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Liposuction of the tummy patient photo gallery. Abdomen - Another gravitational prone area, where I approach is the abdomen in one of two ways. Central Abdomen - The upper and lower abdomen are done as a unit. In many individuals, if only the lower abdomen is done, the upper abdomen will not tighten from the liposuction and gets looser with time. When the entire area is done as a unit, not only does it blend well, but it a stays tight and firm. The central abdomen is prone to irregularities if not done well. Common mistakes are poking the skin with the cannula from underneath, which causes dimpling. Another mistake is being overly aggressive in individuals with poorer skin elasticity, causing loose, sagging skin. I find that I am able to still get a perfectly smooth result and achieve skin tightening in patients with poorer elasticity by havinga lot of respect for the skin. In these patients, I recommend staying deeper in the fat layer and generally being more conservative. In all patients, I always crisscrosse the tunnels from either two or four directions, then finishes with a very small spatula cannula for a smooth skin surface. It is great mistake to approach the abdomen from only one access point. This will increase the risk of irregularities and leave a doughnut of fat around the belly button. Upper, Lower Abdomen, Waist and Flanks - The other half of patients that I perform liposuction on in these areas have the abdomen done all the way around, as these individuals'waists essentially need to be more defined. If the surgeon only does the center abdomen on these patients, they will look wider and flatter. The waist is one area that positioning is extremely important in order to achieve a great result. Many years ago, I found the best way to bring the waistline down is to have the patient lie on their side and hyperextend their back. I then approach the waist from above and below, while crisscrossing the tunnels without poking the skin. I find this far superior then trying to go around the waist as many surgeons do. In those cases, the waist will not be brought down properly and, inevitably, the skin will be jabbed with the cannula tip. A word on pregnancies, liposuction, and tummy tucks: It is generally better to liposuction the abdomen prior to pregnancy. Due to better skin elasticity, I can choose to remove more fat. However, most women I perform liposuction on have already had children. In these cases, I simply adjust how aggressive I’m being on the level of skin elasticity. When properly done, even with poorer skin tone, great improvements in reducing the fullness of this area and tighter skin tone can still be achieved. Unless the muscle and skin have become extremely loose, these patients can usually avoid a tummy tuck. Even if a tummy tuck is eventually necessary, I feel, and studies support, that it is safer to do these as separate procedures and a more complete final result will be achieved. If a liposuction and abdominoplasty are both necessary, I will usually liposuction the abdomen first and refer the patient to an abdominoplasty specialist after several weeks of recovery if necessary. It is important to note that I specialize in liposuction not tummy tucks. Back - This gravitationally prone area is a wonderful area to do if there is fullness. The skin is thick and prone to drooping, so I usually liposuction the mid and upper back as a unit. This is one area where the spatula cannula is used to scrape the dermis from underneath to get maximum skin tightening and lifting. The degree of skin tightening achieved is a blessing because there is no back lift or back tuck. Arms - A gravitationally prone area like the back, the posterior upper arms tend to become flabby and drop if there is fullness. For this reason, I try to encourage women to do liposuction earlier, as opposed to later in their lives, if there is disproportion in this area. By reducing the amount of the fat in the area and getting skin tightening with proper technique the posterior upper arms stay tighter and more defined as time passes. This is important not only in the short term, but even more so in the long term, because an arm lift almost always leads to an unattractive scar. Calves / Ankles - This is one of the more challenging areas to do as the surgeon must shape the whole lower leg, essentially all the way around from the knee to the ankle, to achieve a well-shaped contour. Many less-experienced surgeons avoid this area. Like other areas, I feel that where one places the incision points are crucial to a great result. The only way I have found it was possible to be consistently complete without jabbing the skin from underneath was to place two upper incision points toward the posterior lateral, knee and two lower incision points toward the lateral ankle. Buttocks - In general the buttocks themselves are rarely, if ever, liposuctioned. To get a better butt shape, I liposuction around the buttock -- outer thighs, hips, posterior, upper thigh also known as the banana roll. This, along with building good muscle tone (which is important almost everywhere) gives a smaller, rounder, tighter buttock. I will liposuction the buttock when the area is very protuberant and fat. Liposuction to the buttocks that are just flabby will tend to flatten and drop them. It is especially important to remember not to confuse fat with just flab, which is usually from poor muscle tone. In those rare individuals where I feel they are a good candidate for buttock liposuction, I stay deep (as this is an area prone to dimpling) and define the buttock being careful not to flatten it. When it is done properly on the right candidate, the buttocks will simply look smaller and slightly lifted due to decreased weight. |
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