Dr. Pickart – Reconstructive Plastic Surgeon
Dr. Pickart will be joining us as a featured speaker at the 2012 Meet & Greet and will offer complimentary evaluations all day Saturday May 19th.
Why am I involved with the WLSFA? There are two answers to that question. The short answer is that a number of post-bariatric patients whom I respect have touted the organization. I have learned that it is not a for-profit, marketing corporation, like ObesityHelp.com. Instead. the WLSFA is a public-oriented organization that is doing the hard work–of education, of research, of funding grants, and of political change. The WLSFA fits my professional goals, and I am thus honored to be so associated.
The long answer to my involvement with the WLSFA is a story eight years old. I had just completed both my plastic surgery residency and a fellowship in hand and microsurgery, and I had commenced an Assistant Professorship at Loma Linda University, ostensibly to do and to teach the most difficult hand reconstructions. However, after a few months at Loma Linda, I realized that the university had no complex hand surgery to give me. The previous hand surgeons had departed the university en masse (because of the usual financial gripes) and had taken most of the hand surgery cases with them.
So, for which patients was I going to care? I did have to justify my salary! Back in 2003, laparoscopic bariatric surgery was still in its infancy in Southern California. Some of the bariatric surgeons at the regional hospitals were just beginning to have success with laparoscopic gastric bypass procedures. Many were looking for a plastic surgeon to help them with body contouring after massive weight loss. Nevertheless, absolutely none of the local plastic surgeons were interested. They surely thought, “Tummy tucks are tricky enough. How will we treat somebody who has last more than 100 pounds? What will we do with all of that extra skin?”
To be honest, back then, I didn’t have answers to those questions. But, I needed work! Besides, I liked a challenge; that’s why I had pursued sub-specialty training in microsurgery. Certainly, abdomens and breasts were quite a bit different from index fingers and thumbs, but I reasoned that the principles of one type of reconstruction were the same regardless of their anatomic location.
So, I dove right into my new area of interest. No one at Loma Linda University had ever undertaken post-bariatric body contouring. I myself had never done the operations in my own plastic surgery training. However, the university supported me as a I traveled the country, and as I watched and learned about different techniques from a variety of surgical pioneers.
Then, I got to work. I did a lot of brachioplasties, and learned that the ideal resection is along the back of the arm, and not along the inner arm as I had been (erroneously) taught in my residency.
I did a lot of breast lifts. I learned that most lifts are best complemented with implants, to restore the fullness in the upper pole of a breast.
I did a lot of body work. I learned that traditional tummy tucks are inadequate; they leave behind excess “cones” of skin at the flanks. The post-bariatric tummy tuck must be extended all the way around the body (circumferentially), in order to create harmony by treating the lower torso as a unit.
I did a lot of inner thighs. I learned that minimal incisions in the groin never create happy patients. Analogous to the arms, I now know to create longitudinal incisions that run the length of the proximal extremity.
I did a lot of face and neck lifting. I learned that minimal incision techniques, like “Lifestyle Lifts,” are wholly inadequate. Traditional face/neck lifting actually produce terrific improvements.
Then, Loma Linda University began to squeeze my practice–probably as the university had tried to squeeze the antecedent hand surgeons. I knew that I could never flourish in such an environment, and so I jumped ship. I never really liked the Inland Empire of Southern California, and I had always hated Los Angeles. So, I moved to the ocean, and took my practice to Ventura County.
For the past five years, I have been the only Board Certified Plastic Surgeon along California’s Gold Coast (Ventura, Santa Barbara, and San Luis Obispo Counties) who has specialized in post-bariatric body contouring. As other practices have withered during the Great Recession, I have flourished, because I have been helping to treat a group of patients who have been neglected by the official medical establishment.
WLSFA and I have so much in common. I only hope that I can help some weight-loss patients complete their journeys, and become satisfied with themselves in their own skins.
Michael C. Pickart, M.D., F.A.C.S.
Pickart Plastic Surgery, Inc.
1746 S. Victoria Ave., #250, Ventura, CA 93003
(805) 654-8800 | fax (805) 654-8802