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Bariatric Surgery Cuts Heart Attack Risk for Years

Benefits Hold, Researchers find in 7-Year Follow-Up of Gastric Bypass Patients ekg and stethoscope

June 21, 2012 (San Diego) — Bariatric surgery is known to reduce heart attack risk short-term.

Now, a new study presented here at the annual meeting of the American Society for Metabolic & Bariatric Surgery suggests that benefit is maintained long-term. It followed some patients as long as seven years.

Researchers looked at numerous heart (cardiac) risk factors before and after gastric bypass surgery and found all improved.

“The obese patient has substantially more cardiac risk factors, and that risk is improved after bariatric surgery across the board, regardless of individual cardiac risk factors,” says researcher John Morton, MD, MPH, director of bariatric surgery at Stanford Hospitals & Clinics at Stanford University.

“This study shows that bariatric surgery’s impact on cardiac risk factors is not only effective treatment but enduring,” Morton says.

Bariatric Surgery & Heart Attack Risk: Study Details

All patients had gastric bypass, in which a stomach pouch is created out of a small portion of the stomach and attached to the small intestine. A large part of the stomach and some of the small intestine are bypassed.

In the study, 182 patients were followed for at least three years. By year seven, 57 patients remained for follow-up evaluation. Others dropped out.

”This is the largest long-term follow-up of cardiac risk factors after gastric bypass surgery,” Morton tells WebMD.

The average age was 44 years. Before surgery, the patients’ average BMI was 47 (a BMI of 30 or higher is considered obese). at the start, 33% had diabetes, half had high blood pressure, and nearly one-fourth were on statin therapy to reduce cholesterol.

By seven years, the average BMI was reduced to 34. Patients maintained a loss of about 56% of their excess weight. Weight declined from 286 to 205 pounds, on average.

Improvements in heart risk factors included:

  • Total cholesterol declined from 184 before surgery to 174 after. (Below 200 is recommended.)
  • HDL or “good” cholesterol rose 40%.
  • LDL or “bad” cholesterol improved.
  • Triglycerides (blood fats) declined by about 55%.

High-sensitivity C-reaction protein, a marker of inflammation — which boosts risk for heart attacks — declined by 80%, Morton says.

“We didn’t see any cardiac events in these patients,” Morton says.

Statin drugs, taken by about one in four before, were stopped after surgery. About the same number eventually had to go back on them. Morton says that reflects genetic factors making people vulnerable to high cholesterol.

Morton reports serving as a consultant for Ethicon Endo-Surgery inc., which makes the Realize gastric band for weight loss surgery. He is on the scientific advisory board for Vibrant, which makes an implant system for weight loss.

Bariatric Surgery & Heart Attack Risk: Perspective

The long-term follow-up study ”reinforces what we already know,” says Stephen Wohlgemuth, MD, a bariatric surgeon and medical director of the Sentara Metabolic and Weight Loss Surgery Center, Sentara Medical Group, in Norfolk, Va. Wohlgemuth is also an assistant professor of clinical surgery at Eastern Virginia Medical School in Norfolk.

He reviewed the findings for WebMD.

“Bariatric surgery, particularly gastric bypass, has a very protective effect on cardiac risk factors,” he tells WebMD.

However, he notes that as the years went on, the number of patients declined as some were lost to follow-up. although that is typical in any medical study, it results in incomplete information, he says.

“We base a lot of our information on a small number of patients,” he says, due to those who drop out or are otherwise lost to follow-up.

However, even with those shortcomings, he says, gastric bypass, more so than other weight loss surgeries, appears to be linked with better improvements in heart attack risk and other indicators of wellness or disease.

These findings were presented at a medical conference. they should be considered preliminary, as they have not yet undergone the “peer review” process, in which outside experts scrutinize the data prior to publication in a medical journal.

Bariatric Surgery Cuts Heart Attack Risk for Years

The “Lip Lift”: When a Facelift is Not Enough

Apr 4, 2012 (GlobeNewswire via COMTEX) — Plastic Surgeon Dr. George Weston to Discuss Perioral Rejuvenation at the Aesthetic Meeting 2012 Little-known surgical mouth procedures have big impact on the youth and beauty of the face

RESTON, Va., April 4, 2012 (GLOBE NEWSWIRE) — Board-certified plastic surgeon Dr. George Weston, President of the Austin-Weston Center for Cosmetic Surgery, will speak about the “Lip Lift,” corner mouth lift, and other around-the-mouth surgical procedures at a may 7, 2012 panel at the annual meeting of The American Society for Aesthetic Plastic Surgery in Vancouver, Canada.

