Posts Tagged liposuction
New Fat Doesn’t Return After Liposuction Study
Posted by admin in Dr D's Truth on April 29, 2013
The new study, evaluated 301 patients having liposuction, either alone or in combination with abdominoplasty, using standardized photographs and computer-assisted measurements of body dimensions obtained preoperatively and at least three months after surgery. The study revealed no evidence of fat regrowth in treated areas of the arms, abdomen, or lower body. Additionally, upper body dimensions were unchanged after surgery, indicating no fat redistribution. Average reductions in hip measurements remained significant in patients followed one year or more after both liposuction and combined liposuction/abdominoplasty procedures. The average hip reduction was significant even among a subgroup of 34 patients who gained five pounds or more after surgery.
Source: plasticsurgery.org/News-and-Resources/Fat-Cells-Don%E2
%80%99t-Return-to-Treated-or-Untreated-Areas-After-Liposuction-ASPS-Study-Finds.html
We have discussed fat returning after liposuction before.
Despite the fact that liposuction removes fat, it is not weight loss surgery. People have a hard time realizing this in part because advertising demonstrates the opposite picture usually.
People in whom large weight swings are common have a high redo rate or are just plain unhappy with liposuction. In their cases, weight tends to come back. The best patients for liposuction are those with stable weight.
Technically, the fat removed doesn’t “return.” The cells that were removed during surgery do not come back. You can however fill the fat cells that remain after surgery with more fat depending upon diet, exercise and your metabolism. In this newer study, it should be noted that tummy tuck surgery was included which has better long term rates of fat removal than other operations.
So both the study showing fat returning after liposuction and this newer one showing fat not returning after liposuction and tummy tuck surgery can both be correct…in the right patient groups. It depends upon the general conditioning of your average liposuction patient and this varies.
As always patient selection and consent are all important in choosing your procedure and your surgeon; that is, if you want that fat to stay off.
Best Regards,
John Di Saia MD
Related:
Originally posted 2012-08-01 07:30:57.
“Best OC Tummy Tuck Surgeons” – A Reader Comments
Posted by admin in Dr D's Truth on April 22, 2013
Looking online you look like a “dark horse” candidate for a list of best oc tummy tuck surgeons. I see your results look nice and your medical board sheet is clean. You write that you don’t do liposuction with your full tummy tucks though and you keep your patients overnight with a private nurse. How do you get tight looking results without the lipo and is the overnight really necessary?
Thanks for the kind words “best oc tummy tuck surgeons” although the “dark horse” part is kinda plus and minus. 
Lipo really doesn’t tighten anything. In tummy tuck surgery it is the design of the tissue removed and the closure that does that. The blood supply of the tissue after a tummy tuck makes lipo (in my opinion) risky if done too aggressively. I see my tummy tuck patients with less swelling and with a better shorter recovery since I dropped the flank lipo years ago. I do not make “Swell Hell” patients very often and my skin necrosis rate is very low.
The overnight stay with the private nurse is mainly for leg vein clot prophylaxis as well as to teach patient the “dos and don’t s” of tummy tuck post-op before they go home. I insist upon overnight stays of this sort for anything over a minor tummy tuck in a really healthy patient. The cost is nominal and my safety record has been really great.
I guess I have a defined philosophy for tummy tuck surgery and thus far it has worked pretty well.
Best Regards,
John Di Saia MD
Related:
Dr D’s Practice Web Site Tummy Tuck Section
Originally posted 2011-07-01 07:30:51.
Reader Laura Asks about Water Jet Lipo – Breakthrough or Bull?
Posted by admin in Plastic Surgery Tech Gimmicks on April 22, 2013
Reader Laura Question:
I was wondering if you had heard of or are using this new method. What are your thoughts on this new procedure? Are there more or less risks with this?
Over its history, liposuction has had more gimmicks applied to it than just about any other cosmetic procedure. Some would have easily fit into a late-great Billy Mays’ commercial. This new potential gimmick is called Water Jet Lipo or Aqua Lipo. It reportedly uses water to break up the fat cells to allow their removal.
Amongst the liposuction techniques / advertising terms we have on the menu at present are:
- Tumescent liposuction (pump the tissue up with fluid first)
- Vaser liposuction (ultrasound used to break up the fat)
- Smart Lipo (laser used to melt the fat)
and now
- Water Jet Lipo (water stream used to break up the fat) – also marketed as body jet liposuction and body-jet liposuction.
