Tummy Tuck (Abdominoplasty) can remove excess skin and fat from your belly. It is not weight loss surgery, but a body shaping procedure, designed to optimize your shape.
Tummy Tuck Before and After Pictures (Abdominoplasty)
Tummy Tuck Before and After - Left: Before Abdominoplasty with loose skin, muscle laxity and lower abdominal fat. Right: After Abdominoplasty with tight skin, firm muscles and removal of disproportionate fat. Liposuction (Liposculpture) was also performed on the sides
Sometimes less is more
I am all for using the smallest hammer to get the job done. Sometimes a tummy tuck is more surgery than is needed to get a great result. Sometimes less, a Mini-Tummy-Tuck or Liposuction, is sufficient.
Abdominoplasty and Liposuction are not interchangeable. While liposuction can remove disproportionate fat, a tummy tuck does much more. A tummy tuck can correct loose skin and lax muscle. It is not just a matter of getting better results.
Sometimes Less is Worse
Doing liposuction instead of a tummy tuck is often not a decision between good and better. Liposuction performed on an area with loose skin may make you look worse. Liposuction, even laser liposuction and ultrasonic liposuction, do not shrink skin well enough to convert tummy tuck candidates into liposuction candidates. Liposuction under loose skin can be expected to remove the skin’s support causing additional folding and visible irregularities, lumps and indentations, in the skin.
Remove loose skin from below and above the belly button
Reduce the superficial abdominal wall fat that accumulates on the lower belly
Why do Women and Men have Adbominoplasty?
Common reasons for Abdominoplasty are:
Pregnancy
Fluctuations in Weight
After bariatric (weight-loss) surgery
Stretch marks of the lower abdomen
Aging
Heredity
Previous abdominal surgery
Who is a Good Candidate for a Tummy Tuck?
Abdominoplasty may be a good choice if:
You are healthy.
Your weight is stable.
You have realistic expectations.
You do not smoke.
When not to have Abdominoplasty
Most Board Certified Plastic Surgeons will advice postponing your Tummy Tuck if:
You are trying to become pregnant.
You are planning significant weight loss.
You are continuing to gain weight.
You have uncontrolled medical problems.
You continue to smoke.
Pregnancy and large fluctuations in weight will diminish and potentially undo the benefits of abdominoplasty. Uncontrolled medical problems should always be addressed, but uncontrolled medical problems can significantly increase the risks associated with surgery. Smoking increases the risk of wound healing problems after procedures like tummy tucks, facelifts and breast reduction by 600%. It is best to stop smoking prior to having surgery, and once stopped, why not quit? It will improve your health and appearance.
Tummy Tuck Consultation
If you are considering rejuvenating your belly, make a consultation appointment with a Board Certified Plastic Surgeon. There is no better way to get the specific information you need to make an informed decision. To schedule a personal plastic surgery consultation with Dr. Mele, send us a request via the contact form to the left, or give us a call at (925) 943-6353.
On April 12, 1961, Soviet cosmonaut, Yuri Gagarin, used a space capsule like this to become the first human in orbit. That same year, the first breast implant was developed by American plastic surgeons Thomas Cronin and Frank Gerow.
Breast implant capsules have a bad reputation. Normally, they are only discussed when they are causing problems like capsular contracture or breast implant malposition. However, like a space capsule, the breast implant capsule provides protection, and without breast implant capsules, there would be no breast augmentation.
What is a breast implant capsule?
Whenever a breast implant is used for breast augmentation, your body makes an encapsulating sheet of scar that lines the breast implant’s pocket. This normally thin, soft scar is called the “capsule”, and it is incredibly important in maintaining your breasts’ enhancement.
Have you ever wondered how breast implants stay in place?
The capsule is responsible for keeping the breast implants in the proper position beneath the breasts. It forms in just a few weeks after breast augmentation surgery and keeps the breast implants from freely sliding around. Optimal breast implant position is a combination of careful placement during surgery and a proper capsule. The capsule will quickly line the surgical pocket and provide a smooth, strong interface between the breast implant and the soft tissues of the chest. By reinforcing the pocket, the capsule helps to maintain optimal breast implant placement.
The capsule protects the breast implant.
