Myth: Liposuction is for Weight Loss

Fact: Liposuction does not actually help with weight loss and will not cause a noticeable reduction in weight.

Liposuction is also not an effective way to combat obesity. Obese patients are typically not good candidates for the procedure, as health problems caused by obesity can make elective surgery too risky. Liposuction is best for patients who have a healthy weight and lifestyle, but simply want to improve body proportions or get rid of stubborn fat deposits in specific body areas.

Myth: Liposuction Removes Cellulite

Fact: Liposuction removes fat in deeper tissue layers, but doesn’t affect superficial fat deposits which, in combination with loss of skin elasticity, cause cellulite.

Laser treatments and non-surgical skin tightening procedures may be able to provide temporary cellulite reduction, but the best way to get rid of cellulite is with lifestyle changes that help you maintain well hydrated, collagen rich skin.

Myth: There are Non-Surgical Liposuction Options

Fact: Liposuction is a surgical procedure. There are some body slimming devices out there that claim to provide fat reduction without surgery, however these are often only mildly effective, if at all, and will not provide the same results.

Although liposuction is minimally invasive, it does still involve some sort of anesthesia and incisions needed to insert the suction tube, or cannula, that removes fat cells. So, very small, discreet liposuction scars will be present after the procedure, and patients will need to take at least a few days off work following liposuction.

Myth: Liposuction Can Also Treat Loose Skin

Fact: Liposuction is not an effective skin tightening treatment and cannot get rid of loose skin. However, liposuction is frequently performed in combination with procedures that address flab and excess skin such as a tummy tuck or arm lift surgery.

Some laser liposuction devices claim to offer skin tightening benefits in addition to fat reduction, but any skin tightening achieved with lasers during liposuction is usually minimal and will not do much for patients with moderate to severe skin laxity.

The survey found that women were not just willing to trade time for beauty but also suggested they would forfeit a promotion at work, part of their salary, time with loved ones and even their health.

These findings may be unsurprising given that the survey found 46% of the women had been subject to ridicule because of their looks and 93% claimed to have negative thoughts about their appearance in the previous week.

Nearly 40% of the women said they would elect cosmetic surgery, like liposuction to remove localized fat deposits. This, despite the fact that nearly 80% of the women were either underweight or within a “normal” weight range.

These statistics only stress the importance of choosing a cosmetic treatment, like breast augmentation or  a tummy tuck, for personal reasons, not due to outside influences.

Though it is common knowledge that nonsmokers have a longer life expectancy and much lower risk for some health issues like emphysema and lung cancer, being a nonsmoker has additional benefits.

In regards to recovery from surgery, patients who smoke or have only recently quit smoking are more likely to have an extended hospital stay, possible readmission and a higher likelihood for complications.

The study found, however, that patients who had only quit smoking eight weeks before surgery, such as a facelift or liposuction, experienced no health benefits when it came to surgical recovery. The researchers said that these results are not conclusive, though, and said further research needs to be done.

Dr. William Coleman III, who spoke at the 2010 joint annual meeting of the American Society for Dermatologic Surgery and the American Society of Cosmetic Dermatology and Aesthetic Surgery, said that two ultrasound-based fat reduction platforms currently being studied by the FDA have achieved circumferential fat reduction without surgery in clinical trials.

Dr. Coleman, a clinical investigator and member of the advisory board for UltraShape, said that the Contour ultrasonic fat reduction device developed by UltraShape can produce up to 7.6 cm of circumferential fat reduction.

“It is intended for reducing localized fat deposits mainly on the abdomen, flanks and thighs, and therefore is not a replacement for liposuction,” Dr. Coleman says of UltraShape’s Contour platform. “However, there are a number of clinical studies showing its efficacy in achieving significant circumferential fat reduction.”

Clinical studies of another ultrasound-based fat reduction device, LipoSonix by Medicis, have also purportedly shown a reduction in circumferential fat deposits by 2.8 cm on average.

A published clinical study also backs up efficacy claims of the new CoolSculpting fat reduction platform developed by Zeltiq, which uses cryolipolysis (fat-freezing) technology to permanently reduce fat cells. According to the study, a 25 percent gradual reduction in ultrasound-measured fat is seen six months after CoolSculpting treatment.

Other non-invasive devices utilizing light- and radiofrequency-based technology, as well as mesotherapy (injection lipolysis), have also explored as fat reduction modalities over the years, however as Dr. Coleman points out, these produce less-promising results and likely will not catch on, at least in their current stages of development.

“Mesotherapy will likely disappear unless it becomes safer and more reliable. Mechanical techniques and light-based devices have limited efficacy, and radiofrequency will have to be completely re-engineered to be successful in this market,” says Dr. Coleman.

However, new data released by researchers at the University of Iowa suggests that among Americans, medical tourism is actually less popular than previously supposed.

Brandon Alleman and his team of researchers at the University of Iowa surveyed 45 companies that facilitate medical tourism for U.S. patients and found that these companies have referred only about 13,500 U.S. residents to healthcare and cosmetic surgery facilities outside the country.

