Liposuction Questions Answered

What Happens Prior to Liposuction Surgery?

Before liposuction surgery, a complete medical history is taken and a careful examination is conducted in order to evaluate your condition. During the consultation, your dermatologic surgeon describes the procedure and what results might realistically be expected. Your doctor also will review alternative treatment options and explain the possible risks and complications that may occur. Photographs are frequently taken before and after surgery to help evaluate the amount of improvement.

Liposuction Questions Answered

When is Liposuction indicated?

Liposuction surgery is most effective for removing localized fat deposits in body areas that do not respond to dieting or exercising. Liposuction surgery is not intended as a substitute for weight loss, but rather is a contouring procedure. It is best utilized in a program of exercise and optimal weight maintenance.

Liposuction surgery also has many valuable therapeutic applications and has been used effectively to treat medical conditions like excessive sweating and non-cosmetic fat accumulation, such as lipomas (benign fatty tumors) and gynecomastia (enlarged, male breasts.)

Mini Liposuction : Precise Results & Quick Recovery

One of the most sought-after cosmetic surgery procedures in recent years is liposuction surgery. While not exactly done as a replacement for dieting and exercise, liposuction surgery is designed to remove really stubborn areas of fat which just won’t go away with the more traditional methods of losing weight. Known as a body sculpting procedure, liposuction removes unwanted fat from the abdomen, hips, thighs, buttocks, upper arms, knees, neck, chin, and cheeks.

During the past few years, a number of newly-developed techniques or methods of liposuction have been helping many cosmetic surgeons provide more precise results and quicker recovery times for selected patients. Among these techniques are the ultrasound-assisted lipoplasty (UAL), the tumescent technique, the super-wet technique, and the “mini liposuction”.

First introduced by Beverly Hills liposuction specialist Dr. David M. Amron, mini-liposuction means exactly what the name actually implies: a shorter version of the liposuction procedure. Mini-liposuction is deemed the ideal method to use when making spot reductions in one or two stomach areas in persons who are closer to their ideal body weight. Simply put, a person who is slightly out of proportion because of one or two stubborn fatty areas can be made proportionate with the application of the mini-liposuction procedure.

Mini-liposuction focuses primarily on just one or two areas. The entire procedure, which normally just takes less than one hour of a patient’s time, involves the removal of less than one liter or 2.5 pounds of fat from the area being operated on. Furthermore, the whole mini-liposuction procedure can be done under local anesthesia, which means that a patient faces lesser risks. Most important of all, mini-liposuction will set a patient back by less than $2,500.

Among the areas of the body that mini-liposuction can take care of include those located around the knees, beneath the chin, above the breast at the armpit and behind the elbows. The mini-liposuction procedure can also be applied to other areas of the body which present a small amount of excess fat.

The whole mini-liposuction procedure, while tending to involve very minimal recovery time, can provide a patient with results that can only be described as dramatic.

But as with most cosmetic surgery patients, those who are considering mini-liposuction must have realistic expectations on the results the procedure can give them. If people think they can just undergo mini-liposuction just for the heck of it, they’ve got another think coming. Like what’s been said above, mini-liposuction, or any other liposuction procedure, is no substitute for dieting and exercise. While it definitely can help enhance the appearance and self-esteem of a person, mini-liposuction can’t change the way you look exactly the way you’ve fantasized. It is wise then to further contemplate your reasons for undergoing mini-liposuction before making your decision.

Liposuction Questions Answered

What is Liposuction Surgery?

Liposuction surgery is the removal of excess fat with a small, straw-like instrument called a cannula that is attached to a liposuction machine. The fat layer under the skin is converted to a network of tunnels and the cannula is manipulated within the layers to remove unwanted fatty deposits. An elastic garment is then worn for compression and healing. The result is a resculpting of bulging areas into more attractive contours.

Top 5 Reasons for Revision Liposuction

1. Disproportion
The surgeon has not paid attention to proper body proportion in his evaluation and has caused the patient to store fat in disproportionate and unbalanced ways. Typically, this is when the surgeon does liposuction surgery on an overweight individual who is perfectly proportionate. This can usually be greatly improved by targeting the imbalance with revision liposuction surgery to create a proportioned and balanced shape.

