Archive for category liposuction pre-op tutorial
Here’s a good booty liposuction result:
This young woman had tumescent liposuction on the sides of her thighs and booty in my South Orange County practice. These areas in the thighs are also referred to as the “saddlebags.” It could also be said that she had saddlebag liposuction. Five weeks afterward she looks nicely improved.
Moderation is the key in good liposuction planning. The results of good plastic surgery withstand the changes of time much better than when we target extremes. She achieved a nice change in shape without rippling and irregularities. This was done safely in a clean operating facility under a short anesthetic.
John Di Saia MD
Reader Laura’s Comment:
The ladies in this story have had a “new” form of lipo instead of a tummy tuck. Their stomachs do look thinner but their skin in wrinkly. Would they have been better served by having a tummy tuck and then lipo? Is it just their age that has their skin looking that way?
VASER liposuction has been around for a while. I have used it and it is effective. The main question with newer lipo technologies is: “Are they worth the added expense and can they increase problems?”
Many of them (VASER included) make it even easier to take out more and more fat. As we have discussed here before of course more fat removal is not always desirable.
The concept of “oversuctioning” has been around far longer than these newer tweaked lipo technologies. It can happen with liposuction in any of its forms as each technique requires a judgment call. When a surgeon over suctions an area it can lead to an increased tendency for the skin sag unattractively making some of these people almost look like prunes. In the UK they are calling it “Turkey Tummy.” The age of the patient and any previous surgery are part of the story making the judgment call harder at times. Of course some patients will not agree to a tummy tuck even if it offers real skin tightening and this might also be part of the problem. I can do the “right” operation but only if the patient allows it.
John Di Saia MD
Originally posted 2009-12-30 07:30:54.
Not infrequently we see potential clients in the office who come in with requests foreshadowing later dissatisfaction. One of those statements is believe it or not: “I want lipo.” Yes, you read that right. Liposuction, one of the most popular of the cosmetic surgical procedures, does not deliver in all cases.
When people come in “shopping a procedure” it can be difficult to explain to them that their chosen operation might not get them where they might like. This goes part and parcel to the commercialization of plastic surgery. Ten or twenty years ago people shopped to find a good surgeon. These days clients more commonly choose their procedure and then shop to find someone to do it. This approach can produce problems at times.
When done correctly on the right client, liposuction is a pleasing operation with pretty low key recovery. It is substantially advertised and in this advertising the negatives are frequently minimized. This in part explains the attraction, but the actual procedure can be pretty limited in the results department. When patients coming in for lipo consults grab their tummies and say, “I want this gone” this is cause for concern. Lipo does not really make things disappear. It makes fatty areas smaller. Liposuction is the operation of “thinner.”
The best way to conceptualize this is that liposuction can make a person thinner if a significant amount of fat is present under the skin in the right areas. It will not make the skin tighter over the fat that is removed. Some areas are better treated than others. For skin tightening, a tummy tuck might be in order. The shape of your tummy relates to fat, as well as the quantity of skin and the muscle around that fat. Liposuction (including the tweaked versions of it – SmartLipo, Vaser and laser-assisted lipo) do not substantially affect anything other than that fat. I have used these “advanced lipo modalities” and have gone back to more traditional liposuction, as the results are quite similar and less costly. This of course assumes your surgeon knows what he or she is doing. Liposuction should not be performed by your local butcher. The unfortunate truth is that it has been.
When patients who might have been better served by tummy tuck surgery have tummy lipo, they sometimes complain of lumpiness and looseness afterward. This has been referred to as bad lipo. They are more like “not so great” lipo candidates who had lipo anyway.
When you want “tighter,” liposuction alone will not usually get you there. There are body lifts (of which tummy tuck surgery is one) that balance the benefits of tightening with longer incisions and larger scale surgery. When tightening is to be the main goal, skin more commonly than not must be removed and re-arranged. Sure there are scars but there are results too. Good surgeons know how to hide those scars and minimize them.
The common denominator is “good surgeons.” You need them when you consider plastic surgery so you can stay out of the news.
John Di Saia MD
Originally posted 2011-07-18 07:30:55.
I had abdominal liposuction in Los Angeles last year. Almost all the fat has returned to my entire trunk area. The Dr that performed to procedure did not advise me on how to eat or diet. What can I do now? I paid $4500 last June do I have to do it all over again or is there something else that would help my abdominal area? Please help!!
Liposuction removes fat but is not weight loss surgery. Some patients are better candidates for it than others. People in whom large weight swings are common have a high redo rate or are just plain unhappy. The best patients for this procedure are those with stable weight
Technically, the fat removed doesn’t “return.” The cells that were removed during surgery do not come back. Common thought is that new fat cells are not produced in the body after a patient’s twenties. You can however fill the fat cells that remain after surgery with more fat depending upon diet, exercise and your metabolism.
If you are looking for liposuction to take away your need to watch your diet and exercise levels, think again. In conjunction with sensible diet and exercise, it is a procedure with a very high satisfaction rate.
John Di Saia MD
BTW – Plastic surgeons rarely counsel you on eating or diet. This is not part of the considered norm for liposuction surgery.
Originally posted 2005-08-01 08:00:00.
NEW YORK (Reuters Health) – Liposuction that removes large amounts of body fat can be a safe option for managing obesity in select patients, a new study suggests.
The procedure is not right for all overweight adults, however.
Liposuction on overweight patients usually does not result in weight loss at least not long-lasting weight loss. There are occasional studies trying to promote this idea however. This one contradicts itself somewhat. Many board-certified plastic surgeons do not feel this is safe or advisable.
John Di Saia MD
Originally posted 2009-03-10 07:30:00.