Not only does the capsule help keep the breast implant in position, it also protects the implant. The interior of the capsule is smooth and allows for nearly frictionless movement within its boundaries. The outer layers of the capsule provide enhanced vascular circulation and helps protect the breast implant from infection.
When good capsules go bad.
So what can go wrong with breast implant capsules? The perfect capsule is firm enough to maintain proper breast implant positioning, but soft enough to not be felt. Problems occur at the extremes, so like Goldilocks the capsule needs to be just right, not too hard and not too soft.
Too soft
When the Breast Implant Capsule is too soft, it does not provide enough support for the implant. Gravity pulls the implants down when standing or to the side when laying down. The larger the breast implants, the greater the force. Stomach sleeping also pushes the implants apart. A healthy capsule can resist the tendency toward Breast Implant Malposition, but a good bra helps too.
Treatment for implant malposition can include a capsulorrhaphy, to tighten the capsule, and close off the areas where the implant should not be going. If an overly large breast implant in compounding the problem, a smaller implant can help reduce recurrence. The use of an acellular dermal matrix (ADM) has also become more popular as a way to line, reinforce and thicken the capsule.
Too hard
When the Breast Implant Capsule is too hard, it can compress the implants, and cause Capsular Contracture. Capsular contracture can also result in breast implant malposition. If the capsule is tight only on one side, it will push the breast implant toward the soft side. If the capsule is tight all the way around, it can make the implant feel hard.
Treatment for capsular contracture includes capsulectomy, removing the thickened capsule, and capsulotomy, incising the capsule to allow it to expand. Both these techniques are performed in the operating room. An older, non-operative technique called closed capsulotomy was a way to split the capsule without surgery by forcefully compressing the implant. This has been largely abandoned as it has less predictable results, may lead to uncontrolled bleeding or implant rupture, and violates most breast implant warranties.
Just Right
The most common types of capsules are grade I followed by grade II. Grade I capsules are soft on not detectable from the outside, Grade II capsules feel firmer, but are not tight enough to cause visual changes. Both usually provide adequate support to allow the breast to age naturally, securely on the chest. If you are considering breast augmentation, or you have breast implants and are considering breast implant revision surgery, give me a call at (925) 943-6353 or contact my Walnut Creek Plastic Surgery Office using the contact form in the left column.
Breast Implant Revision Surgery is performed to improve the results of Breast Augmentation. While Breast Augmentation is both safe and effective, our bodies continue to change as we age. Breasts naturally change size and shape over time. This occurs with or without breast augmentation. While most changes are gradual, changes can happen relatively quickly with pregnancy and changes in weight.
Breast Implant Replacement
Breast implants can wear out too, requiring a new implant to be placed. The major US breast implant companies, Allegan and Mentor, do provide Breast Implant Warranties.
What Are the Common Reasons for Breast Augmentation Revision Surgery?
The most common reasons for Breast Implant Revision Surgery are a desire for a change in size, deflation of the breast implant, capsular contracture and breast implant malposition. It is important to clearly identify what problem(s) are bothersome, and to seek a consultation with a Board Certified Plastic Surgeon.
Below is number four of four of my latest Breast Implant Revision Videos. They appeared on KRON4′s Body Beautiful. The series covers Breast Augmentation, Breast Implants and Breast Augmentation Maintenance. The television show was broadcast live, so viewers could call in during the broadcast to have their questions answered. The (415) number shown in the video was only for the show; however, if you have Breast Augmentation or Breast Implant Revision questions, please call our San Francisco Bay Area Plastic Surgery Office directly at (925) 943-6353. If you prefer, you may also use the contact form on the left.
San Francisco Bay Area Breast Implant & Breast Augmentation Revision Video
San Francisco Bay Area Breast Implant Revision Questions
This Breast Augmentation and Breast Implant Revision Surgery video includes:
The type of trauma most likely to cause breast implant deflation
Common reasons for breast implant revision surgery
Changing breast implant size
Breast implant leaks
Capsular Contracture
Breast Implant Malposition
Breast Augmentation and Breast Implants Revision Resources
You are viewing number three of four Breast Implants Revision Video segments from Dr. Mele’s recent Body Beautiful television appearance. Here are links to the other segments:
October was national breast cancer awareness month. The NFL celebrated with NFL Pink’s A Crucial Catch. By teaming up with the American Cancer Society, and by wearing pink caps and gloves, the focus is on the importance of annual screenings, especially for women who are 40 and older.
