liposuction

Which Type of Liposuction Is Best?

types of liposuctionLiposuction is a cosmetic procedure to remove excess fat from specific areas of your body. Everyone is different, and it can be difficult to know which liposuction technique is appropriate for you.

Liposuction may be right for you if you:

  • Are at or near your desired weight
  • Have good skin elasticity
  • Have certain areas that are out of proportion with the rest of your body, and are not improved with diet and exercise

Types of Liposuction Procedures

While everyone has heard of liposuction, many may not know there are actually several different techniques available to help you achieve your desired results.

Regardless of technique, in most cases, the fat is prepared for removal by inflating it with a balanced saltwater solution that often contains lidocaine for pain relief and epinephrine to minimize bruising. This instillation of fluid is referred to as the tumescent preparation of fat.

Suction-Assisted Liposuction

While the preparation for fat removal is fairly standard (as described above), the technique for removing the fat can vary.  The most common type of liposuction involves using negative pressure to remove excess fat from an anatomic area.

After the fat is filled with tumescent fluid, the surgeon uses a thin tube (cannula) that is connected to a suction device. The fat is broken up and removed when the surgeon repeatedly passes the tip of the cannula through the fat. Most of the time, the fat is discarded. However, if you’d like to augment volume in other areas of your body, your surgeon may use it.

A new technology, called power-assisted liposuction, uses a mechanically enhanced cannula for easier passage and more thorough removal of unwanted fat.

Laser and Ultrasonic Assisted Liposuction

Some surgeons prefer to pretreat fat with a laser or ultrasonic device. There are many varieties of these devices on the market, but they all have the same method of treatment. Electromagnetic energy, by laser or ultrasound, is delivered to the targeted fat cells. The energy is converted to heat that breaks down the fatty tissue prior to aspiration, or removal of fat. Though not scientifically proven, some believe that breaking up the fat in this way allows for a better result because there is a more thorough removal of fat and by the tightening of connective tissue including the skin.

Your surgeon can usually perform most liposuction procedures while you are awake, using local anesthetics to numb the area. However, your surgeon can decide if more sedation is needed.

In some instances, patients may be put to sleep completely in the operating room. These decisions are made based on your surgeon’s judgment.

A Nonsurgical Way to Reduce Fat: Coolsculpting®

Coolsculpting is a nonsurgical way to “freeze off the fat.” A special pad is applied to the targeted area to freeze fat beneath the skin, without affecting the skin itself. Once the fat has been frozen and crystallized from the treatment, your body slowly destroys and discards the unwanted fat cells. Most patients start to see changes within three weeks, seeing final results within one to three months. It usually takes two or more treatment sessions to achieve results similar to liposuction.

How to Choose the Right Procedure

If you’re feeling confused by all these options, there’s good news — it’s actually as simple as choosing the right cosmetic surgeon. Ultimately, your results depend on finding an expert surgeon who is skilled in different liposuction techniques and understands what results you want that leads to the most favorable outcome. So, do your homework. Check credentials. Ask to see before and after pictures from their previous liposuction patients. And just as importantly, make sure the two of you communicate clearly.

Emory Aesthetic Center

Emory Aesthetic Center offers a variety of fat-removing procedures. If you’re interested in liposuction, schedule your complimentary consultation and experience the Emory difference today.

Request an appointmentor call us at 404-778-6880.

Choosing a Cosmetic Surgery Center

View of Emory Aesthetic Center Building EntranceWhy Choose Emory Aesthetic Center? If you’ve been thinking about cosmetic surgery, you probably have a lot of questions like “Why choose Emory Aesthetic Center.” “How do I find the right doctor for me?” “How do I know it will be safe?” “What kind of procedure do I need?” Then, like most people, you’ll likely turn to the internet for answers. But is the information accurate? Who and what can you believe?

Emory Healthcare: A Name You Can Trust

Emory Healthcare is the region’s most comprehensive academic healthcare system. It’s home to highly-regarded doctors who conduct innovative research and are ranked among the top for patient care. But is Emory the right place for cosmetic surgery? Absolutely. With an aesthetic center dedicated solely to surgical and nonsurgical cosmetic procedures, how could you go wrong?

Specialized Cosmetic Surgery Team

Cosmetic surgery is what we do. When you choose Emory Aesthetic Center you get a cosmetic surgery team filled with innovators in the field. Many of our expert surgeons teach nationally and internationally and have served as leaders in regional, national and international societies. Collectively, our team has also published hundreds of contributions in journals and books about how to perform cosmetic procedures — safely.

In addition to top-notch surgeons, our entire staff — including anesthesiologists, nurse anesthetists, nurses, technicians and more — works together to provide the best care in a center that meets the highest standards of credentialing.

Wide-Array of Surgical and Nonsurgical Cosmetic Procedures

How can you know if the procedure being recommended is the best choice for you? There’s a saying, “If the only tool you have is a hammer, the whole world looks like a nail.” That’s the problem with going to a center that has limited offerings. You will only be offered the choices they are able to provide.

Body contouring is an excellent example of why it’s important to go to a center that can offer a variety of procedures. Let’s say you want to improve the look of your abdominal area. There are several surgical and nonsurgical options for different situations:

  • Coolsculpting® can reduce small amounts of localized fat deposits, without surgery.
  • Liposuction may be needed if there is a higher percentage of fat to be removed.
  • Abdominoplasty (tummy tuck) is needed to remove significant excess skin from the tummy.
  • A body lift may be needed to tighten and firm the abdomen, thighs, and buttocks of a patient who has lost a significant amount of weight.
  • Or a combination of the procedures above may be required to give the best results.

At Emory Aesthetic Center, we’re continually studying, teaching and publishing about cosmetic procedures, so we’re always on top of the newest developments. We offer the entire spectrum of surgical and nonsurgical cosmetic procedures, including cosmetic surgery, skin care, facial rejuvenation and body contouring. Our familiarity with the full-variety of techniques available enables us to guide you toward the procedure that fits you best.

