Conquer Your Weight

Dr. Sarah Stombaugh: Before we get into the episode, I am thrilled to announce we are launching an online course, The GLP Guide. The GLP guide is a must have resource for patients who have been prescribed any of the GLP medications such as Wegovy, Ozempic, semaglutide, Zepbound, Mounjaro, tirzepatide, Saxenda, liraglutide. There are a lot of them and this course is available for anyone to purchase. We often hear from people who haven't been given much information about their GLP medications. No one has told them how to handle side effects, what nutrition recommendations they should follow, or what to expect in the longterm. And it can be really intimidating and simply frustrating to feel like you're alone in your weight loss journey. With the GLP guide, you'll get access to all of the answers to the most common questions for patients using GLP medications, not sure how to use your pen, struggling with nausea, wondering how to travel with your medications. We've got you covered for only $97 for one year access. This is an opportunity you do not want to miss. The course is launching on October 1st. For more information and sign up, please visit www.sarahstombaughmd.com/glp. You don't have to be on this journey alone. We are here to guide you. And now for today's episode, this is Dr. Sarah Stombaugh and you are listening to the Conquer Your Weight podcast. Announcer: Welcome to the Conquer Your Weight podcast, where you will learn to understand your mind and body so you can achieve long-term weight loss. Here's your host, obesity medicine physician and life coach, Dr. Sarah Stombaugh. Dr. Sarah Stombaugh: Hello everyone and welcome to today's episode of the Conquer Your Weight podcast. This has been a long awaited topic. I have had patients and listeners asking me about dealing with exa skin after the weight loss journey, and so I'm really excited to bring a guest on today, Dr. Eric Anderson. He is a plastic surgeon in the Chicago area and he and I actually went to medical school together. So we are really excited to have this conversation and talk about the role of excess skin, how that can be dealt with, particularly from a surgical standpoint, but even from non-surgical standpoint. We'll talk about that a bit as well. Dr. Anderson, thank you so much for joining us. We are really excited to have you on today. Dr. Eric Anderson: Thank you so much for having me, Sarah. This is a passion of mine. This is something that I really, really like to talk about and this starts with education for everybody. So just a little introduction to myself. I'm a surgeon, I'm a fellowship trained, board certified surgeon. I did general surgery training and then I did plastic surgery training. So I do the full breadth of reconstructive anesthetic surgery. Most of my practice is aesthetic surgery, but I consider surgery after weight loss medication or weight loss surgery as functional and aesthetic surgery. So it is reconstructive and aesthetic. So I think it's a really, really important part of medicine these days and a personal passion of mine. So I'm really excited to be here. Dr. Sarah Stombaugh: Yes, I love that. And tell us about, this has really been an area for a long time. When we think about bariatric surgery, people who've had significant weight loss for any reason, and especially now that we've seen the popularization of some of these GLP and GIP medications, it's really even a broader patient population I imagine, who's seeking and learning about what can I do now that I've had significant weight loss and dealing with excess skin. So if someone comes into your office and they're asking, Hey, I've had this massive weight loss and dealing with excess skin, what are the type of things that are available to support that patient? Dr. Eric Anderson: Absolutely, that's a great question. So first of all, the patient who's lost a bunch of weight, sometimes people call it massive weight loss is not a new thing for plastic surgeons. So bariatric surgery was the first impetus to have a patient with massive weight loss, and we talk about massive weight loss is greater than 50, 75, a hundred pounds. So plastic surgeons have been treating these patients for a long time. So I think the first step to think about is I think it's easiest to go top down and kind of talk about face and then work your way down the body. So things that are available to patients with extra skin. So we think about the top of the body is the face and neck. So a face and neck lift is kind of the first thing to think about when you have all this extra skin around the jawline and then kind of moving all the way down the neck as well. So moving down from that, we have the arms. So usually it's a lot of skin between the armpit and the elbow. Sometimes people call them bat wings or say their little wings or something like that, but that's usually a large amount of extra skin, but there can be a little bit of fat under the skin as well. So we would do an arm lift to address that. Moving down, we have the breast, so usually the breast is an incredibly feminine organ and there's not only extra skin, but usually sometimes a deflation of breast tissue. So really we have to work to restore and rejuvenate the breast tissue as well as lift the breast and take out all that extra skin, which is an incredibly dynamic thing for someone to get a breast lift, have to