CosmeticSurgery.com Staff Report
|A 33-year-old licensed Mental Health Counselor for Winter Haven, Florida, shows the results, right, of her ScultpEase® procedure on her saddlebags.
The after picture was taken one week after the procedure.
(Photo, courtesy of Kenrick Spence, M.D.)
When Kenrick Spence, M.D., an Orlando, Florida, plastic surgeon, was injecting his liposuction patients with the various fluids and pain killers that make the fat extraction process easier, he tried different ways to distract patients on his operating table from the sting of infusion by needle. Dr. Spence did not like to see his patients in discomfort but there’s also a practical side -- aches and distress can also make the whole procedure longer because patients complain and periodically ask for time outs. He tried topical pain killers, which are spread on the skin, but they did not last.
Dr. Spence uses a vibrating, power-assisted cannula -- the wand that does the actual fat vacuuming under the skin -- in a procedure known as PAL (power-assisted liposuction.)
One day, he noticed if he placed the vibrating cannula atop the skin where the needle was inserted, the patient hardly felt a thing. As time went on, Dr. Spence observed the patients were barely distracted from their iPods or reading material when vibrations accompanied injections.
After two years of observation and tinkering with the process, Dr. Spence found:
- The infusion segment went much faster.
- When patients have little or no discomfort and anxiety, they recover faster, with less bruising and swelling.
- The average operation time was cut from two hours to one hour and 15 minutes.
- When Dr. Spence added post-op massage therapy immediately after the procedure, most patients drove themselves home and many returned to work the next day.
“When I first noticed the effects of vibration on the injection sites, I thought back to the dentists who vigorously shake their patients’ cheeks while giving injections into gums,” Dr. Spence told CosmeticSurgery.com
. “Skin vibrations seem to interfere with pain messages sent to the brain.”
Liposuction continues to be the most common invasive procedure done in the United States, with about one third of a million patients having fat surgically removed in 2005, the most recent year for which statistics exist. Patients commonly request liposuction of their arms, neck, saddlebags, abdomen, back and, to a smaller extent, the face and neck. Contrary to popular opinion, liposuction is not a weight loss method but a means to remove stubborn pockets of fat that just will not respond to diet and exercise.
When tumescent (it means “swollen”) liposuction was introduced, the procedure became even more popular. Large amount of fluids -- mostly saline and pain killers -- are injected into the treatment area, often as much three or four times the volume of fat to be removed. It works because the fluids create space between muscle and fatty tissue to create more room for the surgical suction tube to break up and pull out fat cells from the patient’s body.
But then, all those fluids must be introduced into the patient’s body very carefully, with about an hour required for the liquids to percolate through the layers of tissues and enlarge the area before the surgeon can start any more work.
Dr. Spence’s power-assisted cannula also spares the surgeon’s arm, said Lisa A., one of Dr. Spence’s recent hip liposuctioned patients (all of whom asked for anonymity :) “I can’t compare this new liposuction to liposuction I’ve had in the past. For one, I was perfectly O.K. to drive myself home. That evening, I only felt like I had worked out a little too hard and went back to work the next day. The actual SculptEase procedure felt more like a deep massage.”
When the liposuction procedure is completed, the patient has an hour-long session with a massage therapist. The smallish surgical incisions -- 1/8 to 1/4 of an inch -- are left open to allow the fluids to drain. Before SculptEase, most patients had drains inserted in the surgical wounds so the discharge continued for three or four days after a procedure. But patients consider drainage messy, inconvenient and ruinous to clothing. Swelling is also minimized if the liposuction sites are drained as much as possible by the massage therapist. Additionally, medical science has long known that massage can assist the healing process by improving circulation lymph flow and keeping connective tissues flexible.
“After the massage, the patient is fitted with a compression garment and can return to whatever she wants to do, including driving herself home,” Dr. Spence says. “She can usually return to her exercise routine in two or three days and can lift heavy things within a week.”
Dr. Spence says he has scientifically tracked all the SculptEase patients’ post-op experiences over the last two years so that he can “reliably and predictably” say the lion’s share of his patients can return to work the next day, with a few requiring 48 hours away from the job.
“The best part was afterwards when the massage therapist expelled the fluids,” says L.B., a 39-year-old mom who had her inner thighs and saddlebags liposuctioned. “There was no messy stuff when I came home. And, the vibrations at the start were more like tickling on my skin.”
Although she says a liter of fat was taken out, L. B. also drove herself home and saw only a little fluid and blood when she took a shower that evening.
The surgeon has not yet presented his methods and findings to the medical community via a peer-reviewed journal but seems to have everything completed except the actual writing.
Over the years, to test the assumption that vibration detracts from pain in the nervous system, Dr. Spence used vibration on one side of the patients while he was infusing but not on the other. Then, he asked the patient where he or she was experiencing more discomfort. Good vibrations always trumped.
“We found the side on which vibration was used experienced a lot less discomfort,” Dr. Spence says. “Consequently, with vibration on both sides, we could complete the infusion process much quicker.”
He says he was inspired to speed things up for patients because so many of his patients are 30-to-45ish working mothers with children at home and demanding careers. That group is foremost among the many patients who just do not have much time to wait for recovery. Because many of Dr. Spence’s patients are from Jamaica, Barbados and Bermuda -- islands with strong British connections -- word about his services got back to England. Thus, many English patients started booking appointments and flying in. Usually, they visit American malls on the evening of their liposuction.
43-year-old Elizabeth, an urban planner with a six-year-old child, had her saddlebags and hips liposuctioned during a two-hour procedure with Dr. Spence while she was between jobs.
“I was pleasantly surprised,” she says. “I didn’t see or really feel the injections. The doctor removed 1900 cc’s of fat so after the compression garment was put on, I opted to skip the massage and drove myself home. Pain has been minimal and, although I stayed around home, I walked several hours a day, slept great and felt fine.”
Before Dr. Spence started using the more current liposuction procedure, patients asked for him to do two or three procedures at once so that recovery was a one-time event. But now, because less time off work is required, Dr. Spence’s patients no longer ask for multiple procedures during one surgical session. Those patients know they can go back to work the next day so they are scheduling their next liposuction several months away.
“A typical patient asks for her hips done in a month from now and saddlebags in two months,” says Dr. Spence who continues tinkering with the process by studying how magnetic therapy can help reduce swelling quicker.
But maybe the wide appeal of liposuction can be summed up in the wise words of singer Shania Twain who once said, “I don’t want my body to be a distraction from my brain and my talent.”
View Dr. Spence’s website.
Read more about liposuction and see liposuction surgeons in your state.