These companies represent about 70 percent of the market serving U.S. medical tourists, so if, say 23,000 American patients traveled abroad for medical treatments, that makes up only a tiny fraction of the number of patients treated in the U.S. each year.

This is good news to Owensboro cosmetic surgeon Dr. Gerald Edds, as he and many of his colleagues discourage American patients from traveling abroad for cosmetic procedures like liposuction, breast augmentation and even injectables for a number of reasons.

For instance, countries outside the U.S. where cosmetic surgery is less expensive often do not have adequate standards of care and official oversight designed to prevent avoidable complications and poor outcomes.

There is also concern over whether medical tourists actually receive treatment with the products or devices they think they are getting, and that they paid for. Many patients think they’re getting Botox, but end up getting cheap knock-offs of the real thing, along with poor results.

In addition, most surgeons agree that it is important to receive follow-up care from the physician who performed the procedure, which is not usually possible weeks or months after surgery, when patients have returned to their homes in the U.S.

In fact, the study results showed that 93 percent of companies brokering medical tourism packages expect follow-up care to be performed by U.S. physicians.

Given the fact that many physicians are uncomfortable providing follow-up care to patients on whom they did not perform the initial surgical procedure, it can be not only difficult to find a physician who will provide post-surgical follow-up care after traveling abroad for cosmetic surgery, but costly to hire a new physician as well, especially if complications arise and revision surgery is needed.

To avoid the potential risks and difficulties with follow-up care that can arise from medical tourism, it’s best to first choose an accessible, board-certified cosmetic surgeon who performs procedures in an AAAHC accredited U.S. surgical facility.

Let cost be your final consideration in choosing a surgeon, as paying slightly more for a great outcome the first time can end up being much less expensive than paying separately for follow-up care and multiple revision procedures down the road.

There are also a number of financing options available to Americans who do not have the cash in-hand needed to pay for cosmetic surgery, so there is little reason to travel abroad when some of the world’s best surgeons are in your own backyard.

Each of the women questing for the ‘Bridalplasty’ prize has a wish list of cosmetic procedures they would seek should they beat out the competition, in addition to ideas for their wedding cake, dress, invitations and more.

According to an article in the Chicago Sun-Times, the show’s oldest contestant, Allyson, is a 33-year-old who plans to claim a wedding suited to her “old-school rocker chick” tastes and other prizes in the form of liposuction, a breast lift, a breast reduction and Botox, as well as some cosmetic dentistry, if named the show’s victor.

Before I was pregnant with my son, I was in the best physical shape of my life,” Allyson says. “I would love to get back to that and I’m sure [my fiance] would NOT mind some smaller perky boobies on me. I’m 33 and they sag down to my belly. What will happen when I’m 50? Will I have to roll them up and tuck them in my bra?”

Many women face the same troubling physical changes after undergoing the rigors of pregnancy and childbirth, however they are rarely so public as on reality TV shows.

The Sun-Times noted some particularly cringe-worthy scenes on Bridalplasty, such as the one where Allyson uses the spare tire of fat around her stomach to tell Dr. Terry Dubrow, the plastic surgeon featured on the show, “Help me, please. Suck me out.”

Dr. Dubrow is also shown using a marker to circle the problem areas on his topless patients, a scene that, according to the Sun-Times, calls to mind the behavior of a “sorority mean girl.”

“There is something beyond sensational with these cosmetic surgery makeover shows.  There is some indignity involved in the process,” says Owensboro cosmetic surgeon Dr. Gerald Edds.

Although, as Dr. Edds points out, there are certainly humiliating undertones present in Bridalplasty (and most other reality TV shows, for that matter), he like most critics acquiesces to the makeover competition, saying, “As long as the result is good and there are no complications, I suppose it is a win-win for both the ‘winner’ and the celebrity cosmetic surgeon.”

Patient before and after liposuction performed by Dr. Gerald Edds

An article discussing liposuction and liposuction alternatives was recently featured on MSNBC, as plastic surgeons from around the country weighed in to provide consumers with a comprehensive overview of cosmetic fat reduction procedures.

Owensboro liposuction surgeon and cosmetic surgery specialist Dr. Gerald Edds believes it’s important for patients interested in fat reduction procedures to understand the limitations of liposuction and learn about liposuction alternatives before choosing a procedure to sculpt their problem areas.

What You Can (And Can’t) Accomplish With Liposuction

Liposuction surgery can permanently remove stubborn fat deposits resistant to diet and exercise from a number of body areas, including the chin, neck, chest, back, upper arms, abdomen, hips, thighs, knees and ankles.

You will not lose weight as a result of having liposuction, and the procedure is not an effective solution for stretch marks or cellulite. In fact, liposuction procedures can often make cellulite look worse, especially in patients with skin laxity and poor skin quality.

Laser Liposuction

In recent years, laser-assisted liposuction procedures that claim to offer skin tightening in addition to fat reduction benefits have become increasingly popular in the media with the advent of devices like Smart Lipo, Slim Lipo and Cool Lipo.