weight loss. So moving down the body. The next part is the abdomen. So usually we would do a tummy tuck for that. A lot of times we add in liposuction as well, that really gives that nice feminine contour that really gives that hourglass figure for our lady patients. And the incredible thing about abdominal surgery after weight loss is I usually always repair the abdominal muscles. So anytime someone's had a child as well, those abdominal muscles stretch out and we have the opportunity to go in there and actually repair and restore function of the abdomen. So not only is this a really great surgery to remove all that extra skin and some of that extra fat, but also to restore function to the patient and increase core strength. It's really incredible for these patients. Dr. Sarah Stombaugh: Yeah, absolutely. And yeah, go ahead. Dr. Eric Anderson: So along with that, sorry, this is kind of a long-winded response to this question. Dr. Sarah Stombaugh: I love it. Dr. Eric Anderson: Along with that, oftentimes our patients who have lost a bunch of weight, they have almost a huge abdominal sheet of skin that oftentimes covers their pubic area and kind of covers that sensitive area. So keeping in line with the functional benefits to this surgery, it's a lot easier for these patients to be more hygienic and clean that area around the pubic bones and oftentimes help their intimacy life as well. So that's a really, really transformative surgery and a lot of people need that one. Dr. Sarah Stombaugh: Yeah, absolutely. And what else? Dr. Eric Anderson: Working down still continually is we have the hips and buttocks and the thighs. So a lot of times the best way to lift the thighs are on the inside of the thigh. We remove that extra skin and by removing all the extra skin from the inside of the thigh, it circumferentially lifts the whole thigh, which is a great operation to address hips and buttocks. So that's an area where we want volume, we want to have those curves. Curves are not only natural, but they look good too. So a lot of my weight loss patients sometimes need some fat grafting in that area. It's a very natural way to keep that nice curvy volume to the hips and butt, but also restore some of the deflation from the weight loss. Dr. Sarah Stombaugh: And when you think about fat grafting, I assume that's coming from the patient themselves? Dr. Eric Anderson: Yes. Fat grafting is an amazing tool that plastic surgeons have been using for a century. So we do liposuction anywhere in the body. We take that fat, we process it down to only the healthiest, healthiest of those fat cells, and we actually regraft it into the patient in areas that need a little boost of volume. Maybe a place to make you a little curvier. Dr. Sarah Stombaugh: Yeah, absolutely. Okay, cool. And is that it or are there things we're missing when you think about all of the different surgical options out there? Dr. Eric Anderson: Those are all the really big areas that we address along with- Dr. Sarah Stombaugh: I say, is that it? As you've talked about so many different things. Dr. Eric Anderson: So those are the major areas. And then every patient is unique and every patient requires a specific unique treatment plan that's customized to them. So when I talk about these areas, it's kind of in generalities. And then for you as a patient, we will make you a custom treatment plan and say, we could use a little lipo here to really offset your result and really make it fantastic. Or we could take off a little bit of extra skin over here and then we tighten this up here. So everybody really does have a customized plan. Dr. Sarah Stombaugh: Yeah, absolutely. And I can imagine there are some people, as you said, one area is more significant or more concerning to them, whether functionally or just aesthetically that they'd like to repair that area. Tell me, when you think about making a plan for someone, are these typically done all at the same time or are there patients for whom it's actually sequential where you may do one surgery at one time and then separate another surgery at a later date? Dr. Eric Anderson: That's a really important question, Sarah. So there's a lot of data for anesthesiologists, about six hours of surgery is kind of the maximum amount of elective surgery. So something that's not an emergency like our body contouring surgeries after weight loss. So that's really the safety mark for the amount of time of anesthesia. So I tell all my patients, I say I'll do about six hours of surgery at a time, and anything after that, we would stage. So a lot of times I would do the arms and a breast of a patient of mine, and that's about five hours or so. So we'll stop there and we'll come back and bring 'em back in about two months and then do the abdomen and the thighs or something like that. So it's really important to stage these out not only for safety from an anesthesia perspective, but also for your recovery as a patient. I mean, if you come out of surgery and you have incisions on your arms and your breast and your abdomen and your thighs, you're stuck in a body cast. Sure, right. It's hard to do any of your activities of daily living. It's hard to continue on with your life after that. It's a full-time job just to recover. So from a safety perspective and a recovery perspective, always better to break that up. Dr. Sarah Stombaugh: Yeah, absolutely. And