Liposuction, you will hear Vaser-assisted, SmartLipo, sculpting, cool Iipo, all this stuff, all of the current literature shows that three and six months, they are all the same to traditional liposuction done with the tumescent technique and most of them you still have to inject the fluid into the tissue.
We do it under general anesthesia here in our fully accredited surgical center. So who is a candidate for liposuction? Well, unfortunately in many plastic surgeons’ offices if you’ve got money, you’re a candidate. I don’t do it that way. I think the better candidate and the way it was originally intended to be was for someone who has areas that are resistant to diet and exercise: the hips, the lower tummy, the inner and outer thighs, the tall slender lady or the slender lady who has the fullness on the outer thighs so-called Saddlebag Deformity. This is where liposuction was originally intended to be done.
If you’re globally overweight if you have a BMI, a Body Mass Index, over 32, 34, 35 you really shouldn’t get liposuction, you should do diet and exercise and get things reduced and then consider what needs to be done, a breast lift, a tummy tuck etc. When we look at someone to see if they’re a candidate for liposuction, we have to look at the quality of the skin.
Imagine I have two couches in my living room, one couch is covered with spandex, the other couch is covered with linen sort of like the jacket I’m wearing. My wife says to me “Clay these couches are overstuffed, there’re too seventyish-looking, take them out to your shop, get your son to help you, put them up on the bench and take the batting out of them” and like a good husband who has been married for 32 years I say — the last two words in any discussion — “Yes dear”. So I take them outside we put them up on the bench, we take the batting out, we bring them back, we put them in the living room, my wife says “you did a great job on that couch not so good on that couch”. What’s the difference?
The spandex couch has elastic skin the envelope shrinks back so it stays smooth even if we weren’t perfect in taking our batting out that elastic covering snaps back. That’s young skin that is going to snap back, it is very forgiving and gives you a nice contour. Fifty-year old, fifty-five year old or someone with a lot of stretch marks, damaged skin they have skin that’s like linen; it has no elasticity. So when the batting comes out of it, it just kind of folds irregularly and you get folds and divots and waviness and some people they don’t care as long as they look better in their clothes and as long as we understand that ahead of time, I’m perfectly willing and able to do liposuction on that person.
It’s all about expectations if you’re expecting a nice, tight, smooth contour to your skin and you’ve got very damaged skin by having a baby and stretch marks or having older skin that doesn’t have elasticity and that happens around 45 to 50, don’t be surprised if you have waviness afterwards but in some cases that would be okay.
Another place liposuction really is I think indicated is in women that have a pear shape. They’re petite up top, they are petite in their waist, and their bottom and their thighs just really expand and it’s unfortunate. These women will tell you they lose five pounds and their breasts disappear. So for these women I think liposuction is wonderful, we can contour their thighs and contour their buttocks and really bring that volume down and get them in balance again. If they’re really overweight we would at least have them lose weight first, but that’s a good place.
The other place that liposuction is turning out to be really good is in some young women where we do a breast reduction with liposuction, not all but some, and I have a case like that on my website, no scars, just a couple little puncture marks which by the way is how we do liposuction with tiny little puncture marks that are very inconspicuous. We can actually liposuction breasts and get the tissue to shrink down and do a breast reduction without incisions. That’s pretty cool.