Liposuction

Get your figure back! Tumescent, wet and superwet liposuction, superficial liposculpting, ultrasound-assisted liposuction, lipoplasty and laser lipolysis or laser liposuction are the most popular and common plastic surgery procedures performed today. Each technique has a place in the surgeon’s armamentarium to help achieve the best possible result. What all these procedures have in common is the rapid removal of unwanted fat through small stab incisions with the use of thin metal tubes opened at the end called cannulas and in the case of the laser the optical fiber.

Before and After Photos

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History

Liposuction is the most popular cosmetic procedure in America.  The first Lipoplasty using a cannula was performed by Dr. Giorgio Fischer in Rome in the 60`s.  Dr. Michele Zocchi of Turin, Italy introduced us to ultrasound assisted liposuction in the 90’s.  More recently, Laser Lipolysis was developed which has permitted body contouring of areas that before were not possible to treat.  Today, the latest is a return to the Ultrasound technique.  Despite the great deal of good and bad press, liposuction with or without fat transfer is a safe, reliable and very beneficial procedure.  It is also the procedure most often performed by unqualified physicians, so be sure to check the surgeon’s credentials and experience.

Definitions

Liposuction With/Without Fat Transfer

The procedure in which fat is removed by aspiration using the principle of negative pressure via a cannula placed through a very small incision with any of the methods explained below.

Liposuction with Fat Transfer is similar except that the fat is not discarded but transferred in other areas of your body. It is effective in correcting irregularities or depressions such as those between the hip and thighs laterally (this area is called C point) or augment your buttocks.

Tumescent, Wet and Superwet Liposuction

Liposuction performed following the injection of large amounts of diluted numbing medication (Xylocaine and Adrenaline) in the fat compartments underneath the skin. This makes the use of Ultrasound and Laser Assisted Liposuction possible and also decreases bleeding.

Liposculpture

The procedure in which fat is removed with a microcannula usually aspirated through a syringe or a suction device following infiltration with tumescent fluid. In liposculpture the incisions are very tiny especially when using the laser. It enhances the detail of your body by literally sculpturing it.

Laser Liposuction ( Lipolysis )

Laser liposuction is a new and less invasive way to perform liposuction in which a fiber optic laser melts the fat cells (lipolysis) and contracts the connective tissue leading to skin tightening. The fat is then either suctioned out or left in your body to reabsorb. In the latter case only smaller quantities of fat can be removed. It is advertised as producing less bruising and safer since it is performed under local anesthesia. Dr. Hervé Gentile uses the latest generation Laser which is a much improved version over previous ones made from other manufactures.

However, it is not superior to ultrasound liposculpture as both dissolve the fat cells and cause some skin contraction, one using sound waves while the other light. The advantages of laser lipolysis are: (1) the procedure is less invasive and is performed with you awake under local anesthesia (reducing the cost) and therefore you can go back to work right away; (2) the incisions are very tiny as the laser fiber optic is only 1 mm in diameter and therefore no stitches are required and (3) lipolysis can be performed closer to the skin.

To summarize, Dr. Hervé Gentile recommends Ultrasound Assisted Liposuction for the larger cases which require significant volume removal; and Laser Lipolysis for those people with smaller areas requiring treatment or refinement to obtain their desired body shape. Laser Lipolysis offers minimal to no downtime and less expense since general anesthesia is not required. Furthermore, Laser Liposuction can be performed in a more superficial plane causing less waviness and possibly better sculpting. It must be understood that Laser assisted liposuction is only an adjunct to conventional liposuction techniques and is not a substitute for them and therefore not everyone is a candidate.

Internal Ultrasound Liposuction

Ultrasonic Liposuction allows us to more easily remove fat in the back, breast and in redo liposuction. Ultrasound Liposuction has been extensively studied and its beneficial results are backed by proven scientific studies. This in contrast to what some manufacturers claim and promote about their new non-invasive machines or other technological alternatives aimed at liquefying fat.

The ultrasound probe is placed internally underneath the skin via small incisions where the fat is targeted. It is first melted away and then suctioned. This is the preferred method used by Dr. Hervé Gentile for large areas and although it can be performed with local anesthesia the best sculpting results are always obtained when it is performed under general anesthesia.

Fluid infiltration using the superwet technique helps the formation of the cavitation phenomenon. This is the physical principle that creates a progressive increase of bubble gas formation resulting in implosion and fragmentation of the fat cell which is later suctioned with microcannulas.

What is interesting is that this ultrasonic energy does not affect the muscle, bone or nerve, but only the fat cell and this may facilitate skin tightening.

External Ultrasound Liposuction

A technology, which places the ultrasound probe on the surface of the skin before the procedure after injecting tumescent fluid as in Liposculpture. It facilitates liposculpting and decreases bleeding. An additional advantage is that it causes less bruising and pain for the patient and possibly it enhances the result. It is performed with no anesthesia after ingestion of fluids or under local anesthesia. It is not as popular and effective as Internal Ultrasound Liposuction and today it is supplanted by the Laser lipolysis as both are minimally invasive. There are no scars and the fat destroyed by the ultrasound is not removed with a cannula as in conventional liposuction. Long term effects are not proven but may be of benefit in smoothing contour irregularities and softening the firmness in the immediate post-operative period following liposuction. Dr. Hervé Gentile frequently uses it after Internal ultrasound liposuction for this reason. Sometimes multiple treatments are necessary.

ULTRATHERAPY is similar to the external ultrasound technique that has been cleared by the FDA for non-invasive treatment of the neck, chin and chest wrinkles. It also claims that some lifting of your face can occur. However the improvement is minimal at best when one considers the cost.  Only a few selected candidates will  benefit from external  ultrasound  and therefore Dr. Gentile recommends it only occasionally.

