How I Do Liposuction
Liposuction, Lipoplasty, Liposculpture, Suction Assisted Lipectomy (SAL)
All the above names refer to the exact same procedure, which uses a metal or plastic cannula inserted under the skin to remove fat cells under vacuum suction power.
Different Liposuction Techniques
Combines Saline salt solution, Adrenaline and local anesthetic which is injected into the fatty areas to lessen bleeding during Liposuction.
Combines Saline salt solution, Adrenaline and local anesthetic in large amounts which is injected into the fatty areas to lessen bleeding during Liposuction.
Ultrasonic energy is used to liquefy the fat before it is removed.
Internal - The Ultrasonic energy is delivered directly to the fat via a long thin (1/4 inch diameter) rod that emits ultrasonic waves (Internal). This rod is inserted into your fat through a small incision. The liquefied fat is then suctioned out.
External - Ultrasonic energy is passed from the outside through the skin instead of under the skin. The effects of the energy are lessen when passed through the skin.
What I Like & Why
I like the WET TECHNIQUE because I find it gives the correct amount of hemostasis (constriction of blood vessels) without the effects of distorting the area I wish to Liposuction.
Because the Tumescent technique swells the tissue with large amounts of injected fluid, for me this makes it more difficult to judge how much fat I am removing with Liposuction. It also adds the risk of the body absorbing to much of this fluid into the cellular system and getting a condition called "Fluid Overload".
Smart Lipo, LipoZap, EZ Lipo, Laser Lipolysis all the above terms referred to the exact same procedure which involves using a Laser during Liposuction.
The procedure works by inserting a small cannula (tube) containing a laser fiber under the skin. The cannula is moved back and forth delivering the laser’s energy directly to the fat cells, causing them to rupture and drain away. The laser energy may result in some skin shrinkage.
Claims & What I Think About Using Lasers During Liposuction
Although, the claims about Smart Lipo, LipoZap, EZ Lipo, Laser Lipolysis sound fantastic, minimal bleeding no anesthesia and great skin tightening, I do not recommend this treatment over traditional Liposuction for the following reasons:
Burn damage to the skin, similar to that of the Ultrasound Liposuction technique from the heat of the Laser.
Traditional Liposuction must stilled be used when Laser Liposuction is performed.
Lastly, Smart Lipo, LipoZap, EZ Lipo, Laser Lipolysis uses a Laser it has several problems which is why I don't like this technique. Because the Laser melts fat by using heat, the fat can be melted too much in one spot leading to lumps after healing. Also, the Laser must not be directed too close to the skin so the heat from the Laser doesn't leave a skin burn.
Injecting a Solution to Dissolve Fat - Lipolysis
Lipodissolve, LipoZap, Fatdissolve, Mesotherapy, Mesosculpturing, Lipotherapy, Lipostabil, Flab - Jab all these terms referred to the same procedure which uses Phosphatidylcholine based injections to dissolve the fat.
Over several sessions the solution is injected into the prominent fatty areas and into different depths fat under the skin. Some mild swelling and irritation results and the fat continues to dissolve over a few months period of time. Final results may take months to realize.
Claims & What I Think Injections For Dissolving Fat
The promise of Lipodissolve, LipoZap, Fatdissolve, Mesotherapy, Mesosculpturing, Lipotherapy, Lipostabil, Flab - Jab, a non-surgical, permanent method for fat removal and body contouring to make you thinner is obviously very appealing. I do not recommend this procedure for the following reasons:
Injecting any dissolving solution risks uncontrolled results. In other words, the solution may dissolve more fat than wanted or less in another area resulting in unevenness and dimpling of the skin.
Having dealt with fat injections, fat transfers and other Plastic Surgery procedures involving fat, I know the Fat Necrosis is an important risk. Fat necrosis is the destruction of fat, without all the fat being removed. This can leave hard lumps in the area, that my get worse over time.
The FDA has not approved this solution for use.
American Society for Aesthetic Plastic Surgery (ASAPS) Position Paper -Warns Patients to Steer Clear of Injection Fat Loss Treatments
New York, NY (May 14, 2007) - The American Society for Aesthetic Plastic Surgery (ASAPS) released today a warning against the use of injection fat loss treatments. Patients are advised to avoid these procedures, which are commonly known as lipolysis, mesotherapy, or the brand names Lipodissolve and Lipostabil. Although marketed as fat loss treatments, these procedures are scientifically unproven, lacking any objective data on safety and efficacy. In addition, none of these procedures has received FDA approval, with the ingredients poorly defined. The procedures may also be offered by persons without sufficient medical training, thereby putting patients at risk of harm.
My Experience and What I Think is Really Important
Absolute DON'Ts of Liposuction
Don't undergo large volume liposuction, defined as greater than 5000cc of removal in an office based setting.
Don't injected the fat into the breast for enlargement, since most of the fat dies and creates lumps that will be difficult to distinguish from a real breast cancer mass.
Don't have fat removed from the cheeks (unless absolutely necessary), because it will cause a skeleton like look to your face as you age.
What Happens to the Skin and Fat after Liposuction?
I know that the fat doesn't return, so there is no worry of this. However, the fat cells that remain in the area will still be able to enlarge if you gain weight.
You do not have to worry about the body becoming uneven because of weight gain after Liposuction.
I know the skin shrinks and tightens after Liposuction, but that this varies depending on:
Age, Looseness of the Skin, Sun damage to the Skin and Genetics
Certain areas of the body tighten the skin more than other areas.
The greatest skin shrinkage is seen in the: Lower Abdomen, Knees and under the Chin
Poor skin shrinkage is seen in the: Upper Abdomen and Arms
I still like the Traditional Liposuction, it give excellent and consistent results without the worry of burning and creating scars to the skin from the heat, such as when using Laser Liposuction or the Ultrasonic technique.
For Liposuction and Lipoplasty
from Dr. Costanzo of Thousand Oaks
This Board Certified Plastic Surgeon
805 / 373-9919
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