I'm glad you mentioned that. And we think about these surgeries, they are really significant surgeries. So even though they are cosmetic, even though they are elective, these are surgeries that are really still a major surgery, both in terms of the work that's being done and you have, we'll talk through some of the safety and risk of that, but I think as you mentioned, the anesthesia piece, people often don't consider, A lot of times the riskiest parts of surgery are actually the anesthesia itself. And my husband is an anesthesiologist, which, and my listeners may know, I feel like I've mentioned from time to time, but in the work that he does in cardiothoracic and critical care anesthesia, they often have particularly long cases thinking about heart transplants or lung transplants, for example, certain really complex, maybe 12 hour cases even at times. And when you look at something like that, you're talking about a patient who is maybe quite literally otherwise dying in front of you or has an imminent risk of death. And so we compare what are the risks of anesthesia in that situation for someone who is really on the brink and needs the surgery emergently right now to save their life, versus how can we balance out that risk profile for someone who is otherwise healthy? And can we make sure that for one, their recovery is going to be safe, but two, when they are having surgery, that we can really optimize the safety there. Dr. Eric Anderson: Exactly. I think those are fantastic points because as your surgeon, it's my job to understand all those risks and to guide you through the process of this. This is what I do every day. This is what we do every day as physicians, and it really is our responsibility to tell the patients what the risks are and to mitigate those risks and say it's not safe to go more than six hours of anesthesia for an elective procedure. So I think it's really, really important to let people know that it's a process and we guide you through the whole process. It's a journey. Dr. Sarah Stombaugh: Yeah, absolutely. And so tell me, we're talking a little bit about risk, but when we're thinking about the risk of these type of surgeries, what are the other things that you're counseling your patients on and how can you reduce some of those? Dr. Eric Anderson: Yeah, so specifically for our medical weight loss patients, one of the most important things is optimization before surgery. So this is why it's really, really important to have a really long consultation with your surgeon to really trust your surgeon to spend time with them before you need surgery. So meet them, really pick a great surgeon and know who they are and spend a lot of time with them so that you can optimize yourself before surgery. So what do I mean by that exactly? So the most important thing for our medical weight loss patients is nutritional optimization. I mean that by nutrition to the whole body and then specifically the skin. I break those up into two things in terms of whole body nutrition, because these weight loss medications in a sense kind of starve the body is the most important nutrient for medical weight loss for my medical weight loss patients. So what do I mean by a protein forward or a protein heavy diet? So I talk about lean meat, poultry, eggs, and then I want everybody to get between 60 and 90 grams of protein a day. So that's about 15 to 30 grams of protein per meal. There's a lot of really, really good data, and that's a nice sweet spot of protein intake. Dr. Sarah Stombaugh: Absolutely. Dr. Eric Anderson: And then what goes along with that? So how do I track that and how do I know that you're ready for surgery and that your body's ready? So the most important lab value I use is albumin that we get in some basic blood work. Of course, Sarah, I think you probably even follow that for your medical weight loss patients. Dr. Sarah Stombaugh: Yes, absolutely. Dr. Eric Anderson: Yeah. So that is the most important protein marker for me. Dr. Sarah Stombaugh: Well, and I think it's probably my patients or my listeners, they often hear me protein, protein, protein, protein, protein, protein. And it's so important when we're thinking about the weight loss journey, how are we protecting our muscle mass? And the conversation is often around that. But the reality is when you look at the building blocks of our skin, it's very similar. We want to make sure that our body is both from a muscular standpoint, from a bone health standpoint and then from a skin integrity standpoint that we are able to adequately support that with both our macronutrients like protein as well as our micronutrients. So talk to me a little bit about some of that skin piece. Dr. Eric Anderson: Yes. So then the second piece of that is skin health and how can we mitigate the risk of the skin stretching out when we gain weight and then we lose weight and the fat starts to dissolve, but then the skin doesn't quite recoil, and that's really the problem that we see in our large weight loss patients. So that skin quality gets all stretched out. There's a decrease in collagen, there's a decrease in elastin, and then the worse your skin is before surgery, it doesn't magically get better after surgery. So a lot of the mitigation and risk is prevention. So when you start the GLP-1 medications, we really take a look at the overall skin health, not just face and