Category: Body contouring

Body Contouring After Significant Weight Loss

Body Contouring

Weight loss, however big or small, is a major accomplishment. However, those who achieve substantial weight loss may be disappointed by excessive skin folds or loose skin that cover up their well-earned results.

To combat this, many now elect for a body contouring procedure following significant weight loss. After this procedure, patients finally achieve what they hoped to with their dramatic weight loss, a better-proportioned appearance with smoother contours.

What is Body Contouring?

Body contouring is a procedure that eliminates or reduces the remaining excess skin and fat after individuals have lost a significant amount of weight. This procedure also improves the tone of the underlying tissue.

This procedure is not just for vanity. It is often necessary for a patient’s quality of life, as excess skin can make getting dressed or bathing a chore. It may also limit mobility and cause hygiene and medical problems. Chronic skin-on-skin contact can also result in rashes and other sores that can lead to infection. Many times, the only way to remove excess skin is through body-contouring.

Body contouring is not a substitute for exercise and a healthy diet. Individuals receiving body contouring should be willing to adopt a healthy lifestyle to maintain long-term results.

Who is a Good Candidate for Body Contouring?

The best candidate for body contouring is a nonsmoking, healthy individual without a medical condition that could impair healing or increase the risk of surgery. The right candidate has also reached his or her goal weight and is committed to keeping it off with a healthy lifestyle and proper nutrition and fitness. Patients will benefit the most if they have excess skin in certain areas but minimal excess fat.

The ideal candidate also has realistic expectations for his or her results. While surgery can improve the overall appearance, every patient heals differently with varying results. During your initial consultation, it is important to talk to your doctor about the results you can expect.

Body Contouring Areas

Below are the areas most often treated through body contouring.

  • An arm lift removes excess skin and gives a tighter, more defined contour.
  • Buttock Augmentation transfers fat, uses buttock implants, fat grafting, or a combination of these methods to change the size of the buttocks.
  • Labiaplasty reduces the length of the labia minora.
  • Liposuction removes excess fat deposits between the skin and muscle.
  • A mini tummy tuck flattens the look of the belly and primarily focuses on excess skin and abdominal wall laxity below the belly button.
  • A “Mommy Makeover” is a set of procedures custom-designed for each patient to restore and invigorate a woman’s body after the physical effects of childbirth or weight loss.
  • A tummy tuck removes excess fat and skin from the waist, and in most cases restores weakened or separated muscles creating an abdominal profile that is more smooth and firm.

A combination of surgeries may take place at the same time. For example, an “upper body lift” may include surgery to the arms, back, and breasts. A “lower body lift” will focus on the hips, thighs, abdomen, and buttocks.

Procedure & Recovery

Most body contouring procedures are performed under general anesthesia. After surgery, tubes are usually placed in the wound to drain excess fluid, and patients are given medications to control pain and discomfort.

For the next two to four weeks after surgery, soreness, swelling, and bruising is normal. Most people can return to work after two to four weeks, but people with physically demanding jobs need to wait longer. During this recovery period, you will follow up at your doctor’s office regularly to monitor your progress.

Specific instructions may include avoiding bending, straining, or lifting for several days to weeks. Some patients may also need to avoid standing fully upright and stressing any internal sutures as they heal, and to sleep with pillows elevating the knees. To minimize the risk of blood clots, patients need to be up and walking as soon as possible and need to drink plenty of fluids.

Results After Body Contouring

Body contouring results are visible almost immediately; however, it can take a while to see the final results. The results are generally long-lasting, provided that the patient maintains a stable weight and general fitness. As your body ages, it is natural to lose some firmness. However, most of your initial improvements should remain.

Marvel Cosmetic Surgery offers a full range of body contouring procedures providing a more proportionate figure. Contact us today or call 615-538-0399 to schedule your free consultation. Let the Marvel team find the perfect procedure for you!

Male Breast Reduction: Men Can Have Boobs Too!

Who can forget the iconic Seinfeld episode when Kramer invents “the Bro,” a supportive undergarment for men with enlarged breasts? He tries to help George’s father, Frank Costanza, deal with the discomfort of his “man boobs” by designing the man’s version of a bra. Unfortunately, Kramer and Frank can’t sell their idea, and it never takes off.

That plot in the Seinfeld episode is full of one-liners and goofy situations, which makes for funny television.