Luxurious Atmosphere

At Emory Aesthetic Center, you’ll get the best of both worlds — clinical excellence and a luxurious experience. You won’t feel like you’re in a hospital. Our center is quiet and elegant and stands remote from the main campus. Our entire staff is focused on ensuring you have a great experience. Whether you’re here for a skin treatment in our Spa or surgical treatment in the operating room, we’re ready to give you the experience of a lifetime.

Request an appointmentor call us at 404-778-6880.


Choose Emory Aesthetic Center

Emory Aesthetic Center is the right choice for your cosmetic procedure. But don’t take our word for it, schedule your complimentary consultation and experience the Emory difference today.

Target Stubborn Fat with Liposuction

miotto-gabriele-caceres-liposuctionYou cleared out the bulky sweaters and brought in shorts and flip-flops with a smile. But did you hesitate before you put your favorite bikini back in the closet? The truth is you may be at a healthy weight — downright skinny even — and still have areas of localized fat that won’t go away no matter how hard you work out. Those stubborn fat deposits that don’t respond to diet and exercise are ideal target areas for treatment with liposuction.

What is liposuction?

Liposuction (also called lipoplasty or lipectomy) is a safe and proven procedure that allows your surgeon to permanently remove unwanted fat from your innermost layer of skin and sculpt a slimmer, curvier physique.

During the procedure, your surgeon will insert a hollow instrument (cannula) through small incisions. With a controlled back-and-forth motion, the excess fat is dislodged and removed from your body.

Different surgical techniques are available and use slightly different methods for removing the fat once it’s loosened. Your surgeon may use traditional vacuum-assisted, power-assisted or ultrasound-assisted liposuction. Only a surgeon can help you decide which technique is right for you.

Liposuction can be done under local or general anesthesia depending on the areas being treated. It’s an outpatient procedure, so you can go home the same day of surgery. Since there are minimal incisions, patients usually recover quickly. Some bruising and swelling are common, but you can usually return to work and daily activities after a few days.

Which parts of my body can be treated?

Liposuction can be used for contouring almost any area of the body. Most commonly, your:

  • Stomach
  • Waist Line (“love handles”)
  • Arms
  • Thighs

But it can also be used to sculpt your neck, remove a “double chin” or reshape your breasts. The results can be dramatic, creating sleek and slim contours in the treated areas. You may even be able to have multiple areas treated in a single surgery, as long as your surgeon agrees it’s safe to do so.

Liposuction can be done by itself or in combination with other procedures to improve the overall result, such as a tummy tuck. When performed in combination with another procedure, the fat that’s removed is kept sterile and often transferred into your buttocks or breast for augmentation and reshaping of those areas, if desired. The fat can also be used on your face to treat fine lines and wrinkles. This type of procedure is called a fat transfer or fat grafting. Fat from liposuction is a natural, biocompatible and non-allergenic filler.

Am I a good candidate for liposuction?

There are a few things to consider with your doctor when deciding if liposuction is right for you:

  1. Are you at a healthy and stable weight? Liposuction isn’t a weight loss solution and if your weight fluctuates, your results won’t last.
  2. Are you in good general health? As with any other surgery, you must be in good general health before surgery is considered safe for you.
  3. Do you have good skin elasticity? Your skin must be able to retract (bounce back) once the unwanted fat is removed.

Schedule a consultation

Liposuction is a sound and effective way to help you get your body reshaped and bikini ready. Schedule a complimentary consultation with one of our expert cosmetic surgeons at the Emory Aesthetic Center.

Request an appointment

Or call us at 404-778-6880 to schedule your free personal consultation.

Your Body Contouring Questions Answered!

Body Contouring Options - Non-surgical & Surgical On March 28th, 2017, Emory Aesthetic Center plastic surgeon, Dr. Gabriele Miotto held an informative live chat on body contouring. With summer coming, many want to know how to improve the shape of their body and tighten excess or loose skin. Dr. Miotto discussed both non-surgical and surgical options – including CoolSculpting, liposuction and tummy tucks.

The live chat had a great turnout and is now available online.

Body Contouring Live Chat, 3/28/17

[Mar 28 2017, 11:48 AM] EmoryHealthcare: We are starting the live chat in 14 min. Are you, guys, ready? We see a few people online waiting and we are ready for your questions. Dr. Miotto is so excited to help all our guests today!

[Mar 28 2017, 12:00 PM] EmoryHealthcare: Welcome everyone! Thanks for joining us today for our web chat about
Body Contouring with Dr. Gabriele Miotto of Emory Aesthetic Center.

[Mar 28 2017, 12:02 PM] EmoryHealthcare: We’ll get started in just a minute. Dr. Miotto is here to answer all of your questions!

[Mar 28 2017, 12:05 PM] EmoryHealthcare: Please note that all questions are moderated before appearing in the stream, so you may not see yours appear right away, but we will do our best to answer all of your questions today.

[Mar 28 2017, 12:06 PM] EmoryHealthcare: We received some questions that were submitted in advance of the chat, so we’ll get started by answering a few of those first.

[Mar 28 2017, 12:08 PM] EmoryHealthcare: Lynn asked: “I am 5’10” and 126lb. I look skinny but have severe cellulite. I’m embarrassed to wear a bathing suit. What do you recommend?”

Dr. Miotto: If there is no weight issues, cellulite can be improved by localized leg exercising and changing your diet (no sugar, low carbohydrates, etc). Healthy life habits always improve the skin overall. Lymphatic drainage massage can have some beneficial effect if there is fluid retention in the tissues.

If the dimpling is very severe, we can perform a procedure

[Mar 28 2017, 12:11 PM] EmoryHealthcare: Anna asked: “Are there any changes to my diet that I can make to reduce my cellulite?”

Dr. Miotto: Low sugar diet can help with cellulite. If you are overweight, weight loss associated with exercise also improve the quality of skin.

[Mar 28 2017, 12:14 PM] EmoryHealthcare: Sydney asked: “Do sleep and the level of stress I have affect my weight?”

Dr. Miotto: A good night sleep is very important for balancing the body functions. It helps the body produce its hormones and can definitely affect your weight. When stressed, we tend to eat more and not to pay attention to the quality of the food we eat, so it can promote weight gain.

