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Director | Dr. Paul Jarrod Frank
1049 5th Avenue, Suite 2B, New York, NY 10028

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Frequently Asked Questions

The concept of tumescent liposuction is surprisingly simple. Liposuction is a surgical technique that improves the body's contour by removing excess fat deposits located between the skin and muscle. Tumescent Liposuction involves local anesthetic and the use of a small blunt stainless steel tube, called a microcannula. The liposuction cannula, typically connected to a powerful suction pump, is inserted into the fat through small incisions in the skin, and fat is removed by suction as the cannula creates tiny tunnels through the fat. During the healing process after liposuction, these tiny tunnels shrink and disappear, resulting in an improved body contour.

What is the tumescent technique?

The tumescent technique for local anesthesia involves the injection of large volumes of very dilute lidocaine (local anesthetic) and epinephrine (drug that shrinks capillaries) into subcutaneous fat. The word tumescent means swollen and firm. With the tumescent technique, the volume of dilute lidocaine that is injected into fat is so large that the targeted areas literally become tumescent (swollen and firm). The tumescent technique produces profound and long-lasting local anesthesia of the skin and subcutaneous fat.

What are the benefits of tumescent liposuction?

Local anesthesia used in the tumescent technique for liposuction is so effective that patients no longer need intravenous sedatives, narcotic analgesics, or general anesthesia. As a result of the widespread capillary constriction caused by the epinephrine in the anesthetic solution, there is minimal bleeding during and after surgery. This is a major improvement in the liposuction technique compared to the older methods that simply use general anesthesia.

What is the history of the tumescent technique and Dr. Frank’s experience?

Liposuction was initially developed in 1978 in Italy and France, and introduced into the United States in 1982. Developed in the late 1980’s, the tumescent technique has proven to be safer than the older techniques that required general anesthesia, it has also proven to be less painful, has minimized post-operative recovery time, and has produced optimal cosmetic results. Dr. Frank has been performing the technique for 10 years and performs over 300 procedures each year. Tumescent Liposuction is his area of expertise as he dedicates the majority of his practice to it.

What is the difference between Tumescent Liposuction and SmartLipo, Vaser Liposuction, powered liposuction, CoolLipo, LipoLite etc?

Tumescent liposuction is the medical procedure of removing fat under local anesthesia. All other titles are company’s trademarked names of devices/instruments (lasers, ultrasound devices, vibratory devices) that aid in the removal of fat under local anesthesia. They are all used as part of the tumescent technique, not in lieu of it.

Are there any advantages to the above devices and which is the best?

To date, there is no good published and peer reviewed evidence that any laser, ultrasound, radiofrequency, or vibratory devices gives a better, safer result than typical micro-cannular tumescent liposuction. Each company and media outlet will advertise their biased opinion only. Dr. Frank, as a leader in the field of tumescent liposuction, has tested each of these devices and owns a few of them (SmartLipo MPX and VASER, powered liposuction). In his vast experience, Dr. Frank feels these devices are beneficial in certain instances which depend on several physical aspects of the candidate and the nature of the procedure. Dr. Frank does not use these devices if they are not necessary. All devices do carry a small degree of risk in the form of skin trauma and burns. Although Dr. Frank has never seen such complications, it is his goal to accomplish the most by doing the least, thus maximizing aesthetic results and minimizing recovery and risk. None of these devices reduce downtime, blood loss, pain, or risk when compared to Tumescent Liposuction alone both in long term studies and in his own experience. The cost of the procedure is independent of which device or combination thereof he may decide to use. There are instances where he uses several of the technologies on the same patient. Variability of technique that are appropriate for each individual will be discussed upon consultation with Dr. Frank.

What about mesotherapy?

Mesotherapy involves a series of injections of various chemicals that supposedly melt fat. Treatments are painful, traumatic, bruising, and can leave very uneven and lumpy results. There is no true control of any contours. To date, mesotherapy is still a non FDA approved and terribly unregulated and unstandardized technique that is marketed for fat reduction. There are no studies that show its true efficacy and there are studies that suggest significant risk. To change one’s body contour, the accepted standard of care still is still liposuction. The cost is no different in the long term and the risks of mesotherapy can be much greater.

