submitted by Daniel A. Sterling, M.D., FACS

How long must one wait to get a second liposuction procedure?

Depending on the extent of the previous liposuction procedure, one can usually undergo a second procedure within two to three months.  If a large amount of excess fat has been removed under general anesthesia, it does take a period of time to recover and allow scarring and bruising to reduce.  Just as in an incision on the skin results in a “lumpy” scar for a period of time, the same process occurs under the skin after liposuction.  The subcutaneous tissue has been injured during the removal of excess fat and takes time to heal. Frequently there is lumpiness after liposuction that in almost every case resolves fully within several months resulting in a nice, smooth and lump free contour.

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submitted by Daniel A. Sterling, MD, FACS

Are ankles and calves at risk for lumpiness and unevenness after liposuction?

Liposuction, also known as suction assisted lipectomy or lipo, can be performed safely on numerous areas of the body from head to toe with certain exceptions.  Liposuction of the thighs is routinely performed with excellent results.  It is less commonly performed below the knees but can also be done achieving excellent results if care is taken in these delicate areas.  The majority of people do not have a large volume of excess fat but rather have focal collections in the calves and ankle area that they are unhappy with.  It is a very delicate area that requires attention to detail, but most important is that it is performed with very small cannulas to avoid unevenness of resection, or contour deformities such as lumpiness and unevenness.  If performed properly one can expect good results from standard liposuction in almost any area of the body provided one is a good candidate to begin with.  Variables to be considered prior to performing liposuction are the quality and amount of skin overlying the area to be liposuctioned.  If there is a large amount of excess and redundant skin it is difficult to achieve a good result since poor quality and excess skin does not retract as well as skin that has not been excessively stretched or overly thinned.  A combination of liposuction with perhaps a limited resection of skin can give an excellent result in some of these situations.

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Submitted by Daniel A. Sterling, MD, FACS

Will ultrasonic liposuction work on thighs?

Ultrasonic liposuction is one of the modalities that is used infrequently for very specific indications.  In particular, it has been used on very dense fibrous fatty areas such as in the back or male breasts.  The fat of the thighs is quite different than those areas and there is no need to use ultrasonic liposuction on the thighs. Standard liposuction works very well on most areas including the thighs.

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Submitted by: Daniel A. Sterling, MD, FACS

Is liposuction riskier as you grow older?

Surgery is safe regardless of age depending upon your overall health.  A person who is healthy with no significant cardiorespiratory disease can expect a very safe procedure certainly to the age of 70 years old.  Even patients who do have mild cardiorespiratory disease can undergo liposuction but this is usually done in a hospital setting and is also considered very safe.

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Submitted by Daniel A. Sterling, MD, FACS

I had liposuction done but too much was removed.  I now have an indent on one side of my abdomen.  Are fat injections an option to correct this?

Contour problems after liposuction are sometimes correctable.  A sufficient period of time for healing is required to allow all inflammation and scarring to resolve prior to making a final determination on a contour deformity after liposuction.  If one is left with a focal indentation, one option for improving the area is autologous (from your body) fat injections.  Another option may be to liposuction the surrounding area to “feather” the deformity circumferentially.

Submitted by Daniel A. Sterling, MD, FACS

Is liposuction through the belly button possible?

Liposuction through the umbilicus is possible and is done routinely.  However, in almost all cases secondary incisions are made to perform the liposuction from a number of different directions to insure an even contour and removal of fat.  Liposuction incisions are typically approximately 5 mm in length and most are hardly visible long term.

Submitted by Daniel A. Sterling, MD, FACS

 What procedure is done to fix an uneven belly after liposuction?

 In a small percentage of patients, revisions are necessary following liposuction.  A minor contour deformity may be present after liposuction on any part of the body.   If there is a small residual deformity repeat liposuction, often times under local anesthesia, can be performed to correct this.

