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August 26, 2011

What should I expect with my liposuction surgery?

Filed under: Cosmetic Surgery,lipodissolve,Liposuction,Liposuction Beverly Hills,tumescent liposuction — Tags: , , , , , , , , , , — admin @ 11:29 am

In contrast to common beliefs, liposuction is not a weight reduction method; liposuction is in actuality a body sculpting procedure.  It is best for people with relatively stable weight and localized areas of the body that tend to retain extra fat.  For women these areas tend to be the outer thighs, the top of the hips, flanks, abdomen, inner thighs, and inner knees.  In men, it is usually the love handles, flanks, abdomen, and breasts.  The lower face and neck of both men and women benefit greatly from liposuction.

What type of anesthesia is used?

General Plastic Surgeons are accustom to operating on their patients under general anesthesia.  Although under general anesthesia there is no pain awareness by the patient, local anesthesia provides more natural results and faster-healing.  Under general anesthesia, the surgeon can perform liposuction using oversized cannulas very quickly.  An abdominal and flank liposuction that requires 4 hours in the office under local anesthesia may take as little as 45 minutes to perform under general anesthesia.  However, the consequences of this speed include trauma to the muscles just under the fat ― this translates into a prolonged recovery period.

Tumescent liposuction, performed under local anesthesia, uses tiny cannulas that are used are no wider than 2 mm.  Some are only the size of the needles used to deliver the dilute local anesthetic.  Because the patient is awake for the procedure and only the fat to be removed is numb, the patient can report discomfort if the cannula approaches the underlying muscle. This prevents the muscles from being traumatized by surgery.

Typical recovery course and physical restrictions

Under general anesthesia, liposuction with a large cannula can take 6 to 8 weeks before you feel normal.  In contrast, the same liposuction performed under dilute tumescent local anesthesia is associated with almost no blood loss.  Recovery is very rapid compared to the same procedure performed under general anesthesia..

It is common to experience a lumpy firmness after liposuction due to the inflammation caused by the surgery in the fatty areas. This inflammation gradually subsides in 4 to 6 weeks, as the body begins to heal from the surgery.  Due to long term remodeling of the fat, the body continues to improve over a period of 4 to 6 months.  It is common to experience soreness and bruising after the procedure. Generally most people take two or three days off from work and many return some form of exercise in two days.

Compression garments are provide with the procedures and are used for 5 to 6 days. Compare this with other liposuction techniques were compression garments need to be worn for 6 to 8 weeks.

Common complications after surgery

Liposuction with a large cannula can cause a significant amount of blood loss compared to liposuction with the 2 mm cannula.  Blood loss can become so severe that sometimes  a blood transfusion becomes necessary.  Deaths have occurred in association with both tumescent liposuction as well as liposuction under general anesthesia.  Currently it is thought that the rate of death associated with liposuction under general anesthesia is some where between one in 5,000 cases and one in 40,000 depending on the study.  Liposuction under pure tumescent anesthesia is associated with a much lower death rate that is estimated to be approprimately one in 40,000 cases to less than one in 300,000 cased depending on the study.

The time frame before full recovery

The compression garment that is worn for 6 weeks after liposuction under general anesthesia is only needed for 5 or 6 days after tumescent liposuction.  The downside is that tumescent liposuction takes significantly longer for the surgeon to perform and the surgeon needs to be prepared to talk with their patient during surgery.  This means more contact time with the surgeon and ultimately a more expensive procedure. However, the increased safety and rapidity of recovery makes this a very easy choice.

About Dr. Steinsapir

Dr. Steinsapir is an expert cosmetic surgeon who has skillfully performs liposuction procedures in Los Angeles with 20 years of experience.  He only performs tumescent liposuction under local anesthesia because of its superior results and fast, comfortable recovery time.  He is a board certified in ophthalmology and fellowship trained in oculoplastic surgery and cosmetic surgery in Southern California where he specializes in balanced cosmetic surgery for natural results, with an emphasis on minimally invasive techniques, fast recovery time, and leadership in medical technology.  Dr. Steinsapir has a private practice and also serves as an Associate Clinical Professor of Ophthalmology at the Jules Stein Eye Institute, at the David Geffen School of Medicine at UCLA. Contact us today to schedule a personal consultation with Dr. Steinsapir to learn if liposuction is right for you.

Services described may be “off-label” and lack FDA approval. This article is informational and does not constitute an advertisement for off-label treatment. No services should be provided without a good faith examination by a licensed physician and an informed consent with a discussion of risks, benefits, alternatives, and the likelihood of treatment success.  Only you and your treating physician or surgeon can determine if a treatment is right for you.

April 26, 2011

What is the Zerona Laser Treatment?

