An important credential of a qualified plastic surgeon is certification by the American Board of Plastic Surgery (ABPS) or to be a fellow Royal College of Physicians and Surgeons (FRCS) in England or Canada. Unfortunately, in most states any physician with a medical license can perform plastic surgery even if they are certified in another specialty or not board certified at all. Contact the American Society of Plastic & Reconstructive Surgeons at http://www.plasticsurgery.org/ or call 800-635-0635 to verify any surgeon you’re considering is certified by the American Board of Plastic Surgery. This at least lets you know you’re working with someone who trained exclusively to, and is devoted to, doing only plastic surgery. I hold both certifications since I got my FRCS when I was in England.

What role does external ultrasound play in liposuction?

There’s a lot of hype in the media right now about ultrasound and liposuction.  I’ve used external ultrasound for years and years.  I prefer the external to internal.  Ultrasound waves going through the skin mix with a special wetting solution.  This does a couple of things.  It helps the anesthetic disperse more evenly, the fat is softer so it extracts more easily and it sets up collagen regeneration for better skin recoil and elevation. 

What is the most common complication you've seen?

Complications are really rare. Men and women are generally very pleased with their results. I haven't seen any serious complications but, as with any surgery, the potential is always there. Hematoma, is a collection of fluid under the skin that could cause extreme swelling and pain is always possible. That’s why we put you in a compression girdle or garment, ask that you avoid aspirin products for 10 days before surgery and advise that you take it easy for the first three days. If this happens, although it's more painful than usual, most of the time the body will slowly absorb the fluid and you don’t have to do anything. However, if the swelling were to continue to increase, or the pain was not tolerable, you might have to go back to the operating room to remove the fluid to relieve the pressure.

How long will I be at the surgery center and what do I take with me?

You’re usually there a full morning or afternoon or however long it takes before you’ve met the criteria for discharge. Don’t wear makeup or jewelry. The clothing you wear may go home with a stain on it so wear old, loose, comfortable, dark colored clothing.

Can I participate in sports as usual?

After the initial healing period, it’s life like usual. Whether you jog, lift weights, etc., just start slow and work back up to your regular intensity gradually.

 Will all my friends and co-workers notice?

Most patients say nobody seemed to notice specific changes but you may get compliments on an outfit you’ve worn for years that no one ever noticed before. You may weigh exactly the same but someone will compliment a weight gain or loss or ask how long you’ve been working out. So if you’re doing this for any reason other than just how you’ll feel about you, pass, because to tell you the truth, you’re the only person it’s really that important to.

What can I do to speed my recovery?

Because you hurt, early on you'll have a tendency to tense up, take shallow breaths and stiffen your body. It helps if you make a conscious effort to breathe normally and relax your muscles. Keep the ice on for the first 24 hours, it really helps.

How much pain can I expect?

We give you adequate pain medication but, just like any other surgery, the first few days may be intense.  After this you may have soreness that gradually diminishes over the next couple of weeks.

 I have a mitral vavle prolaspe.  Is this a problem?

Mitral Valve prolaspe is not a contraindication to surgery. You will be given antibiotics through the IV at the time of surgery.

 Will I have to stop my medications?

The medications that concern me are aspirin products for bleeding reasons and some MAO inhibitors and diet pills have to be stopped before surgery since they have the potential to make the blood pressure drop too low when mixed with certain general anesthetics. Also, avoid herbal remedies for three weeks before surgery.

 I'm diabetic.  Is this a problem?

No more than any other surgery. It just means you need a little special attention and we may want to involve your primary care physician.

Can we treat more than one area at a time?

I'm happy to treat as many areas as practical, within the limits of safety, during one surgery. If you have smaller amounts scattered in several areas such as the abdomen, waist, hips and thighs, we can probably do all these areas at once. The extent of the procedure is determined by guidelines regarding the amount of fat/fluid we can safely remove at one time without upsetting the body's fluid balance. If you have a large amount in the abdomen, waist and hips we may have to concentrate on just these areas to do a good job. The legs, for instance, may need to be deferred until a second surgery. My fee is based on each operative setting, not how many areas I treat.

My stomach bulges. Will liposuction make it more flat?

Two issues can make the stomach bulge. One is the fat between the muscle and the skin. Liposuction reduces this volume of fat which will make the area flatter but, if you let your stomach muscles pooch out ……you may still have some bulge. Only you can help that by doing exercises to strengthen the muscles.

Will my clothing size go down?

That depends. Say we reduce saddle bags, and the reason you wear a 12 instead of an 8 or 10 is because you can't get your hips in the 8 or 10, then you'll drop a size. However, if it takes a 12 to go around your waist, or the bones of your hips, reduction of the saddle bags will make you look more slender and shapely but you may not necessarily drop a clothing size.

How much weight will I loose?

Very little. The change is in contour, not what you see on the scale. At the most, we really only remove a few pounds of tissue but it doesn't take much volume to make a nice difference in contour. If you were to spread a 2 lb pack of hamburger on your abdomen, think of the bulge it would make. Same principle. This is a finesse procedure. Sometimes what you leave behind is as important as what you take. We are trying to achieve a shape - not just empty a space of fat.

How long do I have to wear the girdle or binder?

Generally, about 3-6 weeks (24 hours a day except when showering or during intimate times) depending on your individual situation and what areas are treated? Panties are worn on the outside so you don’t have to take it up and down all day long. I believe support of the operative sites is very important to the overall result.

Will I see the results right away?

You generally see a major change in contour during the first few weeks but the shape changes even more, very gradually, over the next several months to a year as the healing on the inside takes place. One area may resolve a little faster than another. In the beginning, the treated areas will feel quite rigid when you touch them but they will soften as time passes. Also, because of gravity, you will almost always have more swelling that stays longer in the lowest area treated.

What if I want more done?

Sometimes a patient will request that I do more which can usually be done after the appropriate healing time has passed.

What will my recovery be like?

The first three days, although you're up and about and we want you to keep moving, I like you to take it easy. Read a book, watch Oprah. Elevate your legs if we treated them and keep the ice on. Let someone else take care of the children, do the laundry and cooking. After this you can start resuming activity at your pace and comfort. Expect swelling to go up and down with your activity level.

When can I shower?

After you've been seen in the office for your first postop visit which is usually the day after surgery. No tub baths. Put a skim of Neosporin ointment on the incisions and cover with a bandaid. Don't stay out of your girdle any more than necessary.

What will I need to buy to be prepared for this surgery?

Make sure you have a bag of ice on hand for your ice bags. You'll need bandaids and Neosporin ointment. A box of sanitary pads is convenient (and cheap) to put over any incision that might leak the first day or two.