Seeing a number of patients recently with poor outcomes from liposuction previously done elsewhere prompted me to write this blog. A patient came to me with areas of cold, fixed, thick scarring in her abdomen, with other areas of her abdomen unusually thinned out and essentially absent of fat.
The cold feeling in part of her abdomen is from devascularization from over-aggressive superficial liposuction using an energy source which produces heat and, although it liquefies fat, can create collateral injury. When these areas heal, they form scarring which is relatively fixed or immobile compared to normal tissue.
So the discussion about liposuction must first start with a discussion about energy delivery to tissues. There are a number of newer technologies available to extract fat. They go by many catchy names and involve a heat delivery system based on laser, internal ultrasound, to name a few. The public is often swayed by tempting marketing, promising that these smart technologies provide miraculous fat removal. One problem is that less well-trained medical practitioners gravitate to these marketing strategies to increase their practice. Instead of marketing good results, they market sexy technology. It can be difficult to predict outcomes when these technologies are used aggressively, but when used minimally, they yield marginal achievement.
Using cold cannula technology, thinner tubes with higher flow systems allow the surgeon to keep the heat source – the surgeon- away from tissues and hence decrease the risk to the patient. This is my favored approach. I believe that we as surgeons must leave a little layer of fat in the area we suction. This is only natural. It allows for better healing. Simulating a very lean overall body mass by liposuction is risky. Liposuction should be an aid to help shape people with non-ideal shapes, not to rid the body of fat. Once you are shaped by lipo, if your ultimate goal is to be extremely lean, then the patient must eat and exercise the part. This is the key to success! See the lipo section on my website drspiro.com for cases that depict this! After viewing what I mean, read more below.
The three-dimensional approach I take can’t be offered using these other heat sources. They are really only safely reproducible two-dimensionally. So, for me, it’s a matter of visualizing the female aesthetic and transforming the patient into the best that they can be within reason, safely and reproducibly. I use my approach in 500cc suctions up to 9000cc volumes (which require an overnight stay).
Compare outcomes, not fancy names of technology; buyer beware when body contouring!
