Jacksonville Tumescent Liposuction doctors

Hi there-

As I find myself saying on this site and others all too often, it is very important that you maintain focus on the context of these decisions and constantly remind yourself of the goals you had when you set out on your plastic surgery journey....

When the idea of improving your body contour first sparked in your mind, you immediately had an impression of what you wanted your experience to be like and your outcome to approximate- you want to be safe, and you want to look your very best. 

If we can agree on this point, what I am going to say now will be easy for you to understand.

Is it possible to perform even larger amounts of liposuction under local with a bit of sedation? YES. 

Would I let my wife, sister, or mother do it this way? Unless it was a tiny area (like under the chin), ABSOLUTELY NOT.

Why?-

1. Larger volumes of local anesthetic (like those required to numb larger areas like an abdomen or thighs) will approach TOXIC levels. The fact is that the vast majority of women who have died during or after liposuction over the past ten years died because they received too much local anesthetic.
2. In an attempt to limit the amount of local given during the procedure, the doctors who prefer to do it this way (more on them later) offer to treat one area per day, having the patient return for multiple treatments. Aside from the inconvenience of this, treating area 2 while having to see through the swelling that has formed in area 1 will compromise your doctor's ability to deliver the best outcome...
3. There is no way to give you enough sedation or local that you are pain free. In other words, it's still going to hurt. And when it does, especially if you are sedated, guess what happens? I can no longer do my best for you- because you are moving, because you are expressing pain, and because the knowledge that I am hurting you causes stress and keeps me from concentrating on doing what you paid me to do- my best work. So what ends up happening is that you have a negative, painful experience, and then don't even look as good as you hoped because I couldn't do my best work for you.
4. For all of these reasons, you should stay away from doctors who are ONLY able to offer you the procedure under local. The majority of doctors who tell you that local is the way to go do so because it is quite simply the only option they can offer you. Why? Because they are not surgeons and therefore do not have privileges to do the operation under anesthesia at a hospital or accredited surgery center. The best way to weed these people out is to simply ask them- if I wanted to do it under general, could you do it? Where would it be done? What if you've given me all the local you can safely and I'm still in a lot of pain?

Again- to summarize, if your goals are to be safe, and to have the very best outcome possible, you are much better off dealing with a little hangover from the more safe general anesthetic so that your Board Certified Plastic Surgeon can do his best work for you.

Remember- Board Certified Plastic Surgeons have the credentials and ability to do liposuction under any kind of anesthesia known to man- there is a reason that the vast majority of us still think it's in our patient's best interests to do all but the smallest of areas under more than local with oral sedation.

Hi there-

I could not possibly agree more than I do with Dr. Aldea...

Tumescent liposuction... VASER lipo..... SmartLipo.....Cool lipo... pro lipo....Slim lipo... Body Jet lipo.... ?????

What does this all mean? If I don't get Smart lipo does that mean I'm dumb? If my surgeon recommends Slim lipo does that mean he/she isn't a "Pro"? It truly is a ridiculous situation we have come to with regard to liposuction and the number of people trying to cash in on America's desire to be rid of its collective fat.

In well motivated patients, body contour improvement can be a very healthy endeavor, but how is an otherwise intelligent and well-adjusted person to know the difference between a responsible provider of aesthetic services offering them safe options for help with their body contour and a poorly trained and inexperienced provider more interested in their wallet than in their outcome and safety?

It is first important to realize that all of these devices will require you to undergo a liposuction procedure. The only difference is the approach to the treatment of the fat prior to its removal.

Because they all involve liposuction, and this is in fact a surgical procedure, it is very important that you "do your homework" and find a surgeon certified by The American Board of Plastic Surgery who has the years of training in liposuction necessary to give you the safe experience and superior outcome you deserve and desire.

Behind the amazing number of machines now available to remove your fat, there has followed an army of their sales representatives and an equally impressive number of providers marketing themselves as "liposuction experts".

What has made them "liposuction experts"? In almost all cases, a few days or weekends training with the salesman for the device or with someone more experienced in the procedure. It is their promise that if you have the device in their possession brought to bear on your behalf, your fat will be gone, your skin will miraculously shrink away, you won't need any anesthesia because the device allows painless removal of the fat, and it can be done on your lunch hour. The only thing I am surprised by at this point is that they don't promise you'll get rich and be more sexually alluring after the procedure too.

Selling the particular device to patients is not unlike someone saying to you that because they will give you access to Tony Stewart's racing car that you will be able to win this weekend's race and make a million dollars. Tony Stewart wins races because he is a great racing car driver AND he has a great car....This is no different...

Getting the best outcome from a body contouring procedure depends most on finding a well-qualified and experienced surgeon, and much less on the device used.

Most of these people are so aggressive in their marketing of these questionable devices because they are, in fact, not trained plastic surgeons but rather are either not physicians at all, or they are doctors with core training which would not have prepared them to do liposuction. Many have read recently about a death in my home state of Florida after a healthy 40ish year old mother had liposuction performed be a rehabilitation medicine doctor. Amazingly, I know of eye doctors (!!) doing liposuction as well- and yes, they market themselves as "liposuction experts".

The particular device used can affect the overall experience, however.

Despite the claims of the manufacturer and the practitioners who plunked down the large sum the device costs, Smartlipo has never been proven to shrink skin better than tumescent liposuction. SmartLipo, SlimLipo, Prolipo, and Coolipo all use a laser to destroy the fat cells, allowing them to be removed by liposuction. My problem with these is that, first of all, as a scientist and doctor I am offended when false claims of benefit are made, and that because the lasers will burn whatever you point them at, I worry that your nerves, blood vessels, muscles, and skin may be injured by the laser. In fact, I see at least one patient every month with severe contour deformities and injuries after being treated with one of these devices by a local "liposuction expert".

Bottom line (and in my opinion)- there is no benefit to these devices, they are expensive (meaning that the cost to you, the patient, will be higher as well), and the risks are higher.

Tumescent liposuction is the gold standard to which all other techniques must be compared. It has been proven to be safe and effective over many years (provided that it is performed by a well-trained surgeon). It involves the injection of a fluid into the fatty tissue layer that causes blood vessels to shrink and the fat to expand, making it easier to remove and lowering the risk of a complication.

VASER lipo involves an additional step, in which the fat (after injection of fluid but before suction is applied) is treated with ultrasound energy. Unlike the laser filaments used in SmartLipo and the other devices mentioned above, the VASER probe is blunt and the ultrasound energy it uses is much more specific for fat, so that the risk of injury to the blood vessels and nerves, as well as the muscles and skin are much lower. This is seen in the patient experience of reduced swelling and bruising.

Each time a new (revolutionary!) liposuction machine comes out, I think the most important questions to ask are not "Does it work?", but rather, "Does it work better than what is already available, is it less expensive (not more), and is it safer than what is already available?"

The VASER (in my opinion) passes this test, while the laser based devices do not.

Having said all of that, I would emphasize that it is the education, training, experience, and skill of the surgeon at the end of the liposuction device that will make the greatest difference in your outcome and safety. There is not substitute for the years of training Board Certified Plastic Surgeons receive in liposuction, directly supervised by other Board Certified Plastic Surgeons. A well trained and Board Certified Plastic Surgeon would be more than capable of achieving a better outcome through tumescent liposuction than any eye doctor with a Water Jet. As in the analogy of Tony Stewart above- a great professional with a great tool (like the VASER) would only make those results and their safety even greater.

Please know that I have no financial relationship with any of these companies and have personally tried each of the discussed technologies myself on patients.