But for those men who suffer in real life from enlarged breasts, they’re not laughing.

In fact, “man boobs” will affect at least 30% of males in their lifetimes, according to the National Center for Biotechnology Information. This condition’s official name is gynecomastia. Those who suffer from it experience anxiety, psychosocial discomfort, and fear of breast cancer.

Treating gynecomastia becomes paramount to give patients overall health, wellbeing, and peace of mind. A male breast reduction procedure uses a combination of liposuction and direct excision to reduce the fat and glandular tissue from the breast area, producing a natural, more masculine chest.

What to Expect With Male Breast Reduction

The male breast reduction surgery requires general or local anesthesia — depending on the extent of your reduction — and is done on an outpatient basis. Once the excess tissue is reduced, you will be left with a flatter, firmer chest contour. The procedure is both effective and long-lasting in getting rid of your “man boobs.”

Male breast reduction side effects include swelling and discomfort following surgery, which can be controlled with prescription pain medication. You’ll be given an elastic pressure garment that you’ll need to wear for about two weeks following surgery to help reduce the swelling. Once your stitches are reduced (after two weeks), you can resume normal activities. However, strenuous exercise, sexual activity, or anything else that may risk a blow to the chest should be avoided. 

Male breast reduction surgery may be right for you if:

  • You are healthy
  • Your weight is stable and relatively normal
  • Your breast development has stabilized
  • You have realistic expectations

Schedule Your Consultation for Male Breast Reduction

Don’t suffer any longer with “man boobs”! The condition isn’t funny, and we can help you get the chest you want to see when you look in the mirror. Male breast reduction surgery works, making you more confident at the beach, in the locker room, or in the bedroom.

For more information on gynecomastia surgery, call us at 615-610-7274 or contact us today to schedule a consultation.


Liposuction vs Tummy Tuck – How to Choose

Liposuction vs Tummy Tuck - How to Choose

Bikini season is just around the corner. And if you’re considering a procedure to remove stubborn fat, there are several great options to consider. Two of the most popular procedures to remove stubborn fat and tackle trouble areas are liposuction and a tummy tuck.

So what’s the difference between these two procedures and how do you choose what’s right for you? Let’s break it down and take a look! 


Liposuction in its most basic form, is a popular cosmetic surgery that is performed by using suction to break down and suction out the excess fat deposits from the body

As one of the most sought out cosmetic surgery procedures in the world, liposuction isn’t considered a major operation. In fact, it is considered a very minor invasive procedure and is generally an outpatient type of surgery. Some patients may be under general anesthesia but most only require IV sedation and are allowed to go home the same day as the surgery.

Here are some of the most common “target” areas where traditional liposuction is performed:

  • Abdomen and Waist
  • Back
  • Calves and Ankles
  • Chest Area
  • Hips and buttocks
  • Inner knee
  • Thighs
  • Upper arm

Here at Marvel Cosmetic Surgery, we also offer an all-inclusive liposuction procedure called Lipo360, to contour and shape the midsection, 360 degrees around. The possible areas for treatment are the upper and lower abdominals, the flanks on both sides, and the lower and mid-back.

This procedure uses a vacuum to target and suction fat from specific areas in the midsection. Our surgeons use special techniques to accentuate the patient’s natural curves and create a dramatic yet natural-looking result.

However, bear in mind, Liposuction is not a weight management program nor a solution for treating obesity.

Ideal patients are those who have a good bill of health, are close or near their goal weight (BMI), nonsmokers, have great skin elasticity and have no blood flow/circulation issues. You should consider getting a liposuction if you have areas of fat deposits that are disproportionate to the rest of your body. Patients who still have a significant amount of weight to lose are not good candidates for liposuction.

If you are aiming for a sleeker contour and want more definition in certain areas of the body then liposuction is a great option for you.

Tummy Tuck

A flat and well-toned abdomen is what many of us strive for through exercise and weight control. Sometimes though, these methods cannot guarantee results.

Abdominoplasty or more commonly known as “tummy tuck” is a cosmetic surgery procedure where excess skin and fat from the waist, middle and lower abdomen is removed. This also involves tightening the abdominal muscles which leads to a smaller bulge in the stomach and abdominal area.

