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Randy: You are watching the latest edition of The Wellness Hour, the leader in medical news and information; I'm Randy Alvarez.

My first guest is a Double Board Certified Plastic Surgeon who specializes in a new procedure that he calls the Lipotuck™. This procedure is a combination tummy tuck and high-volume liposuction. If you have unwanted fat around your abdomen because of weight gain or if you have lost weight and now you have sagging skin and stretch marks this new procedure can get rid of that. My advice, stick around for the last edition of The Wellness Hour.

The Wellness Hour, an in-depth discussion with today's top physicians and medical leaders. Now your host, Randy Alvarez

You’re watching the latest edition of The Wellness Hour, the leader in medical news and information. I'm Randy Alvarez.

My first guest is Ahmad Ahmadi, MD. Dr. Ahmadi is Board Certified in both General Surgery and by the American Board of Plastic Surgery. I've been told by other Plastic Surgeons that Dr. Ahmadi is one of the best plastic surgeons in the world. He's here today to discuss the procedure that he developed, the Lipotuck procedure. Dr. Ahmadi welcome to the program.

Ahmad: Thank You Randy.

Randy: The Lipotuck, you pioneered this procedure, is that correct?

Ahmad: Yes.

Randy: It's a combination; liposuction, tummy tuck.

Ahmad: Liposuction and tummy tuck it really works well, it took me a long time to work on it and get it right. It is really a unique combination of tummy tuck and an aggressive liposuction.

Randy: You trademarked this, is that right?

Ahmad: I did trademark it because it really is not just a liposuction or tummy tuck; it really is a combination of the two so hence the Lipotuck.

Randy: Are you teaching other doctors this technique yet?

Ahmad: Not yet but soon. I think once the buzz gets around we will have to start doing some of that too.

Randy: We've talked off camera and why this focus on Lipotuck? Why do you like it?

Ahmad: Well Randy when I started doing tummy tucks I was very unhappy with what it did, basically what it didn't do for the waistline and upper abdomen. If you take a typical patient, they usually have excess skin but that excess skin usually wraps around the body where the tummy tuck stops. It's usually works for the lower abdomen but stops for the upper at doing anything for the upper abdomen or the waistline so liposuction takes over from then on.

Randy: We've invited you on the show to talk about the Lipotuck but your practice, I mean you do everything there?

Ahmad: Pretty much everything. Take it from the top, Botox, the fillers, the Restylane; we do brow lifts, eye lift, rhinoplasty, implants, mid-face lift, otoplasty which is pin back of the ears. Certainly we do breast work and body contouring which usually involves a tummy tuck and liposuction and lifts.

Randy: Okay, now moving on to Lipotuck, this Lipotuck, define it; what does it mean?

Ahmad: In a few words, it's a very unique combination of a tummy tuck and a very aggressive liposuction of the areas that traditionally were not done before.

Randy: What do you mean they were not done before?

Ahmad: Well, during my training, we are usually taught not to do too much liposuction of the abdomen and the waistline during these procedures because they are assumed not to be safe and we were always taught that it may complicate the outcome. However, I'll show you in a few minutes that that's not the case necessarily.

Randy: I talk to surgeons and they say liposuction should only be used for those last little 10 pounds little pocket areas that you can't get with diet and exercise; you're saying that you'll work on the person that's 60, 80, 100 pounds overweight. I mean, is that right? You haven't said that but is that correct?

Ahmad: I think we need to look at this thing a little bit differently. When people come to my office, when these ladies come to my office they've gone through the gym, they've done all the diet, they've done all the exercising, they've signed up at the gyms, they have their own personal trainer and it hasn't done any good because they're not motivated. The motivation being they want to look nice. It has not worked at all for these ladies; they're at the end of the rope basically.

So here I come, I say let me work on one section and one section only. I'm not talking about the whole body liposuction, weight reduction, body lifts or anything like that. Take one section.

Randy: Which is their abdomen.

Ahmad: Which is their abdomen, the back and the flanks and hips and all that and making it perfect; just making it come out perfect. Then tell them, I've given you what you wanted now it's your turn to give me what I want from you and that is I want you get in the gym, exercise, I want you to change the dietary habits, I don't want you to drop by or go through the drive through anymore, you can eat healthy fruits and vegetables and salads. Get rid of all your diet pills and I want you in the gym. And my girls are going to call you; they are going to call you and bug you to make sure that you're following through with the program.

