Send Your Saddlebags Packing

New Hampshire experts discuss liposuction



Illustration by Stephen Sauer

True story: Every year, we look forward to a sure sign of spring. No, not pre-season baseball or the return of warbling songbirds. It's a woman living down the street who, every spring, hooks up her vacuum cleaner to a lengthy extension cord, goes outside and vacuums her front lawn. We kid you not. She seems to focus on the area closest to her impressive annual display of daffodils, but we have no idea what she is sucking up, exactly.

No matter. Many of us enjoy a spring ritual of some sort, and a thorough straightening up is particularly satisfying this time of year. Of course, with bathing suit season lurking, a more personal and intimate sort of clean-up might be appropriate for some of us pasty Granite Staters. If you've been frustrated by jiggling thighs or a paunch that persists no matter how strict a diet and exercise regimen you inflict upon yourself, you might consider liposuction, the cosmetic surgery technique that removes fat by suctioning it out of the body.

The idea of quickly getting rid of unwanted fat is appealing, but it's important to remember that the goal of liposuction is to sculpt and re-contour obstinate fatty areas, not to achieve massive weight loss; the best candidates for the procedure are not obese. "The most aggressive liposuction sessions will remove at the most about 10 pounds," says Wayne K. Stadelmann, MD, FACS, a plastic surgeon with Concord Plastic Surgery. Stadelmann says he "almost never" takes out that much since doing so would change the nature and risk level of the surgery. He typically removes closer to six pounds, he says. Plus, although it might be tempting to go for the ultra-thin supermodel look, patients and doctors would be wise to show restraint since removing too much fat at once through liposuction can result in hollows, waviness and contour irregularities that "are very difficult to reverse," Stadelmann says.

Although liposuction is an invasive surgical procedure, scarring from it is minimal since the access incisions made during surgery are tiny - about three-eighths of an inch long, Stadelmann says, and the procedure is considered low-risk. No surgical operation is completely risk-free, however, so individuals who sign up for liposuction must typically undergo some sort of pre-operative medical evaluation.

And despite liposuction's reputation as a no-sweat-or-hunger-pangs-required form of re-shaping, Stadelmann advises patients who are not already near their ideal body weight to delay the procedure a bit while they attempt to shed some fat the old-fashioned way. Losing pounds prior to liposuction will help maximize the surgery's results, he says, and bring the myriad health benefits that accompany weight loss. Patients who are in a hurry or cannot lose the weight on their own can opt out of this step, he notes.

Overall, though, liposuction involves little effort on the patient's part. Post-procedure, doctors often recommend that patients wear a compression garment and take a break from exercise for a while, which can be a struggle for many body-conscious liposuction patients, Stadelmann says.

One thing's for sure: There's no denying liposuction's versatility. There's nary a body region, it seems, that cannot be liposuctioned. Want to get rid of your muffin top? No problem. Too much freight in your caboose? Consider it re-shaped. Embarassed by your back fat rolls or overly endowed breasts? (That applies to men too, by the way.) Liposuction can fix that too. Even your face can be re-contoured with liposuction, so you don't have to live with basset hound jowls as you age.

Results are not instantaneous, however. It typically takes months before the final, re-shaped you is visible. And ironically, the surgery can lead to temporary fluid-associated weight gain. Stadelmann advises his patients to avoid the bathroom scale for a week or two post-surgery to avoid any anxiety or frustration while the body heals and recovers from the procedure.

But typically, each area only needs to be treated one time, and once liposuction removes the fat cells, they're gone for good; patients who have sensible eating and exercise habits will remain re-shaped in their liposuctioned area. Significant weight gain might plump up treated spots, but the amount of bulge in those areas will be proportionately less than in non-treated areas, and will be less than if you'd never had liposuction, Stadelmann says.

Laser Lipo

Some doctors offer laser-assisted liposuction as a fat removal method. "Laser lipo," as it is sometimes called, differs from conventional liposuction in that a laser is placed into surgically made incisions to melt fat, which can then be suctioned out of the body. Patients' pre-operative preparation and post-operative recovery are similar to that of traditional liposuction patients, says Khalil A. Khatri, MD, a dermatologist and cosmetic laser surgeon at the Skin and Laser Surgery Center of New England and the New England Institute of Laser Research in Nashua. But liquefying the fat makes removing it easier, and the heat from the laser, which is carefully monitored to avoid burns, stimulates collagen and elastin production. That can make the skin in the liposuctioned area smoother and tighter, Khatri says. Compared with traditional liposuction, healing after a laser-assisted liposuction procedure can be faster, Khatri says, and with less bleeding and fewer complications.

Like conventional liposuction, however, laser liposuction is not a weight-loss treatment and is not meant for obese people. In addition, the treatment is not a meal ticket to eat cheeseburgers and fries every day. The best candidates have just a few pesky problem areas - isolated fat bulges that are resistant to diet and exercise - and are committed to caring for their body over the long haul. "[Some people] think once they've gone through the procedure, they don't have to diet and exercise," Khatri says. But "it's part of the whole process. It's not that we do the procedure and then the problem goes away for good. You're still going to have to maintain and do your part."

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