The procedure itself is done through a hip-to-hip cut or an incision at the bikini line. The skin and fat is then lifted off the abdominal wall where any excess skin is pulled down and removed. Any stretch marks as a result of childbearing or obesity is repaired through the stitching. This results in the tightening of the underlying muscles in the abdominal wall, which leads to a flatter stomach.

As this is a more invasive procedure compared to liposuction, recovery times tend to be longer. A patient will need at least 2 to 4 weeks for the body to recover, while scars and swelling may take a couple of months to heal.

In summary, if you’re looking to just sculpt or shape certain “target” areas in your body, then liposuction is the way to go. If your problem is excess skin due to weight loss or child birth, then tummy tuck might be a better fit.

Keep in mind that while these are separate procedures, it is possible to have both of these done to get the optimal results for the ideal body shape you want.

With summer just around the corner, we at Marvel Cosmetic are here to help you achieve your ideal shape. Curious to learn more and decide which procedure is right for you? Schedule a free consultation and one of our doctors will walk you through your options and answer any questions you might have. Reach out to us today at 615-538-0399 and take a step towards a bikini ready body!

Everything You Need to Know About Lipo 360

Everything You Need to Know About Lipo 360

Getting the sexy curves and sleek figure you’ve always wanted is now easier than ever before! We are excited to announce that Marvel Cosmetic Surgery now offers Lipo 360, an all-inclusive liposuction procedure to contour and shape the midsection!

Swimsuit season will be here before you know it! Now is the time to find out how we can help you transform your body and create a dynamic yet natural looking result. Read on to discover everything you need to know about Lipo 360.

What is Lipo 360?

Lipo 360 is an all-inclusive liposuction procedure that is used to contour and shape the midsection, 360 degrees around. The possible areas for treatment are the upper and lower abdominals, the flanks on both sides, and the lower and mid-back.

We utilized the best cosmetic surgery practices to develop a comprehensive range of liposuction procedures designed to lift, tone, and contour your body. What makes this procedure truly unique is the ability to give you the custom results that you want.

How Lipo 360 Works

First, you’ll meet with a patient care coordinator and one of our surgeons. They will listen to your needs and make recommendations based on how you’d like to shape and define your body.

Lipo 360 uses a vacuum to target and suction fat from specific areas in the midsection. Our surgeons use special techniques to accentuate your natural curves and create a dramatic yet natural-looking result. In some cases, the surgeon may also use a laser in addition to traditional liposuction to help melt fat and tighten the skin.

Another added benefit of Lipo 360 is that it does not require general anesthesia. Most patients require only IV sedation for this procedure.

The Recovery

Downtime for Lipo 360 is minimal and most patients can return to normal activities within just a few days. But with any surgical procedure, downtime can vary, and following post-op instructions is a must. Your doctor will provide you with specific guidelines to follow to ensure you get the best results and heal quickly. Be prepared to avoid strenuous activities and exercise following your procedure as your body will need time to heal.

The Right Candidate for Lipo 360

The ideal candidate for Lipo 360 will be within their ideal body weight and someone looking to remove fat from trouble areas that are not easily fixed by exercise alone. Lipo 360 works wonders because it targets both small and large areas of the body to contour and shape.

Getting the curves you’ve always wanted is possible with Lipo 360 and starts with a FREE consultation to meet with one of our doctors. At your consultation you will discuss the results you desire and have the opportunity to ask any questions.

Start your journey today by giving us a call at 615-861-8174.

When Should I Consider a Mommy Makeover?

Mommy Makeover

A Mommy Makeover isn’t one product, but a package of services customizable for each person. The idea is to give mothers an opportunity to restore and reshape areas of their body post-baby. Because of its flexibility, women can add and subtract various surgeries and procedures to tailor the package to their needs, but with so many options available, how do you know which is right for you? We’ve addressed the most common options our clients request when putting together their Mommy Makeover, their benefits, and how you know you are ready!

You Want to Define Curves

For those who are looking to lose weight in the tummy, hips, and thighs, there are liposuction treatments that will get you back to your pre-pregnancy body.