Are some localized areas of fat resistant to diet and exercise?

Yes. Fat located in any area of the body, and especially the abdomen, hips, and under the chin is often resistant to diet or exercise. Similarly, after pregnancy, the fat on the abdomen and hips may persist despite concerted efforts at dieting and exercising.

Are some localized areas of fat inherited?

Yes. Localized accumulations of fat are often inherited and frequently impossible to eliminate by exercise or dieting. After the age of 30, an individual often gains fat according to a genetically predetermined pattern. For these people, liposuction is literally a dream come true. Liposuction is the only realistic means of significantly changing the body’s silhouette. In effect, liposuction is equivalent to being able to focus the effects of dieting to specific areas of the body.

Does the total number of fat cells in the body increase as a person gains weight?

The total number of fat cells in the human body only increases when a person gains a large amount of weight. The normal small daily or weekly fluctuations in a person’s weight are usually associated with an incremental increase or decrease in the average size of the individual’s fat cells.

Who is a good candidate for liposuction?

The best candidates for liposuction are in good health and have realistic expectations. Liposuction can provide a good candidate with a significant improvement, but it is unlikely to achieve perfection. There is no definite age or weight limit for patients. Many liposuction patients are of average size but are concerned about localized accumulations of fat.

Who is not a good candidate for liposuction?

A person who expects absolute perfection is not a good candidate for liposuction. Obese patients or patients who have not maximized their contours with diet and exercise are usually not good candidates for liposuction. A person who has a serious or poorly controlled medical problem is not a good candidate for liposuction.

Is liposuction a reasonable treatment for obesity?

Liposuction is not a good treatment of obesity. Liposuction is not effective, even as a last resort, for people who are unable to lose weight by dieting and exercise. Obese patients almost always regain the weight that is removed by liposuction unless there is a dramatic reduction in calorie intake (by dieting) or a significant increase in calorie expenditure (by exercising). Whenever large-volume liposuction has been used in an attempt to treat obesity by surgery, there has been a significant increase in the incidence of serious surgical complications. It is not safe to remove huge amounts of fat by liposuction. Thus, liposuction will not be of any significant benefit for an obese patient who believes that liposuction will aid in the effort to lose weight.

On the other hand, an overweight person whose weight has been stable for many years and has certain problem-areas of fat may be a good candidate for liposuction. Liposuction in a large patient is reasonable when the goal is to improve a troublesome body contour area.

What is a successful liposuction surgery?

The surgeon's goal is to obtain an optimal aesthetic result rather than to maximize the amount of fat removed. One of the most common causes for disappointment in the results of liposuction surgery is the removal of too much fat, which produces an abnormal or unusual appearance. The cosmetic success of a liposuction surgery is often the result of removing an amount of fat equivalent to less than a pound or two of butter from a woman's saddlebag area or from a man's love handle area. While this amount of fat is relatively small compared to a person's total body weight, it does produce a dramatic change in the patient's silhouette.

Does liposuction always remove cellulite?

Liposuction improves the silhouette of the body, but does not necessarily eliminate the pre-existing subtle "puckering" of the skin that is often referred to as "cellulite." Liposuction does reduce the degree of cellulite to a minor degree but it is unlikely to produce a significant improvement or to completely eliminate cellulite.

Does liposuction decrease my risk of heart disease or diabetes?

Unfortunately, not. Liposuction of any kind only removes fat above the muscle and the result is purely cosmetic. Visceral fat or fat around one’s organs is associated with increased risks for the above conditions. No surgical procedure addresses this type of fat; only dieting.

Does liposuction produce permanent results?

