Liposuction

Permanent Body Sculpting under local anesthesia

The safe way with a rapid recovery

True Tumescent Liposuction is recognized world wide as the technique permitting the greatest safety, most rapid recovery, least amount of pain, and best aesthetic results; in Dr. Voss’ hands it is truly Expert Body Sculpting.

Tumescent Liposuction, invented by a Dermatologist, is the Liposuction Technique of the new millennium. During a tumescent procedure the area is first filled with a dilute local anesthetic and a bleeding inhibitor. This solution and the surrounding fat is then suctioned out. We can avoid general anesthesia with all its associated risks and use straw-like tubes that are much smaller than the traditional ones. Consequently, tumescent results are more precise and much less traumatic for the body. During the procedure, most of our patients listen to music, talk on the phone or simply sleep... After the procedure is over, you get up and walk out of the clinic; you are able to return to a desk-type job nearly immediately and feel comfortable resuming physical exercise within about one week.

Read the answers to some commonly asked questions about liposuction and then View an animation of the procedure ».

What are the advantages of True Tumescent Liposuction?

True tumescent liposuction permits liposuction using only local anesthesia, avoiding the risks of general anesthesia, IV sedation and narcotic analgesics. No stitches are used in this procedure. It is a "walk-in walk-out" procedure, where patients recover at home and are able to return to work quickly. Patients may travel the next day, and generally resume their normal lifestyle within 2 to 4 days. You can resume exercising after only one week.

Who is a candidate for liposuction?

If you are in good health and have one or more pockets of fat that are larger than the surrounding areas and resistant to diet and exercise, you are most likely a good candidate. A consultation session will confirm this.

Is the fat permanently removed?

The fat cells removed will never come back. Weight can still be gained, but generally the more pleasing silhouette remains. Ideally, you should maintain your weight after the procedure.

Can the removed fat now be injected somewhere else?

YES! The fat that was removed can be very useful, since it can be transferred to facial furrows or depressed scars without chance of rejection or of an allergic reaction. Click here for more information.

What if I gain weight after the procedure?

Your existing fat cells will enlarge everywhere, but your body will stay sculpted. After you lose weight again, your fat cells will shrink down again.

Will I be left with loose skin?

Generally, the skin retracts in the same manner as with weight loss. Often, your skin sagged because of the weight of the fat behind it. Once that fat is removed, the skin is able to snap back. More than 90% of all women who think that they need a "tummy tuck" actually do better with tumescent liposuction!

How exactly is Tumescent Liposuction performed?

In order to perform the procedure, Dr. Voss will first mark excess fat areas on your body. A large volume of saline solution containing a painkiller (lidocaine) and a drug designed to prevent blood loss (epinephrine) is then injected using very small needles. Tiny incisions are made in the skin, and a suction tube is inserted through these. The excess fat is removed into a collection system. Since only the small incisions have to heal, you feel only minimal discomfort - we find that most of our patients sleep through much of the procedure. After the treatment, an elastic garment is worn under the clothing for only 3 days.

Is it really safe?

A study found that while Plastic Surgeons reported a death-rate of 1 in 5000 for liposuction, dermatologists that performed True Tumescent Liposuction had no deaths in over 300,000 procedures. Plastic Surgeons are actually changing their techniques now, trying to catch up! Clearly the safest way to perform this procedure is under local anesthesia by a doctor experienced in the area.

IMPORTANT INFORMATION ABOUT TUMESCENT LIPOSUCTION:

Risks of Liposuction Surgery:

Any surgery involves the risk of infection, bleeding, scarring or serious injury, however tumescent liposuction has an amazingly good safety record. One of the reasons that tumescent liposuction is so safe is that neither general anesthesia nor IV sedation is required. A recent survey involving over 15,000 patients who had only tumescent liposuction revealed no serious complications, no serious infection, no hospitalizations, no blood transfusions, and no deaths The greatest risks of liposuction are those associated with general anesthesia. By elimination general anesthesia, the risks of liposuction are dramatically reduced. Patients can minimize the risk of surgical complications by not taking medications or over-the-counter preparations that might adversely affect the surgery. Patients should inform Dr. Voss of any medications being taken either regularly, or occasionally, including herbal remedies.