neck, but the entire body. There's a lot of really good products that reform and repair and restore collagen and elastin to our skin used all over the body. My favorite is elastin reform and repair. That's my favorite body skin product. It is worth the investment in yourself. It's worth the investment in your skin because the better your skin health is before surgery, the better, quicker and faster recovery that you're going to have after surgery. Dr. Sarah Stombaugh: Absolutely. And so I'm excited to hear, because we'll have to talk about some of the nonsurgical things as well and how we support the skin because there's a lot of patients either during the journey or even afterwards that are first, let me look at some of these over the counter things, but before we get there, so we want to think from a risk standpoint, we've really optimized the body beforehand, we've optimized the body, we've optimized the skin. Tell me a little bit more about then as you're moving into this journey, how you're making sure to really support your patients and keep them as healthy and safe as possible. Dr. Eric Anderson: Yeah, so the journey, like I said, this whole process is a huge journey. It's a huge undertaking, which is why you really need to understand and support. Your plastic surgeon needs to understand and support you and make sure you're optimized. So that starts with a thorough consultation. I always outline our goals of surgery. So I always say, what are your priorities in terms of your body pieces? So is it your arms and breast? Is it your abdomen and thighs? And then we go out and we prioritize the areas of the body For my patients that are really, really important, then that's how we kind of approach their staged surgical treatment plan. Once we kind of make that plan out, then we talk about skin health, protein forward diet, things like that, which we already addressed. I always go over risks, benefits and outcomes. That's really, really important. So most of the risks of surgery that I would do for all my weight loss patients involve pretty standard risks for surgery, which are bleeding, infection, and healing issues. This goes back to the optimization before surgery. So the better you are optimized, the more you're able to decrease the risk of all these issues. Mainly the biggest issue that I would see in my weight loss patients are those patients that don't quite get optimized or that don't do a good job with skin health and protein forward diet are sometimes the incisions can separate a little bit. It's called the dehiscence. That's a pretty minor issue, really. The edges of the skin separate a little bit, and that's always something that we can treat, but it's something that can be prevented as well with all of our preoperative care. So that's kind the biggest risk that I see usually the benefits and outcomes. So what can you expect from this? So I like to say you're lighter and tighter. So That's not only do you take all the skin off, but it tightens and lifts things. So this goes back to the concepts that I like to talk about with my weight loss. Patients are, yes, these are aesthetic surgeries, but they're also functional surgeries. You get as much functional benefit from these as you do aesthetic benefit. So yes, you lose some weight and that all that extra skin, yes, you're lifted and things are tighter in your body, which is fantastic. But we also, a lot of patients with extra skin get rashes in the folds of their skin, whether that's under the arms, under the breast, in the groin. So this kind of resolves all that issue. This allows much better hygiene for the patient. And then like I discussed before, it really can improve some intimacy issues that people have had just having extra skin and the inability to really clean those areas really, really well. Dr. Sarah Stombaugh: Yeah, absolutely. And I love the way you say lighter and tighter because one of the things, I had a patient a handful of years ago who had massive weight loss and she had lost about 150 pounds and was really frustrated because she was so close to her goal weight, and I'm looking at her body and I'm like, you are at your goal weight. You just have extra skin. And she went through the process of having plastic surgery and had that skin removed and dropped another almost 20 pounds of skin. And so all of a sudden she's like, wow, I'm at my goal weight. And there was no really additional amount of fat or anything else for her to move or change about her body. She just this excess skin that was not serving her in any way. Dr. Eric Anderson: Absolutely. That's a really great point because I've had a couple of patients in my own practice where they kind of plateau at a weight loss and their extra skin is actually getting in the way of them exercising. It's a physical barrier for them to stay at the gym or to be more mobile at the gym. It's like the skin is moving around when they're trying to be active. And so they're like, maybe I'm not at my exact goal weight yet, but I got to get this off. I got to get this burden off my body. And then once they do that, then they continue soaring. I mean, they spend as much time as they want in the gym. They're able to do all those activities with their family. They're able to hike and bike and do all that stuff uninhibited. So it really is a huge functional benefit to our patients. Dr. Sarah Stombaugh: