Most people, no matter how fit and healthy they are, have areas of extra fat on their bodies that they don’t like. In men it is the waist area, and in women the belly, hips and thighs. Many of us have often thought that it would be nice to have liposuction to remove excess fat and start anew by watching our diet and exercising. However, the traditional liposuction of yesteryear is a traumatic surgical procedure, painful and with a long recovery. Worse yet, a large percentage of people who have had old liposuction end up with lumps, bumps, dimples, and skin irregularities after liposuction.

I have been using tumescent laser liposuction with the new SlimLipo laser lipo technique for almost a year now and am amazed at how much better the tumescent laser liposuction technique is than the old non-laser liposuction method. My patients have smooth, taut skin after laser liposuction, and their recovery after laser lipo is much easier and less painful.

The benefit of the new tumescent laser liposuction technique is that the laser melts the fat before it is removed, making laser lipo fat removal much easier. The tumescent technique minimizes bleeding and discomfort. The laser also tightens the skin as the fat is melted away. The result is more uniform fat removal, smoother skin, less bleeding, and less pain after tumescent laser liposuction.

What is tumescent laser liposuction?

Tumescent laser liposuction is a new liposuction method that combines the use of a tumescent solution with laser fat fusion prior to fat removal. Tumescent solution is a liquid that contains an anesthetic or numbing solution and a vasoconstrictor, a medication that helps control bleeding. The tumescent solution is injected under the skin, into the fat to be removed, prior to beginning laser liposuction or laser liposuction.

The tumescent solution numbs the skin area to control pain and can last up to 24 hours. The solution also prevents bleeding, reducing post-laser liposuction bruising and swelling, speeding recovery.

The tumescent solution is injected under pressure, which swells or distends the fat and makes it easier to remove. Distension and hydration (by adding water) of fat also improves the efficacy and safety of fat-dissolving laser treatment.

The benefits of the tumescent laser liposuction technique are

• Excellent bread control
• Less bleeding and bruising.
• More effective fat removal
• Less risk of skin irregularities after liposuction

How is tumescent laser liposuction treatment done?

Tumescent laser liposuction can be performed while you are awake or asleep. Many areas can be treated while you are awake using only the local anesthesia provided by the tumescent solution. However, the benefits of tumescence are so important that the tumescent solution is also used when laser liposuction is performed under general anesthesia, to control bleeding, enhance fat removal, and manage postoperative pain.

After your skin has been cleansed with a sterile antibacterial soap, the area of ​​skin to be liposuctioned is covered with a sterile drape to prevent contamination. Small punctures are made in hidden areas of the skin and a small needle is inserted under the skin into the fat to be removed. The tumescent solution is then injected into the fat under pressure to swell it and deliver the anesthetic and vasoconstrictor (prevents bleeding) solution.

After a brief waiting period until your skin is numb and the tumescent fluid has taken effect, the laser fiber is inserted through the same puncture sites and the fat is melted away by the laser. The fat liquefies into a thin liquid that is much easier to remove than the fat removed with the traditional liposuction of yesteryear.

After the fat is liquefied, a small tube called a cannula is inserted and the liquid fat is extracted using suction. Because the fat has been liquefied, much smaller cannulas can be used than with traditional non-laser liposuction. This fact results in a less traumatic procedure with small hidden scars, very different from the liposuction of yesteryear.

The laser also tightens the skin as fat is removed. The laser heats the fibers that attach the skin to the body and causes these fibers to shorten, bringing the skin closer to the body. Microscopic studies have shown that many more fibers, called connective tissue, remain after laser liposuction than after non-laser liposuction. I believe this fact helps explain the improvement in skin tightening and smooth skin after laser liposuction.

How will I feel after surgery?

Because the new technique places a numbing solution in the liposuction area, you will experience very little discomfort immediately and for up to 12 hours after the procedure. In addition, you will be given strong pain relievers to control any discomfort.

On the second day you will feel discomfort in the treated areas, however, in my experience, the level of discomfort is certainly much less than that experienced with traditional non-laser surgery. By day 3, most patients feel very comfortable.

You will wear a supportive compression garment on the treated areas which adds additional support and comfort.