Each of these are marketing terms for versions of a liposuction system. They are all currently in use. I have used the first three at one time or another and have found that the results are very similar. In my practice I most often use a modified tumescent liposuction technique which works well and is reasonably cost effective. The “added technology” techniques add to the price tag of course.
My conclusion:
Technology adds a selling advantage to liposuction. Even the representatives who sell the systems come to the office mainly touting how their system will enhance sales. The technical aspects are very similar with occasional small advantages in specialized situations. I will not be rushing out to spend big bucks on any new technology unless good studies show it is significantly better than that which I already use. Those studies are few and far between.
Best Regards,
John Di Saia MD
Related:
Dr D’s Website “Liposuction Index”
Originally posted 2009-08-31 07:30:44.
Tickle Lipo – Breakthrough or Gimmick?
Posted by admin in Dr D's Truth, Plastic Surgery Tech Gimmicks on April 22, 2013
Liposuction is plastic surgery’s “gimmick procedure” having had more angles applied to it than a child’s toy. There is however money to be made in fat reduction so the gimmicks will just keep coming.
Enter Tickle Lipo, a new technology superimposed on the liposuction game. In this newer version of the basic liposuction technique, the cannula, the instrument used to remove the fat, vibrates like a whip inside your fatty layers. This supposedly helps remove the fat more evenly and with less pain.
Tickle Lipo looks like a hybrid between two other forms of lipo already on the market – power-assisted lipo (Pals) in which a motorized cannula breaks up the fat and ultrasonic lipo in which sound waves do it. Will Tickle be better or worse than its fat sucking competitors? That will likely depend upon the technology and the skill of those who handle it.
A funky high tech instrument will not make a non-surgeon into a master plastic surgeon just like a hot race car will not make me into Jeff Gordon. Check the credentials of anyone who wants to use this thing on you and go from there. At this point I would consider Tickle an experiment.
Best Regards,
John Di Saia MD
Related:
Dr D’s Website “Liposuction Index”
Originally posted 2011-02-07 07:30:59.
Age Specific Plastic Surgery – Possible Reasons Why
Posted by admin in Dr D's Truth on April 22, 2013
The American Society of Aesthetic Plastic Surgery publishes statistics every year indicating which cosmetic operations are on the rise. A journalist at the OC Register asked a group of plastic surgeons why this might be. Being that I am opinionated (why do you think I blog here,) I figured I’d take a shot at some of these:
I. Statistic: TEENS – Nosejobs and Otoplasty (commonly referred to as “ear pinning”) on the rise
Dr D: Part of the development of the teen psyche involves becoming aware of social norms. As they do this, they also become aware of differences and develop standards of beauty. Many of these teen nose jobs are justified as medically-needed, but appearance usually factors in. Otoplasty is a similarly social operation.
II. Statistic: YOUNG ADULTS – Breast implants. Ages 19-34. 166,000 a year. (ASAPS)
Dr D: “Beauty standards” are important motivators here as well. Young adults in the workplace (and social groups) see those around them doing these things and often being complimented. Some of these patients may also be seeking after childbirth “body repair.”
III. Statistic: EARLY MIDDLE AGE – Liposuction. Ages 35-50. 143,000 a year. (ASAPS)
Dr D: A slowing metabolism in this age group combined with more involved work schedules (with increased sedentary time) equals increased trouble “holding back the fat.” Liposuction is easy and can help with that. Add some post-pregnancy issues here as well.
IV. Statistic: YOUNG ADULTS – Botox. Ages 19-34. 371,000 a year. (ASAPS)
Dr D: The fad of Botox use in the really young is an advertising phenomenon as there is no good reason for young people to do this other than to “feel” hip.
My opinions of course.
Best Regards,
John Di Saia MD
Originally posted 2011-07-04 07:30:33.
Reader Question: High Def Lipo Versus SmartLipo?
Posted by admin in Dr D's Truth, Plastic Surgery Tech Gimmicks on April 15, 2013
I want liposuction to make my belly flatter after babies. There are so many different types though. Which is better SmartLipo or Hi Def Lipo?
Welcome to the wonderful world of marketing in plastic surgery. Your attention has been captured by two of the companies that market in the area of liposuction – Sound Surgical Technologies (SST) and Cynosure. SST makes the Vaser Hi Def system and Cynosure makes the Smartlipo platform. Vaser uses ultrasound to liquefy your fat and Smartlipo uses a laser.
Is one system better than the other or better than traditional liposuction for you? Probably not.
