Over the past few years I have seen an increasingly common pattern in patients coming in for abdominal enhancement. I am writing about it now in this blog, hoping you will read it and be able to avoid the same problem.
The scenario: a woman will come in concerned about a liposuction that was done elsewhere.
When I examine the patient I find a wavy irregular lower abdomen over liposuctioned, and a full under suctioned upper abdomen. Bulgy top, wavy Bottom.
The conversation goes something like this:
So you had liposuction? Yes, it looked like a good deal.
You had your liposuction awake? Yes, a local anesthesia.
It was done with laser liposuction? Yes.
The patient then wants to know how I knew these things.
Unfortunately, it’s a common pattern we are seeing as laser liposuction under local is pushed and marketed. While the lower abdomen is easily anesthetized with a local anesthesia the upper abdomen is not. The fat is more fiberous and is more difficult to remove. The upper abdomen is more uncomfortable for awake patients. The end result is that the surgeon can be aggressive in the lower abdomen- often too much so, but is not aggressive enough in the upper abdomen because the patients start to complain of pain.
To be fair, when I see these patients the initial surgeon is usually not a board certified plastic surgeon, and in some cases not even a plastic surgeon at all.
There is absolutely a proper role for liposuction under local, but not everywhere in every situation. Please, please patients choose your surgeons carefully. Look for their credentials and qualifications and not just the ad or the word laser. All liposuction tools work well in the right hands, when the right patient is chosen and the best type of anesthesia is used.
But unfortunately, the correction of these problems often requires another surgery, sometime more liposuction, sometimes a tummy tuck or both. Without a doubt, I know these patients wish they had done the correct surgery the first time.