After liposuction the body's new shape is more or less permanent. If a patient does gain a moderate amount of weight after liposuction, then the figure will simply be a larger version of the new body shape. Fat cells that are removed by liposuction do not grow back. As long as the patient does not gain excessive amounts of weight, the new, more pleasing silhouette is permanent. Of course after liposuction the clock keeps ticking, and advancing age will produce the usual changes in the shape of the body associated with the aging process. If a person gains weight after liposuction, she/he will not accumulate as much fat in the treated areas as would have happened if liposuction had not been done. The myth of fat moving around after liposuction is still merely a myth.

Does the fat come back in other spots after liposuction?

If a patient does not gain weight after liposuction, then fat does not accumulate in other areas of the body. However, if a patient gains a significant amount of weight, say more than 10 pounds (5 kg), after liposuction, and then the fat must go somewhere. In fact, the fat accumulates in every area of the body in proportion to the amount of fat cells in each area. Areas where fat cells have been removed by liposuction will accumulate relatively little fat, while areas not treated by liposuction will collect relatively more fat. For example, if a woman gains weight after liposuction of her hips, outer thighs, and abdomen, then most of the fat will be deposited elsewhere such as the woman's breasts, face, back and legs.

Does liposuction cause dimpling or indentations in the skin?

Dimpling and indentations in the skin is a known risk of liposuction. However skin irregularities are very unusual in the hands of a skilled surgeon with the tumescent technique. The use of large diameter cannulas tends to increase the risk of irregularities, while the use of microcannulas (less than 2.8 mm in outside diameter) reduces this risk. When large cannulas are used, any inadvertent passage of the cannula too close to the skin may leave a depression or furrow, whereas one pass too close to the skin with a microcannula will not leave a visible depression.

How much blood is lost during tumescent liposuction?

The tumescent technique is so effective at minimizing blood loss that the majority of patients lose approximately 15 to 30 ml (1 to 2 tablespoons) of blood during large volume liposuction. This is the same volume of blood that is taken for routine pre-operative laboratory studies. In the days before the advent of the tumescent technique, the biggest risk of liposuction was excessive loss of blood during surgery.

How does the tumescent technique reduce bruising after liposuction?

There are two reasons for this significant decrease in bruising. First, because there is so little blood loss with the tumescent technique, there is almost no blood that remains beneath the skin to cause bruising after surgery. The second reason for decreased bruising is that with the tumescent technique there is a considerable amount of post-operative drainage of the blood tinged anesthetic solution. The incisions are so small (about 1.5 mm) and do not require stitches. By allowing these wounds to remain open for two to three days after the surgery, most of the residual blood-tinged anesthetic solution drains out. This minimizes bruising and swelling and accelerates the rate of healing.

How much does liposuction cost?

The fee for liposuction usually depends on how many areas are treated by liposuction. When only one area is treated by liposuction the fee is less than when multiple areas are treated. As a rough estimate, the fees for liposuction may vary from $4,000 to $10,000 for liposuction accomplished on a single day, to as much as $12,000 to $20,000 or more when multiple areas are treated on separate occasions over a period of several months. The cost of liposuction can vary from community to community, and from surgeon to surgeon. To get an accurate estimate, it is necessary to have a consultation with a surgeon and to receive a written quote of the expected fees.

How are the surgical fees for liposuction determined?

Generally, Dr. Frank charges one global fee for the procedure. This is most often the case when liposuction is done in an office-based surgical facility. Other surgeons might require that separate fees be paid for the surgeon, for the anesthesiologist, and for the surgical facility. The fee typically depends on the surgical overhead, amount of time and effort required to accomplish the surgery. If the patient has several areas of concern which are not too large, then liposuction of more than one area can often be accomplished on the same day. The fee charged for liposuction of a second or a third area might be less than the fee for the 1st area, and may range between $1,200 to $4,000, or more.

Should I Base My Decision on the Cost of Liposuction?

