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LIPOSUCTION...
Introduction --
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. Each 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.
The first Lipoplasty using a cannula was performed by Dr. Giorgio Fischer in Rome. Dr. Michele Zocchi of Turin, Italy introduced us to ultrasound assisted liposuction in the 90's. Since then, the newest technology is Laser Lipolysis which has permitted body contouring of areas that before were not possible to treat. Despite the great deal of good and bad press, liposuction 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.
Definitions --
1. LIPOSUCTION:
The procedure in which fat is removed by aspiration via a cannula placed through a very small incision.
2. 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.
3. 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.
4. 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. Herve` Gentile uses the latest generation Laser from Osyris Medical, which is much improved over previous versions such made from different 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. Herve` 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.
5. 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 lipo 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. Herve` 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.
6. 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 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. Herve` Gentile frequently uses it after Internal ultrasound liposuction for this reason. Sometimes multiple treatments are necessary.
The latest technology which boasts the ability to decrease fat without using the knife is HIFU ( high intensity focused ultrasound) has not as yet been approved in the US by the FDA . HIFU destroys fat by sharply focusing low intensity energy just underneath your skin. In the studies conducted outside the US it has shown promise. Clinical trials will determine whether it will be approved in the US.
7. CRYOLIPOLYSIS:
A vacuum suction technique developed to reduce fat by cooling 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 a drawback is that cryolipolysis is associated with a high incidence of numbness. Of course the results will never match those achieved with other liposuction methods and therefore it is indicated only in carefully selected patients who have minimal deposits of fat ( but in these cases Dr. Herve` Gentile recommends Laser liposuction since it offers better results).
8. ENDODERMOLOGIE:
A machine designed to squeeze the skin and fat, thereby temporarily improving the cellulite. Multiple treatments are necessary and it is abandoned today.
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 if you have either poor skin elasticity, skin excess or skin flaccidity and looseness, this will not occur. 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 office surgical suite and takes between 1-4 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. Herve` 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.
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.
PHOTOGRAPHS --
For your convenience you may view a few selected cases by clicking the Photos button on the left. We do have extensive photographic catalogues of pre-operative and post-operative photographs that you can view by contacting our office and scheduling a complimentary consultation.
See also:
TUMMY TUCK (ABDOMINOPLASTY)
1-361-881-9999 or 1-877-GENTIL4
Contact us by
HERVE` GENTILE, MD, FACS
A BETTER YOU
1102 Ocean Drive
Corpus Christi, TX 78404Our facility is certified to the highest standards by the American Association for Accreditation of Ambulatory Facilities (AAAASF) as a class C (the highest classification).