Mark Edinburg, MBBCH, FRACS (retired)

Hello and thank you for your question.

Liposuction is still the gold standard for removing fat, particularly if it is not confined to a small pocket. Having said that, at my clinic in Sydney, I looked for a long time for a reputable and scientifically based non-surgical fat reduction system, so that I have a medical-grade option(there are so many 'fluff' options on the market) to offer those patients who were unwilling to go to liposuction and willing to accept the differences. And we have had great results and many happy patients.

So, in your case, I would probably suggest that you consult with a board certified Plastic Surgeon(in Australia we use the term 'Specialist Plastic Surgeon') who has experience with both. That way, you can hear about your options, and be in a better place to make decisions about your treatment, together with your surgeon.

I hope this has helped.

Mark

Hello, and thank you for your question.

Briefly, liposuction address the excess fat issue, but does nothing for the loose skin causing the sag or apron effect- that is where the tummy tuck comes in. In my many years experience as a Specialist Plastic Surgeon, I have usually add a small amount of liposuction to all tummy-tucks, as quite simply, everyone needing a tummy tuck usually has some excess fat as well. And also, even though various procedures. like liposuction alone, or non-surgical Fat-freezing(CoolSculpting) may result in a some skin tightening after the fat and resulting bulge on the skin has been removed, this is fairly small, and if you have a lot of excess skin and skin laxity, then surgery will be needed to address this. That skin sag is not going to bounce back by itself- a tummy tuck will most likely be necessary.

I must stress that, until you and your Plastic Surgeon get to meet, and he can do a thorough and detailed examination, and listen to what concerns you and what you are trying to achieve, you cannot get a realistic list of options that may or may not be appropriate for you. People are so different in their anatomy and concerns and expectations. I find once I sit down and talk with my patients and explain what the advantages and disadvantages are for different options, and specific for that particular patient, then patients feel much better equipped to make decisions.

Hello, and thank you for your question.

By now it is probably obvious to you that this is not the usual tummy tuck presentation, and you can see there is some divergence of opinion about what exactly would work for you.

Although you have sent photos, I cannot stress strongly enough how important the physical examination is. There are lots of components that will help your surgeon to arrive at an options list for you. Then the 2 of you can discuss together the advantages or disadvantages of the different options.

You want to look great, and you want to be safe, and you want to consider not doing anything that will be detrimental in for your lifestyle and in the future, like having kids.

So, I'd suggest consult with an experienced Board Certified Plastic Surgeon. I always feel establishing a good communication style with my patients is essential, so that we are both 'on the same page' when we discuss your options and what is likely to help you.

And, by the way, well done for the weight loss. Your body will love you for it.

Hope that helps.

Mark

To give you perspective, I am a Plastic Surgeon and I have a number of surgeries available to treat my patients' concerns with areas of fat. However I could not find a non-surgical option that might work for some of those patients who were not candidates, for a number of reasons, for liposuction and/or tummy tuck or other appropriate surgeries. I looked for years for a product that was available that has credible research and technology to support it. And CoolSculpting has been a very useful addition to my practice.  Pathophysiology is why only the fat cells are affected by the cold. I don't find a difference in results of fat or thin people- its more about the area you are treating(will reducing the fat benefit you is the question 

We have 2 machines (mainly so that we can treat 2 areas, or left and right at the same time). As long as the assessment is done by someone professional(I only employ registered nurses in my clinic, not non-medical personnel), and as long as the treatment is carried out by a credible practice, I think your results should be great. I recommend a Plastic surgeon in your home town. That way you are speaking to a practice that deals with, and advise on, many different aspects of cosmetic surgery from a specialist's perspective. And they can advise if this is indeed the most appropriate treatment for your situation.

I have been using CoolSculting for over 3 years in my clinic in Sydney Australia, with really outstanding results. We have no patients with long term problems. Their results have been well maintained(as long as they don't put on weight obviously). Lumpy is not a result of the reduction in the fat, but can occur due to the size and shape of the applicators leaving an area untreated. An experienced appropriately trained and skill therapist should be able to allow for this in planning.

And of course, be realistic in your expectations. Speak to your therapist about this.

And finally, beware of cheaper imitations. As with many cases, there is a often a reason they are cheaper that is not good for you and the professional outcome! It's your body.

I hope I have helped.

Mark

Hello and thanks for your question.

The story you tell, and the picture you paint, is typical of many people I see at consultation. Men and women. That saggyness you describe will require a tummy tuck(abdominoplasty). There is no other way to get rid of both the skin and underneath layers of sagging. In my practice, I tend to include a small of abdominal liposuction as a part of my surgery to target the fat sitting there.