Cryolipolysis ( Coolsculpting )

A vacuum suction technique developed to reduce fat by freezing the fat cells. The lipids contained in the fat cells crystallize and the fat cell dies and is reabsorbed by your body. It is similar to external ultrasound since it is not invasive and does not require general anesthesia but cryolipolysis is not only associated with discomfort and swelling lasting a few days but also has a high incidence of numbness in the treated area.  Other  disadvantages are permanent surface irregularities, severe pain and rarely a paradoxical increase in your fat.  The other drawback is that it requires multiple 1 hour procedures to treat each single area and since most patients have numerous areas that need to be addressed this equals to long hours and days to complete the treatment.  Of course, the results are less dramatic and will never match those achieved with other liposuction methods.  Therefore, it is indicated only in carefully selected patients who have minimal deposits of fat but in these cases Laser liposuction offers better results.

Endodermologie

A machine designed to squeeze the skin and fat, thereby temporarily improving the cellulite. Multiple treatments are necessary and it is quietly being abandoned today despite the media hype describing it as revolutionary.

Art of Liposuction

Liposuction is a medium of artistic expression that displays itself in:

1. application of scientific knowledge
2. the production of what is beautiful
3. a perfection of workmanship
4. a perpetual quest for improvement in technique
5. a skill attained through clinical experience
6. avoiding to expose patients to unnecessary dangers as artistry and safety are related and above all
7. making people feel happy about what they see in the mirror     Dr. Gentile has been performing liposuction since the 80’s.

Body Fat and Liposuction

No matter how much exercise you do, certain areas of fat in your body remain. These areas such as the saddle bags in women and the love handles in men are resistant to dieting as well as strenuous exercising.

Genetically we are all provided with a certain number of fat cells for storage of energy. Fat cells have the capability of increasing or decreasing in size in direct relation to your weight gain or loss. This in turn is related to your caloric intake and consumption. The fat cells that are removed with liposuction are permanently removed and therefore never come back. Since liposuction does not remove skin, the skin must contract and tighten and this will not occur if you have either poor skin elasticity, skin excess or skin flaccidity and looseness. Liposuction results are quite often spectacular if performed on selected persons, but no matter how good your skin is, it is not realistic to expect perfection or to expect liposuction to dramatically change your life. Liposuction is a great operation for removing undesirable fat from any area of the body such as abdomen, breasts, thighs, buttocks, flanks, knees, chin, neck, arms, back and in certain selected patients to perform etching of their abdominal muscles.

Procedure

The procedure is performed in our accredited office surgical suite and takes between 1-3 hours depending on how many areas desire treatment. This operation will give excellent results if performed on the right patient since there is no ideal candidate. The type of procedure used will be determined by the person’s build. The conventional superwet technique is almost always used by Dr. Hervé Gentile, in combination with internal and/or external ultrasound assisted liposculpting and/or laser liposuction. The surgery requires small incisions about a quarter inch long placed near the fat to be suctioned. Occasionally, cellulite limited to a very small localized area can be improved by detaching the fibrous attachments just underneath the skin with the microcannulas, sometimes combining it with fat injection to contour depressions or irregularities. Following surgery a tight elastic compression garment is applied for a few weeks to prevent excessive swelling, bleeding and bruising. More importantly this will also help in shaping the suctioned area as well as shrinking the extra skin and .

Postoperative

You can experience minimal discomfort or some pain which can be controlled by medication. Swelling and bruising slowly subsides in weeks. If you develop a lot of hardness or firmness you will have a few 5-10 minutes external ultrasound treatments to soften the area thereby enhancing your final result. Some patients also have numbness which is usually temporary. Overweight patients will have a higher chance of contour irregularities but their look will be improved in clothing. Usually your scars will almost seem to disappear as they fade with time. Although you will notice the result quickly after surgery, your final result will not appear for several months. Everybody will think you lost weight and nobody will know unless you tell. Your results may be dramatic as your saddlebags, your love handles and buffalo hump in the back disappears, or your legs and hips look shapelier and thinner, but liposuction is not a substitute for exercise and weight loss. To maintain your figure, if your are not at near ideal weight, you will need a proper diet and a moderate exercise program. Remember that liposuction, diet and exercise complement themselves and now is also the time to show off your new figure.

Liposuction Complications

The tumescent technique for liposuction is unquestionably the safest form of liposuction. When tumescent liposuction is done correctly, it is a very safe procedure. Most of the liposuction complications are often the direct result of lack of caution, poor judgment, over confidence or inexperience. Risks of Liposuction must be well understood by all prospective liposuction patients. In order to minimize the risk of liposuction, the patient must be aware of the following facts:

1. Too much liposuction occurs when excessive volume of aspirated fat is removed or too many areas are treated in one stage. This results in excessive surgical trauma and is an important cause of serious complications. Unrelated and multiple surgical procedures on the same day as liposuction are unnecessary, unsafe and are also associated with a higher risk of complications. It is important that you gave your procedure performed in an accredited surgical center.
2. Skin irregularities and depressions are frequently the result of the surgeon’s inattention to detail, inexperience and poor judgment. Overweight patients will have a higher chance of contour irregularities, but their look will be improved in clothing.

Cost

Your cost will obviously depend on how many areas you will need to have addressed. Therefore, it can range from as low as $ 3,800 to $7,000 or more.  Our  quote is all inclusive and the liposuction is performed in our accredited office surgery suite.

Photographs

For your convenience you may view a few selected cases in our Liposuction Before & After photo gallery. To see our extensive photographic catalogues of pre-operative and post-operative photographs please contact our office and schedule a complimentary consultation.