True Tumescent Liposuction



Abdomen | Waist | Flanks | Arms | Hips | Thighs

Liposuction of the Abdomen

The abdomen is the area most frequently treated by liposuction and is often a patient's highest priority. Performed by a skilled liposuction surgeon on a good candidate, tumescent liposuction of the abdomen can produce a smooth, natural result with excellent skin retraction. The shrinking of the skin following tumescent liposuction, known as skin retraction, has practically eliminated the need for abdominoplasty, or tummy tuck, since its invention by Dr. Jeffrey Klein in 1985.

It is important to realize that liposuction is not a cure nor an appropriate treatment for obesity. Although someone with abdominal obesity may think that liposuction could lead to a permanently flat belly, some patients have visceral fat, which is fat around the internal organs that cannot be treated by any cosmetic procedure. Therefore, not all patients are good candidates for abdominal liposuction. A consultation in person is the only way to determine whether abdominal liposuction would produce a significant difference in the size of a patient's abdomen. A consultation is also important for determining if a patient has an umbilical hernia, or an 'outy' belly button, which is a contraindication for abdominal liposuction.

An ideal candidate for liposuction has been at a normal, stable body weight for at least 2 years and is physically fit and healthy. Other people, including some who are obese, can be reasonable candidates for the procedure as long as they are not likely to increase their body weight further and as long as their expectations are in line with what liposuction can be reasonably expected to achieve.



Liposuction of the Waist

Tumescent liposuction of the waist is one of the most satisfying liposuction procedures because it has several beneficial effects on body contour. The waist, also known as the 'love handles,' first of all often causes bulges seen while wearing clothing, which some patients call a 'muffin top' appearance. This can often be eliminated with tumescent liposuction, which causes skin retraction or tightening because it is capable of removing fat that is near to the skin surface. This fat is called superficial fat, and it is superficial liposuction that causes the skin of a given area to shrink following tumescent liposuction.

Tumescent liposuction of the waist also reduces the waist size, which can make clothing fit better or lead to a reduced clothing size depending on how much fat is in the area and how disproportionate the area is to the rest of the patient's body. By slimming the waist, the female body takes on a more 'hour glass' appearance, while the male body takes on a more 'V' shape. If the area has caused bulges or 'rolls' in the body contour, this also many times is eliminated or greatly improved.

Another beautiful effect of waist liposuction on body contour is the improvement in buttocks contour. While waist liposuction does not generally involve any liposuction of the buttocks itself, the fat of the waist lies directly above the fat of the buttocks, and tends to give the buttocks a more square appearance. By removing this fat, the buttocks appears rounder and subtly fuller.

It is important to realize that liposuction is not a cure nor an appropriate treatment for obesity. Although most patients have fat in the waist area and can have a reduction in waist size, patients with abdominal obesity may experience a relative augmentation of the abdomen after aggresive waist liposuction. This is because some patients have visceral fat, which is fat around the internal organs that cannot be treated by any cosmetic procedure. A slim waist with a large abdomen is generally not considered to be an improvement in body contour. Therefore, not all patients are good candidates for waist liposuction. A consultation in person is the only way to determine whether waist liposuction would produce a beneficial change to body contour. Many patients require liposuction of the abdomen and waist for a natural, aesthetically pleasing result.

An ideal candidate for liposuction has been at a normal, stable body weight for at least 2 years and is physically fit and healthy. Other people, including some who are obese, can be reasonable candidates for the procedure as long as they are not likely to increase their body weight further and as long as their expectations are in line with what liposuction can be reasonably expected to achieve.



Liposuction of the Upper Back (Flanks)

Tumescent liposuction of the upper back or flanks, similar to liposuction of the lower back or waist, helps to restore the feminine 'hour glass' contour of the torso. Liposuction of this area both slims the area, reducing clothing size in very disproportionate cases, and reduces the appearance of rolls, which tend to appear horizontally on the back when excess fat accumulates there.

Areas associated with the upper back include two fat pads that appear around the axillary or underarm area. These are called the anterior and posterior axillary fat pads. These fat pads tend to cause contour problems especially associated with bra use. The posterior fat pad causes a roll that is pinched above the bra line in the back, and the anterior fat pad causes a small vertical roll on the front of the chest in between the arm and the cup of the bra. Though generally small, these fat pads can cause much distress, and many women find liposuction of these areas to be very satisfying cosmetically.