This problem varies from patient to patient in the way it presents, how you body looks, and how it affects your lifestyle. I recommend you consult with a board-certified Plastic Surgeon (we use the term 'Specialist Plastic Surgeon' here is Australia). This gives you the opportunity to discuss your individual concerns with someone who is a Specialist in this field, who can advise you of what options are practical for you. The you can both arrive at a treatment plan together.

In my practice, I find that communication between my patient and I helps set expectations that are realistic, and sets the stage for happy fulfilled patients. So many patients report that their lives have been so improved by having this surgery.

I hope I have helped and wish you well.

Mark

Hello, and thanks for your question.

We live in a world where we want everything cheaper, preferably on sale), and right now.

That works for some things, and not others.

Price is, of course, a factor for most of us. Consider if the trade-offs are worth it for you.

-Do you know someone in your home location by reputation?

-Will your surgeon be close by- you need follow up visits after your surgery, and we encourage patients to close or come in if they are concerned or need some reassurance, and what will you do if you have a concern or complication in the weeks and months after the surgery that needs addressing?

So, going to another location is a trade-off. Make a sensible decision, keep your perspective, as this is surgery, not supermarket shopping, and deserves different consideration.

Hope this helps

Mark

Hello, and thank you for your question.

Knee fat can be tricky, so needs to be appropriately assessed. Is it fat or due to some other reason, like swelling?

If we determine it's fat, you have a choice of surgical(liposuction) and non-surgical options(CoolSculpting). Both are effective, given the correct conditions, and in my practice, some patients are more appropriate for the one, and some for the other. Fat injections have also recently been launched in Australia, approved at this time for chin only.

So, in my opinion, get a qualified professional assessment. I believe a Specialist Plastic Surgeon. The you will know what options are best for your situation.

Hope this helps.

Mark

Hello, and thanks for your question

Firstly, a visit to your CoolSculpting provider is absolutely necessary, so they can work out with you what still does or does not need treating, and what is appropriate for treatment. In our practice we recommend 6 week intervals when treating over the same area, however overlapping treatments are also possible in some areas

In our experience the front of the arm is not an area we would treat as the fat layer is often not soft enough to be drawn into the applicator.  Yes you can overlap areas however it must be done in a way that does not create any dips or irregularities in your results.

CoolSculpting is a fantastic product(and beware of clones- they are usually cheaper for a reason!). And a skilled, experienced provider makes all the difference. I believe in this so strongly that I employ only Registered Nurses whereas many practices employ non-medical people to treat.

Your CoolSculpting provider will be able to advise you on you the best treatment plan for your individual needs and this sometimes means saying no to areas to ensure you get optimal results.

Hope this helps and good luck with you CoolSculpting journey.

Mark

Hello, and thanks for your question

I am an Australian Specialist Plastic and Reconstructive Surgeon(referred to as 'board certified' in the US), and as such, offer a range of options for chin fat, including liposuction and both CoolSculpting and fat injections(product names differ slightly here although the actual product is the same).

 You need someone qualified in both these procedures to assess appropriately. I suspect, that, as your chin fat is minor, you may not be a good candidate for CoolSculpting, as the applicator may not have enough fat to 'grab'(that’s one of the limitations of CoolSculpting, which is highly effective but your situation needs to be appropriate for it)
. So, fat injection my be more appropriate in your case.

Do you research by consulting with a real person. Get a professional opinion. Preferably with a Plastic Surgery practice, in my opinion, as we deal every day with body cosmetic issues and are highly trained and skilled to do so. 

Hope this helps.

Mark

Hello Kaydee

Thanks for your question.

Well done for losing the weight. Tummy Tuck is a great surgical option to address loose sagging layers, of both the skin and layers beneath. It is the only option that will address all these at the same time. If you can further improve you 'after' photo with exercise and diet, then I would encourage you to do so. But if you cannot achieve that, and I think from your question that you are saying that won't happen, then there is no other way to effectively address all your concerns. Tummy tucks can also be combined with liposuction, if appropriate for you.

Yes, you will have a scar. This will be strategically placed in your panty line. This will also fade over time. But this is surgery, and you have to go in to it with your eyes wide open and informed. Maybe it would help for you to set a goal? And once that time frame is achieved, see where you are up to physically, and decide whether or not you wish to consult with a Specialist Plastic Surgeon. In Australia Tummy Tuck surgery after weight loss such as yours(there are a few qualifying issues) has some Medicare and Health Fund rebates for the surgery and hospital stay. Your Plastic Surgeon should be able to guide you so that you make decisions from an educated perspective.

I hope this has helped and wish you well in your journey.