Dr. Levens' Parkland Life Magazine Articles

Liposuction Update By David J. Levens, MD, PA, FACS

Liposuction is a popular treatment for women and men with stubborn areas of "diet resistant" fat bulges that neither dieting and exercise nor “slimming” designer jeans can eliminate.  Consistently over the last 10 years, liposuction has been one of the three most common cosmetic plastic surgery procedures performed in the U.S.
           
The surgery has evolved over the years to make the procedure safer, the recovery easier and the results better.  Earlier liposuction techniques used larger cannulas (thin, tube-like instruments to extract the fat)  and little or no "wetting" solution, often resulting in more trauma with more discomfort and bruising, prolonged recovery and less than ideal contour improvement.   Today, the vast majority of surgeons utilize thinner, less traumatic cannulas along with a wetting or "tumescent" solution of physiologic fluid mixed with local anesthetic and epinephrine to ease the fat removal and minimize bleeding and discomfort.
          
Most patients report only minor post-surgical discomfort and are ready to return to work in 2 to 3 days (with a few restrictions), though some bruising, swelling and numbness can last 3-6 weeks.  Maximal improvement and results can take up to 3 months and are always enhanced by starting at a relatively ideal body weight and/or rapidly resuming exercise, sensible eating and maintaining or losing weight stability after the procedure.  Other alternative techniques involve the use of both internal and external ultrasonic energy to help break up the fat and newer techniques utilize laser energy internally. 
           
The use of various injections directly into the areas of fat deposits that purportedly "dissolve" the fat without the need for surgical removal are typically offered by non-plastic surgeons.  These injections sometimes known as "mesotherapy" are not well regulated, the results are inconsistent and the treatment is not a replacement for liposuction. However, scientific investigation is underway and in the future the treatment may have a role for minor localized areas such as in touch-up procedures.  
           
Typically liposuction is performed in an operating room setting under anesthesia administered by an anesthesiologist or nurse anesthetist for optimal patient comfort and safety.  Here’s how it works:
           
First, the surgeon draws detailed topographic markings on the body, marking "high" and "low" contour areas to help guide the amounts of fat removed and areas to avoid.  Initially, the tumescent solution is injected.  The cannula enters via tiny incisions made in concealed areas, where possible, and is inserted to the proper depth of the fat deposit. It is then passed back and forth until an appropriate amount of fat has been removed. The entire bulging area is treated in this way, with careful and controlled removal of fat. The surgeon constantly checks the cannula position, contour and the fat "aspirated" or removed by observing with his or her hands and eyes.  Preoperative diagrams noting specifics such as asymmetries (one thigh fuller than the other), help to plan anticipated removal amounts which are used as a guide to smooth, uniform and adequate removals.  Incisions are then carefully closed and an elastic garment or dressing is fitted over the areas to put gentle pressure on the skin, prevent excess fluid accumulation and assist in re-contouring and shaping the areas suctioned.
           
Rare complications common to all surgical procedures can occur (bleeding, infection, scar tissue formation).  More commonly, minor irregularities of the skin surface and contour and asymmetries can occur and minor touch-up procedures may occasionally be indicated.
Most surgeons limit the removal to 5 liters of fat aspiration during one surgical session. The vast majority of liposuction procedures can be performed within these limits, including combinations of treated areas, such as thighs, hips, buttocks and stomach, or the combination of liposuction with other types of plastic surgery such as facelift or tummy tuck.  Lliposuction can be used to eliminate excess fat deposits on almost any part of the body.
           
One of the reasons liposuction is so popular may be that it can provide dramatic results especially for motivated women and men who are well prepared and follow through with consistent exercise and weight management.  Patients generally do not lose significant weight, but they do lose inches. The fat cells that are removed during liposuction are gone for good.  Fat deposits are less likely to reappear in exactly the same spots. However, significant post-surgery weight gain can show up elsewhere on the body.

Who is a candidate for liposuction?  The ideal candidate is a healthy woman or man within 15-20 pounds of his/her ideal weight.  The most satisfied liposuction patients are those that follow through with discipline and weight management.           

Interested in seeing past articles? See our archived Parkland Life Articles page.

David Levens, MD, PA, FACS has been practicing cosmetic surgery in Coral Springs since 1989.  In addition to his private practice at 1725 University Drive, Dr. Levens has served as Vice Chief of Staff and Chief of Surgery at the Coral Springs Medical Center. He is Certified by the American Board of Plastic Surgery and is a member of the American Society for Aesthetic Plastic Surgery and the American Society of Plastic Surgeons.  Dr. Levens has been cited repeatedly in Miami Metro Magazine’s annual lists of “Best Doctors in South Florida”.  He earned his medical degree at Columbia University, New York, and served residencies in general surgery and plastic surgery at Montefiore Hospital & Medical Center, New York.  He lives in Coral Springs with his wife, Linda, and their two children, Danielle and Ben. He can be reached at 954-752-1020 or www.DrLevens.com.