The trend continues: a high demand for body contouring by women and men. In recent years cryolipolysis (CoolSculpting) has received lots of hype just like LASER-liposuction did before it. Even though it is a non-surgical procedure it still requires a large time commitment and significant cost to the patient with limited results due to its lack of skin tightening. Liposuction, in its basic form, has been employed for many decades and, with proper patient selection and appropriate execution of good techniques, can produce results which sculpt the human form to a more pleasing shape without surgical excision of skin. I have been in practice for seventeen years and I have seen many modifications of liposuction with various added energy sources such as ultrasonic, water pulses, LASER, and mechanical oscillation cannulas. Regardless of the technology the most important variable is the surgeon who is performing the liposuction. They should be a Board Certified Plastic Surgeon who understands the concept of even skin flap elevation, the normal desired anatomy of the body part, the concept of wound contracture related to inflammation and collagen deposition, and the understanding of the potential life- threatening complications which need to be minimized or avoided. Liposuction is surgery whether performed in an office, surgery center or hospital and appropriate judgement and skill is required. So, do your homework and choose wisely to ensure predictable safe outcomes.
Liposuction to improve or enhance the shape of the body can result in unwanted contour irregularities of the skin. This can be the result of incomplete fibrous tissue release and or skin retraction or uneven removal of the underlying fat. Even in experienced hands some contour deformities can occur requiring minimal revisions. In my hands, the most predictable lipocontouring technique is the one championed by Dr. Simeon Wall called PAL/SAFE which is not a completely new concept but has led to much more precision and artful outcomes. Essentially it employs the use of a power added handpiece attached to an oscillating cannula. I also utilize a technique by Dr. Dan DelVecchio called SST (simultaneous separation and tumescence) to enhance the pace of the surgery. The essential features of the amalgamation of these two concepts include infusing a wetting solution containing dilute epinephrine and lidocaine retrograde through an oscillating expanded basket cannula which allows the surgeon to immediately wet the fat and prevent bleeding while also breaking up the fibrous encasement surrounding the fat cells under the outer skin. This is also when any cellulite (ligaments that bridge deeper tissue to the dermis of skin) can be released as well. The key principle is to completely release the fat to be freely mobile while still attached to a blood supply and the overlying skin is completely released. The second stage is the aspiration of the unwanted fat volume of a given area to create the new shape. The last step is the equilibration of the remaining fat left behind and re-distributing relative areas of excess fat to areas of deficiencies with a cannula similar to racking pea gravel to an even level throughout the area of concern leaving behind an even surface. The concept of the skin re-distribution or retraction can occur evenly if the overlying skin is released and the skin quality is acceptable for the technique. Loose hanging skin with lots of stretch marks are not candidates for any contouring without associated skin resection such as tummy tucks.
Liposuction to create new body contours can be a very effective technique with the right trained surgeon and the appropriate candidate. The precision advanced techniques described above are the best way, in my opinion,to ensure good results with minimizing contour irregularities. Therefore, I prefer to use the MicroAire PAL system with SAFE and SST concepts for my body contouring procedures. To inquire about a consult and to see if this procedure is right for you please contact my office, The Lucas Center, at 865-218-6210 or email thelucascenter.com