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What is Liposculpting?
Before we get into defining liposculpting, let’s review the anatomy of an adipocyte, or fat cell!
In our adolescence years (< 20 years old), our fat cells actually grow in number. Beyond that (>20 years old), our fat cells no longer increase in number but rather increase or decrease in size with weight gain or loss.
The reason this becomes important is because liposculpting permanently removes the adipocytes! A big misconception with liposculpting is that after lipo, you fat shifts to another area - this isn’t true!
For example- let’s say you lipo your abdomen but skip your love handles. When you gain weight, your fat cells in your love handles will increase in size and “grow” whereas your abdominal region won’t (because those cells have been permanently removed!).
This is also why a 360° degree approach becomes important.
What’s The Difference Between High Definition and Traditional Liposculpting?
What’s the difference between High Definition and Traditional Liposculpting?”
Everything.
Before we get into high def lipo, let’s review our anatomy again. Most areas of our bodies have fat divided into three distinct layers: superficial, intermediate and deep.
Traditional liposculpting mostly allows for debulking via removal of the deeper layers of fatty tissue.
On the other hand, high definition liposculpting employs the use of VASER. This novel tool allows me to go through all of the layers of fat, evenly- including the intermediate and superficial layers, through the same small incisions as traditional lipo- to emulsify, or liquify, the fat. Next, the liquified fat is suctioned out and muscle definition emerges.
High Definition liposcultping allows me to remove significant amounts of fat- enough so that it enables your underlying muscle definition to pop out! This is how we achieve abdominal etching and highlight your semilunar lines, linea alba, and inscriptions.
Traditional Liposculpting
High Definition Liposculpting
What is VASER?
Other than being a game changer in high definition liposculpting, VASER is an acronym. It stands for:
Vibration
Amplification of
Sound
Energy at
Resonance
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It’s an ultrasound assisted tool that emulsifies (or liquifies) the layers of fat which can then be liposuctioned, and used for fat transfers, such as BBLs.
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Unlike laser assisted liposculpting that kills the fat cells, VASER allows you to safely transfer healthy fat cells to other desired areas! The great thing about VASER is that it can be performed through the same poke hole incisions of liposcultping!
Let’s also briefly review basic anatomy.
Most areas of our bodies have three distinct layers of fat: superficial (top layer), intermediate (middle layer), and deep (lowest layer).
The deep layer of fat sits on the muscles. Traditional (non-VASER) liposculpting is meant to debulk the deep fat layers. VASER, on the other hand, can be performed throughout all three fatty layers. This not only allows for maximal fat removal/extraction, but also introduces the realm abdominal etching which allow your muscle definition to come to life!
Check out our video on how we address the skin after we’re done with VASER assisted liposculpting!
Your Liposuctioning Journey
We start our day with preoperative markings - one of the most important steps of a successful surgery. These become the blueprints to our amazing results. Once complete, we then go to the operative suite, where you comfortably undergo anesthesia and your body is cleaned with an antiseptic solution. The solution helps kill off any bacteria that naturally lives on your skin- which helps reduce the risk of an infection.
We then start the procedure with the infiltration of tumescent anesthesia. That’s merely fluids mixed with a numbing agent, and other proprietary medications that will allow for a successful surgery. Next, we thoroughly perform our VASER assisted liposculpting. We have a great video on this- so make sure you check that out.
At the conclusion of the procedure, we place two drains in the front, and one drain in the back- in well hidden areas!
And voila, you’ve become the best version of you. Make sure to watch our video on compression garments and foam!
Male Liposuctioning
When it comes to liposculpting, there are several key differences between male and female patients!
In a male patient, the ideal aesthetic is a “V” shape. That keeps in mind a wider upper back to accommodate the muscular anatomy with a more narrow waistline. The upper aspect of the buttock then creates a shelf.
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The muscular anatomy is variable with either a 4- or 6-pack. Highlighting of the vertical lines (linea alba, semilunar lines) also adds a dimension of height to the patient whereas the inscriptions add an element of muscular tone.
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These procedures are made possible through the use of VASER assisted liposculpting to maximize the extraction of fat via ultrasound guided technology.
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Skin tightening is then made possible through the use of Renuvion J Plasma which causes subdermal coagulation through the use of helium gas and radiofrequency, or BodyTite!
Female Liposuctioning
There are several noteworthy differences between male and female patients when it comes to liposculpting!
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In a female patient, the ideal aesthetic is a “S” shape. This incorporates a snatched waistline with a harmonious flow into the hips and lateral thighs.
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This is in contrast to the “V” shape of a male patient.
Similar to the male patient, the muscular anatomy is variable with either a 4- or 6-pack. Highlighting of the vertical lines (linea alba, semilunar lines) also adds a dimension of height to the patient whereas the inscriptions add an element of muscular tone.
These procedures are made possible through the use of VASER assisted liposculpting to maximize the extraction of fat via ultrasound guided technology.
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Skin tightening is then made possible through the use of Renuvion J Plasma which causes subdermal coagulation through the use of helium gas and radiofrequency, or BodyTite!
Liposculpting Recovery Timeline
The recovery timeline of liposculpting is actually pretty short!
You’ll be able to return to work in about 7 days post-operatively.
You will have limitations on what you can lift though!
You want to restrict strenuous activities and heavy lifting for about 4 weeks!
Where Can We Harvest Fat From?
As part of any fat transfer procedure, like a BBL (Brazilian Buttock Lift) for example, we need to have an adequate supply of fat to harvest! Fat transfer procedures involve the harvesting of fat from one area and the transfer to another area.
Fat can be harvested from essentially any area that has an adequate reserve of adiposity (or fat). These areas include the: neck, chest, lateral chest, upper and lower abdomen, pubic area, torso/flanks, lateral hips, inner/medial thighs, outer/lateral thighs, arms, upper/middle/lower back, banana rolls, knees, calves.
