Breast Augmentation and Smartlipo – Can They Work together?

Breast Augmentation and Smartlipo – Can They Work together?

The answer is yes and no.

I do my breast augmentations in a surgicenter, outside of my office, because I use general anesthesia (GA). I do my Smartlipo cases in my office. I will do regular liposuction when the patient is under GA.

What does this mean in practical terms?

I am a huge fan of Smartlipo. I have had many patients, who have had Smartlipo with me in the week or weeks before having their breast augmentation. This works great. Many patients prefer that since they are already asleep, for both cost and convenience reasons, to have their breast augmentation done and at the same time, have their liposuction done.

There is no absolute right or wrong answer to this question. In general, for those wanting the absolute best result from their liposuction, it is generally preferable to do the Smartlipo in my office, in advance of the breast augmentation. You can return to work the day following Smartlipo. This approach does require more time from you and me, and since the Smartipo is much more time consuming procedure, and requires additional equipment, this will cost more. However, you will be saving some time under general anesthesia, which will raise your OR costs and your anesthesia costs.

I will discuss both these options with you, when you come in for your consult since the decision, will be an individual one.

 

What are the best areas for Smart Lipo?

What are the best areas for Smart Lipo?

Patients want to know, which areas respond best to Smartlipo?

The true answer is every area will respond well to Smartlipo provided that the skin tone is good and there is not a ton of fat there. You will get an especially good result, if you work out more after the procedure and lose some weight by improving your diet.

One area that is almost always excellent is the flanks/love handles. This is because the skin tone here is almost always good. Next I would say, the lateral thighs do very well. 

The upper and lower abdomen, and inner knee area, will depend on your skin tone and this does not depend on your age. Upper arms and neck can do nicely but in women in their late 50’s or older, usually do not have good skin tone, at this point in their lives.

The inner thigh area, even in younger women, may not have very good skin tone. This means there can be some improvement but it will not be close to perfect, unless you have excellent skin tone.

If your skin tone is not ideal, rather than have you just wear a support garment, like a Spandex, for just 5 days,  I may ask you to where it most of the time for 6-12 weeks. This does not mean every minute. You can still go to the pool etc and not wear the support garment. Remember you will continue to improve for 6 months in most cases.

Will people know that I had Smart Lipo?

I often get asked, “will people know that I had Smartlipo?”

The answer depends on who are those people? If you are referring to your partner, then the answer is “yes” unless they are very unobservant or they are away for a week or two.

The incisions for Smartlipo are very small, only about 3 mm. I usually cover them with small steristrips that will stay on for a week. Also, I recommend that you wear spanx or a compression garment for at least 5 days and sometimes for several weeks.

Will my partner know that I had smart lipo?

Your partner may wonder why you are wearing a compression garment to bed, if that is not your normal attire for bed. You may have to explain to your partner that the steristrips are a fashion statement and of course, have nothing to do with incisions or surgery. Also sometimes the incisions may leak the first night of surgery. This will stop by the time you go to work the next day, but your partner may wonder, if you have continence problems. It also may be difficult to explain why the bed is wet after you have slept in it the first night after Smartlipo. Or they may wonder why you are putting a towel under you when you go to sleep. Other than these very personal times, there won’t be any glaring differences.

Most patients do not bruise very much or at all, after Smartlipo, but it definitely does occasionally happen. It may be challenging to explain to your partner, why you have bruises on your love handles or your hips. Perhaps you can fib and tell them that you have a very aggressive trainer at the gym, who insists on hitting you with a stick, if you don’t do your exercises with perfect form. Or maybe it was that cardio-combat class at the gym that is unbelievably tough.

If you are used to jogging with your partner, your partner may wonder why you are taking 5 days off from working out. However it is only 5 days off from exercising, so perhaps you can convince them, that you are working on your meditation skills for 5 days. This will convince your partner that you are doing way too much yoga.

Will everyone else know that I’ve had smart lipo?

If you are talking about anyone except your partner knowing – the answer is that it is fairly easy to hide the Smartlipo event. If you do get some bruising, you may have to wear garments that hide these areas. However you will be back at work the next day. Spanx or compression garments, can easily be worn under your clothing. You are showering and dressing normally and moving normally the very next day. It can be very easy to keep the procedure a secret if you have Smartlipo with me.

Of course, I hope you will be so thrilled with the results that you will want to tell all of your friends and write reviews all over the internet about how much it has helped you.