[Mar 28 2017, 12:22 PM] EmoryHealthcare: Tina asked: “After having two babies, I have a lower abdominal pooch that just won’t go away with diet and exercise. I’d love to get back into my bikini. What can I do?”

[Mar 28 2017, 12:22 PM] EmoryHealthcare: Dr. Miotto: After having babies, the abdominal pooch is usually caused by fatty deposits, skin laxity or muscle laxity, or even a combination of those. During the consultation, we can determine the main cause of the pooch and decide between the different procedures we do which one will be best for you. Options include liposuction, tummy tuck, Coolsculpting or a combination of them.

[Mar 28 2017, 12:23 PM] EmoryHealthcare: Tatyana asked: “I am unhappy with my stomach. I am considering liposuction. What is the recovery like?”

[Mar 28 2017, 12:23 PM] EmoryHealthcare: Dr. Miotto: Recovery depends on the amount of liposuction that we need to do but usually patients go back to work in 5-7 days.

It is common to have tenderness for the first 48-96 hours that responds well to pain medications. A postoperative compression garment is also recommended for a couple of weeks to help with healing. Mild bruising and swelling can last for a few weeks so plan to do the procedure at least 4 weeks before going to be beach

[Mar 28 2017, 12:25 PM] EmoryHealthcare: Caroline asked: “I like to eat fruit for dinner. Like bananas and grapes. And oranges. Does this habit contribute to my weight gain?”

[Mar 28 2017, 12:26 PM] EmoryHealthcare: Dr. Miotto: Weight gain can have many factors.

Eating fruits at night could contribute to weight gain. Sweet fruits like bananas, grapes, oranges have a high fructose content that functions as sugar in the body. Think about sweet fruits as desert and start your dinner with vegetables and legumes instead to balance your diet and reduce the sugar content of your overall intake.

[Mar 28 2017, 12:26 PM] EmoryHealthcare: Maria asked: “When I wear a dress, it looks like I have a muffin on my belly. I don’t like being in pictures because of it…. How can you help me?”

[Mar 28 2017, 12:28 PM] EmoryHealthcare: Dr. Miotto: Fatty deposits in the abdomen can look like a “muffin top”. Depending on your skin laxity and muscle tone it is possible to remove the extra fat with liposuction or a tummy tuck. Non-invasive fat removal using Coolsculpting could also be an option in some cases.

[Mar 28 2017, 12:33 PM] EmoryHealthcare: Kara asked: “When would one consider a tummy tuck over lipo?”

[Mar 28 2017, 12:33 PM] EmoryHealthcare: Dr. Miotto: Liposuction does not treat skin or abdominal muscle laxity, it only removes fat. So if there is an association of fatty deposits with skin laxity and/or muscle laxity a tummy tuck is the right procedure for you.

[Mar 28 2017, 12:33 PM] Guest5387: what exactly is cool sculting

[Mar 28 2017, 12:37 PM] EmoryHealthcare: Dr. Miotto: CoolSculpting® is an FDA approved treatment that works without surgery, needles, or anesthesia.

[Mar 28 2017, 12:37 PM] EmoryHealthcare: The procedure cools and freezes unwanted fat—without damaging surrounding tissues.

[Mar 28 2017, 12:37 PM] EmoryHealthcare: Once the fat has been frozen and crystallized from the treatment, the body will slowly break down the unwanted cells and dispose of them, resulting in gradual fat loss following the treatment.

[Mar 28 2017, 12:37 PM] EmoryHealthcare: Most patients start to see results within about three weeks, with final results becoming apparent within 1-3 months after treatment.

[Mar 28 2017, 12:37 PM] EmoryHealthcare: Great question, @Guest5387! Thank you.

[Mar 28 2017, 12:39 PM] EmoryHealthcare: Kelly asked: “I want to add some fullness to my bottom. What are my options?”

[Mar 28 2017, 12:39 PM] EmoryHealthcare: Dr. Miotto: A great option to add fullness to the bottom area is by transferring your own fat into the buttocks. Fat is removed from areas like abdomen, waist line, tights or back using liposuction. Then, the fat is prepared as a filler and reinjected into the buttock to increase the volume and improve the shape of the area.

[Mar 28 2017, 12:41 PM] Guest8698: Do you recommend waist training?

[Mar 28 2017, 12:41 PM] EmoryHealthcare: Great question, @Guest8698!

[Mar 28 2017, 12:42 PM] EmoryHealthcare: Dr. Miotto: That is an option for body shaping but the effects are not reliable for long term improvement. It also depends on your weight, initial body shape and exercising.

[Mar 28 2017, 12:42 PM] Guest7903: What procedures do you recommend for men?

[Mar 28 2017, 12:42 PM] EmoryHealthcare: Thank you, @Guest7903!

[Mar 28 2017, 12:42 PM] EmoryHealthcare: Plastic surgery procedures can be done for men and women alike. Liposuction, tummy tucks and Coolsculpting are frequently used to improve body contouring in men of all ages.

[Mar 28 2017, 12:43 PM] EmoryHealthcare: @Guest7903, that was a response from Dr. Miotto 🙂 Thanks 🙂

[Mar 28 2017, 12:45 PM] Guest2220: Where can I see a full list of of the services Dr. Miotto offers?

[Mar 28 2017, 12:46 PM] EmoryHealthcare: @Guest2220, Dr. Miotto does all of the facial and body contouring procedures available on the Emory Aesthetic Center’s website page here: http://www.emoryhealthcare.org/centers-programs/aesthetic-center/index.html

[Mar 28 2017, 12:46 PM] EmoryHealthcare: @Guest2220, thanks for the great question 🙂

[Mar 28 2017, 12:47 PM] Guest8162: I’m a male with just enough fat below the bellybutton to bother me. A friend who’s had cool sculpting said it didn’t work. Do you recommend another type of non-invasive procedure?

[Mar 28 2017, 12:48 PM] EmoryHealthcare: @Guest8162, Dr. Miotto says: Unfortunately, there is no other non-invasive fat removal procedure that is effective. I would recommend a small liposuction. When the fatty deposits are small it can safely be even done under local anesthesia with a light sedation or even under straight local anesthesia.