“You don’t need laser lipo for someone with good-quality skin. It’s for an older patient who has lost elasticity,” says Dr. Barry DiBernardo, a New Jersey liposuction expert and laser liposuction pioneer.

Laser liposuction devices may offer patients with mild skin laxity some tightening benefits, however many surgeons argue the evidence of this is inconclusive and more dramatic skin tightening results can only be achieved via surgical excision of loose skin.

Tummy Tuck, Liposuction or Both?

According to surgeons who contributed to the MSNBC article, there is often confusion among body contouring patients as to whether liposuction or a tummy tuck is more appropriate for sculpting the abdominal region.

While liposuction is ideal for removing fat, tummy tuck surgery is ideal for removing stretch marks and excess skin on the abdomen such as that which forms following pregnancy. Sometimes the two procedures are combined when both unwanted fat deposits and loose skin and stretch marks are present on the abdomen or waist.

Non Surgical Fat Reduction

Non surgical fat reduction with devices like those made by Zerona or Zeltiq is new technology that at least initially appears to reduce inches and small fat deposits in patients, however no longer term data has been collected regarding the effectiveness of such procedures.

Non-invasive liposuction alternatives like lipodissolve and mesotherapy that purport to reduce fat by way of a series of injections are not FDA approved, and many plastic surgeons encourage patients to avoid these sometimes risky procedures.

The decision came following an investigation that stemmed from a complaint made by a patient who underwent liposuction at Jean-Baptiste’s clinic in 2009, which found that the doctor allowed two unlicensed medical assistants to perform liposuction on the patient in an unregistered surgical facility.

The board also found that Jean-Baptiste failed to document important surgical details of the liposuction procedure, including the amount of anesthesia used and the amount of fat removed, and also did not perform an adequate pre-operative exam prior to surgery.

The fact that the Florida Board of Medicine purposefully moved to increase Jean-Baptiste’s fine from $10,000 to $50,000 illustrates the gravity of board members’ concerns regarding unqualified physicians performing cosmetic procedures.

“I think he’s in a lot of trouble because he doesn’t have a surgical background,” said Dr. Trina Espinola, a St. Petersburg surgeon and Florida medical board member.

Jean-Baptiste completed a family medicine residency and is certified by the American Board of Family Medicine.  The only cosmetic surgery training Jean-Baptiste had completed at the time of the Florida Board of Medicine’s investigation was a three-day liposuction course.

“This kind of case underscores how a weekend of coursework doesn’t prepare physicians to perform procedures such as liposuction,” said Chris Nuland, a Jacksonville attorney representing Florida’s plastic surgeons and dermatologists, who have expressed concern regarding the rise of untrained aesthetic medicine practitioners, whose patients they end up treating when complications arise.

Cosmetic surgery is a lucrative, cash-only industry that is largely unregulated.  Anyone with an active medical license is legally allowed to practice cosmetic surgery, however the firm, decisive action taken by the Florida Board of Medicine against Jean-Baptiste will hopefully serve as a warning and deter untrained, unqualified medical professionals from seeking to make a quick buck at the expense of patient welfare and ethical practice standards.

Although none of the spas in question were located in Kentucky, the procedure is likely available in our area. Consumers should be cautious according to the FDA. With an injection of certain chemicals (phosphatidylcholine, deoxycholate, and others) practitioners claim that lipodissolve can remove areas of persistent fat.  However, The procedure lacks supporting scientific evidence as a fat removal treatment.

The Medspas involved were apparently claiming that Lipodissolve was “superior to other fat removal procedures, including liposuction” and making misleading claims about the safety record and effectiveness of lipodissolve.

Given the lack of supporting evidence for lipodissolve and the side effects reported by consumers, officials in the FDA felt it was necessary to crack down on these misleading claims and warn consumers about them.  The medical spas are being instructed to “correct these violations and prevent similar violations in the future.”

Read more about this story on FDA.gov

The piece raises some interesting ethical questions: While the procedures could certainly be beneficial to individual nurses in the short term, would such a practice harm the nursing profession as a whole?

According to reporter Dan Bilefsky, nurses in the region “insist they are under enormous pressure to look good in a society where attractiveness is often as highly prized as clinical skills.”  Critics argue that the incentives could promote an idealized body image for nurses, in a profession already suffering from misconceptions about technical competence.  A spokeswoman from the Czech nurses association argues that nurses are still perceived as “low level workers” with little to offer besides manual labor.  Nurses after all, aren’t intended to be models, but caregivers that provide an enormous benefit to the medical profession and the public they serve.  A misplaced emphasis on their physical appearance could undermine public perceptions of their competence and value.

Still, others may not see any problem with offering incentives through procedures like breast augmentation or rhinoplasty; perhaps they’re analogous to employee discounts at a retailer, vacation packages, or other career perks.

The ethical issues being discussed probably aren’t a product of the incentive programs alone, but rather an objection to the sexism and discrimination that underlie them.