Can I Have Liposuction and Breast Augmentation At The Same Time And Soon?

Q: Dr. Eppley, I have thought about liposuction a long time on my abdominal area which has always had a roll, even as a child. I would like to consult on liposuction and perhaps breast augmentation. I am going on vacation by the middle of June and did not know if it is even possible to schedule with you prior to that time.

Breast Augmentation in Hispanic Women Dr Barry Eppley IndianapolisA: It is very common to perform breast augmentation with any number of other body contouring efforts. Coming breast implants with a little bit of liposuction would not extend that recovery to any significant degree. Given that you are going on vacation in the middle of June, I would recommend that you have this surgery at least six weeks in advance of that event so you can be fully recovered, have few if any twinges of discomfort/soreness and be able to be completely in the the benefits phase of the surgery with little body ‘memory’ of the actual surgery. Thus it would be ideal for you to have this surgery no later than the end of the month. We strive to service our patients in an expeditious manner so I can see that happening on our end. I will have my nurse contact you tomorrow to find a convenient consultation time as soon as possible.

Dr. Barry Eppley

Indianapolis, Indiana

 

Does Liposuction from A Brazilian Butt Lift Cause Weight Loss?

Q: Dr. Eppley, I am interested in a Brazilian Butt Lift. Could this procedure include having liposuction for weight loss reasons as well as butt enlargement? It seems like you get two benefits at once, a bigger butt and dropping your weight at the same time.

A: Every Brazilian Butt Lift requires liposuction to harvest the fat that needs to be transferred by injection into the buttocks. This almost always comes from the abdomen, flanks and waistline and as much fat is taken as possible in most cases. But to call this liposuction harvest, or any liposuction procedure, a weight loss method would not be appropriate. That is not what it accomplishes. Liposuction is a shaping technique but it does not create any substantial or sustained weight loss in most cases.

Dr. Barry Eppley

Indianapolis, Indiana

Do I Need Liposuction Or A Tummy Tuck?

Q: Dr. Eppley, I am not sure if I  need Lipodissolve or a tummy tuck. I have gained 15 pounds or more since I have turned 40 and now can not seem to lose it.  I am not sure what I need to get my clothes to fit right again. Does the lipodissolve work? How much is the cost between them? What is the diffenence? How much time will be needed off work for a tummy tuck?  Will the weight come back right away? The weight is around my middle, love handles and my thighs and butt.

A: Choosing between liposuction and a tummy tuck is a common dilemma for many women, although many times it is a more hopeful wish that liposuction alone will create the result they want. While I don’t know what you look like, I am absolutely certain based on your description that lipodissolve injections are not the answer. They are for very discrete small areas of fat which is not what you have. The question is only then whether it is liposuction alone or liposuction combined with a tummy tuck. Seeing a picture of your stomach would be helpful in answering that question. There is no doubt you need liposuction, it is just whether there is enough loose skin across the stomach to justify a tummy tuck as well.

Dr. Barry Eppley

Indianapolis, Indiana

 

Is Liposuction Before Having Children A Waste?

Q: Dr. Eppley, I am a 21 year old female wanting to have liposuction to get rid of my stomach and reduce the fullness on my sides. I feel it would give me a much better figure and more of the hourglass look. My questions is whether doing it at my age would be a waste since eventually I am going to get pregnant. I want to look better now but I also don’t want to throw money away either. Please advise.

A: You have to recognize that many cosmetic procedures are not always going to create permanent results. This is particularly true when it comes to fat removal liposuction procedures. There are a lot of factors that influence the long-term retention of liposuction results, of which future pregnancies are certainly one of them. You also have to recognize, which you already know, that whether you have liposuction or not that an eventual pregnancy is going to change your stomach and waistline area. These changes will effect skin more than fat but they would not be considered to be beneficial at keeping the look of a liposuctioned result. The issue with looking at the ‘value’ of liposuction is how soon after were you planning to become pregnant. In other words, how much time would you enjoy the benefits of liposuction? If you were looking to become pregnant within the year after the procedure then it would not be a good use of your effort and money. But if there are no foreseeable plans for pregnancy as far as you can see in the future (years), then the benefits of liposuction may outweigh its cost when it amortized over that period of time. To put it any other way, how much would you pay a month to have a better looking stomach over that period of time?