[Mar 28 2017, 12:49 PM] Guest950: Sorry if this was already asked, but do those heat based non surgical procedures work and do you recommend them?

[Mar 28 2017, 12:50 PM] EmoryHealthcare: @Guest950, Dr. Miotto is asking if you could please clarify which ones you are including in your question. Thank you.

[Mar 28 2017, 12:52 PM] EmoryHealthcare: We are so excited about your questions, everyone! We have 9 min left and 3 questions are now being answered by Dr. Miotto, so they will be posted in a minute. Please submit your question asap if you’d like her to answer them. Thank you 🙂

[Mar 28 2017, 12:52 PM] Guest950: I think it’s called thermage?

[Mar 28 2017, 12:53 PM] EmoryHealthcare: Thank you, @Guest950, Dr. Miotto will answer in just a second 🙂

[Mar 28 2017, 12:55 PM] EmoryHealthcare: We have 2 questions’ answers coming and you have 6 min left to ask yours 🙂

[Mar 28 2017, 12:56 PM] Guest761: Can I get body contouring after bariatric surgery?

[Mar 28 2017, 12:56 PM] EmoryHealthcare: Very good question, @Guest761!

[Mar 28 2017, 12:56 PM] EmoryHealthcare: @Guest761, Dr. Miotto said: “Absolutely! There are several procedures that can be performed to treat the extra skin and fat that remains after massive weight loss.”

[Mar 28 2017, 12:57 PM] EmoryHealthcare: Bella asked: “When would one consider a tummy tuck over lipo?”

[Mar 28 2017, 12:58 PM] EmoryHealthcare: Dr. Miotto: Liposuction does not treat skin or abdominal muscle laxity, it only removes fat. So if there is an association of fatty deposits with skin laxity and/or muscle laxity a tummy tuck is the right procedure for you.

[Mar 28 2017, 12:58 PM] Guest2220: Does Emory offer financing for procedures?

[Mar 28 2017, 12:59 PM] EmoryHealthcare: @Guest2220, we do offer financing through Care Credit https://www.emoryhealthcare.org/centers-programs/aesthetic-center/become-a-patient/index.html

[Mar 28 2017, 12:59 PM] EmoryHealthcare: @Guest950, Dr. Miotto said: Heat based procedures were designed to improve skin laxity of the face and body. They have some effect for mild laxity, mostly on the face and neck, but not a consistent effect for body skin laxity. They are not effective devices for fat removal.

[Mar 28 2017, 1:00 PM] EmoryHealthcare: That’s all the time we have for today. Thanks so much for joining us! As we mentioned, we’ll follow up with a blog post to answer any questions we didn’t get a chance to address today.

[Mar 28 2017, 1:01 PM] EmoryHealthcare: Thanks for your questions. Have a great day, everyone!

[Mar 28 2017, 1:02 PM] Guest950: Thanks for your time

[Mar 28 2017, 1:02 PM] Guest3275: thank you!

[Mar 28 2017, 1:02 PM] Guest5784: It says Dr. Miotto explores cutting edge technology. are there any techniques or procedures she uses that haven’t been mentioned?

[Mar 28 2017, 1:02 PM] FSUnole755: I’ve seen advertisements to Cool Sculpting and it seem like everyone is doing it. Should I be selective on choosing a person to do body contouring?

[Mar 28 2017, 1:03 PM] EmoryHealthcare: All unanswered questions will be answered in a followup blog. Thanks, everyone and enjoy the rest of your day!


About Dr. Miotto

Dr. MiottoDr. Miotto is constantly exploring cutting edge technologies to provide the best available options to her patients. She has published and presented on aesthetic plastic surgery in many national and international meetings. Her main interests include body contouring, facial rejuvenation, eyelid surgery, rhinoplasty, aesthetic breast surgery and fat grafting.

After completing medical school under a full academic scholarship at the prestigious Federal University of Rio Grande do Sul, Dr. Miotto trained at the Hospital de Clinicas and at Santa Casa in Porto Alegre, Brazil. She also received additional training at Emory University and completed a fellowship in Aesthetic and Oculoplastic Surgery with Dr. Clinton McCord and Dr. Foad Nahai at Paces Plastic Surgery in Atlanta. She is a “Membro Titular” of the Brazilian Society of Plastic Surgery, the highest level of credentialing for board-certified plastic surgeons in Brazil.

Dr. Miotto is committed to providing excellent care to her patients. She has a passion for restoring and enhancing beauty through surgical and non-surgical cosmetic procedures of the face and body.

Your Body Contouring Questions Answered: Getting Ready for Swimsuit Season

swimsuit-chat-260x200-emailAs we kick-off the summer months and have officially reached bathing suit season, it is natural that many of us take a look in the mirror and think about how we might change our body. In addition to keeping a healthy diet and exercising regularly, there are now more choices than ever in how we might achieve our goals. But with so many choices, both surgical and non-surgical options, choosing what body contouring procedure is best for you can be difficult.

During our live chat on Tuesday, March 22nd, hosted by Emory Aesthetic Center’s plastic surgeon, Dr. Felmont Eaves, we answered your questions around body contouring options to help shape your body for summer and tighten excess or loose skin. Dr. Eaves discussed both surgical and non-surgical procedures – including liposuction, tummy tucks, and thigh lifts.

Below are just a few highlights from the chat. A full list of questions and answers can be found on our chat transcript. You can also visit emoryaesthetic.org for a full list of services and treatments offered by the Emory Aesthetic Center.

Question: How do you get rid of a stomach belly fat?

Dr. Eaves: If diet and exercise don’t get you what you want, then there are three main ways to address belly fat, non-surgical fat reduction, liposuction, or abdominoplasty. Which one is best for a patient depends on their individual circumstances.

