Plastic Surgery
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The ideal candidate for liposuction is not overweight but has excess accumulation of fat in certain anatomical locations. The most common locations in women are the abdomen, flanks, and thighs and neck. Other areas include the arms, back, and buttocks. In men the most common area is the lower abdomen and love – handle. It is important that the overlying skin is relatively firm. If the skin is very loose for instance in the abdominal area, that patient may be a better candidate for an abdominoplasty. The method of liposuction involves tumescent infusion followed by fat extraction. I use power – assisted liposuction which gives me greater ability to sculpt the fat. It is important to understand that liposuction is a sculpting procedure requiring experience and three – dimensional skill.
An exciting new technology in liposuction is ultrasonic liposuction. This involves the use of an ultrasonic probe that emulsifies the fat prior to extraction. Ultrasonic liposuction (UAL) is more aggressive. In my practice indications for UAL include men, areas that have had previous liposuction and in patients that have a small amount of lax skin for instance in the arms and abdomen. The UAL energy causes some skin contraction (tightening), which does not occur with conventional liposuction. UAL has become a very rewarding technology for my patients. There are other emerging technologies involving laser probes. At this point they appear to be more expensive, and offer no additional benefit. Before I will offer a new technology to my patients it has to be proven, offer an advantage over existing technology and be safe. Not just a marketable buzzword.
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Dr. Elliott - Plastic Surgery
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When considering breast enhancement the concept seems relatively simple, but there are many options to consider. Most of the options discussed are soft, that is there is rarely an absolute wrong or right way of approaching breast enhancement with a patient. But after 25 years of experience with this operation I will share with you the thoughts that I share with a patient considering augmentation.
The best candidate for breast augmentation is healthy, has no immediate history of breast disease has a good intrinsic shape to her breasts and torso, and has some loose skin. That doesn’t exclude patients with variations but there may depending upon what is observed discussion in addition to augmentation related to lifting or shaping the breasts at the same time as augmentation to enhance the results.
The approach to surgery is most of the time dictated by the patient’s Intrinsic breast shape and contour. Options include infra – mammary, peri-arreolar, trans-axillary, and trans – umbilical. I am in disfavor of the TUBA approach and do not like the trans axillary. With both approaches there is greater morbidity especially concerning implant malposition. I have found no reason to abandon approaches that are for the most part predictable. New developments in procedures sometimes benefit the surgeons marketing program more than patient outcomes.
The most controversial issue is implant type, saline or silicone. It must be disclosed to patients that no implant type is infallible, that there are long term risks associated with both. There are pros and cons to both saline and silicone, Since January of 2007, the majority of my patients have chosen silicone and have been very happy, but this choice is made only after thorough review of the pros and cons of their choice.
The last issue is not new in my practice, but has emerged to the foreground due to some high profile misadventures. Elective cosmetic surgery should be performed by a qualified {board qualified or board certified} plastic surgeon in an accredited facility that ensures a safe environment. Preparation of the patient for surgery should include appropriate medical tests and workup to help lower the intrinsic risks of any surgical procedure.
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Dr. Elliott - Plastic Surgery
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Breast Implants
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