Q: Nine weeks ago, I had SmartLipo™ to my knees, outer and inner thighs and banana roll. My weight is still 5-7 pounds above what it was pre-lipo even with very clean eating and daily exercise. Will wearing the compression garment at this point reduce swelling and assist with permanent skin tightening and improved results?
A: There is NO benefit to wearing a liposuction compression garment beyond 2 months? The longer answer is that in the early days after the procedure the garment is comforting and minimizes swelling. But after the first couple of weeks, swelling is significantly less, and my patients wear their garments for the duration that they need, based on comfort. This is influenced by swelling, of course, but there is no right or wrong regarding how long one wear’s the garment. It doesn’t have a long term impact on the outcome of the procedure.
A: Liposuction is the process of removing fat from under the skin by suctioning. The modern version of liposuction was developed in the mid-80’s by a dermatologist when he figured out how to make the fat numb with local anesthesia so that the patient didn’t have to be out under general anesthesia. About seven years ago lasers were introduced to act as an aid to the suctioning of the fat by prepping the fat and heating the skin to aid in skin contraction. The lasers do not substitute for suctioning. That is still the main event when one has liposuction. Not everyone needs a laser to have excellent results with liposuction. The decision to use the laser or not is something to discuss with your surgeon at the time of your consultation.
A: Sadly, no. Visceral fat is the fat that is located inside our bodies where our organs are located. This fat isn’t reachable with liposuction; only subcutaneous fat that is located between the muscle and the skin can be reduced with liposuction. If you’re unsure if your fat is visceral or subcutaneous, visit a physician who specializes in liposuction who can examine you and tell you what you have. The only way to reduce visceral fat is the old-fashioned way: good eating habits and good exercise habits. By far and away, the most important part of that formula for success involves good eating habits!
Q: What kind of liposuction is the safest? I’ve tried to research the safest, best type of liposuction, but can’t seem to find which option is safest. My husband does not want me to undergo general anesthesia and is most worried about the safety of the procedure. He is an anesthesiologist and has seen the dangers. I just want my saddlebags done, I am pleased with the rest of my body. And, if a procedure is safer, does that mean it will be less effective?
A: I believe the safest kind of liposuction is done with local anesthesia. The published evidence in the medical literature is clear that liposuction is very safe when performed with local anesthesia. Here are the important points:
The safe dose of lidocaine, the local anesthesia, is well established, and there is a wide margin between the safe dose and an overdose.
An allergic reaction to lidocaine is so rare, that it’s considered something that just doesn’t happen.
General anesthesia medications are associated with adverse events that aren’t always predictable; patients do have unexpected adverse events that can be life-threatening.
When a person is “out” under general anesthesia, they’re unable to communicate with the surgeon if they’re feeling something they shouldn’t be feeling. For example, a patient who is “out” may not feel the surgeon straying from the fat space and invading a part of the body where the surgeon shouldn’t be. Local anesthesia makes only the fat numb and comfortable, but not the other parts of the body; it’s another safety feature.
When an anesthesiologist is concerned about his wife undergoing general anesthesia, that’s pretty telling.
A: C-section scars are often tightly bound with the skin adherent to the underlying connective tissue and muscle layer giving an indented look. Fat then accumulates above and below the indented scar. Doing liposuction to reduce the excess fat can greatly improve the appearance. Also, the liposuction cannula can sometimes be used to carefully release the bound skin from the underlying muscle and connective tissue. A laser may have value in skin tightening, but not in removing the scar tissue.