Archive for the ‘Ultrasound Assisted Liposuction (UAL)’ Category

Liposuction can remove inches from your waist

Wednesday, February 2nd, 2011

Liposuction can remove inches from your waist by removing localized fat deposits at the Flanks (known as “love handles”) and the area of the lower abdomen ( sometimes referred to as a “pooch”).  Liposuction is considered body contouring and is not to be considered as a method of weight reduction, however, in the properly selected individual a dramatic reduction in waist circumference can be obtained.

I just saw a patient in follow up who lost over 7 inches from a single UAL (Ultrasonic Assisted Liposuction) procedure.  This individual was frustrated at prior attempts to lose the “love handles and “pooch”  of the lower anterior abdomen.   In addition, this individual had to reduce the waist circumference by four inches because of occupational requirements. Based on the well localized areas of fat deposits, I was quite certain I could attain this degree of improvement utilizing  Ultrasonic Assisted Liposuction.  Although I do not guarantee or promise a certain amount of circumference loss when performing a liposuction procedure, experience has taught me who can expect the most improvement  We were both pleasantly surprised with the measurements at three months post op.

Ultrasonic Assisted Liposuction (UAL) is especially useful in removing  fat from the flank region of the waist. This area is quite fibrous and the fat is not as easily or consistently removed with conventional Suction Assisted Liposuction (SAL) techniques.  Also,  UAL has the added benefit of potentially increasing the amount of skin retraction, thus improving the final contour of the treated area post operatively.  This individual went from the typical convex deformity of the flank region before the UAL procedure to having a youthful concave curvature to the flank region post operatively. The anterior lower abdomen responds just as favorably to SAL (Suction Assisted Liposuction) as it does to UAL  (Ultrasonic Assisted Liposuction) procedures. This is because this area is not fibrous.  UAL may be more beneficial in this region if there is poorer skin tone or some stretch marks on the skin. This is due to the increased potential to cause a more pronounced skin retraction utilizing Ultrasonic Assisted Liposuction

What liposuction will NOT do is provide an individual with a “six pack”  of the abdomen or increase muscle definition.  It does not matter which liposuction technique is utilized. It is false advertising when you see a before and after photo where an individual goes from being a “fatty” pre op to having  a “Mr. Universe”  physique post op. The same can be said for “Lipo Dissolve” and the other non invasive “laser” techniques  which so often  promises results which simply can not be attained. Remember:  if it sounds too good to be true, it probably isn’t.

Liposuction procedures are not methods of weight reduction!  I often am asked “how much weight will I lose?”.  I have no idea how to answer that question and I have done literally a thousand liposuction procedures over the last fourteen years.  I tell my patients who pose that question the same thing : I can reduce the thickness of the area treated  so that you can only “pinch an inch” post op,  but I can not tell an individual how that will correlate to weight loss.

So how do you know if you can expect to decrease your waist circumference with a liposuction procedure? Only a thorough  examination  and consultation will tell.   There are many factors to be considered and a qualified plastic surgeon who is well trained and thoroughly experienced in the use of liposuction can make those types of determinations.

I have seen many men who present with the classic “pot belly” or “beer belly” who thought that they could “lose their gut”  with a liposuction procedure only to be told “not so”.  In some individuals this type of  deformity is due to fat accumulation inside the abdomen and not an accumulation of fat beneath the skin. Only subcutaneous fat (the fat beneath the skin) can be removed with liposuction procedures.

Other patients have poor skin tone which makes them poor candidates for liposuction. The skin has to be able to retract post operatively for liposuction to be a viable option. Other individuals simply have too much skin and fat to be addressed with  only liposuction  and would be better served with an abdominoplasty procedure,  sometimes with  concurrent liposuction .  Abdominoplasty surgery in conjunction with  liposuction can absolutely do wonders to improve the contour of an individual’s waist.

Of course, no discussion regarding cosmetic surgery  would be complete without stressing the importance of patient safety. You must be in good physical condition to undergo liposuction surgery. Once again, a well qualified plastic surgeon can make that determination.

