Liposuction (Lipoplasty)

At the Hunstad Center, liposuction is one of the most popular cosmetic plastic surgery procedures.  It is the permanent removal of localized areas of fat.  Although the procedure is not specifically for weight loss, significant amounts of fat can be removed which results in a fairly substantial weight loss.  Inconspicuous areas are chosen for a small incision, less than one quarter of an inch, through which fluid is injected.   This minimizes bleeding.  Fat is then removed using a hollow tube or cannula.  Our doctors utilize a mechanical, motorized device known as power-assisted liposuction.  This is a motorized device, which moves the cannula back-and-forth allowing a greater degree of precision and control.  Areas that are commonly treated include the neck, chest or breast area in men, arms, abdomen or tummy, love handles, back, buttocks, thighs, knees, and calves.  In areas that are denser, ultrasonic assisted liposuction is utilized.  Through the same inconspicuous openings, a solid titanium cannula is used to emulsify fat using ultrasonic energy.  The liquefied fat is then removed using power-assisted liposuction techniques.  If very small areas are being treated, we may utilize the syringe technique for liposuction.  Prior to liposuction, we employ the tumescent technique.  This is where large volumes of diluted lidocaine and adrenaline are injected into the fat, which allows liposuction to be performed with minimal bleeding.  The instrumentation used for this is known as the “Hunstad System” which is distributed by the Byron medical group.  It is the most widely utilized system in the world for tumescent anesthesia.  Dr. Hunstad invented this technique in 1992 and it has proven to be extremely popular.  Recovery is dependent on the number of areas treated and the volume removed.  Smaller areas can have a short recovery time of only a few days, but larger, more extensive procedures typically require a longer recovery period. 

Tumescent liposuction of the entire abdomen and back can offer a fantastic improvement of the shape and contour of one's body.  By performing circumferential suction of the trunk, a dramatic improvement in shape, contour, and physique is often obtained.  Because excess fat is usually present in not just localized areas but more generally, circumferential liposuction of the trunk, as in this patient, can offer a complete improvement to the entire torso.  Inconspicuous entry sites are used to instill tumescent fluid and to suction out that.  When circumferential truck liposuction is performed, usually two drains are required which are removed within the first week following surgery.  This speeds up the resolution of swelling which is very desirable.  Usually by two weeks, most patients can return to virtually normal activities.  It is common for patients to share with us that they have reduced their dress size by at least four to eight sizes or more!  As you can see in these pictures, this change in contour is truly dramatic.
 

1. Is liposuction a reasonable treatment for obesity?

Liposuction alone is not a treatment option for obesity. Liposuction is used to treat areas of abnormal deposits of fat. It can help to re-contour areas of excess fat such as abdomen, arms, legs, and the neck. It however cannot cure obesity.

2. What is a successful liposuction surgery?

A successful liposuction surgery is one that meets the expectation of both the patient and the surgeon with no complications.

3. Does liposuction cause dimpling or indentations in the skin?

Liposuction should not cause dimpling or indentations of the skin. These contour irregularities are known complications of the surgery however.

4. What Alternatives Are There to Liposuction?

There are no true surgical alternatives to liposuction.

5. What type of liposuction is the best?

There are many different techniques used in liposuction. Each technique varies by the amount of fluid injected and the instruments used in assisting removal of the fat. Laser assisted liposuction is the one of those techniques and is the best type of liposuction. The technique allows for easier removal of fat and the ability to tighten the skin where liposuction has been performed. In addition, it aids in recovery by decreasing bruising and post-operative swelling.

6. How much liposuction is excessive (Staged liposuction, Mega liposuction)?

Typically removal of 5 liters or more is considered excessive by most. Safety is paramount in these surgeries and precautions should be made to prevent adverse events.

7. How is Tumescent Liposuction performed?

Tumescent liposuction refers to the technique of infiltrating a large volume of saline that is combined with epinephrine (vasoconstrictor) and lidocaine (an anesthetic) into the areas of liposuction. This aids in removal of fat and limits the blood loss associated with the procedure. Blood loss is less than 1% of aspirate that is removed using this technique.
 

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The following patient is 36 years old. She is 5'4" tall and prior to surgery was 134 lbs. She came to the Hunstad Kortesis Center with a desire to regain her pre-baby body with a "mommy makeover"! She underwent Liposuction to her hip rolls and her circumferential thighs, as well as a Full Abdominoplasty with muscle tightening . 200cc of her own fat was reinjected into her buttocks to alleviate indentations. During this section of the procedure, Dr. Kortesis removed a total of 5 lbs. These photos were taken at 7 months post surgery. (KORTESIS 2011)
Before	After
36 year old- 5 pound weight loss following Smartlipo to her full abdomen and hip roll areas. KORTESIS
Before	After
34 years old – This patient underwent large volume Smartlipo to her full abdomen, circumferential thighs and buttocks. She has lost an astonishing 41 pounds to date! HUNSTAD
Before	After

Before After       Liposuction   The following 30 year old patient underwent liposuction to her hip rolls (lower back) as well as her thighs circumferentially, knees and buttocks. During this procedure, she lost 18.6 lbs. and inches off her hips and thighs! Before After The following 39 year-old patient underwent liposuction to her abdomen and thighs. She lost 15 pounds during this procedure as well as 2 sizes! Before After Inner Thigh Liposuction Before After (HUNSTAD)     Circumferential Thigh Liposuction Before   After (HUNSTAD)     Before After (KORTESIS)   Liposuction of the Arm   Before After Liposuction of the Back   Before After Before After
Abdominal and Back Liposuction
The following patient lost 10 pounds and 2 dress sizes after liposuction to her abdomen, hip rolls and saddlebags.
Before	After