Archive for October, 2009

Which Liposuction Technique Works Best with Abdominoplasty?

Thursday, October 29th, 2009
bariatric-article

Sometimes when patients are asking me if they’ll need a tummy tuck or liposuction, the best answer is really “both.” For moms and post-weight-loss patients particularly, a tummy tuck alone just won’t take care of the extra fat that usually collects near problem areas like the hips, lower belly, and thighs. Even for many men, it usually doesn’t make sense to deal with the muscle and skin, but ignore the fat altogether.

With so many different liposuction options available today, how do you know which to go with? In general, I prefer Power-Assisted Liposuction (PAL) and sometimes I will also use Ultrasonic or Smartlipo™ Laser-Assisted Liposuction. Here’s why:

  • PAL does a better job of dealing with larger fatty deposits. Abdominal fat tends to collect as a single large deposit instead of multiple smaller ones, and the gentle vibrations of PAL make it much easier for me to remove that large patch of fat without harming the muscle and the skin that I’ll need to take care of during the abdominoplasty.
  • PAL with UAL or Smartlipo gives better definition. For some patients this isn’t an issue, since an abdominoplasty in Beverly Hills by itself will do a pretty good job of emphasizing whatever muscle definition you already have. But very often I’ll have patients who want abdominal etching or microliposuction to help delineate their muscle tone a little better, and Smartlipo lends itself well to the very-small-scale fat removal that this kind of procedure involves.

Post-Bariatric Surgery – What Are the Risks?

Monday, October 26th, 2009
lipo-article

Can “extreme” cosmetic surgery procedures (specifically, the “total makeover” type of surgeries that usually follow extreme weight loss) lead to death or life-threatening injury? It’s a frightening question and one that is on the minds of many patients seeking dramatic change through surgery. While the answer to this question highly depends on the specifics of each patient and each procedure, there are some basic facts that you can keep in mind.

Post-weight-loss patients do need to be aware of a few risks that aren’t a factor for other patients. At the same time, you should know which risks you don’t need to worry about.

  • Combining surgeries doesn’t necessarily add to the surgical risk, even for post-bariatric patients – I’ve personally performed multiple studies to find out whether cosmetic surgery patients have an added risk of complications when they pair other procedures with abdominoplasties (tummy tucks). These studies indicate that certain combined procedures do not have increased risk when compared to individual procedures. While post-bariatric tummy tucks are not quite the same as traditional tummy tucks for Pasadena and other Southern California patients, these studies do indicate that there is no “general rule” that combined surgical procedures will lead to increased risk.
  • The biggest surgical risks might have to do with the weight loss process itself – Post-bariatric surgery patients need to pay very careful attention to the quality of the nutrition they’re getting, especially during healing. After weight loss surgery, patients should be limiting the volume of food they consume. Unfortunately, some patients may not pay adequate attention to whether or not they’re getting enough of the vitamins and minerals that they need to minimize risks like seroma (fluid collection) and tissue necrosis.

Because post-bariatric procedures offer such important benefits for patients’ quality of life and even their health, most patients feel that they are well worth the risks. And, when it comes to risk, the only way to determine the safety of any cosmetic surgery procedure with any level of certainty is to consult a qualified plastic surgeon about your specific case.

Mommy Makeovers: Safety Facts You Need

Thursday, October 22nd, 2009
mm-article

If you’re like most of my patients, you’ve probably heard about “Mommy Makeover” combined procedures, but you probably haven’t heard much about why these procedures are safe to combine. Along with several of my colleagues, I recently updated a study (initially published in 2006) that evaluated complications following combined breast surgery and abdominoplasty. We found that the combined procedures performed at Marina Outpatient Surgery Center over the period of the review were safe and effective, with complication and revision rates similar to standalone procedures.

The Rumor

Some people might assume that combining procedures could lead to increased risk – twice the surgery, twice the risk, right? Not necessarily. While this may be true of some combined procedures out of the scope of our study, it was not the case for the combined abdominoplasty/breast enhancement surgery cases we reviewed.

The Reality

We tracked the complication rates for hundreds of women who received breast enhancement (augmentation, reduction, lift, and removal or replacement of breast implants) combined with a Beverly Hills tummy tuck (abdominoplasty) at our Southern California practice. What we found is that not one patient experienced life-threatening complications such as deep vein thrombosis or pulmonary embolism. The overall complication rate (34%) and revision rate (13%) were very similar to those reported for individual procedures.

As always, it’s important to point out that any surgical procedure carries inherent risk. However, the conclusion that may be drawn from this study is that, all other factors such as physician skill and surgical facilities being equal, combining breast enhancement with a tummy tuck does not appear to be significantly riskier than performing breast enhancement or a tummy tuck alone. This is good news for many patients because combining procedures can be more affordable and lead to a quicker recovery.

Dr. Grant Stevens

I am a board-certified Beverly Hills plastic surgeon with over 20 years of experience researching and implementing new approaches to plastic surgery. At Plastic Surgery Insider, you get the benefit of my experience and authority when you read my perspectives on the latest news and procedures in plastic surgery.
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