Risk of Irregularities of the Skin:

Tumescent Liposuction using microcannulae is the least likely to cause any significant or noticeable post-surgical irregularities of the skin. By magnifying the fatty compartment, the tumescent technique permits more accurate removal of fat, with greater assurance that the liposuction cannula will not inadvertently approach too near the undersurface of the skin, which would cause irregularities. Thus the tumescent technique helps to minimize the risk of post-surgical irregularities or rippling of the skin. Liposuction might improve pre-existing irregularities of the skin such as dimpling, but prospective patients should not assume that there will be significant improvement. It is unrealistic to expect perfectly smooth skin. Patients should expect that their skin will have approximately the same degree of dimpling and irregularities as existed before tumescent liposuction surgery. Ultimately, after liposuction, the skin texture should be within normal limits. A casual observer should not notice any evidence of surgical irregularities of the skin. However, it is possible that a noticeable irregularity of skin may result, and require a little touch-up liposuction.

Cellulite:

Liposuction of the thighs, while improving the silhouette, does not necessarily eliminate the subtle "puckering" of the skin often called "cellulite". Cellulite results from the pull of fibrous tissue that connects skin to underlying muscle. While tumescent liposuction may reduce the degree of cellulite, it is unlikely to eliminate it. Liposuction should not worsen cellulite.

Liposuction and Obesity:

Liposuction is not an appropriate treatment for obesity. Liposuction is not a substitute for a prudent diet, good nutrition, and regular exercise. Obese patients may be good candidates for limited liposuction if their goal is simply to improve the shape of certain limited areas of the body.

Postoperative Healing:

Normal healing after tumescent liposuction involves a limited but definite degree of soreness, swelling, bruising, and lumpy firmness. A temporary mild numbness of the skin may persist for up to 4 months. Most patients can actually see some improvement of their silhouette within one week after surgery. However, because of the slow resolution of post-surgical swelling, the ultimate results following liposuction usually require 12 to 20 weeks to be achieved.

Realistic Expectations:

Although the results of liposuction are often quite spectacular, it is not realistic to expect perfection. It is impossible to guarantee the precise amount of improvement that will result from liposuction. Patients should not have unrealistic expectations. Although most patients will achieve something in the range of 50% to 80% improvement, it is unreasonable to expect 95 % improvement or near perfection. For liposuction of a very large area, maximum improvement may require a second procedure for which there would be an additional fee. Patients who would be satisfied with a 50% improvement would be reasonably good candidates for liposuction. The "50% improvement" is intentionally a vague measure. It indicates a definite perceptible improvement, but something short of perfection. If a 50 % improvement would make a patient happy, then it is likely that these expectations will be met. Our patients generally achieve a more than 50% improvement.

Longevity of Results:

The fat cells that are removed by liposuction do not grow back. If the patient later gains or loses weight, the change tends to be distributed proportionately over the entire body. Although one can expect some changes with aging, provided that the patient does not gain large amounts of weight, the patient's new, more pleasing silhouette, is relatively permanent.

What should I expect on the day of Tumescent Liposuction?

Upon arriving in the clinic reception area, you will be greeted and asked to sign your surgical consent forms. You will then change into a surgical gown, and be escorted to the operating room. After one last trip to the bathroom, pre-operative photographs will be taken and finally the areas on your body that are to be treated with liposuction are marked with a felt-tipped pen. Next, you will lie down on the surgical table and the nurse will show you the various positions you will be required to assume during the surgery. Practicing these positions in advance of the surgery helps make the surgery go faster and easier. It usually takes about 30 to 45 minutes after arrival before the surgery begins.

We routinely place an intravenous (IV) access in your arm for safety purposes. The IV provides an excellent means to give medications if it were ever necessary. The IV is much like the car seat-belt; it is put in place routinely but it is only rarely needed. A blood pressure cuff is placed on your opposite arm, and cardiac monitor leads are placed on your chest. Next, using extremely thin and short little needles, the doctor or the nurse will anesthetize the skin at sites where the longer needles will be inserted to anesthetize the subcutaneous fat. Patients usually experience a slight pricking sensation as the skin becomes "numb".

Next, a large volume of dilute tumescent anesthetic solution is carefully and gently injected into the targeted fat. Once an area has been well infiltrated with the anesthetic solution, the fat is usually completely numb. However, there may be small areas that are only 90 % numb. In order to check that the entire area is 100 % numb, another needle is passed throughout the area. If an incompletely anesthetized area is encountered, the patient will feel a mildly sharp discomfort. When the patient indicates that some tenderness is encountered, more anesthetic solution can be immediately infiltrated exactly where it is needed. Thus, with the patient's alert cooperation, 100 % numbness is achieved. After the infiltration of the anesthetic is complete, but before beginning liposuction, you will be escorted to the bathroom one more time.

