Liposuction or Suction Assisted Lipectomy (SAL) has been a major part of the plastic surgery practice for over 30 years. While at the Mayo Clinic the practice of liposuction changed from performing the procedure “dry” to becoming one that is “wet”. Dry meant without the use saline tumescence. Wet meant using saline to distend the fat cells prior to removal. This is how most liposuction is done today worldwide, with the instillation of tumescent fluid (saline with epinephrine and lidocaine) 5-10 minutes prior to the fat removal. This is the foundation of what many consider the best technique done today.
Changes to the Procedure
What has changed for me is that in training and while at Charlotte Plastic Surgery, many people considered “large” would be considered a candidate for this procedure. People that underwent liposuction had a high volume of fat removed, which meant over 5 liters at one procedure. I thought if someone needs 5 liters of fat removed, maybe they need weight loss prior to the procedure. After all, the body stores fat where it is designed too and then will lose the fat in a more even distribution. So, for the past 20 years and at Capizzi MD, we created a wellness plan to incorporate weight loss prior to the procedure. If one comes in interested in SAL and they are within 20lbs of their ideal body weight, he or she may be a “good” candidate for the procedure, but if our wellness program can get to 10lbs or closer, they will become an “excellent” candidate and potentially a better result. We are about great results for all our patients.
Liposuction not the Only Treatment for Body Contouring
Liposuction (with power-assisted control) is not the only treatment we offer for body contouring at Capizzi MD. We have other tools in the tool box. We offer a Wellness Program (headed by our Nurse Practioner, L. Grace Anglin, and D.N.P.); Coolsculpting (of which our staff has graduated from the Coolsculpting University); Kybella (injections to dissolve fat); Profound radiofrequency micro needling for cellulite and skin tightening.
What happens during Liposuction?
Liposuction uses cannulas and a suction machine. At first while at Charlotte Plastic Surgery, the physicians used a manual technique or ultrasonic that caused more bruising and had larger incisions, now with the PAL system it has become infinitely easier for the removal of fat, less bruising, and more detailed contouring of the body. My patients can work, workout, walk, and move about the following day after SAL. It is nearly the most common procedure in my practice. The most common is breast augmentation with gummy bear silicone gel implants. Many of those patients add a mini-liposuction procedure to an area they are concerned. Now I see people adding the liposuction and asking me to place it to enhance their gluteal areas (Brazilian Butt Lift = BBL). When liposuction is added to a tummy tuck and breast implant procedure it is often termed a Mommy Makeover. Now Mommy Makeovers incorporate breast augmentation with gummy bear silicone gel implants, a tummy tuck (abdominoplasty), liposuction of the hips and inner/outer thighs, and gluteal enhancement. If cellulite is evident, we can address it with the Candela Profound micro needling treatment effectively.
The cannulas for the best liposuction are microcannulas and are small Mercedes tips with 2, 3, 4mm in diameter to finely tune. Through an incision of 4mm we can contour the hips, inner and outer thighs, AND augment the gluteus or lift the buttock. This repurposing of fat to the upper gluteal area to fill in an area of increasing concern.
The technique of liposuction has evolved over time to become a more precise, safe procedure with far less bruising and discomfort than the original. Downtime is minimal with use of the power assisted liposuction system and patient satisfaction is among the highest of cosmetic procedures.