Posts Tagged ‘non-surgical liposuction’

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.

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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.

Liposuction versus CoolSculpting®: Which is Right for You?

Lipo vs CoolSculptingLiposuction and CoolSculpting® are two very different procedures that are designed to reduce unwanted fatty deposits. So with both procedures producing the same outcome in the end, how are you to decide which is best for you? Like so many things in cosmetic medicine, it depends . . .Let me break down the differences between the two so that you can make the best decision for you.

Liposuction was developed in the 1980’s and has been around a lot longer than CoolSculping. There are now many types of liposuction including Suction Assisted Lipectomy (SAL) – the original technique but still a great one; Ultrasound Assisted Liposuction (UAL) that uses sound waves to break up the fat, Power Assisted Liposuction (PAL) that uses vibration, Laser Assisted Liposuction (LAL) that uses laser energy, and Fluid Assisted Liposuction (FAL) that works like a water jet. Despite the different approaches, all of these techniques can work well, and none is clearly superior over the other, despite marketing claims to the contrary.

Liposuction is a surgical procedure and can be performed under local anesthesia, under sedation, or with full general anesthesia. The type of anesthesia you will need depends on the area(s) to be treated and the amount of fat that needs to be removed. In general, the more areas that you treat, the more sedation or full general anesthesia you will need. The incisions for liposuction are small, typically less than 1/4 inch, so there isn’t much scarring. There is, however, a recovery period that lasts for a few weeks – bruising and swelling are most common. Patients can usually resume light exercise after a few days.

As opposed to liposuction, CoolSculpting® is a non-invasive procedure that doesn’t require anesthesia at all. The CoolSculpting system includes a disposable gel pad that is placed over the treatment area. A cooling head is then placed over the gel pad and suction is activated. The machine has a base that cools the liquid flowing through the headpiece and pulls the fatty area into the head, therefore, freezing the fat. After an hour or so (or two hours for a non-suction treatment type) the cooling head is removed and the frozen area is massaged briefly. Although there can be some discomfort when the tissue is first pulled into the cooling head, this becomes numb once the cooling starts and the massage doesn’t hurt. Like liposuction, it takes a few weeks to see the final result, and although there really isn’t much pain, like liposuction, the treated area can feel a little tender for a while.

Liposuction is the more aggressive treatment of the two, allowing more fat to be removed in a single session. Because CoolSculpting removes less fat per treatment, patients may need several sessions of CoolSculpting to get their optimal result.

Patients who are thinking about other cosmetic surgical procedures may be better candidates for liposuction than CoolSculpting since they would already be under aesthesia. In addition, the combination of liposuction with an excisional procedure (think tummy tuck with liposuction) is very powerful and can deliver dramatic results. Another example of when liposuction is preferable is when a patient might want to add volume to an area and they want to do so with their own fat. Liposuction can be used to harvest fat for fat transfer to another site. Liposuction is often preferred when there are many body areas that the patient wants treated, as these can be done all at one time, rather than over many different sessions with CoolSculpting.

CoolSculpting can be a great option for smaller fatty deposits. It is also a great choice for patients that are keen to avoid surgery, either for personal preference or because of health issues that may increase the risk of surgery.

Patients always wonder which is more cost effective – liposuction or CoolSculpting. This is another it depends situation. If a patient is treating a single small area that will probably be effectively treated with two sessions, then CoolSculping makes a lot of sense and may be cheaper. However if there are multiple sites to treat, and some of these will need three or more CoolSculpting sessions to get full resolution, then liposuction may be the less expensive of the two.

In the long run the choice of which is best for you depends on you – how you feel about it, what issues are the most important, and how aggressive you want to be in removing the fat. If avoiding surgery is super important to you, and you’ll accept less dramatic results in order to do so, then CoolSculping might be your best option. On the other hand, if you’d rather get as much fat off as possible, and would rather do this in one session instead of several, then liposuction may be your best bet. Let the board certified cosmetic surgeons at the Emory Aesthetic Center help you figure out what approach is best for you.

404-778-6880
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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.

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.

What is the Best Method of Liposuction?

Liposuction AtlantaStandard Lipo, Laser Assisted Lipo, Ultrasonic Lipo, Power Assisted Lipo, Tumenscent Lipo, Smart Lipo, Safe Lipo, Tickle Lipo…there are many different types of liposuction procedures currently offered in the market place, so logically patients are always asking “which is best for me?”. Although some practitioners may have strong feelings one way or another, the short answer to the question is that all of these techniques work, and the results are similar for all.

Liposuction became popular in the 1980s. The initial method of liposuction used hollow tubes (cannulas) to suction out fatty tissues from under the skin using very small incisions. Although initial techniques worked well, the results got even better when surgeons began using smaller, finer cannulas. A major advance occurred when the technique began to incorporate the injection of a dilute solution prior to suctioning. This technique was very helpful in reducing blood loss and bruising, and is commonly used in most types of liposuction today. During the 1990s, new technologies began to emerge to make the procedure even easier by using the application of energy to break up fatty tissues. Ultrasonic assisted liposuction (UAL) uses sound waves, power assisted liposuction (PAL) uses mechanical vibrations, and laser assisted liposuction (LAL) uses laser energy to this end. Some even newer technologies use water pressure to the same effect.

Although companies advertise significant advantages of their technologies over the competition, the scientific literature does not support major differences. Two particular studies about liposuction deserve special attention. The first study looked at over 26,000 consecutive patients undergoing liposuction by many of these different technologies.1 The authors found that overall the results were similar between these different groups. A second study published in 2011 examined trends in liposuction techniques among 492 plastic surgeons.2 In this study, the authors found that all these technologies are currently used by plastic surgeons, but that only a minority (about 10%) used laser liposuction (which include “Smart Lipo” and “Slim Lipo”), and that standard liposuction was still the most common technique used. While energy-based liposuction techniques can help your surgeon with hard to treat areas like the flanks, chest, and back, they also have an increased potential for complications such as burns. With experience and familiarity, however, all of these techniques can be safe and effective.

Non-Surgical Liposuction?

There is even a non-surgical procedure that may be an option for you. Cool Sculpting, which freezes the fat, is an office procedure that doesn’t require anesthesia.

So if all these technologies work, how should a patient choose? First of all, don’t be fooled by fancy ads promising huge results using the latest technology. Second, do your homework to select a qualified plastic surgeon with significant experience in all types of body contouring surgery, including both liposuction and excisional surgery such as tummy tucks. Here at the Emory Aesthetic Center, our surgeons have extensive experience and can explain the differences between all these techniques. We offer a full spectrum of options, and we will customize a plan that best fits your needs.

References
1Triana L, Triana C, Barbato C, Zambrano M. Liposuction: 25 years of experience in 26,259 patients using different devices. Aesthetic Surgery Journal 2009: 29: 509.
2Ahmad J, Eaves FF, Rohrich RJ, and Kenkel JM. The American Society for Aesthetic Plastic Surgery (ASAPS) Survey: Current Trends in Liposuction. Aesthetic Surgery Journal 2011: 31; 214.

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