Another beautiful effect of waist liposuction on body contour is the improvement in buttocks contour. While waist liposuction does not generally involve any liposuction of the buttocks itself, the fat of the waist lies directly above the fat of the buttocks, and tends to give the buttocks a more square appearance. By removing this fat, the buttocks appears rounder and subtly fuller.

It is important to realize that liposuction is not a cure nor an appropriate treatment for obesity. Though effective liposuction of the upper back can reduce the size of the upper torso, obese patients will tend to notice less of a difference than patients of normal weight because of the size of the bony and muscular frame, which will of course be larger in a larger person. However, many obese patients tend to have horizontal rolls due to accumulated fat in this region, and this contour issue should significantly improve with tumescent liposuction. An evaluation in person is the best way to determine whether liposuction of this region would yield satisfactory results and whether the anterior and posterior fat pads should be treated simultaneously. Many patients combine liposuction of this area with liposuction of the upper arms, due to the proximity of the fat compartments and the presumably genetic tendency of the body to accumulate fat in both areas jointly.

An ideal candidate for liposuction has been at a normal, stable body weight for at least 2 years and is physically fit and healthy. Other people, including some who are obese, can be reasonable candidates for the procedure as long as they are not likely to increase their body weight further and as long as their expectations are in line with what liposuction can be reasonably expected to achieve.



Liposuction of the Arms

Liposuction of the arms, though technically difficult, is associated with some of the highest levels of patient satisfaction. Tumescent liposuction, through the use of fine instruments called microcannulas, can effectively remove the troublesome fat that accumulates under the upper arm while leaving a natural, aesthetically pleasing contour. Traditional liposuction and ultrasonic liposuction (Vaser) are often incapable of producing satisfactory results because they leave evidence that liposuction was performed. The arms, much like the front thighs and buttocks, are areas that should only be treated by tumescent liposuction.

Many patients find themselves in the gym, sometimes working with personal trainers, doing arm exercises to try to reduce arm fat, making the arms more lean. Unfortunately, there is no exercise that can remove localized fat. For this reason, liposuction and exercise have completely different effects on the body. Exercise can reduce a person's body fat percentage, reducing the amount of fat the person carries throughout the body. Liposuction focuses on specific problem fatty areas without affecting the rest of the body. Many patients who are lean, healthy, and of normal body weight still find themselves unsatisfied with the amount of fat they have on their arms. With tumescent liposuction, this fat can be reduced significantly, yielding slimmer arms without causing noticeably loose skin.

Although liposuction is not a cure nor an appropriate treatment for obesity, many obese people are unable to buy clothes due to arm size. In most cases, this problem can be solved with tumescent liposuction of the arms. A consultation is necessary to determine whether liposuction of this region would yield satisfactory results and whether the upper back should be treated simultaneously for optimal results. A good candidate for tumescent liposuction of the arms has been at a stable body weight for at least 2 years and is unlikely to increase in body weight in the future.



Liposuction of the Hips

Tumescent liposuction of the hips can create a smoother profile as the waist transitions to the thighs. It is commonly performed simultaneously with waist liposuction and can be combined with outer thigh liposuction as well to improve the body's silhouette from mid-waist to mid-thigh. Some patients have disproportionate hips and therefore would receive the greatest benefit from this procedure. Frequently, such patients will complain of a bulge between the waist and the thighs, which may be accentuated by underwear or bathing suits. While a relatively small area on most patients, satisfaction with this procedure can be very high as even slight bulges can cause great distress for an individual.

Many patients that have had traditional liposuction of the waist alone have noticeably disproportionate hips as a result. This can accentuate the buttocks but leave a square appearance that does not appear natural. Although the effect on the buttocks is subtle, tumescent liposuction of the hips can improve the beauty of the buttocks by helping to restore a rounder, more natural shape. Patients with more developed buttocks muscles will have a slight butterfly appearance to the buttocks contour, which is generally considered aesthetically superior. Combining liposuction of the hips and waist with fat transfer to the buttocks can accentuate such a contour even in patients that have underdeveloped buttocks muscles.

