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Top ten questions to ask about liposuction

Q:

What facts are important to know about liposuction before scheduling a procedure?

A:

More than 400,000 patients had liposuction in 2016 according to the American Society of Aesthetic Plastic Surgeons, making it the most popular surgical cosmetic procedure in the United States.


There is a good reason that so many patients are interested in liposuction; it can provide the individually tailored body sculpting results that people truly appreciate. Patients also appreciate that this minimally invasive technique is done on an outpatient basis and requires a very short recovery time.


The best way to get optimum results is to make sure that you are an informed and educated patient before your consultation. Asking your plastic surgeon the following ten questions will help you make the right decision.


1. Are you board certified by the American Board of Plastic Surgery?


This is a question you should ask even before you schedule a liposuction consult. Do some research online and make sure that the plastic surgeon you choose for a consultation is board-certified by the ABPS. If they are board-certified it means that they have undergone extensive training in their specialty and that they routinely pass rigorous board certification exams. The three surgeons at Edina Plastic Surgery are all board-certified.


2. Who is a good candidate for liposuction?


Liposuction should not be considered as a treatment for obesity; it is best used to treat stubborn, excess fat deposits that cannot be resolved by diet and exercise. The best candidates are patients who are healthy, exercise regularly and have realistic expectations of the procedures’ results.


3. What are the benefits of liposuction?


With continued healthy eating and diet, the effects of the liposuction procedure can be permanent. This procedure helps to smooth and contour the skin; and it can result in a dramatic improvement in appearance.


4. What type of liposuction will be performed?


When your doctor meets with you they will suggest the type of liposuction that is best suited for your particular needs. The right technique for your situation may depend on several factors, including treatment location, the extent of correction desired, and your doctor’s personal protocols. Ask your surgeon which type of liposuction they perform on a routine basis; a skilled doctor will be experienced in a variety of techniques.


5. Can I have liposuction at the same time as another cosmetic procedure?


It is very common for patients to have liposuction at the same time as another procedure such as a tummy tuck or a breast augmentation or lift. Your doctor will be able to tell you whether you are a good candidate for multiple procedures.


6. If I choose to have liposuction will the results be permanent?


When liposuction is performed, the fat cells that are removed do not return. However, if the patient experiences future weight gain, the surrounding fatty tissue can still expand. Ask your surgeon for ideas on how to best maintain your liposuction results for the long-term. They will have advice on how to best retain your newly refined physical contours.


7. Where will my liposuction procedure be performed?


Because liposuction is normally performed as an outpatient procedure, you will need to arrange for a ride home after the procedure. At Edina Plastic Surgery we perform liposuction procedures at our own state-of-the-art accredited surgical center which is located within our clinic. Some surgeons use an off-site day surgery facility that can be miles from their clinic location, so make sure you are familiar with that location and that it is convenient for you.


8. What type of anesthesia will be used?


Liposuction surgery is typically done under adequate anesthesia to allow your surgeon to do the very best job possible. For larger areas, this will be a general anesthetic. While local anesthesia can be used for smaller areas, there are limits to the area that can be done safely with this technique.


9. How long does the liposuction procedure take?


Traditional liposuction typically takes approximately three hours or less to complete. In some cases where large areas or multiple areas are being treated at the same time, the procedure can take longer.


10. Is there anything I need to do beforehand to prepare for my surgery?


First and foremost, patients are advised to quit smoking before the liposuction procedure. Smoking can prolong healing of wounds. You may also need to discontinue certain medications as they can cause bleeding issues during surgery. Ask your doctor for pre-procedure instructions.

Breast Implant Revision Surgery

Q:

When should you consider a breast revision? What are the benefits of having a breast implant revision surgery? How do you tell if you are you a good candidate for breast revision? How is a breast revision procedure performed?

A:

Breast implant revision surgery, (also known as breast implant replacement) commonly involves removal and/or replacement of saline or silicone breast implants. This surgery is performed to change the size or type of a patient’s implants and to correct any complications from a primary breast augmentation. Restoring a youthful breast contour and appearance is one of the benefits of this procedure.