Dr. Barry Eppley

Indianapolis, Indiana

How Much Does The Fat Weigh That Liposuction Removed?

Q: Dr. Eppley, I had liposuction recently on numerous areas of my body including my stomach, love handles, and thighs. My doctor told me he removed two and a half liters but couldn’t tell me exactly how much it weighed. He showed me a picture of a bag that contained the fat removed, which looked like a lot, but he said he didn’t weigh it. can you tell how much you think it weighed? 

Liposuction (Fat Canister) Dr Barry Eppley IndianapolisA: Patients often want to know how much fat in weight was removed during their liposuction procedure. While plastic surgeons remove and record the volume of fat removed in liters, that has little meaning to most patients.

In calculating liposuction weights, one has to start with knowing that 1 US gallon equals close to 3.8 liters. While a gallon of water weighs about 8.4 lbs, fat however will weigh less because it is less dense.  A gallon of fat is known to weigh about 7.4lbs. The density of fat is 0.9 grams/ml or 1000ml (1 liter) or a weight of 0.9 kg. Taking these calculations, one liter of fat equals roughly 2 lbs. Therefore 2.5 liters of liposuctioned fat will weigh close to 5 lbs.

While one liter of pure fat weighs about 2 lbs, it is actually less straightforward than that when it comes to fat removed by liposuction. What is removed in liposuction is called the aspirate and not just pure fat. Liposuction aspirate is a mixture of solid pieces of fat, free fatty acids (broken fat cell contents or oil) blood and tumescent solution. (what was injected into the area before liposuction) Thus, liposuction aspirate is not 100% fat but just a fraction of it. (a big fraction just not 100%) As a result, one liter of liposuction is really less than 2 lbs of fat removed and may be realistically closer to 1.5 lbs of actual fat. However when you factor in the number of fat cells that have remained behind inside the patient that have been damaged or destroyed and will be lost as the tissues heals, it is still fair to round up the total fat ‘removed’ to 2 lbs/liter.

Dr. Barry Eppley

Indianapolis, Indiana

Would Liposuction Leave My Stomach With Loose Skin After?

Q: Dr. Eppley, I am interested in liposuction or a tummy tuck, preferably liposuction though. I have had two pregnancies, seven years apart with the last one being five years ago. This has left me with loose skin and fat around my mid section. I am 38 years old and weigh 140 lbs and have a 34″ waistline measurement. I feel great, I just can’t get rid of the skin and fat around and under the naval area. I have had two abdominal surgeries in the past and skin hangs over the suprapubic scar. If I just have liposuction will I be left with flabby skin?

A: As a general rule, if one has significant loose skin on their abdomen before liposuction they will still be loose skin afterwards. While many forms of liposuction have been touted about their ability to tighten skin, the amount of skin tightening obtained is almost always far less than what patients desire. As I always tell patients, liposuction can tighten skin in the range of millimeters, however, patients are interested and need skin tightening in the range of centimeters most of the time. With loose skin around the belly button and overhanging a suprapubic scar, you would be better served by having a mini tummy tuck which would incorporate liposuction with it. Given that you already have a suprapubic scar you might as well take advantage and use the entire scar for a mini tummy tuck. It does not add that much more scar length and its ability to remove skin make it more than a worthwhile trade-off.

Dr. Barry Eppley

Indianapolis, Indiana

Will Liposuction Get Rid Of My Inner Thigh Bulges?

Q: Dr. Eppley, I am interested in liposuction or perhaps one of the non-invasive body contouring approaches. I am a petite 23-year old female who is 5’4” tall and weights 112 lbs. I am in pretty good shape, but have areas of fat on each of my inner posterior thighs that will not go away with any form of exercise and have been there all my life. I would be very happy with a visible reduction of this area and the bulges eliminated. I am also very apprehensive about any procedure requiring general anesthesia and would greatly prefer to reduce risk. But on the other hand, I don’t want to waste money on noninvasive treatments that don’t offer a significant improvement.

