Lipo alternatives or is surgical lipo best for me?

Question

Hello, I understand lipo is the most effective way of losing hard to lose fat but I am really afraid of getting lipo. I'm getting a breast reduction and lipo on my jaw/under chin but I'm afraid of getting lipo on my body. I spoke with a doctor who recommend alternating sessions between Vanquish and emsculpt for my belly and Vanquish and CoolSculpt for my thighs. I would like some more opinions. What do you guys think? Should I just go ahead with surgical lipo? How do I overcome the fear? Thanks.

Hampton A. Howell, MD · Answer

Hi.  I would recommend more of a surgical approach with liposuction or SmartLipo.  SmartLipo has the additional benefit of likely more skin tightening than just traditional regular liposuction, although that is still a good option.  I am curious as to why you would be worried about liposuction on the body when you are going through an arguably bigger or at least similar surgery recovery-wise by having a breast reduction done and are okay having liposuction on other areas.  But that is really only a question that you could answer.  Noninvasive options could include CoolSculpting and Emsculpt, but I think you would be expected to get a better result with surgery such as liposuction to treat it more thoroughly.  I would recommend consulting with a board certified plastic surgeon with good experience in all of these areas including liposuction as well as the noninvasive options.  Good luck and take care, Dr. Howell

Jason Emer, MD · Answer

you need a surgical improvement -- liposuction, internal heating and possibly skin removal or tightening.  vanquish, coolsucpting, TrusculptID will do very little. hormonal optimization will help a lot (see link). I suggest a comprehensive approach with surgery, weight loss / hormones, exercise, diet. 
You need a formal evaluation by an expert in body shaping and contouring to determine what is best.  Traditional liposuction awake and smart liposuction are old methods and do very poorly for tightening skin or significant skin tightening or contouring.  Small problem areas can be improved slightly by these methods.  The best in body contouring not only removes fat with energy devices like VASER ultrasound but also internally heat the skin with radio-frequency devices such as J PLASMA/RENUVION, InMode BodyTite, ThermiRF to heat the under surface of the skin and tighten it at the same time as fat removal. These combinations are called 4D HIDEF VASER contouring and can only be done by a well . trained body contouring specialist. At the same time fat should be harvested, PRP and stem cells added and injected into muscles or indentations/cellulite to get body shaping and contouring.  This is known as a Brazilian butt lift when you inject the fat to the buttock for contouring and lifting, but fat can also be used in areas such as the chest/breast, arms/shoulders, calves and face.  Cellulite should also be treated with cellfina, sculptra, subcision and/or fillers such as bellafill, renuva synthetic fat, or sculptra.  If skin is very loose before surgery then it will need to be removed such as lower abdominal skin (tummy tuck/abdominoplasty), breast skin (breast lift), arm skin (brachioplasty).  Overall you need a full assessment, but simple liposuction alone will not tighten skin and needs a combination of various methods -- fat removal, skin tightening, defining, fat grafting, skin removal -- to get the best in body contouring and body sculpting.  Dr. Emer.

Robert M. Tornambe, MD · Answer

While I understand your concerns and anxiety about liposuction, is important to look at the big picture. Traditional liposuction has been around for over 35 years with a very high rate of satisfaction and relatively low rate of complications. It truly is the gold standard for removal of fat from areas of your body resistant to diet and exercise. The so-called “non-invasive“ treatments such as Vanquish and CoolSculpt have quite a high rate of dissatisfaction because of the length of time needed to see results and minimal improvement. I recommend first embracing a realistic and sensible diet and exercise program, and then reassess your body and consult with a board-certified plastic surgeon with regard to possible liposuction for troublesome areas. Best of luck.

Robert L. Kraft, MD, FACS · Answer

It’s interesting that you aren’t afraid of breast reduction but fear liposuction of the abdomen, which is far less invasive. You will not benefit adequately from the non-surgical methods so don’t waste your money on them.   Also keep in mind that, after breast reduction, the lower body will be disproportional and will need more treatment to avoid a pear shaped appearance. Best wishes.

Omar E. Beidas, MD, FACS · Answer

Dear youdontknowmee,
First of all, and most important, make sure the surgeon who will do you surgery is board-certified.Secondly, what is your fear due of getting liposuction due to? It does not sound like it is anxiety/nervousness about having surgery, as you did not express fear of the breast reduction. Liposuction is a very safe procedure when performed by a board-certified PS. There are certainly risks, as with any procedure, so talk to your surgeon about these.Regarding your last question about non-surgical lipolysis, the other alternatives you mentioned do have merit. However, keep in mind these methods usually require several sessions and the final result is still inferior to surgical means.Best of luck.

Mats Hagstrom, MD (license on probation) · Answer

Liposuction is the correct treatment for you. Nonsurgical options will leave you disappointed.Eating less is another option.Best, Mats Hagstrom MD

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