For instance, non-surgical treatments like Coolsculping® work best in patients with smaller amounts of fat and youthful, elastic skin. Liposuction works best in similar patients, however is more aggressive in terms of fat removal. The tummy tuck is the “king” of tummy contouring – it can tighten muscles, reduce fat, and tighten skin. Tummy tucks are more common in patients that have had pregnancies or who are a bit older and have developed some skin laxity.

Question: I have 2 weeks until I have to be in a bathing suit. What are some quick fixes that can be done with belly and thigh bulges?

Dr. Eaves: That doesn’t give much time! I’m afraid that neither surgery nor non-surgical fat removal would work and get you ready in such a short period of time.
One thought, however. We often think about concentrating on getting our bodies (or faces) ready for a big event. However to get your body where you want, it really takes a sustained, consistent approach. Crash diets and hours in the gym for short periods of time doesn’t really get you anywhere . . . a good, healthy, balanced and sustainable diet coupled with a reasonable exercise routine that you can stick with is the key. Of course surgery can help a lot, but the patient gets the very best results when they get their weight and health to a good place.

Question: Is there such a thing as a “mini” tummy tuck which does not have to go all the way across the abdomen?

Dr. Eaves: Not only is there the mini-tummy tuck, but some patients are candidates for tummy tucks with even shorter scars – the endoscopic tummy tuck. However before you get excited about these options, be aware than only a very small percentage of patients are candidates for these procedures. In order to be a candidate, you need to have good, elastic skin and relatively small amounts (or not) excess fat.

These procedures are ideally suited for patients who have experienced some spreading of the muscles of the abdomen from pregnancy, which we call a diastasis recti. If you have any significant amount of loose skin, or more significant fatty deposits, you are unlikely to get a good result with a limited scar approach. That being said, we now use techniques to help the scar appear better, such as special sutures that take the tension off of the skin. There sutures also eliminate the need to have surgical drains with a tummy tuck, which is a big plus.

Question: I need help with both my tummy and my breasts. Can I have both surgeries at the same time?

Dr. Eaves: Not only can you treat both the tummy and the breasts at the same time, but this is a very common procedure. For the tummy, most often this involves a tummy tuck due to the effects of the pregnancy. What we might do in the breasts depends on how the breasts recovered after pregnancy and maybe breast feeding. For instance, if the breast lost volume but didn’t become saggy (we call that “ptosis”), then a breast augmentation is a great option.

If you like the size of the breasts but they have become too droopy, then you would likely want a mastopexy, or breast lift, but without implants. It is also quite common to do both breast augmentation with implants and a lift. If you have a consultation with a plastic surgeon, he/she can help you sort through these options and see which is best for you.

cta-learn-blue

or call us at 404-778-6880 to schedule a consultation

If you have additional questions for Dr. Eaves, please feel free to leave a comment in our comments area below.

Fat Grafting 101: What You Need To Know

lovely-ladyIf you are like me, you spend hours at the gym trying to get rid of it and you diet to prevent it. You know what I am referring to…“love handles”, “saddle bags”, basically the accumulation of fat on certain areas of our bodies. But without fat, our faces would appear drawn and old, our breasts and butt would droop and our hands would look like skeletons. In other words, fat is a necessity and it has its benefits. In the right location and quantity, it is a sign of youth. I am not recommending you hang up those running shoes, but at the Emory Aesthetic Center, we can reorganize this necessary fat to improve your appearance, address early aging, and make you feel better about yourself. I am referring to a technique called autologous fat transfer or fat grafting. Let me answer some common questions to help you make an informed decision when considering undergoing this procedure.

What is autologous fat grafting and how is it done?

Some refer to it as fat transfer or fat grafting, but the concept is not new and has been reported as early as 1893. Modern fat grafting did not develop however until the 1980’s with the popularity of liposuction. Today, in a fat grafting procedure, fat is harvested from the body by liposuction. The fat is gently prepared for injection back into the body, and then grafted into an area of deficit with small needles or cannulas. The fat is carefully placed in multiple tissue planes so that it receives plenty of oxygen and nutrients so it can develop a new blood supply. The fat that survives provides the soft tissue volume to address areas of need. The fat that does not survive is absorbed.

What are the common sites of fat grafting?

The most common areas for fat transfer are the face, breast, buttocks and hands. In the face, fat transfer can be done alone or combined with chemical peels or excisional techniques such as a facelift. Fat is typically placed in the cheeks, nasolabial folds (smile lines), and even hollowed temples. Very little volume is needed to improve these deficient areas.

Fat can also be used instead of implants to augment the breast or buttocks. These procedures require larger volumes of fat grafts and in some cases, require more than one surgical stage to get the desired result. Fat grafts can also be used to correct lumpectomy deformities after breast cancer treatment and contour irregularities after liposuction. Releasing the scar in these instances and filling the deficiencies with fat grafts is a powerful improvement tool.

What is the recovery?

Recovery after fat grafting alone is generally rapid and may only be prolonged if additional procedures are performed at the same time. As an example, fat grafting to the cheeks alone may result in bruising of the cheeks and minor discomfort at the fat donor site (where the fat was taken), but requires no time away from work. If this is combined with a full facelift, then the recovery may require 2-3 weeks away from work. Recovery is also longer if a larger volume of fat is transferred. For example, a buttock lift where 600cc of grafts are placed will require 2-3 weeks of recovery compared to the fat grafting of 10cc to the cheeks where you return to work in 2-3days. After an isolated fat grafting procedure, you might notice a week or two of swelling, possibly more if the volume of grafts is high. The injected areas will likely be bruised and feel firm. The sites where the fat was taken will follow a similar recovery. The incisions are small so once swelling and bruising improve, you can be back to regular activities in a relatively short time.

Are there any complications?

Complications like infection can occur but are rare with isolated fat grafting. Donor site complications such as bleeding or contour irregularities are also rare. An additional complication is “loss” of the graft. This refers to fat not picking up a blood supply and being absorbed over time. Typically we wait to judge the increase in volume for 3-6months after the procedure to ensure that the fat has survived.

If you look in the mirror, and see fat that you wish were somewhere else, fat grafting may be a great procedure for you. Come meet with one of the board-certified physicians of the Emory Aesthetic Center. We can discuss your goals and see if fat grafting alone or in combination with other procedures is right for you.

