Liposuction is a cosmetic procedure that is used to remove stubborn pockets of fat in different areas of the body. Contrary to popular belief, liposuction is not a method of weight loss. Instead, it is a contouring procedure, used to improve the proportions of the body.
There are many different types of liposuction, each one using three key elements:
A cannula, or a device used to extract the fat
A device that suctions the fat through the cannula
A fluid that is injected prior to the procedure, making the fat safe to remove
In today’s modern age of sensational advertising, companies have developed many different kinds of liposuction. There’s ultrasound liposuction, known as Vaser®. There’s laser liposuction, such as SmartLipo™ or SlimLipo™. While each type professes to have its own advantages, Dr. Rahban believes they are all relatively the same.
When it comes to liposuction, Dr. Rahban believes it is not about what you remove, but rather what you leave behind. Any surgeon can remove large amounts of fat resulting in irregularities. Not every surgeon can remove a conservative amount of fat, leaving the patient smooth and proportionate.
Ultrasound and laser liposuction add another element and marketing opportunity: heat. Because the ultrasound or laser produces heat at the tip of the cannula, companies claim this causes the skin to contract. While that may be true in some instances, that technology is being pushed beyond its capacity, causing other kinds of deformities. If a patient is not a true candidate for liposuction after pregnancy, these methods won’t compensate for the resultant skin laxity.
While a Mommy Makeover liposuction can be a useful adjunct to other cosmetic procedures, it is perhaps the most misunderstood procedure in plastic surgery. There are quite a few pitfalls associated with liposuction, and it is often oversold. It is not a miracle cure for weight loss. It is a precision contouring tool. In the right hands, it produces conservative and refined results. In the wrong hands, it produces contour irregularities, rippling in the skin and is sometimes even hazardous to one’s health.
Dr. Rahban cautions that patients should be wary of before and after photography associated with liposuction. As a photographer himself, Dr. Rahban knows these photos are frequently shot with flash photography, which prevents ripples and irregularities from being visible. Additionally, most patients on galleries are photographed within 6 months of their liposuction. However, damages and irregularities don’t begin to form until one year after surgery. People may look good initially, but they won’t be happy a year later.
Am I a candidate?
Because liposuction is not a weight loss method, the ideal candidate for liposuction is in relatively good shape and around their ideal body weight. Even despite regular exercise, candidates for liposuction Mommy Makeovers can experience stubborn pockets that won’t budge. If you are looking to maintain soft, even curves after liposuction, visit Dr. Rady Rahban for one of the best Mommy Makeovers Los Angeles can offer you.
In addition to the above, liposuction candidates should have good skin elasticity, which will allow it to conform to the new, slimmer contours. If this is not the case, liposuction will not only produce zero improvement, but it will also make you look worse, as the fat underneath the skin is what’s holding the skin tight. When the fat is removed, semi-loose skin will become very loose skin. This is a condition very common to moms. Moms, after having children, almost always have some degree of looseness to their skin, making them very dangerous candidates for liposuction.
All too often, people try to “get away with” liposuction in lieu of excisional surgery such as a tummy tuck post pregnancy. In many cases, they are only left disappointed down the line when not only do they not look better, they look worse than they ever did. Common problems are loose skin and indentations and deformities known as contour irregularities.
The above is specific to the abdomen. Other areas are generally fine to undergo conservative liposuction with mild skin quality.
Candidacy for liposuction is best discovered in a live consultation, at which time Dr. Rahban can examine your trouble areas and determine which cosmetic treatment is most suitable. Additionally, Dr. Rahban will examine the quality of your skin to determine its elasticity. In this way, he will ensure you won’t be left with contour irregularities following liposuction.
Liposuction after pregnancy may correct stubborn pockets of fat in the following areas:
Note: while each surgeon approaches the consultation process differently, Dr. Rahban feels they should all have the same basic elements, ensuring patients leave very well informed regarding surgery. Below is how Dr. Rahban conducts a consultation.