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For confidential personalized information and advice, please call us at 1-800-640-0290 during business hours: Monday through Thursday 8:30 a.m. - 4:30 p.m. and Friday 8:30 a.m. - 4 p.m. EST. You can also visit our website on liposuction for more information or use the online contact form to send an inquiry. LATE AFTERNOON & EVENING HOURS NOW AVAILABLE.  

Submitted by Daniel A. Sterling, MD, FACS

Will sutures from mini abdominoplasty or liposuction be visible?

All of the sutures used for a miniabdominoplasty or liposuction are absorbable thus no sutures are visible following either of these procedures.  Even in a standard abdominoplasty all of the sutures are buried and are completely dissolvable.

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For confidential personalized information and advice, please call us at 1-800-640-0290 during business hours: Monday through Thursday 8:30 a.m. - 4:30 p.m. and Friday 8:30 a.m. - 4 p.m. EST. You can also visit our website on liposuction for more information or use the online contact form to send an inquiry. LATE AFTERNOON & EVENING HOURS NOW AVAILABLE. 

Submitted by Dr. Daniel A. Sterling

I have been trying to loose weight for the past six months. I am 6’ 2” and currently weight 280 lbs. I am very discouraged as the weight is coming of slowly (I have only lost 20 lbs). I am considering liposuction of the abdomen as I feel it will give me more energy and I will be able to exercise longer without the added weight. Should I consider liposuction?
 

Liposuction is not considered a massive weight reduction surgery. However, it can in the right circumstances improve ones ability to exercise. Certainly large volume liposuction, which is considered liposuction of any volume over five liters, can significantly decrease the abdominal girth which allows one to fit and feel better in their clothing which in turn may encourage one to participate in exercise activities more often. Usually the removal of large amounts of fat by liposuction can result in some loose skin but that can be addressed when the person is at or near a relatively ideal weight.
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For confidential personalized information and advice, please call us at 1-800-640-0290 during business hours: Monday through Thursday 8:30 a.m. - 4:30 p.m. and Friday 8:30 a.m. - 4 p.m. EST. You can also visit our website for more information or use the online contact form to send an inquiry. LATE AFTERNOON & EVENING HOURS NOW AVAILABLE .

Submitted by Dr. Daniel A. Sterling

Liposuction can be performed for very small volumes of fat, as well as significantly large volumes.  Depending upon the patient’s goals in terms of body contouring, liposuction can be performed in combination with surgical procedures. Many patients wish to just reduce the overall bulk and would like to look and feel and fit better in their clothing.  I have performed liposuction for people who are not at an ideal weight but who afterwards feel much better in that they are fitting better into their clothes and their clothing has actually gone down several sizes.  Anything in excess of 5 liters of liposuction is considered large volume and is done in the hospital setting, usually with an overnight stay. Anything less than 5 liters can be done in the outpatient setting with the patient going home that day.

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Most people do not know that breast reduction can be done with liposuction. We have been using this approach for many years in male breast enlargement (gynecomastia) as the preferred technique when possible for this problem.

A standard breast reduction (reduction mammaplasty) uses a variety of incisions to both reduce the volume of the breast and to reposition the nipple to a higher location. This results in an esthetically pleasing breast with considerable reduction of symptoms.

Some patients do not want the extensive scarring of the breast that results from a breast reduction (reduction mammaplasty) and instead simply want a reduction of the volume of the breast so that they can be more comfortable.

The best candidates for liposuction breast reduction are older women in whom fat has replaced the normal mammary glandular tissue. Often these breasts contain mostly fat, and this fat can be liposuctioned, as it is routinely done for other cases requiring liposuction. Often the breasts can be made about 50% smaller, and the tiny entry points for the liposuction cannulas are barely noticeable. The breasts do not appear as “perky” after this approach, but the symptoms of breast enlargement are markedly improved. It is also less expensive to have the surgery done this way, and is therefore especially suitable for women who have been denied insurance coverage.