Decisions about liposuction should not be based solely on the cost of liposuction. The cheapest procedure might mean that the surgeon does the procedure quickly and incompletely. Liposuction is a hand-crafted art form. It is more reasonable to base your decision about liposuction on the surgeon's reputation, the surgeon's apparent skill and facility, the surgeon's experience and the surgeon's ability to communicate with you in a manner that is professional, sincere, comfortable, and unhurried. Five years after your liposuction, you will probably not remember the exact amount you paid for the surgery, but you will be aware of the quality of the results for the rest of your life. The most common source of disappointment following liposuction is dissatisfaction with the degree of improvement ("it looks as if nothing was done") or unhappiness with uneven lumpy-bumpy results. The liposuction cost should not be the main basis for your choice of surgeon. Do not put your body on the bargain rack.

How much weight can I lose by liposuction?

Patients should not expect to lose a dramatic amount of weight with liposuction. However, because fat is removed from cosmetically important areas, liposuction should produce significant improvements in aesthetic appearance, as if you lost a significant amount of weight.

What can I expect if I get pregnant after liposuction?

Pregnancy does not permanently alter the results of liposuction. If a woman has liposuction and subsequently becomes pregnant, gains weight, gives birth and finally loses the excess weight of pregnancy, then her original liposuction improvements will return, just as if she had never been pregnant.

Will liposuction improve the stomach I acquired after my last baby?

Yes. Liposuction typically provides excellent improvement of the abdomen after pregnancy. In fact, for the vast majority of patients, liposuction provides a better and more natural appearance than a tummy tuck.

How much fat can be removed? How many pounds?

The maximum amount of fat that can be removed safely is probably about 6 to 8 pounds (3 to 4 liters). The greater the volume of fat removed on a single day the greater the risk of complications. If a patient requires removal of more than 6 to 8 pounds of fat, it is safest to divide the liposuction into separate surgical procedures each separated by 3 to 4 weeks.

How long will it be until I see results?

Most patients will see 90% of their ultimate liposuction results within one to four months after surgery. For the first few weeks after surgery there is postoperative swelling. The rate at which this swelling subsides depends on the surgeon’s surgical technique and method for postoperative care.

What are the risks of liposuction surgery?

As judged by current worldwide experience, liposuction is amazingly safe. Rare problems that can potentially occur with any surgical procedure include infections, bleeding, skin ulcerations, and nerve injury. The tumescent technique minimizes these risks. As with any surgical procedure, liposuction is associated with certain common side effects such as bruising, swelling and temporary numbness. Although irregularities of the skin are possible following liposuction, this side effect is minimized by tumescent liposuction using microcannulas and the skill of an experienced surgeon. In Dr. Frank’s practice, there have never been any life-threatening complications requiring hospitalization.

Have there been any deaths related to tumescent liposuction totally by local anesthesia?

No. There have been no reported deaths associated with tumescent liposuction totally by local anesthesia. Virtually all deaths associated with liposuction have been associated with 1) multiple unrelated surgical procedures performed on the same day (facelift, breast augmentation, hysterectomy, etc), 2) excessive amounts of liposuction or an excessive number of body areas treated by liposuction on a single day, 3) the use of general anesthesia or heavy IV sedation with narcotics. Liposuction is an extremely safe procedure provided the patient is not exposed to excessive surgical trauma, excessive narcotic analgesics, or prolonged use of general anesthesia.

Where Is Liposuction Performed?

Liposuction can be performed in a doctor’s accredited outpatient surgery center, or in a hospital. This is now a New York State Law. Any doctor’s performance of any type of liposuction in an unaccredited office is considered medical misconduct.

What are the Important Characteristics of a Safe Surgical Facility?

There are 3 state approved accreditation boards. Dr. Frank is accredited by AAAHC. Information about this can be viewed on our website.

Is it safe to have liposuction in a surgeon’s office?

If the surgeon’s office is accredited, then liposuction can be done safely in the office. Accreditation of a surgeon’s office documents that the facility has passed an inspection and has strict policies and procedures for patient safety. A state licensed surgery center has met the same high standard required of hospitals. Accreditation or state licensure demonstrates an extra effort to optimize patient safety.

Is Liposuction safer in the hospital?