Your consultation should be done by your plastic surgeon and not by his staff, such as his coordinator. In many cases, patients are offered free consultations, but you must understand that often means you’ll get a hurried consult. As a point of reference, Dr. Rahban on average spends up to an hour with each patient, reviewing not only what the patient came in for, but also explaining all the nuances such as the risks and alternatives to what that patient has requested.
There is no way to accelerate the dissemination of knowledge when it is so complicated and crucial.
During a liposuction consultation, Dr. Rahban covers several crucial points. Firstly, he gathers data regarding your specific cosmetic objectives. After all, the goal is your satisfaction and confidence. Plastic surgery is all about what you are trying to accomplish. Just because a surgeon likes a result, it does not mean you will like it. In all plastic surgery, you are the unique element in the equation.
Second, he’ll determine whether the amount of fat warrants undergoing liposuction. He will additionally perform a series of examinations to establish whether your skin is of proper quality to do well with liposuction. During this time, he may examine excisional options, such as a tummy tuck.
Next, Dr. Rahban lays out your options, including types of liposuction available, any options concerning tummy tuck/liposuction combinations, and other factors involved in determining which procedure will produce the best body contouring result. This is where modern plastic surgery differs from times past—it used to be paternalistic, in which the surgeon simply decides what’s best for the patient. These days, plastic surgery is collaborative. Dr. Rahban goes through all options and recommends what he think is the best option. He concurrently educates the patient on everything that is open to her, allowing her to fully weigh in on her personal preference.
As an extension of this, Dr. Rahban also reviews what patients should not expect from surgery. He is well known for telling his patients the truth and establishing a healthy level of expectation. Most patient dissatisfaction is related to inaccurate understanding and expectation of their surgery. Dr. Rahban deals in full disclosure to prevent this from occurring.
In the interest of helping his patients fully understand the procedure, Dr. Rahban will take this opportunity to review all potential risks. While some risks are quite unlikely, he still wants his patients to be aware of the potential downsides of liposuction. All surgeries come with risks. Therefore, he believes the only time to engage in surgery is if the benefits far outweigh the risks. If you will only have a mild improvement, Dr. Rahban will most definitely recommend you do not undergo the procedure.
During a consultation, Dr. Rahban has one primary purpose—total patient education. He wants each patient to fully understand the nuances of liposuction, as well as every risk and exactly how the procedure applies to them, allowing them to make the best decision for themselves. With his honest, candid approach, Dr. Rahban brings a new level of care to ensuring his patients know exactly how liposuction works.
Liposuction procedure
Note: while no two surgeons perform this procedure identically, most techniques have a similar series of steps. Below is a brief overview of Dr. Rahban’s technique, allowing you to gain a more detailed understanding regarding how your surgery will be performed. The more you know, the more control you have.
Liposuction is performed using tumescent solution. Tumescent means swollen or firm. Tumescent solution is a diluted form of local anesthetic with epinephrine. The epinephrine shrinks the capillaries and makes it safe so patients don’t have a lot of blood loss. The purpose of tumescent solutions is threefold:
It makes the fat tense and firm, making it easier to remove mechanically
The epinephrine causes the blood vessels to constrict, making it safer so the patient doesn’t suffer blood loss
The anesthetic helps with pain after surgery so the patient is not uncomfortable
While some surgeons do liposuction under local anesthetic, Dr. Rahban does his procedures under general anesthesia, as he finds patients are more comfortable and he has better control of what he’s doing.
In addition to providing total comfort for the patient, tumescent anesthetic causes the targeted tissue to become swollen and firm. Further, it causes vasoconstriction, or shrinkage of the surrounding capillaries. Tumescent anesthetic creates minimal blood loss during liposuction, contributing to the safety and effectiveness of the procedure.
Once the tumescent solution has been injected, Dr. Rahban creates entry points through which he does the liposuction. The access points are very small, less than a centimeter in size. He inserts the cannula through these locations, giving him access to the area he wants to address. The key to liposuction is using multiple access points, rather than one. While at first patients are concerned about the number of incisions, it’s more important that the target area get addressed from multiple areas so the contour is smooth.
