Liposuction is one of the most commonly performed procedures in the United States. It is most effective to help contour the body in areas where diet and exercise have not succeeded by removing excess fat deposits through a tiny suction tube. It can flatten the abdomen, decrease hips, thighs, and buttocks, trim the waist and love handles, and reduce fatty bulges in the knees, neck, and arms.
The Ideal Candidate
The best candidate for liposuction is a patient who is at or close to their baseline weight. Liposuction is not a successful tool for weight loss. It is ideal for stubborn fat or problem areas. The most notable results are in patients who regularly exercise and eat a nutritious, balanced diet. With that said, I have had some patients who are on their way to obtaining their goal weight and liposuction helps to springboard them into a better lifestyle.
Tradition or High Tech
In the hands of a skilled surgeon, traditional liposuction and laser or ultrasound-assisted liposuction both will lead to excellent results. Traditional liposuction is best performed on patients who have pockets of excess fat while having firm, elastic skin. Patients who have loose skin may be better served by undergoing a lifting procedure where the excess skin and fat is removed or by using laser or ultrasound-assisted liposuction technique like VASAR, SmartLipo, or SlimLipo which heat and tighten the overlying skin while removing fat.
To Cut or Suck: Tummy Tuck or Liposuction
Many patients question if they need a tummy tuck or if liposuction will give them an equally good result without the large scar. Prior to pregnancy, young women with a slightly protuberant abdomen usually only require liposuction. The scars after liposuction are discrete, the recovery fast and results fairly predictable. Most women who have had children require not only the removal of fat and skin but also muscle tightening. These women will not benefit from liposuction alone. In fact, the removal of fat may result in even looser skin and will do nothing for the abdominal bulge.
Depending on the extent of excess skin and laxity of the abdominal wall, some patients may benefit from undergoing an abdominoplasty or tummy tuck. Liposuction alone will remove excess fat but will not tone skin, remove stretch marks, fix a rectus diastasis (widening of the rectus muscles) or remove overhanging skin. Many patients who undergo an abdominoplasty will require supplemental liposuction on their flanks to help contour their waistline. I will help formulate a treatment plan tailored to your body and the results you wish to achieve.
The Male Breast and Gynecomastia
Enlarged male breasts or gynecomastia affects nearly half of all men at some time in their lives. Some cases will resolve without treatment but often treatment is necessary. Although gynecomastia may be due to a systemic disease, heredity, steroids, or medications, the cause of it is often unknown and may not be related to body weight. For many men, large breasts cause social awkwardness, embarrassment and lower self-confidence. Through a simple, outpatient procedure many men are able to regain a smooth, contoured, more masculine chest.
Patients who do not require a significant amount of skin to be removed may benefit from liposuction alone. Traditionally, most patients would require liposuction with the addition of a small incision around the areola (dark skin around your nipple) to remove excess glandular tissue. When necessary, the glandular tissue is separated from the skin and underlying muscle and removed through a very small incision hidden under your nipple. It is important that when removing glandular tissue that a small amount is left behind avoiding a possible contour deformity or inverted nipple. Recent developments in technology have dramatically changed the need for extra incisions in many patients. I have found that by using ultrasound-assisted (VASER) or laser-assisted (Slimlipo and SmartLipo) liposuction, I am able to break apart the glandular tissue, leaving a smoothly contoured chest without the extra incision around the areola. I often will use two entry sites which are less than one inch in length located under the arm and in the lower outer part of your chest. Liposuction involves moving a cannula, a thin, hollow tube, back and forth in a controlled motion to loosen and remove excess fat similar to a vacuum. The addition of heat via ultrasound or laser-assisted liposuction not only decreases the need for extra incisions but also causes skin tightening; converting some patients who may have needed a skin excision to patients requiring only liposuction.
Most patients are concerned about not being left with a smoothly contoured body. It is also important to use small liposuction cannulas and to perform the operation in a deeper plane of fat to avoid these issues. I am very particular about using precise, small diameter cannulas to ensure that lumps and bumps are not left behind.
Liposuction is performed as an outpatient procedure in a surgical suite or surgery center. The surgery usually lasts for one to three hours depending on the size of the area. You will go home later that day dressed in a compression garment. Although most patients go home that evening, when liposuction is combined with larger procedures or when large volumes of fat are removed, patients often stay overnight at the surgical suite. Due to the local anesthesia used in the procedure, mild sedation is often enough for smaller cases whereas general anesthesia may be needed when combining procedures
Immediately after surgery, your body will be bandaged with a compression garment. You will wear this garment around the clock for your first two weeks after surgery. The garment will help reduce fluid retention and help shape your new body. You will likely find that you feel swollen and sore for the first few days after surgery. Most patients will take pain medication for 1-3 days and return to work in 4-5 days. Bruising may continue for two weeks.
You can begin light exercise on day one but it is best not to overexert yourself as it will lead to increased swelling. You can resume strenuous activity in three weeks.
The fat cells removed via liposuction are permanently removed from your body. Although the results from surgery are visible immediately, as the swelling subsides you will see a flatter, more defined body. Tissue retraction, definition, and contouring will continue to improve for one year. The change in your contour should be long-term but weight change, pregnancy, and natural aging may subsequently alter your appearance. Although the results are often not immediately obvious due to swelling, they will continually improve as the swelling subsides to reveal a more contoured, slimmer you.
A Picture is Worth a Million Words
A picture may be worth a million words but in the age of the internet, online photos can be viewed by billions of eyes. In respect of patient privacy, a before and after section was not created on our website. Several patients have agreed to allow their photos to be viewed by prospective patients in the office. You may request to view photos during your consultation. Some patients have also agreed to speak with prospective patients if you would like to learn more about the procedure from a patient’s perspective
The First Step
If you are considering gynecomastia surgery, please call our office at (212) 600.4109 to arrange for a consultation. Our New York City practice accommodates out of town and international patients who need to travel in for surgery as well as those who are local to Manhattan.
I wanted to thank you again for giving me the opportunity to experience a little of your magic world. I will be coming back for more, that’s for sure!
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Thank you so very much for your professionalism and wonderful work you did. I cannot begin to express my gratitude and appreciation for helping me “through the process”. I feel like a new person!
Dr Doft’s care was excellent. Very patient, flexible and understanding. This made the process much easier.
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