No. The vast majority of liposuction surgeries are performed in an outpatient surgical facility. Liposuction in an accredited office is probably safer than liposuction done in a hospital. One possible explanation for this is that liposuction surgery in the hospital tends to be accomplished under general anesthesia and hospital surgery is associated with an increased risk of surgical wound infections.

Is there any preparation necessary for the procedure?

As long as a patient has no uncontrolled medical conditions and is under the age of 65, no medical clearance is necessary from a primary care doctor. Dr. Frank sends patients for routine pre-surgical blood work to check the liver, the kidneys, one’s blood count and any unknown susceptibility to bleeding (blood work is more detailed than what is gotten at checkup visits with one’s own doctor). In addition, we have patients avoid certain medicines for 1-2 weeks which can increase the potential for bruising (i.e.: aspirin, pain relievers, and vitamins) A list of medicines to avoid is provided for patients.

Can I take medicines that I normally take up until and after the procedure?

Dr. Frank has patients continue all medicines for chronic medical conditions unless they increase the risk of bruising. These will be reviewed upon consultation with Dr. Frank.

Can I have the procedure done if I am HIV+ or have a history of Hepatitis?

As long as a patient’s chronic medical condition is stable and treated, there is no contraindication to having the procedure performed safely and successfully.

How many incisions are made?

The number of linear incisions or adits (tiny round holes) that are placed in the skin is determined by a number of factors including size and location of the area being treated, and the surgeon’s technique. In general, when just one or two incisions are used in an area, the incisions tend to be somewhat larger (greater than 1/4 inch long), and are closed with stitches. In contrast, Dr. Frank uses small diameter microcannulas and typically makes multiple (4 to10) tiny adits in an area, which are so small (less than 1/8 inch in diameter) that no stitches are required. These adits usually heal without noticeable scarring.

How long will it take for the incisions to heal?

Incisions or adits usually close up in a week or two, and become completely healed with no scabs within 2 to 4 weeks. The incision sites slowly become less and less visible over 3 to 12 months, except in patients who have very darkly pigmented skin, in which case the incision sites may remain visible for a longer period.

Is it necessary to have an IV during liposuction?

Intravenous fluids are not necessary but an IV (open line) is kept in for safety and emergency purposes.

How long does it take to complete a typical liposuction procedure?

The average patient will be in the surgical facility for 3 to 4 1/2 hours. However, the actual surgery may only require 2 to 3 hours. The length of time that it takes to complete a liposuction depends on the size of the patient, the number of areas being treated, and the type of anesthesia being used. Because it takes a certain amount of time to inject local anesthesia, it usually takes longer to do liposuction using local anesthesia than it does using general anesthesia. We are sculpting not debulking.

Is the procedure painful?

Getting the procedure is similar to getting dental work done. The only part that is uncomfortable is getting the local anesthesia injected. Patients are given a variety of mild sedatives including Demerol and Valium to make them comfortable during the numbing process. Individuals are awake enough to get up for a bathroom break but sedated enough to sleep soundly through the procedure. Once the patient is numbed, there is only a sensation that something is being done without any discomfort. The sensation is of movement only. Patients do not have to visualize what is being done unless they request to visualize the procedure.

How soon after surgery do I have to return for a post-operative check-up?

Policies regarding the timing of follow up visits after liposuction vary from surgeon to surgeon. Dr. Frank prefers to see patients 4-7 days after the procedure. By this time, patients have reached there maximum of any potential bruising or swelling.

How long do I remain in the surgical facility after tumescent liposuction?

When liposuction is done totally by local anesthesia, patients can usually depart from the surgical facility within 30-45 minutes of the completion of surgery. Dr. Frank prefers that patients have a provided snack and drink fluids while he and his staff review post-op instructions and answer any questions.

What is the purpose of elastic compression garments?

The body does not like empty spaces. Compression will help close the space that was once occupied by fat. Compression garments can help prevent bruising, swelling and seromas (collection of blood and fluids). With Dr. Frank’s technique compression is only necessary for a few days to a week or two (depending on the patient). Traditional liposuction generally requires several weeks of compression and or the use of surgical drains.

How long does any drainage of fluid last?

