- Liposuction
- Introduction
- How It Is Done
- Patient Photographs
- What to Expect After Surgery
- Complications
- Care After Surgery
- Frequently Asked Questions
- Abdominoplasty (Tummy Tuck)
- Massive Weight Loss
- Thigh Lift
- Liposuction of Arms
- Brachioplasty (Arm Lift)
- Buttock Augmentation
- Calf Augmentation
- Hand Rejuvenation
- Labiaplasty
- Tattoo Removal
- Laser Hair Removal
Liposuction - Frequently Asked Questions
Q. Does it hurt?
- The pain level is moderate and usually well tolerated. Patients tell me it is about what they expected.
Q. Does the fat come back?
- The fat cells removed by liposuction are gone forever. Fat cells that are left behind can swell if you gain weight and shrink if you lose weight, but the numbers are reduced forever. Liposuction offers a permanent improvement in body proportions.
Q. Where do you put the incisions?
- I use as few incisions as possible to cover the areas I need to treat. When treating the abdomen and flanks, there is one on either side of the pubic area and for each flank. These are placed so that they would typically be hidden by a bikini. The access incisions for the inner thighs are in the groin crease on each side. The outerthighs are accessed using the same incisions used to treat the flanks, and an incision on the lower buttock. The knee incision is tucked in the crease just below and on the medial side of the knee. (See Intraoperative Photographs) They fade with time and are usually inconspicuous. If any is objectionable, it may be revised.
Q. Do you leave the incisions open?
- Some patients have heard that the incisions are left open to allow fluid to drain out. Howerver, most plastic surgeons prefer to close them and allow any remaining fluid on the inside to be absorbed. This makes it easier for the patient because it is not as messy afterward. Also, the incisions heal better and with less scarring if they are sutured, as opposed to leaving them to heal in on their own.
Q. Do I have to wear a girdle?
- It sounds onerous, but most patients feel more comfortable in the garment after surgery. The garment helps limit swelling. You wear it for a month after surgery.
Q. Will liposuction help my cellulite?
- You should not expect much improvement in cellulite. Liposuction removes fat and improves proportions but is not primarily for smoothing skin irregularities. We still do not have a good treatment for cellulite. I certainly have had patients whose cellulite is improved after liposuction, but I am careful not to promote liposuction as a cellulite treatment. It is a body shaping treatment. If my patient has an improvement, that's great, but she should not expect it.
Q. Does LipoDissolve® work as well as liposuction?
- LipoDissolve®, a type of mesotherapy, involves injection of chemicals (one is phosphatidylcholine) under the skin to dissolve fat. It is being marketed by sales consultants as an alternative to liposuction. After all, who wants surgery if there is a non-surgical alternative?
- The problem is that there are no controlled scientific studies showing LipoDissolve® to be safe and effective. Unlike Botox®, which was used for treating wrinkles before being FDA approved for cosmetic uses (its safety being proven and FDA approval obtained for other medical uses), the FDA has not approved LipoDissolve® or phosphatidylcholine for any purpose. The American Society for Aesthetic Plastic Surgery recommends against LipoDissolve® until it has been properly evaluated.
Q. What are the risks associated with LipoDissolve®?
- Although non-surgical, and often performed by non-surgeons, LipoDissolve® is not without risks, including skin indentations, pigmentation changes and infections (which can be resistant to antibiotics). Unfortunately, plastic surgeons are now seeing unhappy patients who complain about painful injections, hard knots at the injection sites, and disappointment with the results. LipoDissolve® is being recommended to patients who would benefit much more from liposuction and tummy tucks.
Q. Is LipoDissolve® effective?
- According to the editor of the Journal of Plastic and Reconstructive Surgery (115:1425, 2005), "it is mind-boggling to think that a physician would inject patients – or that patients would allow physicians to inject them – with unknown, unproved substances based on hearsay and unsubstantiated clinical findings." And that it is "inconceivable" that plastic surgeons would embrace such a treatment.
- Liposuction, on the other hand, has been shown to be safe, effective, and is FDA approved. Ultrasonic liposuction selectively targets fat cells. The liquefied fat is then suctioned away so the body does not have to absorb it.
- This contrasts with LipoDissolve® injections, which cause the fat cells to die and then relies on the body's inflammatory response to "mop up" and absorb the dead tissue products into the body. Dr. Alan Matarasso states (115:1420, 2005): "To ensure some level of safety before using phosphatidylcholine in mesotherapy, it would be prudent to know the products of dissolution, whether or not free fatty acids are released into the patient's bloodstream, whether the injected chemical is absorbed into the bloodstream, the effects on the liver and other organs, the appropriate dose, and so on."
Q. Is LipoDissolve® expensive?
- LipoDissolve is not inexpensive. A series of treatments, usually five to ten, costs about the same as liposuction, about $5000.
- Are the results comparable? Readers can visit the LipoDissolve® websites to view photographs and compare these with the results of liposuction. Clearly, the volume of fat removed by a single liposuction procedure exceeds what can be achieved with repeated, multiple LipoDissolve®"spot treatments."
Liposuction is the only treatment that can provide comprehensive and continuous contouring involving all areas of the body. - For the patient who wants results, there is no substitute. Not surprisingly, liposuction is the most popular cosmetic surgical operation performed today.
