Body Contouring And Liposuction

Elliott H. Rose, MD -  - Plastic Surgeon

The Aesthetic Surgery Center

Elliott H. Rose, MD

Plastic Surgeon & Reconstructive Surgeon located in Upper East Side, New York, NY

Body Contouring And Liposuction Specialist

Body Contouring and Liposuction Q & A

by Elliott H. Rose, MD

Body Contouring (Body Sculpting)

The ideal candidate is someone who watches his/her diet, exercises, does not smoke, and who, otherwise, is reasonably fit. Body contouring entails safe, minimally invasive techniques of modified tumescent liposuction and/or skin trimming (i.e. following pregnancy or weight loss) to achieve the most sculpted look. Pre-surgical computer imaging offers the patient a realistic assessment of body contour alterations.  A  hollow tube (cannula) is used to extract the liquified unwanted fat pockets from specific body areas that have been unresponsive to proper diet and exercise, including thighs, knees, and buttocks; abdomen and hips; upper arms and above the breasts; calfs, knees and ankles. Many of these fat accumulations persist because they are hormonally sensitive to normal levels of circulating estrogen or testosterone. The procedure is most effective in patients who are within 15 to 20% of normal body weight. The firmer the skin, the greater the retraction and redraping following liposuction.

Services offered are as follows:

  • Liposuction of abdomen and hips
  • Liposuction of thighs, knees and buttocks
  • Liposuction of arms
  • Adbominoplasty (“tummy tuck”)


Liposuction – Abdomen and Hips

Liposuction (suction assisted lipectomy) is a form of body sculpting performed through minimally invasive, well concealed stab incisions. With this technique, a hollow tube (cannula) is used to extract unwanted fat pockets from specific body areas that have been unresponsive to proper diet and exercise, including thighs, knees, and buttocks; abdomen and hips; upper arms and above the breasts; calfs, knees and ankles. Many of these fat accumulations persist because they are hormonally sensitive to normal levels of circulating estrogen or testosterone. The procedure is most effective in patients who are within 15 to 20% of normal body weight. The firmer the skin, the greater the retraction and redraping following liposuction.

During the procedure, performed under “twilight” sedation anesthesia, the patient is constantly repositioned on the table to allow for the best sculpting along anatomical muscle masses (i.e. lateral thighs, hips, etc.). Smaller cannulae are used near the surface to soften skin dimpling (cellulite). Extracted fat may be recycled and injected into areas of cellulite depression to achieve a smoother skin contour. The procedure is extremely safe if fat and fluid extracted is kept to less than 3500 cc.

Procedure and recovery

The surgery is performed at our state of the art AAAASF outpatient facility, The Aesthetic Surgery Center. The fat pockets are marked with the patient standing. A saline solution containing a vasoconstrictor (to shrink blood vessels and reduce blood loss); local anesthetic (lidocaine); and an enzyme to break down fat is instilled under pressure into the fat pockets. Small bore cannulas (hollow tubes) are inserted through tiny stab incisions and attached to a suction machine to extract almost pure fat from the deeper layers. Closer to the skin surface, tinier cannulas are used to soften dimpling in the skin (cellulite) and wavy irregularities. Recycled fat may be further reinjected into depressed cellulite pits. Operating time is usually one and a half to three hours, depending on the extent of surgery.

A pre-fit customized elastic garment is worn for two to three weeks post surgery to control bruising and swelling and to allow for skin to redrape over the treated areas and during the daytime (beneath clothing) for a few more weeks for support. Most patients are back to work within two to three days and may resume more strenuous exercises within two to three weeks.

Improvement in body contour is observed immediately (even beneath the elastic garments!). Your new body shape is reasonably permanent provided you maintain a good nutrition and exercise regimen. Fat accumulation, if it does recur, is usually more diffuse throughout the body and not only in the prior “bulges”.


Breast Augmentation

Breast augmentation is one of the most popular plastic surgical procedures. Over 200,000 were performed last year. Breast enlargement is useful for patients who have lost volume following pregnancy or who have just never been satisfied with their smaller breast size.

Dr. Rose has introduced the concept of “adjustable” breast implants (as seen on ABC Evening News in New York City). In this technique, the filling tube of the saline implant is brought out externally through a tiny gap in the surgical incision and left in place within the sterile dressing until the first dressing change (at one to two days). At that time, with the patient alert and sitting, fluid is added or subtracted according to the patient’s individual preference of size and shape.

Procedure and Recovery

The procedure is performed under “twilight” sedation (you are totally unconscious) administered by a Board certified anesthesiologist at our state of the art AAAASF outpatient facility, The Aesthetic Surgery Center. FDA approved McGhan implants are inserted through incisions around the areola (dark skin surrounding the nipple). A breast lift to reshaped sagging breast may be performed in conjunction with breast augmentation to increase firmness and size. The length of the operation is usually one and a half to two hours.

A compressive surgical bra is continuously worn for three weeks post surgery to help reshape the breast contour. Additional bra support is usually necessary for another two to three weeks. Most patients return to work within two to three days. Strenuous exercise may be resumed in three to four weeks.

Breast augmentation patients are some of the most grateful of all patients. You will observe firm, uplifted breasts at the first dressing change. Breasts, of course, will eventually sag in response to gravitational pull but the improvement in body proportion is well worth it.