Filed under: Cosmetic Surgery,Liposuction,Liposuction Beverly Hills,tumescent liposuction,Zerona Laser Treatment — Tags: , , , , , — admin @ 7:42 pm

Zerona® Laser Treatment is intended to be a non-invasive alternative to liposuction.  The promotional material describing the Zerona Laser Treatment suggests that shining a low-energy laser on the skin causes damage to the fat cells below the surface of the skin.   Specifically, these promotional materials suggest that the cell walls become “porous” after being exposed to the Zerona Laser Treatment causing the fat stored within them to be excreted.  Over the two-week treatment period, consisting of six, forty-minute sessions, the fat cells in the target areas allegedly become smaller and flatter. However, there is no scientific evidence to suggest that this method of body sculpting is effective.  The company touts FDA approval for the device.  However this only means that it is safe to expose the skin to the laser light from the device.  It does not also mean that the treatment does what the manufacture claims.

Safe, Non-invasive, Effectiveness Questionable

Despite the testimonials of allegedly satisfied patients who have had Zerona Laser Treatment, there is no independent, peer reviewed studies showing that this treatment is effective.   Individuals reporting on RealSelf.com have raised significant questions regarding the effectiveness of this treatment.  Interestingly, the Zerona Laser Treatment protocols also call for altering your diet.  Any calorie restriction that is severe enough is likely to cause weight loss.  This does not mean that also shining a laser at your body further enhances the body contouring simply caused by a calorie restriction.  It is unclear if the Zerona Laser is more effective than shining a laser pointer at your body.  What does appear accurate is that this treatment is probably completely safe.  However, if you spent thousands of dollars for a treatment that is supposed to contour your body and are disappointed, this may be of little solace.

Zerona vs. Laser Liposuction

Zerona Laser is not surgery or liposuction.  It is simply a fancy low energy laser shined on the skin.  The treatment is a bit of a light show so one might have the impression that it is actually doing more than it is.  However, it is not a surgery or invasive procedure.  In contrast, Smartlipo™, or laser liposuction uses a small cannula assisted with a laser.  The aspect of the surgery that seems to please most patients is that their liposuction is performed under local anesthesia with a mild oral sedative.  Like tumescent liposuction, the down time for laser liposuction is minimal under local anesthesia.  The results are comparable to what can be accomplished with other methods of performing liposuction under local anesthesia.

Unlike Zerona Laser Treatment, laser liposuction is similar to tumescent liposuction in that local or general anesthesia is administered and the procedure is invasive.  Laser liposuction yields visible and proven results only because it is essentially tumescent liposuction ― the laser has no scientifically-proven impact on the procedure.

Why all the hype?

Marketing people understand that the public is fascinated by lasers and is under the impression that any treatment with laser must be better.  However, due to a loophole in how the FDA approved devices, manufactures only need to show that these devices are safe.  This is a much less rigorous standard that drugs are held to.  Drugs must be proven both safe and effective.  So when a company reports that their device is FDA approved, the public may think that devices also must meet the safe and effective standard; is not the case.  Consequently, device manufactures have more leeway in marketing their devices compared to drug manufactures.  Care is therefore needed in assessing device claims.

About Dr. Steinsapir

Dr. Steinsapir is an expert cosmetic surgeon who has skillfully handled liposuction procedures in Los Angeles and Beverly Hills for over 20 years.  He only performs tumescent liposuction under local anesthesia because of its superior results and fast, comfortable recovery time.  He is a board certified opthalmologist and fellowship trained in oculoplastic surgery and cosmetic surgery in Southern California where he specializes in cosmetic surgery with an emphasis on minimally invasive techniques and surgery, and leadership in medical technology.  Dr. Steinsapir has a private practice and also serves as an Associate Clinical Professor of Ophthalmology at the Jules Stein Eye Institute, at the David Geffen School of Medicine at UCLA.  Contact us today to learn how Dr. Steinsapir’s experience and training make him an expert provider of liposuction.

October 1, 2009

The Straight Talk About Liposuction

Filed under: Dr. Steinsapir,Liposuction Beverly Hills — Tags: , , , , , , — admin @ 6:27 pm

At times the “The Battle of the Bulge” becomes extremely challenging to conquer, despite regular exercise and a healthy diet. Liposuction is an effective cosmetic procedure that addresses the excessive fat that gets accumulated in certain areas of your body, which is difficult to remove by natural means.

The areas that commonly concern women include the inner and outer thighs, inner knees, stomach, and flanks. In men the common areas of concern are the love handles, stomach, and flanks. Less common areas include the tail of the breast in women and the breast area in men. Liposuction is one of the most popular cosmetic procedures. However, it is essential to understand what liposuction can and can’t accomplish. How liposuction is performed, and what factors contribute to make liposuction unsafe.

Even though liposuction is one of the most widely performed cosmetic methods, there remains a lot of confusion about the best way to perform liposuction and when it should be performed. Dr. Steinsapir, a renowned Eye Plastic and Cosmetic Surgeon in Los Angeles and Beverley Hills, provides his input on liposuction by presenting the following valuable facts…

Liposuction: Not a Quick Fix for Your Weight Problem
Liposuction is a body sculpting technique and not a weight reduction procedure. Liposuction improves your silhouette by getting rid of the fat that is localized to only certain areas of the body. As such, the surgery is best for individuals with stable weight. If you regularly yo-yo in weight more than 15 pounds, then liposuction is probably not right for you.
It is a misconception to think that you will lose weight from liposuction. You will not. While fat is removed from the body surgically, the swelling that follows usually more than compensates for the fat removed. The reality is that only two things determine our weight: How much we eat and how much we metabolize.