Who Gets Breast Cancer?
Worldwide, 1.5 million people are expected to be diagnosed with breast cancer in 2011. The importance of self-examination and mammograms cannot be overstressed. The earlier breast cancer is detected, the better the cure rates, and the smaller the need for mastectomy. Controversy in the timing and number of mammograms has been highlighted here on the San Francisco Plastic Surgery Blog, and as new technology and detection strategies develop, these recommendations will change. We will continue to add our voice to San Francisco Breast Cancer Awareness.
What Can a Plastic Surgeon Do?
Plastic surgeons usually get involved after the diagnosis of breast cancer is made. I have been involved on both sides of the stethoscope, personally and professionally. The diagnosis is made worse by not knowing what to expect. Once the diagnosis is made, and the plan is selected; however, being able to contribute with breast reconstruction can be a big positive.
What Options Are Available for Breast Reconstruction?
Breast reconstruction in 2011 consists of two main options: Breast implants or breast flaps. Breast reconstruction with a breast implant is often begun at the time of mastectomy. The advantage of this immediate reconstruction is the ability keep a breast mound despite the mastectomy. Sometimes the reconstruction is better delayed until after the initial other treatments like chemotherapy or radiation.
Breast flaps include local rearrangement of skin, fat and even muscle from the abdomen and back, as well as microvascular transplantation. These operations can also be either immediate or delayed. They require additional surgical time and the healing of a “donor site”, but can avoid some of the complications associated with a breast implant.
What’s on the Horizon for Breast Reconstruction?
New technologies are also being explored. Fat and stem-cell grafting are being explored as “less invasive” methods of breast reconstruction, but these still remain controversial and should only be performed as part of a well planned and IRB reviewed investigation until more is known.
Another novel method involves a little of all the above. An Australian company, Neopec, uses a temporary implant, a flap of fat and a special gel to enhance cell growth, in an attempt to fill the space created by the implant and eventually form a new breast mound made of the patients own fat cells.
Breast Cancer Awareness Month – All Year Long
While it is nice to help restore that which is lost, it is better to treat breast cancer early before a mastectomy is necessary. So as Breast Cancer Awareness month draws to a close, and we continue to Walk for Breast Cancer and Race for the Cure, please remember your mammogram and to do a brief monthly self breast exam for the other eleven moths too.
Breast Augmentation remains one of the procedures that I perform most frequently. Whether you’ve always had small breast and want them larger, or you had larger breast and want them back, Breast Augmentation can help you achieve your goals.
Breast Implant Revision Surgery is performed to improve the results of Breast Augmentation. While Breast Augmentation is both safe and effective, our bodies change as we age. Breasts naturally change size and shape over time, and this happens even after breast augmentation. Changes can certainly be exacerbate by pregnancy and changes in weight, but most of the time the changes are gradual and sneak-up on us.
What’s New in Breast Implants and Breast Augmentation?
If you are considering Breast Augmentation or Breast Implant Revision surgery, you should know that new breast implants are available and more are on the horizon. New techniques are also being developed to help make your Breast Enhancement simpler, safer, more predictable and easier overall. Be certain to seek a Board Certified Plastic Surgeon for all your Cosmetic Breast Surgery needs.
Below is part three of four of my Breast Implant Revision Video that appeared on KRON4′s Body Beautiful. Options in Breast Augmentation, Breast Implants and Breast Augmentation Maintenance are reviewed. The television show was broadcast live, so viewers could call in during the broadcast to have their questions answered. The (415) number shown in the video was only for the show; however, if you have Breast Augmentation or Breast Implant Revision questions, please call our San Francisco Bay Area Plastic Surgery Office directly at (925) 943-6353. If you prefer, you may also use the contact form on the left.