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Dr. Rahban’s philosophy:
The key to liposuction is not what you remove, but what you leave behind. In order to accomplish smooth contours, you need to leave behind an upper layer of fat that’s been untouched. The fat is generally divided into superficial and deep layers. The fat in the deep layer is the fat that should be removed, leaving behind the superficial layer untouched as a buffer so your skin looks smooth. When people are overly aggressive trying to remove all the fat, the skin gets damaged and the rippling and irregularities are formed. Dr. Rahban is more concerned with being conservative than getting out every drop of fat.
After Dr. Rahban is done removing the fat, he goes back with a special cannula called a basket cannula that equalizes the remaining fat. Because fat is solid or semisolid, it is removed in globules rather than a flowing stream. The remaining fat doesn’t naturally fill in the removed globules. By breaking up the remaining fat with the basket cannula, Dr. Rahban helps it to settle in a natural, even contour.
After the liposuction, the closure of your cannula sites is as important as the procedure itself. If they are not closed well or worse, left open as many surgeons do today, they will be unsightly and a telltale sign of your liposuction. Dr. Rahban’s approach to cannula sites is the same as any other closure—it is a fastidious closure that minimizes scarring.
Bandage-wise, Dr. Rahban uses a specialized technique. In addition to closing your wounds, he covers your liposuction area up with a special foam tape and foam padding. When you wear these with a compression garment, it minimizes bruising significantly at one week following surgery.
Depending on the number of areas addressed, liposuction with Dr. Rahban takes approximately.
Non-surgical alternative to liposuction
For patients who do not require surgical intervention for stubborn fat pockets, a non-surgical alternative is CoolSculpting®. This FDA-approved procedure uses controlled cooling to freeze the fat cells, allowing the body to eliminate them through natural means. With over 1.5 million treatments performed, CoolSculpting is a proven method of reducing fatty tissue. Your surgeon can help you determine if this cutting edge treatment is right for you.
Preparing for liposuction
For patients receiving liposuction, preparation begins about two weeks before the procedure. Every patient goes through a thorough pre-operative process. This begins with a pre-op visit two weeks prior to surgery. This is similar to a second consult. During this time, you will go over the details of your surgery with Dr. Rahban, and you will get a second opportunity to ask questions and go over your procedure, thus ensuring a complete understanding.
In the world of plastic surgery, this second visit is unusual. However, because the first visit can sometimes be overwhelming, patients often come up with new questions latently. Dr. Rahban provides this second visit so his patients can be completely at ease with every question answered.
Dr. Rahban and his staff perform a laboratory evaluation and any other workup to ensure your complete safety. If Dr. Rahban feels you are not ready to undergo your procedure for health reasons, he will assuredly cancel your procedure. His only interest is that you are safe to undergo surgery.
Dr. Rahban and his office will additionally give you step-by-step instructions for the days and weeks leading up to surgery. These instructions will include all actions necessary to prepare for your day of surgery, such as what medications to stop taking, and plenty of other guidelines to ensure you are physically fit to undergo surgery.
If you have any questions prior to your surgery, our office is available to you. Call or email us any time, and we will help with anything you need. Our goal is total peace of mind for our patients, as well as a safe, successful procedure.
Healing and recovery
Note: the recovery listed below is according to Dr. Rahban’s routine. Other surgeons may have a different approach to the recovery process.
Directly after liposuction, you will remain in our recovery suite for an hour until you are ready to go home. Because the effects of anesthesia do not fully wear off for 24 hours, you will need assistance during this initial period, including a ride home. If you are alone in the city, Dr. Rahban and his staff will make arrangements for individuals who can help you throughout your process. At home, it is wise to set a centralized location to relax, with medications and other necessities within easy reach.
When receiving liposuction, the healing process is crucial to a beautiful result. For this reason, our office will ask that you strictly adhere to our list of post-operative guidelines. It’s of paramount importance that you do your part. Dr. Rahban and his staff will hold you accountable to your portion of your own successful recovery. We will give you a full list in our office, but below are several examples so you know what to expect.
Dr. Rahban strongly believes in the use of a surgical binder following liposuction. He will ask you to wear this binder for a total of six weeks to ensure the best outcome. He feels the binder helps maintain the desired appearance of the new contours, in addition to limiting complications such as fluid accumulations called seroma. This binder must remain on with no breaks for the first week after surgery.
