Liposuction is one of our most popular procedures for instantly slimming the waistline and other parts of the body that tend to have pockets of fat that are genetic or resistant to exercise. This is a very straightforward procedure, and easy for patients to understand. However, it must be performed carefully and conservatively by an experienced surgeon to achieve optimal results.

When liposuction was first developed in the mid 80’s, it involved one step—removing the fat. This was effective but resulted in a significant amount of blood loss. Therefore, the amount of fat that could be safely removed without a blood transfusion was about 2 liters, or 2 quarts.

In the mid 90’s, “tumescent” liposuction was developed. This added an important step, flooding the fatty tissue with saline fluid combined with local anesthesia and adrenaline, which keeps blood loss to a minimum—less that one percent of the fluid removed. Compared to early liposuction, tumescent liposuction removes essentially pure fat, allowing about 5 liters to be removed safely.

In more recent years, a third step has been added to the procedure, to help melt fat and shrink skin. This is accomplished with technology such as ultrasound and laser. VASER® is such a technique. These are the three steps of VASER® Liposelect Suction:

1. Tumescence: infiltrate tissue with fluid
2. VASER: selectively melt fat and shrink skin with internal ultrasound device
3. Suction melted fat

There are several important factors to choosing a surgeon, including recommendations from friends, personality, physician training and board certification, and experience.

Referral from Friends: Many prospective patients find confidence if they have a close friend or other trusted individual who has already undergone a successful procedure. This is often a good first step in making a decision. However, not all patients know someone who has had surgery. Most of our patients are referred by satisfied friends who have been our patients.

Personality: It is important to develop a good relationship with a surgeon, where communication is easy and trust can be developed. A patient needs to feel intuitively that they are in good hands with someone they can trust. Bedside manner is important.

Training and Certification: In years past, only plastic surgeons performed cosmetic surgery. However, in recent years doctors from many different specialties are more commonly performing cosmetic surgery procedures, including Ear, Nose, and Throat doctors (also known as otolaryngologists and facial plastic surgeons), Dermatologists, Ophthalmologists, and Gynecologists. Only a surgeon who has completed residency training in an accredited training program can become certified by the American Board of Plastic Surgery. There are many Boards, and it is easy for patients to become confused, or assume that when a doctor says they are “Board Certified” it all means the same thing. BE CAREFUL! Learn more about the significance of Board Certification here.

Experience: Finally, consider the physician's experience, the most important factor in making a decision. As with all professions, expertise is directly proportional to experience, meaning the total number of procedures performed. Medical literature illustrates that biggest predictor of success in surgery is volume, in other words, the number of times that a doctor has performed a procedure.

If the doctor is recommending a specific procedure, how many has he performed? How often does the surgeon perform this procedure?

While board certifications and training are important, a surgeon's experience with the procedure itself is more important. Don't hesitate to ask pointed questions about recommended procedures.

Most body types have areas that are predisposed to fat storage, and even with rigorous diet and exercise, those unwanted bulges often persist. Patented VASER® Technology and the advanced LipoSelection® technique now offer a safe alternative for eliminating unwanted fat, revealing a smooth new shape with fast recovery. VASER stands for Vibration Amplification of Sound Energy at Resonance.

The next generation in body contouring, VASER Lipo uses ultrasonic energy to selectively break apart fat deposits while preserving other important tissues. Whether you need help with a small problem area or a major transformation, VASER Lipo allows us to do our very best work.

Ultrasonic energy has been used for years in a wide array of medical applications - from catching that first glimpse of a baby to cleaning your teeth. Now the gentle power of ultrasound has evolved to fat removal. VASER Lipo uses an ultrasonic technology that is tissue-selective. The ultrasound energy targets unwanted fat, but preserves other surrounding tissues—such as nerves, blood vessels and connective tissue—to promote smooth contours and rapid healing. Maximum results and minimum downtime are what you can expect with VASER Lipo.

