By Elana Pruitt © 2006
PlasticSurgery.com Editor
The majority of men and women have to practically fight to stay fit. And even after sweating up a storm all week long in Pilates and calorie counting every bite you chew, you are left with results that hardly justify how dedicated you are to keeping in shape. So you may ask yourself: Is liposuction my best option? And does this mean that I will never gain back weight in those same areas?
When it comes to getting plastic surgery, don't commit to anything on a whim! It is an elective fat removal method – or what many people probably consider – the procedure to give you the body you wish you were born with. There are risks, uncertainties, and not to mention, a variety of methods you may want to become familiar with before going forward. One of the most important aspects of maintaining the fabulous look your doctor gives you? Your commitment to a good diet and regular exercise.
Plastic surgery gave one anonymous 27-year-old from Southern California the extra help she needed: “I got liposuction because I had that back fat near my bra strap, as well as on my mid-back and lower back."
In about four hours, the mother-of-one received rhinoplasty, breast revision with implant replacement, and liposuction to her “love handles" and waist. Due to her loss of appetite for the first two weeks after surgery, she says that her abdomen was “super flat."
Now, nine months later, she admits that her midsection has gotten a little “pudgy" from a self-proclaimed weakness: “I eat junk food and my weight goes up and down." Yet, she is still happy with the results from liposuction. “They weren't drastic, just a little contouring to make my clothes look better on. I can still see the difference on the love handles and in the waist."
With the evolution of liposuction in the past 30 years, the techniques and methods used today have unique qualities, with some more favorable than others. New York plastic surgeon Dr. Steve R. Fallek prefers the tumescent technique, referring to it as the “Gold Standard."
Born from the traditional liposuction method, which broke ground in 1974, the tumescent technique has grown to be the most common fat removal method among plastic surgeons. After proven risks associated with the original suction-assisted lipectomy procedure, such as excessive trauma to the tissue, extensive blood loss, and nerve damage, a dermatologist decided to revise the procedure by developing the tumescent technique for better safety in the early-80s.
As compared to traditional liposuction, which is performed using a dry cannula to suction fat with intense levels of negative pressure, the tumescent technique employs a large, controlled volume of saline and adrenaline with the use of local anesthesia (the traditional method uses general); injecting a higher ratio of fluid than what is taken out.
“You must watch out for fluid overload," says New York plastic surgeon Dr. George Lefkovits, who specializes in liposuction and buttock fat transplantation, acknowledging that doing so could cause “pulmonary edema" – fluid in the lungs. The super-wet technique, which entails an equal amount of fluid injection and fat removal (1 to 1 ratio), also utilizes the use of general as well as local anesthesia. Taking a considerably shorter time than the tumescent technique, the super-wet technique is generally regarded as safer than the tumescent technique because it reduces the chance of fluid overload. Yet, a major downer to this method is that it tends to cause more blood loss than the tumescent technique; however, it takes less time to perform.
Two other popular variations of liposuction include ultrasound-assisted lipoplasty (UAL) and power-assisted lipectomy (PAL). Developed in the early to mid-90s, the UAL procedure transmits heat and ultrasonic energy to melt away fat cells upon removal. Burns are one major risk, which Dr. Lefkovits says can develop on the skin as well as underneath it. But some doctors may prefer the UAL method for fibrous areas of men's bodies, such as the abdomen, back, and chest.
Then introduced in more recent years, the PAL method brought another dynamic to the scene; involving the use of a cannula attached to a power device designed to break up fat and eliminate the manual back-and-forth motion. But although it generally offers less bruising and faster recovery, not every doctor favors this modification. “I don't like to give up the use of my hands," says Dr. Lefkovits, citing that he prefers the super-wet technique.
No matter how much dieting and exercises a person does, some places do not budge. "Patients should 'pretty much' be at an ideal weight," he says. “Problem areas like ‘saddlebags' are genetically disposed – this is where liposuction is effective. For men, places like pouches, love handles, and male breast reduction are typical focus areas."
According to the American Society of Plastic Surgeons (ASPS), “The best candidates for liposuction are normal-weight people with firm, elastic skin who have pockets of excess fat in certain areas. You should be physically healthy, psychologically stable and realistic in your expectations."
When you meet with your surgeon, you will learn that this procedure does not offer long-lasting changes without your continual dedication to staying fit and healthy. Dr. Fallek says he always jokes with his patients about staying on top of what they're consuming.
“Getting liposuction doesn't mean that they can now stuff their face at night with junk. It removes fat cells, but the other cells that remain behind can get fat," he says. Therefore, it is possible to gain back weight in the same area if a patient does not take care of his or her appearance in regards to dieting and exercise, says Dr. Lefkovits. “If people watch their weight, they should not need a second liposuction procedure – even if they think they do," he affirms.
“I have thought about if I would do the lipo procedure again, and I think I will," says the 27-year-old post-op patient, having yet to mark a full year since surgery. “I definitely would like to have a little lipo done to my lower abdominal area for a completely flat stomach."
The lesson she's taken away from her experience with surgical fat removal runs true, and may be the most common sentiment your plastic surgeon will share with you: “The thing you have to remember that after having lipo is that you need to watch what you eat and exercise. It is only a temporary quick fix if you don't maintain it."