How safe is office-based liposuction?

A recent paper published by Startling et al in the journal Dermatological Surgery (2012;38:171-177) examined 10 years of data collected in Florida and 6 years from Alabama. The investigators looked at all in-office adverse event data in order to determine which were the safest surgical procedures carried out in-office.

Here are some of the conclusions which were made:

1. Cosmetic procedures performed in offices by dermatologists under local and dilute local anaesthesia yielded no reported complications.
2. Liposuction performed under general anaesthesia requires further investigation because deaths from this procedure continue to occur despite the ability to use dilute local anaesthesia for this procedure.
3. Requiring physician board certification and physician hospital privileges does not seem to increase safter of patients undergoing surgical procedures in-office.
4. There were NO deaths from liposuction when using tumescent local anaesthesia.

As expected, the study reported that liposuction is extremely safe when using tumescent anaesthesia instead of a general anaesthesia. There was no mention of conscious sedation so we are unable to comment on that although we believe that conscious sedation provides patients the best of both worlds in anaesthesia - i.e. complete pain relief without the risk of a general anaesthetic.

Can I have Vaser 4D Sculpt if I've had liposuction before?

Many of our Vaser 4D Sculpt patients have had liposuction before but now want to benefit from the sculpting effects of this new technique. Patients who have had a liposuction before will be referred to as 'secondary patients'. They often are not aware that their previous liposuction will make any future procedures much more challenging with greater risks and more unpredictable results. So during a detailed consultation with me, I always explain the following points:

• The previous liposuction will have caused fibrosis (scar tissue) beneath the skin and sometimes this is quite dense. Dense fibrosis raises the risks of perforation and uneven results because more force is required to pass the instruments through the tissues. However, the Vaser 2.0 Lipo system, delivers ultrasound energy much more efficiently and this copes very well with fibrotic tissues.
• When trying to create a six-pack or High Definition Liposculpture, the lines may not be as obvious during the surgery due to the fibrosis. In a patient who has not had lipo before, the sculpting is more obvious because only fat is sculpted. However, in a lipo (secondary) patient, the sculpting is done in both fibrotic and fatty layers and because the fibrotic layers are more stiff, they do not necessarily reveal their new shape straight away.
• There will be much more inflammation and swelling in secondary cases because there will be generally more trauma and blood loss when compared to first timers. As such, more aftercare sessions are generally required over a longer time and results may take much longer to develop (even up to a year). The strength of the definition achieved is much more unpredictable due to the prolonged, although patients will be slimmer and there will be a hint of definition in the worst case scenario.

For a full consultation with Dr Ravi Jain in London or Harpenden, please call 01582 762877 now.

THE FIRST VASER 2.0 LIPO SYSTEM ARRIVES IN EUROPE

We've had 9 months experience now with the Vaser 2.0 Lipo system at Riverbanks and we absolutely LOVE it because it allows us to treat more difficult cases such as patients who've had liposuction before, correct deformities from previous liposuction, perform vaser 4D sculpting and also harvest and transfer fat to other areas of the body such as the hands, decollete, buttocks and scars because the stem cells in the fat are preserved.

Here's Vaser's official press release about this news:


VASER for Physicians | News & Events - THE FIRST VASER 2.0 LIPO SYSTEM ARRIVES IN EUROPE

How quickly will I see results after Vaser when treating my man boobs?

When treating gynecomastia with the Vaser 2.0 Lipo system at Riverbanks, we are confident that you will see results immediately. Here are some photos taken immediately before surgery started, and right at the end of the same surgery.

before

after Vaser 2.0 Lipo

Vaser 2.0 Lipo system

The Vaser 2.0 Lipo system at Riverbanks Clinic is the ONLY one in the UK. It allows our team of Vaser specialists to create amazing results like above with much more accuracy than previous models. Only Dr Jain has the Vaser 2.0 Lipo system in the UK, the very latest in Vaser Lipo technology.

If you would like to find out more, visit our main website or book a consultation.

What happens if I put on weight after Vaser?

I get asked this question a lot and during my consultations I make sure this is covered even when it is not asked as it is an important fact which needs to be considered. Lets first explain how fat is deposited in adults.

pinching subcutaneous fat

Adults have a finite amount of fat cells and not usually grow any more fat cells. When people put on weight, their current fat cells simply expand, and when they lose weight, these cells shrink again. Men and women lay down fat differently. Women tend to lay down fat under the skin and around the abdomen. This is called peripheral fat or subcutaneous fat and is easily pinchable around the waistline. Only when women are obese do they tend to put down fat internally around the organs.

