Liposuction in New York
Frequently Asked Questions
Can I do liposuction instead of going on a diet?
Liposuction is not a substitute for a diet. Good nutrition and exercise are an important factor to staying fit. Liposuction is ideal for those patients who have defined areas of fatty deposit that they can’t seem to lose by diet or exercise. Common sites for treatment include the abdomen, hips, back, thighs, and arms.
Are you taking all the fat out from the areas you suction?
No, liposuction does not remove every single fat cell from a given treatment area. You want to maintain an even layer of the more superficial fat so that contour deformities do not result. In fact, overzealous liposuction can cause severe deformities that sometimes cannot be corrected.
Will the fat come back in those areas that were suctioned?
Liposuction decreases the overall volume of fat cells in a given treatment area. New cells will not grow back in the areas treated, however, if you gain weight, the cells that are present in that area will enlarge. I tell patients that if you gain weight then the weight will probably be more evenly distributed and not accumulate as frequently in the areas previously suctioned.
What are the different types of liposuction techniques that are available today?
There are many different ways to perform liposuction. I like to divide them into those that use heating devices and those that do not. The ones that do not use heat include traditional liposuction and power-assisted liposuction (PAL). Those that use heat include ultrasonic liposuction devices like Vaser and laser lipolysis machines like Smart Lipo. The heating devices in my opinion tend to have a higher risk of fluid collections (seromas), prolonged numbness, and the potential for burns.
What is Vaser Liposuction?
Vaser liposuction is a form of ultrasonic liposuction that can be performed in an office based operating facility. It uses high frequency ultrasound that generates heat to melt the fat that is being treated. Once this is performed, the emulsified fat is then suctioned with more traditional cannulas. Some believe that the heat can cause skin contraction, but it does not appear that it improves skin contraction any better than other techniques, including traditional liposuction.
I have some numbness after liposuction, will this get better?
It is pretty common for patients to develop some numbness, or what is called dysesthesia, after liposuction. This is commonly due to swelling and usually improves over a six to eight week period when the swelling subsides. On the other hand, the heating component devices like Vaser or laser lipolysis machines (i.e. SmartLipo) tend to cause prolonged numbness.
I heard that some patients can get burns from liposuction. Why is that?
Burns are more likely to develop with liposuction devices that generate heat. Maneuvers in using the probes leading to what is called “end hits” tend to cause burns. This is more common with the Vaser machine or the laser lipolysis devices such Smartlipo or Powerlipo. This is almost unheard of with traditional liposuction or power-assisted liposuction
What is PAL?
PAL stands for power-assisted liposuction. This is a liposuction machine that assists the surgeon to perform the liposuction. The handle oscillates the liposuction cannula back and forth. It is still a mechanical process that is thought to decrease surgeon fatigue during the procedure.
Does skin tightening occur with liposuction devices?
In general, liposuction can cause some skin tightening. But I do not think that any one machine will give you “true” skin tightening in the sense that if the skin is loose, it will tighten up significantly. Although this is suggested as a benefit for using the liposuction devices that heat the tissues, the results in my opinion are not any better than more traditional techniques.
How does traditional liposuction differ from power-assisted liposuction (PAL)?
Traditional liposuction uses standard cannulas that are connected to suction. The surgeon uses these cannulas in a manual forward and back motion to mechanically suction the fat. In my opinion, this is one of the least traumatic techniques available for liposuction.
What is tumescent liposuction?
Tumescent liposuction refers to the infusion of fluid into the tissues during a liposuction procedure. It usually consists of a sterile salt water solution, usually Lactated Ringers, along with lidocaine (an anesthetic), and some epinephrine (a blood vessel constrictor). This fluid fills the space (or tumesces) where the fat is. It helps with constricting the blood vessels both by pressure of the infused solution and as a result of the effects of the epinephrine. This in turn decreases the risk of blood loss during the procedure. The lidocaine numbs the area being treated and can help with early post-operative discomfort. The majority of liposuction techniques use variations of the tumescent technique. There are different levels of fluid infiltration referred to as wet, super wet, or the tumescent technique. These three vary by the ratio of infusion solution to fat removal. The true tumescent technique usually uses fluid in a ratio of 3:1 infusion to fat removal. I will most commonly use a wet or super wet technique to limit the amount of fluid infused in any one patient during liposuction.