San Francisco Bay Area Breast Implant & Breast Augmentation Revision Video
San Francisco Bay Area Breast Implant Revision Questions
This Breast Augmentation, Breast Implant Revision Surgery video includes:
The Breast Implants currently available
Saline Breast Implants – Natrelle (Allergan) and Mentor (J&J)
Silicone Gel Breast Implants (Natrelle and Memory-Gel)
Soft-Solid Silicone Breast Implants (GummiBear Implants)
Natrelle 410′s*
Mentor Contour Profile Gel (CPG)*
*The 3 yr and 5 yr data for the 410′s and CPG breast implants surpasses that of the breast implants that are already approved in this country. Why are they not approved? Only your FDA knows for sure.
Breast implant deflation
What are the signs and symptoms associated with a leaking breast implant?
How to check for a breast implant leak
How long do Breast implants last?
How are breast augmentation and breast lifts combined?
Breast Augmentation and Breast Implants Revision Resources
You are viewing number three of four Breast Implants Revision Video segments from Dr. Mele’s recent Body Beautiful television appearance. Here are links to the other segments:
If you are considering surgery for a Tummy Tuck, or Abdominoplasty, you may be interested in a post-surgical incision care research study.
General Information
We are now enrolling patients in a clinical research study to look at an investigational post-surgical incision care dressing used in scar healing. If you are thinking of having a tummy tuck (also called abdominoplasty), you may qualify for the clinical research study. The investigational dressing will be applied to one side of your abdominoplasty incision and the other side will be treated will be treated per the normal standard of care.
To Qualify You Must
To qualify you must:
be a man or woman between the ages of 18 and 65
be willing to participate in the study to evaluate a new dressing 1 week after a tummy tuck procedure
not have any known reactions to medical tapes or adhesives
not have a history of collagen vascular disease, cutis laxica, connective tissue disease, psoriasis, or lupus
not be diagnosed with scleroderma
not have a BMI > 30
not have had weight loss of >100 lbs. within six months of the tummy tuck procedure
not be a current smoker
not be taking steroid therapy within 2 months from the date of study enrollment
Study Participation Involves
Study participation involves:
study-related procedures and investigational dressing at no charge
weekly office visits (lasting approximately 20 minutes) for up to 12 weeks post surgery with application of a new dressing at each visit
photographic record taken of the incision at several visits
follow-up visits and photographic record at six and 12 months post surgery
Enrolled participants will be compensated for their time and travel at the completion of the study. To learn more about this study give us a call, (925) 943-6353, and schedule a free consultation appointment. We are conveniently located in the San Francisco East Bay Area community of Walnut Creek, California.
This is an IRB controlled study. More information about this clinical trail is also available here.
Breast Implant Revision Surgery is performed to improve the results of Breast Augmentation. Breast Augmentation Revision can help with Breast Implants are the wrong size, in the wrong position, have developed capsular contracture or when other cosmetic deformities require correction. Specific techniques have evolved for the correction of the most common problems that can occur with Breast Implants. Some recently developed new techniques have significantly improved the results of breast implant revision for problems that have been difficult in the recent past.
San Francisco Bay Area Breast Augmentation
This segment of Body Beautiful focuses on before and after results. Breast Augmentation is reviewed, as well as the correction of specific breast implant problems like capsular contracture and implant malposition (bottoming out and symmastia). The following Breast Implant Revision Video was broadcast on KRON4′s live Medical Monday show, Body Beautiful. The television show allows viewers to call in during the broadcast and have their questions answered. The (415) number shown in the video was only for the show, so if you have Breast Augmentation or Breast Implant Revision questions, please call our San Francisco Bay Area Plastic Surgery office directly at (925) 943-6353, or use the contact form on the left.