The following are suggested guidelines:

  • If your saline breast implants have deflated or an X-ray or MRI suggests that your silicone implant has a shell leak.
  • If you want to change your implant/breast size
  • If you have tightening of the scar tissue around the implant (capsular contracture) or your breast implants have shifted in position.
  • If your breast tissue has changed as a result of skin stretching or weight loss/gain.

These are some of the benefits that patients have experienced:

  • Your breasts will regain a youthful shape.
  • You have the ability to increase or decrease your breast size.
  • Your breast symmetry will be improved.

Even if your breast implant surgery was perfectly planned and beautifully executed, changes can occur over time. If you are in good general health, have a positive attitude and realistic expectations, you are most likely a good candidate for this procedure.

The exact procedure your surgeon will use for breast implant removal and replacement varies depending on the reason for your breast revision.

Change in implant size: If you decide to change your implant size, your surgeon will frequently use your original incision for implant removal and replacement. If you want a larger implant, your doctor will surgically enlarge the “pocket,” or space in the breast, surrounding your implant to accommodate a larger implant. If you want smaller implants, your doctor may surgically reduce the size of the pocket with sutures to properly fit smaller sized implants. A breast lift may be done at the same time.

Capsular contracture (hardening of the capsule and implant): Your doctor will probably use the same incision used to insert the original implants to remove the hardened capsule and implant. He or she will then insert a new implant.

Implant rippling: When the edges of saline breast implants are visible and palpable (able to be felt), your surgeon may use the same incision to remove or reposition the implants as was used to originally insert them. Other options include using a different type of implant or placing the new implant into a different breast pocket that either has thicker muscle coverage or uses other tissues to cover the implant edge.

Implant malposition: Sometimes implant pockets are created too far apart or too close together, resulting in poorly positioned breasts. To correct this, using the prior incision, your surgeon will manipulate the scar tissue from the capsule surrounding the implant and reconstruct the pocket in the appropriate position using suturing techniques. Your surgeon may need to utilize other tissues to reinforce this new implant pocket and may recommend using a cellular dermal matrix product to add additional support.

Implant removal: If your implants are large and your skin has stretched, your surgeon may recommend a breast lift in addition to implant removal, but implant removal alone may suffice. The original incision created to insert the implant will almost always be the same one used to remove it. The lining around the implant, or “capsule,” is often surgically removed at the same time to facilitate rapid healing.

Elevation of nipple and areola position: If it is necessary to elevate the position of your nipples and areolas (pigmented skin surrounding the nipples), you will need additional incisions. Incisions around the upper portion of the areola will be adequate in cases where not much elevation is needed. When more lifting and tightening is necessary, an incision all the way around the areola, including a vertical scar extending down from the areola to the crease under the breast, may be necessary. For cases where significant excess skin needs to be removed (such as in women who have had massive weight loss), a third incision may be necessary that will extend horizontally beneath the breast, following the natural curve of the breast crease. If your nipples need lifting, the nipples and areolas remain attached to underlying mounds of tissue and this usually allows for the preservation of sensation and the ability to breastfeed.

The goal of the board-certified plastic surgeons at Edina Plastic Surgery and our entire staff is to help you achieve the most beautiful and natural-looking results, as well as making your surgical experience as easy and comfortable as possible.

Liposuction and The Ideal Female Silhouette

Q:

I’m considering having liposuction on my hips and buttocks. How do the surgeons decide how much fat to remove during the procedure?

A:

Despite what most people may believe, the main goal of liposuction is not really about removing as much fat as possible. The most important thing that plastic surgeons consider is whether the fat that is left behind will artfully preserve the natural contours of the body.

“There is a true art in performing liposuction,” says Dr. Robert Wilke, a board certified plastic surgeon at Edina Plastic Surgery. “Removing too much fat can not only destroy the natural contours of the body, but it can also lead to skin irregularities that may be hard or impossible to completely correct in the future. A good surgeon will take many different factors into account to achieve the best result in the overall silhouette. That is why it is so important to consult with a board certified plastic surgeon who is very experienced in this area.”

When surgeons perform liposuction of the hips, it typically also involves the flanks in order to create a smoother, more natural transition. When the fat rolls, also referred to as love handles or muffin tops, are removed or reduced the buttocks area will appear more voluptuous.