Drainage comes out of the unstitched incisions that are made during the procedure. This limits swelling and bruising. For most, the amount of drainage is negligible because of special absorptive pads that Dr Frank places under a garment to be worn for 24-36 hours until the first shower and bandage removal. The majority of drainage occurs during this initial period. Small patients with small areas of fat drain very little while larger patients may notice a few days of drainage. In 90% percent of patients, it is of no inconvenience by the time the patient returns to work in 48 hrs. Band-Aids will absorb any residual fluid.

How long before beginning normal activities after tumescent liposuction?

Most patients can return to a work within two days after tumescent liposuction. Because of the significant decrease in swelling, inflammation and pain, patients are able to return to normal physical activities very soon after tumescent liposuction. There is no limitation to physical activity other than what common sense would dictate. Some patients are able to return to light aerobic exercise within a day or two after surgery. Some patients do find the soreness after surgery more significant than others, but on the average, most patients are quite surprised at how quickly they are able to return to normal activity.

How long until I can exercise?

Within one to two days after surgery, all patients should be physically able to walk around inside the house and go for short walks around the neighborhood. Dr. Frank prefers that patients do not remain in bed.

Most patients can resume their routine exercising within 1 week after liposuction. Initially, patients should not attempt too much. It is recommended that patients start out by doing about 25% of their usual amount of exercise, and thereafter increase their daily exercise as tolerated.

How long before I can fly in an airplane or drive?

Unless Dr. Frank gives explicit instructions to avoid flying and driving, most patients can fly or drive after 24 hours after liposuction. For many days after surgery, patients must avoid prolonged sitting in a car or airplane. Prolonged sedentary inactivity (such as sitting in an airplane for long intervals) increases the risk for deep-vein thrombosis (blood clots) in the legs. Frequently getting up for a stretch and a brief walk minimizes this risk.

How long before I can have sex?

There are no restrictions regarding sexual activity after liposuction other than limitations imposed by postoperative soreness and tenderness of the treated areas. Otherwise liposuction usually does not interfere with a patient having gentle sexual encounters.

How long will initial bruising and swelling last?

The duration of bruising and swelling after liposuction usually depends on the post-operative care technique used by the surgeon. The amount of bruising varies considerably between patients but is generally minimal. With tumescent liposuction, the little bit of bruising is nearly gone one to two weeks after surgery in most patients. With open-drainage (incisions are not closed with stitches) and appropriate compression garments (worn for 3 to 6 days) swelling is 80% resolved 4 weeks after liposuction. Patients are generally, “beach ready” in 2-4 weeks.

If my liposuction surgery is divided into two or more surgeries performed on separate days, how much time should there be between surgeries?

There is no strict rule concerning the optimal amount of time between successive liposuction surgeries. Safety concerns are more important than is any consideration about convenience for the patient or surgeon. Dr. Frank usually recommends 4-6 weeks.

How long after liposuction will the soreness or tenderness persist?

During the two days immediately after liposuction, the amount of pain experienced depends on the type of anesthesia used for liposuction. Local anesthesia usually persists for more than 24 hours after surgery. Liposuction under general anesthesia, without using local anesthesia at the same time, is much more painful and typically requires narcotic analgesia. With Dr. Frank’s technique, soreness is usually the most intense 2 to 4 days after liposuction and then decreases steadily. The tenderness and soreness typically is slightly bothersome for 1 to 3 weeks, but gradually subsides over the following next 4 to 8 weeks.

What is the quality of the pain after liposuction?

Immediately after tumescent liposuction, the local anesthesia persists for 12 to 24 hours, so that the only discomfort is described as soreness or tenderness. Beginning the day after, the quality of pain is similar to that of muscle soreness that one might experience after having worked-out too vigorously. This type of pain rarely requires any medication other than acetaminophen (Tylenol).

What is the intensity of the pain after liposuction?

95% of patients require no prescription pain medicines. Dr. Frank will provide it for patients if necessary.

How does my skin elasticity affect the results of liposuction?