“While many people are familiar with lip augmentation and lip injections, a Lip Lift is very different,” says Dr. Weston. “You can lift lips just as you can lift a face.

“As we get older, the lips get longer, they turn down at the corners, they get thinner, and the area around the mouth gets loose. My talk is going to be on how to make a mouth look younger. an old mouth makes a face look old even after a facelift. If you don’t address the mouth, you can’t have a youthful face. On average, you can make a face look about five years younger by adding mouth procedures to your facial rejuvenation.

“There are several procedures my partners and I perform to increase the youth and beauty of the mouth,” Dr. Weston continues. “With the Lip Lift, we can shorten the upper lip and make an old mouth look young again, or just make an upper lip that is too long regardless of age shorter and more attractive. we can make an incision right in the crease under the nose–the resulting scar is well-hidden in the crease and is usually imperceptible–and actually shorten the upper lip and make it shorter, poutier and more youthful. So we shorten the upper lip, turn up the mouth corners with a corner mouth lift, directly excise loose skin in the nasolabial region if necessary, and we can also augment the lip at the same time to make it look fuller.

“If you look at pictures of young models in magazines, you’ll notice that they have a short upper lip and a pouty, turned-up mouth,” Dr. Weston notes. “Those are characteristics that are not achieved by simply increasing the size of the lip with injections. with lips, bigger is not always better. It’s about achieving total aesthetic harmony in the entire mouth area as well as the rest of the face.”

The founder of the Austin-Weston Center for Cosmetic Surgery, Dr. Harvey Austin, who retired in 2005, invented the corner mouth lift and wrote a paper on the Lip Lift in 1986 in Plastic and Reconstructive Surgery, the journal of the American Society of Plastic Surgeons. Adds Dr. Weston, “We have evolved these procedures over the past 25 years to make them even better, to make the scars not as noticeable, and to make the mouth even more youthful than before.

“It’s great stuff and really gratifying to see a face looking younger with just a few small mouth procedures added to facial rejuvenation procedures.”

Watch Dr. Weston’s YouTube video for a more in-depth look at the Lip Lift and perioral rejuvenation at The Austin-Weston Center for Cosmetic Surgery.

The Austin-Weston Center for Cosmetic Surgery.

less than 10% of board-certified plastic surgeons specialize exclusively in cosmetic surgery. The other 90% perform reconstructive surgery and cosmetic surgery. Dr. Weston and his partners, Robert K. Sigal, M.D., and Byron D. Poindexter, M.D., perform cosmetic surgery exclusively and are one of the largest such groups in the metropolitan D.C. area.

Dr. Weston joined the Austin-Weston Center in 1987 and has served as its President since 1994. an instructor of other plastic surgeons both nationally and internationally, Dr. Weston’s innovative procedures have been included in numerous cosmetic surgery medical journals. to arrange an interview with Dr. Weston, please call our Media Relations Department at 703-230-2537.

about The Austin-Weston Center for Cosmetic Surgery

Founded in 1978, The Austin-Weston Center for Cosmetic Surgery is the first free-standing center established exclusively for cosmetic surgery in the Washington, D.C. area. its surgeons, George W. Weston, M.D., Robert K. Sigal, M.D., and Byron D. Poindexter, M.D., have over 55 years of combined surgical experience among them. The doctors are board-certified by The American Board of Plastic Surgery and are members of The American Society of Plastic Surgeons. The AAAHC-accredited office-based surgery center has 5 on-site operating rooms and is staffed by over 30 professionals dedicated to the highest standards of patient safety, privacy and service. View our website at www.austin-weston.com . For more information, please contact the Austin-Weston Center’s Media Relations Department at 703-230-2537.

