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Liposuction

The modern era of liposuction plastic surgery started in 1980 when Swiss and French physicians first presented their techniques of "lipolysis." Viewed from the current perspective, the description of their procedures was revolutionary, but primitive by todays standards.

The newer techniques of liposuction, ultrasound or ultrasonic liposuction (UAL) and power assisted liposuction (PAL) are safe and consistently produce results that were not obtainable in the past. All aspects of the newer techniques have been analyzed to maximize the patient safety during the liposuction surgery: the metabolism of fats, the anesthesia, and the reproduction of standard techniques that afford the patient good results and maximize the patient safety and comfort.

It should be noted that there is no ideal method for liposuction. Almost on a monthly basis, a new "revolutionary" technique is introduced through popular magazines and television. Often the time needed to objectively analyze new instrumentation and publish these results in professional journals is years after the introduction of a "brilliant lipo" or other technique that professes to render all other methods obsolete. However, newer innovations have made the results more protectable and consistent. The most important factor in determining the result for a liposuction is the experience and knowledge of the surgeon involved. Good results are obtainable with almost any technique, and similarly poor results are equally obtainable with newer as yet, unproven techniques.

Operation: Liposuction is individualized according to the needs of the patient. It may be performed in our fully accredited office-based facility or as an outpatient in a hospital. If a hospital facility is desired by the patient, Dr. Sherman operates at the New York Presbyterian Hospital-Weill Cornell Medical Center; Lenox Hill Hospital, and the Greenwich Hospital. Depending upon the facility that you choose, the costs of each facility varies.

The operation usually takes 1/2 to 2 hours depending upon the amount of sites to be performed, and the amount of fat to be removed. The patient is then monitored in our recovery room, and leaves our facility approximately one to two hours after surgery. If you live out of the New York area, it is best to spend the first night after surgery at one of our local hotels that we use for convalescence.

Ideally, the patient should have a stable weight for months before surgery. Patients with high BMIs (body mass index) should seek dietary consultation and weight management before liposuction is entertained. If you desire, our office may help you to arrange this consultation.

In women, the most frequent areas of liposuction are the outer thighs, inner thighs, and circumferential legs. Other areas include the hips, waist, and upper back rolls. In men, typically the "love handles" at the waist are treated as well as the breasts, and chest area to treat gynecomastia. Read more about male liposuction.

The amount of fat that may be removed varies from patient to patient. This is based on the height and weight of the patient, and the relative health of each patient. Massive amounts of fat should not be removed at one time; the "insult" to the patient is too much. Patient should be comfortable at all times, and the convalescence should be manageable and comfortable. The amount of fat that is removed during liposuction ranges up to 6L. Occasionally, it is advantageous to stage liposuction, limiting the amount of fat to be removed at each operation rendering the procedure safer, and the convalescence easier.

This is a volume and contour procedure. This is not the surgical answer to diet management. As noted above, we often recommend that patients seek dietary counseling and support to ensure that the procedure results are not short-lived.

Tumescent fluid consisting of lidocaine, epinephrine mixed with saline is injected prior to the procedure starting. This minimizes pain and reduces the bruising.

Anesthesia: Most of our patients undergo surgery with intravenous sedation anesthesia, a type of "twilight" sleep. We also use LMA anesthesia, where a soft tube is placed in the airway for protection. The patient is breathing without the assistance of the anesthesiologist, unaware of the procedure that is being performed. All our anesthesiologists are board certified and highly experienced. Each has worked with Dr. Sherman over the years. We believe that the choice of anesthesiologist is as critical as the choice of plastic surgeons. Nurse anesthetists are never used.

Convalescence: The length of time that is needed for convalescence after liposuction depends on the amount of fat that is removed, and the reaction of each patient. Other factors include the general health of the patient and the elasticity of the skin. Most of our patients return to work in 3 to 5 days after the liposuction procedure. It may take up to two weeks to resume exercise and normal activity.

Patients are instructed to wear a garment for several days after the liposuction procedure. After this time, support garments such as exercise shorts may make you more comfortable, but it is not necessary, and has no bearing on the final result. Postoperative massage and ultrasound may also be useful. All of these are available through our office.

Insurance Reimbursement: There is no insurance reimbursement for liposuction.

Complications: In our experience, complications after liposuction are limited. Bleeding and infection are rare. Skin loss has been described but also is exceedingly rare. The revision rate for these procedures is significantly under 10% of patients. At the time of consultation Dr. Sherman will address all potential complications and will tell you the incidence of each complication in his practice.

Liposuction Techniques

Ultrasound Liposuction (UAL or Ultrasonic Liposuction)

Tumescent Liposuction

Power Assisted Liposuction (PAL)

Male Liposuction

To set up a private consultation with Dr. Sherman, contact us today. Call us at (212) 535-2300 or e-mail us.