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or call us at 404-778-6880 to schedule a consultation.
emoryaesthetic.org

About Dr. Anderson

anderson-ericaErica Anderson, MD, is board certified by the American Board of Plastic Surgery and currently holds an appointment as Assistant Professor in the Division of Plastic Surgery at Emory University. Dr. Anderson completed her general surgery residency and plastic surgery residency at the University of Colorado Health Sciences Center and associated hospitals in Denver, CO. She completed a year of advanced training in Aesthetic Surgery at Grotting Plastic Surgery in Birmingham, Alabama.

Dr. Anderson returns to Emory University after being in private practice in Arlington, Virginia. While there, she maintained a busy aesthetic and reconstructive practice and also served as Medical Director for the Wound Healing and Hyperbaric Center at Virginia Hospital Center.

Dr. Anderson’s academic and research interests are largely focused on clinical outcomes with regards to cosmetic surgery. Her areas of clinical interest are diverse including cosmetic surgery of the breast and body as well chest wall reconstruction and wound care.

Dr. Anderson is married with 3 children, Trent, Connor and Fiona, and 2 vizslas, Max and Mimi.

Your Weight and Plastic Surgery: Why It Matters

exercising-2womenSometimes patients will go into a plastic surgeon’s office excited about a decision to finally move forward with breast or body contouring surgery, but then afterwards emerge having found out they are not currently a candidate because of excess body fat. This scenario is not only disappointing, but it can be an emotionally deflating and potentially embarrassing experience for patients. As plastic surgeons we sympathize over the emotional pain that such patients feel, and we want to help them realize their goals. However there are several specific reasons that your plastic surgeon might recommend weight loss prior to undergoing a procedure and our motivations are only to provide you with the safest care and the best results.

According to the Centers for Disease Control (CDC), currently 69% of the U.S. population over 20 years of age is overweight. Of this percentage, 35% is obese. So how does the CDC calculate this statistic? First, the CDC defines “normal” weight, “overweight” and “obese” using a formula that calculates Body Mass Index (BMI). This is based on your height and weight. A “normal” BMI is 20-25, “overweight” is defined as a BMI of 25-30, and a BMI over 30 is technically considered “obese”. The BMI calculation is not perfect – for instance it does not take into account muscle mass versus fat mass – yet it is a pretty good basic measurement nonetheless. And it is important to us as plastic surgeons because BMI is a good predictor of the risks of surgery and the likelihood of a good result.

Many medical studies have shown that increased BMI is a predictor of potential complications that can occur from plastic surgery. A higher BMI is associated with an increased risk for wound complications, such as dehiscense (the wound opens up), infection, or tissue necrosis (tissues do not survive due to poor blood supply). The increases are typically small for patients who are overweight – a BMI 25-30, but they start increasing quickly as the BMI enters into the obese range. In general, it is a fair statement that the higher the BMI, the higher the risks of surgery. These complications can be significant, so as plastic surgeons we consider these risks with great thought.

In addition, the results that you can get are likely to be much better if your weight is in a better range. Let’s consider a couple of examples. Say, for instance, that a patient wants breast reduction surgery, but they are very heavy. Even when the breasts become smaller and more uplifted, it is extremely difficult for us to deal with the fullness lateral to the breasts (the “bra roll”), which significantly compromises the aesthetic result. In addition, it is much harder to get a beautiful transition between the breast and the abdomen due to the excess weight. On the other hand, let’s consider the patient that is overweight and wants a tummy tuck or liposuction. In this instance, the surgeon will not be able to remove all the excess fat in these areas, as it is technically challenging and can look odd as it is out of proportion to the surrounding fatty deposits. Even a lot of liposuction cannot fully solve this problem. Body contouring surgery is great for shaping your body, but it is not a method or substitute for weight loss or weight control.

What is the “cutoff” BMI number for plastic surgery? That is a difficult question, and there are some exceptions based on individual surgical procedures, body fat distribution, muscle mass and other factors. Many plastic surgeons consider a BMI above 30 or 32 to be in the range where surgery should be delayed until weight loss is achieved. If you are interested in calculating your own BMI, there are several free online tools, including the one from the Emory Bariatric Center.

As plastic surgeons I believe that we have an ethical responsibility to guide our patients related to their weight and desire for surgery. When surgery is unfavorable due to weight, there is the opportunity to partner toward a weight loss goal. Struggling with excess weight is a problem that so many of us deal with, and it is good to know that someone is on your side and understands. We can provide some advice, but even more importantly we can help guide you toward weight loss experts that help with diet modification and even newer procedures – such as the recently approved intragastric balloon – to assist with weight loss. Let the board certified plastic surgeons of the Emory Aesthetic Center, along with the Emory Bariatric Center, help you achieve the weight and body that you want. Imagine the joy of finally getting your weight under control, and then having the surgery you want to get the most effective results.

404-778-6880
emoryaesthetic.org
Click here to schedule your personal consultation.

About Dr. Eaves

eaves-iii-felmontDr. Eaves recently returned to Atlanta, Georgia, to head the Emory Aesthetic Center as Medical Director, having previously completed his plastic surgery residency as well as a fellowship in endoscopic and minimally invasive plastic surgery at Emory University, The Emory Clinic, and associated hospitals. Before joining the Emory Aesthetic Center, Dr. Eaves was a partner in Charlotte Plastic Surgery for more than fifteen years and served as group president from 2010-2012.

His professional and institutional committee memberships and offices include an impressive list of national, international and local plastic surgery organizations, societies, boards, task forces, advisory councils, coalitions and foundations, including having served as President of the American Society for Aesthetic Plastic Surgery (ASAPS) from 2010-2011 and Trustee (2011-Present).

Dr. Eaves’ primary areas of academic inquiry have been in minimally-invasive and endoscopic aesthetic surgery, patient safety, system and process improvement in plastic surgery, evidence-based medicine applied to plastic surgery and recontouring surgery after massive weight loss. He has received several patents for new medical devices he developed, and has made major clinical service contributions to his field. Dr. Eaves has published more than 100 articles, book chapters and book reviews on plastic surgery in peer reviewed publications, as well as manuals, videos, computer programs and other teaching aids and has coauthored the first textbook on the topic of endoscopic plastic surgery.

