Written by Dr. Cross
As Dr. Cross 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. It is a technique that can be used all over the body, from the neck to the chest, abdomen to back, legs down to calves. There are dozens of liposuction techniques, from traditional liposuction to ultrasonic, laser to Vaser. More important than the technique used, however, is the surgeon performing the technique. In certain situation, specific forms of liposuction are more appropriate, but for most patients, the surgeon performing the procedure is more important that the type of liposuction that is used.
Before and three months after of liposuction of the legs using Dr. Cross’s three step technique. Note that even the right thigh fold that is seen under the buttock region is less noticeable in the after picture. *Results May Vary
The area of fat that is most commonly addressed with liposuction is the fat that lies under the skin, known as subcutaneous fat. The thickness of this fat varies in different regions of the body. Running through the fat are bands of ligaments, called septae, that originate near the muscles under the fat and insert on 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.
Nearly all forms liposuction start with an identical first step. A solution is infused into the fat that helps to numb the fat and reduce bleeding and bruising. The solution is delivered through a long, thin instrument, just thicker than a needle. The fat is then often treated with some form of energy, like ultrasound or laser, to break up the fat cells. Finally, the cells are removed using another long, thin instrument, just slightly larger than the one described earlier. The entire procedure is performed using incisions that are smaller than the diameter of a pinky nail.
One of the most important innovations to liposuction has been the development of a 3 step process to produce the most corrective, yet even results. The process involves loosening of the fat cells using a Power Assisted Liposuction (PAL) System. Vibratory mechanics are used to release the fat cells from their attachments to surrounding tissues. The blood vessels, nerves, and other important structures are left intact, during the process, limiting the trauma to the tissues and thus the bruising and discomfort during the recovery period. The 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 insure that lumpiness and irregularities are eliminated. While this three step process takes slightly longer than traditional liposuction, it is safer than laser or ultrasonic liposuction because it has no chance of burning the underside of the skin. The loosening and blending components allow Dr. Cross to remove more fat, with greater safely than was ever before possible.
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The recovery time will be dependent on the areas being treated and the amount of fat this is removed. For instance, the flanks tend to be more sore than the abdomen, the thighs more than the arms. For most patients, however, significant soreness, if present, is limited to the first few days after the procedure. Patients are able to get back to all of their normal activities within a few days and are able to start exercising in 1-2 weeks.
All patients wake up after the procedure in a garment to provide support and gentle compression. The garment is similar to a medical version of Spanks. The garment is removed in two days, at which point patients are able to shower and wash over their entire body. A second garment is provided, so patients can wash one and wear the other. Unlike other practices, Dr. Cross only has his patients where the garments for 1-2 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.
Before and results three months after of liposuction of the abdomen. Despite the patient starting with relatively loose skin, this result was achieved with liposuction alone, using Dr. Cross’s three step technique. The procedure was performed during one session and took less than 2 hours. * Results May Vary