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Liposuction & Fat Grafting: What You Need To Know

Dr. Barry Lycka MD - March 14, 2016

Liposuction has changed dramatically over the last 20 years. It used to be a – frankly – dangerous procedure that was done whilst you were asleep under general anaesthetic.

Now it has developed into a procedure where you are awake and you can even sit up and check out what is happening and ask to remove a bit more!

So maybe you have been wondering about getting liposuction but are worried? Or you have lots of questions going round your head?

Well if that is the case, then this week’s chat with our popular repeat guest, Dr Adam Schaffner is for you. Dr Schaffner is a triple Board Certified Plastic Surgeon with a practice in midtown Manhattan, New York.

Dr Lycka & Dr Schaffner talk about the massive changes that have happened with liposuction over the years and especially how the current ‘patient awake’ techniques are so much better. They are much safer than ever before, and both doctors encourage patient feedback during the liposuction procedure itself. They discuss important aspects of current liposuction techniques and highlight the benefits to patients and surgeons from using powered instruments to extract the fat.

The fat that is removed during liposuction used to be thrown away. Now it is viewed with delight because it can be used to enhance and augment other areas of your body. This is known as fat transfer, fat grafting or auto-augmentation. It can be put into your hands, or face, and is a great alternative to implants for buttocks and breasts.  What a perfect idea – get rid of fat from where you don’t want it and put it where you do!

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Liposuction When You Are Awake

Patients no longer have to face the risks of  general anesthesia to have liposuction.  By allowing a patient to have liposuction under local anesthesia, they can be kept very comfortable with the medications that we have available to us today. Patients are comfortable and safe, but they can also provide feedback & input so for example if the thighs are being treated, they can sit up, look at their thighs and say, hey why not take a little bit more. OR if the fat is being transferred into their breasts or hands, they can look down and ask for a bit more to be put in here or there. Both Dr Schaffner & Dr Lycka love being able to chat with their patients while doing this procedure, and it is very valuable to getting the best possible results for them. They both agree that it really helps to foster that patient/ physician relationship, and it also helps patients to feel confident about referring the doctor to their friends and family for similar types of procedures.

It Limits Blood Loss

Using local anesthetic methods also limits the amount of blood loss. Typically 2 or 3 liters of fat could be removed from a person, and there would be only a 10cc blood loss in an average procedure. That is an amazingly small amount. In the old days with liposuction three was a lot of blood and a little bit of fat removed – now it’s almost pure fat that is taken off.  Part of the reason for that change is because the numbing medicine contains adrenaline. While waiting for the numbing medication to take effect the adrenaline constricts the blood vessels which is why there is very little blood loss when it is time to remove the fat.

The Fat Can Be Re-Used

When a person’s fat is harvested carefully it can be re-used to ‘fill-in’ other areas of their body. It is already pretty pure as we discussed, and the fat cells are still viable. They are harvested and kept moist, and sterile, in a closed system, and with excellent technique, they will ‘take’ in their location and grow and give excellent results 3-12 months later.

Better Instruments – Faster Healing & Recovery

Using powered instruments helps to  decrease the fatigue and trauma to the surgeon, preventing repetitive stress injuries. And, it is also easier on the patient. More fat is removed with every stroke, so it is more efficient, with less tissue trauma, less bruising, less swelling, and less discomfort. The patient is on the operating table for less time which means better patient safety.

And when there is less trauma to the patient there is faster healing. Dr Lycka finds it totally amazing even these days that we do the procedure on a Friday and on Saturday patients are typically doing most of their regular activities. It is beyond belief for a procedure that previously was potentially life threatening, and is now something that is fairly easy. Obviously that is in qualified experienced hands, with a qualified and experienced doctor doing it but it has really paid off for our patients!

Choose Your Surgeon Wisely!

It is important that the physician is qualified and experienced in performing liposuction under local anesthesia. It is not the same technique as liposuction under general anesthesia. The doctor you choose should have done hundreds of procedures, done this way and they should be an expert, an advocate for this. They should be Board Certified, with good before and after photos, and you should be able to speak to their patients who have already had the procedure. Have they been happy?

Breast Surgery Using Fat Grafting

The newest thing in breast surgery is fat grafting. It is also known as fat transfer, auto-augmentation, and natural breast augmentation. Previously we had to use implants to enhance the size of the breast but now we can use your own fat. Sometimes we will use both an implant and fat. Multiple studies have been performed and the large plastic surgery societies, breast societies, radiology societies have all concluded that it is safe to transplant fat into human breasts. It is one of the most common ways to reconstruct the breasts of breast cancer patients and it also helps to reverse the signs of radiation therapy.

It Has To Be Done Properly

Fat Grafting to the breast gives high rates of patient satisfaction but it does have to be performed properly. It is very technique dependent. The fat has to be put into the right layers in the breast, in the correct way, in small amounts. Too much fat in one place will die and there will be lumps and bumps. Done properly, it gives a very nice soft breast that feels and looks natural. and patients provide direct feedback whilst on the table by being able to sit up and look straight ahead at a mirror to see themselves and their new shape and size and decide whether they want to be bigger or are happy at that point.

Not All Breasts Are A Good Candidate

A good pre-operative analysis of the breast is very important. There are some breasts that are not great candidates for fat grafting. If there is a very tight ‘envelope’, constricted, or tuberous breasts then those types of breast, may be better served using an implant or possibly an implant with fat.

Fat Is A Great Alternative To Fillers

If people are having HA fillers repeated every 6,9,12 months and are happy with the results, then they should consider fat grafting instead.  One key point that people need to know is that the fat behaves as the region from which it came. This means that if it came from the belly, and it went into the face, then it will still expand or contract the way it did when it was in the belly. So make sure that you have a good diet and exercise and maintain stable weight!

Other Devices Help Too

A range of energy based devices has also made a difference. Whether it’s  using a laser, ultrasound, or radio frequency, we have the ability to help minimize tissue trauma, help with collagen formation, tighten skin, and melt fat. Not only using some of those internally for liposuction, but using them afterwards with the external devices that help with skin quality as well.

Things Have Changed – Go See What Can Now Be Done For You!

Things have changed so much that even if you have seen a cosmetic doctor before and decided not to go ahead, or what you wanted wasn’t possible – then you should go see them again. There are things that can be done now that were previously ‘science fiction’. Things that hadn’t been thought about are now pretty commonplace. Doctors are constantly learning new technologies, new techniques, and a doctor who is keeping up with the times, they should be able to offer the latest techniques and therapies.

Contact details for Dr Adam Schaffner

Dr Adam Schaffner

Telephone: New York City: (212) 688 6600    https://www.drschaffner.com

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