Liposuction, also known as lipoplasty and body contouring surgery, is a popular cosmetic procedure that uses suction to remove excess fat deposits from the skin and muscle. This procedure works well on stubborn fat deposits. Read more about Liposuction


SlimLipo™ is a liposuction technique that uses laser wavelengths to dissolve fat. And unlike traditional liposuction, there is no need for general anesthesia and extensive downtime. With a few tiny incisions, this laser gently “melts” fat for quick and permanent results. Since the lasers stimulate skin cells into producing collagen and elastin, you can also tighten up the skin;

Special note: Liposuction treatments aren’t a form of weight loss. The right candidate for liposuction has lost most of the baby weight before they undergo surgery. Fat cells are easily reproduced by the body, so you want to be as close to your ideal weight as possible. Read more about SlimLipo™

Tummy Tucks

Tummy tucks are also quite popular and will help dramatically improve your stomach’s appearance by reducing excess fat, skin, and tissue. You can also use this procedure to repair any abdominal separation. You can choose between two options. A Mini Tummy Tuck focuses on the lower abdomen by tightening the muscles and reducing loose skin. This surgical procedure flattens the look of the belly, but with less invasive techniques than a standard tummy tuck. A standard Tummy Tuck focuses on a larger area of the torso. Your doctor can help you decide the best option. Read more about Tummy Tucks

You Want to Restore Lost Breast Volume

If breastfeeding has left you with noticeably thinner or saggy breasts, you have a couple of options to restore lost volume. While you can breastfeed if you have implants, we don’t recommend nursing mothers to undergo surgery.

Breast Lift

A breast lift can help repair and reshape your breasts without the need for implants. Depending on the amount repair required, an incision around the areola or down the breast allows for skin to be tightened and the nipple to be raised. This procedure will help restore your breast to a more youthful position. If a more dramatic look is favored, a breast augmentation can also be a good option to give volume and lift to the chest. Read more about Breast Lift

Breast Augmentation

Breast Augmentation is another option to restore lost breast volume. Implants can help to balance your figure, boost your confidence and restore volume to your chest. Breast augmentation is a major surgery that does require some recovery time. There are many different sizes, shapes, and fillers available which allows each client to customize the look. Deciding on what shape and size to go with is best discussed in your consultation, just bring along some pictures. Read more about Breast Augmentation

You’re Ready to Smooth Out Lines

Late nights can leave you with noticeable lines around the face and eyes. There are facials, injections, and skin-resurfacing treatments that will help.


Botox® works by using Botulinum toxins, which are injected directly into the facial muscle to restrict muscle movement. Deeply etched lines in the face, often created by intense concentration or constant furrowing, will smooth out with regular use. Regular Botox treatments mean preventing new creases from forming while smoothing out the appearance of what you already have. Read more about Botox®


Fillers are made with hyaluronic acid which is injected into the face to smooth wrinkles. The filler itself has a gel-like consistency that is injected into the skin to smooth fine lines. These particular fillers can last from 6 to 12 months before being absorbed. Brands such as Juvederm, Juvederm Voluma, and Restylane are all options for those who are interested in the Hyaluronic Acid option. Read more about Fillers

Regardless of the option you choose, the procedure is non-invasive, which means you can start a treatment plan soon after giving birth.

What should I do next?

Mothers in the Nashville, Franklin and Tullahoma area looking to restore their post-baby body should consider a mommy makeover. 

Are you ready to see what Dr. Jeffrey Marvel can do for you? Call 615-329-3900 or contact us to set up your initial consultation.

Biggest Beauty Trends for 2018

Biggest Beauty Trends for 2018

The new year is here, bringing with it fresh beauty trends. 2018 is all about celebrating what you were born with and enhancing what you already have. The focus is shifting to a more natural look in makeup, hair, and cosmetic trends. Below we’ve compiled a list of the top beauty trends people will be requesting and using in 2018.

Natural Makeup

Forget heavy, caked on foundations and powders; celebrities are now minimizing the amount of makeup they apply and focusing instead on their natural features. This means ditching the heavy use of highlighters on the cheeks, nose, and under the eyebrow. The idea is to enhance your natural beauty. You’ll see this look a lot on the red carpet, especially at this year’s Oscars.

The Longer, the Better

Lobs and Bobs will take a back seat because Rapunzel hair is the new length for 2018. The 90’s are back with luscious locks falling to a hip-grazing length and a middle part. If you decided to chop it all off last year, you don’t have to wait years for it to grow out, just invest in some quality hair extensions.