How to Minimize Smart Lipo Recovery Time

Minimize Smart Lipo Recovery Time

One of the best things about Smartlipo, is the fact that virtually everyone goes back to work the next day (nothing is 100% but almost 95% of my patients do). You may drain some fluid overnight but this almost always stops the next morning. You can shower the next morning, put on your compression garment and then drive to work.

How will you feel? This will vary from person to person. The most frequent things I hear are: “sore”, “not too bad”, “I feel a bit beaten up” or “I feel like I had a crazy hard workout at the gym yesterday.” These are all quite normal responses and as you can expect the comments will vary from person to person.

I think you will bounce back much quicker from this procedure (and almost every procedure that I do) if you get up moving immediately. It is also good to do gentle stretches from the beginning. There is no reason why you should not have a full range of motion. Everything in life is a balance. I want you up moving and walking and going up and downstairs and walking the dog etc. But I also want you to take a bit of extra time to rest up. Any procedure will wear you out somewhat and it is important to give your body a bit of extra rest time. I don’t want you working out for 5 days. However, after 5 days, you can go at it hard, if you feel up to it. Some of my patients will and others will take it somewhat easier for 10 days or so.

I am a great believer in vitamin and supplements. I particularly like the DFH products which you can find as a link on my web site. It is probably a good idea to stop any weird supplements and herbs and megadose vitamins a week before surgery. I think you can resume them a day or two after Smartlipo.

You will generally feel better if you wear any type of  compression garment for 5 full days (except, of course, in the shower) and most people will want to wear it much longer when you exercise.

I am always available for questions in the post op period. I give all of my patients my cell phone number after surgery and they are encouraged to text me if they have any concerns.

Fine Tuning the Athletic Body

Fine Tuning the Athletic Body

The Extra Help of Smart Lipo

You have worked your butt off for your athletic body. You get to the gym 5-6 days per week. You have really modified and been strict with your diet. You have lost weight and all your friends think you look great. You have come a long way from where you started. However, as your body has gotten better, your expectations for yourself have gone up. You have had to buy all new clothes because your former ones are all too large for your frame.

But where are those defined abdominal muscles? Why are there still love handles? How could those saddle bags possible still persist?

Smart lipo almost certainly can be a helpful tool to get you closer to your goal. Let me preface my comments by saying that I do not believe any liposuction technique can “liposculpture” you to a 6-pack or make you into the cover a Fitness magazine. If it was as easy as that, we would be seeing them all the time in the gym! I have serious ethical issues, with those advertisements that suggest they can. Smart lipo works in conjunction with your diet and exercise program. You don’t want to put on weight after your Smart lipo and in many cases, you want to lose a few pounds.

Smart lipo is minimally invasive (to get a real result, I believe you need a small incision so that the fat can be accessed and melted – in comparison to CoolSculpt which is much less effective) and only requires incisions that are a miniscule, 3 mm or so (⅛ of an inch). It is done in the office with local anesthetic, plus often an oral sedation pill. Since you are not put to sleep, you are at no increased risk of blood clots and pulmonary emboli. There is no anesthesiologist to pay. You go home immediately afterwards and can return to work the very next day. It is important to note, that you will continue to improve for 6 months and you are very unlikely to be perfect.

Smart lipo with the fiberoptic laser  making direct contact with the fat, is a great way to be very precise with the fat removal. It is then liposuctioned away. This can be an excellent tool to get you much closer to the body that you have always wanted. 

My cosmetic consults are free and I look forward to discussing the options with you.

Unhappy with Your Love Handles and Lower Abdomen?

Unhappy with Your Love Handles and Lower Abdomen?

Have you tried dieting and exercising but still feel that your love handles and lower abdomen are too full? Or are you at a road block where you know you should be dieting and exercising but can’t get the willpower to put yourself through the cycle of dieting and exercising again.  Do dieting and exercise not seem to work for you?

I am a board certified plastic surgeon, who has done over 600 Smartlipo cases (as of March 2016, so could be much higher by the time you read this) and many tummy tucks, so I have some thoughts on this issue.

I feel there are 3 major options for you and which option is best can vary from person to person. Some patients will benefit from Smartlipo, some from a Tummy Tuck and some patients need to just diet and exercise before they proceed to either of these two options. These are some of the items you should consider. Let me preface my comments by saying that there is no magic (despite Hollywood and TV shows and some unscrupulous advertisements, suggesting otherwise) If you want to look your best, you will still need to lose weight. However, sometime doing either a tummy tuck or Smartlipo, can help motivate you to start dieting and exercising. I have many, many patients, who after doing one of these procedures, get highly motivated and does a great job losing weight and transforms themselves.

