So why bring this up now? Well, in Massachusetts, we have about eight to ten weeks of summer, and by mid-June, whatever is going to be exposed will be exposed. If you’ve fretted about your flanks and thought you should have your love handles handled, you really want to do it as soon as possible, otherwise, you’ll spend another summer in a muumuu.
First off, a couple of basic facts about liposuction. Number one: Liposuction is not a method of weight loss. Contrary to popular belief, you cannot lose a lot of weight through liposuction. It is a contouring procedure, which is useful to correct problem areas in individuals who are otherwise within range of their ideal weight. For example, I have treated several men who are proud of the marathons they’ve run, but despite an active lifestyle and good diet, they are still troubled by fat in the flanks—“love handles.” Most of these patients will tell me that they’ve had the problem for years, even since their teens, and nothing they do gets rid of the fat. That is also true for men with extra chest fat, or gynecomastia. I will do an entire column about that in the future, but for now, just realize that it’s not always laziness or poor diet that leads to these problem areas of fat accumulation. Liposuction is, to my knowledge, the only effective means of “spot reduction” for these patients. As for the amount of weight they actually lose—it may be a couple of pounds. But the point is it’s the very pounds of fat that diet just won’t eliminate.
Number two: Liposuction works. For the right patients and the right problem, that is. I can’t tell you how many times people ask me if liposuction works. The answer is yes—it removes the fat cells that are resistant to fat loss, and those cells never come back. Nonetheless, an individual can still put on weight, in which case the remaining fat cells store additional fat, making the cells bigger. In fact, that’s how fat works—the cells get bigger with weight gain and smaller with weight loss. You don’t make more fat cells after puberty unless you experience massive weight gain—over 150% of your ideal body weight. For most patients, treating the problem areas and maintenance of a good diet and exercise program will provide long lasting results. If weight gain does occur, in most cases, it will be more generalized throughout the body. In some cases, however, there may be a secondary spot that is favored for weight gain, in which case that area will get bigger. I have had the occasional woman who underwent thigh liposuction, following which she had a little “auto-breast-augmentation” with mild weight gain. That’s not necessarily a bad thing, of course, but one can’t predict where that secondary spot might be located.
So what’s the rush? Although many advertisements would like you to think that you can have your liposuction procedure during your lunch hour and be dancing by the weekend, liposuction is real surgery with risks and a need for recovery that should not be taken lightly. One must wear compressive garments after the procedure for at least a month in most cases. Pain medication is usually required except for the most minor procedures. Some limitation of activity is necessary for a period of time afterwards. And sometimes the results aren’t perfect, and revision surgery is required. So if your hoping to hang out at Herring Cove in your thong this summer, you need to have your surgery before the middle of May, so that you’re out of your compression wear and so that most of the swelling and any bruising has resolved by mid-June. Even that’s cutting it close, but if everything goes perfectly, you’ll be all set.
What about SmartLipo, SlimLipo, VASER, and all of the other slick, “less invasive” options to blast your fat cells away? There is a reasonable amount of controversy over the benefits of technology in liposuction, and the jury is still out on how helpful some of these techniques are. What is generally accepted, however, is that the training and experience of the operator is critical, and simply having access to one of these machines does not guarantee success. Rather, it is more important to find a surgeon certified by the American Board of Plastic Surgery (visit www.plasticsurgery.org) with experience in doing liposuction than it is to find someone who has a SmartLipo machine in his or her office. The technology may be especially useful in a limited number of circumstances, but for most patients, a well-executed procedure using conventional liposuction will provide a good result.
So, in a nutshell, if you’re considering liposuction, find a surgeon who does a lot of it. The best option, I think, is word of mouth. Talk to friends and find someone that you can trust. Websites are helpful and on-line forums can also be useful, but a generous advertising budget that gets someone’s rankings up in a google search doesn’t guarantee that the person is right for the job. If possible, get more than one opinion on what you’re looking for. When you meet the surgeon, be honest and direct, and if you have questions, make sure they’re answered. Be sure to understand how the procedure works, what sort of recovery you can expect, including restrictions, garments, travel and work limitations, and what sort of outcome to anticipate. Are your goals realistic? Ask about pricing and payments, and be sure to find out about revision policies and associated fees. Once you find your surgeon, you’re on your way!