Compression Garments are Important after Liposuction

Dr. Larry Nichter

A compression garment is required and beneficial after liposuction because:

  1. It restricts the amount of edema that forms and hastens its resolution by mechanical pressure.
  2. It decreases the amount of bruising.
  3. It assists the loose skin in retracting or shrinking.

It is common to have weight gain due to edema, serum that collects in the area, and the tumescent fluid that was injected. This will resolve over time. The more you wear the garment initially, the quicker this fluid resolves.

Edema: a condition characterized by an excess of watery fluid collecting in the cavities or tissues of the body.

The length of time that the garment should be worn varies depending on the amount of fat removed, the elastic nature of your skin, how much loose skin remains, and other factors. Your surgeon would give you the best advice, however this is the general routine for my patients.

The first garment should be fitted for you in the office prior to surgery and applied in the operating room. Often it will become loose as the edema is mobilized, and then it will need to be replaced. Spanx is a reasonable compression  garment if it gives enough support and is the right size. I have my patents bring them in so I can confirm that it fits well.

Most important advice is to listen to your surgeon, as he or she knows how much fat was removed, the elasticity that remains in your skin, and amount of skin redundancy.

I recommend that my patients wear their garments for a minimum of three weeks full time then for twelve hours at a time (day or night). If there is not a lot of redundant skin, this continues to a maximum of six weeks.

To be effective, the garment needs to fit snugly—but not too tight as that can make it difficult to sleep or cause pressure problems (inspect your skin when it is exposed if you are uncomfortable). As the edema resolves it is common for patients to switch to a smaller garment that fits. A Spanx-type garment would work fine, rather than ordering one or paying more at your doctor’s office.

—Dr. Larry Nichter, MD, FACS

The Most Popular Plastic Surgery Procedures 2011

Dr. Larry Nichter would like to make blog readers aware of new statistical information about plastic surgery and cosmetic procedures in the United States.

The number of cosmetic surgical procedures in America increased by 1% in 2011, the statistical survey by the American Society of Aesthetic Plastic Surgery has shown. Over 1.6 million such procedures were done in the United States last year.

In the fifteen years since the survey began (1997), the overall number of cosmetic procedures done in the United States has increased 197%.

Liposuction was shown to be the most popular procedure. Two breast surgeries—augmentation and lift—were among the top five most popular cosmetic surgeries:

  • Liposuction — 325,332 procedures
  • Breast augmentation — 316,848 procedures
  • Abdominoplasty — 149,410 procedures
  • Eyelid surgery — 147,540 procedures
  • Breast Lift — 127,054 procedures

The survey also showed a 2% decrease in the number of nonsurgical procedures, although 7.5 million such procedures were performed (constituting 82% of all cosmetic procedures).

  • Botulinum Toxin Type A — 2,619,739 procedures
  • Hyaluronic acid — 1,206,186 procedures
  • Laser Hair Removal — 919,802 procedures
  • Microdermabrasion — 499,427 procedures
  • IPL Laser Treatment — 439,161 procedures

An analysis on the society’s website attributed this growth to the aging of the Baby Boomer generation as well as their children.

Some other interesting findings from the survey include:

  • 91% of all cosmetic procedures were done on women (8.4 million procedures). This is a 208% increase over the last 15 years.
  • Of the 800,000 men who had cosmetic surgery in 2011, the most popular procedures were liposuction, rhinoplasty, blepharoplasty, breast reduction (for gynecomastia), and facelift.
  • About $10 billion was spent on cosmetic procedures in the United States, and of that $6.2 billion was spent on surgical procedures, the rest was spent on nonsurgical procedures such as injectables, skin rejuvenation, and laser hair removal.

Source: Babbitt, Adeena. “Celebrating 15 Years of Trustworthy Plastic Surgery Statistics.” ASAPS.

The California Breast Lift®

Dr. Larry Nichter

Want to enlarge or improve your breasts with your own fat?

For years, Plastic Surgeons and their patients have desired to transfer unwanted fat from their tummy or thighs to their breasts. We are now are able to do this safely.

If you have been considering a Breast Lift or improving your appearance after breast augmentation or Breast Reconstruction but are not comfortable with introducing artificial material into your body, you may want to look into the benefits of breast augmentation with fat transfer. An alternative to breast implants is fat transfer also known as fat grafting or lipoinjection. This technique allows women the option of enhancing the appearance of their breasts without the potential problems of saline or silicone implants such as hardness, rippling or rupture.

Who is a candidate?

  • Any woman who is healthy
  • Women with sufficient body fat for the procedure
  • Women considering breast augmentation who wish to be one cup size larger or less
  • Women who have had breast augmentation or reconstruction but who lack fullness or have contour concerns. Fat transfer can further enhance and reshape your breasts while smoothing out visible or palpable edges of breast implants. This will disguise implant rippling and wrinkling.
  • Women with normal mammography

Dr. Nichter has successfully transplanted fat into the face, buttocks and other body areas for decades and are now using this same technology to enhance breast shape and size. Plastic surgeons have been transplanting fat to the breast since 1995 but caution and study were necessary to make sure there were not harmful effects. Furthermore, results in the past were variable, dependent on surgical equipment, technique, surgeon’s skill, and individual patients healing abilities.