You will be able to get up and walk, eat, walk, use the bathroom, and do normal daily activities the day after your procedure. I recommend that you do not go to the gym or do vigorous physical activity for the first week to ten days because I want the healing process to not be affected during this time.

How long does the recovery take?

You will be active and walking from day one. However, I will limit your strenuous exercise and weight lifting or aerobics for ten days.

Your garment will change to a light Spanks type garment after three to five days. If small sutures are used to close small puncture sites, they will be removed on the fifth day.

When small areas like the chin or a minor tummy tuck procedure are done, some people return to work the next day. I do not recommend going back to work the same day, I want you to be calm and rested the first day.

Recovery to a more normal skin appearance can take anywhere from ten days to two weeks for swelling and bruising, if any, to resolve.

Your skin’s appearance, skin tightening and outcome will continue to improve for three to six months as the skin gradually tightens over the areas where fat has been removed. What is remarkable about the technique of this new technique is that the skin is much smoother than after the traditional suction lipectomy of yesteryear. I believe that laser fat dissolution prior to removal results in a more uniform fat removal.

Which laser is better?

I use the SlimLipo Aspire system made by Palomar Medical. I chose this laser because SlimLipo uses the only laser wavelength that is specifically absorbed by fat. SlimLipo uses a laser wavelength of 924 nm (nm = nanometers, one millionth of a meter and describes the wavelength of the color of the laser in the visible light spectrum, which for 924 nm is yellow, the color of fat ).

The 924 nm laser wavelength used in SlimLipo dissolves or releases three to five times more fat during laser application than other commonly used wavelengths. The other wavelengths used by different machines target water, not fat, and are less efficient and less specific at dissolving fat.

The 924nm SlimLipo also works great on hydrated fat, which means laser fat dissolving works great after the tumescent fluid is injected.

How do I find a surgeon?

I am a board-certified plastic surgeon, so I am very prejudiced that a board-certified plastic surgeon should perform your procedure. My opinion is that if you are going to have surgery of any kind, you want a board certified surgeon who has been fully trained and is adept at caring for a surgical patient. You want the security of knowing that if something goes wrong, your doctor will have the skill, experience, and training to care for you.

Many dermatologists do liposuction. If you want to have your procedure done by a dermatologist, I recommend making sure your dermatologist is board certified and fellowshipped in dermatologic surgery.

I recommend that you visit the following sites to learn more about liposuction surgery and how to verify your doctors’ training, experience, and board certification status:

American Board of Plastic Surgery

American Society of Plastic Surgeons

American Society of Aesthetic Plastic Surgeons

What questions should I ask the doctor?

Don’t be intimidated by the white coat, and don’t be afraid to ask the doctor important questions. You are an educated consumer, and a good doctor will appreciate the fact that you are prepared and have done your reading. I prefer to have informed patients, they always improve after surgery. Plastic surgery is not a place for sudden decisions or impulse purchases.

In my book Save Your Face, in chapter ten, I give details about how to choose your doctor and what questions to ask. A brief summary of important questions are:

o Are you certified by the American Board of Plastic Surgery?

o How often do you perform this procedure?

o Do you think I am a good candidate for this procedure?

o Are you comfortable operating me with my particular objectives?

o Do you anticipate a good result? Because?

o Can you show me before and after photos of the patients you have operated on?

o Can I speak to a patient who has had this surgery for you?

o What are the emergency arrangements for nights and weekends? Is available?

o Will my procedure be performed in an approved operating room or outpatient facility under standard safety and sterilization precautions? Are emergency services and monitoring available if needed?

The most important thing is to trust your instincts during your visit to the doctor. Is the office clean and professional? Do the doctor and staff treat you respectfully? Ask yourself if I would feel comfortable calling these people and depending on them if I have an emergency at night or on weekends. Will I feel comfortable expressing my concerns or disappointment if I feel this way? If you detect any discomfort or uncertainty, you should consult another doctor.

This new laser procedure is a remarkable and revolutionary advance in liposuction and fat removal techniques. The benefits can be very significant. However, the results of liposuction, like any surgical procedure, are highly dependent on the skill and experience of your surgeon. Choose wisely and I hope you have a very happy outcome.