Liposuction is not a procedure that is commonly performed on the butt cheek due to the increased risk of skin asymmetries and the possibility of a sagging appearance. This is particularly true when performing liposuction on the lower half of the buttocks.

Rather than doing liposuction on the actual buttock cheek, the vast majority of patients benefit from liposuction of the upper/outer butt, outer thigh and hip-flank area.

Excess fat in the upper-outer buttock makes it appear flatter and wider. For this reason, contouring the area with liposuction can provide a dramatic improvement for the butt appearance even without the use of silicone implants or Brazilian butt lift (fat transfer).

It is important to note that the amount of fat removed via liposuction must not only be determined by the patient’s desired post-op size but balanced with the consideration of the patient’s skin elasticity and ability to re-drape to the new contour.

If a surgeon removes more fat volume than the skin can handle, a wide variety of problems can result including visible and palpable rippling or a sagging appearance. While skin asymmetries can be improved by fat transfer, which in essence is a liposuction procedure in “reverse,” patients can only expect some level of improvement, as opposed to a complete remedy.

“To put it simply,” says Dr. Robert Wilke, “the goal of liposuction in the hips and buttocks is to remove just the right amount of fat while leaving behind enough fatty tissue to preserve the natural contours of the body and maintain a smooth skin surface and a feminine silhouette.”

Breast Implant Considerations

Q:

I am considering getting breast implants. What are the steps involved in deciding what size implant will look most appropriate?

A:

Breast implant preferences vary substantially from woman to woman and the size choice can be influenced by factors such as lifestyle, goal appearance, and modern trends.

Past trends/future trends.

In the past, the larger, more obvious breast implants were a popular look. While a full, high, and round silhouette will always have some popularity, many women today are leaning towards a more modest, natural-looking breast enhancement.

Bigger Isn’t Always Better.

Dr. Robert Wilke, a board-certified plastic surgeon from Edina Plastic Surgery shares his thoughts on this topic. “When patients come in for a breast augmentation, we listen carefully to their goals. What is the type of look that they are hoping to achieve?” Dr. Wilke emphasizes the importance of the consultation. “We devote a lot of time during the consultation to implant sizing. We have the patient try implant sizes in a bra to see how this looks, then proceed to using computer imaging on our Vectra XT 3D Camera to determine the optimal size for each patient.”

Trends in breast augmentations: “The Brazilian B”.

While the United States consistently performs a high number of cosmetic surgeries compared to most other countries, Brazil is a solid competitor for the most annual cosmetic surgeries. Breast augmentation is one of the most commonly performed surgeries in both countries, but it’s the Brazilians who have popularized the modern trend toward smaller implants, dubbed the Brazilian B. The trend has since gained traction in the United States as iconic Brazilian models such as Gisele Bündchen showcase how sexy a perkier breast size can be.

One Size Does Not Fit All In Breast Implants.

When deciding which implant will provide a patient with her desired appearance, the surgeon must account for many factors besides size. For example, different implant profiles involve varying levels of height from the chest with corresponding base widths. The implant profile you choose can influence your breast shape as well as how natural your chosen size appears on your body frame. Additionally, chest proportions, breast shape, and the amount of pre-existing breast tissue can all impact the end results of the augmentation; which means that the same implant volume can deliver a variety of different looks on different patients.

The Vectra XT 3D camera at Edina Plastic Surgery is a high tech tool to help determine the appropriate implant size for each patient.

Patients love it that they can see the virtual results of breast augmentations on their very own bodies. Here is just one of many testimonials we’ve received about this incredible technology.

“I am 57 years old and giddy with joy at the results of my breast augmentation. I credit the Vectra 3D camera with giving me the courage to “go for” the size implants that I chose. I have always been a small-breasted woman and am quite petite so it was difficult for me to imagine myself with larger breasts. When I tried on the implants with a “demo bra” I thought I looked ridiculous but when I saw myself on the Vectra 3D camera it made all the difference. I looked great! Thank you Edina Plastic Surgery for my new beautiful breast and for having this technology.”

Pre-pregnancy body procedure

Q:

I waited until I was 36 to have my first child. Can a mommy makeover help me regain my pre-pregnancy body?