I had tummy liposuction a year or so ago and my doctor removed 2000 cc. I didn’t lose weight but looked good. And now a year later my love handles are growing. I have a muffin top now and I am up 5 pounds. What gives? I thought I wasn’t supposed to gain weight after lipo. Is there some kind of guarantee?
First topic: Liposuction and weight loss.
Most patients don’t lose much weight after liposuction. Liposuction is a contouring procedure.
Second topic: Liposuction will not keep you from gaining weight. It tends to change how you gain weight though.
The best liposuction candidates are those who have their weight in a stable range (a few pounds) and still have problems areas. If you have weight fluctuations before liposuction, the surgery will not prevent you from having them afterward. Liposuction tends to change the way you gain weight (and where) and this varies between patients.
When used on patients with persistently fatty areas and good skin despite a good diet and exercise plan, liposuction usually works well. Determining who might be the best candidates takes experience and honesty.
Third topic: Liposuction guarantees?
Liposuction is presented differently by different practices. I do not know how it was presented to you before you had it. I am honest with my patients.
Personally, I find practices that guarantee results with liposuction amusing. How can anyone guarantee that another person will not gain weight after any procedure? Patients can even gain weight after gastric bypass surgery. Even the best plastic surgeon can’t in good faith guarantee that someone’s metabolism and appetite will not throw a monkey wrench into his surgical results.
I do guarantee that I remove fat if it is there and I can show patients images of that fat. I advise them appropriately before and afterward and do a quality operation. That is really all that a qualified plastic surgeon can guarantee. The rest is up to the patient.
John Di Saia MD
Originally posted 2009-10-15 07:30:12.
If fatty tissues are available, liposuction can decrease them. You may stand to get “thinner” with liposuction, but you don’t want to have to much fat removed. A thin and even pad of fat on the skin flap is needed to keep you from looking weird. Removal of too much fat tends to leave the treated area looking irregular and bumpy.
Remember Tara Reid in the midst of her liposuction ordeal? Like Tara, patients who have been “oversuctioned” tend to look “moth eaten.” The skin’s surface loses its even contour. In some cases a “cobblestone” appearance is seen. This is very hard to fix. Avoid it.
If you are looking for tightening of the tissues, liposuction isn’t it. In this case, skin resection and /or muscle tightening (like a Tummy Tuck) might be in order. Body Lift surgery is the category of skin tightening surgery in which tummy tuck surgery belongs. There are other body lifts named for the area in which they are used.
John Di Saia MD
Originally posted 2005-07-10 22:10:00.
I’m 110lbs over normal weight. I can’t seem to lose the weight. Is lipo a good idea for me? Besides my weight I’m healthy.
Liposuction is not a “cure” for weight problems. By the way you phrased your question it looks like that is your main goal. You are better off losing weight and getting into a stable range and then using liposuction for fine tuning if at all.
Overweight patients who have liposuction tend to put the weight back on and lose far less than they had hoped when all is said and done. Their remaining fat cells simply overfill with fat and/or new areas that were not problematic before surgery are recruited for more fat storage after surgery.
The bottom line is that really overweight patients who have lipo tend to gain the weight back later. Look elsewhere.
John Di Saia MD
Originally posted 2010-05-19 07:30:33.
We have discussed liposuction and the multitude of gimmicks that have been applied to it before. Over the years, I have used a fair number of liposuction modifications to see if the results were worth the expense.
In 2008, I performed over a hundred Smart Lipo procedures while contracted to a marketing company. While I do not think Smart Lipo is any worse than tumescent liposuction, I did not find it to be any better. I am able to get the same results with the modified tumescent liposuction set up that I have been using for years. The “Skin Tightening” aspect of the Smart Lipo system was vastly overstated by the product representatives by my evaluation anyway.
Smart Lipo and some of the other liposuction modifications are in my opinion more marketing gimmicks than ground shattering technological advances. If you want to spend your money on them, that is fine. Your ultimate results however are more a function of your surgeon’s skill and the problem for which you seek surgery than the technology that may have attracted you.
That is Dr D’s truth.
John Di Saia MD
Originally posted 2010-12-17 07:30:55.
The case of Dr. Ehab Mohamed — who first came under fire after a series of investigative reports by KNX 1070 — has taken a very dark and tragic turn: one of his patients has died. Dr. Ehab Mohamed, an Encino-based OB/GYN, was charging as much as $650,000 for some procedures, yet allegedly lying about his credentials. Now, a wrongful death suit has been filed and the LAPD thinks a crime may have committed after 61-year-old Sharon Carpenter Nicholson died on Mohamed’s operating table. Carpenter had undergone a $100,000, day-long liposuction procedure.
Another non-plastic surgeon loses a patient during a “cosmetic” procedure. This $100,000 all day liposuction case by an OB/GYN doctor was punctuated by the patient’s death as her husband waited nearby. You have to wonder if the patient spent any significant amount of time looking into this doctor’s credentials. She was paying roughly ten times the going rate for even large scale liposuction performed by a real plastic surgeon. I write this as a board-certified plastic surgeon who was actually trained in how to do this operation safely in residency and has been consistent in advising against marathon cases. Eight hours of liposuction is risky. I operate my liposuction patients under shorter safer conditions and have a perfect safety record. This case will undoubtedly be reviewed by the California Medical Board. Despite the fact that I am in their expert reviewer program, I will not be the reviewer after writing this.
While I sympathize with the family on this tragic case, it very likely could have been avoided. People need to get into the habit of checking up on their prospective surgeons before allowing them to operate. I have discussed how this can be done pretty easily on my web site.
John Di Saia MD