Longview Liposuction doctors

Tummy tuck surgery involves 2 main components:

1. Excising the excess skin typically from the level of the umbilicus to the suprapubic region (often in an elliptical fashion)
2. Tightening of the abdominal wall fascia from xiphoid to the suprapubic region.

Consider the typical case of a woman after several pregnancies. During pregnancy, to accommodate the baby, the skin, as well as the underlying fascial structure (often mislabeled as muscle), stretches. Unfortunately, after delivery, not all of the skin retracts to the pre-pregnancy state, and neither does the underlying fascia. Obviously, there are various degrees of postpartem residual changes. A similar situation may arise from significant weight loss as well.

In the cases above, a tummy tuck surgery would address both components involved - i.e. excess skin and loose/lax underlying fascia.

In contrast, liposuction involves removal of fat underneath the skin. It does not address the skin nor the underlying fascia. In fact, at times, liposuction may cause the skin to become more loose, as fat is removed (which essentially acted to support/fill the skin). So it comes down to identifying which of the 3 components are in need of correction:

If it's skin or the muscle - tummy tuck surgery. If it's mainly fat - liposuction. If it's both - then it depends on your priority: which bothers you more? The loose skin of the lower abdomen or the fat?

Although it is tempting to say both and request both tummy tuck surgery AND liposuction at the same time, this would compromise the blood supply to the remaining skin and increases the risk of complications (ask your surgeon about this). Contouring of the flanks and hip regions is possible, but significant liposuctioning of the central abdomen in conjunction with a full tummy tuck surgery is often not recommended.

As a last possibility, one could consider a mini-tummy tuck (involving excising only part of the excess skin - thereby leaving you with some residual skin excess) with liposuction. Because a "mini" tummy tuck is being performed, a more aggressive liposuction can be done without compromising the blood supply to the abdominal skin. All in all, the right choice depends on identifying the components (skin, fascia, fat), your priority (what bothers you the most), and your understanding of the various options and their limitations (as well as potential complications/risks).

Of course, any of the surgical options would require you to be in a good physiologic condition and with minimal risk factors (e.g. smoking - which significantly increases the risk of complications - to a point where many surgeons would not perform tummy tuck surgeries if smoking cannot be stopped perioperatively).

Simplified view of liposuction will be presented. Liposuction (and all of the "million" variations of it) involves fat removal using thin cannulas attached to a suction power device. This part is virtually the same for all units available. The part that is different is the means by which the fat is "broken" down PRIOR TO THE ASPIRATION (removal of fat).

• Traditional liposuction units use cannulas with holes, with which the surgeon mechanically breaks the fat and aspirates at the same time by moving the cannula back and forth.
• Power-assisted liposuction units use an external power source, which causes movement of the cannula itself, in addition to the movement back and forth by the surgeon.
• Ultrasonic liposuction units deliver ultrasonic energy to break down the fat. Depending on the unit, fat is aspirated concurrently or separately (but during the same surgery) using a suction cannula. VASER is an example of an ultrasonic unit.
• SmartLipo (laser) unit uses light energy (i.e. laser) to break down the fat PRIOR TO THE ASPIRATION. At times, if a small area is addressed, fat aspiration may not be performed, as the body over time will absorb the broken down fat.

So what really is the difference between the various units if they all end up with ASPIRATION AS THEIR FINAL STEP? Basically, the energy source required to break down the fat:

• Mechanical (Surgeon)
• Power Assisted (electrical/gas power + Surgeon)
• Ultrasound
• Light (Laser)

The purported benefits of the latter two are they result in less trauma to the tissues, implying less recovery, less swelling, etc. Furthermore, because energy is also delivered to the undersurface of the skin as it is being delivered to the subcutaneous fat, some skin tightening can be seen. This is more true of SmartLipo (laser) unit.

Several caveats:

1. Obviously, the overall recovery time is very dependent on the magnitude of liposuction performed - irrespective of the unit used. Small volume liposuction requires less recovery than larger volume liposuction.
2. Even with the latest technological advancement, the the outcome is largely dependent on the operator (i.e. the surgeon) and the candidacy of the patient (determined by the surgeon).
3. Excellent results can be seen with ALL UNITS, likewise, less than ideal outcomes can be seen with all units, as the unit is only as good as the operator using it. Some inherent advantages of VASER, SmartLipo units can be potentiated in selected patients IF THE RIGHT PATIENT IS SELECTED.
4. Surgery is surgery. All surgeries have inherent risks and potential complications. Please do not trivialize any surgical procedure, despite what you read and hear. Consult your local professional about the various options, benefits, potential complications and limitations and be fully informed prior to any procedure.