It is normal to have a specific set of wants and desires when considering plastic surgery. Not being able to find a surgeon to meet those goals can be frustrating. It’s your body; you want it to look perfect. Dr. Kao had one such patient named Alexandra who was fed up with surgeons telling her that it was impossible to achieve the breast lift she wanted without extensive scarring. Instead of doing a traditional anchor breast lift and approaching her breast lift from the typical angle, she pushed Dr. Kao to think outside of the box and develop a unique breast lift technique that he named after her—the Alexandra Breast Lift—(mentioned in a previous blog) to provide this patient and others like her with the beautiful breast appearance they want.
Some people believe that they will no longer have to exercise and maintain a proper diet after liposuction. Unfortunately, this is not the case. While liposuction is an excellent way to reduce excess body fat in specific areas, the removal of fat cells is by no means a guarantee against future weight gain. The cells that are removed during liposuction will not regenerate. However, patients may find that if they do not make alterations to their exercise and diet routines after liposuction, they are more apt to gain weight in areas of their bodies that were not previously problematic.
Liposuction can also be used as a form of breast reduction in men, but several important factors must be considered first. The surgeon must determine whether the excess tissue in the breast is fatty or glandular. If the breast is primarily fatty tissue, then liposuction is an excellent method for reducing the size and improving the appearance of the chest.
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A breast lift involves both repositioning the nipple areola complex higher on the chest wall and reshaping the breast. Unfortunately, there are no completely scarless breast lifts. There are 4 main types of breast lifts performed depending on the amount of sagging, excess skin, surgeon preference, and patient preference. Each one has a slightly different scar pattern. The ones with the least amount of scarring also tend to be the least effective in terms of lifting and coning the breasts into a more perky shape.
Cost is incredibly variable. It depends on the city and the provider. If you go to a plastic surgeon in New York City, it costs a lot more than seeing a non-plastic surgeon in a rural area. There are plenty of non-plastic surgeons offering discount liposuction. But, this can be somewhat risky due to their limited training backgrounds. And bad liposuction is very difficult to fix - I perform a lot of revision liposuction trying to fix poorly performed liposuction.
Facial liposuction is most often performed with a micro-cannula using a tumescent technique. In some cases, liposuction of the chin, neck, and jowls, as well as other facial liposuction procedures, can have better results in these problem areas than other surgical techniques. Liposuction can also be more desirable because it minimizes scarring when compared to other type of facial enhancement. This treatment is usually performed on or below the chin and jaw line to reduce the appearance of sagging skin in the neck, a double-chin, or hanging jowls.
Certain health conditions may prevent patients from being suitable liposuction candidates. People with chronic ailments such as diabetes and high blood pressure are more likely to achieve less-than-desirable aesthetic results. Individuals who have compromised immune systems and those who suffer from diabetes, poor blood circulation, heart disease, or lung disease should not undergo liposuction, as they could suffer serious health complications. If patients have recently had another surgery in the area they would like to treat, they should wait until the area has healed before considering liposuction.
When skin is damaged, the body repairs it by creating new collagen fibers, which gives the healing area a different look and texture: a scar. The “mended” skin will be less flexible than the skin around it, and it may have no hair follicles. The scarred skin might be a different color than surrounding skin and the color will change as healing progresses. This is completely natural.
However, minimizing the appearance of scars on the breast will be of vital importance to your surgeon. The whole point of a breast lift procedure is to make the breast more attractive, and conspicuous or heavy scarring defeats that point. Most scars will typically heal and fade within two years, but will always be present. Your surgeon will consider it a part of their job to keep these scars discrete, not a bonus. They may also prescribe cortisone cream and use silicone sheeting to help reduce the appearance of scars after surgery.
Before exercising after liposuction, patients should consult their surgeons for specific, individual guidelines for liposuction recovery. Most plastic surgeons encourage patients to begin a gentle walking routine within three to four days of their liposuction. Mild exercise protects against the formation of blood clots in the legs and other post-surgical complications.
For tumescent liposuction, the most common technique, your doctor will make one or more small (one-quarter inch or less) incisions in the area to be treated and inject a large quantity of a mixture of saline (salt water), local anesthesia, and epinephrine into your tissue. The fluid causes the fat to become swollen, firm, and easier to remove. (It also constricts your blood vessels, which reduces bruising, blood loss, and recovery time.) The surgeon then inserts the cannula through the same incision and passes it back and forth under the skin to break up the fat before suctioning it out. For a very small area, the procedure takes around 30 minutes, while a 360 liposuction—which includes the abdomen, flanks, back, and all around the torso—lasts three to four hours.
While there is no upper age limit for patients who want to have liposuction, there are risks associated with any type of surgery. Therefore, patients should be in basically good health in order to safely undergo the procedure. Patients who suffer from serious medical conditions or who take certain medications may not be good candidates for liposuction. Consult with your primary care physician and plastic surgeon to find out whether you are an appropriate candidate for this procedure. Because liposuction removes fat but does not tighten skin, patients with good skin elasticity tend to experience the most aesthetically pleasing results. Older patients typically have less supple skin than younger patients.
Unfortunately, there aren't any scarless breast lifts. You need to understand that there will always be a trade off - you will have scars but you will have the breast shape you desire. You cannot get one without the other. Anchor scars tend to be more unsightly, but may yield the best results for some patients. Other patients may get great results with a vertical lift, leaving a thin vertical scar that tends to heal very well.
Dr. Kao believes that the best results are achieved when the correct procedure is performed on the right patient. The Alexandra Breast Lift can be performed with or without implants and can provide beautiful results on specific patients. However, if you aren’t the right patient for this technique, Dr. Kao will evaluate your needs and develop a treatment plan that works for you. Stay tuned for our next blog on breast lift candidates and the consultation process.
Trying to eliminate pockets of excess fat that accumulate on the abdomen, flanks, thighs, and other areas of the body can be a frustrating process. Often, diet and exercise on their own are just not sufficient to the task. In such cases, many people who want to achieve more aesthetically pleasing body contours turn to liposuction, which has been one of the most popular plastic surgery techniques for more than three decades now. This safe, proven procedure has allowed millions of patients to improve their figures through the precise targeting and removal of isolated deposits of fat. Often combined with other plastic surgery procedures such as abdominoplasty ("tummy tuck" surgery) and breast augmentation, liposuction is a potentially ideal solution for anyone looking to refine and rejuvenate their contours.
Doctors disagree on the issues of scarring with not suturing versus resolution of the swelling allowed by leaving the wounds open to drain fluid. Since the incisions are small, and the amount of fluid that must drain out is large, some surgeons opt to leave the incisions open, while others suture them only partially, leaving space for the fluid to drain out.
Your comfort with the scars are a very personal aspect of the surgery, but to the extent you are able, I urge you to keep in perspective the lesser importance of the incision pattern. I advise patients never to compromise contour for a lesser scar. I’d argue that it is more important to choose a highly experienced board-certified plastic surgeon who is a specialist in cosmetic surgery of the breast and body. Good luck with your surgical journey!