San Francisco Bay Area Breast Augmentation & Breast Implant Revision Video
San Francisco Bay Area Breast Implant Revision Questions
This Breast Augmentation, Breast Augmentation Revision Surgery video includes:
Before and After Pictures of Breast Augmentation
Before and After Pictures of Breast Augmentation Revision including:
Before and After Pictures of Breast Augmentation Revision for a Breast Implant that is too low and a poorly formed inframammary fold (IMF)
Before and After Pictures of Breast Augmentation Revision for Grade III Capsular Contracture causing the Breast Implant to be too high (Capsulotomy/Capsulectomy)
Before and After Pictures of Breast Augmentation Revision for Grade IV Capsular Contracture causing the implant to ride up and appear significantly smaller
Before and After Pictures of Breast Augmentation Revision for Breast Implants that are too close (as seen in symmastia) and too far from the midline (often causing a large gap between the breast implants) and rippling on the inside of the breast (medial rippling)
Before and After Pictures of Breast Augmentation Revision for severe bottoming out with internal capsulorrhaphy (though a breast lift is the most frequently selected option)
Breast Augmentation and Breast Implants Revision Resources
You are viewing part two of four Breast Implants Revision Video segments from Dr. Mele’s recent Body Beautiful television appearance. Here are links to the additional segments:
Breast Augmentation remains one of the most popular cosmetic plastic surgery procedures. While often the procedure lasts a lifetime, breast augmentation revision is quite common. Breast Implant Revision has emerged as a specialty unto itself. While many of the tenants that lead to excellent Breast Augmentation results will also apply to Breast Augmentation Revision, new and specific techniques have evolved for the correction of the common problems that can occur with Breast Implants.
The most frequent reasons for Breast Augmentation Revision Surgery include the desire to change the size of the breast, breast implant deflation, problems with the position of the breast implants and tightening of the scar that normally forms around the breast. The last listed is called capsular contracture.
San Francisco Bay Area Breast Augmentation
What follows is a Breast Implant Revision Video segment from KRON4′s live Medical Monday show, Body Beautiful. The television broadcast allows viewers to call in and have their questions answered live. The (415) number shown in the video was only for the show, so if you have Breast Augmentation or Breast Implant Revision questions, please call our San Francisco Bay Area Plastic Surgery office directly at (925) 943-6353, or use the contact form on the left.
San Francisco Bay Area Breast Augmentation & Breast Implant Revision Video
San Francisco Bay Area Breast Implant Questions
This Breast Augmentation, Breast Augmentation Revision Surgery video includes:
What to consider before having Breast Augmentation
Is “routine maintenance” for Breast Implants required?
If my Breast Implants are too high, can they be lowered?
If my Breast Implants are too low, can they be raised?
If my Breast Implants are too wide, can they be moved towards the middle?
If my Breast Implants are too close together, can they be separated?
What causes Breast Implants to fail?
Can I maintain my body proportions and have Breast Augmentation?
What are the problems associated with Breast Implants which are too big?
Breast Augmentation and Breast Implants Revision Resources
You are viewing one of four Breast Implants Revision Video segments from Dr. Mele’s recent Body Beautiful television appearance. Here are links to the additional segments:
Breast Augmentation and Breast Implant Revision San Francisco Bay Area – 1 of 4 (You Are Here)
Anthem Plastic Surgeon Gets 25 Years for the Deaths of Three Patients
…but Dr. Peter J. Normann, MD, was never a Plastic Surgeon. He was never a Surgeon and is now, thankfully, no longer a Doctor. Today, Peter J. Normann is a convict, a prisoner of the State of Arizona, convicted of multiple murderers.
My deepest sympathies to the families and friends of these three patients, and to others who have come forward since these tragedies. I have written several posts on the San Francisco Plastic Surgery Blog about how to select a Plastic Surgeon. I’m certain the jaded view these as self serving; however, I view these as part of my duty as a physician to do no harm. While this is but one case, there are too many others, and saying nothing, and ignoring the problem, would be harmful.
No one is perfect. Everyone makes mistakes, even well trained, experienced Board Certified Plastic Surgeons. The reason I spent eight years in training after graduating from the University of California, Davis, School of Medicine, was to reduce the chances of mistakes, to gain as much knowledge and experience as possible, and to prevent poor decision making. To not only learn how to operate, but how to provide patients with the best environment in which to operate and maybe most importantly, to know when not to operate. In this light, I present the following information, and three simple links that can help you have the safest possible plastic surgery. In fact, two of these links can help you, no matter what type of elective surgery you are considering.
How to Check Your Doctors Credentials – As Easy As 1, 2, 3
There are three places every patient should check before having any plastic surgery.
Let’s use these simple online resources to check out Dr. Normann…
Dr. Normann – Didn’t Check Out
#1 – The American Board of Plastic Surgery
A quick check on the American Board of Plastic Surgery website reveals “No records found…” for Dr. Normann. This means he is not a Board Certified Plastic Surgeon.
