tummy tuck

Realistic Liposuction Results: What Can I Expect?

Liposuction ResultsUnderstanding what any treatment can do . . . and even more importantly, what it can’t do . . . is critical for you to know when considering the best cosmetic procedure to address your individual needs. This is particularly true for liposuction, as the tremendous popularity of the procedure has spawned some misconceptions and unrealistic expectations. In the right patient liposuction is a wonderful procedure with small scars, quick recovery, and dramatic results. However, in the wrong patient liposuction can lead to disappointment, and if pushed beyond appropriate limits, can even lead to deformity requiring surgical repair.

One of the most common misconceptions about liposuction is that it can help you loose weight. Liposuction, in general, is not an effective weight loss tool. In order to keep the procedure safe, there are long-standing recommendations to limit the amount of liposuction done on an outpatient basis. Very large amounts of liposuction can be associated with the development of loose skin in the treated areas.

Another misconception about liposuction is that it can tighten loose skin, especially if it is “laser liposuction” or “ultrasonic liposuction”. For sure the skin will retract some after any liposuction technique due to the skin’s inherent elasticity, however meaningful tightening typically doesn’t occur, despite marketing claims. Although rare, I’ve had to help a couple of patients in which their surgeon pushed an energy-based liposuction (laser or ultrasound) too far in hopes of tightening the skin. Doing this can lead to an irregular appearance to the skin, lumps, and even burns and visible scarring. The long and the short of it is, if you have significantly loose skin and want it to be smoother and tighter, liposuction by itself is probably not the procedure for you.

Cellulite – that frustrating, pitting appearance of the thighs or buttocks – is another area that patients sometimes expect liposuction to help but it really doesn’t. Currently there aren’t great treatments for cellulite that give consistent and dramatic results (again, despite the marketing!). Sometimes patients have pits that are associated with loose skin but don’t have real cellulite, and in these cases a body lift – not liposuction alone – can help these areas. Here’s a test you can do at home — lift up on the skin above the pitting area. If the pits smooth out dramatically, then the pits are probably related to loose skin in the area and you might be a candidate for a lifting procedure. If you lift and the pits just stare back at you, then a lift is probably not for you.

We’ve just reviewed the things that liposuction doesn’t do, but the great news is that liposuction of the right amount and in the right patient is safe, effective, and gives predictable results. The patients that do the very best with liposuction are at a good weight but have certain stubborn areas that just won’t go away with diet or exercise. The best candidates also have tighter, more elastic skin. Often, but not always, that means that younger patients are better candidates for liposuction.

However if you have some loose skin, don’t despair. Liposuction can still be a powerful tool to contour your body when combined with an excisional procedure. For example, let’s say you have some fatty collections in the love handle area and in the front of the tummy but you have loose skin in the lower part of the tummy. In this case you may be a great candidate for liposuction combined with an abdominoplasty (tummy tuck). Liposuction can smooth and contour the flanks and can thin the upper abdomen while excision of the fat and loose skin of the lower tummy will tighten everything up.

Another area where it is good to set expectations relates to recovery. Patients always want to know how they’ll feel after liposuction, how long it takes for the pain to fade, and how long until the swelling is gone and they see their final result. In general, liposuction is less painful and with a quicker recovery than excisional procedures, like a tummy tuck. Patients are often able to return to work after only a few days, and although they have some soreness for a couple of weeks, they are able to function well. Usually patients can resume light exercise within 2 weeks. There will be swelling, although often even swollen areas look better than before surgery. The majority of the swelling is gone by 3-4 weeks, although subtle amounts of swelling can take 3-6 months to resolve. You may also develop some bruising, and if so, this typically fades away within a couple of weeks.

Liposuction is the most common aesthetic surgical procedure performed in the United States, and with good reason: liposuction works and it works well. It works best in patients who are good candidates and who are not trying to have liposuction do more than it is capable of delivering. The board certified physicians of the Emory Aesthetic Center are happy to consult with you about what are reasonable expectations of liposuction in your individual circumstance, and help develop a treatment plan specific to you.

404-778-6880
emoryaesthetic.org

About Dr. Eaves

Felmont Eaves, MDDr. 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.

Tummy Tucks 101: Answers to Frequently Asked Questions

tummy tuck 101Tummy tucks – also known as abdominoplasties – have grown significantly in popularity over the past 15 years, and they are now one of the most common procedures performed by plastic surgeons. Part of the reason why tummy tucks have grown in popularity over the years is our increased focus on health and fitness, but another big reason is that tummy tucks can provide dramatic results. There have been recent advances in the procedure that offer better pain control and a better recovery. Now may be a good time to take a fresh look at some of the most common questions that patients ask us about abdominoplasties.