Should I have Smartlipo done on my abdomen?
Patients always ask me about the specific technique that they have read about in the press and want to know if a specific technique or device is best for them. In general, I do not think a specific device is any better than any other. Quite frankly, I think it is more surgeon-dependent rather than anything else. I always tell my patients that it is not the wand (the machine) but the magician (the surgeon) that creates all the magic!
How much fat can you remove in one operative setting?
This is a question I get asked quite often. In general, I perform most of my surgeries in an out-patient facility. The ASPS or ASAPS recommends that no more than five liters of fat be removed in any one operation in an out-patient facility. Some states like Florida have limited the aspiration to even less fat.
Do I have to wear a garment after liposuction?
I like my patients to wear a compression garment that is especially made for liposuction post-surgical care. I think that the compression helps minimize the risk of fluid collections, and helps to decrease post-operative swelling. In general, I think that patients are more comfortable during the recovery. I like my patients to wear these garments for three to six weeks. I usually have them purchase two so that they can wear one and have a clean one available to change into. Some surgeons do not recommend garments to their patients.
Can I have liposuction of my hips?
Liposuction of the hips, more specifically the flanks or outer thighs, can be performed as part of a liposuction procedure. However, the only way to be properly evaluated is to be seen in person for a proper evaluation.
Can I have liposuction of my chest?
A common request from men is to ask about liposuction of their chest. If the chest does not have a lot of loose skin or feels more fatty than glandular, liposuction alone may be an excellent choice. For those men who might have a glandular component to the chest that would not be amenable to liposuction alone, then they may require a small glandular resection, perhaps through an incision around the border of the areola. In men who have severe skin laxity, they may require a skin excision and glandular excision as well. This can be performed using several different techniques. Most will require a compression garment.
Will I need a drain after chest liposuction?
If liposuction is the only procedure performed, I do not usually place a drain. However, I will commonly place closed suction drains when large amounts of skin and soft tissue are removed surgically.
Submental liposuction, is it a good idea?
Submental liposuction refers to liposuction of the area under the chin. If a person has a significantly fatty neck, liposuction of this region can be quite satisfying. It can usually be done through a small incision underneath the chin or behind the ears. The fat that is superficial to the platysma muscle is the area best treated by liposuction. It is important to try to maintain a thin layer of fat between the skin and muscle if possible to help minimize the risk of overtreatment. However, if there is a lot of loose skin, subplatysmal fat, or plastyma muscle banding, liposuction alone may not be enough, and there are surgical options that may be able to treat these concerns.
Will liposuction be right for me if I have had a few kids and my skin is loose?
If a woman has had multiple pregnancies and now complains of loose skin and a weak protuberant abdomen, then liposuction may not be the right procedure for her. Loose skin will likely become looser after liposuction in these types of patients. A full tummy tuck may be a better treatment option to treat the loose skin and tighten the muscles. Liposuction can sometimes be performed on the abdomen at the same time when limited abdominal flap elevation is performed, or done before or after a tummy tuck.
Can I have liposuction because I want to lose weight?
Liposuction is really not a good idea for someone who is looking to have liposuction to treat obesity. If a person is significantly overweight or obese, then diet and exercise are the best ways to lose the weight. Liposuction is ideal for those patients who are close to their ideal weight but can not get rid of unwanted areas that are recalcitrant to diet and exercise. Liposuction is a great procedure to improve contour. In fact, I have been using it a great deal in combination with fat augmentation in women who want a Brazilian butt lift.