#2 – The American Board of Medical Specialties (ABMS)
The ABMS website is the best way for you to determine what board has certified your doctor. Checking the American Board of Medical Specialties (ABMS) website currently reveals no certification by any board. According to healthgrades.com, he was Board Certified in Internal Medicine at some point in time, but this cannot be confirmed on the ABMS site. The reasons may be 1) He was never Board Certified in Internal Medicine; 2) He was Board Certified in Internal Medicine, but he did not pass recertification; or 3) His Board Certification was removed after his Arizona Medical License was revoked. The best case scenario here is that Dr. Normann was Certified by the American Board of Internal Medicine, but this not a Surgical Board.
#3 – The State Medical Board
A check of the Arizona Medical Board website reveals: one listing for Normann, Peter J. with a listed specialty of Emergency Medicine.
His detailed profile reveals that Peter J. Normann graduated Medical School on June 27, 1994, from St George’s University in St. Georges. The Caribbean Campus located in St. Georges, Grenada, West Indies, is perhaps best know from the October, 1983, invasion of Grenada. Part of President Reagan’s justification for the invasion was to rescue American medical students at St. George’s University endangered by the violent coup that had overthrown Grenada’s Prime Minister, Maurice Bishop.
The profile also states that Normann completed a three-year residency (06/24/1994 – 06/30/1997) in Internal Medicine at Roger Williams Medical Center in Providence, RI. At this time, it cannot be confirmed on the American Board of Medical Specialties (ABMS) website, and the ABMS website is the best way for you to determine what board has certified your doctor.
The Arizona Medical Board site also lists Normann’s License Status as Revoked. A revoked license means no license, and the practice of Medicine without a license is a crime. Call me Dr. Obvious, but this is worth knowing even if you are not having plastic surgery. For example, in November, 2004, Dr. Bach A McComb, DO, injected himself, his girlfriend and another couple with fake Botox leading to emergency room admissions for the resulting overdose and prolonged hospitalization for systemic paralysis. A simple check of Dr. McComb’s license prior to the incident, would have shown that his license was suspended for overprescribing painkillers. People convicted of bad judgement are likely to have recurrences. Dr. McComb couldn’t buy Botox without a license. His solution, additional bad judgement and the use of unregulated black market Botox.
Back to Normann. On the Arizona Medical Board’s Website, his areas of interest are listed as Emergency Medicine, Internal Medicine and Dermatology. His training however, was only in Internal Medicine, and at some point in time, he was ABMS Board Certified in Internal Medicine. While there is some overlap with Internal Medicine, Emergency Medicine and Dermatology are specialized branches of Internal Medicine with their own residencies, additional years of training and separate ABMS Board Certifications. Surgery is not a branch of Internal Medicine. After medical school, surgical training and medical training diverge. There is little overlap between Internal Medicine and Surgery, and even less overlap between Internal Medicine and the specialized procedures performed by Plastic Surgeons.
Too Many Red Flags
Normann’s credentials do not add up to excellent plastic surgery training. A quick Internet search reveals he was not a Board Certified Plastic Surgeon. He was an Internal Medicine doctor with no formal surgical training. He certainly did not complete a Plastic Surgery residency. During the course of the murder investigation, it was revealed that he had seven sessions of training in liposuction.
Your Federal and State Governments Cannot Protect You
Every state maintains a Medical Board. Their job is to check the training of all physicians and surgeons practicing in the state, and if qualified, the boards allows the qualified doctors to purchase a license to practice medicine. Each state has its own board, but the requirements are not widely varied. The federal government regulates prescription drug use, and licensed physicians can purchase a DEA certificate which allows them to prescribe drugs. Neither the state nor the federal government restrict the practice of medicine based on the type of training a doctor has completed. In fact, the MD degree is granted after completing Medical School, and a state license is granted in California after completing one year of internship and passing the required exams. With a state license, a DEA certificate can be obtained, before any specialized training is started.
