By far the most common procedure in Body Contouring is Liposuction. Modern Liposuction was pioneered in Europe by the Parisian Plastic Surgeon, Yves G. Illouz, M.D. His technique took advantage of the fact that fatty tissue is fragile when compared to the nerves and blood vessels that travel through it. Therefore, if you take a blunt-tipped surgical tube (we affectionately call it a cannula because that sounds more impressive), place it under the skin and apply suction, a portion of the fatty tissue is removed. Although many patients request, “Take as much as you can get!,” surgeons should never do that. Many patients regret going to doctors who approach fat removal with this attitude. Lesson number one regarding Liposuction: It really does not matter how much fat you remove. What matters is how much and where you leave it. Think about it. When a sculptor is shaping a piece of marble, does anybody really care how much is on the floor when they are done?

The main drawback of the original technique of Liposuction was that 50 percent of the fluid removed was blood. Many patients were required to bank their own blood and received it after surgery. Obviously this was not acceptable. Tumescent Anesthesia was the solution for this problem. Although some practitioners still call this “tumescent liposuction,” the fact is that “tumescent” has nothing to do with liposuction. Rather it is a form of anesthesia. The word tumescent means to inflate. This technique involves the injection of very dilute local anesthetic that causes the blood vessels to contract. This prevents excessive bleeding. Therefore, instead of losing 50% blood, patients lose less than 5%. Obviously, because of safety concerns, no competent surgeon today performs liposuction without some form of “tumescent” or “Superwet” anesthetic technique.

It seems that every week or so a surgical equipment company comes out with a new type of Liposuction. Technologies include ultrasonic energy, lasers and even water under pressure. They make claims of more thorough fat removal (I think we covered that above), less down time, bruising, pain, etc. In time many of these marketing claims prove to be untrue or nearly impossible to substantiate or disprove. I personally bought one of the first Ultrasonic Liposuction units available in the middle 1990’s and found it to be effective and helpful with a few challenging patients. However, in my experience, the bruising and discomfort was the same and the recovery a little longer (because it probably caused a little more trauma). To illustrate the point I am trying to make, let me tell you a little story. A few years back I attended a Cosmetic Surgery meeting where live surgery was being performed. They were showcasing two techniques of Liposuction; Traditional vs. Ultrasonic. The Surgeon using the traditional surgical cannula was a master surgeon from Italy who had a real flare for artistry, curves and proportions. The Surgeon with the ultrasonic machine was an expert from the United States and was showcasing the latest technological advancement. In the end, the ultrasonic patient had a lot of fat removed and had an acceptable result that most would say was good. The patient that had the old-fashioned technique went from your typical proud mother of three to the woman that most healthy men would chase after on the beach!

Lesson number two regarding Liposuction: Choosing the right Surgeon to perform the Liposuction in Sacramento is an infinitely more important decision than what tool they are using to remove the fat. One should choose their surgeon based upon their credentials, experience and artistic sensitivity. Remember that just because a technology or instrument is new does not necessarily make it better. Although medical technology continues to evolve and improve, be careful about claims that are “too-good-to-be-true” and advertisements that push a tool or technique rather than a qualified surgeon. The reality is that if it was that much better, every Plastic Surgeon would have it. After all, Tumescent Anesthesia is used in all forms of liposuction for obvious reasons.

A final thought. Because of many factors, some Liposuction is being performed by doctors who are not Plastic Surgeons board certified by The American Board of Plastic Surgery. Many of these other doctors only offer Liposuction in their approach to Body Contouring. They are a hammer who only sees the world as a nail that they want to hit. Plastic Surgeons who have achieved  certification by the American Board of Plastic Surgery are qualified to offer an array of Body Contouring options for each patient. By offering a complete set of techniques, Board Certified Plastic Surgeons can arguably achieve  the highest quality results for each individual patient.