The appearance of skin after liposuction depends on the skin’s elasticity. Skin should look smooth and natural after liposuction. Even with poor skin elasticity, the skin usually looks good after liposuction. Younger people generally have better skin elasticity than older people. People who have previously been obese and subsequently lost a great deal of weight will have less skin elasticity than someone who has never been obese.

I am older and don’t have much skin elasticity, can liposuction still work?

With poor elasticity, liposuction in some areas of the body (such as the inner thighs or upper abdomen) may show some degree of skin wrinkling. The degree of wrinkling after liposuction is approximately the same as one might expect if the patient had lost the same amount of fat from the area by dieting. Even with poor skin elasticity, the cosmetic benefits of liposuction often outweigh any noticeable increase in skin wrinkling.

How does liposuction affect the appearance of the skin?

The usual degree of skin change seen after liposuction is the same change that one would see if it were possible to lose an equal amount of fat in these localized areas simply by dieting. Liposuction cannulas make small tunnels in the fat, and leave multiple attachments between the skin and the underlying muscle tissue. These fibrous connections contract during the healing process and maintain the skin in its natural position. In patients who have good skin elasticity, tumescent liposuction generally does not result in excessive folds of skin. Liposuction generally does not cause the skin to appear more wrinkled. Liposuction can often significantly improve folds of fat and skin on the back below the bra. Pre-existing wrinkles on the inner thighs and upper abdomen are generally not made worse or improved by liposuction.

Can liposuction improve sagging abdominal skin?

Liposuction dramatically improves the appearance of the abdomen in the vast majority of women. By removing the heavy fat that causes abdominal sagginess, liposuction allows the skin’s natural elasticity to retract and elevate the skin. In order for liposuction to improve abdominal sagginess the skin must have some elasticity and there must be some subcutaneous abdominal fat that can be removed by liposuction. Only in relativity few cases, where the skin has little or no elasticity and little or no subcutaneous fat, liposuction cannot improve a sagging abdomen.

How much scarring can I expect?

Scars with liposuction can occur, but it is usually minimal. One of the most attractive features of liposuction is that the incisions are so small and the thus the scars are also quite small. The amount or degree of scarring depends on both the surgeon’s technique and the patient’s genetic or inherited scarring tendency.

Does liposuction produce visible scars?

Scars are not a common problem with modern liposuction which uses very small cannulas (microcannulas) and thus only very small incisions are required. Most liposuction scars fade and disappear with time. Visible scars are more likely when large liposuction cannulas are used, and in patients who have darkly pigmented skin.

What types of scars occur with liposuction?

There are two types of marks that can remain on the skin after liposuction. One is a true scar, and the other is known as dyschromia with a dark (hyper-pigmented) or light (hypo-pigmented) spot on the skin. Any incision in the skin can result in a scar. Fortunately, most of the scars associated with liposuction are either so small that they become virtually invisible or the scar is strategically located on an area of the body where the scar in not easily seen.

Why do incision sites become darkly pigmented in some patients?

Any type of injury to the skin can produce inflammation which in turn produces post-inflammatory hyper-pigmentation. An incision, acne pimple, insect bite, or a rash from poison oak can produce post-inflammatory hyper-pigmentation. The darker a patient’s natural pigmentation, the more intense (darker) and more persistent is a spot created by post inflammatory hyper-pigmentation. In lightly pigmented skin post-inflammatory hyper-pigmentation usually disappears in less than six months, but in very darkly pigmented skin it may last for 2 to 4 years or more.

What medications are available to treat Anxiety prior to surgery?

Medications that reduce anxiety are known as anxiolytics. Relatively small doses of the group of drugs known as benzodiazepines, diazepam (Valium), lorazepam (Ativan), and midazolam (Versed) can reduce anxiety. At higher doses, these drugs cause sedation. It is common for a liposuction surgeon to prescribe a benzodiazepine pill to be taken the night before surgery. An additional dose is often given immediately before surgery.

Is an anesthesiologist necessary with Dr Frank’s technique?