A:

Mommy makeovers have become increasingly popular over the past 10 years. This is at least partly due to so many women having children later in life; many are over 35. As such, their bodies may be less resilient than those of their younger counterparts, and the after-effects of pregnancy can be loose abdominal skin, separated abdominal muscles, fat deposits in areas that are resistant to diet and exercise, and droopy breasts. And while diet and exercise can be helpful, in many cases for these patients, plastic surgery is needed to get the kind of improvement that they’re looking for.

“Many of the patients that come to us for mommy makeovers are over 35,” says Dr. Robert Wilke, a board certified plastic surgeon at Edina Plastic Surgery. “Healthy women who are done having children can be excellent candidates for abdominoplasty, liposuction and a breast lift, reduction or augmentation. The overall satisfaction rate for mommy makeovers is very high. Many women have told us that they are delighted with the transformation and their only regret is that they wish they had come in to see us sooner.”

For a typical “mommy makeover”, the board certified surgeons at Edina Plastic Surgery often perform abdominoplasty combined with liposuction, and very frequently the patient also has a breast lift, reduction, or augmentation. Mommy makeover procedures remove extra skin, minimize stretch marks and lift the breasts and body to regain a comparable figure to pre-pregnancy form. Our surgeons listen carefully to each patient and advise them on the most appropriate procedures.

Women are having babies later when their bodies aren’t as resilient.

According to the National Center for Health Statistics, in 2000 the average age of a first time mother was 24.9 years. In 2014, that age had risen to 26.3. And although that may not seem to be a big change, it is representative of a trend that women are waiting longer to have children due to a combination of factors including improved birth control, improved fertility treatments and other socioeconomic reasons.

For many mothers; especially those over 35, one of the most challenging aspects of giving birth is regaining their pre-pregnancy bodies. Many plastic surgery procedures are aimed at providing assistance for those looking to regain their svelte physique. Due in part to the popularity of television shows that focus on plastic surgery procedures, requests for multiple procedures done at one time are rising each year.

Multiple procedures; just one recovery period.

Patients appreciate the fact that when having a mommy makeover, they can have multiple procedures performed at once, thereby having a single recovery vs. three separate ones. With the advent of much-improved anesthesia techniques that allow a safer anesthetic with fewer after-effects, combined with the popularity of such shows as “Extreme Makeover”, requests for multiple procedures at one setting are increasing rapidly.

Recovery time for mothers with children must be considered carefully, and the doctors at Edina Plastic Surgery suggest that patients have a support plan in place to make sure that supplemental help is available for household chores and childcare post-surgery for one to two weeks.

Breast lift surgery

Q:

After having two children I am very unhappy with how my breasts look. Is a breast lift a good option for someone like me?

A:

Statistics released by the American Society of Plastic Surgeons (ASPS) show that breast lift procedures are growing at twice the rate of breast implant surgeries. Since 2000, breast lifts have grown by 75 percent. Breast implants are still by far the most-performed cosmetic surgery in women, but lifts are steadily gaining. In 2014, more than 90,000 breast lift procedures were performed by ASPS member surgeons.

Dr. Robert Wilke, a board certified plastic surgeon at Edina Plastic Surgery says, “Many women develop droop in their breasts over time, often due to the effects of pregnancies and breastfeeding. Some really like the idea of achieving a more optimal breast shape by using the tissue they already have, while some choose to restore breast volume with an implant in addition to a lift. Breast lifts can help them look and feel younger, which is why this procedure has such a high satisfaction rate.”

According to the statistics, women between the ages of 30-54 made up nearly 70 percent of the breast lift procedures performed. More women who have had children and whose breast volume has decreased are consulting plastic surgeons.

Over the years, pregnancy, nursing and the force of gravity take their toll on a woman’s breasts. As the skin loses its elasticity, the breasts often lose their shape and firmness and begin to sag. Patients want a solution for the excess skin and want to see their breasts “back up where they are supposed to be”.

Women often ask if they are good candidates for a breast lift. The ideal candidates for a breast lift are healthy women who are realistic about what the surgery can accomplish. The best results are usually achieved in women with small, sagging breasts. Breasts of any size can be lifted, but the results may not last as long in heavy breasts.