Since a license is granted before specialized training is started, there are no restrictions on the type of medicine a license holder can perform. A doctor trained in Internal Medicine (diabetes, high blood pressure, lung disease…) can perform brain surgery, as long as they conform to the standard of care. This pushes the responsibility onto hospitals. Hospital medical staffs review qualifications within each specialty and grant privileges for specific procedures after a period of supervised proctoring. This peer review can help for hospital based disciplines like brain surgery, but most cosmetic surgery is outpatient surgery and is not performed in a hospital. The American Society of Plastic Surgery and the American Society for Aesthetic Plastic Surgery both require that all members have hospital privileges for all procedures they perform, even if they are normally performed outside the hospital.
Time for Restricted Medical Licenses
There has been much debate through the years for States to do more to protect their citizens from unqualified doctors practicing outside the scope of their training. Special interest money has made this is most impossible, and there is little interest in drafting this difficult legislation. While reviewing silicone breast implant leakage rates, the FDA noted that leaks occurred more often in the hands on non-Board Certified Plastic Surgeons, often in the operating room. Debate was had to restrict the use of breast implants to only physicians who are Board Certified Plastic Surgeons. It was decided that the FDA lacked the authority to enforce such a recommendation and, the subject was dropped. Until there is a public outcry for reform, it is unlikely that we are going to get this sort of assistance from our States.
Buyer Beware
So it is up to you to find the best doctor for the job. It is your body, your health and your life. Plastic surgery is elective surgery, and you have time to decide how to proceed and who to trust. Resources are available online to help you make the best possible decision. While the recommendations above cannot guarantee perfect results, they can certainly improve the odds.
Be certain to check the three resources above. If your surgeon is a member of the The American Society of Plastic Surgery and the American Society for Aesthetic Plastic Surgery, you can be assured that they are Board Certified Plastic Surgeons, with valid state licenses, who practice in Accredited facilities, and who maintain hospital privileges.
Bargain Basement Plastic Surgery
Bargain hunting is great, but not for Plastic Surgery. A low price might mean corners are being cut, and you may pay the ultimate price for it. I want the best possible outcomes for my patients, and this is reflected in everything I do. I completed eight years of residency after medical school, and maintain both the Board Certifications I have earned, one with the American Board of Plastic Surgery and the other with the American Board of Surgery. I operate only in accredited hospitals and surgery centers. I work with Board Certified anesthesiologists. I only use FDA approved products from reputable sources. I maintain membership in the most prestigious Plastic Surgery Societies. All of this costs more than cutting the corners, but it shows my patients that I take my responsibilities seriously, and that I am committed to achieving the best possible outcomes. A cut rate purse might look good, but low quality doesn’t last. You can always purchase another purse, but you cannot replace your face, your breasts, your tummy or any other part of your body. Why risk something irreplaceable? You are worth taking care of. While there can be no guarantee that you won’t meet a Dr. Normann, by taking a few precautions, you can increase your chances of walking away before the encounter ends badly. More details, and video coverage of the case, can be found here: ABC15 Phoenix, AZ.
I find inspiration for my blog posts from the questions I hear every day in my Walnut Creek Plastic Surgery office. The question today is about using Liposuction for Weight Loss. The issue is brought up by patients looking to get rid of a stubborn bulge, and doctors looking to help their patients. With the advent of Bariatric Surgery, there finally is a true weight loss surgery. Liposuction is not weight loss surgery, but it can help to remove the fat that causes unsightly bulges. Liposuction can zero in on specific problem areas like nothing else can.
Liposuction Before and After Pictures
Liposculpture
The first time I heard the term Liposculpture my first reaction was: good flamboyant marketing term. However, the more I thought about what Liposculpture implies, the more appropriate the term seems. The procedure for removing fat by vacuuming away localized collections is more descriptively termed Liposuction or suction assisted lipectomy.
Direct Lipectomy
Lipectomy is the generic term for the removal of fat (lipo) not the lip. Lipectomy has a long “i” like liposuction. Direct lipectomy is what is done with Tummy Tucks (Abdominoplasty). During a Tummy Tuck excess fat is removed with any loose skin from the lower abdomen by direct excision. Liposuction can be used to decrease fullness in the hips and around back, and this can lead to a shorter scar in cases where the skin tone is good. Liposuction is not recommended on the tummy during a Tummy Tuck, as this can lead to complications. Direct lipectomy, on the other hand, is performed under direct vision and can safely remove the deep fat during a Abdominoplasty.