Randy: So you're not afraid to do surgery on a patient that's 60, 70, 80 pounds overweight?

Ahmad: I would use that with caution. I choose my patients carefully, they have to be motivated.

Randy: Motivated 60 pounds, 70 pounds overweight person?

Ahmad: Not a problem.

Randy: Really?

Ahmad: Not a problem; they have to be motivated and they have to be healthy. Obviously this is an elective procedure and the outcome needs to be safe. We're not saving lives and we're not doing heart bypass surgery on a sick patient; we are taking healthy patient and we want the patient to come out healthier at the end of the day. So this procedure, it is for overweight people but we're looking at it differently. Let's give you a jump start, let's get you in the gym and do the rest by yourself now.

Randy: Okay we're going to take a quick break, when we are back we have to look at these photos. You're watching The Wellness Hour, the leader in medical news and information - I'm Randy Alvarez. We are talking about the Lipotuck procedure with Board-Certified Plastic Surgeon Dr. Ahmadi - we'll be right back.

Patient # 1: Oh my God Lipotuck has changed my life in such a tremendous way; my self-esteem, my appearance all of the compliments that I get from other people. Since I've had Lipotuck I feel much healthier; actually I feel like I almost had a gastric bypass. I don’t eat as much, it has just totally made a change in my health status. After having the procedure, Lipotuck made me feel like a new woman.

Randy: You're watching The Wellness Hour, the leader in medical news and information I'm Randy Alvarez. We are here with Board-Certified Plastic Surgeon Dr. Ahmadi and we're talking about the Lipotuck procedure. Okay Dr. Ahmadi, a recap, and people just tuning in. We're talking about high volume liposuction tummy tuck. So let's move to this first photo.

Ahmad: Let's take a look at this before picture. She is one of my most favourite patients, she has a lot of history. She came to my office and there was something about her that I sensed, something deep as if she had been very depressed for quite a long time. I knew that her concern was there tummy but she'd been turned down, she had been offered more aggressive procedures like the gastric bypass.

Randy: You mean she was turned down by other surgeons to do lipo or tummy tuck?

Ahmad: For the tummy tuck but they couldn't guarantee that she'd come out flat and chiselled, that hourglass formed out that she was looking for. She saw through other friends you know, people that I had done and she got to know me. She came to my office finally, very shy lady very shy at the beginning; she even had a hard time showing me her abdomen. It was very hard for her to show all this extra skin.

Randy: This looks like a man's belly, this is a huge overhang and I've talked to other surgeons about this and this is very difficult I've been told.

Ahmad: This is not an all-too-familiar patient in my office, this is as typical as they come, as they in my office. Let's go work together; the extra skin starts way from above the belly button

Randy: What about this ugly dimpling?

Ahmad: Way below and the dimpling well, that's really the belly button but you can’t really see it, it’s buried under all that the wrinkled skin and stretch marks from pregnancies and if you were to examine her she would have no tone to her abdomen. The more important thing is I want you to look at and I want the audience to realize is that, this is not only extra skin, there's a lot of fatty tissue underneath it. If you just cut the skin from here to here which I did, you are going to end up with a very tight abdomen below the belly button but very rounded up on top; it's not going to look good.

Randy: Okay, tell me this so I understand; you're saying you removed, you cut this much skin out from here to here?

Ahmad: That's what it took, that's what it took to achieve.

Randy: So that's this much skin?

Ahmad: That’s that much skin wrapped all the way around.

Randy: You cut it out?

Ahmad: Cut it out, gone.

Randy: Tell me what you do by the way? Help me understand the tummy tuck aspect to this; what are you doing surgically?

Ahmad: Well, it's basically removal of a skin. You have to know how much to remove so that it comes together at one end and tighten the abdominal fascia, bring the musculature back together and then the liposuction comes in, a lot of liposuction.

Randy: Okay so you cut out that area and I guess stretch marks could be in between there, dimply skin and then you're pulling it together?

Ahmad: The stretch mark is gone, they're thrown away, and that’s it. You throw away the skin that has all that stretch mark, it’s gone.

Randy: That’s like 6 inches of skin area.

Ahmad: At least; sometimes more like 12 inches.

Randy: Like a foot of skin you remove.

