you’re sightseeing, so you don’t have to resort to buying overpriced, unhealthy snacks when hunger strikes.

Think before you drink! Ordering a poolside frozen margarita can blow a good portion of your calorie count for the day. This is not to suggest that you shouldn’t unwind with a few cocktails while you are on vacation; it’s just that you can make the healthier choice when it comes to alcohol too. Instead of sugar-laden cocktails, choose lower-calorie drinks like a white-wine spritzer, light beer, red or white wine, flavored vodka with club soda, or tequila on the rocks with lime.

Maintaining a healthy lifestyle is easier than ever to do these days. Resorts offer amazing activity opportunities and restaurants are serving up more healthy options. It’s up to you to choose wisely while still treating yourself.

Dr. Shawn Tsuda and his staff wish you happy, safe, and healthy vacations this summer. If you live in the Las Vegas area and are considering bariatric surgery, schedule an appointment. He and his expert team can help find the right treatment for you.