A simple home test can help determine whether a breast lift may be appropriate. To perform the pencil test, a woman simply places a pencil under her breast. If the breast tissue holds the pencil in place against the chest, this can imply that there’s a hanging nature to the breast that can be fixed with a lift.

Patients who had had breast lifts often say that they feel more confident after having the procedure. Many say that they are delighted to be able to wear clothing that would either have not fit correctly, or not looked appropriate before their surgery.

Breast augmentation remains the most popular plastic surgery procedure for women. In 2014, there were 286,254 breast augmentation surgeries performed by ASPS member surgeons. That represents a growth of 35% since 2000, less than half the rate of the statistical growth of breast lifts (75%).

Body contouring post-bariatric surgery

Q:

I had bariatric surgery and have lost a great deal of weight. I am considering having body contouring surgery. Are there any studies that show that this surgery helps patients like me keep the weight off?

A:

According to a new study by Henry Ford Hospital researchers, patients who have plastic surgery to reshape their bodies after bariatric procedures are able to maintain “significantly greater” weight loss than those who do not have surgery.

Many previously obese patients opt for plastic surgery. The types and extent of the surgeries can vary widely; but tummy tucks, arm lifts, breast and body lifts are very common. These procedures can be very effective in removing inelastic excess skin and tissue after substantial weight loss and to reshape or recontour bodies.

The results of the study are encouraging to the plastic surgery community. When improved body image translates into better long-term maintenance of a healthier weight it also translates into a better quality of life for these patients. This improved aesthetic combined with better health is the kind of end result that is very satisfying to both plastic surgeons and their patients.

The study followed patients who underwent bariatric surgery at Henry Ford Hospital. Study results were presented at the annual conference of the American Society of Plastic Surgeons. Of the patients studied 47 subsequently underwent body recontouring procedures.

The Henry Ford researchers recorded each patient’s Body Mass Index, or BMI – a weight-to-height ratio used to determine degrees of obesity – both before their bariatric surgery and 2.5 years after the procedure. Of the patients who underwent contouring surgery, the average decrease in BMI was 18.24 at 2.5 years, compared to 12.45 at 2.5 years for those who did not have further surgery.

These findings suggest that aesthetic procedures following bariatric surgeries may well contribute to improving the long-term results.

Bariatric surgery is used to help obese patients lose weight and includes several types of procedures that limit the amount of food the stomach can hold, including removal of a portion of the stomach or constricting it with a gastric band. Such weight loss can be significant, and result in a lower risk of diabetes and heart disease. This type of surgery can have a significant positive impact on obese patients, but long-term success still depends on patients changing their eating habits post-surgery. There is currently a high incidence of patients who regain weight after the surgery, so procedures that help incent patients to keep the weight off are a positive step in long-term maintenance.

Facial Aesthetic Surgery

Q:

I had a friend who had fat grafting in her face. Is this a popular procedure and if so why?

A:

According to a recent survey of Plastic Surgeons, facial fat grafting is increasing in popularity.

The practice of transplanting fat by injecting abdominal or other fat to fill out cheeks, creases and areas that are sagging has become more widely embraced by plastic surgeons in the past few years. According to results of a survey by NYU Langone Medical Center researchers, the process of fat grafting is gaining in popularity.

The American Society of Plastic Surgeons is the largest plastic surgery specialty group worldwide, and 309 randomly-selected members were asked to complete the survey.

Surgeons were asked about their methods of harvesting, processing, and injecting fat, the most commonly selected injection sites, and their opinions on the overall efficacy of grafting as a facelift procedure. They were also surveyed as to how often they used fat grafting in facelifts.

85 percent of the 309 facial aesthetic surgeons surveyed use fat grafting as a technique to enhance the results of facelift procedures designed to smooth wrinkles and creases, and eliminate sagging. Of this group, over 70 percent reported adopting the method within the past 10 years.

The survey results show that a majority of plastic surgeons across the country are adopting fat grafting as a standard technique to optimize the results of facelift procedures.

Researchers say the survey is believed to be the first of its kind to determine the frequency and extent of plastic surgeons’ use of the injectable fat-grafting method for facelifts. The survey results are summarized in the journal Plastic and Reconstructive Surgery.