Ahmad: Absolutely yes.

Randy: Seems like horrible scarring.

Ahmad: Well no not really, I'll show you some pictures afterwards.

Randy: So this woman's after we're going to see in a second, obviously. Okay let's back to this woman; huge overhang, what were her options?

Ahmad: Well, she could have the traditional tummy tuck that would address the lower abdomen but it would stop right over here and it would undress the upper abdomen. She would come out of it looking maybe pregnant.

Randy: What does that mean?

Ahmad: Well, if you don't like researching the upper abdomen, you're going to still have that fatty bulge up there. She’ll have a higher upper abdomen.

Randy: You see that a lot?

Ahmad: That’s a typical outcome.

Randy: And that's in the surgeon's hands?

Ahmad: That's the best thing in the hands of any Board-Certified Plastic Surgeon. If I were not to do this the tummy tuck on her she would come out of it very unhappy.

Randy: Looking pregnant.

Ahmad: Looking at this a few months pregnant, but what I want you to concentrate on is that the stretch marks go way behind, you can see them over here on the sides too and the fact that there's quite a bit of fatty deposit on the sides; so it's not only the front part but it's usually at the sides that you have to concentrate on and that's where the Lipotuck comes in because it is an unique, very unique overall makeover of the abdomen and the trunk.

Randy: Okay, is it possible she would go to another surgeon and they say you know what, lose 30 pounds first before doing lipo?

Ahmad: They will go to another surgeon; typically the surgeons answer would be you need to a few pounds or let me do liposuction first and then come back for the tummy tuck or let me do the tummy tuck first come back for the liposuction; I'm doing it all at once. I used to be one of those surgeons who have kind of breaking the grounds over here; we're going to do only one session now, safely.

Randy: You did the surgery, you did a tummy tuck and the lipo; you got very aggressive.

Ahmad: This lady started with a size 16, she went to size 8 in two and a half months. I can see that you don't believe me.

Randy: Actually when you look at the before and after side by side, you got rid of that complete overhang so this scarring.

Ahmad: The scarring, this is only two and a half months out and I promise you that in a few months you will not see much of that scar and she can wear a bikini, she can now enjoy going to the beach, she can go to the swimming pool with her kids in the neighbourhood.

Randy: Very natural looking belly button by the way.

Ahmad: Yeah, belly button one of my pet peeves; I have to get it right. If you want a natural belly button you really have to know what you're doing.

Randy: Now with this before and after, this was not possible. These kind of results were not possible before.

Ahmad: Before that Lipotuck was invented.

Randy: Or discovered.

Ahmad: They could be done, they could possibly be done in multiple stages; either do the tummy tuck first or come and do the liposuction first and then switch the surgery. You would have to go through two sets of surgeries, you would have to have two recoveries which is not necessarily a good thing because you have to go through the procedure twice, people have to take care of you twice and you have to recover twice.

Randy: Aside from the time, better result to do it one shot?

Ahmad: Absolutely.

Randy: This is high volume, this is great. Other surgeons, because I received your photos, a Board-Certified Plastic Surgeon in California, showed him, he says this is amazing and it really is.

Ahmad: These are the comments that I get all the time.

Randy: I'm not trying to endorse you here doctor but it truly is a huge dramatic difference, anybody can see this. So she has a flat stomach now?

Ahmad: The comments that I get most about these pictures is that these are of two different people but they are not; I promise you they're not, these have not been touched up. The procedure does work, it works very well and it's safe.

Randy: All the dimpling that was around her.

Ahmad: It's all gone, it's all thrown away.

Randy: You cut it out?

Ahmad: It's all gone, their skin gets cut from here to here, it gets thrown away but a lot of the work gets done on the waist; I don't want you to dismiss the waste. Anybody can do a tummy tuck, pretty much anybody can do it. Anybody can do liposuction nowadays but it takes a few individuals who know what they're doing to combine the two procedures together and get it right.

Randy: Hitting it hard on the.

Ahmad: Hitting it hard on the sides, that's what your waistline is, hitting him hard on the side and making sure that that scar falls in a natural curve so it gets hidden by the common bikini styles.

Randy: So she can wear a bikini that's hidden.

Ahmad: Yes look at it I mean you know it would be very easy for her to just pick up any bikini at one of those fashionable places, Victoria's Secrets and all that and then just enjoy the sun and the outdoors now.