As an extension of this, Dr. Rahban is also a believer in post-liposuction massage. This serves to get the fluid out, as well as smooth the fat that’s left behind.
Wound and incision care
At the time of your surgery, your wound will be sterile, and it will be covered with a sterile dressing. Dr. Rahban will ask you to keep that dressing on for seven days. While some patients feel as though their wounds are getting dirty, it is exactly the opposite. Non-sterile materials such as fingers and water introduce bacteria that cause infections. When you open your wound to clean it, you’re laying it open.
Because of the dressing, you should take sponge baths for the first week. This not only makes your life easier, but also helps ensure the incision doesn’t get infected. After that, Dr. Rahban will give you further instructions as far as maximizing your cosmetic outcome and minimizing your scars.
Activity level
During the first week, Dr. Rahban recommends that you get up and move around the house in order to prevent blood clots. At the same time, limit your activities to mild movement. There should be no lifting greater than 5 pounds and no cardio for 6 weeks.
Medication
The first week following surgery, you will be taking pain medication, along with antibiotics to prevent infection. If the liposuction was combined with a tummy tuck, you will take a stool softener, as the abdominal muscles will be healing from the procedure.
Surgical Drains
There are no surgical drains necessary following liposuction.
Follow-up
After liposuction, Dr. Rahban schedules a total of five follow-up appointments. Most plastic surgeons schedule two follow-ups, during which time you may not even see the doctor. During every follow-up appointment, Dr. Rabhan sees his patients personally. He believes it is the patient’s responsibility to follow up with him. This is because patients may not know something is wrong until they see a professional. From Dr. Rahban’s viewpoint, plastic surgery is a team approach, and you must do your part by showing up to your follow-up appointments.
In addition to the pre-scheduled follow-up appointments, Dr. Rahban is available to his patients at any time after surgery. If there are any questions or concerns that arise, he and his office are available to help. Just give us a call and we will provide every bit of assistance.
Liposuction risks
Liposuction risks include but are not limited to:
Bleeding
This is a very rare complication. Despite this, we take action to minimize the risk as much as possible. This primarily includes having the patient stop all medications that promote bleeding at least two weeks in advance, such as anti-inflammatories, aspirin and supplements.
Infection
Also quite rare, infection is thoroughly combatted before, during and after surgery. The night before surgery, we have patients wash themselves with an antiseptic soap. We give patients antibiotics directly prior to surgery, as well as after surgery. Additionally, Dr. Rahban has very strict post-operative instructions regarding wound management that he believes reduces the risk of infection.
Scars
While an inevitability of surgery, the issue is not whether you will have a scar, but rather the quality of your scar. The goal is for you to have a well-healed, faint or fair scar with time. In order to prevent the unsightly scar that so many people are worried about, Dr. Rahban takes steps to minimize it.
Dr. Rahban believes in a 50-50 rule. Fifty percent of scar healing has to do with the technique of your surgeon’s closure, or how well the incised tissues are brought back together. The other fifty percent is the patient’s biology. Because a patient has little control over her biology, there is a lot of emphasis placed on your surgeon and his closure technique. While many surgeons place their emphasis on post-operative scar management, there is very little science that any of these modalities actually work. Therefore, Dr. Rahban focuses on an unusually fastidious closure technique to ensure that all tissues heal with minimal scarring.
Please refer to his timeline on wound management for more information.
Contour irregularities
Following liposuction, a patient’s skin may have a rippling appearance or have divots or depressions. Such irregularities are caused by uneven fat removal or poor skin elasticity. If left uncorrected, these irregularities can be permanent. Additionally, a careless or hasty surgeon may puncture the skin from underneath with the cannula, causing a clearly spotted appearance.
Burns
This can be caused by friction from the cannula at the cannula site or more significantly, by some of the more advanced liposuction techniques such as laser and/or ultrasound liposuction. As these technologies utilize heat, it can physically burn your skin during the procedure if your surgeon is not careful.