This information was brought to you by Cision http://www.cisionwire.com

http://www.cisionwire.com/the-austin-weston-center-for-cosmetic-surgery/r/the–lip-lift–when-a-facelift-is-not-enough–plastic-surgeon-dr–george-weston-to-discuss-perioral- ,c9243114

The following pictures are available for download:

This news release was distributed by GlobeNewswire, www.globenewswire.com

SOURCE: The Austin-Weston Center for Cosmetic Surgery

Dr. George Weston, Dr. Byron D. Poindexter, & Dr. Robert [Image] Sigal Left to right: Dr. George W. Weston, Dr. Byron D. Poindexter, and Dr. Robert K. Sigal Before-and-After Perioral [Image] Rejuvenation Actual patient, 56, underwent Lip Lift, corner mouth lift, direct excision of nasolabial folds, perioral fat grafting, and dermabrasion.

(C) Copyright 2010 GlobeNewswire, Inc. all rights reserved.

The “Lip Lift”: When a Facelift is Not Enough

Ethnic Rhinoplasty on the Rise According to Rhinoplasty Society's President-Elect

Dallas, TX (PRWEB) June 07, 2011

Dr. Rod Rohrich, president-elect of the Rhinoplasty Society, an international educational organization supporting surgeons who specialize in rhinoplasty (cosmetic nose surgery), urged colleagues at the society’s 2011 annual meeting in Boston to prepare for an increase in requests for rhinoplasties by patients of ethnic descent. Dr. Rohrich, a Dallas rhinoplasty surgeon, co-chaired a symposia on this topic at the annual meeting of the Rhinoplasty Society in Boston. He also urged his colleagues to study non-Caucasian features and unique requirements for operating on patients with different ethnic backgrounds ranging from the Hispanic nose to the Persian-middle eastern nose. This is an emerging trend in the USA which is parallel to the globalization of all cultures in the USA population.

“It’s becoming more accepted for people who have noses with pronounced ethnic characteristics to opt for surgical refinement that helps them blend into American society better, as well as correcting individual facial deviations that make them stand out uncomfortably,” said Dr. Rohrich, who has performed many ethnic rhinoplasties and published a number of articles on the subject in professional peer reviewed journals.

“Every patient is different, but more patients than ever want to preserve ethnic characteristics while correcting individual facial features. Patients with non-Caucasian ancestry used to ask for Caucasian-type noses, which usually resulted in an over-operated and unnatural look,” he explained.

Retaining ethnic characteristics in rhinoplasty, according to Rohrich, requires careful pre-operative analysis of the patient’s nose in comparison to general characteristics of that person’s ethnic group. the process also requires careful study of ethnic differences in nasal structure, such as skin thickness and width of the bony base, in order to plan proper procedures.

“A multitude of surgical maneuvers is often necessary to address all the salient characteristics of the ethnic nose and produce the desired aesthetic result,” Rohrich explained. Surgical and aesthetic requirements vary for different ethnicities. African-American facial characteristics, for example, are different from Asian or Middle Eastern characteristics and therefore require a different approach to both analyzing and treating these nasal variations.

“Surgeons used to learn how to create a certain type of nose, and patients would choose the surgeon based on the type of nose they wanted. Modern rhinoplasty is not a one-size-fits-all procedure as it used to be, and ethnic heritage should be one of the considerations in planning,” Rohrich said.

Rohrich, who has trained hundreds of plastic surgeons worldwide in both rhinoplasty and cosmetic surgery, performs both primary and secondary rhinoplasty in addition to facial cosmetic surgery in Dallas, Texas. Rohrich said surgeons who would like to learn more about ethnic rhinoplasty can receive additional hands on training in courses and are welcome to attend the annual, international Dallas Rhinoplasty Symposium. Surgeons also can seek training from doctors who specialize in ethnic cosmetic surgery. For more information about ethnic rhinoplasty, practitioners can contact Dr. Rohrich through his assistant Malacha O’Brien at (214) 821-9114 or by email at malacha.obrien(at)dpsi(dot)org.

About Rod J. Rohrich, M.D., F.a.C.S. Dr. Rohrich holds the Betty and Warren Woodward Chair in Plastic and Reconstructive Surgery at UT Southwestern Medical Center in Dallas, Texas. He also holds the UT Southwestern Medical Center Crystal Charity Ball Distinguished Chair in Plastic Surgery. He is a graduate of the Baylor College of Medicine with high honors, with residencies at the University of Michigan Medical Center and fellowships at Harvard University (hand/micro surgery) and Oxford University (pediatric plastic surgery). He has twice served as president of the American Society of Plastic Surgeons. He has been repeatedly selected by his peers as one of America’s best doctors, and has twice received one of his profession’s highest honors, recognizing his contributions to education in his field: the Plastic Surgery Educational Foundation Distinguished Service Award. Dr. Rohrich participates in and has lead numerous associations and councils for the advancement of plastic and reconstructive surgery. He is a native of North Dakota.