Enhancing Your Shape with Liposuction

Screen Shot 2015-09-04 at 1.29.17 PMYear after year, liposuction remains the most common cosmetic surgical procedure in the United States and around the world (although breast augmentation often competes for the top spot). Cosmetic surgeons who perform liposuction are not surprised, as liposuction is one of the most powerful tools in their toolbox to help patients. Many patients, however, may not always be aware that liposuction can work to shape your body in several ways . . . not just as an isolated technique to remove fat.

Liposuction really came into its own during the 1980s. The principal of liposuction is simple – fluid is injected into the fatty layers to help remove the tissue and reduce bleeding, then a blunt hollow tube (a ‘cannula’) is inserted through tiny incisions to suck out the fat. Surgeons move the cannula into different layers and patterns to reduce the thickness of the fat layer and create a smooth surface.

Over the years, several adjunctive technologies have been developed to help with liposuction. These include ultrasonic assisted liposuction (UAL, sound waves help break up the fat), laser assisted liposuction (LAL, the laser energy helps disrupt the fat), power assisted liposuction (PAL, a vibrating tip helps break up firm tissues), and water assisted liposuction (pulses of water help break up the fat). Although the companies that produce these machines will always claim theirs is the best, all of these technologies – including standard traditional liposuction (SAL) without an energy source – work very well. The surgeon’s familiarity with the technology is far more important than which machine they use. As a patient, you should pick the surgeon, and let them use the technology that they feel will work best, rather than be pulled in by fancy company advertising or an interest in a particular technology.

So how can liposuction enhance your shape? Liposuction can remove fatty deposits of the stomach, the flanks (‘love handles’), the thighs, the back, the arms, and under the chin. Patients often treat many areas at one time, and that is a safe and logical strategy, as long as the amount of aspirate (the liquefied fat and liquid that is sucked out) does not exceed recommended amounts. Your surgeon will use the fat removal to, in essence, sculpt your new look. By removing fat in certain areas and leaving the normal fat in others, your contours and curves are optimized.

However in addition to just removing fat, liposuction is important in two other ways. When patients have loose skin, liposuction can be combined with skin removal to create dramatic improvements. A tummy tuck is a great example of how liposuction and excision can be combined . . . by removing the loose skin the tummy skin become tight and smooth, but by adding liposuction the fatty layers can be reduced and shaped as well. It is a great combination.

As a final mechanism, liposuction can function in reshaping your body by providing fat that can be put into other areas where you would like more volume. Over the past 5-10 years, this has been an exciting development in body contouring surgery, as cosmetic surgeons have gotten better and better at using fat to enhance shape. Harvesting fat in one area through liposuction, and then injecting it into another area (‘fat grafting’) can be very powerful. The transplanted fat can enhance volume in areas like the buttocks, the breasts, or the face (think fuller cheeks or softening the deeper grooves around the mouth).

It is important to remember that liposuction is not a weight loss solution – if you need to loose weight, you will get your best results if you do so prior to having liposuction. It is also important to realize that liposuction cannot tighten loose skin. If someone has loose skin in an area where fatty deposits are to be removed, then a combination of liposuction with resection of the loose skin (think tummy tuck with liposuction) is much more likely to give a good result. Liposuction works best in patients who are at a good body weight, have smooth, elastic skin, and where the fatty deposits they want to treat aren’t too big and are well defined.

If you are thinking about how to reshape your body, come in and see one of our board certified cosmetic surgeons at the Emory Aesthetic Center. We can look at your body, help you think through and refine your goals, and figure out how liposuction – or other minimally invasive or surgical procedure – can help you achieve the body shape that you want.

404-778-6880
emoryaesthetic.org
Click here to schedule your personal consultation.

How To Get Cosmetic Surgical Results Without Surgery

natural-beautyNo one really wants to have surgery if they don’t need it; therefore, it isn’t surprising that cosmetic surgeons are asked quite often how someone can get surgical results without actually having surgery. Well, it certainly sounds good . . surgical results without surgery, right? The problem is that it really doesn’t work that way. The long and the short of it is in order to get the dramatic results of surgery, you have to have surgery. But with all of the new non- and minimally-invasive treatment options that have become available in recent years, the answer isn’t always so cut and dry, and there are options. It is not a matter of good versus bad, but really understanding the differences between the surgical and the non-surgical options, and figuring out which one is going to best help you achieve your goals.

The facial region is the area with the greatest number of non-surgical options, from Botox® to dermal fillers and chemical peels to lasers and micro-needling. Non-surgical treatments can be quite effective in the face when you are treating the right problem. Botox® does a wonderful job of temporarily softening wrinkles in the forehead, between the brows, and the sides of the eyes. Dermal fillers can plump up the cheeks and minimize creases around the mouth. Skin products, in-office chemical peels, Intense Pulsed Light (IPL), micro-needling, and lasers can do a superb job of improving the fine wrinkles, texture, and pigment in the skin. However, if you are looking to reduce the jowls, tighten the neck or lift droopy brows or eyelids, then non-surgical treatments won’t provide the results that you seek. It is extremely common patients will undergo a blend of surgical and non-surgical procedures to take advantage of the strengths of both. In younger patients who are not yet ready for surgery, non-surgical options may provide them exactly what they want.

For breast augmentation, the surgical versus non-surgical comparison doesn’t work, because there really aren’t non-surgical options to do the things that patients want. At the present time you can’t increase the breast size, reduce the breast size, or lift up drooping breasts without surgery. In the breast, though, the discussion is often around full length or reduced incision approaches. Like non-surgical treatments, reduced scar approaches sound really positive – and of course who wouldn’t want that? However, in some cases a full scar approach is required to get the degree of results that a patient wants or needs.