“Do I need a full tummy tuck, or can I have a smaller scar – say with a “mini” tummy tuck or just liposuction?”

There is not just one type of tummy tuck – abdominal contouring can include a variety of approaches depending on one’s individual situation. It is often helpful to think of a tummy tuck in terms of where the problem is. Is there too much loose skin, is there too much fat, or have the muscles been stretched or separated by pregnancy? If your skin is relatively tight then you may be a good candidate for a reduced scar approach, such as liposuction (tiny scars), an endoscopic abdominoplasty (1-2 inch scar), or a mini-abdominoplasty (a scar about the length of a C-section). On the other hand, if there is a lot of loose skin that you will need tightened, that will require a longer scar. If there is too much fat, then liposuction can be combined with the removal of skin – a very common situation. If the muscles are separated, then some sort of tummy tuck with muscle repair is needed, however the incision can be short or long depending on the skin.

“Do I have to have a drain after a tummy tuck?”

Historically the answer to that question was “yes”; however, new techniques have eliminated the need for drains in many cases. We now can use special stitches – known as progressive tension sutures – to seal the tissue together so that there is no need for a drain. The progressive tension technique has another advantage as well; it often allows us to remove a bit more skin than we could otherwise. Although I currently can’t prove it, I also suspect that the sutures help make the scar from the tummy tuck better because they reduce the tension on the skin during healing. Patients love it when they don’t have to have drains.

“How much pain will I have after a tummy tuck?”

Historically tummy tucks were one of the more painful operations that plastic surgeons performed, especially when repair of the muscles was required. Over the past several years, the development of some new ways of controlling pain has helped this situation a lot. First came the development of pain pumps – these are devices that push a local anesthetic through a small tube and into the area of surgery. These were very helpful and many surgeons still use them, but it requires a tube coming out of the skin. More recently there has been the development of a long lasting local anesthetic which can give significant pain control for up to 3 days, and it doesn’t require a tube. Good pain control clearly makes the recovery more pleasant. It also means that less narcotic pain medicine is required; therefore, there is less chance of a reaction to the medication. In addition, it may make the surgery even safer by allowing patients to move around more easily and to be more active.

“How long is the recovery after a tummy tuck?”

Well, the answer depends on several factors and to what level of recovery you are thinking about. If you don’t need the muscles repaired, it is likely that your recovery is going to be easier and quicker. Most patients having a full tummy tuck (with muscle repair) find that they are generally able to drive a car within a week, depending on their pain level (remember you don’t want to drive when on narcotic pain medicine). Many patients can work remotely from home, and find that they are able to log on to their computers, answer emails, or even have a conference call after only a few days, although they won’t feel like going in to work for maybe 2-3 weeks post surgery. Light exercise (e.g. walking or gently peddling on a stationary bike) can start by this time as well. By 6-8 weeks, most patients would consider themselves fully or nearly fully recovered, although it is worth remembering that the nerves will continue to heal, the scar will continue to fade, and the swelling will continue to go down for several months.

“Will the results last?”

Yes! As long as your weight remains stable over time, abdominoplasties are typically a ‘once and done’ procedure, never needing to be repeated. Of course your skin will age a bit over the decades, but it usually never gets back to the looseness that you may have experienced before surgery.

“After pregnancy, my tummy needs help, but my breasts do, too. Can you work on both at the same time?”

Not only is the answer “yes”, but combining a tummy tuck with a breast lift or breast augmentation – popularly called a “mommy makeover” – is very common. Moms love their little ones, but it is great to get their bodies back, too!

Will a tummy tuck help my stretch marks?”

That depends on where the stretch marks are located, but the answer is usually “yes”. A full tummy tuck removes most of the skin in the lower abdomen, and any stretch marks in this zone will be removed along with the loose skin. Stretch marks outside of that zone are not really going to be helped.

The board certified physicians at the Emory Aesthetic Center keep up with the latest developments in abdominoplasty. We are happy to work with you to help create a plan that is best for you.

404-778-6880
emoryaesthetic.org

About Dr. Eaves

Felmont Eaves, MDDr. 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.

Ask the Doctor: How Do Fat Transfers Work?

Fat TransfersPatients often ask “How do fat transfers work, and do they last?” It is a very good question, and pertinent, too, because fat transfers have become very common in cosmetic surgery over the past several years. Fat transfers have assumed an important role in facial rejuvenation, breast augmentation surgery, buttock enhancement, and the secondary treatment of body contouring deformities, so it is important to understand what is going on.