About the Rhinoplasty Society the Rhinoplasty Society is a non-profit organization dedicated to the open exchange of innovative ideas and techniques concerning rhinoplastic surgery. the society consists of surgeons throughout the world who specialize in rhinoplasty. the goal of the Society is education, allowing surgeons who have a strong clinical, teaching and research interest in rhinoplasty to exchange and develop ideas and to work out problems in a common forum of mutual respect and collegiality.

Read the full story at http://www.prweb.com/releases/2011/6/prweb8541138.htm

<a href="http://www.digitaljournal.com/pr/330280tag:news.google.com,2005:cluster=http://www.digitaljournal.com/pr/330280Tue, 07 Jun 2011 13:08:00 GMT 00:00″>Ethnic Rhinoplasty on the Rise According to Rhinoplasty Society's President-Elect

BMJ Group blogs: BMJ » Blog Archive » Andrew Burd on conflict of interest

Following on from my blog on professionalism, I want to discuss conflict of interest. The term has been appearing more and more in the world of medicine.  A 2009 study reported in the new England Journal of Medicine found that orthopaedic surgeons at a large annual meeting were somewhat reluctant to share details of their financial support from industry.

In the same year the medical world was rather shocked by the editor in chief of the Journal of the American Medical Association being embroiled in a tale of threat, accusation, and counter accusation which all revolved around the failure of the publication of a conflict of interest declaration by the author of a paper reporting the use of the antidepressant Lexapro in stroke victims. An interesting post appeared in the Wall Street Journal and also a commentary in the journal Society (2009;46:472-476).  Jonathan Leo, the “nobody” who authored this commentary details a novel conflict of interest declaration at the end of his article. I am quoting this at some length as it brings a very interesting perspective into the discussion about what constitutes a conflict of interest “conflict of interest declaration: Since conflicts of interest are the catalyst behind this firestorm, it is only appropriate for me to be forthcoming.  while I do not have a financial conflict of interest, my ideological conflict is that I believe that the relationship between academic medicine and the pharmaceutical industry is not healthy and the clinical trial process has become tainted by marketing pressures. I also believe that, unfortunately, medical journals shoulder part of the blame for this situation. this state of events has resulted in patients being given only a partial presentation of the science behind many of the medications they take. While I look at all of these problems as ideas worthy of debate, some see this viewpoint as a declarable conflict of interest.” 

There are other areas of conflict of interest that can be of importance to medical professionals that do not relate directly to medical practice, or academia. These concern the more publically accountable aspects of the professional life and come under the term corporate governance.

The key elements of good corporate governance include honesty, trust and integrity, transparency and accountability, mutual respect, and a commitment to the organisation. in particular medical professionals who might be part of the management team in a hospital or officers of a professional association should conduct themselves honestly and ethically, especially concerning actual or possible conflicts of interest.  it is generally recognised that reliance on the integrity and ethics of individuals is bound to eventual failure.  Because of this, many organisations establish complicance and ethics programs to minimise the risk of acting outside ethical and legal boundaries. in particular it is necessary to promulgate unequivocal policy and guidelines for the avoidance and declaration of actual and possible conflict of interest.

In this context a conflict of interest is a situation in which the best interests of an organisation competes or is in conflict with the financial or personal interests of one of the officers or trustees or those of their relatives and close personal friends. the area of contracts and tenders has the greatest scope for abuse and corruption and to minimise risk it is essential that robust procedures and guidelines are in place. These will include procedures such as drawing up rules on conflict of interest to be re-circulated at annual intervals; ensuring that declarations of conflict of interest should be made in writing, preferably on a standard proforma and ensuring that any member of the management board who has declared a conflict of interest or has a possible conflict of interest should refrain from being involved in the matter in question.