2. Asymmetry
Excess fullness in one area is usually very easy to improve or fix by targeting the asymmetric side with properly done revision liposuction surgery.

3. Not enough fat taken (too conservative)
This is also quite easy to remedy with subsequent revision. Although, I feel it is very important to achieve the best result the first time when I am doing the surgery. It is better to be more conservative than more aggressive, as it is easier to remedy.

4. Too much taken (too aggressive)
If the surgeon has been overly aggressive, especially in certain parts of the body where skin elasticity is poor, it can be difficult even in an expert’s hands to make things perfect. Usually, I can make significant improvements with a combination of fat grafting and skin tightening procedures and sometimes micro liposuction surgery at the edges of where too much fat was taken to blend the area.

5. Indentations, rippling, and ridging of the skin
This is usually caused by poking, jabbing or rasping the underneath part of the skin during liposuction surgery or by being too aggressive in areas with decreased elasticity. It can also be caused by liposuctioning in the wrong direction (ex: horizontally in the upper outer thigh). Depending on the patient, I do revision liposuction surgery to the whole area again with a very small spatula canula, perform a fat transfer and or do skin tightening procedures-such as thermage.

Liposuction - Learn About Each Area - Chest

The gynecomastia area is gravitationally prone. The male chest is a common area for liposuction. With age, the male chest tends to become fuller and drop with loss of elasticity in muscle and skin tone. The male chest is one area where I choose to be very aggressive in with fat removal. Like most areas, I approach each side from two directions to be through with the tunnels. I am careful to make sure that I get the area under each nipple completely, which is many times a combination of fat and glandular tissue.

Liposuction - Learn About Each Area - Neck

This is another gravitationally prone area. Try to catch this area earlier as opposed to later if there is any fullness. If it drops too much over time and there is loss of elasticity, a lower face and neck lift may be the only option. The majority of improvement from well done liposuction of the neck comes from the surgeon knowing how to get the maximum, even skin retraction. Although only minimal fat is generally removed, even the fattest necks, can see great improvement. I liposuction the neck in one of two ways:

1. Submental Liposuction- For those that have fullness only in there middle part of the neck, under the chin (mentum). In these patients, it is not necessary to liposuction the whole neck and access can be from one small incision under the chin.
   
   
2. Entire neck - For those that have fullness of the lateral neck, it is important to liposuction the entire neck up over the jaw line, and sometimes the jowls, to achieve an optimal result. If this patient has only submental liposuction from one midline incision, the central part of the neck will retract without the lateral neck retracting. The results will either look unnatural or incomplete. For these patients, I use three incision points: one under the chin and one under each earlobe. The worst and unavoidable result of neck liposuction is having to wear a chin strap for five to seven days full time and another seven to ten days part time. For this reason, unlike other areas where my patients can camouflage having had the procedure done under clothing, most patients have to take some off work to recover and heal in private.

Liposuction - Learn About Each Area - Anterior Thighs

This is another area that is rarely done by surgeons. One must be careful not to flatten the anterior thigh as a wider looking less feminine shape will result. But once again, if there is quite a bit of bulk (fat not loose muscle) the anterior thigh successfully can be de-bulked, if one stays in the deeper fat and knows how to approach this area from four directions. It is important to follow the shape of the leg so it looks natural from any when viewed from any angle. Additionally, if there is a lot of bulk to the anterior thigh and the outer or inner thighs are done, it may be necessary to blend those areas with the anterior thigh to achieve the proper contour.

Liposuction - Learn About Each Area - Buttocks

In general the buttocks themselves are rarely, if ever, liposuctioned. To get a better butt shape, I liposuction around the buttock -- outer thighs, hips, posterior, upper thigh also known as the banana roll. This, along with building good muscle tone (which is important almost everywhere) gives a smaller, rounder, tighter buttock. I will liposuction the buttock when the area is very protuberant and fat. Liposuction to the buttocks that are just flabby will tend to flatten and drop them. It is especially important to remember not to confuse fat with just flab, which is usually from poor muscle tone. In those rare individuals where I feel they are a good candidate for buttock liposuction, I stay deep (as this is an area prone to dimpling) and define the buttock being careful not to flatten it. When it is done properly on the right candidate, the buttocks will simply look smaller and slightly lifted due to decreased weight.