Before and After Photograph

(Left: front and side view) An 18-year-old with a preoperative cur size of 34DD (Right: front and side view) 550 cc of fat was removed from the left breast, and 600 cc of fat was removed from the right breast. The patient's postoperative cup size was 36C.

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Following my blog entry of March 26, 2007, another article was published also noting breast enlargement after liposuction. The first article was published in 2003¹  and noted that 34% of 73 liposuction patients reported a 30-40% increase in breast size.

The second article appeared in the April 15, 2007 issue of Plastic and Reconstruction Surgery ² and was based on a study done in the Netherlands. In this article, 48 patients had liposuction compared to a control group of 53 similar patients who had abdominoplasty. The liposuction patients were noted to have significantly more breast enlargement (23 of 48 patients = 48%), and actually confirmed in 19 patients (40%) compared to 11 patients in the abdominoplasty group (21%) and objectively confirmed in 6 patients (11%).

Reference:
1. Yun PL et al. Breast Enlargement Observed After Power Liposuction: A Retrospective Review. Dermatol Surg. 2003; 29; 165-167; discussion 167.

2. van der Lei, B et al. Spontaneous Breast Englargement following Liposuction of the Abdominal Wall: Does a Link Exist. Plastic and Reconstruction Surgery 119:1584-1589, 2007.

I came across an interesting article from the Mount Sinai School of Medicine in New York discussing breast enlargement following liposuction in the abdomen, hips and thighs.¹ In a study of 73 liposuction patients, 34% reported a 30-40% increase in breast size.

The change typically occurred several months after liposuction in the abdomen, hips or thighs, and it was associated with the extraction of a large volume of fat.

One theory is that "there are more androgenic receptors (male hormone) in the abdomen, hips and thighs and when you remove them, you have a relative increase in the estrogenic receptors in the breast."

In my own experience, patients who gain weight after liposuction gain the weight in different parts of the body, with minimal weight gain in the area that had liposuction. Although we have done hundreds of liposuction procedures, I was unaware of the breasts getting larger, perhaps because we didn't ask the question. If any of our readers have personal experience with this please email us at info@plasticsurgerypa.com. Thank you.

Reference:
1. Yun PL et al. Breast Enlargement Observed After Power Liposuction: A Retrospective Review. Dermatol Surg. 2003; 29; 165-167; discussion 167.

The following article was excepted from a press release by the American Society of Plastic Surgeons

Study Confirms Adoption of Healthy Diet and Exercise Key to Successful Outcome

May 5, 2006

ARLINGTON HEIGHTS, Ill. – Patients are weighing in on liposuction, the most popular cosmetic plastic surgery procedure in 2005, and resoundingly saying they would have the procedure again. According to a study in May's Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS), 80 percent of patients were satisfied with their results and 86 percent would recommend the procedure to family or friends.

Liposuction is one of the most satisfying procedures for patients and most effective at eliminating localized fat. The majority of patients recognize their role in maintaining positive results and pursue a healthy diet and exercise. These patients typically maintain or lose weight after surgery, while those that do not may gain small amounts of weight. Ultimately, one's lifestyle can affect long term-results.

According to the study, approximately 57 percent of patients reported no weight change after having liposuction – 46 percent of these patients actually reported a weight loss, losing an average of five to 10 pounds in less than six months. Forty-three percent of patients reported gaining weight, with the majority gaining between five and 10 pounds more than six months after surgery.

Fifty-five percent of patients reported an average decrease of three dress sizes after liposuction. Thirty-five percent said their clothing size did not change.

Thirty-three percent of patients reported exercising more after the procedure, while 58 percent had no change in their exercise regimen. In addition, 44 percent reported eating a healthy diet, while 53 percent reported eating the same.

More than 323,600 liposuction procedures were performed in 2005, according to ASPS statistics. In this study, the thighs and abdomen were the most common liposuctioned areas, followed by the hips, buttocks and knees.