You would be better served looking for a good doctor in your area than centering upon a marketed platform which may not may not benefit you. Let your doctor guide you. That is part of the care for which you pay him or her.
Best Regards,
John Di Saia MD
Originally posted 2011-05-23 07:30:18.
Tummy Tuck Redo – Orange County, California
Posted by admin in "Good Plastic Surgery in the OC", Dr D's Patients, Dr D's Truth on April 8, 2013
Previously I discussed the relative reluctance of plastic surgeons to post images of revisions. Tummy Tuck Redo surgery can offer good results when the patients are properly chosen and the surgery is carefully focused. Not everything can be easily fixed of course.
“M” is a lady who had had a tummy tuck twenty years prior. After she visited another surgeon she had additional upper abdominal liposuction some years later. She never got the tightness she had wanted from that liposuction so later she considered revision of her tummy tuck. She did very well with her redo tummy tuck. Her pre-operative skin excess was greatly improved and the hollows created by the prior liposuction were also corrected in part. Not seen well in these images is the “puffy pubis” (commonly called a Ken Doll) she had following her original surgery. This was also nicely improved via her revision.
She is quite pleased with her smoother sexier appearance.
Best Regards,
John Di Saia MD
Related:
Dr D’s Standard of Care for the Best Tummy Tuck
Originally posted 2011-12-16 07:30:06.
Why Tara Reid had a Ripply Stomach
Posted by admin in Dr D's Truth on April 1, 2013
Tara Reid’s ripply stomach was an internet phenomenon for years. She had obviously had liposuction. What went wrong?
More likely than not, overzealous liposuction left those marks. This is really irregularity in the fatty layer beneath the skin. In order to maintain a smooth contour to the skin, there needs to be fat between the skin and muscular layer. Preferably, this layer should be even.
Here is an image of a woman that came to the office requesting that I repair her abdomen after a well-known plastic surgeon had performed liposuction:
Her smoking history made surgery ill-advised, therefore I was unable to help her.
The bottom line is that it is best to be conservative in liposuction cases. We don’t want to take all the fat. You need just a bit and this is why.
Best Regards,
John Di Saia MD
Originally posted 2005-05-14 08:47:00.
Liposuction- The Truth
Posted by admin in Dr D's Truth on November 26, 2012
I get hassled about my take on liposuction gimmicks once in a while. To some other surgeons in Orange County, it is as if I am pissing on the very thing that makes your local plastic surgeon a living.
While I reserve the right to poke fun at what I see as the myriad of liposuction gimmicks out there, the main point is that liposuction can be a good procedure in the right patient. Whether or not the purportedly “newer and better” liposuction modalities (Smart Lipo, Vaser, Aqualipo and the like,) are really any better is debatable.
As liposuction modifications have been marketed with more hyperbole than seen in a late Billy May’s commercial, people have begun to think of these trademarked systems in progressively more unrealistic terms. Americans are suckers for technology and the marketing types know it.
A related problem is that liposuction is used in many patients for whom it is not the best idea. This again has more to do with liposuction becoming a commodity as opposed to an operation.
The Bottom Line:
Liposuction is best for people with relatively stable weight who have fatty deposits that remain despite diet and exercise. It is not a weight loss procedure but rather a body contouring operation. Some areas are more treatable than others. The skill and judgment of the surgeon are primary and pivotal in the outcome and the effectiveness of any one liposuction system over another is widely open to debate and may be more of a matter of advertising appeal than medical fact.
Best Regards,
John Di Saia MD
an Orange County Plastic Surgeon
Originally posted 2011-03-21 07:30:40.
OC Weekly $3000 Breast Implant Ads – and a Story
Posted by admin in Dr D's Truth on October 11, 2012
As some of you might know I serve as an expert witness for the California Medical Board in cases of suspected negligence and malpractice. Not long ago I testified in a case of a not-so-qualified doctor (my opinion) in a liposuction death. Remember as the medical expert in this case, I reviewed the doctor’s training and experience. It was so weak that he would have failed a hospital credentials committee evaluation for sure. Unfortunately, these cases are confidential and I can’t divulge the name.
What I can divulge is that leafing through the OC Weekly recently I saw an advertisement by the aforementioned doctor offering incredibly inexpensive breast implant and liposuction work. I wonder if his dead former patient found him in these ads. Be careful when you select a surgeon this way.
Really.
Best Regards,
John Di Saia MD
Originally posted 2011-03-16 07:30:57.
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