Lipo, Smart Lipo and/or Breast Augmentation?

I am considering liposuction of the abdomen and hips. The dilema that I face is that I am unsure of which technique is best. I am not a fan of general anestesia so I wanted to know if anyone had smartlipo and how their results are? I am also considering breast augementation, which I know I will have to have GA for so I may opt to have both at once but is this safe? I am also conserned with the downtime. I anticipate taking 14 or 2 weeks off from work, is this realistic? Any help would be nice.

Doctor Answers (18)

Breast Augmentation and Liposuction

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It is very common to perform a breast augmentation and then to liposuction the tummy or other trouble areas in one setting.   Please talk with your PS to learn more about his/her recommended postop care plan


Houston Plastic Surgeon
4.5 out of 5 stars 128 reviews

Liposuction with Breast Augmentation

+1

At Gill Plastic Surgery, we commonly combine breast augmentation with liposuction of the abdomen and flanks.   Depending on the amount of skin excess you have, your best longterm result may require a tummy tuck.   Evaluation by a board certified plastic surgeon will give you the best treatment plan to meet your goals.     General Anesthesia is definitely recommended for this type of combination procedure.   I wish you all the best and a great result!!

Paul S. Gill, MD
Houston Plastic Surgeon
5.0 out of 5 stars 42 reviews

Breast Augmentation and Liposuction

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Great question! Here is my two cents and it may sound familiar as it looks like my colleagues agree-

Liposuction of the abdmomen/hips, (and I add flanks up near the posterior rib cage for full hour-glass effect),and breast augmentation in a healthy woman is VERY common in my practice.  As far as liposuction, I have tried many different techniques and concluded that the technique is not as important as the skill and experience of the surgeon. Laser assisted liposuction, of which there are a number of brand names, Smartlipo, relies the use of a laser close to the undersurface of the skin for "tightening". At this point, I would LOVE to say it works better than traditional liposuction (I think laser technology is fantastic and really COOL, but the science is not there yet...I am still awaiting definitive scientific studies to prove it works better...they are coming I feel, but verdict is not out yet!).  Laser assisted lipo also takes much longer to do...sometimes, if you choose to have it done awake (with local and not General anesthesia), you may need to have multiple procedures until your goals are reached.

Patients make the assumption, incorrectly, that sedation is safer than general anesthesia. Under general anesthesia, a board certified anesthesiologist will use monitors to check your heart rate, heart rhythm, blood oxygen levels, blood pressure and temperature throughout the entire procedure.  All this monitoring allows him or her to keep you just deep enough that you are asleep but still breathing on your own. This allows me to concentrate on surgery...and allows me to use less local anesthesia (lidocaine) and to be more aggressive with the contouring. Liposuction associated complications (namely DEATH are many times associated with Lidocaine toxicity or excessive amounts of local anesthesia used to keep awake patients comfortable...unfortunately, the toxic levels do not build up until 12 to 24 hours AFTER the procedure, when it is many times too late).

If you choose to have sedation (which I would NEVER recommend for a submusclular breast augmentation, my preferred technique for Breast Augmentation) make sure you have a Board Certified Anesthesiologist performing the sedation (in the event you need to be converted to full general  anesthesia).

Couple of quick rules with REAL surgery like liposuction and breast augmentation: Find a Board Certified Plastic Surgeon, who uses a Board Certified Anesthesiologist, both of whom work together in a certified operating room (either hospital based or ambulatory surgery center).

Your safety should be everyone's first concern!

I hope this helps!

Good Luck!

Dr. C

johnconnorsmd.com

John Philip Connors III, MD, FACS
Atlanta Plastic Surgeon
5.0 out of 5 stars 15 reviews

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Breast augmentation and liposuction together

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Belinda,

We often combine liposuction with breast augmentation in a very safe manner.  Be sure that your surgeon is board certified and that the facility that you have the surgery in is certified as well.  Your anesthesiologist should be board certified also to ensure your optimum safety.  The type of liposuction that you require is sometimes based on what your skin and body fat is like.  Smartlipo is generally better for patients with loose skin because it tends to help tighten the skin.  Your surgeon should be able to determine if it is needed for you.  Two weeks off from work is more than reasonable.  Good luck!

Kenneth R. Francis, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 32 reviews

Breast Augmentation and Liposuction

+1

It is certainly safe to perform liposuction at the same time as a breast augmentation when the liposuction volumes are not extreme. The technique of liposuction (smart, laser, vaser, ultrasound, etc) is less important than the experience of the individual performing the liposuction. The point of the anesthesia should be to make the experience comfortable. In small volume liposuction, the use of local anesthesia and tumescence is reasonable. However, in a setting where a moderate amount of liposuction is being performed, adequate anesthesia including replacement of fluids is essential for patient safety. When combining procedures in multiple body areas, a general anesthetic is more appropriate. Two weeks of recovery is about average for moderate liposuction combined with a breast augmentation. Keep in mind that liposuction is an invasive procedure despite whatever the marketing may tell you. It is important to know how much liposuction is planned as the risks of lidocaine for anesthesia in the tumescent fluid may outweigh the benefits of avoiding general anesthesia.