  1. The first consideration is how much fullness do you have in your lower abdomen and love handles. What is your skin tone like in your lower abdomen? The love handles almost always have good skin tone and will respond well to liposuction or better yet ,Smartlipo. If you have a lot of loose skin in your lower abdomen, you will almost certainly need a tummy tuck.
  2. Do you have a lot of bowing to your lower abdomen? Is the fullness due to muscle laxity or fat? If it is due to muscle weakness or fascial weakness (eg from having children) you may need a tummy tuck to tighten these up.
  3. Can you take time off from work? If you do Smartlipo, you can return to your job the very next day. If you do a tummy tuck, you should generally plan 10-14 days off from work (though you can get some work done at home)
  4. Are you willing to accept a scar?  A tummy tuck scar fades nicely with time but it is long. Usually it is well worth it, in order to get a better shape for your body. Remember, only a select few see your scars, whereas your better shape will be seen by everyone in all of your clothes. The scars from Smartlipo are usually almost invisible.
  5. Have you considered supplementing your diet with both vitamins, minerals and maybe a detox program or weight management program. I am impressed with the Designs for Health products which can be found through a link on my web site. They deliver their products to your house, so you don’t need to come by the office to get them.

Nothing is a substitute for a free cosmetic consult so that I can see you person. However, if you live out of the area, you can email me and send me pictures and I can usually do a consult this way.

6 Things to Consider Before Getting Smart Lipo

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6 Things to Consider Before Getting Smart Lipo

1.) Are you a good candidate for Smart Lipo?

You should ideally be within 15-20% of your ideal body weight, though recently I have pushed this for a few select patients and have gotten very good results. I do this in the office under local anesthetic, usually with a mild oral sedation. However, you don’t get to watch since I have you wear our sun tan goggles.

2) What is your skin tone like?

You need to have some skin tone with Smartlipo to get a nice result. It is true that you do get some skin tightening with Smartlipo, but only a relatively small amount. If you have a lot of loose skin on your abdomen, you will probably need a Tummy Tuck. One of the great advantages in going to a board certified plastic surgeon for your Smartlipo is that I can offer other techniques such as a Tummy Tuck. I don’t try and make everyone fit one procedure.

Another challenging area is the upper arms. I can usually get a nice improvement to the upper arms, but only if you have some degree of skin tone. If you have very loose upper arm skin, you are probably going to do much better with an arm lift. This is a more involved surgical procedure which I also offer.

3) Are your expectations realistic?

Many of my patients have achieved very significant improvements from the Smartlipo. However, I am very clear from the beginning: Smartlipo will decrease fat but it will not change your weight very much at all. It will give you a better body contour. To get your best results, you usually have to improve your dieting or your exercising in order to lose some weight (assuming you are overweight – you can do Smartlipo even if you are a perfect weight).

Thus, I can offer you an improvement but I will never make you perfect. It is impossible for anyone to give you a 6 pack without you doing a lot of hard work on your own after the procedure.

4) Are you patient?

You will continue to improve for 6 months after your Smartlipo. This is not like a breast augmentation, when as soon as the procedure is over, your body has been transformed. Sometimes you can see changes by 2 weeks and for many other patients, it can take 2 months before you start to see the difference. You will continue to get better and better, for the next 6 months, provided you do not put on weight after the procedure. If you live in the area, I will bring you back for follow up at 2 weeks, and then at 2,4 and 6 months. I will usually wait and photograph at these 2 monthly visits.

5) Can you survive 5 days without hard exercise?

I let you shower the next day and have sex and go for walks and drive etc. However, I want you to take 5 days only, from working out very hard.

5) Can you afford it and take time off from work?

The great news is that virtually everyone goes back to work the next day. Of course, you don’t have to, but everyone that does not have a physically demanding job goes back to work the next day.

Smartlipo is quite affordable to most people. We also offer financing. At the time of your free consult, I will give you a written quote with all costs involved. However you should expect to pay at least $3,000.00 with the cost going up depending on the number of areas you want to have done.[/vc_column_text][/vc_column][/vc_row]

How much does Smart Lipo cost?

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Smart Lipo Cost

I often get asked about the cost of Smartlipo. I think it is surprisingly affordable. I am sure that different surgeons price it differently, so I will simply give you my pricing.