Experience has shown that giving a sedative by mouth, such as Lorazepam (Ativan), permits better local anesthesia than when intravenous sedatives are used. This is because an alert patient is more capable of detecting subtle areas of incomplete anesthesia. A patient who is too sedated might easily ignore an incompletely anesthetized area, and then feel more discomfort when liposuction is actually done. Therefore minimizing sedation actually maximizes patient comfort.

Although there is some variation between patients, the actual liposuction process is usually painless. If some burning discomfort is encountered, then additional anesthetic solution can be infiltrated.

After completing liposuction, absorbent pads are placed onto the tiny incision sites (the incisions are so small that no stitches are required). Finally, after the IV-line is discontinued and the compression garments are pulled on, you are ready to get up and go home. Because of residual local anesthetic, it is several hours after completing the liposuction before any significant soreness begins. Although you will feel well enough after surgery to drive yourself home, you should not do so because large amounts of local anesthetic may cause some drowsiness.

The tumescent technique minimizes post-operative discomfort. Because the residual local anesthesia lasts for 18 to 36 hours, plain Tylenol is sufficient to treat post-operative discomfort. With the Tumescent Technique there is no post-surgical nausea, nor the unpleasant feeling of a "hang-over" usually associated with general anesthesia.

LIPOSUCTION DOCTORS DISAGREE ON SAFETY OF LIPOSUCTION:

According to statistics from their respective professional organizations, Dermatologic Surgeons currently perform about 100,000 liposuctions annually, with Plastic Surgeons accounting for more that 170,000 fat removal procedures per year.

"Our study found that liposuction is safest when it is performed as a solo procedure under local (tumescent) anesthesia in an outpatient setting by a board-certified dermatologic surgeon" said William P. Coleman, III, MD, clinical professor of Dermatology at Tulane Medical School in New Orleans and co-author of the study. "In fact, our data shows that there have been no deaths form liposuction by dermatologic surgeons, probably because the proper precautions are followed", added Dr. Coleman, president of the American Society for Dermatologic Surgery, which is credited with developing stringent guidelines of care for liposuction surgery.

While all surgical procedures carry some risk, experts say that risks associated with liposuction can almost always be traced back to a physician adopting an overly aggressive approach to the procedure. The PIAA study confirmed this finding and demonstrated that the primary predictor of complications after liposuction was the use of general anesthesia. Patients who had liposuction performed under local anesthesia using the tumescent technique had no fatalities and fewer complications.

According to Dr. Coleman, some of the aggressive approaches which patients should be aware of when considering treatment and selecting a physician include:

• Extracting large amounts of fat
• Using general anesthesia in a hospital setting
• Performing multiple procedures during the same surgery

"Patients deserve to know that liposuction is much safer when using local anesthesia. The favorable safety record of dermatologic liposuction reflects a conservative approach to the procedure and provides a model for training physicians of all specialties," concludes Dr. Coleman.

What about SMARTLIPO™ Laser Body Sculpting?

Here is a link to a letter Dr. Voss recently wrote to her patients

What should I do if I have further questions?

Please feel free to contact the office with any questions you might have. You can also schedule a 30 minute information session ($50) for an evaluation during which you can bring up any questions you might have, and have a look at all of Dr. Voss' before and after photos. We can even put you in contact with patients who have had Tumescent Liposuction done by Dr. Voss so that you can ask them about their experience.

Testimonials

"My chin of fat is gone, very easy, not painful at all. I'll be back."
- name withheld by request

"Dr. Voss was wonderful, I had liposuction of my hips and thighs and now look and feel fantastic. Thanks so much to Dr. Voss & staff for everything! You are the best!!"
- name withheld by request

"Dr Voss and her staff did a wonderful job of making me feel comfortable. The procedure was relatively painless, and the recovery was quick! I am so very pleased with the results and would not hesitate to do it again."
- name withheld by request

"Dr. Voss, thank you for your kindness and gentleness with my lipo experience it was a surprisingly painless and emotional experience also. Thank you for taking care of me."
- name withheld by request

"Dr. Voss, thank you for all of your efforts on my behalf. My clothes fit nicely. I even went down a size! I feel more relaxed, confident and ready for swimsuit season."
- name withheld by request

"Dear Dr Voss,
Thank you so much for the wonderful changes that you have made for me.
The tumescent liposuction was a perfect solution for my tummy. The procedure was very easy and the recovery time has just blasted by so quickly. Everyone I see is just amassed at the results. Thank you from the bottom of my heart!"
- name withheld by request