How I do Liposuction

Liposuction, Lipoplasty, Liposculpture,
Suction Assisted Lipectomy (SAL)

all the above refer to the exact same procedure, which requires a metal or plastic cannula inserted under the skin to remove fat cells under suction power.

 

Techniques of Liposuction

Wet technique: Injected into the fatty area to lessen bleeding during Liposuction.  Combines Saline solution, Adrenaline and local anesthetic.

Tumescent technique: Injected into the fatty area to lessen bleeding during Liposuction.  Combines large amounts of Saline solution, Adrenaline and local anesthetic.

Ultrasonic technique: Ultrasonic energy is used to liquefy the fat before it is removed.

Internal - The ultrasonic energy is delivered directly to the fat via a long thin (1/4 inch diameter) rod that emits ultrasonic waves (Internal). This rod is inserted into your fat through a small incision. The liquefied fat is then suctioned out.

External - Ultrasonic energy is passed from the outside through the skin instead of under the skin.  The effects of the energy are lessen when passed through the skin.

 

What I like and Why

 

 

I like the Wet Technique because I find it gives the correct amount of hemostasis (constriction of blood vessels) without the effects of distorting the area I wish to Liposuction.

The Tumescent technique for me makes it more difficult to see what you how much fat I am Liposuctioning and adds the risk of the body absorbing to much of this fluid and getting a condition called "Fluid Overload".

Laser Liposuction

 

 

 

Smart Lipo, Lipo Zap, EZ Lipo, Laser Lipolysis all the above terms referred to the exact same procedure which involves using a Laser during Liposuction.

The procedure works by inserting a small cannula (tube) containing a laser fiber under the skin. The cannula is moved back and forth delivering the laser’s energy directly to the fat cells, causing them to rupture and drain away. The laser energy may result in some skin shrinkage.

The Claims and What I Think

 

Although, the claims sound fantastic, minimal bleeding no anesthesia and great skin tightening, I do not recommend this treatment over traditional Liposuction for the following reasons: 

Damage to the skin, like with the Ultrasound Liposuction technique from the heat of the Laser. 

Also, even when using the Laser, traditional Liposuction must be done. 

Lastly the Laser gives less control over the results because the Laser energy may be applied unevenly during the Liposuction procedure.

 

Injecting a Solution to Dissolve Fat

Lipodissolve, Lipo-Zap, Fatdissolve, Mesotherapy, Mesosculpturing, Lipotherapy, Lipostabil, Flab - Jab all these terms referred to the same procedure which uses Phosphatidylcholine based injections to dissolve the fat.

Over several sessions the solution is injected into the prominent fatty areas and into different depths fat under the skin.  Some mild swelling and irritation results and the fat continues to dissolve over a few months period of time.  Final results may take months to realize.

The Claims and What I Think

 

The promise of a non-surgical, permanent method for fat removal and body contouring to make you thinner is obviously very appealing. I do not recommend this procedure for the following reasons.  

Injecting any dissolving solution is risks uncontrolled results.  In other words, the solution may dissolve more fat than wanted and less in other areas resulting in unevenness and dimpling of the skin.

Having dealt with fat injections, fat transfers and other Plastic Surgery procedures involving fat, I know the Fat Necrosis is an important risk.  Fat necrosis is the destruction of fat, without all the fat being removed.  This can leave hard lumps in the area, that my get worse over time.

The FDA has not approved this solution for use.

Medical Warning about Injections to dissolve fat:

American Society of Plastic Surgeons (ASPS)

American Society for Aesthetic Plastic Surgery (ASAPS)

 

My Experience and What I Think is Really Important

Absolute DON'Ts of Liposuction

Don't undergo large volume liposuction, defined as greater than 5000cc of removal in an office based setting.

Don't injected the fat into the breast for enlargement, since most of the fat dies and creates lumps that will be difficult to distinguish from a real breast cancer mass.

Don't have fat removed from the cheeks (unless absolutely necessary), because it will cause a skeleton like look to your face as you age.

 

What happens to the Skin and Fat after Liposuction?

I know that the fat doesn't return, so there is no worry of this.  However, the fat cells that remain in the area will still be able to enlarge if you gain weight.    You do not have to worry about the body becoming uneven because of weight gain after Liposuction.

I know the skin shrinks and tightens after Liposuction, but that this varies depending on:

Age, Looseness of the Skin, Sun damage to the Skin and Genetics

Certain area of the body tighten the skin more that other areas.

Great skin shrinkage is seen in the: Lower Abdomen, Knees and under the Chin

Poor skin shrinkage is seen in the: Upper Abdomen and Arms

I still like the traditional Liposuction, it give excellent and consistent results without the worry of burning and creating scars to the skin from the heat when using Laser Liposuction or the Ultrasonic technique.

How I do My Liposuction

 

General anesthesia:

I prefer this over Tumescent technique which uses only Local Anesthesia.  This is because I can always be more aggressive at removing the fat.  If you are awake, you may still feel some pain which can disrupt my concentration and limit the aggressive removal of fat.

Compression Garments:

I find that if you wear a compression garment for a month, while making sure your skin stays smooth under the garment, this will improve skin shrinkage and overall smoothness in the following the Liposuction.

The Surgery:

1 to several hours depending on the number of areas to be Liposuctioned

Out-patient or same day surgery

Pain is moderate and easily controlled with pain medication

Restriction of activities is generally for 3 weeks

Time off work can be as little as a few days

For Information on Liposuction, Lipoplasty and SAL Suction-Assisted Lipectomy, Lipodissolve,Smart Lipo, Mesotherapy, Lipo Zap visit Dr. Costanzo in Thousand Oaks, a Plastic and Cosmetic Surgeon, Board Certified in Plastic Surgery and trained at the world famous Mayo Clinic.  He performs Liposuction and Lipoplasty Beverly Hills Style for individuals in Southern California, Beverly Hills, Los Angeles, Encino, Sherman Oaks, Chatsworth, Woodland Hills, Tarzana, Granada Hills, West Hills, Malibu, Calabasas,Agoura, Oxnard, Simi Valley, Moorpark, Camarillo, Santa Barbara, Los Angeles County, Ventura County and Santa Barbara County. Call for a free consultation with an experienced Plastic Surgeon in Liposuction.