Yes, absolutely. Well, and I think this piece, I love that you were talking about patients who are sort of almost there and that this ends up being a step in the direction of their goals of continuing their mobility and everything. So tell me, when you're planning with a patient for skin surgery, I mean certainly I imagine many patients come to you nearing the end of their weight loss journey. But if you were to look at really a broad population and thinking about, okay, where in your weight loss journey does it make sense to have skin removal? Tell me about that. Is there a period of time that you need to be at a stable weight? Is there a certain number that you're looking for, percentage that you're looking for? How do you know that you've lost enough weight to move forward with this surgery without risking needing a redo operation? Tell me a little bit about that. Dr. Eric Anderson: That's a fantastic question. So this is where the relationship between the surgeon and the patient and then their weight loss medication provider is really, really important. So I have my patient work with their weight loss medication doctor provider to establish a really good goal weight. What is that goal weight? What is going to be my happy weight? And then usually somewhere within 10 or 15 pounds of that weight would be the most ideal position to have surgery. Like I was saying, there's that small subset of population who say, I'm plateauing. I can't, the skin is a barrier, the skin is a mechanical barrier for me, and I can't be active. That's maybe a lesser case, but I think within 10 or 15 pounds of goal weight is the perfect time to have surgery. So when I do someone's weight loss surgery, I tailor their result on the table on the operating room table to their weight on that day. And that result is good, like I said, within about 10 or 15 pounds. Dr. Sarah Stombaugh: Okay. Excellent. And that's a great way to think about it because a lot of people may wonder, at which point should I be thinking about this? So tell me if someone, as they're pursuing their weight loss journey, they are losing weight, they're recognizing that skin removal, body contouring, that these things are important for them and it may be part of their journey later. At what point would you recommend consulting with a plastic surgeon such as yourself? Dr. Eric Anderson: I was just about to talk about that. Dr. Sarah Stombaugh: Excellent. Dr. Eric Anderson: The earlier you establish care, the better. So that helps build that relationship with me. That helps we have more time to talk about your goals, your aesthetic goals, your functional goals, what you want to get to. That lets me know maybe you do plateau and you want to come in and you say, Hey, I'm plateaued. I need help. So that's what we're here to do. So the more you can communicate with us, the earlier you can get in, we establish goals for you. And then I have you talk to your medical weight loss provider as well, and that really lets all of us talk together and establish that really stage goal and prioritize the outcome for you. Dr. Sarah Stombaugh: Absolutely. Well, I think the highlighting the piece too of why it's important to work with someone like myself or someone who is board certified in obesity medicine, having a physician who is directly overseeing your care is so important throughout these types of things as well. It's very common that we're optimizing patients for surgery. Very common in other arenas too, like joint replacement for example, or patients who are pursuing in vitro fertilization. There's a lot of people for whom they have a very specific goal weight that we need to get to and optimize with this idea that surgery is in the future. And I think one of my biggest concerns is that the popularization of these medications is amazing. I'm so glad that we've got conversations going that people are open to using these medications that they're asking for them and advocating for themselves. But we've also seen this huge shift where you can fill out a form online and get medication delivered to your doorstep. And that's terrifying to me that there's patients for whom they're using these medications without that comprehensive support such that when you look at optimizing yourself for surgery, are they really getting the micronutrients, the macronutrients? Are there other aspects of their health they're addressing? So tell me a little bit about, I guess some of your thoughts on where we're at with some of that right now. Dr. Eric Anderson: I cannot agree more. I've had patients that come into my office and I always ask them, who is your provider? Your GLP one medication provider? And a couple people will say, well, I filled out a form online and I gave them my credit card, and something came in the mail like, oh, that kills me. I hate wild. They have no support. They have no lab work, they have no instruction and guidance through the macronutrients, the micronutrients, and also the kind of mental journey through this as well. So you need support. I mean, these medications are an incredible tool. They're a powerful tool, but you need support. You need coaching, you need mentorship through this. It's so important not only through the medical aspect, but the surgical aspect as well. So really, really important. Dr. Sarah Stombaugh: Well, my favorite thing is when I can a relationship with a surgeon