10 Guidelines For Liposuction

1. Skills, Artistry and Hands of the Surgeon

To consistently achieve an outstanding result with liposculpture, the surgeon needs perfect judgment and meticulous technique. As with any cosmetic surgery, liposculpture surgery is extremely dependent on the experience and skills of the particular surgeon as any mistake in technique can adversely affect a perfect result. I do not believe in a team approach or having multiple people performing my surgery. I have always and will always take full responsibility for every aspect of your surgery to ensure the best possible result. I am the only person I trust to perform all aspects of your surgery, from placing the local aesthesia to the entire contouring and sculpting procedure. Liposculpture surgery is the only major cosmetic surgery I perform. I also believe in quality service over quantity and purposefully limit the number of surgeries I perform each week.

2. A Complete, Honest, Comprehensive Evaluation

I believe that a great result and a happy patient begins with a proper complete consultation and evaluation by the surgeon. It is absolutely necessary to be seen prior to the surgery. I am the only person who determines if a patient is a good candidate for liposuction. Every patient must be evaluated by myself prior to surgery and understand what I feel the results will be. I examine every single patient from their neck to ankles to determine where they are genetically disproportionate and may benefit from liposuction. Liposculpture is a balancing procedure and unless comprehensive evaluation is performed by the surgeon a patient may be thrown permanently out of proportion. A discussion between myself and the patient must take place in order to be clear about every aspect of the procedure and the expected results. For out of town patients, photographs are evaluated only by myself and I only allow patients to travel to see me once I have determined they are a candidate. They must arrive at least one day prior to surgery where I re-evaluate and examine areas in person.

3. Getting it Right the First Time

Liposuction surgery is the most common cosmetic surgery in the United States. It also has one of the highest revision rates with some studies showing revision rates as high as 25%, or one in four surgeries. My revision rate is approximately 1/1000, and if there ever is a need for revision it is almost always very minor. I virtually never have irregularities, dents or ripples. I do everything to nail the results the first time. I appreciate how difficult it can be to make a poor result better. I perform a lot of revision liposuction surgery for patients from around the world and can almost always make a great improvement in areas that previously had poor results. However, I strongly feel that the best opportunity to make it perfect is the first time, and I use my experience and skills to achieve this.

4. Man over Machine

Do not be fooled by aggressive and possible deceitful marketing. A great result is much more about the integrity, good judgment, eyes, hands, skills and artistry of the surgeon versus what machine or technology is used. Like I have always said, try to find the right surgeon rather than looking for a machine (please read “Proper Liposuction Evaluation and Technique: An Expert Opinion”). Liposuction is a contouring and sculpting procedure not that dissimilar to sculpting a beautiful piece of artwork. It is essential to have a great eye and it is very important in terms of what you are feeling with your hands. The machine is not going to guarantee you a great result. Personally I do not trust or prefer some of the newer technology such as lasers or ultrasound that “melt fat”, as I lose some of the fine control and tactile feel that is so important in meticulous sculpting. In my revision work, I have seen some of the worst results from lasers or ultrasound in the hands of people without perfect technique and judgment. And with regard to the myth (see top 5 myths) that liposuction makes your skin looser while lasers or ultrasounds tighten your skin, this is simply not true. When liposuction is done properly the skin tightens on its own. Please also read “area by area” for a more detailed discussion of my technique for each particular area of the body.

5. Purely Local Anesthetic

Tumescent liposuction was developed in the mid 1980s by dermatologic surgeons like me. I feel this has been the greatest advancement to date in the safety and improved results of liposculpture surgery. I like to call this pure tumescent liposuction to distinguish it from other forms of tumescent liposuction where general anesthesia is used. As far as I am concerned, once you use general anesthesia with liposuction you lose many of the benefits of the local anesthesia which are:

Safety: A study several years ago in a major peer reviewed plastic surgery journal demonstrated a 1/5000 mortality rate from liposuction under general anesthesia. When liposuction is performed properly under purely local anesthesia properly there have been no deaths.

Recovery: The proper infiltration of the local tumescent anesthesia prior to surgery helps to hydro dissect (loosen with water) the fatty tissue. It also allows much more pure fat removal with far less bleeding. In addition, I am careful to stay only in the fat layer (where I belong) to avoid unnecessary trauma to muscle and other tissue. This results in faster recovery with less bruising and discomfort.

Results: The ability to always position patients exactly is crucial to obtaining a perfectly sculpted, smooth result. It is imperative to never poke or jab or tent the skin from underneath as I feel this is the most common cause of irregularities, dents and ripples, as well as incomplete results. It is virtually impossible to obtain the same exact positioning with a patient under general anesthesia and this can definitely affect a great result. Even though I will rarely do cases under general anesthesia or conscious sedation I try to encourage purely local anesthesia for all the above listed benefits.

6. A Surgical Center

Despite how others may represent liposuction or liposculpture it is a surgery. Although I have never had a single serious complication (including infection or bleeding) in thousands of patients, I do not believe in taking chances. I perform every surgery in a fully accredited, state and medicare-licensed surgical center. Every surgery is in a completely sterile setting and every patient is monitored. For the safety of my patients and others I do not want them to drive themselves home (even though they will feel they can) and essentially insist on them being escorted by a friend or family member.

7. The Post-Operative Follow-Up Visit

I personally call the patient the night of surgery to check on them. I also feel it is important in terms of compete care that every patient must be seen by myself within the first week post-operatively. A follow-up appointment between day one and day seven is required to make sure of proper healing and to answer any questions the patient may have. However, it is too early to truly discuss results at this point. Mostly all patients return to work or light exercise in two days. The next appointment typically occurs at three months to take photographs and look at and discuss results. If out of town patients are not able to return, this may be done via email and telephone communication.

8. Education

I strongly encourage patients to learn as much as possible and be discerning prior to surgery. As an expert on national internet chat rooms and by my weekly radio show, I do my best to clarify misunderstandings for patients about liposuction. Do not be impulsive but take the time to educate yourself. I understand that as a patient it is difficult to sort through the aggressive, often hyped-up confusing marketing, but with time, patience and good judgment you will increase your chances of finding the right surgeon to perform your surgery and make you happy with a great result.

9. Price

While I am extremely fair and competitive with pricing for my surgery, I feel it is important to not have this be the major factor in choosing a surgeon. I want a patient to choose me because they feel and understand that I am the best surgeon to achieve their goals and then decide if the price is agreeable. This is not buying a washer and dryer, or a television set. A less than optimal result is far too costly in many ways. My surgical fee and the operating room fee is based on how long the surgery takes (between 30 minutes and 2 ½ hours) and not by adding up areas. If you must know my fee range prior to scheduling a consultation you may call my office and ask for my Patient Care Coordinator, Martineque McClain.

10. Service

Unfortunately it seems that service in our modern world is in many ways on the decline. As a doctor and surgeon I am providing a service and I try to never forget this. I take it very seriously that my patients are putting their trust and confidence in me. I have the responsibility to take care of them and do my best to ensure the well-being and happiness of every patient.