Surgical Fat Reduction for Targeted Body Contouring in the Philadelphia Area
The fact that patients routinely choose liposuction at the Philadelphia area's Cross Plastic Surgery is not a surprise to Dr. Kevin Cross. As he wrote in his most recent text book chapter on liposuction, "Liposuction is the most commonly performed surgical procedure in cosmetic plastic surgery, and for good reason."
Performed correctly, liposuction can be a very effective shaping tool. As a body-contouring strategy, it can be used all over the body, from the neck to the chest, from the abdomen to the back, from the upper thighs down to the calves. There are also dozens of liposuction variations, including traditional liposuction, which involves manually freeing fat cells for removal, and liposuction that uses ultrasonic or laser energy to loosen the fat. More important than the technique, however, is the surgeon performing the technique. Specific forms of liposuction are more appropriate in certain situations, but for most patients, the surgeon performing the procedure is the most important factor.
What Does Liposuction Involve?
First, it is important to understand that each fat cell is like a tiny balloon filled with a small amount of fat. When many of these cells congregate in one area and swell to a large size, they can be difficult to shrink back down again—even with diet and exercise. The result can be a stubborn bulge, such as the pocket of fat that causes a double chin, or more significant bulk, such as excess volume on the belly and flanks.
Nearly all forms of liposuction at Cross Plastic Surgery start with an identical first step: Dr. Cross will infuse the targeted tissue with a solution that helps to numb it, as well as reduce bleeding and bruising. This solution is delivered through a long, thin instrument, just thicker than a needle.
Next, the fat must be freed for removal. Historically, plastic surgeons would move a hollow tube called a cannula back and forth to release fat cells from their surrounding tissues. The freed fat would then be suctioned out through the cannula, which performed double duty as a vacuum tool. Dr. Cross now uses a three-step process for fat reduction, which involves freeing the fat before removal to allow suctioning to occur in a gentler and more precise fashion. He then blends the remaining tissues to help ensure a smooth end result.
This three-step process involves what is known as a power-assisted liposuction (PAL) system. Vibratory mechanics loosen the fat cells, leaving blood vessels, nerves, and other important structures intact during the process. This limits trauma—and thus reduces bruising and discomfort during recovery. These freed fat cells are then removed using less suction power than is typically used for liposuction, further reducing tissue injury and recovery time. The remaining fat cells under the skin are then blended in the third step to avoid lumpiness and contour irregularities.
The entire procedure is performed using incisions that are smaller than the diameter of a pinky nail.
Other advances in technology allow for the application of energy, such as ultrasound or laser, to break up the fat cells, but these techniques tend to be over-used by doctors. This is why Dr. Cross feels that these techniques should be used only in certain situations, because, in most cases, they increase risk of complications—including fluid collections and burns of the underside of the skin—without adding benefit to the end result
What Fat Does Liposuction Remove?
The fat most commonly addressed with liposuction is known as subcutaneous fat, lying just under the skin. This fat's thickness varies in different regions of the body.
Running through the fat are bands of ligaments, called septae, which originate near the muscles under the fat and connect to the overlying skin. The relationship between the thickness of the fat and the density of the bands determines how safely an area can be treated without resulting in irregularities like waviness and depressions.
Dr. Cross will assess any area where fat reduction is desired and determine the best technique for achieving ideal results.
What Is Recovery Like After Liposuction?
Recovery time after liposuction will depend on the area or areas being treated, as well as the amount of fat that is removed. For instance, patients tend to find that the flanks are more sore than the abdomen, and the thighs more sore than the arms. For most liposuction patients, however, significant soreness, if present, is limited to the first few days after their procedure. They are typically able to get back to all of their normal activities within a few days and are able to start exercising in one to two weeks.
All patients wake up after the procedure in a garment to provide support and gentle compression. This garment is similar to a medical version of SPANX and is removed in two days, at which point patients are able to shower and wash their entire body. A second garment is provided at this point, so patients can alternate by washing one while wearing the other. Unlike other practices, Dr. Cross only has his patients wear the garments for one to two weeks at most.
Patients often see improvement over their pre-treatment appearance within a week or two, but final results are not seen for a few months.
*Results May Vary
Before & After Photo Gallery
See for yourself the patient transformations that can be achieved by Dr. Cross and his team.
Will the Fat Come Back in Other Places After Liposuction?
Dr. Cross commonly gets asked whether removing fat from one area can cause the fat to grow back in other areas. This is a question that patients have been asking Dr. Cross since he started performing liposuction. Fat will not spontaneously show up in another part of the body if it has been removed from a different location. What can happen, however, is that fat can increase in other locations if a patient gains weight. If weight gain used to mean that fat increased in an area, and that area is then treated with liposuction, the same weight will not as easily be able to accumulate where it used to go. In that case, it may preferentially go to other areas, but this occurrence is rare.
More Options for Body Contouring
Liposuction is ideal for removing excess volume, but a different approach is needed to address stretched-out skin. A tummy tuck will remove sagging tissue left behind after significant weight loss or pregnancy, as well as repair separated muscles. Excess skin can also be removed via arm lift, thigh lift, buttock lift, lower body lift, face lift, and neck lift.
Patients with a double chin may choose Kybella® for fat reduction. This injectable uses deoxycholic acid to break down fat cells in the submental area. No surgery is involved, but results are more gradual and less dramatic than possible with liposuction.
In places where septae pull the surface skin down into dimpled areas of cellulite, Cellfina® can sever the connective bands for a smoother look.