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Cover+ Feature for help with postoperative issues, only to find these surgeons turn their backs on them," Dr. Patel says. "They say, 'It is your fault you are in pain or have regained weight.' In reality, a discerning surgeon who performs a thorough workup will, nine times out of 10, find a mechanical reason for postsurgical pain." Dr. Patel finds that working with these patients can be extremely gratifying. "They are discouraged, but it is the most rewarding work we do," he says. "We are fortunate to be able to help them." Body enhancement Through Reconstructive Surgery Some patients find their postsurgical bodies have excess skin. In addition to cosmetic issues, extra skin on the arms, chest, back, stomach and suprapubic region may cause chafing and infections. The extra skin may also make personal hygiene difficult. "Extra skin may become a location for fungal infection," Dr. Chattar-Cora says. "Patients may even need hospitalization." Because extra skin poses health concerns, Dr. Chattar-Cora sees his work as reconstructive rather than simply cosmetic. "About two years after a bariatric procedure, or once weight loss has stabilized, patients may become interested in plastic surgery," he says. "Our community is not wealthy, and insurance companies do not often understand that these are medically beneficial procedures, so we work hard with patients to contain costs and provide options for payment." Dr. Chattar-Cora prefers to perform reconstructive surgery on an outpatient basis. He offers myriad procedures, some in conjunction, depending on patient need, including brachioplasty, circumferential abdominoplasty, face lifts with neck tightening, and surgery for male and female breast ptosis, including repositioning nipples. "Choosing the right bariatric medicine center with a dedicated support staff will lead to peace of mind," Dr. Patel says. "As physicians, we need to organize within our community to drive home the message that there are solutions to the obesity epidemic. We need to be champions in this fight, taking an aggressive approach and working together." To refer a patient for a bariatric consult, please call 877-215-WELL or visit http://swgeneralhospital.com. ■ "the approach to bariatric patients must be one of empathy, guided by a firm belief that patients are experiencing a disease process. the stereotypical description of a patient with morbid obesity is that he or she is not disciplined enough to push away the plate or commit to exercise. this is categorically untrue. Most academic bariatric surgeons agree that obesity is a symptom of a poorly defined disease process." — Nilesh Patel, MD, Medical Director of Bariatric Services at Southwest General Hospital The physicians of Texas Bariatric Specialists are independent practitioners who perform their services as separate entities from Southwest General Hospital and IASIS Healthcare. 8 | San Antonio MD News ■ mDNewS.COm