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Liposuction Tops the Plastic Surgery Charts ...Again Staff Report

Medically Reviewed by Andrew Fragen, M.D., F.A.C.S

Almost half a million patients had liposuction during 2005, according to the American Society for Aesthetic Plastic Surgery (ASAPS.) The American Society of Plastic Surgeons (ASPS) also tracks its members’ procedures from year to year and reports that liposuction has increased 470 percent from 1992 to 2005. Consequently, surgeons and medical manufacturers are adding new tools to the surgeons’ bag, along with ever more patient-friendly methods and different ways of taking out the fat.

Like many others who consider liposuction, 47-year-old Lisa Amorosa in Orlando, Florida, had been putting it off. But Lisa, a trust advisor for a wealth management firm in Orlando, hated the saddlebags on her thighs and had tried every possible workout routine and diet she could find. But nothing worked. Moreover, Lisa is only four-foot-ten so the extra weight on her diminutive frame really stood out.

Finally, she made an appointment with Kenrick Spence, M.D., a board certified Orlando plastic surgeon, and asked about removing or reducing her saddlebags with liposuction. Dr. Spence agreed that diet or exercise won’t affect Lisa’s thighs and scheduled her for liposuction under a local anesthetic.

“The procedure went like clockwork,” Lisa told “I stayed awake through the entire procedure and took only a day off afterwards. About a cup of fat came off each thigh; overall it makes a huge difference in the way I look in clothes. I Sometimes, I pull my jacket back and say, ‘Hey, look at that new, slim contour! Isn’t that totally better!’”

Three Dress Sizes

Lisa is among good company. The May, 2006 issue of Plastic And Reconstructive Surgery, the official medical journal of American Society of Plastic Surgery (ASPS,) found 80 percent of 209 patients who had the procedure at the University of Texas were satisfied with their results; 86 percent said they would recommend the procedure to friends and family. The study also revealed:
  • *55 percent reported dropping an average of three dress sizes after surgery.
    Oddly enough, the patient’s 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 engaging to exercise because not as much body bulk gets in the way.
  • Liposuction

    The New York Times recently reported that, thanks to new equipment and techniques, liposuction frequently removes as little as one to three ounces of fat on backs, knees, ankles and chins.

    But what exactly is liposuction? Invented by Giorgio Fischer, an Italian gynecologist in 1974 and now known to surgeons as suction-assisted lipectomy, the procedure uses a thin, vacuum-powered tube known as a cannula to remove fat through small incisions in the skin. The amount of flab extracted from the body can be the equal of two pats of butter taken from the face or dozens of measuring cups full of fat from the stomach, thighs and buttocks. The surgeon actually removes fat cells so that area will never become obese again. But that’s not a free ticket to unlimited eating and drinking -- if you gain weight later, your body will just store it elsewhere.

    Areas most commonly liposuctioned? For women, it’s thighs and abdomen, followed by the hips, buttocks and knees. Most men ask to have flanks (“love handles”) and stomachs treated. The best candidate is in good health and of normal, or near-normal, weight with excess fat in spots that do not respond to diet or exercise.

    Shape and Contour

    Intones Rod Rohrich, M.D., chairman of plastic surgery at University of Texas Southwest Medical Center:
    “One of the key messages I give patients is that liposuction is merely a way to shape and contour unwanted fat from trouble areas like hips and thighs,” he says. “It is not a method for losing weight.

    A vast improvement on the basic procedure became popular when tumescent or “wet” liposuction was introduced in the 1980s. The patient’s treatment area is injected with large amounts of saline and adrenaline to help prevent bleeding and swelling while making the fat, and the operation, easier on both surgeons and patients.

    Because most patients remain awake during the procedure, some surgeons ask their patients to stand so the doctor can see how the body’s contours look. Usually known as “Stand up Liposuction,” Lisa stood to see how her thighs would look afterwards. Patients are encouraged to chime in with their opinions and ask the surgeon to extract a little more, if needed. If the patient feels woozy, a Nurse or other colleague lends a hand for support.

    “When the patient is able to stand during the procedure, I can see the correct contours of her body,” says Thomas L. Lyons, M.D., a cosmetogynecologist who uses liposuction to add filler to labia majora which results in a more youthful vulvar complex for patients who want improvements of the female genitalia. (Cosmetogynecology combines gynecology, female cosmetic surgery and medicine.)

    “Two-thirds of my patients own their own businesses and must get back to work quickly,” says Lisa’s surgeon, Dr. Spence who says his tumescent liposuction patients often go shopping the night of their procedure and return to normal activities within 24 hours. Dr. Spence is remaining mum about the new procedure until trademark paperwork is completed, but he combines liposuction with massage right after the operation to speed and aid recovery.


    Yet another leap forward happened with the development of ultrasound machines which are designed to break up fat with sound. (21 percent of the 456,000 liposuction patients treated in 2005 had fat removed by an ultrasound device.)

    Another step up came with the Vaser Assisted Lipopolasty (VAL,) a method that also uses ultrasound but claims to break up and liquefy fat while leaving blood vessels, nerves and connective tissues more intact. Consequently, a Vaser procedure is said to result in low to minimal pain and low rates of bruising or swelling and reduced healing time.

    Because the surgeon makes a sawing motion to move the cannula back and forth just under the skin, some liposuction models are equipped with a power assist to take over the load for the doctor.

    Additionally, the FDA recently approved disposable cannulas. It’s an improvement because zero chance exists for the patient to acquire a hospital-based infection through that equipment. Each operation starts when the surgeon opens a sealed package and pulls forth a suction cannula, heretofore untouched by human hands. Currently, most liposuction cannulae are made from stainless steel; some experts say germs and microbes can lurk in the nicks of reused equipment and survive sterilization.

    “The new, disposable cannulas are also lubricated so they slip more easily through tissues and increase safety,” says the manufacturer Tulip BioMed CEO Marc Pilkington in San Diego.

    Fit for Life

    Due to increased demand for liposuction, cosmetic surgeon Edward Lack, M.D. and president-elect of the American Academy of Cosmetic Surgery Association, offers something extra for his liposuction patients: a chance at fitness for life. After your surgery, you can sign onto his Lipo Lifestyle Program in which you have the services of a staff nutritionist and fitness specialist who help patients maintain the results.

    Of course, we can’t lose all the fat in our bodies. The brain, for instance is entirely fat. And without a brain, you might look good, but all you would be capable of doing is running for public office.

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