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Ultrasonic Assisted Liposuction (UAL)

Thursday, November 25th, 2010

Ultrasound Assisted Liposuction  (UAL) has been used safely and effectively for years for the removal of  subcutaneous fat for body contouring purposes, but this technology has not been embraced by all surgeons for a number of reasons: it takes specialized training which requires time away from one’s practice, there is a steep learning curve in order to use this technology safely,  effectively and to avoid post operative complications, and perhaps  just as importantly, there is a substantial finacial investment to aquire the necessary equipment. In some regards, the debate has come down to “the have’s”  and the “have not’s” so to speak. Those who have the necessary training, experience and access to the equipment stand by Ultrasonic Assisted Liposuction as a valuable adjunct to their cosmetic surgery practices, while those who do not sometimes disparage UAL as  “unnecessary”.

Ultrasonic Assisted Liposuction utilizes a specialized cannula which vibrates at 22,500 Hz which emulsifies fat allowing the subcuataneous fat to be removed with far less bleeding than which can be achieved with standard Suction Assisted Liposuction (SAL).  The reduction in post operative bruising is very much appreciated by my patients. This is especially true in my UAL patients who had  undergone standard Suction Assisted Liposuction (SAL) in the past by other surgeons.  These patients consistently remark about the great contour improvement after UAL but without the extensive bruising they experienced with their prior SAL procedure.

Another great benefit of Ultrasound Assisted Liposuction is that the ultrasonic energy actually creates more of a stimulus for skin retraction post operatively.  Skin retraction  is a very important consideration for the patient considering any type of liposuction or body contouring procedure. This benefit is obvious when considering the needs of a patient wanting to reduce the size of the breast and hoping to avoid post operative scarring which can occur if the skin must be surgically removed versus allowing the skin to retract by itself following an Ultrasound Assisted Liposuction procedure. As with all cosmetic procedures, patient selection is the key to a safe and successful outcome.

I have used UAL extensively in my body contouring practice for the last 14 years. I have found Ultrasonic Assisted Liposuction to be a very safe and  effective adjunct to abdominoplasty, thigh lift, neck lift,  and virtually all of my liposuction surgeries, but it can also be used for the reduction of breast tissue in both males as well as females. I utilize  UAL for both male and female breast reduction procedures because of the unique advantages offered by Ultrasound Assisted Liposuction which are not associated with standard SAL (Suction Assisted Liposuction).

Gynecomastia  (male breast enlargement) affects up to 15% of the male population, but the good news is that it can be effectively and safely treated with Ultrasonic Assisted Liposuction (UAL) in a large percentage of cases, thereby reducing the post operative scarring associated with excisional breast reduction surgery.

Last week I was able to utilize Ultrasound Assisted Liposuction in a male patient  for gynecomastia reduction . This patient  required a very limited excisional incision on one side  to remove a marble sized piece of breast tissue which was  not completely removed by UAL alone. This results in far less post operative scarring which I think all patients are hoping for in any type of cosmetic surgery procedure. This patient has seen a remarkable improvement in his chest region  while avoiding  the more extensive scarring which would be inevitable without the use of UAL.

I continuously utilize Ultrasonic Assisted Liposuction (UAL) in conjunction with other excisional type of body contouring procedures such as abdominoplasty, lower body lifts, and thigh lifts because it reduces blood lost, thus making these combination procedures safer to do together.

The only way to know your options for   body contouring purposes and if UAL is a valuable adjunct to your needs, whether it be for reducing unwanted excessive breast tissue, ( male or female),  or to improve the contour of your waist or other problem areas, is to have a consultation with a well trained Plastic Surgeon who has extensive training and experience in all aspects of body contouring surgery. No one technique  or technology is best suited for all patients. The use of newer technologies and techniques allows for a custom tailored approach which is uniquely chosen for each individual patient based on that patient’s particular needs, desires and expectations. This is the approach I use for every one of my patients

Once again, thanks for your time. Tim Bradley, MD

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Gynecomastia/male breast enlargement

Friday, November 5th, 2010

Gynecomastia (male breast enlargement)  can be successfully treated surgically with  minimal visible scarring in most patients.  Liposuction alone , or a combination of liposuction and surgical excision is used to remove excess fat and in many patients, abnormal breast tissue. The choice of procedures is very much dependent upon each individual’ s physical characteristics, as well as the surgeon’s experience and expertise in treating gynecomastia.

