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Large Volume Liposuction Palo Alto

View Before and After PhotosPrior to its USA introduction in 1982, liposuction was embryonic in nature and had only been tried sparingly in France and Italy. In 1982, I first became interested in liposuction because I saw the technique as a safe easy way of removing unwanted fat about the face and neck. I took all the training courses and my career in liposuction began. Since then, I have performed liposuction on over 3200 patients.

Initially, liposuction was applied to just cases of small limited disproportionate areas. Eventually, multiple area liposuctions and inclusion of larger patients brought the advent of larger volume liposuction.  I began treating larger volumes in 1985 and by 1999 I had a series of over 630 large volume patients. This was reported in the Journal of Plastic and Reconstructive Surgery and is the world’s largest series of large volume liposuctions. By current agreed definition, current volumes of over 10 lbs. (5 liters) of fat are considered large volume. The study progressed slowly and resulted in an excellent experience with many happy patients and no serious complications or problems. A series of over 950 cases of large volume liposuction is in progress eventually to be reported. My largest series volume on one patient with three procedures is nearly 49 lbs.

There are many good candidates for large volume liposuction. Patients must, of course, be healthy, cooperative, and working to manage their own weight. People less than 50 lbs. over their ideal chart weight make excellent candidates. Those ranging 50-75 lbs. over their ideal weight may also be good candidates. In my evaluation I consider the patient’s stability and motivation to control weight. Once I determine candidacy, I will perform large volume liposuction. In the 70 to 100 lb. overweight group, I perform in-depth critical analysis of health, age, weight, weight patterns, exercise, and motivation. Some of these patients are also deemed candidates for large volume liposuction. In the 100 lb. or more over chart weight group, only a few are accepted as large volume liposuction patients. In general, these folks need to lose weight, but a few with one particularly large disproportionate area (abdomen, buttocks, or thighs) will be considered. Addressing these problematic areas can be of great value to the selected individual. At 150 lbs. over chart weight, there are essentially no candidates for large volume liposuction surgery. These people need to lose weight either on a special program, bypass surgery or another bariatric procedure. Once their weight is down, liposuction can achieve excellent results. In considering larger volume liposuction, it is important to assess and realize that all volumes of fat removal are relative. A person who is 5’2” and 150 lbs. will have a smaller large volume liposuction number with significant improvement than a person that is 6’9” and 375 lbs. with the same volume number. This is logical.

These procedures are done under general anesthesia and can take 3 to 8 hours depending on the number of areas addressed. It is pleasing to witness typically rapid recovery. Most patients return to work and play in 7 to 10 days. We ask that all patients with large volume liposuction reflect the weight removed when they step on the scale in 6 to 8 weeks. For example, if a person of 150 lbs. has liposuction and 10 lbs. is removed during the procedure, the patient’s new weight should be 140 lbs. at 6 to 8 weeks. Before that time, there is some fluid retention as after any surgery or injury.  If the patient weighs 150 at 8 weeks, she has gained weight, in which case the result will be less favorable and not as smooth. Skin contraction after a very large volume liposuction is typically excellent, but not perfect. Where skin tone has been compromised due to excessive weight followed by weight loss or is age related, there can be limited skin contraction. This is especially true about the abdomen, lower back, buttocks, thighs and arms. If this is likely, the patient will be informed prior to surgery (10% indicated). There are however, individuals who have had massive weight loss with fairly good remaining skin tone, that have benefitted from the Vaser application.

Garments are worn for about 2 to 4 weeks post-operatively. Garments are quite comfortable, but after the 2 to 4 week period, I do not require them.

Massage speeds along the result in liposuction, but is not mandatory. I am not yet convinced that the many advertised techniques of reducing fat or cellulite by various machines are very useful. I always monitor every new technique and machine carefully to determine its clinical value to my patients.

Ultrasonic liposuction has been a wonderful technique for large volume liposuction procedures. Ultrasonic liposuction was introduced into the United States in 1996. I was appointed a member of the ultrasonic liposuction evaluation team of the American Society of Aesthetic Plastic Surgery. Initially, there were 7 of us and we grew to 14 members. Each member was provided with an ultrasonic liposuction machine for one year before they were released for general use. I was selected because of my vast liposuction experience and my active faculty status at the Stanford University School of Medicine. I found the ultrasonic technique excellent and then founded the Ultrasonic Liposuction Center of Palo Alto and the Plastic Surgery Center. Stanford’s 6th year residents in plastic surgery rotate with me at my Plastic Surgery Center to learn the techniques of ultrasonic liposuction. However, let me be perfectly clear, I am the only surgeon performing liposuction on my patients.

The Vaser® Sound Surgical Liposuction System (LipoSelection®) is, in my opinion, the finest system to date. Vaser Sound Surgical’s brilliant founder and ultrasonic scientist, William Cimino, Ph.D., is considered a world leader in ultrasonic technology.

Based on my vast experience, I believe the Vaser liposuction system affords patients greater comfort, faster recovery, better skin retraction, less pain, and the best possible results. The Vaser system is a low heat way of delivering ultrasonic energy that specifically selects fat cells. Other ultrasonic systems deliver high heat and can potentially produce burns, pain and seromas. I have no financial ties with any company. I have tried other systems, such as power liposuction, and found them far less safe, producing results that were less comfortable and not as effective as Vaser treatments.  As I mentioned before, I consider the various external fat reducing machines as well as injection techniques (mesotherapy) not very useful or productive. Vaser LipoSelection has made my large volume liposuction procedures far easier and better for patients. I have determined it is the best way to go for my patients. Vaser LipoSelection has been a wonderful addition to small, medium, and large volume liposuction.

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