Asymmetry
As some of the areas of liposuction are done on both sides of the body such as the love handles or thighs, one may notice that the two sides do not match. While no individual’s body is exactly symmetrical, the goal is for them to be very close in shape and size.
Sensory change
Sometimes patients experience sensory changes of the skin surrounding liposuction. Most often this sensory change is transient or temporary, but can rarely be permanent.
Dr. Rahban's approach
“What sets me apart in how I do liposuction is that I am conservative. Patients don’t like to hear that, but the reality is that in order to avoid rippling and irregularities, you have to know how much to leave and how much to take, and that’s truly an art. The number one problem with liposuction is removing too much—you can never put it back. I am very slow and methodical in my approach. That’s the key. There is no magic, and there is no special liposuction. It’s just how you do it. You’ve got to pay attention.
“In liposuction, there is an importance placed on the overall physical appearance of a patient. Rather than only addressing a single trouble area, I take the entire body into consideration, ensuring that fat removed in one area doesn’t create disproportion in another. With this firmly in mind, I create a liposuction plan for each patient to produce the best possible results.”
Liposuction cost
There is no standard cost for liposuction as there are many unique variables. Below is a list of the elements that will determine the cost of your procedure so you understand what exactly you are paying for.
The skillset of your surgeon. Is he or she a plastic surgeon or a cosmetic surgeon? Is he or she board certified? A board certified plastic surgeon will often be more expensive.
How long it takes to perform the procedure. Generally the faster your surgeon, the less facility and anesthesia fees and the greater the surgeon’s profit. Therefore, surgeons have an incentive to work more quickly. When it comes to surgery, faster is not better. Be sure to ask your surgeon how long the procedure will take and be wary if it seems too quick.
The average time for liposuction is: 1-3hrs.
The anesthesia provider. There are many types of anesthesia providers. An anesthesiologist who is a medical doctor will be more expensive than a nurse anesthetist. Do your research and find out who provides anesthesia for your plastic surgeon. Dr Rahban is partial to using an anesthesiologist as opposed to a nurse anesthetist.
The facility in which your operation is performed. Unfortunately, surgery centers and hospitals are not all created equal. The more sophisticated the facility, the more expensive its hourly fee. Facilities that are Medicare-certified tend to be more costly as well.
Questions to ask your surgeon
Below are specific questions to ask your surgeon during your consultation. Each of these will allow you to understand his or her approach and thus make an informed decision. To print these questions so you can ask your surgeon, see link below to download a copy take with you to your consultation.
Candidates for liposuction after pregnancy should have good skin elasticity, which will allow it to conform to the new, slimmer contours. If this is not the case, liposuction will not only produce zero improvement, but it will also make you look worse, as the fat underneath the skin is what’s holding the skin tight. When the fat is removed, semi-loose skin will become very loose skin.
The key to a Mommy Makeover liposuction is using multiple access points, rather than one. While at first patients are concerned about the number of incisions, it’s more important that the target area get addressed from multiple areas so the contour is smooth.
After Dr. Rahban is done removing the fat, he goes back with a special cannula called a basket cannula that equalizes the remaining fat. Because fat is solid or semisolid, it is removed in globules rather than a flowing stream. The remaining fat doesn’t naturally fill in the removed globules. By breaking up the remaining fat with the basket cannula, Dr. Rahban helps it to settle in a natural, even contour.
In order to accomplish smooth contours, you need to leave behind an upper layer of fat that’s been untouched. The fat is generally divided into superficial and deep layers. The fat in the deep layer is the fat that should be removed, leaving behind the superficial layer untouched as a buffer so your skin looks smooth.
Every patient goes through a thorough pre-operative process. This begins with a pre-op visit two weeks prior to surgery. This is similar to a second consult. During this time, you will go over the details of your surgery with Dr. Rahban, and you will get a second opportunity to ask questions and go over your procedure, thus ensuring a complete understanding.
After a liposuction Mommy Makeover, Dr. Rahban schedules a total of five follow-up appointments. Most plastic surgeons schedule two follow-ups, during which time you may not even see the doctor. During every follow-up appointment, Dr. Rabhan sees his patients personally.