Liposuction by Area
Liposuction is an art; it is not simply removing excess fat. And, it is not about getting out as much fat as possible. I strive to obtain a perfectly proportioned body for each of my patients.
There are certain areas of the body that I have identified as “gravitationally prone” areas. The tightening of the skin that is achieved with my technique prevents these areas from getting looser with time. In addition, I have outlined the common pitfalls that can lead to poor results during liposuction procedures.
Dr. Macri has experienced great success in performing liposuction in the following areas:
- Male Chest
- Love Handles
Liposuction surgery will begin with an initial consultation where Dr Macri will evaluate the patient to determine whether he or she is a good candidate. Although liposuction can be performed on patients from 18 to 70, the ideal patient is one who is fit with good skin elasticity, as patients with good skin elasticity will ensure better results. Many experienced surgeons, such as Dr.Macri prefer to perform tumescent liposuction, which requires only a local anesthesia. This reduces the risk of blood clots and provides the doctor with better access to the body (with increased patient mobility).
Liposuction surgery is performed using a tool called a cannula, a cylindrical tool which breaks up and removes fat. The cannula is inserted through small incisions that heal very well. Full results of liposuction can be seen within 6 to 12 months of the surgery. Initial bruising and swelling, depending on the patient, last for a few days. The patient usually returns to work and exercise within a few days of surgery.
Liposuction by Body Area:
Outer Thighs – Also known as saddle bags, this is probably the most common problem area for women. This area defines a woman’s width in her lower half. Even small differences in the outer thighs can make a great improvement to a woman’s silhouette. When done properly this area gives a smaller, rounder shape to the buttocks. I can choose to remove more fat in this area, because the skin is thicker. Technique-wise, it is important to approach this area vertically; otherwise horizontal bands can result and cause a rippling look to the skin. It is extremely important to pay attention to symmetry in this area, as it defines the outer silhouette.
Inner Thighs – This is a gravitationally prone-liposuction procedure and another very common problem area for women. Unfortunately, this area is also more prone to irregularities if not done properly. The skin of the inner thighs is much thinner and if the surgeon does not have respect for the elasticity of the skin in this area, irregularities will result. Also, proper patient positioning is crucial to ensure a natural result. Some patients only need the upper, inner thighs done. But, in others, it is important to contour the whole inner thigh down to the medial knee to obtain a natural, well proportioned result.
Flanks – Also known as the love handles, this is an area that is gravitationally prone where liposuction can be done as a preventative measure. The flanks or love handles are the most common problem area in men. This is a relatively straight-forward area to do, as it is usually well-defined with good skin elasticity. It is a very important area to be treated preventatively as this area sits at the bottom of the back.
Hips – This area lies just below the flanks toward the upper, outer area of the buttock. In most women, it transitions into the flank area. This area, as well as the outer thighs and saddlebags regions, are the most important areas to shape properly and result in a rounder, more well-defined buttock.
Abdomen– Another gravitational prone area, where I approach is the abdomen in one of two ways.
- Central Abdomen – The upper and lower abdomen are done as a unit. In many individuals, if only the lower abdomen is done, the upper abdomen will not tighten from the liposuction and gets looser with time. When the entire area is done as a unit, not only does it blend well, but it a stays tight and firm. I find that I am able to still get a perfectly smooth result and achieve skin tightening in patients with poorer elasticity by having a lot of respect for the skin. In these patients, I recommend staying deeper in the fat layer and generally being more conservative. In all patients, I always crisscross the tunnels from either two or four directions. It is great mistake to approach the abdomen from only one access point.
- Upper, Lower Abdomen, Waist, and Flanks – The other half of patients that I perform liposuction on in these areas have the abdomen done all the way around, as these individuals waists essentially need to be more defined.
A word on pregnancies, liposuction, and tummy tucks: It is generally better to liposuction the abdomen prior to pregnancy. Due to better skin elasticity, I can choose to remove more fat. However, most women I perform liposuction on have already had children. In these cases, I simply adjust how aggressive I’m being on the level of skin elasticity. When properly done, even with poorer skin tone, great improvements in reducing the fullness of this area and tighter skin tone can still be achieved.
Unless the muscle and skin have become extremely loose, these patients can usually avoid a tummy tuck. Even if a tummy tuck is eventually necessary, I feel, and studies support, that it is safer to do these as separate procedures, and a more complete final result will be achieved.
Back – This gravitationally prone area is a wonderful area to do if there is fullness. The skin is thick and prone to drooping, so I usually liposuction the mid and upper back as a unit. The degree of skin tightening achieved is a blessing because there is no ‘back lift’ or back tuck.
Arms – A gravitationally prone area like the back, the posterior upper arms tend to become flabby and drop if there is fullness. For this reason, I try to encourage women to do liposuction earlier, as opposed to later in their lives, if there is disproportion in this area. By reducing the amount of the fat in the area and getting skin tightening with proper technique, the posterior upper arms stay tighter and more defined as time passes. This is important not only in the short term, but even more so in the long term, because an arm lift almost always leads to an unattractive scar.
Buttocks – In general the buttocks themselves are rarely, if ever, liposuctioned. To get a better butt shape, I liposuction around the buttock, outer thighs, hips, posterior, and upper thigh also known as the “banana roll”. This, along with building good muscle tone (which is important almost everywhere) gives a smaller, rounder, tighter buttock. I will liposuction the buttock when the area is very protuberant and fat. Liposuction to the buttocks that are just flabby will tend to flatten and drop them. It is especially important to remember not to confuse fat with just flab, which is usually from poor muscle tone. When it is done properly on the right candidate, the buttocks will simply look smaller and slightly lifted due to decreased weight.
Neck– This is another gravitationally prone area. Try to catch this area earlier as opposed to later if there is any fullness. If it drops too much over time and there is loss of elasticity, a lower face and neck lift may be the only option. The majority of improvement from well-done liposuction of the neck comes from the surgeon knowing how to get the maximum, even skin retraction. Although only minimal fat is generally removed, even the fattest necks can see great improvement. I liposuction the neck in one of two ways:
- Submental Liposuction – For those that have fullness only in the middle part of the neck, under the chin (mentum). In these patients, it is not necessary to liposuction the whole neck, and access can be from one small incision under the chin.
- Entire neck – For those that have fullness of the lateral neck, it is important to liposuction the entire neck up over the jaw line, and sometimes the jowls, to achieve an optimal result.
Chest– The male chest area is gravitationally prone. The male chest is a common area for liposuction. With age, the male chest tends to become fuller and drop with loss of elasticity in muscle and skin tone.