Gynecomastia is more prevalent than most people realize, affecting 10-15% of the male population. The reasons why gynecomastia occurs is beyond the scope of this discussion, but it can be a socially crippling situation for most males. Patients affected by gynecomastia are very reluctant to wear form fitting shirts and often times refuse to remove their shirt in public.  It is amazing to witness the change in self confidence in the patients who elect to have their condition treated surgically. Each one of my patients have gone from wearing loose fitting dress shirts pre -operative to wearing form fitting pull over polo shirts post operative. This type of scenario  is very gratifying for both patient and surgeon.

In my experience, most males who present with gynecomastia (enlarged breast tissue)  are of relatively normal body weight and  have mostly localized fat  in the chest region as the predominant physical finding, with  (and sometimes, without) a variable  amount of palpable breast tissue directly beneath the nipple areoalar complex (the nipple and the dark pigmented tissue around the nipple is referred to as the “nipple areolar complex or NAC).   In this type of patient, liposuction alone , especially Ultrasonic Assisted Liposuction (UAL) can be utilized to remove this tissue to produce a smooth post operative contour of the chest. This is an option only if the patient does not have an excessively large breast and  has good quality skin which will allow for adequate skin retraction post operatively.

Ultrsonic Assisted Liposuction (UAL) has been utilized for the treatment of gynecomastia for years and is the method which I  routinely utilize as well. The ultrasonic energy can remove breast tissue as well as fat provided there is not an excessive amount of palpable breast tissue. Suction Assisted Liposuction (SAL) and its variations, can not reliably address breast tissue.

In patients in which  palpable breast tissue remains after the liposuction  has been performed, surgical excision of the breast tissue is necessary. The incision can be well hidden along the border of the pigmented tissue of the areolar to minimize or completely hide the post operative incision scar. It has been my experience that the scar is not visible at conversational distance given adequate time to allow for healing, usually 8 – 12 months post operative.  Most times I can tell the patient to anticipate a scar depending on my  pre -operative physical  findings, but I always make provisions in the consent process to tell a patient that I may have to perform an excision even if I anticipate that liposuction alone should be sufficient.  There are times when I can palpate more breast tissue in the  operating room after the surrounding fat tissue has been removed than I could pre-operatively.  In this instance, I perform adiitional excsional surgery.

In some patients the most predominant pre operative physical finding is a palpable breast “bud” (  a “breast bud” refers to actual abnormal breast tissue directly beneath the nipple areolar complex which is well demarcated and can be of variable size, from the size of a grape to as large as a plum).  In these cases, excisional surgery is required with a variable amount of liposuction used in order to contour the surrounding chest tissue to prevent what is known as a “saucer deformity”  post operative.  Imagine a circular depression in the chest where the breast tissue had been excised…we all want to avoid that type of situation and that is the reason to augment the excision with liposuction.  Syringe liposuction can be utilized in these cases.  I have never seen a “suacer deformity” in my practice utilizing the combination of techniques.

I have seen patients who are morbidly obese with very large, redundant breasts. These  individuals are not candidates for the types of surgical approaches just discussed. In these individuals a formal breast reduction surgery is required. It is the same type of scarring pattern as seen in the female population. Men  who present with this situation must be accepting of the necessary post operative scarring if they are to have a smooth, flat chest contour post operative.

The only way to know for sure if you are candidate for any of the interventions just discussed is to be seen in consultation by a well trained, highly experienced and properly credentialed  surgeon. Not only will you be educated as to your surgical  options, and  if you are a suitable candidate for surgery, but you  should also expect to  learn about the expected post operative recovery and have all of your questions and concerns addressed.

Posted in Gynecomastia (male breast reduction), Liposuction, Ultrasound Assisted Liposuction (UAL) | No Comments »