The Truth About Liposuction

Q: I had a friend years ago that had liposuction on the bottom half of her body. 10 years had passed since I saw her; I could not believe my eyes, her face and arms had gained so much weight I didn’t recognize her! Is it true when you lipo from one part of the body it can deposit to other parts?

A: This is an interesting question and addresses a common misconception. Liposuction is currently the most commonly performed aesthetic surgical procedure in the United States. The concept is relatively simple, analogous to a vacuum cleaner that selectively removes excess fat between the skin and the first layer of muscles – it cannot remove deeper fat, for example that inside your belly around your intestines (the deep fat can only be removed by decreasing caloric intake).

The excess outer fat can be reduced by running a metal tube through the fatty layer, creating empty tunnels, which collapse as the patient heals and gives a patient the desired contour improvement. During the liposuction process, the excess fat is physically removed, collected in large bottles (up to five liters can be safely removed in one sitting), and disposed of as biological waste. This removed fat, therefore, cannot go to other parts of your body! Even the thinnest super model has a thin layer of fat under the skin and, when surgeons perform liposuction, at least a half inch layer of fat is always left between the skin and the muscles. The problem is that removal of the fat does not prevent someone from gaining weight in the future!

The equation is pretty basic – your weight is the result of what you consume minus what you burn off. If you eat roughly what you burn, before or after surgery, your weight will be stable and your fatty layer will remain at the same thickness. If you burn more than you consume, your fatty layers will decrease in thickness. Unfortunately, the converse is also true – if you consume more than you burn, whether or not you have had liposuction, your fatty layers will increase in thickness. This increase in thickness will occur over the part that was liposuctioned as well as over other parts that were never suctioned. We all know some overweight people with massive thighs or arms, large bellies, and very full necks, whether they have had prior liposuction or not. Liposuction is designed to treat stubborn area that do not respond to diet and exercise – liposuction is not a weight loss technique and does not prevent someone from gaining weight in the future!

When considering any surgical procedure, it is important to find a surgeon who you trust and to have all of your questions answered. You should know all the facts about your procedure and be aware of the risks prior to committing to the procedure or entering the operating room. It may also be a good idea to see photographs of your surgeons previous patients and their results.

Dr. Bunkis MD, FACS of Orange County Plastic Surgery is a Harvard trained, Board Certified Plastic Surgeon and has 30 yrs of surgical expertise. Call Orange County Plastic Surgery at 949-888-9700, email your questions to info@ocps.com or visit our website for more information. Serving Irvine, Newport Beach, Mission Viejo, Laguna Beach, Rancho Santa Margarita and surrounding cities.

Who to Believe – My Plastic Surgeon or My Dermatologist?

Q: I am 54 years old and beginning to see signs of aging. I asked my dermatologist for suggestions regarding products and she told me I was “too far gone” and suggested a laser procedure. I saw a plastic surgeon who told me that was nonsense and suggested a face lift instead. I want to look better but don’t know who to believe.

A: I can begin by telling you that both are correct, at least in part, and I am certain that both doctors are giving you advice based on their view points, training and expertise. The problem is that most dermatologists do laser resurfacing and not surgical procedures – they tend to recommend procedures they know how to do, regardless of what is best for the patient. And likewise, many surgeons do not do resurfacing procedures and may suggest a surgical procedure without considering the resurfacing option.

Without a consultation, I will have to answer this question in the most general terms. I will begin by telling you a few words about aging and what we can do about it. Two events happen simultaneously as we age. Surface changes occur from excessive sun damage. You can use sun blocks, hats and sun glasses to minimize sun damage as you get older. A laser treatment will remove these superficial signs of aging, but will not affect the dropping and skin laxity, particularly in the jowl and neck regions, that also occur with time.

These latter changes are the result of heredity and will not be altered by sun blocks or helped with a resurfacing procedure. In order to alter neck and jowl sagging, plastic surgeons pick these layers back up and tighten them as part of any traditional or midface lift procedure. Frequently, brows will be elevated back to where they once were, or baggy eyelids will be addressed at the same operation so as to restore a sense of balance to the final result – for example, very baggy eyelids would detract from an otherwise well done face lift which gave a patient a youthful neck.

Such surgery will not, however, alter sun damage or the quality of your skin. Another very important factor is a patient’s expectations – these have to be met! Some patients want nothing but a total improvement, others are willing to settle for less improvement because they are not bothered by certain features or because they are trying to save money. Your best bet is to find an aesthetic surgeon well versed in both the traditional surgical procedures as well as the various resurfacing procedures (chemical peels, laser resurfacing and dermabrasion) so that you can be presented with all the options and then you can decide which is the best option for you. Though your results may vary from a surgeon’s previous patients, during your consultation, you may ask your plastic surgeon to see photos of patients they have worked on. In this way you can get a better idea of the results of different procedures and decide on what will suit you best.

Dr. Bunkis MD, FACS of Orange County Plastic Surgery is a Harvard trained, Board Certified Plastic Surgeon and has 30 yrs of surgical expertise. Call Orange County Plastic Surgery at 949-888-9700, email your questions to info@ocps.com or visit our website for more information. Serving Irvine, Newport Beach, Mission Viejo, Laguna Beach, Rancho Santa Margarita and surrounding cities.