David Bogue, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 12 reviews

Liposuction and Breast Augmentation

+1

Technique is less important than results.  Shop surgeon and results, not technique.  Five years from now, it won't matter whether you had SmartLipo, DumbLipo, LaserLipo, Ultrasonic Lipo, Tumescent Lipo, or no lipo, but it will matter what your abdomen and hips look like.  Leave the technique to the surgeon, but YOU evaluate his or her results on others from pictures, and how much you trust the surgeon to accomplish your desired result.  Liposuction and breast augmentation are routinely performed together, under the same anesthetic, safety depends on where you have it done.  Every Surgeon Certified by the American Board of Plastic Surgery must operate in accredited facilities.  If you stick with an ASPS and/or ASAPS surgeon, you will be safe.  Two weeks off should be plenty, unless your work is very physically demanding.  Most of my patients are back to office work within a week after a moderate amount of liposuction and breast augmentation.

Steve Laverson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 38 reviews

Liposuction and fat injection to the breasts.

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You may want to consider the option of liposuction with injection of the fat into the breasts if you desire a modest augmentation.

The fat is aspirated from the abdomen or thighs using a syringe method or modified suction technique. The fat is typically purified and then transferred to smaller syringes where it is injected into the desired areas.

The results are difficult to predict because "fat take" (the amount of fat which survives after being transferred) can vary anywhere from 20 to 80%. The success depends on several factors. It is like trying to predict how many seeds will sprout when you plant them in the ground.

Fat must be obtained from a donor site and therefore satisfactory quantity and quality of fat must be available. The procedure requires an anesthestic and may be performed in the office or surgicenter. On average, 50% of the injected fat will be absorbed but the fat which remains is permanent. Several operative sessions may be required to achieve the desired result.

Many experts believe that the best results are obtained by external expansion of the breast skin in order to enhance the blood supply of the breast and render it more soft and supple to more easily receive the grafted fat. This is commonly achieved using a breast pump device that is worn at least 10 hours a day for up to 4 weeks prior and after each fat injection session. Although the grafting can be performed without this pump, the results are not likely to be as successful and it is considered essential to optimize the outcome.

Risks can occur regardless of surgeon or technique. These include but are not limited to: infection, hematoma, discomfort, asymmetry, undesirable effect on associated muscles, overcorrection, undercorrection, pain, prolonged swelling, dimpling, fat necrosis, fibrosis, cyst or abscess formation, nodularity, interference with nursing and aging, alteration in shape with nursing and aging, interference with surgical, oncologic, mammographic, or imaging of the breast, adverse medication reaction, allergic reaction, need for additional "touch up" injections, palpability, visibility, distortion with muscular contraction, need for secondary revisions, and inability to guarantee a specific cosmetic result
 

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 48 reviews

Liposuction and breast augmentation

+1

I always tell patients it is not the wand but the  magician with the wand that creates the magic. Liposuction is liposuction it depends upon the skill of the surgeon. You can have both donw at the same time usually and 2 weeks should be good.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 18 reviews

Liposuction

+1

Liposuction performed at the same time as breast augmentation is reasonable and common.

Smart Lipo is a form of laser assisted liposuction. The laser fiber is passed through the skin into the body and the laser beam is then passed down the fiber. Proponents claim that it breaks up fat cells, coagulates any bleeding tissue and results in more skin shrinkage than liposuction without laser. Ergo there is supposedly less bruising and swelling and so recovery times are shorter. The skin shrinkage after laser assisted liposuction may end up being only in those patients with skin laxity from the aging process. This is different from excess skin due to being overweight. More scientific investigation is required before this can be considered true.

In studies comparing standard suction-assisted lipoplasty with internal neodymium:yttrium-aluminum-garnet low level laser-assisted lipoplasty (SmartLipo) at 3 to 5 days, 12 to 15 days, and 6 to 11 months showed no difference between the 2 methods in terms of surgeon and patient satisfaction, time used in the procedures, swelling, bruising, time of recovery, body mass index, DNA proteins. Less pain, lower lipocrits, higher triglycerides, and DNA cellular membrane traces were detected in the laser-assisted lipoplasty SmartLipo sides. Some sources have mentioned a concern that the higher blood levels of free fat in SmartLipo cases may pose a health hazard but this has never been proven. The bottom line is SmartLipo benefits the manufacturer monetarily more than it benefits anyone else.

Aaron Stone, MD
Los Angeles Plastic Surgeon

You can conbine liposuction with breast augmentation

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Combining liposuction and a breast augmentation in a young healthy woman is common practice in the US.  I have tried many different liposuction techniques and concluded that the technique is not as important as the skill and experience of the surgeon performing it.  Smartlipo relies the use of a laser close to the undersurface of the skin.  I saw a young girl who had it done by another (non plastic surgery boarded surgeon) and received a full thickness burn (inside to outside) across her thigh.  Smartlipo also takes much longer to do.  The company will tell you that each area should take about 45 minutes.

Many people assume that sedation is safer than general anesthesia which is not necessarily true.  An anesthesiologist will use monitors to check your heart rate, rhythm, blood oxygen levels, blood pressure and temperature.  He will be watching all those vital signs constantly.  All this monitoring allows him or her to keep you just deep enough that you are asleep but still breathing on your own.  Even when my patients want sedation I have it given by an anesthsiologist.  I cannot concentrate fully on surgery, watch all the vital signs and direct the nurse on which drugs to administer when and how much.  If you chose to have sedation (which I would never recommend for a submusclular breast augmentation) make sure you will be fully monitored, the staff is ACLS certified and the operating room certified.  If it is an office or outpatient facility make sure to check that your surgeon has priveleges to do the procedures you are having at the hospital.  You can do this by calling the medical staff office at the hospital and asking them.  Your safety should be everyone's first concern.  Unfortunately, that is not always the case.  Ask the right questions.

Lori H. Saltz, MD
San Diego Plastic Surgeon
4.5 out of 5 stars 11 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.