It is important to realize that liposuction is not a cure nor an appropriate treatment for obesity. Although most patients have fat in the hip area and can experience a reduction in hip size, patients with abdominal obesity may experience a relative augmentation of the abdomen after aggresive liposuction of the waist and hips. This is because some patients have visceral fat, which is fat around the internal organs that cannot be treated by any cosmetic procedure. Slim hips with a large abdomen is generally not considered to be an improvement in body contour. Therefore, not all patients are good candidates for hip liposuction. A consultation in person is the only way to determine whether hip liposuction would produce a beneficial change to body contour. Many patients require liposuction of the abdomen and waist along with the hips for a natural, aesthetically pleasing result.

An ideal candidate for liposuction has been at a normal, stable body weight for at least 2 years and is physically fit and healthy. Other people, including some who are obese, can be reasonable candidates for the procedure as long as they are not likely to increase their body weight further and as long as their expectations are in line with what liposuction can be reasonably expected to achieve.



Liposuction of the Thighs

Liposuction of the thighs can be divided into four parts: the inner thigh and knee, the outer thigh, the front thigh, and the posterior or back thigh. Tumescent liposuction, which is performed with very fine instruments called microcannulas, is particularly well suited for treating the thighs because it can provide smooth, natural results even in areas that are typically avoided by practitioners of traditional liposuction.

Many patients who opt for liposuction of the inner thighs have inner thighs that touch or rub together, which can be uncomfortable and make clothing fit poorly. It is important in most cases to treat the inner knee at the same time as the inner thigh because more fat can be removed, slimming the thigh more effectively, and because a smoother contour of the inner thigh can be achieved. Neglecting the inner knee can often lead to disproportionate inner knees after inner thigh liposuction.

Outer thigh liposuction is very effective at reducing the 'saddle bag' appearance that many patients find distressing. The most common female fat distribution pattern involves mostly the hips and thighs, which is why hip and outer thigh liposuction are so popular. Reducing the fat in these areas can effect a more sleek contour and help to reduce the pear-shaped appearance associated with the female fat distribution pattern. With the special positioning pillows that are part of the tumescent liposuction technique pioneered by Dr. Jeffrey Klein, the outer thighs as well as the inner thighs can be reduced while maintaining in a beautiful, natural manner.

The front thigh is an area that, to this day, is avoided by most liposuction surgeons because the large cannulas used in traditional liposuction can leave skin irregularities that are aesthetically unacceptable. Through the use of microcannulas, tumescent liposuction is capable of reducing the front thigh without leaving irregularities of the skin. Though some patients would benefit from liposuction of the entire thigh, it is recommended to limit liposuction of the thighs to two to three parts to prevent complications. Indeed, this dedication to safety is why tumescent liposuction has such an excellent safety record, with major complications being practically unheard of.

Patients with very disproportionate thighs will sometimes be best served by adding liposuction of the posterior or back thighs to their selection of areas to be treated. In particular, there is an area of fat just below the buttocks known as the banana-form fold. This area must be treated with caution, as excessive liposuction in this area can cause a double gluteal fold. This area usually has contributions from both the inner and outer thigh fat compartments and is typically treated simultaneously with these areas. The rest of the posterior thigh can be liposuctioned as needed to blend in with the rest of the thigh.

It is important to realize that liposuction is not a cure nor an appropriate treatment for obesity. Although most patients have thigh fat and can experience a reduction in thigh circumference with liposuction, obese patients are likely to have enlarged thigh muscles, which will mean liposuction will make less of a difference than they would like. A consultation in person is the only way to determine whether thigh liposuction would produce a beneficial change to body contour.

An ideal candidate for liposuction has been at a normal, stable body weight for at least 2 years and is physically fit and healthy. Other people, including some who are obese, can be reasonable candidates for the procedure as long as they are not likely to increase their body weight further and as long as their expectations are in line with what liposuction can be reasonably expected to achieve.




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A. Bonelli, MD
1840 Mease Dr.
Suite 401A
Safety Harbor, FL 34695
tel.: (727) 330-7748
fax: (727) 408-5206


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