I am often asked about options for liposuction by my patients. These patients generally fall into three groups: those that need skin removal in addition to fat removal e.g. tummy tuck), those that would have an obvious benefit from liposuction and those that don’t need much contouring but have a small problem area (the ones whose friends would say they are ridiculous for asking).

Traditional liposuction is still the gold standard for fat removal in a patient that would have obvious benefit. There currently is no substitute for traditional liposuction in these patients. It is very difficult to evaluate these non – invasive machines, such as CoolLipo or other ultrasound based therapies because they generally require patients to diet, require multiple treatments and the photos are rarely standardized (you can make it look like there has been a significant change without actually having done anything). Moreover, the surgeons who tend to carry this machine tend not to be plastic surgeons. Many are ENT (Ear, Nose, Throat) Doctors who are “Facial Plastic Surgeons” and not certified by the American Board of Plastic Surgery. They do not have training or privileges to perform liposuction at hospitals.

Traditional liposuction involves making small incisions and introducing fluid containing lidocaine and epinephrine. The lidocaine helps numb the area and the epinephrine helps decrease blood loss associated with the procedure. The fat is then removed manually with small cannulas. Up to 5-6 Liters can be removed safely in this manner. I generally recommend IV anesthesia for this procedure. Be cautious of surgeons who offer this as an office – based procedure. While it can be done from a technical standpoint, there are certainly safety precautions which must be met and few doctor’s office have these. Liposuction can be one of the most dangerous procedures we perform and if something goes wrong in this setting, the delay in treatment to get to a hospital by ambulance can make all the difference. Furthermore, as the numbing medicine is removed and wears off, it is difficult to “finish” the procedure to make a nice contour.

When in doubt, visit me and I can give you an honest opinion about what would best suit your needs and what is the best “Bang for the Buck”!