It is completely normal to regain the fat that has been removed, but due to the sculpting of the body with liposuction the fat that returns is more evenly distributed over the entire body, rather than getting disproportionately re-deposited in the problem areas. Your body weight primarily depends on two factors, the quantity and quality of the food that you consume and your metabolic rate. The only way to lose weight is to increase your metabolism by regular exercise and follow a healthy diet. No form of liposuction will cause you to weigh less.

Tumescent Liposuction: The Safest Liposuction Technique
Pure Tumescent Liposuction under local anesthesia is the safest technique to eliminate those stubborn fat cells. Widely acclaimed for his minimally invasive treatments, Dr. Steinsapir practices tumescent liposuction in Los Angeles because it causes minimal tissue trauma, nearly no blood loss, and a fast recovery. To execute this procedure, Dr. Steinsapir uses a dilute local anesthetic, which is infiltrated gradually into the fatty areas, and the fat is removed by micro-cannulas or very small cannulas. A microcannula takes out smaller amounts of fat with each pass offering a highly refined method to control how fat is sculpted.

Liposuction: Under General Anesthesia or Local Anesthesia?
The major difference between liposuction under general anesthesia and local anesthesia is safety. Liposuction under general anesthesia is much more profitable for the surgeon than doing liposuction under tumescent local anesthesia. The same liposuction that can be done in 45 minutes under general anesthesia may take about 3 hours to perform under local anesthesia. This means that surgeons who do liposuction under general anesthesia can do 3 times the number of cases in the same time frame. This is why liposuction is still performed this way.

However, you pay a huge price for your doctor’s convenience. The death rate due to liposuction under a general anesthesia has been estimated as 1 in 5000 cases, which is alarmingly high. Compare with the death rate associated liposuction under a local anesthesia, which is estimated as 1 in 500,000. This proves that liposuction performed under local anesthesia is much safer than performed under general anesthesia.

There are additional benefits for doing liposuction under local anesthesia. For one, with much few drugs in your system, you recover much faster. Instead of being hung over for days with a general anesthesia, you feel very much yourself the next day. There is far less trauma with liposuction under local anesthesia. The reasons for this are straightforward. When you are under general anesthesia, surgeons tend to do very aggressive liposuction with larger cannulas. This means that you are severely beaten up during surgery. It can take 6 to 8 weeks before the body recovers from this type of trauma. Blood loss can be so severe that a blood transfusion and hospitalization are needed. Not so with tumescent liposuction under local anesthesia. Liposuction is done with very small micro-cannulas and a pace that is comfortable for you. This means much less trauma, much more rapid recovery, and minimal blood loss. Hospitalization and blood transfusions are not reported in large studies of this technique. Most people return to their work out in two days with some soreness.

Laser Liposuction vs. No Laser
Laser based liposuction systems are being touted in marketing as the greatest thing since sliced toast. The marketing proposition is very compelling: lasers are sexy. It is practically a sure fired sales pitch. It works equally well on doctors and the public. However, think about another laser service: CO2 laser resurfacing. This has been and continues to be a huge disaster for the public. There are literally thousands of women out there with scarred or depigmented faces out there. Even after these complications were recognized and there was a public backlash, docs were out their performing these awful procedures. The reason was simple. Once you sign a 6 year lease or buy these very expensive machines, every one coming into your office has to be pushed into the service whether it is right for them or not. I know one doc who tells his patients that their faces will be depigmented by the service and there will be a line between where the face was treated and the neck skin where treatment stopped. At least he is honest about what this treatment does.

We are seeing a similar type of hype with the laser based liposuction machines with unrealistic before and after pictures. Typically these show a flabby stomach in the before and a rock hard etched 6-pack stomach in the after picture. Sure, this could be the same person but it is impossible that the only difference was laser liposuction. Try laser liposuction plus a carbohydrate free diet, hundreds of hours in the gym, and a little photoshop. Again, these machines cost over a hundred thousand dollars. Once a doc buys the machine, everyone is going to be pushed into this procedure. There is no evidence that the device is better than tumescent liposuction or any other form of liposuction. The incisions needed to insert these devices under the skin are larger than those needed for the microcannulas. The bottom line here is that you will be bearing the expensive of this pricy machine with no evidence that it is any better that pure tumescent liposuction under the safety of local anesthesia.

Liposuction: The After-Effects
It is common to experience a lumpy firmness after liposuction due to the inflammation caused by the surgery in the fatty areas. This inflammation gradually subsides in 4-6 weeks, as the body begins to heal from the surgery. Due to long term remodeling of the fat, the body continues to improve over a period of 4 to 6 months. It is common to experience soreness and bruising after the procedure. Generally most people take two or three days off from work and return to their work out in two days. Compression garments are provide with the procedures and are used for 5 to 6 days. Compare this with other liposuction techniqueswere compression garments need to be worn for 6 to 8 weeks.

Contact Dr. Steinsapir today for a Liposuction consultation and discussion that is perfectly tailored to your needs, concerns and desires.