Randy: You have more photos?

Ahmad: Well let's look at this lady; she's a professional, she owns multiple businesses around my office. She came to me a few months ago and she was very unhappy; she was very unhappy about her tummy. She'd been through the gym, you've heard this before and we just talked about this. She's typical story, she's been to the gym, she tried the diets you know, all that but she just couldn't lose the weight. Once the skin is stretched out so much.

Randy: This is after pregnancy?

Ahmad: Some of it is pregnancy but in her case a lot of it was just weight gain by just not eating right. She's a professional, she owns multiple businesses and she just didn't have time to take care of herself. This is beginning to sound all too familiar now; she's got extra skin from here to about here, a lot of skin and you can see it's been stretched out. If she goes and just walks out, this skin is just going to drop and drop and drop.

Randy: This is a common look, I don't see women, as a layperson I don't see this look, this is common.

Ahmad: Well, maybe you don't notice it but there are a lot of people out there they just hide it, they'll hide it maybe they sit at home. These are our secretaries, these are our moms, and this could be our sisters out there. Once you start eating junk food and not exercise this is what happens to your body; unfortunately pregnancy doesn't help at all either.

Randy: As a surgeon what are you looking at that you know you have to do? What do you see wrong with this picture?

Ahmad: I look at the waist first, I try to block out in my mind the tummy; I look at the waist first.

Randy: Very thick from here to here.

Ahmad: Very thick, a lot of fatty deposits on the side and a lot of stretch marks. Traditionally, we get taught to look at the tummy, the tummy is the front part of the abdomen but when I get to think about it more, I realized that it's the waistline that I need to work on first, the area that's been missed .

Randy: That means from the frontal view, the waist, is that what we are talking about, the waistline?

Ahmad: Pretty much yeah; look at this three-quarter shot, this area right over here, this is the area that I want to work on because even if you achieve a good tummy tuck.

Randy: You get a boxy look.

Ahmad: You get a clamshell look; I wouldn't call it box I would call it a clamshell, it’s like closing the lids of a clam together, it ties it in the front and it bulges out the sides. That's what happens.



So what I ended up doing for her was the Lipotuck. Started by doing an aggressive amount of liposuction on the sides removing the skin on the sides first which is different.

Randy: How much skin did you remove on this woman? Looking at it with the pen show me.

Ahmad: Pretty much from here to here which is almost about a foot.

Randy: This whole area right here you cut it out?

Ahmad: Thrown away, all that.

Randy: I just can’t understand how you're able to cut out that part above the belly button then create a new belly button.

Ahmad: Well you just have to pull them very tight.

Randy: You have to go back in and make a belly button? Is it an artificial belly button or it's the same belly button?

Ahmad: It’s the same belly button but it comes through a new hole.

Randy: I got it, okay.

Ahmad: So the skin gets draped over it, make a new hole and the belly button comes through but all of it is to make it look natural and I've worked on that quite a bit.

Randy: Let's take a look at the after.

Ahmad: Here is the after picture you can see.

Randy: Absolutely shocking.

Ahmad: Hourglass on the sides; she went from size 16 now she's about 10.

Randy: This is a very sexy woman now.

Ahmad: Yes and you look at it and I'll tell you what is appealing. Look at the waistline, it's completely different, it's caved in. She's got positive curves now instead of what she had before -negative curves.

Randy: She could wear low-cut pants in this photo.

Ahmad: Absolutely. You probably had a hard time looking at that scar, she's further out she's about 4 months out.

Randy: I don't see any incision, is it below this? Is it below this part?

Ahmad: The incision is somewhere around here.

Randy: And that's it?

Ahmad: That's it. Second feature of Lipotuck, the upper abdomen its flat; traditionally you can't get that with tummy tuck.

Randy: You went to go high, you went very high.

Ahmad: You have to go high and you have to be aggressive over here. People worry about doing liposuction in this area because it may compromise the vascularity of the flap, the flap may die and turn black; horrible thing to happen, never had it happen to me. Over and over again it works and the belly button natural-looking belly button and inny not an outy, you got to get an inny.

Randy: So how does this woman's life change? What did she tell you?

Ahmad: Oh my God, you should see her, she's just full of joy she's just full of life. She came into my office and she just cried and gave me lots of hugs and we have become very good friends since then.