A: Liposuction would be the most efficient and effective method of fat removal for your inner thigh areas. But given their small size, this could be done under local anesthesia with or without oral or IV sedation if you were so motivated. While Coolsculpting or Exilis devices would produce some positive changes in the inner thigh bulges, it would not be as much nor as fast as with microcannula liposuction fat extraction. Since these inner thigh bulges have been present your entire life and this body area is not a known fat depot side, the reductive changes induced by liposuction should be permanent.

Dr. Barry Eppley

Indianapolis, Indiana

Will Liposuction Get Rid Of My Buffalo Hump?

Q: Dr. Eppley, I am interested in Liposuction of the Dorsocervical fat accumulation.  I am curious if you do this procedure and what ball park of cost would this procedure be in. Please advise as I need your help. 

A: Liposuction is an excellent option and often preferred treatment for neck fat. I believe when you refer to the dorsocervical fat accumulation, you seek the classic ‘Buffalo Hump’ reduction. This is a procedure that I have done numerous times (most commonly in the HIV patient although not always) and I have found that the use of laser liposuction (Smartlipo) can give a very effective reduction without the need for an open operation with a long incision. This is a procedure that takes less than an hour to do, often under sedation or general anesthesia. (it is helpful to have the patient have a good anesthetic depth so the liposuction procedure can be aggressive) Buffalo humps consist of a very fibrous type of fat (often looking more white than yellow) as opposed to a softer and more buttery type of fat more commonly seen in many areas of the body including the anterior neck. This is why laser liposuction or power-assisted liposuction (PAL) is used as it is more effective at breaking up this more dense fat that is held together by fibrous tissue bands. Buffalo humps can be very effectively reduced by this liposuction approach. In my experience, patients have not reported a recurrence of this posterior neck fat accumulation. The ballpark cost would be in the $4,000 to $4,500 range.

Dr. Barry Eppley

Indianapolis, Indiana

Will Liposuction Work For My Abdominal Problem?

Q: Dr. Eppley, How much for liposuction, specifically smart lipo, of the abdomen? Here is a picture of my abdomen. I am not interested in a tummy tuck scar and the recovery time. Thanks.

A: While I can understand why you would want to pursue some form of liposuction, it is neither the appropriate or effective contouring procedure for your abdominal problem. You have as much excess skin as fat as part of the loose abdominal overhang. Removing fat will only cause more loose skin and will not get rid of the overhang. It may likely leave your abdominal problem with no substantative improvement. While no one understandably wants a tummy tuck scar or the recovery from it, this is the only procedure that will be effective for your concerns. Do not waste money or effort on a liposuction procedure that will not work for you.

Dr. Barry Eppley

Indianapolis, Indiana

Should Liposuction Incisions Be Closed?

Q: Dr. Eppley, when you do liposuction do you close the incisions with stitches or staples or just leave them open? A relative of mine across the country had liposuction recently on her stomach and thighs and they didn’t close her incisions. I didn’t realize that liposuction was done that way. She said her incisions bled for days and she had to keep changing her wet bloody garments. How does this affect the liposuction result and does it increase the risk of infection?

Thigh Liposuction Indianapolis Dr Barry Eppley

A: Whether a plastic surgeon chooses to close liposuction incisions is a matter of personal preference. There is no evidence that not closing these incisions increase the risk of infection or affect the outcome of the procedure in any way. It is common for the liposuction incisions to leak fluid for 24 to 36 hours after the procedure which is primarily induced by the wearing of the compression garments. (squeezing it out) What one sees, although it looks like a lot of blood to the patient, is actually just a little bit of blood mixed with the tumescent solution that was infused at the time of the surgery. One could argue that the more this fluid comes out the less swelling and bruising that will  subsequently occur. If the fluid does not come out it stays in the body and must be absorbed over time as one heals. If the incisions are closed probably less fluid comes out but a fair amount will still ooze out anyway. This is why I tell patients to not sit or lay on anything they value (without a blanket) for the first few days after surgery.

That being said, I do prefer to close my liposuction incisions (with the exception of those placed inside the belly button) as it increases the likelihood of better scars, small as they may be.

Dr. Barry Eppley

Indianapolis, Indiana