The key element as to whether a declared or possible conflict of interest is sufficient to mandate withdrawal from a committee responsible for a decision making process is whether an independent, fair-minded, and properly informed observer would conclude that there was a real possibility of bias in the contribution of the individual concerned to the discussion and process of making the decision.  it must be emphasised that this real possibility must be distinguished from a mere suspicious or fanciful speculation.

Clinical governance and corporate goverance go hand in hand in medical professionalism and let no one pursuade you otherwise.

Andrew Burd is professor of plastic, reconstructive and aesthetic surgery at the Chinese University of Hong Kong. his major clinical interests involve paediatric burns care and the role of plastic surgery in the palliation of advanced malignancy. Academic interests include pragmatic ethics related to the practice of medicine including research and publication.

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BMJ Group blogs: BMJ » Blog Archive » Andrew Burd on conflict of interest

Gastric Bypass Study Results

Women have an easier time than men after gastric bypass surgery, a new study shows.

In a study of nearly 38,000 laparoscopic bypass patients University of Nebraska researchers found that women were almost five times less likely to die after the surgery, according to a report presented at the annual meeting of the American Society for Metabolic & Bariatric Surgery. Women also had 25 percent fewer complications and were one third less admissions to intensive care units.

Experts weren’t surprised by the results.

“Generally if you’re comparing a man and a woman of the same body mass index, the surgery will be easier to do on the woman,” says Dr. Amir Mehran, director of bariatric surgery at the University of California, Los Angeles. “That’s because women tend to carry their weight on their hips, buttocks and chest, whereas men tend to carry all their weight in their belly, which makes the surgery more difficult.”Source: www.msnbc.msn.com/id/37902869/ns/health-diet_and_nutrition

The post weight loss plastic surgery is easier on the women as well. Men are larger cases and take more post-operative care. Women adjust better.

This study also found that patients did better when they had the gastric bypass along with someone else in the family:

The difference, Slotman says, is the encouragement people get from a family member who is going through the same thing. The support makes it easier to make dramatic changes in lifestyle and eating habits to keep the weight loss going.

My wife and inlaws have all had gastric bypass surgery. It is easier to undergo what seems like an ominous feat with family around who are going through it or have been through it.

Best regards,

Dr Di’s Post-Gastric Bypass Plastic Surgery Website Section

Originally posted 2010-06-28 07:30:47.

Gastric Bypass Study Results

That Squeaking Sound Might Come From Your New Hip

FRIDAY, Feb. 18 (HealthDay News) — Months after getting a ceramic hip replacement, some patients may be startled to find their artificial joint starts squeaking.

Not everyone who gets a ceramic fitting will end up getting one that squeaks, but those who do are likely to be taller, heavier and younger than their silent counterparts, new research shows.

Fortunately, the squeaks are more of a nuisance than a serious problem, stated the authors of a study to be presented at the annual meeting of the American Academy of Orthopaedic Surgeons, Feb. 15 to 19 in San Diego.

Other experts agree.

"although it's disconcerting to have noise coming from a hip replacement, there is no significant implication as far as either the quality of the relief from the hip replacement or in terms of its longevity or any other objective measure that would indicate that the squeaking has a deleterious effect," said Dr. Michael Bronson, chief of joint replacement surgery at Mount Sinai Medical Center in new York City.

Dr. Craig Della Valle, associate professor of orthopedic surgery at rush University Medical Center in Chicago, added: "I don't think there's any data to show that squeaking is harmful to patients. It doesn't seem to have any real consequences."

That said, the noise could indicate that "the bearing surface isn't performing quite the way it should," Della Valle said. "Most of the data seems to indicate that [the squeaking results from] abnormal wear on the bearing surface, and that leads to loss of normal lubrication and that leads to noise."

Three major surfaces are used for hip replacements — metal-on-plastic, ceramic-on-ceramic and metal-on-metal, said Della Valle.

"all of them have pros and cons and it remains controversial which is the best and for which patients," he said. "Metal-on-[plastic] is kind of the standard and the plastic has changed over time to become more wear -resistant, but historically the big problem with plastic is it wears, hence the interest in 'hard bearings' [such as ceramic] that are more wear-resistant."

The researchers reviewed records on 2,406 hip replacements involving ceramic-on-ceramic bearings that they performed at Mater Hospital in Sydney, Australia, between June 1997 and December 2008. all patients had had osteoarthritis.

The authors identified 74 squeaking hips in 73 patients (some people have both hips replaced), representing 3.1 percent of the group.