Randy: Does this give her as you say, the leverage to start taking care of herself better?

Ahmad: She already has. I see her at the gyms regularly, I know she's eating well because we keep in touch so this is a good example of what Lipotuck can do for you. Jumpstart, let me take care of the body, let me tell you what I can do surgically for you and you run and do the rest of it through nutrition and diet and exercise.

Randy: Okay good. Another quick break and we'll be right back, more photos. You're watching The Wellness Hour, the leader in medical news and information. I’m Randy Alvarez and we're talking about the lipo tuck procedure. If you're unhappy with your abdomen, my advice, stick around for this next segment; we've got dramatic photos coming up. We'll be right back.

Patient # 2: I've never really had a waist, I always carried a lot of weight around my middle, I had a stomach and I wanted to get rid of that. I was a 10/12 and now I'm a 4/6. Oh, I would say don't do it unless you're going to have Dr. Ahmadi do it; he knows what he's doing and I just feel like he's the best. He's very, very professional, he's very meticulous, he is very kind and I just think Dr. Ahmadi is a wonderful doctor.

Randy: You're watching The Wellness Hour, the leader in medical news and information I'm Randy Alvarez. We are here with Board-Certified Plastic Surgeon Dr. Ahmadi and we're talking about the Lipotuck, combination liposuction and tummy tuck.

Okay, Dr. Ahmadi, what are we looking at here?

Ahmad: A very young lady, has never been pregnant, just overweight and we all know how you get there; you just stop exercising, you start eating the junk food and that's what your body ends up with.

Randy: Huge overhang; what is this right here?

Ahmad: This is above the belly you know, the skin starts hanging below the belly button first and then it starts doing the same above the belly button. You can also see the upper flank areas, these are not her arms; these are actually rolls of skin and fatty tissue that had to be addressed.

Randy: So you're able to remove that fold.

Ahmad: It has to be a part of the procedure; it's a one-stop shopping for this look, Lipotuck.

Randy: Lipo and tummy tuck obviously on this one. So what did you do? How much skin did you have to remove or did you have to remove any skin?

Ahmad: Removed skin pretty much all the way from above the belly button; a lot more on this lady, a lot more all the way down to where the blue line is.

Randy: Okay, so I understand; you removed that whole area.

Ahmad: That's correct.

Randy: And then you?

Ahmad: Pulled it together and then started doing the unthinkable liposuction the area.

Randy: The unthinkable. Why do you call it the unthinkable?

Ahmad: Because that's what I've always been taught, cannot liposuction that flap too much and very aggressive liposuction for those plastic surgeons who are.

Randy: Miserable? Was she miserable?

Ahmad: Absolutely not.

Randy: I mean miserable before.

Ahmad: Before? They were about to go through a divorce and a breakup.

Randy: Is that right?

Ahmad: Yeah.

Randy: So you did the liposuction.

Ahmad: Life changed, look at the after picture, look at a waistline going from positive curves which is the positive curves now; you can barely see the scar.

Randy: What do you mean positive curves?

Ahmad: That hourglass look, the curve, those pleasing curves, that sexy look.

Randy: This is very sexy, I mean to look at the before, if we could go to the before for a second; and when you look at that before, you would not guess that this woman? How many weeks later?

Ahmad: She is about 3 months out now.

Randy: 3 months out?

Ahmad: Correct.

Randy: In that photo?

Ahmad: In that photo and a lot of skin was removed, a lot of skin and a lot of liposuction was performed.

Randy: She gets a second chance.

Ahmad: She got a second chance at marriage, it all worked out fine.

Randy: And it bothered her though? I guess which is the most important thing.

Ahmad: Correct, yes but again what you want to look at is how flat the upper abdomen is, how natural the lower abdomen is, it's not pulled t too tight.

Randy: The thing right here, there was a little fold right there, that's gone.

Ahmad: That's gone.

Randy: You lipo way up into the back?

Ahmad: All the way up to the armpits and all the way around to the back and all the way down to the upper thigh. I have to address the trunk in one shot.

Randy: You did the unthinkable; like you say other surgeons would say and your training, your formal training that said you can't do this.

Ahmad: I've always been told that and I had to break the rules.

Randy: You break the rule to get a great result. Okay, we have time for a few more photos.