 

Breast Lift

With time and multiple pregnancy, the breasts may sag and lose their shape. Gravitational forces stretch the skin and redistribute the breast mass at the lower pole of the breast. Mastopexy (breast lift) is a surgical procedure designed to trim away the extra skin, reshape the breast into a more youthful projection, and elevate the nipple/areolar complex to a higher level on the chest wall. Often times, if the breasts are small and have lost volume after pregnancy, a saline implant is inserted simultaneously with the breast lift to improve the size and shape.

Procedure and recovery

The procedure is performed under “twilight” sedation (you are totally unconscious) administered by a Board certified anesthesiologist at our state of the art AAAASF outpatient facility – The Aesthetic Surgery Center. (Occasionally it is done in the hospital). Stitches are in a circular pattern surrounding the areola (dark skin around the nipple) and may extend in an “anchor ” pattern over the lower pole of the breast and in the crease below the breast. In less saggy breasts, a “doughnut” mastopexy is performed, trimming skin in a circular pattern around the areola and thus avoiding the more visible vertical scar.

A pre-fit elastic bra is worn for two to three weeks post surgery to provide support and reduce swelling and bruising. It is replaced by a softer bra of choice for an additional comfort. Most patients return to work in five to seven days. More strenuous activity may be resumed at three to four weeks (depending on the extent of the surgery).

Patient satisfaction is very high following this procedure, particularly if the vertical anchor scar is avoided. While the breasts will continue to sag with gravity, weight gain or loss, or further pregnancy, the improvement in shape and appearance is well worth it.


Abdominoplasty

Also known as a “tummy tuck”, this form of body contouring is effective in removing saggy skin from the lower abdomen, tightening the weakened abdominal wall muscles (following pregnancies), and softening the wrinkled skin above the umbilicus (belly button). The procedure, often performed in conjunction with liposuction of the hips and upper abdominal fullness, is not suitable for weight loss and is generally performed in patients who are within 15 to 20% of their normal weight.

Procedure and recovery

The procedure is usually performed at our state of the art AAAASF outpatient facility, The Aesthetic Surgery Center under “twilight” sedation administered by a Board certified anesthesiologist. (In some circumstances where excessive skin and fat is removed, the procedure is done at the hospital). The incision is placed at the lower abdominal crease just above the pubic hairline and is well concealed by underwear or swim suits. A second circular incision placed around the navel is more visible but often is not necessary in a partial abdominoplasty (“mini-tummy tuck”).

A custom pre-fit elastic garment is worn for three to four weeks to control bruising and swelling and allow the skin to redrape over the treated area. Return to work is generally within two to three weeks. More strenuous exercise may be resumed at 4 to 6 weeks. A flatter abdomen is observed immediately (even beneath the garment!). Results are usually long lasting if you adhere to good nutrition and regular exercise.


Liposuction – Thighs, Knees, Buttocks

Liposuction (suction assisted lipectomy) is a form of body sculpting performed through minimally invasive, well concealed stab incisions. With this technique, a hollow tube (cannula) is used to extract unwanted fat pockets from specific body areas that have been unresponsive to proper diet and exercise, including thighs, knees, and buttocks; abdomen and hips; upper arms and above the breasts; calfs, knees and ankles. Many of these fat accumulations persist because they are hormonally sensitive to normal levels of circulating estrogen or testosterone. The procedure is most effective in patients who are within 15 to 20% of normal body weight. The firmer the skin, the greater the retraction and redraping following liposuction.

During the procedure, performed under “twilight” sedation anesthesia, the patient is constantly repositioned on the table to allow for the best sculpting along anatomical muscle masses (i.e. lateral thighs, hips, etc.). Smaller cannulae are used near the surface to soften skin dimpling (cellulite). Extracted fat may be recycled and injected into areas of cellulite depression to achieve a smoother skin contour. The procedure is extremely safe if fat and fluid extracted is kept to less than 3500 cc.


Procedure and recovery

The surgery is performed at our state of the art AAAASF outpatient facility, The Aesthetic Surgery Center. The fat pockets are marked with the patient standing. A saline solution containing a vasoconstrictor (to shrink blood vessels and reduce blood loss); local anesthetic (lidocaine); and an enzyme to break down fat is instilled under pressure into the fat pockets. Small bore cannulas (hollow tubes) are inserted through tiny stab incisions and attached to a suction machine to extract almost pure fat from the deeper layers. Closer to the skin surface, tinier cannulas are used to soften dimpling in the skin (cellulite) and wavy irregularities. Recycled fat may be further reinjected into depressed cellulite pits. Operating time is usually one and a half to three hours, depending on the extent of surgery.

A pre-fit customized elastic garment is worn for two to three weeks post surgery to control bruising and swelling and to allow for skin to redrape over the treated areas and during the daytime (beneath clothing) for a few more weeks for support. Most patients are back to work within two to three days and may resume more strenuous exercises within two to three weeks.

Improvement in body contour is observed immediately (even beneath the elastic garments!). Your new body shape is reasonably permanent provided you maintain a good nutrition and exercise regimen. Fat accumulation, if it does recur, is usually more diffuse throughout the body and not only in the prior “bulges”.

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Elliott Rose, MD
895 Park Avenue
New York, NY 10075