Patients with squeaky hips were likely to be a little bit taller: a mean height of about 5 feet 7 inches compared to 5 feet 6 inches. they were also heavier (176.8 pounds versus 168.4 pounds) and younger (average age of 60 versus 65). and, they were significantly more active, all of which suggest the noise is caused by increased mechanical demands, the authors said.

Obesity was not associated with squeaking, the authors said.

Average time to when the squeaking first began was 14 months after the operation. only 5 percent of patients reported squeaking each time they took a step, and 63 percent said their new hip made noise less than once a day.

Bending caused joints to squeak more than walking, stair climbing or participating in sports, the authors found.

Some people do have a second operation to silence their artificial hip said Della Valle. another surgery isn't ideal, but a patient might consider it if the joint "squeaks with every step they take," he said.

Experts note that research presented at meetings has not been subjected to the same type of rigorous scrutiny given to research published in peer-reviewed medical journals.

More information

The American Academy of Orthopaedic Surgeons has more on joint replacement surgery.

That Squeaking Sound Might Come From Your New Hip

Dallas Plastic Surgeon Wins Accolades

Board-certified plastic surgeon Dr. Steve Byrd has recently been the recipient of many local, national, and international honors. the awards reflect his commitment to the field of plastic surgery and to his own patients.

Dallas, Texas (PRWEB) August 22, 2010 — Dr. Steve Byrd, (drstevebyrd.com) a board-certified Dallas plastic surgeon, has garnered many awards and accolades throughout his career. Recently, he was awarded Honorary Membership in the Australian Society of Plastic Surgeons. he has also been named as one of "America's Top Doctors" by Castle Connolly for more than 5 years in a row, a 2010 "Super Doctor" in Texas Monthly, and was recognized as one of "America's Top Plastic Surgeons" for 2010 by the Guide to America's Top Plastic Surgeons.

"I feel deeply honored by every award I've received," says Dr. Byrd. "I strive to be more than just a skilled technician – I also want to provide my patients with care and compassion along with a commitment to safety and comfort."

As a keynote speaker at the 2008 Australian Society of Plastic Surgeons annual meeting, Dr. Byrd was heralded by the Society as a "true giant of world plastic surgery" and "an innovative thinker who has been able to translate these thoughts into masterful results." In gratitude for his participation at the 2008 conference and as an acknowledgement of his contribution to the field of plastic surgery, he was awarded Honorary Membership in the Society.

"I've become widely known as an innovator, someone who has developed and refined techniques that I perform for plastic surgery in Dallas and that can be implemented by surgeons in other areas so that they, too, can deliver fantastic results for their patients," explains Dr. Byrd.

An example of one of the innovative techniques Dr. Byrd uses, the endoscopic approach to breast augmentation in Dallas uses a tiny camera to assist surgery and can be performed with a small incision hidden in the armpit. this is only one example of the procedures he refines to meet the needs of a wide range of patients.

"I'm very pleased to be named a 'Super Doctor' by Texas Monthly," says Dr. Byrd. "Nominees for this award are actually selected by their peers – other doctors who were asked to name the physicians they would trust to care for their families and loved ones."

While Dr. Byrd explains that he enjoys the opportunity to visit plastic surgeons internationally and share ideas with his peers, his top priority is the care he provides for patients in Dallas. "this is where I've made my home and where I've refined my techniques," he explains. "my patients and experiences here have made me who I am as a surgeon – I owe much of my success to them."

Dr. Steve Byrd (drstevebyrd.com) has been performing plastic surgery at his practice in Dallas, Texas for over 25 years. he is certified by both the American Board of Surgery and the American Board of Plastic Surgery. Dr. Byrd earned his Medical Degree with honors at the University of Texas Medical Branch. In addition to serving his patients from the Dallas/Fort Worth area, Dr. Byrd has held a variety of teaching appointments at the University of Texas Southwest Medical Center and is a member of a number of professional societies, including the American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery.

Steve Byrd, M.D.Marta Traugott(214) 821-9662E-mail InformationTrackback URL: prweb.com/pingpr.php/Q3Jhcy1NYWduLUluc2UtSGFsZi1QaWdnLVNxdWEtWmVybw==

Dallas Plastic Surgeon Wins Accolades