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What is Liposuction Surgery?
Liposuction is a minimally invasive procedure for both men and women in New York City that removes stubborn fat from specific problem areas. This plastic surgical procedure allows people to contour their body shape and remove unwanted fat.
Liposuction is ideal for people who have isolated areas of fat that are not responding to diet or exercise. Most often, these areas of concern are the abdomen, love handles, arms, thighs, and neck. Men can benefit from liposuction of their chest for male breast reduction. (See gynecomastia treatment)
Although liposuction can help heavier patients to “slim down,” it is not a weight loss procedure, and should not be considered a substitute for a healthy diet and exercise routine. In addition, it may not be recommended for people with skin laxity issues, as skin in the treated area may actually become looser after liposuction. In this case, a surgical procedure to remove excess skin may be the better choice.
This highly customizable surgical procedure usually takes between one and three hours and has a recuperation time of two to five days.
Why is Liposuction Performed?
The goal of liposuction is to treat areas of unwanted localized fat deposits to achieve a more pleasing figure. Dr. Steven Wallach, a board-certified Manhattan New York plastic surgeon, understands the history and evolution of liposuction techniques over the years. Originally, the goal was simply to flatten areas of excess fatty tissue. More recently, techniques were developed to perform “abdominal etching;” to bring out the lines of the abdomen so that a more “cut” look is achieved.
Further refinements of these techniques have evolved to promote even better definition in all areas of the body: the abdomen, flanks, chest, back, legs, and arms. Individuals who have a relatively low body fat concentration and want more definition in specific areas are the best candidates for liposuction in New York. This can be achieved by bringing out the differential natural shadowing and curves that well-framed physiques have.
The History and Development of Liposuction
Liposuction has evolved over the years from its original development in the mid-1970s. Plastic surgeons started out performing this procedure with sharp-tipped cannulas (thin, hollow tubes used to remove the fat) by using a “dry” technique (no wetting solution to help diminish blood loss). The early results were good, but were limited in being able to remove large quantities of fat mainly due to blood loss from the procedure.
The techniques improved when practitioners began using blunt-tipped cannulas and wetting solutions, thereby diminishing blood loss and allowing more fat to be removed in each session. This resulted in better and safer results from liposuction procedures.
Wetting solutions usually have a mixture of a balanced sterile salt solution, lidocaine (an anesthetic), and epinephrine (a blood vessel constrictor). The combination of these three ingredients allows for relatively pain-free treatment with narrowing local blood vessels both by tissue expansion using the salt solution and the vasoconstrictor effects of the epinephrine. This provides for a minimum of blood loss during the procedure.
Since the development of these wetting solutions, many variations in the concentration of fluid infusion and fat removal have been created. This includes techniques described as the wet technique, the “super-wet” technique, and the tumescent technique.
The instrumentation has also evolved over the years, and there are many different tools that can be used for a body contouring procedure. Dr. Wallach performs liposuction using many different tools along with the tumescent technique. He may use standard cannulas, power-assisted liposuction (PAL), ultrasound-assisted liposuction (UAL), the VASER liposuction machine, or laser lipolysis using machines such as Smartlipo for any given liposuction procedure. Dr. Wallach has also presented and published papers on body contouring procedures.
- Traditional Liposuction
- Power-Assisted Liposuction (PAL)
- Ultrasonic Liposuction (UAL)
- Laser Lipolysis (Smartlipo™)
- Alternative Liposuction Options
The term “traditional” is really a misnomer. It suggests that this is an old, outdated technique, when in fact it is the most popular liposuction technique used today, incorporating tumescent fluid infusion. Learn more about traditional liposuction.
Tumescent Liposuction Procedure
First, the tumescent fluid is infused through several small incisions near the area(s) that require treatment. After waiting several minutes for the vasoconstrictor action of the solution to take effect, liposuction is performed. Blunt cannulas with holes near the tip allow for an almost bloodless removal of fat cells without disturbing the majority of sensory nerves or blood vessels in the surrounding tissue.
- It is unlikely to develop seromas (fluid collections) or hematomas (blood collections) from tumescent liposuction. Even less frequent are skin burns because the cannulas do not generate any heat.
- This procedure is somewhat labor-intensive for the operating surgeon because of the back and forth motion required to aspirate fat without assistance from the device.
Power-Assisted Liposuction (PAL)
This technique uses cannulas that are on either a compressed gas-powered or electric handpiece that moves the cannulas back and forth. This allows Dr. Wallach to use less energy to remove the excess fat cells.
PAL Liposuction Procedure
The procedure is similar to that described for “traditional liposuction”. The only difference between power-assisted and traditional liposuction is that Dr. Wallach does not have to manually break up fat tissues, as the handpiece performs most of the work.
- Incision size is the same as traditional liposuction. There is less manual exertion because the oscillating handpiece does most of the work. It is suggested to use this procedure to treat more fibro-fatty regions such as the hips, back, and male chest.
- There may be a slightly increased risk of seroma formation than traditional liposuction.
Ultrasound-Assisted liposuction (UAL)
This technique uses ultrasonic technology to loosen and emulsify fat. Now more surgeons are using the Vaser® machine. Vaser stands for Vibration Amplification of Sound Energy at Resonance. Vaser is different from previous UAL devices because the ultrasonic energy is emitted from the rings on the side of the cannula as opposed to the cannula tip. The heat that is generated from the ultrasonic vibrations is focused on the sides of the cannula. This helps minimize some of the potential complications of using this technology.
