Dr. Daniel Morello
Liposuction is a surgical procedure that appears deceptively simple. This has led to many non-plastic surgeons such as dermatologists, gynecologists, and others advertising their services for liposuction, sometimes with little or no experience and training. For liposuction, the warning "caveat emptor" (let the buyer beware) is very true. In fact, excellent results from contouring by liposuction are ultimately related to the surgical skill, training, and aesthetic judgment of the operating surgeon. I believe that this is the strongest reason that most patients prefer to have a surgeon certified by the American Board of Plastic Surgery .
Liposuction, also known as suction-assisted lipectomy, is a surgical vacuuming of fat beneath the surface of the skin. It is used to reduce fullness in any area of the body. It is an excellent method of spot reduction but is not a substitute for diet or a method of weight loss. For the most part, the size and shape of our body is an inherited characteristic, and this is particularly true regarding body contour. No matter how we scramble the genes, the ones that control fatty tissue deposits in certain areas show themselves with few modifications.
To understand the potential of liposuction we must be aware that everyone is born with a definite number of fat cells, and we cannot make more after our teenage years. Weight gain involves enlargement of these cells and vice versa for weight loss. Therefore, anything that decreases the number of fat cells has a permanent effect and makes a disproportionate area more in balance with the rest of the body. Any future weight fluctuation will result in a more even distribution of fat, unlike pre-surgical disproportionate contours.
Liposuction is best done on people with localized areas of protruding fatty deposits with the goal of improving contour. Patients who are slightly overweight can benefit from liposuction also, using it to "jump start" their program. Good skin elasticity is desirable since it permits the skin to shrink and adapt to the reduced contour. Loose skin or absence of good elasticity can limit the amount of fat that I can remove. The so-called cellulite problem is usually not improved by liposuction, and the same can be said for stretch marks.
There are no age limits for liposuction, as skin excess and elasticity are the most important factors in selecting patients. Liposuction is most frequently used to treat the abdomen, thighs, and hips in women and to treat love handles and male breasts in men. It can also used in many other areas including bra line rolls, buttocks, knees, calves, and neck. If there is excess fat under the jaw line or neck and the skin is good, liposuction can be done to produce a more youthful, sculpted jaw line. The actual amount of fat removed varies, but it is important to recall that liposuction is about contour not about loss of weight. Fat weighs surprisingly little but precise removal of fatty deposits can produce dramatic changes in contour.
The tumescent technique of liposuction involves injection of a solution containing saline, local anesthetic, and small amounts of adrenaline. I use this technique in all cases and am thus able to have almost no blood loss and minimal pain, bruising, and swelling. Many patients who formerly required generally anesthesia for liposuction can now be done with tumescent technique and intravenous sedation that is given by a board certified anesthesiologist. Small incisions (only about one-quarter inch) are used for access and I place them in inconspicuous locations. . Liposuction can be done in combination with other surgical procedures avoiding a separate anesthetic, healing period, and operating room expense.