Should I be concerned that my surgeon doesn't recommend massage or foam after Vaser lipo surgery?

Question

Hello, I will be getting vaser lipo 360 soon. After doing some research I notice that foam/board and massages are recommended for faster smoother results. However, my surgeon only recommends to wear the postoperative compression garment. Now I'm nervous that I won't get the best results. Should I be worried? Are there other surgeons that have the same postop recommendation as my surgeon regarding the garment only?

Jason Emer, MD · Answer

The best in body contouring not only removes fat with energy devices like VASER ultrasound but also internally heats the skin with radiofrequency devices such as Renuvion (J-Plasma), InMode BodyTite, and ThermiRF to heat the undersurface of the skin and tighten it at the same time as fat removal. These combinations are called 4D HI-DEF VASER Liposuction and can only be done by a well-trained body contouring specialist. At the same time, fat should be harvested and purified, with PRP and stem cells added, and then injected into muscles, indentations and cellulite to get body shaping and contouring. For a Brazilian butt lift (BBL), we inject the fat into 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 a combination of Cellfina, 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: tummy tuck/abdominoplasty for lower abdominal skin; breast lift for excess breast skin; and/or a brachioplasty for loose arm skin.

I recommend following up with your physician about their suggested after care protocol. I have my patients wear compression for 3 to 6 weeks straight and then overnight for 3 to 6 months after their procedure. I suggest adding hyperbaric oxygen, IV therapy, and lymphatic massage along with your compression to help decrease swelling. To improve your final results, I also recommend adding Vanquish for further fat removal; truSculpt iD, Exilis, Forma, and Venus Legacy for additional skin tightening; and Cellutone / ZWave to make the skin smooth, remove scar tissue, and improve the skin’s appearance.

See an expert. Best, Dr. Emer.

I recommend following up with your physician about their suggested after care protocol. I have my patients wear compression for 3 to 6 weeks straight and then overnight for 3 to 6 months after their procedure. I suggest adding hyperbaric oxygen, IV therapy, and lymphatic massage along with your compression to help decrease swelling. To improve your final results, I also recommend adding Vanquish for further fat removal; truSculpt iD, Exilis, Forma, and Venus Legacy for additional skin tightening; and Cellutone / ZWave to make the skin smooth, remove scar tissue, and improve the skin’s appearance.

See an expert. Best, Dr. Emer.

George Marosan, MD · Answer

Thank you for your question. The VASER liposuction technique allows the surgeon to deliver better body sculpting. Now, not every surgeon who owns this modality is able to use it to its maximum potential. The surgery and postop care is varied among surgeons and so are the results. There are multiple variables in this type of surgery and the more of these are controlled and streamlined, the better the results. As a Total Definer surgeon, I specialize in advanced body sculpting techniques using the VASER. Postoperatively, I have my patients wear the compression girdle for 6 weeks, with foam pads inside them. Massage is beneficial to help with the resolution of swelling, but not mandatory.
Look at your chosen surgeon's preop and postop photos and see if similar body types as yours achieved the shape that would please you. Otherwise, see other board certified plastic surgeons who specialize in advanced body sculpting techniques for an in person consultation. Remember, revision surgery is more expensive and might not be totally correctable. Good luck.

Dennis Wolf, BScHons, MBBCh, MRCSEd · Answer

Hi there,that is completely up to the surgeon and each surgeon will have their own guidelines.However you can see that most do recommend massages and wearing some form of support.Maybe they have just not explored that avenue.It's worth asking- there is no harm in doing that.
RegardsDr Wolf

Cem Payasli, MD · Answer

Thank you for sharing your question. Yes, I also only suggest wearing the compression garment for 3 weeks.

Please feel free to contact me for a consultation. 
instagram.com/drcempa

Best regards, 
DR. CEM PAYASLI 
MEMBER OF INTERNATIONAL SOCIETY OF AESTHETIC PLASTIC SURGEONS

Arian Mowlavi, MD, FACS (license on probation) · Answer

This partly depends on the areas you are getting VASER lipo, but in almost all cases lymphatic massages are very important. Lymphatic massages ensure the smooth contour of the results. For example, if you are having abdominal etching done using VASER lipo, massages are so important to create the lines that define a six-pack or four-pack. The Gold Standard for superior liposuction results requires use of the advanced technology of ultrasound assisted VASER liposuction. As an official trainer of VASER liposuction, I perform full body liposuction cases every week. VASER liposuction has been the only modality that has consistently resulted in outstanding liposuction outcomes. VASER liposuction ensures a smooth contour regardless of degree of excess fat by virtue of being able to remove any and all remaining fat comprehensively and uniformly. If skin redundancy is observed, Renuvion technology can be simultaneously applied to tighten your skin to optimize your overall contour outcome. A Skype or FaceTime consultation with a VASER specialist will help you get an accurate recommendation and pricing.

Respectfully,
Arian Mowlavi MD, FACS
Realself 100 Hall of Fame Inductee

Respectfully, 
Arian Mowlavi MD, FACS
Realself 100 Hall of Fame Inductee

Mats Hagstrom, MD (license on probation) · Answer

Each plastic surgeon has the Rona postoperative protocol. What happens after surgery has very little to do with final outcomes in comparison to how the procedure is done.

Once the surgeon is done with the procedure the results will form the same regardless of postoperative protocol.

Personally I don’t believe compression garments add very much benefit but I do use them because they are considered industry standards. Our protocol is to use them for two weeks.

I occasionally use foam but I do not believe it affects the final outcome.

I personally do not recommend postoperative massage and also I do not believe it has any impact on the final results.

The only variable that matters is who does the procedure and if the patient is a good candidate for the procedure in the first place.

To get the best results I suggest a follow.

Avoid traveling long-distance for elective surgical procedures unless there are no appropriate providers locally.

Rely on in person consultations.

Schedule multiple consultations with surgeons in your area who have a good reputation for the procedure you’re interested in.

During the in person consultation to ask each surgeon to show all of their before and after pictures of the procedure you’re interested in. The goal is not to see the best results of their career but to see what average results look like and get confirmation of how many of these procedures that surgeon has performed.   Ideally the surgeon should be able to find before and after pictures of patients who are very similar body shapes and contours to your own.

An experienced plastic surgeon should have an abundance of before and after pictures. A highly  experienced plastic surgeon will have several hundred or even thousands of before and after pictures for each procedure.

Read all the reviews on various physician review websites avoiding providers with any significant number of justified negative reviews.

Organic  unmanipulated reviews tend to follow fairly equally among different review websites.  Those with an excessive number of positive reviews on a single website may be a telling sign of aggressive marketing.

The presence of justified negative reviews can be more important than an abundance of positive reviews.

Don’t schedule surgery during the consultation.

Give yourself time to think about important decisions like permanently and irreversibly changing your body.

When in doubt slow down and schedule more consultations.

The outcomes of this procedure are all over the place based exclusively on the skill and experience of the surgeon.

Best,

Mats Hagstrom MD

Kristine Brecht, MD (license suspended) · Answer

Dear MA,
After liposuction compression garments 24/7 during the the healing process are a must. I also want my patients to be walking regularly starting the next day after surgery.
Some parts of the body may or may not benefit from massage and foam boards after surgery, and these need to be discussed with each individual on a case by case basis.
Best. Dr Brecht 
Seattle, Wa

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