Vaser Liposuction Procedure
Incisions for access for UAL procedures require a slightly larger incision than with either “traditional” or PAL techniques. Access protectors are secured at the incision sites while the ultrasonic energy is used. The ultrasonic probe is inserted after tumescing the fatty layers, and the energy from the ultrasonic probe both loosens and emulsifies (liquefies) the fat. Once this step is complete, standard liposuction cannulas are inserted to remove the fatty tissue.
- There is less manual work than performing “traditional” liposuction or even PAL. Vaser may work better on fibro-fatty regions such as the hips, back, and male chest. It also may be able to give better contour definition and skin contraction upon recovery.
- Ultrasonic techniques have a higher seroma rate than other techniques. Ultrasound liposuction techniques also have a higher rate of skin burns due to the heat generated during the procedure. Ultrasound techniques may also have prolonged numbness over the skin as compared to other techniques. The procedure also takes longer than traditional or PAL techniques.
Laser lipolysis (Smartlipo™)
This technique uses laser light energy to emulsify fat. The heat generated from the laser light may also encourage some degree of skin contraction. This added technology allows for more delicate or intricate treatment.
Smartlipo Liposuction Procedure
First, small incisions are made for tumescent access. The treatment area is tumesced using a cannula and then laser light might be used at the beginning of the procedure to emulsify or break up the fat deposits or used at the end of the procedure to heat the skin in an attempt to cause skin retraction. In either case, a traditional cannula is inserted to remove the emulsified fat.
- Laser-assisted liposuction is better for treating small areas. Small incisions are used to complete this procedure. May induce some skin retraction following recovery.
- Laser lipolysis may have an increased seroma rate as compared to traditional and PAL techniques. Laser lipolysis has a higher rate of skin burns due to the heat generated during the procedure. It may produce prolonged numbness over the skin as compared to the other techniques. A laser liposuction procedure takes much longer than other liposuction procedures. There may be very little to no skin contraction after the procedure. For more information on the pros and cons of Laser lipolysis, visit our blog.
Liposuction Under Local Anesthesia
Dr. Wallach also offers liposuction with local anesthesia. If the fat you are looking to remove is localized, then it is perfectly acceptable and safe to remove the fat without the deep sleep of general anesthesia. Depending on the areas you are looking to treat, liposuction under local anesthesia could be a good fit for you.
- The main advantage of local anesthesia is not having to manage the effects of general anesthesia. Many patients like the comfort and safety that comes with local anesthesia. Unlike general anesthesia, you are able to eat a light meal on the day of your procedure. You also avoid the typical anesthesia “hangover”. Local liposuction treatments are also done is less time, so you can get back to your life quicker. Lastly, due to the fact this can be done in the office, local liposuction is offer a cheaper option than liposuction with general anesthesia.
- Due to the fact that you are awake during the procedure, local liposuction is often considered less comfortable for the patient. In addition, you are limited in the amount of fat that can be removed during a liposuction procedure with local anesthesia.
Who is a Good Candidate for Liposuction?
A good candidate for liposuction in New York City is at a healthy, stable weight and is medically cleared to undergo a plastic surgery procedure. People who have stubborn fat deposits that they’d like to get rid of are generally eligible for liposuction treatment.
People with loose skin or who may not experience skin tightening after the procedure may not be good candidates for liposuction, as the procedure can create issues of skin laxity in certain patients.
How Much Does Liposuction Cost?
The fee for liposuction usually is charged per area. This can vary from as little as $2,500-$6,000 per area. Dr. Wallach will provide an accurate, honest quote for your unique procedure during a liposuction consultation in his Manhattan office.
What Are the Risks of Liposuction?
In general, liposuction is a very safe procedure with little downtime and few complications. The most common may be contour irregularities. Less common issues include persistent numbness, fluid collections, and infections. The most common issues that develop include asymmetry and contour irregularities which may be related to under- or over-treatment. Some other less common issues include infection, seroma, hematoma, dysesthesia, unfavorable scarring, and need for revision.
What Should I Expect During My Liposuction Recovery?
Immediately following your treatment, you will be monitored to ensure your vitals are in good shape as you recover from either the local or general anesthesia.Dr. Wallach will place you in compression garments both to help reduce swelling and fluid accumulation as well as help protect your natural-looking results.
Recovering from liposuction usually requires patients take two to five days off of work and normal activities, and refrain from strenuous activity for up to two weeks, depending on Dr. Wallach’s instructions. Your liposuction results will start to become apparent as swelling goes down and incision sites heal, typically taking between four to six weeks. After the six-week mark, most liposuction patients feel back to normal and are starting to see and enjoy the results of the procedure.
Schedule a Consultation For Liposuction in Manhattan, NYC
Something Dr. Wallach frequently tells patients who come in for consultations is that the results of liposuction don’t depend on the specific device, technique, or even procedure performed, it’s about the person performing it. With Dr. Wallach leading your liposuction, you can be sure that you’re getting the best liposuction treatment in Manhattan. To find out if liposuction can help you achieve the body figure of your dreams, feel free to contact Dr. Wallach by calling our office or contacting us online today. We can’t wait to help you get the results you’ve been waiting for!