Let me preface my comments by saying that you can always find it cheaper. However, I want to stress that even though there are small incisions, and you can return to work the next day, and it is done in my office with just local anesthetic and often some oral sedation and no IV’s, – does not mean anyone should be doing it just because they can afford the expensive equipment. I personally think it is very questionable that physicians, who are not plastic surgeons, are doing this. Even more questionable is when non-surgeons are doing this. Not everyone is a good candidate for Smartlipo and if you cannot offer someone more aggressive procedures, when the patient needs it, there will be a tendency to do it on the less than proper patient.  It is extremely safe, if you know what you are doing. I have done many, many years of plastic surgery and traditional liposuction before I started doing Smartlipo, many years ago.

I have done over 550 Smartlipos in my office as of February 2016. You also have to ask yourself, if it is being offered on Groupon, do you really want to do it? Would you get your neurosurgeon or your heart surgeon or your eye surgeon, from Groupon? I didn’t think so.

How Do I Charge?

I charge by the area. An area is one anatomically area: eg a love handle (flank), an outer thigh. The inner thigh is a separate area. I divide the upper and lower abdomen into two areas. There is the neck (submental)  and the bra line and the inner knee area, etc. You get the idea. I assume that each area is bilateral. This means you are paying for one area, when you do both outer thighs (saddle bag area). If this is confusing, my staff or I would be happy to explain it to you.

The more areas you do, the cost increases but each additional areas causes a smaller incremental cost.[/vc_column_text][/vc_column][/vc_row][vc_row type=”in_container” scene_position=”center” text_color=”dark” text_align=”left” overlay_strength=”0.3″][vc_column column_padding=”no-extra-padding” column_padding_position=”all” background_color_opacity=”1″ background_hover_color_opacity=”1″ width=”1/1″][pricing_table style=”default”][pricing_column color=”Accent-Color” title=”1 Area” id=”1456083148-1-40″ tab_id=”1456087732384-7″ price=”3,600″ currency_symbol=”$”]There is also a $500 facility fee.[/pricing_column][pricing_column color=”Accent-Color” title=”2 Areas” id=”1456083148-2-49″ tab_id=”1456087732534-10″ price=”5,600″ currency_symbol=”$” interval=”2 Areas”]There is also a $500 facility fee.[/pricing_column][pricing_column color=”Accent-Color” title=”3 Areas” id=”1456087739957-0-7″ tab_id=”1456087739959-2″ price=”6,600″ currency_symbol=”$” interval=”3 Areas”]There is also a $500 facility fee.[/pricing_column][/pricing_table][/vc_column][/vc_row][vc_row type=”in_container” scene_position=”center” text_color=”dark” text_align=”left” overlay_strength=”0.3″][vc_column column_padding=”no-extra-padding” column_padding_position=”all” background_color_opacity=”1″ background_hover_color_opacity=”1″ width=”1/1″][vc_column_text]

What are My Fees Now?

For the first area it is $3,600. second area is $5,600 (total not adding the $3,600 to it) third area is $6,600 and so on.

These are approximate numbers. If your area is much larger than normal, the fee may be slightly higher.

You can do more than 3 areas. If you do many areas or they are very large areas, I sometimes will do the surgery in two separate sessions which can be a day apart or more, depending on what works best for you.

Promotional Pricing

Yes, the good news is that we are running a 30% discount special off the price of the surgery. This means for three areas (for eg) you should pay $ 6,600.00 but instead you pay only $4,620.00 plus the $500 facility fee. For two areas you pay only $3,920.00 plus the facility fee. 

Do We Offer Financing?

Yes. and many patients do finance their surgery. My staff can help you with this. We use Carecredit and Alpheon.[/vc_column_text][/vc_column][/vc_row][vc_row type=”in_container” scene_position=”center” text_color=”dark” text_align=”left” overlay_strength=”0.3″][vc_column column_padding=”no-extra-padding” column_padding_position=”all” background_color_opacity=”1″ background_hover_color_opacity=”1″ width=”1/1″][vc_video link=”https://www.youtube.com/watch?v=QHshN9UJYAc”][/vc_column][/vc_row]

SmartLipo versus Coolsculpt

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SmartLipo versus Coolscuplt

I personally believe that Coolsculpt essentially has marketed itself entirely on the fact that they have ignored the existence of Smartlipo (Laserlipo).

Let’s first start with…

What is Coolsculpt?

