Liposuction

Q: I’m 5’4” tall and weigh 135lbs, exercise 3 times a week, and watch what I eat. Yet, I can’t seem to lose the bulges of my outer thighs, hips and stomach. Is there help for me?

A: I see many patients who share the same scenario. Despite exercise and diet, certain problem areas persist. These localized areas of adiposity or fatty deposits are in many cases genetic. Patients will often comment that others in the family share the same body structure. In some instances the problem areas develop after pregnancy or weight loss. No matter what the cause, the solution typically involves a so-called body contouring procedure. Body contouring can be classified into excisional and nonexcisional.

Nonexcisonal body contouring is simply another way to say liposuction (also known as suction-assisted lipectomy or SAL). Liposuction involves the removal of fat via small, access incisions through which thin metal rods or cannulas are inserted. These cannulas are attached to a specialized suction device so that as the fat is disrupted it is removed through the cannula. Liposuction also involves the injection of large amounts of fluid (tumescent fluid) just prior to the actual suctioning, which usually contains an anesthetic (lidocaine) as well as epinephrine, which constricts blood vessels and thereby minimizes bleeding and bruising. Most of this fluid is then removed with the fat. Traditional SAL is therefore a mechanical process of breaking up the fat and removing it with suction. Newer methods exist which also utilize ultrasonic energy to disrupt the fat (ultrasonic-assisted lipectomy or UAL) or vibration energy (power-assisted lipectomy or PAL). A well-trained, experienced, board certified plastic surgeon will use each as needed to obtain the optimal results.

The key for successful liposuction however is the skin. Once the fat is removed, the skin must shrink and reshape. Healthy, elastic skin will recoil. Older, sun damaged, stretch-marked skin will not. Which brings us to excisional body contouring. Excisional simply means “cutting away” the excess. Tummy tucks (abdominoplasty), arm lifts (brachioplasty), inner thigh lifts, and buttock lifts are all examples of excisional body contouring. The hallmark to all of these procedures is that not only must fat be removed, but excess skin must also be removed to obtain the desired result. In many cases, liposuction and excisional body contouring are combined. The main point to remember is that with significant skin excess or poor quality skin, liposucton alone will not solve the problem.

The final point to mention is that body contouring is designed to optimize shape. It is by no means a method of weight reduction. Patients must fall within 15-20% of their optimal weight before body contouring should be considered. If someone is more than 20% above their target weight then they should lose those extra pounds before proceeding with body contouring. Conversely, body contouring procedures also will not prevent future weight gain. So it is important to continue regimens that maintain your optimal weight.

During the initial consultation and examination, decisions will be made regarding the quality of skin and the quantity of fat excess so that the appropriate procedure will be selected to obtain the optimal results. For further information about body contouring procedures log onto www.drhainer.com or call me for a complimentary consultation.