On the other hand, men tend to put down fat inside the abdomen, around the internal organs first. When they are obese they then lay down fat under the skin. This has important consequences as internal fat or 'visceral fat' can lead to heart disease, diabetes and cancers. So it is very important for men to lose visceral fat to prolong their lifespan. However, most men have both peripheral and visceral fat present especially those that work out, and there may be more peripheral than visceral fat present in such individuals. If so, they maybe suitable candidates for Vaser 4D Lipo.

before & after Vaser 4D Sculpt

Liposuction gets rid of peripheral fat very effectively and it is this fat which we sculpt in Vaser 4D Sculpting.  On the other hand, visceral fat cannot be treated with liposuction! The only way to get rid of visceral fat is through lifestyle changes. However, the good news is that visceral fat responds very well to lifestyle changes such as diet and exercise. On the other hand, peripheral fat responds more slowly and that is why many people get frustrated when they can't lose more weight around their waistline despite shrinking the size of the tummies.



So what happens if you gain weight after liposuction?
After liposuction, there is a reduced amount of peripheral fat in the body. So when someone's lifestyle becomes more sedentary the body will lay down fat. But if there is no peripheral fat to absorb this extra fat, then the next place to take it is the internal visceral fat, inside the abdomen and thorax. This is very unhealthy for reasons explained above. The other areas which may grow are areas of untreated peripheral fat such as the buttocks or breasts. So if someone does put on weight after Vaser, they may get bigger buttocks or breasts or their tummies may swell.

This is why any form of liposuction should NOT be used as a weight loss alternative but more of a option for getting rid of stubborn areas in patients who are only slightly overweight. Vaser 4D Sculpt can be used to treat patients who were previously considered to be too slim for traditional liposuction and this has opened up sculpting possibilities for a whole new population.

If you need more Vaser Lipo information contact our friendly team on 01582 762 877 now!

How does Vaser Lipo work?

Vaser Lipo is a 3rd generation ultrasound device used to EMULSIFY fat before removing it from the body with relatively gentle liposuction. How is this possible? Well, the best way to explain it is to describe how traditional Suction-Assisted-Liposuction (SAL) works first.

With SAL, fluid is injected into the fatty tissue in order to minimise blood loss and also soften some of the fat. The fat cells are present in small globules of fat, a bit like seeds in a pomegranate and are held in place by collagen scaffolding, much like the pith in a pomegranate. These globules are STILL ATTACHED to the body when SAL is commenced. So it is necessary to use a relatively high powered suction to detach the fat from the body and as a result  there tends to be a higher amount of collateral damage, i.e. damage to the other structures such as blood vessels, nerves and also the collagen scaffolding. This is why there is a higher amount of blood loss with SAL when compare to VASER, and also why recovery is often slower.

pomegranate

Fat structure

Fat before treatment

VASER Lipo, starts off in a similar fashion to SAL, in that the fat is first injected with anaesthetic fluid in order to minimise blood loss, provide pain relief and also soften the fat. BUT, before suction is performed, the Vaser probe is inserted into the body and it emits ultrasonic waves into the fat to shake the fat globules off the body, breaking them up in to smaller groups of VIABLE fat cells, which look like a liquid. The energy from the Vaser probes primarily effects just the fat cells and so the surrounding tissues such as nerves, blood vessels and skin are left largely undamaged. Then the special suction tubes valled VENT-X Cannulae are used which have no sharp edges, and together with LOW POWER SUCTION, the fatty liquid is removed. The Vent-X Cannulae and low power suction cause hardly any collateral damage and so the body is less traumatised and hence recovery is quicker.

infusing anaesthetic fluid

Emulsification of fat

Aspiration (suction)

Natural Skin Restraction

Below is a video of how the Vaser probe emulsifies a fatty globule, extracted from a live operation performed at Riverbanks Clinic.

For more information about Vaser Lipo and to see if its suitable for you, book a consultation here.

Male Breast Reduction with Vaser in the UK

Gynecomastia reduction is one of the most popular cosmetic procedures requested by men in the UK. Many men have suffered since childhood and are embarrassed to take off their tops in front of others, such as on the beach, swimming pools or sometimes in front of new partners. Sufferers often carefully choose loose clothing to hide the shape of their breasts. For many men, the condition is not responsive to diet or exercise and so the only alternative is surgery. Previously, the only option was quite a traumatic procedure with a long recovery. Vaser liposuction is a much gentler treatment option with many men returning to work in just a couple of days.

Watch this video to see Dr Jain explain how a Vaser Lipo surgery is performed to treat gynecomastia. This video contains surgical footage.

Surgery is performed under a light anaesthesia called 'concious sedation' where you will have all the benefits of a general anaesthetic (i.e. absolutely no pain or memory of the event) but without the risks (i.e. you are breathing yourself and awake). Following treatment, you will need to wear a compression vest for 3 weeks 24/7 then another 3 weeks for 12 hours a day. Most men require simple painkillers such as paracetamol for about a week. Results are evident very quickly.

If you would like to book a consultation with one of our Vaser specialists call our clinic on 01582762877. Consultations are available in Harley St or Harpenden.