When diet and exercise fail, liposuction wins

Do you have:

• Areas of stubborn body fat that won't budge—no matter how often you go to the health club?
• Excess fat deposits that make certain areas of your body appear disproportionately large?
• A body weight within 30% of your ideal, but a busy schedule that doesn't allow you to spend hours in the gym every week?

Many men and women are turning to liposuction to get rid of isolated fatty areas that are resistant to diet and exercise. By removing fatty deposits, this procedure can significantly improve your contours and design a more flattering shape.

Liposuction—most commonly performed on the abdomen and hips—is the most popular cosmetic plastic surgery in the U.S. The American Society for Aesthetic Plastic Surgery reports that 403,684 liposuction procedures were performed on men and women in 2006.

What is liposuction?

Liposuction—also known as lipoplasty or suction lipectomy, is a minimally invasive plastic surgery procedure that sculpts the body by suctioning away unwanted fat deposits.

Since its debut in France more than 20 years ago, liposuction has gained worldwide experience and is now safer and produces more predictable results than ever before.

Who is a candidate for liposuction?

The best candidates for liposuction are men and women close to their ideal weight with good overall health and elastic skin tone.

Which body areas can liposuction treat?

• Face
• Neck and under the chin
• Breasts (in men and women)
• Upper and lower back
• “Bra bulge” in the mid-back
• Upper arms
• Upper chest near the armpit
• Abdomen
• Inner and outer thighs
• Back of thighs above the knees
• Buttocks
• Knees
• Calves
• Ankles

Who is not a good candidate for liposuction?

You are likely not a good liposuction candidate if you have:

• A history of smoking or poor healing
• Lupus
• Diabetes
• Chronic blood or heart disease
• Poor skin elasticity

Older patients have less elasticity in their skin; their liposuction results will not be as favorable as someone younger with good skin tone.

How is liposuction done?

Dr. Rappaport performs liposuction using a cannula&mdsah;a blunt, hollow rod attached to a flexible plastic tube. This tube is connected to a high-powered vacuum machine.

Dr. Rappaport makes tiny incisions and inserts the cannula below the skin to loosen and remove fat, sculpting the region. Cannulas come in different sizes to treat different areas of the body.

Which liposuction techniques does Dr. Rappaport use?

Dr. Rappaport performs three liposuction techniques:

• With the tumescent technique, Dr. Rappaport pre-injects the fat with a saltwater solution containing small amounts of adrenaline and a local anesthetic. This fluid helps him remove the fat more easily, controls bleeding in the area, provides anesthesia during and after surgery, and helps reduce bruising. Tumescent liposuction can be done under general or local anesthesia.
• Power-assisted liposuction, or PAL, complements tumescent liposuction. Dr. Rappaport uses a powerized cannula which requires less force to remove unwanted fat, especially in more fibrous tissue.
• Ultrasound-assisted lipoplasty, or UAL, is a two-step technique in which Dr. Rappaport uses energy from sound waves to liquefy the fat before suctioning it out of the body.

What kind of anesthesia is used for liposuction?

Liposuction can be done either under general anesthesia, where you will sleep through the procedure, or under local anesthesia with sedation to relax you. The type of anesthesia Dr. Rappaport recommends for you will depend on the extent, size and location of the areas of surgical involvement.

Does liposuction require a hospital stay?

Most liposuction procedures are performed in an outpatient setting in one to three hours.

How much fat is removed during liposuction?

Liposuction removes up to five liters (about 11 pounds) of unwanted fat, depending on the patient and the body area being treated.

Large-volume liposuction, involving more than five liters of fat, is more complex and may be performed in a hospital or considered a multi-stage procedure.

What is involved in recuperation from liposuction?

You can expect to be up and walking around shortly after liposuction surgery to minimize risks due to poor circulation. To promote proper circulation and reduce swelling and bruising, you will need to wear an elastic garment on the treated area to compress your new shape. Most patients are back to work within the week.

You will probably experience some temporary numbness, bruising and swelling. Contour irregularities may occur as fat settles. You will see results immediately, but your body contours will continue to refine over several weeks. Your overall shape can continue to improve with proper exercise.

Dr. Rappaport answers questions
about liposuction

I really need to lose weight. Is liposuction a good option?

“Liposuction is not a weight loss program, but it is sometimes the only way to eliminate fat deposits that do not respond to diet and exercise.”

Do you perform liposuction in combination with other procedures?

“Yes. I often use liposuction in conjunction with tummy tucks, lower body lifts and upper body lifts for best results. Liposuction is also very effective in refining certain facial and neck procedures.

Which liposuction technique is best for me?

“Before I can determine which liposuction technique is best for you, I need to look at your overall health, skin quality, body mass, estimated volume of fat to be removed and the number of sites to be treated. I can easily determine this during your personal consultation.”

Can my dermatologist do liposuction on me?

“A dermatologist can perform liposuction if he or she has completed specialized training in liposuction and if the procedure is of limited scope. Facial plastic surgeons are well- suited to do liposuction if the case involves only the face and neck.

“A board-certified plastic surgeon is the only medical professional you should consider for any area of your face, breast or body, particularly if liposuction is combined with other surgical procedures.”

Can liposuction give me a six-pack?

“No. Liposuction does not tighten skin; it sculpts the body. A six-pack is muscle, and only exercise can create one. However, liposuction can reveal better definition of the underlying musculature.”

Is it true that liposuction can help cellulite?

“No. In fact, it can make cellulite worse. Liposuction removes volume, which can result in making the skin looser if you don't have good skin elasticity. Cellulite is not fat.”

Will my fat come back, or is liposuction permanent?

“Liposuction doesn't remove all fat cells. If you gain a lot of weight, the treated areas will get larger, but the overall improvement in contour will remain. It is important to commit to a regimen of healthy diet and exercise to maintain and maximize your results.”

What results can I expect from liposuction?

“The primary goal of liposuction is to improve the contour of the treated area, creating better body proportion. Very soon after surgery, you can expect to see a noticeable difference in the shape of your body. Many patients find that their new, slimmer shape boosts their self-confidence and makes them look more attractive in clothing.

“Your incision line will fade in the months following surgery, although the scar will be permanent. Unless you gain or lose a significant amount of weight, you can expect to retain your new shape for many years.”