My practice implements cutting edge technology, known as VASER assisted liposculpting to maximize my fat harvesting and removal! This allows me to remove fat from all three adipose layers- superficial (top), intermediate (middle) and deep (bottom)- as opposed to traditional lipo that limits you to the deeper layers of fat!
In a different video, we discuss all of the areas where we can transfer our harvested fat!
Where Can We Harvest Fat From?
Where Can We Transfer Fat To?
In a different video, we reviewed all of the areas where we can harvest fat from.
Let's review all of the areas where we can transfer the healthy, harvested fat! The key thing to remember is that we want to transfer that fat as soon as we harvest it in order to give it the absolute highest chance of survival! In my practice, I also use VASER assisted liposuctioning which increases my fat harvest yield and survivability!
Fat can be transferred to essentially any part of the body that has become fat deplete (ie due to aging) or that is desired to be bigger (breasts, buttocks, etc). Common areas include: tear troughs (undereyes; done instead of fillers), lips, chest (for chest masculinization), breasts (in lieu of augmentation with implants), deltoids, lateral hips, and buttocks (aka BBL).
Where Can We Transfer Fat To?
What Are Drains?
A drain is just a tool that helps collect fluid!
Whether you’re having a tummy tuck or liposculpting, there is always the creation of a “potential space.” For example, when we liposuction the fat, it creates a an “empty” or “potential space.” Now, our bodies are smart- they try to fill the space the best way they know how to- with fluid. That’s where the drains come in and drain that fluid.
The removal process depends on several factors- color, character, quantity. Initially, the effluent color is reddish. It’s often times confused with blood in the early post op period. However, it’s not- it’s a thin fluid (unlike blood), that looks more like Kool-Aid; this is called serosanguinous drainage. As time goes on, this color changes to more of a straw or apple juice color, and is called serous drainage. The goal is to have less than 30cc of thin, serous drainage in a 24 hour period prior to removal.
Surgical Drain Care
We previously discussed what drains are, and their functionality. Now, let's discuss how to take care of your surgical drains!
1. Clean the drain. This is done to minimize the risk of infections! The easiest way to do this is to hold the drain in place from the exit site of the skin with your non-dominant hand, and to clean the drain with your dominant hand using alcohol. Once you reach a distance, keep your dominant hand clamped, and advance your non-dominant hand to the spot. You’ll repeat this until you reach the drainage bulb.
2. Empty the drain. As the bulbs fill, you’ll want to empty the contents and record the output.
3. Compress the drain. You want to ensure that the drain is always compressed to allow a vacuum like seal of the fluid into the collection bulb.
Voila. You’re now a surgical drain care expert.
Waistline Narrowing
Waistline narrowing involves the maximal removal of fat from the waist line and love handles! It’s performed differently for males and females. The proper aesthetics of a male patient is more of a “V” shape whereas the female counterpart is a “S” shape.
Depending on the degree of skin laxity, redundancy, and adiposity (or fat), we have two options:
1- VASER assisted liposculpting with Renuvion J plasma skin tightening
2- Lateral thigh and buttock tuck with/without VASER assisted liposculpting
Keeping proper aesthetics in mind, I am able to sculpt the abdomen, flanks and waist using the assistance of VASER. VASER allows for the adipocytes (or fat cells) to transform into a more liquified state through the use of ultrasound guided technology. After VASER, I then evacuate the fat through liposuctioning. This is then followed by Renuvion J-plasma or BodyTite skin tightening.
If you have a lot of loose/redundant skin and fat, you may require a lateral thigh and buttock tuck which will remove the bulk of the tissue via an incision that will definite the shape of the buttock.
We often times will perform a concurrent BBL (Brazilian Buttock Lift) at this time as well.
Brachioplasty vs Arm Liposuctioning
When it comes down to arm contouring, we need to think of two things:
1- Amount of adiposity (fat)
2- Degree of skin redundancy (loose skin).
Let’s start with a preliminary exam.
Stand in front of a mirror and lift your arms up like a “T” (or 90 degrees from your torso). If you notice a significant amount of skin hanging under your arms when you lift them, you will likely need an incision to eliminate the redundant skin. The length of the incision is determined by the degree of excess skin, and it’s location.
My goal is to always minimize incisions, if possible!
On the other hand, if you don’t have much hanging or loose skin, but rather have bulk due to adipostiy, you are a great candidate for arm liposculpting and skin tightening!
Thigh Gaps
A thigh gap is defined as the distance between the medial, innermost aspects of the thighs.
There are two ways to achieve this- one involves an incision, and one doesn’t. Let’s start with the latter. If you experience chafing or rubbing of your inner thighs but don’t have a lot of loose skin, you are a perfect candidate for VASER assisted liposculpting, with or without the need for Renuvion J Plasma or BodyTite skin tightening.
On the other hand, if you have quite a bit of loose skin- you may require a medial thigh tuck. That involves an incision in the inner most portion of your thighs to eliminate the loose, redundant skin. This can be performed in addition to VASER assisted liposculpting.
Coolsculpting and PAH
Over the years, coolsculpting has become more and more popular! We see the commercials and advertisements everywhere! “Freeze the fat!”
Does it work?
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Yes.
But, some patients end up with something called “Paradoxical Adipose Hyperplasia,” or “PAH.”
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Coolsculpting works by cryolipolysis, or freezing the fat. What then happens is that the surrounding fat cells don’t have anchoring support which then will cause hyperplasia of the fat cells. This may cause inadvertent mounds of fat in areas where the paddles were placed!
To treat PAH, we use VASER assisted liposculpting with either Renuvion J-Plasma or skin excisions depending on the degree of skin laxity!