Essentially Coolsculpt is a non-invasive procedure where special paddles are placed on fatty areas, cold temperatures travel through the skin, and the cold temperature damages the fat cells.

Why Do I Say That Coolscuplt has little place if people know SmartLipo Existed?

Coolsculpt markets itself as a non-invasive alternative to painful surgery with downtime and moderate risks. This might be true if Smartlipo were painful, moderately invasive, and had real downtime. However, Smartlipo is done in my office with no IV therapy. Although it is invasive, it is minimally invasive through very tiny incisions, which are only about 3-4 mm in size. (about this size __). Since it is done in the office, you go home immediately. Many patients take a small pill for oral sedation, which means you should not drive or do any important work that day. However, some patients take no sedation and can drive themselves for the procedure and can work from home for the rest of the day. Everyone showers and goes back to work the next day. Thus except for losing the rest of the day from Smartlipo, there is minimal downtime.

There is very little risk from Smartlipo if your surgeon knows what he is doing. I have done over 550 Smartlipo cases in my office with no complications, as of February 2016.

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Which is More Effective: SmartLipo or Coolscuplt?

Even on the Coolsculpt website, it acknowledges that more fat will be removed with liposuction. I feel that Smartlipo, with the addition of the laser, allows a better result than liposuction alone.

When Smartlipo is done, a fiberoptic laser fiber is inserted through a very tiny incision and direct contact is made with the fat cells. The heated laser beam instantly melts these fat cells. The area is numbed up fully so that you do not feel any of the heat or any discomfort.

If the Coolsculpt works at all, it is significantly limited because it has to pass through the skin, without damaging it and then penetrate into the fat but not so deeply as to damage the muscles or organs under the fat. It also relies on your body to remove the fat, whereas with Smartlipo, I remove the damaged fat through liposuction, after the laser has melted it.

Is There Any Role for Coolscuplt Now That SmartLipo Is Readily Available?

Coolsculpt costs less than Smartlipo (though Smartlipo is quite affordable and we offer financing). There will be a small number of patients who just cannot afford SmartLipo but want to have something done. Coolsculpt seems like a good option in that case. Also, there may be patients who are post-op who want some additional fat loss and again, if Smartlipo is not an option, Coolsculpt may be a good alternative. 

Lastly since Coolsculpt is non-invasive, it may be an option for those patients on certain medication that they cannot stop such as aspirin and other blood thinners (you would have to check this with the company).[/vc_column_text][/vc_column][/vc_row]

What’s the difference between liposuction and Smart Lipo?

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What’s the difference between liposuction and Smart Lipo?

I often get asked what’s the difference between liposuction and Smart Lipo? I think that Smartlipo will always be better since it has that extra middle step of using a fiberoptic laser fiber to melt fat and heat up the skin from the inside.

How is regular liposuction done?

In most cases, liposuction will be done in the operating room under general anesthesia. A fluid will be injected into the area to be liposuctioned. This fluid will have some lidocaine (usually) to help numb the area and a small amount of epinephrine to decrease any bleeding or bruising. After waiting a few minutes for the these to take effect, the liposuctioning is carried out. The incision is closed with a small dissolving suture and then you are done.

What is different about Smart Lipo?

Liposuction starts off the same as above, except that I use a much higher concentration of lidocaine to numb you up since you are awake (I frequently will give you a pill to relax you, such as Ativan, but then you must have someone drive you. This will not knock you out but will simply relax you more. Many patients elect to forgo this and thus can drive themselves). I have my patients take two Celebrex pills (we will phone this in for you. It has gone generic so they should not be expensive).

After I have numbed the area fully, I insert a small fiberoptic laser fiber into the fatty area through a very tiny incision. The laser fiber  is very small, about the size of the inside of a BIC pen. Everytime that I fire the laser, multiple times per second, it sends out 2 different wavelengths of laser beams, which does 3 things. It melts the fat. It heats up the skin, so that they will be a gradual skin tightening. Lastly, it will coagulate any small blood vessels, decreasing the bruising.

After I have finished lasering, I will liposuction away the melted fat and liquid. I use a smaller cannula often to do this as well, though it will depend on the amount of fat present. Since I am often using smaller, more delicate instruments, I have so far, (over 550 cases done as of February 2016) had no problems with uneveness. There is a quicker return to work and less pain. Almost everyone returns to work the next day. I feel that there is no downside to doing Smartlipo versus regular liposuction and I believe that in most cases, there will be a better result.

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