Liposuction - Learn About Each Area - Calves / Ankles

This is one of the more challenging areas to do as the surgeon must shape the whole lower leg, essentially all the way around from the knee to the ankle, to achieve a well-shaped contour. Many less-experienced surgeons avoid this area. Like other areas, I feel that where one places the incision points are crucial to a great result. The only way I have found it was possible to be consistently complete without jabbing the skin from underneath was to place two upper incision points toward the posterior lateral, knee and two lower incision points toward the lateral ankle.

Liposuction - Learn About Each Area - Arms

A gravitationally prone area like the back, the posterior upper arms tend to become flabby and drop if there is fullness. For this reason, I try to encourage women to do liposuction earlier, as opposed to later in their lives, if there is disproportion in this area. By reducing the amount of the fat in the area and getting skin tightening with proper technique the posterior upper arms stay tighter and more defined as time passes. This is important not only in the short term, but even more so in the long term, because an arm lift almost always leads to an unattractive scar.

Liposuction - Learn About Each Area - Back

This gravitationally prone area is a wonderful area to do if there is fullness. The skin is thick and prone to drooping, so I usually liposuction the mid and upper back as a unit. This is one area where the spatula cannula is used to scrape the dermis from underneath to get maximum skin tightening and lifting. The degree of skin tightening achieved is a blessing because there is no ‘back lift’ or back tuck.

Liposuction - Learn About Each Area - Abdomen

Another gravitational prone area, where I approach is the abdomen in one of two ways.

1. Central Abdomen - The upper and lower abdomen are done as a unit. In many individuals, if only the lower abdomen is done, the upper abdomen will not tighten from the liposuction and gets looser with time. When the entire area is done as a unit, not only does it blend well, but it a stays tight and firm. The central abdomen is prone to irregularities if not done well. Common mistakes are poking the skin with the cannula from underneath, which causes dimpling. Another mistake is being overly aggressive in individuals with poorer skin elasticity, causing loose, sagging skin. I find that I am able to still get a perfectly smooth result and achieve skin tightening in patients with poorer elasticity by having a lot of respect for the skin. In these patients, I recommend staying deeper in the fat layer and generally being more conservative. In all patients, I always crisscross the tunnels from either two or four directions, then finishes with a very small spatula cannula for a smooth skin surface. It is great mistake to approach the abdomen from only one access point. This will increase the risk of irregularities and leave a doughnut of fat around the belly button.
   
   
2. Upper, Lower Abdomen, Waist and Flanks - The other half of patients that I perform liposuction on in these areas have the abdomen done all the way around, as these individuals waists essentially need to be more defined.

Liposuction - Learn About Each Area - Flanks

Also known as the love handles, this is an area that is gravitationally prone where liposuction can be done as a preventative measure. The flanks or love handles are the most common problem area in men. This is a relatively straight forward area to do, as it is usually well-defined with good skin elasticity. It is a very important area to be treated preventatively as this area sits at the bottom of the back. Over time, this area can begin to bulge out over the jeans or waistband because of the weight of the back skin and muscle. This is an area where through liposuction I can create a sheet of fibrous tissue under the skin that causes tightening and pull back of the skin. This fibrous tissue keeps the area tight in the future.

Liposuction - Learn About Each Area - Hips

This area lies just below the flanks toward the upper, outer area of the buttock. In most women, it transitions into the flank area. I usually do the hip-flank as one unit in patients with disproportionate fullness. The hip-flank mound makes the buttock look square or boxy and takes away from the nice feminine contour between the waist and the buttocks. This area, as well as the outer thighs and saddlebags regions; are the most important areas to shape properly and result in a rounder, more well-defined buttock.