In the past, liposuction involved 2-3 weeks of painful recovery with months of post-operative swelling. The results were many times mixed and patients with loose skin had little improvement. Now with the advent of laser and ultrasound assisted liposuction devices like SmartLipo™ and VASER® Lipo, this procedure has immensely changed. It requires an average of 7 days of recovery with a relatively painless post-operative course. Patients with loose, redundant skin who were not good candidates for liposuction in the past are now getting a second look. Although removing the unwanted pockets of fat has always been the standard, we now have the ability to tighten the skin from the inside. It is a real game changer.
The most desirable aspect of these SmartLipo™ procedures is that it is performed in my office suite. A surgical center or hospital is not required. There is no need to have sedation or general anesthesia and there is no need to pay expensive operating room or anesthesia fees. The procedure is completed under local anesthesia and with minimal associated pain or discomfort.
My patients love the results of this procedure and I have been pleasantly surprised by how much this device has transformed my practice. Our Aspen office is now the only Cynosure certified training center in the Western Colorado. We regularly train other surgeons and their office staff and I lecture nationally and internationally on the use of this device. Even though it began as a simple interest in an up and coming technology, it now is the most common procedure we perform on a weekly basis. This laser technology has given us the tools to magically melt the fat away, in the office.
Liposuction was introduced in the United States over 30 years ago. Initially popularized by both plastic surgeons and dermatologist, the safety record has been well established. In the past decade, this procedure has changed significantly with the introduction of newer technologies and surgical techniques.
Liposuction refers to the removal of unwanted areas of subcutaneous fat (fat that exist between the skin and muscle) with an aspiration cannula (metal tube that is the width of a straw and is hollow in the middle). The areas of fat are injected with tumescent fluid (a mixture of saline, lidocaine and epinephrine) before the fat is removed. With the addition of epinephrine and lidocaine, the surgery area is anesthetized, making the procedure fairly painless. Most importantly, general anesthesia or intravenous sedation is not required.
Liposcultping refers to the advanced surgical techniques that are often combined with liposuction procedures. Although other names like ‘Hi-Def’ are used, it all refers to the same approach. In our clinic, we use these techniques to improve the definition of the body while simultaneously removing unwanted fat. These consist of 80% of the cases we perform in the clinic and the results have continued to improve with the addition of VASER® Lipo and/or SmartLipo™ procedures.
Liposuction procedures are transformative. Those areas of unwanted fat that persist on the face, neck and body, even with active dieting and exercise, can be easily removed. This drastically improves a person’s appearance by improving the body contour and emphasizing body definition. In those individuals who have less fat and want more toning, advanced liposculpting techniques are used to give them a more athletic appearance. Although this is a highly advanced surgery, these techniques can really enhance definition, especially in those areas that are resistant to even the most intensive work out regimen.
Clearly, liposculpting is not meant for individuals with notable weight issues. Diet and exercise should be emphasized before proceeding with these types of procedures. Contrary to what some physicians may tell you, these procedures will not have a measurable change in the appearance of cellulite unless a separate cellulite treatment is added to the procedure regimen. Furthermore, it will have no affect on the appearance of stretch marks and may actually worsen their appearance.
Nearly all the areas of the body are potential treatment areas for liposuction. The standard areas for treatment include the upper and lower abdomen, flanks (upper hip), upper and lower back, bra line, saddlebags, inner thighs and knees. More advanced areas of treatment include the neck and face, breast, arms, buttocks, circumferential thighs, calves and ankles.
With a standard liposuction procedure, there is little associated skin tightening. For young patients with thick elastic skin, this is not a concern. But for patients with loose skin after pregnancy and weight loss, standard liposuction has the potential to make the treated area look worse. This is especially true for places like the neck, which often have loose skin related issues.
With the advent of ultrasound (VASER® Lipo) and laser (SmartLipo™) assisted liposuction devices, the concerns regarding loose skin have been greatly reduced. Due to their skin tightening abilities, these devices have revolutionized the body-contouring field and have allowed for the integration of more advanced liposculpting techniques. Over 90% of our body-contouring cases use VASER® Lipo and SmartLipo™ devices.
In contrast to standard liposuction, there is also an extreme reduction in post-operative swelling, bruising and discomfort with these devices. In general these devices reduce the recovery time and discomfort by 50%. With the addition of post-procedure Smooth Shapes treatments, the recovery time in some cases is negligible (limited to less than 1 week)
Although medical doctors of any specialty can attend weekend courses offered for liposuction training, these only address the rudimentary requirements to complete these procedures safely. On the contrary, 2 to 5 year plastic surgery fellowship programs universally focus on advanced liposuction training of the face and body. Therefore, a plastic surgeon certified by the American Board of Plastic Surgery would be the most well equipped to complete these procedures.
Once the competency of a liposuction surgeon is established, it is important to review the technology that they utilize for their procedures. Integration of newer devices like VASER® Lipo, SmartLipo™ and Smooth Shapes are integral to achieving superb results with advanced liposculpting techniques.
It is important to thoroughly review a surgeon’s credentials, before and after pictures and operative facilities before proceeding with a liposuction surgery. When in doubt, ask for patient references, specific to the area of the body being treated with liposuction. In the end, choosing a surgeon that has a focus on body contouring, and most importantly, advanced liposculpting procedures, will give a patient the best opportunity to have a desirable result.
Recovery from more advanced liposculpting procedures that utilize newer technologies like VASER® Lipo or SmartLipo™ on average is 7 to 10 days. If the procedure is completed in the office and is contained to 1 or 2 areas, the recovery time is reduced further. Most patients complain of only mild discomfort after surgery and that resolves within 5 to 10 days. Swelling and bruising does occur but is minimized with these devices. A compressive garment over the area of treatment will be worn daily for at least 2 weeks. Exercise can begin 2 weeks after surgery and clearance for full activity begins at three weeks after surgery. Return to work, depending on the job duties, can be as early as 3 to 4 days after surgery if needed. At 1 month after surgery, 90% of the healing will be completed and the final results are seen after 6 months.
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