Since 1995, recent advances have led to the development of special instruments made just for fat grafting. Dr Nichter uses his decades of experience and advanced knowledge of this technique to transfer body fat from other unwanted areas to the breasts. Though this procedure is still considered investigational to a degree, more and more qualified plastic surgeons are using this technique successfully.   The advantage of this technique is its ability to create a natural augmentation without an implant. Fat grafting (also called lipoinjection or fat transfer) to the breasts is indicated for different reasons: as an alternative to implants for mild to moderate breast augmentations, to provide fullness to the upper part of the breast during a breast lift, after pregnancy, age, or weight loss, following breast reconstruction, or to minimize the visibility or rippling of existing breast implants. Typically up to one breast size enlargement is possible in most patients. Fat transfer to the breast is usually done as a single procedure resulting in approximately half a cup volume increase. In women desiring additional breast enhancement a subsequent procedure can be performed. Each surgery consists of two components:

  1. Harvesting the fat: Fat is removed from your abdomen, hips, “love handles” or other areas using a fine cannula similar to the one used for liposuction but skinnier. This fat is rinsed with sterile saline solution and then packaged into syringes and prepared for transfer. Approximately 20% of fat removed is suitable and available for fat grafting.
  2. Fat transfer into the breasts: The prepared fat is injected in small amounts at a time and widely distributed within the layers of the breast so that these living fat cells can pick up a healthy new blood supply.

Advantages of Fat Transfer to the breasts:

  • Fat cells are natural and you are using your own tissue without any foreign body or implant.
  • Harvesting of the fat by liposuction has the added benefit to enhance your shape by removing unwanted fatty deposits
  • The breast can be shaped or sculpted in more detail than is possible using implants alone.
  • Minimal incisions reduce the possibility and degree of scarring
  • No implant is used, therefore there is never a need for replacement, or any potential for capsular contracture (hardening of the implant).
  • Fast Recovery Time: Recovery time is about 1 week and usually less uncomfortable from implants that are placed beneath the muscle.

Although, breast augmentation performed with the lipoinjection technique takes longer than traditional breast augmentation (with implants) the benefits are substantial including no need for implant replacement in the future.

In the past, significant questions were raised about the ability of Mammograms or MRI to detect breast cancer after injecting fat into the breast. However, there is no evidence that fat transfer to the breast is less safe than any breast surgery. Large studies have begun over the last several years to study fat grafting to the breast. With or without breast surgery, calcifications and lumps can occur. Breast diagnostic studies including physical examination and mammograms should be used to monitor every patient diligently using standard guidelines.

As a general rule, surgeons with extensive experience in grafting large volumes of fat to the body are most likely to obtain the best results. We believe fat transfer should only be performed by surgeons certified by the American Board of Plastic Surgery that have experience in  fat grafting. Few plastic surgeons have this experience. This ensures that your surgeon has advanced knowledge and technical familiarity, but also the subtle anatomy and aesthetics of breast augmentation.

Our patients remain the biggest source of our referrals. Over time they continue to remain thrilled with their results from these and similar procedures. I continue to share their enthusiasm and appreciate their long lasting rejuvenation which seems to affect them inside and out.

—Larry S. Nichter, MD, MS, FACS

For more information about the No Implant Breast Augmentation by fat grafting or other cosmetic procedures performed by Dr.  Nichter call our office number: (949) 720-3888.

Liposuction may lower your risk of heart disease

Patients who have had liposuction or liposuction with abdominoplasty may be likely to experience a reduction in their triglyceride levels, making them less susceptible to cardiovascular disease.

These findings were the result of a new study of 322 fat-reduction patients (270 women and 52 men). The review of the data found that the triglyceride levels of many of these individuals dropped from dangerous levels to normal ones.

Medscape Medical News interviewed a plastic surgeon involved in the study:

“Patients with normal triglyceride levels experienced no significant change after liposuction. […] However, patients with levels of greater than 150 mg/dL demonstrated a 43% reduction. In fact, 62% of these patients whose levels were at risk before liposuction had normal levels after liposuction.”

Triglyceride levels over 150 mg/dL are considered a risk factor for stroke, type 2 diabetes, and a host of other medical problems.

From the same article:

“We do know that the drop in triglyceride levels we found in these patients actually exceeded what can be accomplished medically, so it may be that there is a therapeutic benefit.”

Doctor Nichter is one of the most experienced, well-trained plastic surgeons in the United States. With 27 years of experience in liposuction, education in the latest techniques, and a multitude of satisfied patients, Dr. Nichter is the trusted choice when it comes to fat-removal procedures.

Source: Does Liposuction Offer More Than A Cosmetic Benefit? Medscape Medical News