Only recently have significant non-surgical options emerged for treatment of the abdomen, flanks, and thighs. These treatments are directed at two primary goals – reducing the fatty layers and tightening the skin. Infrared therapy, external ultrasound, and cryolipolysis (fat freezing) are all energy devices approved to reduce the thickness of the fatty layer. CoolSculpting® is a fat freezing treatment currently available, and it is the treatment that we have chosen to offer at the Emory Aesthetic Center due to the level of comfort experienced by patients and the medical studies that support its use. But not all patients get the results that they seek. And while a few patients don’t seem to achieve much of a result, a small number of patients are “super-responders” who can get a dramatic result, sometimes with just one treatment. But overall, most patients will see a 10-20 percent improvement in an area with a single treatment, but for additional improvement they will need repeat treatments. Liposuction is the surgical counterpart to fat freezing. Not surprisingly, liposuction allows us to treat more areas at a time, be more aggressive in fat removal, and depending on the number of areas to treat and the number of CoolSculpting® sessions, sometimes liposuction can be less expensive as well.

At this point, non-surgical treatments seem to do a better job at fat removal than skin tightening. For this reason, there isn’t much in the way of non-surgical options for patients that may have significant skin laxity, for example when they need a tummy tuck or thigh lift. In these instances, surgical resection can be combined with liposuction to not only tighten the skin, but to sculpt the tissues as well. It is because of this combined strategy that tummy tucks, for instance, can produce some of the most dramatic improvements of any of the surgeries that plastic surgeons perform. However, if a patient is young and has generally good skin quality, with limited fatty deposits, fat freezing without the need for surgery can be a great option.

To pull it all together, there are some things that surgery can do that non-surgical treatments simply can’t do. In other cases non-surgical treatments can be highly effective and can provide for you the results you want – without the need for a surgical procedure or significant recovery period. What is best for you depends on your specific appearance, your tissues, and your goals. At the Emory Aesthetic Center, we are happy to be able to offer the entire spectrum of surgical and non-surgical options. Our board-certified physicians can work with you to determine the best solution for you and your desired result.

404-778-6880


emoryaesthetic.org


Click here to schedule your personal consultation.

About Dr. Eaves

eaves-iii-felmontDr. Eaves recently returned to Atlanta, Georgia, to head the Emory Aesthetic Center as Medical Director, having previously completed his plastic surgery residency as well as a fellowship in endoscopic and minimally invasive plastic surgery at Emory University, The Emory Clinic, and associated hospitals. Before joining the Emory Aesthetic Center, Dr. Eaves was a partner in Charlotte Plastic Surgery for more than fifteen years and served as group president from 2010-2012.

His professional and institutional committee memberships and offices include an impressive list of national, international and local plastic surgery organizations, societies, boards, task forces, advisory councils, coalitions and foundations, including having served as President of the American Society for Aesthetic Plastic Surgery (ASAPS) from 2010-2011 and Trustee (2011-Present).

Dr. Eaves’ primary areas of academic inquiry have been in minimally-invasive and endoscopic aesthetic surgery, patient safety, system and process improvement in plastic surgery, evidence-based medicine applied to plastic surgery and recontouring surgery after massive weight loss. He has received several patents for new medical devices he developed, and has made major clinical service contributions to his field. Dr. Eaves has published more than 100 articles, book chapters and book reviews on plastic surgery in peer reviewed publications, as well as manuals, videos, computer programs and other teaching aids and has coauthored the first textbook on the topic of endoscopic plastic surgery.

Can Men Get Plastic Surgery?

guysAt the Emory Aesthetic Center, we have traded in our Cosmopolitan subscription and replaced it with Sports Illustrated. Why? It’s simple. Plastic surgery is no longer just for women.

Today, we are seeing more and more men of all ages requesting plastic surgery for cosmetic reasons. We’ve discovered that men are just as worried about their appearance as women. But it is important to know that men’s needs may be different, as most cosmetic procedures have been designed with women in mind. Factors to consider include skin thickness, beard growth, and body type.

Let’s review the top plastic surgery procedures men are requesting by the numbers.

Face-Lift/Neck-Lift
Results last: 10 to 15 years
Recovery: 7-10 days
Cost: $12-14,000

Eyelid Lift
Results last: 15 to 20 years
Recovery: 7-10 days
Cost: $6-8000 for upper and lower (half of that for just upper)

Body Liposuction
Results last: Depends on maintaining a healthy lifestyle and weight
Recovery: 1-2 days
Cost: minimum $4500-unmlimited based on areas treated

Breast Reduction
Results last: Permanent
Recovery: 2-3 days
Cost: $8-10,000

Rhinoplasty
Results last: Permanent
Recovery: 5-7 days
Cost: $7-9,000

Botox®
Results last: 6 to 9 months
Recovery: 0 days
Cost: $300-600 per treatment

Dermal Fillers
Results last: 1 to 2 years
Recovery: 1-2 days
Cost: $450-800 per syringe

At the Emory Aesthetic Center, our board-certified physicians understand that the delivery of plastic surgery is different for men than women. We will approach your individual goals with personal attention and help you choose the procedure that is right for you.

404-778-6880
emoryaesthetic.org

About Dr. Anderson

Erica Anderson, MDErica Anderson, MD, is board certified by the American Board of Plastic Surgery and currently holds an appointment as Assistant Professor in the Division of Plastic Surgery at Emory University. Dr. Anderson completed her general surgery residency and plastic surgery residency at the University of Colorado Health Sciences Center and associated hospitals in Denver, CO. She completed a year of advanced training in Aesthetic Surgery at Grotting Plastic Surgery in Birmingham, Alabama.

Dr. Anderson returns to Emory University after being in private practice in Arlington, Virginia. While there, she maintained a busy aesthetic and reconstructive practice and also served as Medical Director for the Wound Healing and Hyperbaric Center at Virginia Hospital Center.

Dr. Anderson’s academic and research interests are largely focused on clinical outcomes with regards to cosmetic surgery. Her areas of clinical interest are diverse including cosmetic surgery of the breast and body as well chest wall reconstruction and wound care.

Dr. Anderson is married with 3 children, Trent, Connor and Fiona, and 2 vizslas, Max and Mimi.