An anesthesiologist should be present only when a patient is given general anesthesia. Dr. Frank performs the procedure only with "conscious sedation"; therefore, no anesthesiologist is needed.

What Alternatives Are There to Liposuction?

Liposuction is never absolutely necessary. If you decide that liposuction is not for you, then you may consider the following alternatives to liposuction. Weight loss without liposuction can produce excellent aesthetic results. Weight loss can be achieved by dieting (decreased calorie intake) or by increased exercise (expenditure of calories). An alternative to abdominal liposuction is a tummy tuck.

What is a tummy tuck?

A tummy tuck (abdominoplasty) is a major surgical procedure requiring general anesthesia, and involves liposuction and excision to remove fat, plus a large excision of skin. The typical result is usually a flatter tummy with a large scar extending from the pubic area to the lower abdomen to anterior hips. Because the surgeon can directly visualize the muscles of the anterior abdominal wall during a tummy tuck, lax abdominal muscles can be surgically tightened during a tummy tuck procedure. Before the invention of liposuction, a tummy tuck was the only surgical method for removing excessive abdominal fat. In many patients (but not all) liposuction of the abdomen can often provide equivalent or better results than a tummy tuck. Because liposuction is safer and causes less scarring compared to tummy tucks, abdominal liposuction is now far more common than tummy tucks.

How does abdominal liposuction differ from a "tummy tuck"?

Liposuction of the abdomen removes most of the fat found under the skin and above the abdominal muscles. When patients have good abdominal muscle tone, liposuction can provide a dramatic improvement, with a natural appearance of the abdomen, and with minimal scarring. In the vast majority of liposuction patients, the natural elasticity of abdominal skin contracts smoothly, and there is no need to surgically remove skin. A tummy tuck can result in an unsightly scar that extends across the entire lower abdomen, just above the pubic area in addition to an unnatural appearance of the belly button. The recovery after liposuction is much safer, quicker and easier than the recovery after a tummy tuck.

What are the advantages of a tummy tuck (compared to liposuction)?

The only patients for whom a tummy tuck is superior to abdominal liposuction are the relatively few women having extreme degrees of lower abdominal skin laxity, unusually extensive stretch marks, or severely stretched abdominal muscles (as a result of pregnancy). A tummy tuck surgically removes skin with severe stretch-marks (striae-distensae). Liposuction does not remove stretch marks. A tummy tuck can produce a flatter abdominal wall by tightening the abdominal muscles. Some loose abdominal skin does not mean that a tummy tuck is necessary. After liposuction, abdominal skin often contracts to a surprising degree so that an excision is not necessary.

What are the disadvantages of a tummy tuck?

Tummy tucks are often associated with ugly scars producing a deformed appearance of the pubic and lower abdominal areas. Although the lower abdominal area is usually covered when a bathing suit is worn, the scars are quite apparent without clothes. The removal of a large segment of lower abdominal skin requires that the belly-button be repositioned and surgically reconstructed. A surgically altered belly button often does not have a natural appearance. Tummy tucks are far more dangerous than abdominal liposuction. Tummy tuck surgery has a much higher risk of surgical complications such as blood clots in the lung (pulmonary embolism) compared to liposuction. In most cases, liposuction alone, without a tummy tuck, produces excellent cosmetic results and avoids the risks and additional expenses associated with a tummy tuck.

Is the cost of a tummy tuck greater than liposuction?

Tummy tucks are approximately 2-3 times as expensive as liposuction of the abdomen. The recovery time required before a person can return to work after a tummy tuck is typically two to four weeks longer than after liposuction of the abdomen.

How can one minimize the risk of complications associated with a tummy tuck?

When a tummy tuck is indicated, some surgeons believe it is safer to first do a liposuction and then, several months later, do the tummy tuck. Often the patient is so pleased with the initial liposuction that she no longer sees a need for a tummy tuck. Second, if the results of the liposuction are not sufficient, then dividing liposuction and tummy tuck into two separate relatively minor surgical procedures is usually much safer than one major surgery.

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