As part of the survey, the ways in which plastic surgeons practice fat grafting were analyzed. The most popular sources of fat were from the patient’s abdomen (over 80 percent of the respondents’ cases) and from the hips (10 percent of cases). The amount of fat injected into the face to replace volume loss from aging ranged from 11 cubic centimeters to 25 cubic centimeters (about 3 to 5 teaspoons).

Surgeons typically add extra fat to compensate for the amount of fat likely to be reabsorbed by the body, about 40 percent of the initial injection. The rest remains indefinitely. By contrast, synthetic/commercial dermal fillers, an alternative to injected fat, last only nine months to a year and require repeated injections.

According to the survey group, the most commonly injected areas of the face are the cheek, the region below the lower eyelid, and the nasolabial folds, or creases between the nose and corners of the mouth.

Fat grafting is currently the only widely used method able to counter so-called volume deflation in the face, or loss of fat over time. The results of fat grafting procedures have improved dramatically in the past 10 years. Initial results were sometimes unpredictable and inconsistent. A deeper understanding of the facial anatomy in regards to fat compartments has led to refinements in fat grafting, along with more consistent and longer-lasting results. Reports of complications are rare.

Breast Augmentation Satisfaction Rate

Q:

I’ve heard that the satisfaction rate for breast augmentation surgery is very high, but how high is it?

A:

According to a study published in Plastic and Reconstructive Surgery, the official medical journal of the American Society of Plastic Surgeons, ninety-eight percent of women undergoing breast augmentation surgery say the results met or exceeded their expectations.

The women surveyed in the study also reported improvements in self-esteem and quality of life after breast augmentation.

“So many patients tell me that their breast augmentations have changed their lives for the better,” says Dr. Robert Wilke, a board certified plastic surgeon at Edina Plastic Surgery. “For many women it improves their confidence and makes them feel much more comfortable to wear all types of clothing. Breast augmentation is the most common procedure that we perform. We do see an increased demand in the springtime, however, as people are thinking about shedding the winter clothes and getting ready for swimsuit season.”

225 consecutive women who returned for interviews at least one month after breast augmentation over a five-year period were interviewed for this study. Interviews included questions about the recovery, results, complications and psychological effects.

The average patient age was 34 years old, and the majority of women received saline-filled breast implants placed under the muscle. The average implant volume was 390cc.

Eighty-five percent of women rated their new breast size “just right.” Thirteen percent would have preferred a larger size and less than two percent a smaller size. Only one percent expressed dissatisfaction with their scars, which were usually located in the crease under the breast. Seventy-five percent of women rated their breast firmness “just right.” When asked to rate the result, over half of the patients gave it a perfect 10 on a scale of 1 to 10. Almost all patients (98 percent) reported that the results met or exceeded their expectations.

Increased Self-Esteem and Other Psychological Benefits.

When asked about psychological effects, 92 percent of women reported improved self-esteem after breast augmentation and 64 percent reported an improved quality of life. Before surgery, the majority of women (86 percent) were self-conscious about their breasts. After surgery, only 13 percent were self-conscious about them.

Breast augmentation is the most popular cosmetic surgery procedure in the United States-approximately 286,000 operations were performed in 2014, according to ASPS statistics. The study results provide new information for women considering breast augmentation, particularly in terms of their expectations of the recovery and results.

Candidate for eyelid surgery?

Q:

Who is a good candidate for eyelid surgery?

A:

In general, good candidates for eyelid surgery are:

  • Healthy individuals who do not have a life-threatening illness or medical conditions that can impair healing
  • Non-smokers
  • Individuals with a positive outlook and specific goals in mind for eyelid surgery
  • Individuals without serious eye conditions
  • Excess skin and fine wrinkles of the lower eyelid

Remember that the eyelids are part of the face. The appearance of a drooping upper lid may also be due to relaxation of the forehead skin and eyebrow. Sometimes a drooping eyelid is caused by stretching of one of the upper eyelid muscles, the levator.

The board-certified plastic surgeons at Edina Plastic Surgery specialize in cosmetic procedures including blepharoplasty. We welcome you to come in for a free consultation.

They will evaluate your anatomy thoroughly to determine the causes of your eyelid appearance, and what procedures might best remedy them.