Looking Beautiful on a Budget – Wrinkle Repairs

Q: I am in my early 50′s and I’m starting to see wrinkles. Many of my friends have gotten facelifts and Botox® injections but I’m terrified of needles and knives! Are there any over the counter products that will tighten my skin?

A: Great question! You will know when you are saggy enough to warrant surgery, but in the meantime, there are many non-surgical treatments that can improve the quality of your skin.

Most of us do not appreciate fine facial wrinkles, hyperpigmentation and tactile roughness. Now you can have smoother, less pigmented skin with the newest FDA approved Tretinoin cream, Refissa®. It is emollient based and does not dry out your skin. This product has become the gold standard medical treatment for photo-damaged skin. It works by stimulating cell turn over and causing the sun damaged outer layers to slough off. Refissa® is the first important step to healthier skin. Always remember sun protection year round!

The next step, now that your skin is healthier, may be one of the many peels offered. There are many peels to choose from. For the purposes of this article we will focus on the Microlaser peel. Microlaser peel, the “week-end” skin peel, treats skin conditions more aggressively than the Refissa® is capable of doing. The Microlaser peel is performed with Sciton’s Erbium laser which uses a computer guided scanner to ensure maximum precision treatment uniformly. You will see improvements in just a few days

What exactly does the Microlaser peel treat?

It is a minimal to full epidermis laser peel that precisely removes the outer most layers of the skin. The procedure is individually tailored to the nature of the problem to be corrected: wrinkles, scars, keratoses, pigmentation problems, overall sun damage.

How often does a Microlaser peel need to be done?

As mentioned above, year round sun protection is a key to healthy skin. The results of any treatment, not just the Microlaser peel, will last longer and be more efficacious if you avoid future sun damage. One Microlaser peel procedure will usually be sufficient for a few months but subsequent treatments may be required. As mentioned earlier treatments are customized to each person. During your consultation we can determine what will be best for you.

What can I expect from the treatment?

Smoother, healthier, more vibrant skin. A blended complexion with a lessening of fine lines.

Is the treatment painful?

When you go into the office, a topical triple anesthetic cream will be applied. This application will make the procedure quite tolerable. Afterwards you can have a surface Oxygen treatment.

What is my aftercare? Do I need to wear any bandages or dressings?

No. Microlaser peel is not like a CO2 laser and requires nothing more than a protective ointment like Aquafor or vaseline. This is used as a barrier while you grow new epithelium(baby cells, new skin). You may also go back to your plastic surgeon’s office for oxygen treatments over the next few days.

As you can see, there are options to a scalpel and needle when making your skin look better! Make sure you discuss your concerns with your plastic surgeon prior to any procedure.

Dr. Bunkis MD, FACS of Orange County Plastic Surgery is a Harvard trained, Board Certified Plastic Surgeon and has 30 yrs of surgical expertise. Call Orange County Plastic Surgery at 949-888-9700, email your questions to info@ocps.com or visit our website for more information. Serving Irvine, Newport Beach, Mission Viejo, Laguna Beach, Rancho Santa Margarita and surrounding cities.

Plastic Surgery After Weight Loss Surgery

Those who have had weight loss surgery will find a significant difference in their energy levels as well as how they look. However, there are often times where the drastic change in weight leaves behind extra skin that was used to support the extra weight. If this is the case, then having plastic surgery can help you in going back to a normal body shape after the weight has been lost.

Weight loss surgery can allow you to loose an average of two pounds every week. This change can move you from belonging to the category of morbid obesity to being on target weight and being healthy. However the extra weight will often times stretch the skin on your body. Because of this, you may have found that you have lost the weight, but not the extra skin that was used for your body. The problem with this extra skin is that it won’t disappear with diet and exercise. This can then cause problems with looks, finding the right type of clothing and hygiene problems.

There are several types of plastic surgery procedures that you can consider having. The first is known as abdominoplasty, or a tummy tuck. This will not only remove the extra skin from this area, but will also tighten muscles that are near your abdomen. This is done by an incision being made in the abdomen. The extra skin will be removed from the incision, and then stitched back together. This is one of the more popular surgeries as most of the skin is found to stay around this area.

If the extra skin is in other areas, you can also use plastic surgery. Arms and thighs are common places to have extra skin that may need to be removed. You can also consider a face lift to remove the extra skin. Often times, not having this surgery will cause you to look older than you really are. Plastic surgery for your face can be divided to having an eye, brow or complete face lift. There are also options for having a complete lower body lift if you have several places with excess skin.

If you are considering plastic surgery to remove excess skin from your weight loss surgery and new figure, it is best to give your body some time to not only loose the weight but be ready for the surgery. The surgeries will cause your body to be stressed from the incisions and performance. Because of this, it is best to give some time before deciding to perform the surgery.
Plastic surgery is one possible step that may be implemented after you have received weight loss surgery. If you have found that you have lost a large amount of weight but the rest of your body isn’t making the right changes, then plastic surgery can help. Before looking into this, make sure that you are healthy and at your target weight. From here, you can decide the areas to get the excess skin removed; giving you a cleaner and healthier look.