Fat transfer is a lot like the old real estate saying: It’s all about location, location, location. Most of us have extra fat in areas we don’t want, and the beauty of the fat transfer is that we can remove some of this unwanted fat and relocate it to where we want to enhance volume. Even though this concept is quite simple, the actual way the procedure is performed has taken cosmetic surgeons many years to develop. We are still constantly improving and enhancing our techniques as we get a better understanding of how these techniques affect the survival of the fat in the new location.

The first step in fat transfer is to collect the fat from the donor site. The most common location where we harvest fat is the tummy, but we can use many potential sites, including the love handles, the thighs, and the back of the arms. The fat is collected by liposuction, either using a syringe system or a system with a fat collection chamber. The fluid obtained during liposuction (the aspirate) is then treated to remove excess fluid from damaged fat cells so that concentrated fat is ready to inject. There is significant variability in how surgeons prepare the fat for transplantation. This prepatory step can be as simple as gently straining the aspirate, may involve washing the fat, or may involve centrifuging the aspirate. The prepared fat is then loaded into syringes for injection.

The injection of the fat cells into its new “home” is done using fat grafting cannulas, these are generally small and designed to be gentle on the fat cells. The surgeon injects the fat into many tunnels and layers, as you want the fat to be widely dispersed in the tissues and not to “pool” in one area. Pooling leads to a decreased “take” of the transplanted fat. To explain this further, I like to use the analogy of planting seeds. Like seeds, the fat grafts need to get nutrients from the bed in which they are planted in order to survive. If you plant a full bag of seeds into a single hole in the ground, the seeds in the middle of the “pool” would not be able to get their roots into the dirt and would eventually die. That’s how it works with transplanted fat – if you put too much in one place, the cells in the middle will die and will be absorbed by the body.

When fat cells survive in their new location, they are there forever, and will be of stable size (unless you gain or loose a lot of weight). Cosmetic surgeons love to argue sometimes about the best way to harvest, prepare, and transplant the fat in order to optimize graft survival, and although we’ve made tremendous progress (fat transplantation is now highly effective and reliable – probably in the range of 70% survival), I don’t think we know all the answers yet. Be cautious if you feel you are being sold a “magic solution” for fat grafting, as these are often not backed up by good clinical evidence, at least currently.

One more word of warning relates to “stem cell fat grafts.” Stem cells are a current hot topic in medicine, and indeed stem cell science has tremendous potential to change the way medicine will be in the future. All tissues – including fat harvested for transfer – have stem cells anyway. However there is currently no compelling science to support the clinical claims of any special stem cell fat transplantation techniques in aesthetic surgery, and there is a lot of deceptive advertising to entice unknowing patients. In fact, both the American Society for Aesthetic Surgery and the American Society of Plastic Surgeons have issued a joint statement emphasizing this point.

The physicians at the Emory Aesthetic Center keep up with the latest developments in fat transplantation, and we’d be happy to help you figure out how they can work for you.

404-778-6880
emoryaesthetic.org

About Dr. Eaves

Felmont Eaves, MDDr. 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.

Get Ready for Summer! Join our Live Chat on Body Contouring

Body Contouring ChatWith the warmer weather fast approaching, it’s time to start trading in those hats and gloves for shorts and swimsuits. To help get your body ready for the summer, join Emory Aesthetic Center plastic surgeon, Dr. Felmont Eaves, on Tuesday, March 10, 2014 from Noon – 1PM as he discusses body contouring options that can help improve the shape of your body and tighten excess or loose skin. Dr. Eaves will walk you through both surgical and non-surgical options – including liposuction, tummy tucks, arm or thigh lifts and surgery after weight loss. If the normal effects of aging or childbearing have made you wonder if a cosmetic body contouring procedure is right for you, you won’t want to miss this chat.

Dr. Eaves will answer all of your questions to ensure you are confidently ready to take the next step such as:

  • What are the different types of body contouring options offered to me?
  • What types of results can I expect to see?
  • Are there non-surgical options to firming my body?
  • What can a body lift surgery do for my figure?
  • How long is the recovery time after a liposuction?
  • Does a tummy tuck or body lift leave scars?
  • What is the benefit of having my body contouring procedure performed at a place like Emory Aesthetic Center?

Sign Up

Chat Details:

Date: Tuesday, March, 10, 2015
Time: 12 noon – 1pm EST
Chat leaders: Dr. Felmont Eaves
Chat Topic: Body Contouring: Getting Ready for Summer