Ahmad: Let's look at this one together now. She does not have the same problems as in the other pictures that we saw; she's got more fatty tissue and less of a skin problem.

Randy: So with this potbelly, this is a younger patient. How old?

Ahmad: She's about 40, she’s had a couple children.

Randy: Decent skin tone, good skin tone.

Ahmad: You can hardly see any stretch marks on that picture and that's because probably she didn't gain too much weight during her pregnancy.

Randy: Would a surgeon look at that and say she doesn't need a tummy tuck, she just needs lipo?

Ahmad: Commonly made mistake. You would liposuction this lady, skin would start hanging in the middle and especially towards the flank and if you really want to know how to go about that just have them sit down in front of you after they've done liposuction and you can see the skin just fold right on itself.

Randy: By the way, does this work for men and women?

Ahmad: It does, it works great for men too.

Randy: With the big overhang.

Ahmad: With the big overhangs, however, you have to be careful with men because a lot of men have what we call intestinal fat; inside is fat.

Randy: For those hard stomachs.

Ahmad: Exactly.

Randy: They may not be great candidates but for the ones that has fatty overhang that's good?

Ahmad: It will work.

Randy: So back to this woman again.

Ahmad: I had to think differently about it; she would at most get a mini tummy tuck and maybe a little bit of liposuction. What I gave her was a more aggressive tummy tuck and a very, very aggressive liposuction. Again, I started doing liposuction on the sides first because that's the area that I would like to address first during the surgery; you've got to get the sides trimmed down otherwise it will not look good. Then you move on to the upper abdomen, liposuction it aggressively and then remove the extra skin.

Randy: When I look at this before and after side by side, it's subtle I mean it's drastic but it's also very subtle. She doesn't look done because I've seen some tummy tucks out there interviewing surgeons over the years, some of them, that belly button is flat as a board.

Ahmad: They're just sticking your face, you going oh my God what happened.

Randy: This is natural; in fact if I saw her in a bathing suit and I feel like I have a good eye for this now that I've looked at a lot of before and after pictures, who would know she had anything done?

Ahmad: Well, if she covers it up, she covers up the scars.

Randy: I don't see any incisions on her and she had a tummy tuck?

Ahmad: The incision is there, you just have to look for it.

Randy: This is an athletic look as well.

Ahmad: It's a very natural look; the idea is not to overdo it, you want to do just enough amount of liposuction to get those positive cures that we're talking about going, flatten the upper abdomen, remove enough skin but not too much so that it's not too tight below the belly button and the pubic area.

If you look at a female's body, it's a lot flatter on top above the belly button that it is below the belly button. They got more waist than the men but the flanks are a lot curvier than ours. The man's body is completely different, it's very angular, and it is very straight. Women have more curves so you have to recreate those curves.

Randy: What do you say to the person watching this? They think maybe they're too far gone, they already went to a surgeon who said I don't know you might have to lose 50 pounds first.

Ahmad: I would say come on over let me take a look at you. I’ll be very honest with you; if I think that you're not a candidate for it and you’re not going to have good results, you'll hear it from me.

Randy: Because you make it sound like you're going to lipo anybody. So you do turn some people away?

Ahmad: I have turned people away, mostly people who I don't think will end up giving me back what I want from them which is diet and exercise. Remember it's a contract between us; I will do this for you but you will have to give me back the diet and exercise that's the key. That's what all these patients need, just a jump start to get them started and then the rest of it is up to them but I don't want to let them go.

I do keep in touch with them and we're building a support group for each other, for these ladies so that they can talk they can share their stories and those skeptical people are more than welcome to listen to them and join them and talk with them over the phone or even visit them. All these people are happy to tell their stories to the skeptics out there.

Randy: Dr. Ahmadi, thanks for coming on the show. Great stuff and very interesting.

Ahmad: Thank you for having me.

Randy: You've been watching The Wellness Hour - I'm Randy Alvarez. If you would like to see this interview online live you could visit our website at www.Wellnesshour.com. For now, I wish you good health.

Thanks for watching The Wellness Hour, the leader in medical news with your host Randy Alvarez the authority on health issues.

* Results may vary

Dr Ahmadi is member of American Board of Plastic Surgery

Houston Board Certified Plastic Surgeon

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Dr Ahmadi is member of American Board of Plastic Surgery

Houston Board Certified Plastic Surgeon