Products The Multi-Task

In 2017, the Korean 10-step beauty routine was a huge hit. It was great for keeping your skin looking healthy and bright, but also an excellent way to pamper yourself. However, in 2018 products will focus on being multitaskers that will promise to fix more than one issue in a single application. They should balance out skin tone, hydrate, and smooth texture.

Breast Augmentation

Breast augmentation continues to be one of the most popular cosmetic procedures, but it looks a little different in 2018. Requests to look like Pamela Andersons or Dolly Parton has tapered off and now, most women prefer the healthy size of Taylor Swift or Jennifer Lawrence. The idea is having enough to work with, without looking like you’ve had any surgery done. Small and perky is the most requested size.

Blondes Have More Fun

The biggest hair color trend for 2018 is all about blondes, but just not the way you think. Instead of applying root to tip, leave the roots dark and style with a tasseled wave for the ultimate look. You’ll also want to skip the bleach because it’s all about a warm, rich tone that compliments your natural glow.

A New Red Lip

A red lip never goes out of style, and this year it’s going to get a new update. You can now sport red lipstick in glitter and metallic. These fresh finishes give lips extra dimension and glamour. Shades vary from deep rich raspberry to a bright cherry which means regardless of your undertones, you can find a shade that works for you.

Face Oil

Coconut and argan oil are fantastic for your face, but 2018 will introduce us to the moringa oil. It mimics the oil your skin naturally produces making it easy to apply to any skin type. It’s lightweight, so it nourishes deeply and works well on dry skin. This oil is also following the multitasking trend by working as an excellent moisturizer for the face, body, and hands.

Acid Peels

Acids peels had a moment in the early 2000’s, and they are making a comeback in two ways. There are gentle at home grades you can apply every day with retinol cream, and then there are the advanced versions you can get done in a Medspa. For example, Vitamin C peel works wonders for treating uneven skin tone, acne, scarring, fine lines, and wrinkles. The Vitamin C Peel sloughs off dead skin leaving you fresh and radiant. This also allows for you skin to better absorb that multitasking product you are using on your face. 

To book your facial peel or to schedule a consultation call 615-329-3900 today!

The Rise of Male Breast Reduction Surgery

The Rise of Male Breast Reduction Surgery

There are a surprising number of men who suffer from gynecomastia, a condition characterized by enlarged breasts due to an overgrowth of tissue. More and more men are becoming body conscious and Male Breast Reduction surgery is becoming a frequently requested procedure. But why are male breasts becoming enlarged in the first place? It appears the culprit includes everything from medication to lifestyle.


Gynecomastia can affect any male. Most often it is prevalent in pre-pubescent boys and men over 50. It’s actually caused by an imbalance in the estrogen and testosterone hormones. With an influx of estrogen, man boobs or “moobs” form. Because young boys haven’t hit puberty and adult men start to drop testosterone levels as they age, it’s a quite common occurrence. However, when adult men between the ages of 18-34 start to show larger breasts, the cause is usually from an imbalance within the body.

The cause of the imbalance

As of 2016, at least 40% of adult men suffer from gynecomastia. The reasons vary, but most are a result of medications or lifestyle choices. Antidepressants, liver, and heart pills are just some of the medications that can cause a development in extra breast tissue. Excess consumption of alcohol and high levels of stress can also have a serious effect on your body by throwing your hormones out of whack. Man boobs are also a common characteristic associated with obesity and overweight males.

The best candidates

The best candidates for Male Breast Reduction are those with a stable body weight and fairly elasticated skin. It should be noted, male breast reduction is not a substitute for weight loss and every effort should be made to lose weight before resorting to surgery. It’s also best to have realistic expectations of your results.

About the procedure

During your breast reduction procedure, your doctor uses a combination of liposuction and direct excision to remove the fat and glandular tissue from the breast area. The surgery requires general or local anesthesia (depending on the extent of your reduction) and is performed on an outpatient basis. Once the excess tissue is removed, you will be left with a flatter, firmer chest contour.

The downtime and side effects

Male breast reduction side effects include swelling and discomfort. Usually, your doctor will prescribe pain medication to help make the recovery process more comfortable. You’ll be given an elastic pressure garment that you’ll need to wear for about two weeks following the surgery to help reduce swelling. Once your stitches are removed, you can resume normal activities. However, strenuous exercise, sexual activity or anything else that may risk a blow to the chest should be avoided.