or with someone's, whichever team member that we're handing off to, but particularly in this case of surgery that like, Hey, I've optimized this patient in X, Y, Z way. These are the reasons I think they're doing well. These are the concerns that I have. What's your perspective? And having that sort of warm handoff is really a nice way to make sure that the patient is optimized and is in a good position both in that surgical period and then sort of on either side of it as well. Dr. Eric Anderson: Exactly. I think there's a lot of analogies that go to the medical treatment of GLP-1 medications that also apply to the surgical treatment as well. It's not, you don't just prescribe the medication and walk away. I don't just operate and walk away. It's a whole journey. You have to help your patient through this. You have to coach your patient through this. You have to let them know what the expectations are for the medication, what the expectations are for surgery, what the expectations are for recovery. So it really is a whole encompassing experience. It's not just a one and done day thing. So I think those are very analogous. Dr. Sarah Stombaugh: Yeah, absolutely. Thank you for sharing that. I'd love to hear, so you had mentioned a product elastin that you really like as an option to help support the skin. Tell me a little bit for the patient who is either like, no way I'm not having surgery, or are there things that I can try that are nonsurgical that maybe supportive? Tell me a little bit about are there any decent options out there that can support people who are maybe borderline on if they need surgery or people for whom they're really concerned about the risk of surgery and would like to try something? Maybe not over the counter, but either over the counter or a cosmetic disease, right, Dr. Eric Anderson: Nonsurgical. Dr. Sarah Stombaugh: Exactly. Dr. Eric Anderson: That's a fantastic point. So I kind of group people in how much weight loss they have, and depending on how much weight loss they have usually tells me can they go toward a more non-surgical option or are they going to need surgery to remove excess skin and sometimes a little bit of extra fat. So usually the borderline for me has been around 50 pounds. So if you lose under 50 pounds, usually we can treat your issues. And so what are the things that are available with that? The frontier of aesthetic medicine right now is bio regenerative medicine, and that's been one of the most powerful tools for our practice and non-surgical options as well. So what do I mean by that? The two biggest players in that space right now are Sculptra and Radius. So what those are, they're not filler, they're not neurotoxins, they're not neuromodulators. They actually stimulate the body to restore itself. So they increase collagen, they increase elastin, they can build up those type one and type three collagen fibers in your body just by stimulating the body to repair itself. They're really, really incredible tools that we have. So those are two of the biggest tools. And of course a little bit of filler, a little bit of Botox as well can go a long way. But under 50 pounds is kind of the fence that I'm seeing right now. That's not a tight standard rule. That's just kind of what I've been noticing anecdotally in my practice. Dr. Sarah Stombaugh: And tell me something like sculpture, that's an injectable, is that right? Dr. Eric Anderson: It is an injectable. So yes, it is an injectable material, but it's not filler and it's not Botox. It is a totally unique product that's been around for about 15 years. And the uses for that are not only on the head and neck, but also on the body too. So I can do a non-surgical BBL or Brazilian butt lift with Sculptra, which is really, really incredible. You can better skin quality, increase those collagen fibers, increase elastin and build a nice modest, subtle amount of volume non-surgically with Sculptra. It's a really, really incredible tool. And it's nonsurgical. Dr. Sarah Stombaugh: Yeah. Oh, that's cool. Okay. I definitely interrupted you. Tell me what else were you going to say? Dr. Eric Anderson: No, I think that's not only the frontier of aesthetic medicine, but also for patients that lose that smaller amount of weight with GLP-1 medications. Those are great, fantastic options, and they're nonsurgical. Another thing that we've been using a lot is radio frequency with microneedling. So I think the most notable devices that Morpheus8, which a lot of people have heard about or read about in tabloids and whatnot, that's a pretty incredible device as well. There's lots of lasers that we have that can help tighten skin, help increase collagen, increase elastin, all those things. And they all work subtly. If you have huge amount of hanging skin on your arm, surgery is the only thing that's going to help you from that perspective. But if you need a very slight modest modification, radio frequency, microneedling, lasers, things like that can really push you in the right direction. Dr. Sarah Stombaugh: Okay, I love that because I think a lot of people, we hear about some of these body contouring procedures, and while that's amazing, it's also a really big undertaking. And for some people, I think certainly meeting with a plastic surgeon and understanding, okay, this is my body, these are my concerns. Looking at these areas of concern, which