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Beauty Tech Review: Body Contouring - Liposuction


While several methods and devices are now available to give your body the shape you've always wanted, many physicians still prefer traditional liposuction as their body sculptor of choice.

Liposuction was developed over the course of many years as an effective method of reducing spotty fat deposits that patients were unable to do away with on their own. Over the years, new methods and technologies have been developed that have made liposuction an increasingly safe and effective treatment for body contouring. Even with all of the new laser assisted or ultrasound assisted lipo treatments available now, many physicians rely on traditional liposuction as their method of choice for lipolysis.

"The bottom line is, traditional liposuction works, it works well, and it works well on the majority of patients," says Dr. Mark Schusterman, board certified cosmetic surgeon of Museum District Aesthetic Plastic Surgery in Houston, TX. "The important thing for people to understand is that liposuction is not a weight loss procedure, it's a shape changing procedure. So if you have some issues with the shape of your body, liposuction can often help. And that means that a lot of patients come in that aren't really that overweight, in fact some of them are very much at their optimal weight but they just have these problem areas that they have trouble getting rid of and liposuction can help with those areas. It can improve the shape of your body."

The basic concept behind how liposuction works is pretty simple, a physician uses suction to take out fat from where a patient doesn't want it. Though the concept is simple, it's application isn't. The fat is not liquid in the body so it doesn't just suction out easily, it must be treated first. Dr. Schusterman describes, "[A]ll liposuction requires energy to remove the fat. Somehow you've got to apply energy into the fat tissues, break it up, and get it out. We use a combination of suction, and physical energy -just the rapidly moving in and out of these cannulas... to remove the fat in traditional liposuction. The other modalities aid in that, or basically change the way we do it."
Dr. Mark Schusterman Liposuction Results Before and After
Actual Results of Dr. Mark Schusterman, The Museum District Aesthetic Plastic Surgery

Dr. Schusterman says that one of the benefits of traditional liposuction is the ability to treat a wide variety of patients. "A lot of my patients are moms, a lot of my patients are co-eds and soccer moms. A co-ed might be getting married or going to a big event and just has these problem areas that they want to get rid of. They're active, they're working out, they're on a good diet. Same thing with the moms, so many of them have problem areas after pregnancy, and come in and want not just the liposuction but a breast lift and a tummy tuck and those kinds of things, and doing this altogether in one procedure is very attractive to them, so they're the typical patients that want this."

He says that though liposuction can help kick off a weight loss program, it shouldn't be used as a method of losing weight. "If a patient is overweight, they can have some liposuction, but they shouldn't use the liposuction as a mechanism of losing weight. A lot of patients will come in and have a little bit of liposuction and maybe a tummy tuck and maybe a breast reduction, and that helps them get back into a more active lifestyle, so it kinda jumpstarts their healthy lifestyle. But I think we have to be careful as plastic surgeons not to oversell this because it is not a substitute for a healthy lifestyle, and I want to make that very clear to potential patients and the public out there."

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"A lot of patients ask if it's permanent, and yes, it is permanent. Once those fat cells get removed, they're removed forever," says Dr. Schusterman. "The next question is, will I get fat in other areas? Because they read that that's what happens. Well, there's two answers for that.... First of all, if you have liposuction, that doesn't give you a free pass to eat anything you want, you still have to watch your diet and continue to exercise. You can get fat. And the second comment is that, your shape will always be different. Your shape will always be what's created with the liposuction. But you can still get fat ? you'll just have that different shape. So it'll feel like the fat is going to other areas, but that's not what's happening, we're not removing every fat cell from those areas, we're just removing enough to get the shape that we want. But you can still get overweight, you can still get fat. This is just an adjunct to diet and exercise. And once you've gotten into a good diet and exercise program, and you're still having those problem areas, liposuction can help."

One critical development in the evolution of liposuction has been the tumescent technique. In this method, the physician pumps in a solution of saline, lidocaine and adrenaline into the treatment area. This mixture provides numbing and also causes blood vessel constriction so that damage to those tissues is greatly reduced. According to Dr. Schusterman, "[tumescent] is the standard of care now. A lot of patients come in and they have their list of questions and they say 'do you do the tumescent technique?' If you're going to somebody that doesn't do the tumescent technique, you shouldn't be going to them, because that pretty much is the standard of care at this point. When we say tumescent technique, that's actually broken down into different levels of injection, I think the original tumescent technique injects 3 times as much fluid as is removed, most plastic surgeons are doing a one to one. The fluid does a lot of different things, it not only helps in terms of the adrenaline causing less bruising and bleeding, but it also just seems to help break the fat up and get it out. Because of the way it expands everything, it just makes it easy to do the liposuction."

Dr. Schusterman says that the surgery typically takes about 2-3 hours, depending on how much is being treated and liposuction costs about $3000-$5000 per area. After surgery, patients wear compression garments to help them heal properly. "We provide [the patient] with a compression garment that they need to wear - I'd say religiously - for about a week, and then as much as humanly possible for two weeks after that. After three weeks they don't have to wear it but most of them continue to because it feels more comfortable. Basically I tell them no significant exercise or activity for a week. Most of them won't exercise for a month because they're just too sore but they can get back to their regular non-exercise activities after 2 or 3 days."
dr. mark schusterman
Dr. Mark Schusterman
After nine years of practice at the University of Texas M.D. Anderson Cancer Center, Dr. Schusterman's finely honed skills in microsurgery are now available for the aesthetic surgery patient as well. In recent years, Dr. Schusterman has expanded his interests in plastic surgery with a focus on patient education and an array of special amenities for clients interested in aesthetic enhancements.

Dr. Schusterman was a Professor and Chairman of Plastic Surgery at The University of Texas M.D. Anderson Cancer Center and held the prestigious Charles M. McBride Professorship in Surgical Oncology. After leaving M.D. Anderson Cancer Center, he joined Baylor College of Medicine as a clinical professor in the division of Plastic Surgery.

American Health and Beauty Beauty Tech Review Body Contouring
American Health and Beauty, in an effort to provide the most up-to-date information to our readers, presents the Beauty Tech Review. The next installment in this ongoing series discusses Body Contouring technology. Join American Health and Beauty editor, Keith Veseleny, as he speaks with leading physicians who share their knowledge on each body contouring platform.

The Beauty Tech Review: Body Contouring - will include: Dr. Mark Schusterman on Traditional Liposuction, Dr. Thomas Barnes on Laser Lipolysis, Dr. Jeffrey Hall and Dr. Victoria Falcone on Tickle Lipo, Dr. David Broadway on Ultrasonic Assisted Liposuction, Dr. Todd Malan on {!Water Assisted Liposuction | Body-Jet}, Drs. Rox Anderson, Henry Chan and Lori Brightman on CoolSculpting, Dr. Elizabeth VanderVeer on Injection Lipolysis, and Dr. Thomas Barnes and Dr. Richard D'Amico on Radio Frequency Liposuction.

Previous Beauty Tech Reviews have included the following topics: Laser Lipoloysis and Fractional Resurfacing.