Suction Assisted Lipectomy (SAL) aka Liposuction
Liposuction also removes fat. A thin cannula, 2 to 4 millimeters in diameter, is used to vacuum away unwanted fat. The advantages of liposuction over direct lipectomy include smaller incisions and the ability to place the incisions away from the areas of disproportionate fat. This allows me to place the incisions in “hidden” areas, while removing the fat from areas that may be exposed.
The term liposuction is descriptive of the method, and it does allow for the permanent removal of the fat cells from selected areas. Unlike weight loss, your metabolism and genetic programming don’t pick the areas where the fat leaves, you do.
Liposculpture
Liposculpture is not a method of liposuction. It is another term used to describe the process Liposuction. By exchanging the suction for sculpture, the emphasis is placed more on the artistry than the process. The engineer in me likes Liposuction, because it is a precise description of the mechanism, but Liposculpture appeals to my artistic side and emphasizes the versatility of technique.
Sculpture is three-dimensional artwork created by shaping or combining hard materials – typically stone such as marble – or metal, glass, or wood. Softer (“plastic”) materials can also be used, such as clay, textiles, plastics, polymers and softer metals. The term has been extended to works including sound, text and light.
Fat can be added to the softer (“plastic”) materials. In the hands of a Board Certified Plastic Surgeon, fat too can be contoured to more visually pleasing form. Disporportionate bulges can be reduced, and in some cases, indentations filled by Fat Grafting. The ability to reestablish normal proportions to the body is the real power of Liposculpture. Fat is a living medium, so the results are not written in stone, but there is no better way to remove stubborn deposits of fat when the genetic plan won’t cooperate.
Weight Loss
Weight loss and Lipo are complementary processes. While there is overlap, neither can substitute for the other. Weight loss by definition is the reduction of weight. When we burn more energy than we consume, we lose weight. Our bodies are extremely efficient, and this efficiency can cause health problems. Today, the number of calories that would have taken an entire day to hunt or gather can now be obtained in just a few minutes, a few feet away. Whether it’s a short walk to the kitchen or a ride to the drive-through, calories can be found quickly and with a minimum of energy spent.
When we lose weight, it leaves from whatever area is genetically next in line. We cannot diet or exercise a specific body zone away. Sit-ups do not target the fat of the abdomen. Sit-up strengthen abdominal muscles, and burn calories, but those calories come from wherever your genetics say they should come from. You can’t choose.
Liposuction is not the solution to overconsumption, but it can be a great way to get a disproportionate body back into shape. Unlike weight loss, Liposuction does allow you to selectively remove areas of disproportionate fat. Liposuction does not cause you to burn more or consume fewer calories, however. Your weight is set by your metabolism, not by liposuction.
Liposuction – Like a Fad Diet with a Big But…
Removing fat with Liposuction is like removing fat with a crash diet. Unless other changes are made, when the diet is over, the weight returns. However, there is a big difference. Remember the part about getting to choose where the fat is removed? Unlike a fad diet, your genetics don’t choose where the fat leaves. Liposuction allows disproportionate areas of fat to be removed preferentially. This means that weight gain after Liposuction tends to be more proportionate.
Your Weight After Liposuction
The best candidates for Liposuction are near their ideal weight. One reason for this, is that the upper limit of weight removed with liposuction is around ten pounds. If someone is 100 pounds overweight, removing ten pounds is not likely to make a dramatic visual impact.
If you are near your ideal weight, you are likely to stay near your ideal weight. Fewer areas are likely to be disproportionate, and removing five pounds from a localized area can be a big change (4.4 pounds of fat will fill a two liter beverage bottle). If the weight comes back, usually it does not all come back in the same place, so the results will last.
Combining Weight Loss With Liposculpture
The combination of weight loss and Liposculpture is unbeatable. For some, weight loss alone will give a well proportioned body, but most of us have specific areas that collect the fat first. Out of proportion fat is the Achille’s heel of weight loss; however, the removal of disproportionate fat is the forte of Liposculpture. Liposuction can serve as a positive kick start for further weight loss. We naturally want to protect our investment, and once we can see positive results, we are motivated to make them even better.