category do I fall into of a having body contouring really makes sense and would be both physically helpful, aesthetically helpful for me, functionally helpful for me? Or am I someone for whom this is more minor, whether it's because of the amount of weight loss, the age I see sometimes I have patients who are younger that I'm like, where did your skin, it just like whoop, it comes back together easily sometimes, not always, right? There's so many genetic factors that play a role in our skin. So I mean, I have to imagine really the ultimate answer is you got to sit down with a plastic surgeon, have some of these conversations, and look at what's going on specifically with you and your body. Dr. Eric Anderson: Exactly. That's why you hit the nail on the head. You need to sit down with your plastic surgeon, really go through a customized treatment plan and ask the questions, understand the tools that are out there, and I sit down with all my patients and have at least an hour long consultation. We go through all, we address all the areas of your body, top to bottom, and I tell you, these are the options that we have. These are the tools in our toolbox for you, and these are which ones I think will be best for you, because then I tell them why. So really, really important to have that conversation so when our patients are educated, they understand why we're doing it, and they buy in, they have that knowledge and it makes sense. So I think it all starts with education. Dr. Sarah Stombaugh: Absolutely. Well, I love that I have the feeling that we could talk all day long about these I type of things, but before we do, tell me is there anything in our conversation that you're like, oh my gosh, I feel like her listeners just really need to know and understand this and we haven't had a chance to talk about it yet? Dr. Eric Anderson: Yeah, I think you hit a lot of points, a lot of incredible points, but I think it's really important to take a step back and understand this is a journey and you need to pick a provider who is expertly trained, who you really trust and spend time with them. Everybody has different aesthetic goals, different functional goals. It's really important to understand your patient and to piece that all out and spend time with your provider. So that's what we're here to do. We can't forget we went into medicine to help people, and that's first and always. So yeah, I think that's most important. Dr. Sarah Stombaugh: Yeah, I love that. And if people are in the Chicago area and looking for a plastic surgery and if they're interested in learning more about you or this type of work, where can they go to learn more? Dr. Eric Anderson: Yeah, absolutely. So my practice is called Impressions Chicago. I operate with two other surgeons that do head and neck plastic surgery only. My focus is breast and body. And we'd be really, really excited to meet with anybody. And of course, anybody who wants to make a consult through your practice, we'll get a free consultation for sure. So we want to extend that to all your listeners. Dr. Sarah Stombaugh: That's amazing. So we will make sure to put all of your information in our show notes. So anyone who's in the area. I see patients in Illinois by telemedicine, so I know I've got some patients who are really excited about this episode. They've been asking me about information. So for anyone who is in the Illinois area, definitely check out Dr. Anderson and his team. Maybe even worth traveling for an experienced team of docs such as yourselves. Dr. Eric Anderson: We do have a large portion of our practice that travels. Chicago's a centrally located city and it's easy to get to, and we have a pretty good percentage. I think it's about 40% of our practice is out of town. Dr. Sarah Stombaugh: Okay. Well that's amazing too because even just thinking about resources and logistics, I'm sure you have support staff who are really helpful in walking patients through that. Dr. Eric Anderson: Absolutely. We have partnerships with all the hotels in our area, and so we give our patients a discount there. And a lot of times we even help with the travel fee too. I think we have a $500 travel benefit for our patients from out of town. Dr. Sarah Stombaugh: Okay, cool. Well, that is not something I knew about. So it sounds like really anyone, it's easy to get to Chicago Airport, even from Charlottesville, Virginia. We have a direct flight. We have direct flights to like five places, but one of them is Chicago, so. Excellent. This has been really fun. Thank you so much, Dr. Anderson for coming on today. I really appreciate it. Dr. Eric Anderson: Yeah, thank you so much for having me. I'm always happy to answer any questions too. If people want to put questions in the common area, I'm happy to respond to those. I respond to a lot of questions on Instagram as well. My handle is Dr. Eric W. Anderson, so we'll put that in the comments as well, and people can feel free to ask any questions. Dr. Sarah Stombaugh: Yes, absolutely. Well, thank you so much for coming. This has really been a pleasure. For all my listeners, thank you for joining us. Sounds like there's such a great opportunity to engage with Dr. Anderson. Ask him questions if you have them, or to consult with him and his team, so we will have all that information available for you. Thank you so much for joining us. We will see you all next week.