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With New techniques

Liposuction Tops the Charts


In many ways, 47-year-old Lisa Amorosa, a trust advisor for a wealth management firm in Orlando, Florida, was like many people who think about, and then have, liposuction. Lisa hated the saddlebags on her thighs and had tried every possible exercise routine and diet she could find. But nothing worked. Lisa stands only 4-10 so the extra weight on her diminutive frame really stood out.

Before & After Lipo
Lisa had one other surgical rejuvenation from Kenrick Spence, M.D., an Orlando plastic surgeon, so she made another appointment to ask about removing or reducing the saddlebags. Dr. Spence agreed that Lisa’s thighs were not going to be reduced by diet or exercise and scheduled her for liposuction under local anesthetic.

“The procedure went like clockwork,” Lisa told CosmeticSurgery.com News. “I stayed awake through the entire procedure and only took off the day after the procedure. A little over a cup of fat came off each thigh and it makes as huge difference in the way I look in clothes. In fact, at work, I sometimes pull my jacket back and say, ‘Hey, look at my new contour! Isn’t that totally better!’”

Patient Friendly


Lisa has plenty of good company. According to the American Society of Aesthetic Plastic Surgery, (A.S.A.P.S.) liposuction was 2005’s top surgical cosmetic procedure as an estimated 455,500 patients had the procedure. Consequently, liposuction has become a more patient-friendly procedure with new devices, techniques and protocols constantly being added to the surgeons’ bag of tools.

For instance, one of the reasons Lisa’s procedure went so well is because Dr. Spence has been working for the past two years on developing a new method that combines liposuction with deep tissue massage. Because Dr. Spence is plodding through the trade- mark registration process, he is understandably a bit tight-lipped about exactly how the procedure is performed. Nonetheless, thanks to word-of-mouth, patients from England, the Barbados, Jamaica, as well as the United States, have asked for the procedure during the last two years, says Dr. Spence.

“I can say, however, that another professional who fully understands both liposuction and massage therapy completes the procedure,” says Dr. Spence. “Basically, I have combined procedures that are already F.D.A. approved. This new technique came about because there is a huge demand for patients to be able to get back to work immediately. For instance, 66 percent of my patients own businesses and just can’t take a week off for healing.”

Wants and Needs


Additionally, the professional plastic and cosmetic surgery societies are constantly surveying liposuction patients to discover the wants and needs of those who occupy operating tables. For instance, one patient survey at the University of Texas revealed that 86 percent of liposuction patients were satisfied and would recommend the procedure to others. The study of 200 liposuction patients also found:

  • 55 percent reported dropping an average of three dress sizes after surgery. Oddly enough, the patients’ post-op weight often stays the same. Nonetheless, clothes often fit better.
  • 33 percent reported they were exercising more. Many former liposuction patients say it is easier and more fun for them to exercise because not as much body bulk gets in their way.
  • 44 percent said they were eating a better diet. Patients who adopt a healthy diet and exercise routine usually maintain or lose even more weight after surgery, while those who don’t may gain small amounts of weight.

But what exactly is liposuction? Is it for people at least 200 pounds overweight and the surgeon just vacuums all the corpulent flesh away? No, not even close. Actually, the procedure is designed to remove though tiny incisions small areas of diet-and-exercise resistant fat with a thin, vacuum-powered tube known as a cannula. The amount of porcine tissue extracted from the body can be as small as the equivalent of two pats of butter taken from the face or dozens of measuring cups of fat removed from the stomach, thighs and buttocks. The surgeon removes actual fat cells so the treatment area will never again become portly. However, the procedure is not a free ticket to unlimited consumption. If you gain weight later, your body will just store it elsewhere. Recovery after surgery depends on how much fat has been taken out; moreover, patients usually wear compression garments over the treatment area for at least a week.

Areas most commonly liposuctioned? Thighs and abdomen, followed by the hips, buttocks and knees.

Tumescent Liposuction


Another improvement on the basic procedure became popular when tumescent liposuction came along. The patient’s treatment areas are injected with large amounts of saline and adrenaline to help prevent bleeding and swelling while making the fatty tissues easier to remove. The technique made the operation easier for patients and surgeons because general anesthesia -- and a much longer and more uncomfortable recovery period -- was no longer required.

Because the surgeon makes a sawing motion to move the cannula back and forth just under the patient’s skin, some cannulas became equipped with a power assist to lighten the load on the surgeon. Another, known as ultrasound-assisted liposuction (U.A.L.) use sound waves to liquefy the fat after the fluids are injected. That also minimizes bruising and bleeding. More current techniques are constantly being offered. For instance, some surgeons ask their patients to get up before the operation is finished to see how the body’s contours look while standing. Known as “Stand up Liposuction,” the surgeon can make additional, touch-up strokes if needed. If the patient feels woozy, O.R. colleagues lend a hand for support.

Yet another wrinkle on standing liposuction is done by Thomas L. Lyons, M.D., a plastic surgeon with offices in Atlanta, Blue Ridge, and Greensboro, Georgia. Dr. Lyons originally thought he would be performing cosmetic gynecologic liposuction on patients under general anesthesia. But when he found the procedure could be done under a local, he also asked his patients to stand so he could better see the correct contours in their usual position. Patients were encouraged to look in a mirror and tell the surgeon if they wanted more tissue removed.

Manhattan plastic surgeon Lawrence Reed, M.D., performs arm lifts, or brachioplasties by making a small incision in the arm and removing excess fat through liposuction. However, the vast majority of arm lifts operations result in a scar running from the armpit to the elbow on the bottom side of the arm.

And, finally, because so many people are having liposuction, the F.D.A. recently approved disposable cannulas, the thin tube that enters the body and suctions up the fat. It’s an improvement because there is zero chance for the patient to acquire an infection through disposable equipment. Each operation starts when the surgeon opens a sealed package and pulls forth a lubricated cannula, untouched by human hands. Yet currently, most stainless steel cannulas are repeatedly sterilized for reuse.

But probably the message about liposuction repeated thousands of times day in doctors’ offices nationwide is about the basic intent of the operation. Intones Rod Rohrich, M.D., chairman of plastic surgery at University of Texas Southwest Medical Center: “One of the key messages I give to patients is that liposuction is merely a way to shape and contour unwanted fat in troublesome areas like hips and thighs,” he says. “It is not a method for losing weight.” So don’t be surprised if you go to see a surgeon for a liposuction consultation and he or she tells you to go home, get on a more effective diet and workout plan for six months or so, lose some weight and then come back to talk about the procedure.



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