Dr. Jeffrey Marvel is one of the most recognized names in the Middle Tennessee area for surgical and non-surgical procedures. 

Are you ready to see what male breast reduction can do for you? Call 615-329-3900 to book your consultation today!

What is SlimLipo™ Liposuction?


SlimLipo LIposuction Dreaming of the perfect bikini body, but can’t seem to achieve the results that you want? You’re not alone. There are many of us who struggle with weight loss and have tried almost everything to achieve a slim, toned figure. If you are experiencing difficulty achieving the sleek shape you want SlimLipo™ might be the right option for you.

What is SlimLipo™?

SlimLipo™ is a new laser liposuction technique that uses laser wavelengths, to dissolve fat. With a few tiny incisions, this laser gently “melts” fat for quick and permanent results. This is a definite advancement over traditional liposuction since the procedure is minimally invasive and you can receive a slimmer look with shorter downtime.

Like other laser treatments, the improvements are multifaceted. Since the lasers stimulate skin cells into producing collagen and elastin, you can not only improve the contours of your body (with the removal of fat) but tighten up the skin in that area so you aren’t left with any sagging or wrinkles. The simplicity of the procedure makes it ideal for anyone looking to target small trouble spots like the arms, neck, and chin.

With SlimLipo liposuction we can treat almost any area of the body in both men and women, with very minimal discomfort. Anyone who has previously had traditional liposuction can also experience the benefits of SlimLipo™ if they wish to continue with a fat removal process.

Depending on the area being treated, this procedure can take as little as an hour, but the true assessment is best achieved by contacting us to talk about your options.

With spring just around the corner, now is a great time to explore your options. And for a limited time only, we are offering a special of only $900 per area!

Call 615-329-3900 or contact us today learn more or schedule a consultation today!


10 Questions to Ask Your Cosmetic Surgeon


Considering cosmetic surgery? Here are 10 questions to ask your cosmetic surgeon before embarking on your journey:

  1. Are You Board Certified?

An ABCS certification will give you the peace of mind that your surgeon is qualified to successfully perform their job.

  1. Would you suggest any alternatives?

A good cosmetic surgeon will discuss with you any alternative options to surgery you haven’t yet considered. These conversations will help you to establish a trusting relationship with your new surgeon.

  1. What does the preparation period look like?

Talk to your doctor about the steps you need to take prior to undergoing surgery in order to ensure you’re ready for the procedure.

  1. How much experience do you have with this particular procedure?

Ask your surgeon how many times they’ve performed your desire procedure in order to better understand their expertise.

  1. What are the risks associated with this surgery?

Understanding the complications that could potentially arise will help you to make an educated decision on whether cosmetic surgery is right for you.

  1. What will my recovery period look like after the cosmetic surgery is completed?

Not all surgeries will allow you to hit the ground running the day after they’re completed. While some may involve little recovery, others may require a longer time period.

  1. Do you have hospital privileges?

If your surgeon has hospital privileges, they will be able to continue to treat you should anything go awry during the surgery.

  1. Where will you perform the surgery?

Make sure that your surgeon only performs procedures at accredited locations.

  1. Check your doctor’s records.

Your state’s medical boards will provide you with extensive information about your surgeon that you will want to know before agreeing to use them for your surgery.

  1. Finally, create a list of your own questions to ask your surgeon.

Still have some lingering questions on your mind? Prepare yourself with a list of questions to ask your surgeon – it is their responsibility to educate you on the procedure you are considering.

Cosmetic surgery is a big decision. You deserve to have all the information about the procedure at your disposal before agreeing to undergo it. This list of questions will ensure that you and your surgeon create a healthy and trusting relationship before embarking on this experience together.

Need more information? Contact us today and we would be happy to answer any of your questions.

Mommy Makeover — Combination Procedure

mommy makeover combination procedure

Today’s women no longer have to hide or conceal the areas of the body they’re uncomfortable with following their pregnancy. Board-certified plastic surgeon Dr. Jeffrey Marvel offers a plastic surgery solution known as the mommy makeover. 

A mommy makeover is a combination of body-contouring procedures that work harmoniously to restore the figure you had before your body’s radical changes. Some of the more common procedures that go into a mommy makeover are the tummy tuck, liposuction, and breast augmentation.

For more details about the mommy makeover or to schedule an appointment for a consultation, contact Dr. Marvel’s Nashville office.