Over 100,000 procedures have been performed to date with no serious complications attributed to the VASER Lipo System. In a recent study published in the Aesthetic Surgery Journal, patients treated with VASER Lipo had 7.5 times less blood loss than those treated with traditional liposuction.

The VASER Lipo System received FDA Clearance for body contouring in September 2002. VASER Lipo is a trusted body contouring method in a society saturated with fad procedures.

Physician users report the following VASER Lipo benefits:

1. Smooth, predictable results in all areas of the body
2. Improved skin retraction
3. Reduced number of re-treatments
4. Fast patient recovery
5. Reduced physician fatigue

Physicians can treat a wide range of body areas and volumes with the VASER Lipo system. Typical areas include abdomens, hips, waists, thighs, backs, buttocks, arms, male chests, female breasts, knees, calves, chin and face. VASER Lipo can be performed under local or general anesthesia.

Ideal candidates are not obese. Ideal candidates are at a stable weight and have one or a few areas that can’t be reduced, even with diet and exercise. Patients with firm, elastic skin will have the best results.

Excessive smoking may compromise your results.

Consultation
To ensure the most natural looking results, Dr. Alexander will recommend the procedure which most appropriately matches the your needs and to offer realistic expectations for post-surgery outcomes.

Dr. Alexander will evaluate the areas of your body which you feel are out of proportion. He will examine your skin tone and determine if there is excess skin, a common problem in patients complaining of excess fat. He will help you determine if you are a good candidate for this procedure.

The success and safety of your liposuction procedure depends greatly on you being completely candid during your consultation. We will ask you questions about your health, desires and lifestyle.

Be prepared to discuss:

• Why you want liposuction, your expectations and desired outcome
• Medical conditions, drug allergies and medical treatments
• Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs
• Previous surgeries
• History of exercise, nutrition, and weight loss

We may also:

• Evaluate your general health status and any pre-existing health conditions or risk factors
• Examine the areas of your body that bother you and check your skin tone
• Take photographs for your medical record
• Discuss your options and recommend a course of treatment
• Discuss likely outcomes of liposuction and any risks or potential complications
• Discuss the use of anesthesia during your liposuction procedure

Prior to surgery, we will have you:

• Take certain medications or adjust your current medications
• Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding
• Stop smoking well in advance of surgery

During a Pre Operative appointment, usually 1-2 weeks before surgery, we will:

• Get lab testing or a medical evaluation
• Tell you what to do on the night before and morning of surgery
• Discuss the use of anesthesia during your procedure
• Explain post-operative care and follow-up, and what help you will need after the procedure

Although Liposuction surgery is relatively straightforward, it's important to remember that the procedure still requires precision and skill. It is important to have realistic expectations about your procedure. Be honest with your physician about your goals and expectations concerning recovery time and anticipated results.

Medications are administered for your comfort during the surgical procedure. An anesthesiologist will administer general anesthesia, which is usually required for this procedure. Doctors who recommend local anesthesia for this procedure are usually dermatologists. The procedure usually takes much longer and is more painful when done this way.

The procedure typically takes about one to two hours depending on the individual and certain surgical variables. There are four basic steps to a Breast Augmentation.

Step 1 – Marking
Dr. Alexander will special anatomic marks on the areas to be treated while you are standing. These marks are critical to achieving an even result. This will also give you the chance to discuss the areas to be treated.

Step 2 – The incision
Tiny incisions are made close to the areas to be treated. Usually one incision is required per area.

Step 3 – Tumescent Fluid Infusion
Dr. Alexander will inject tumescent fluid into the treatment areas. Tumescent fluid is a mixture of lidocaine and epinephrine. The solution helps expand the tissue layer, while the lidocaine numbs the area, and the epinephrine works by shrinking the blood vessels. This will not only help to control bleeding during the procedure, but will help to minimize bruising during your recovery.

Approximately 1cc is placed for every cc of fat that will be removed. This is called the “superwet” technique. The “tumescent” technique places about 3cc for every cc of fat removed. This is done when the procedure is going to be done under local anesthesia.

Step 4 – VASER® Emulsification of Fatty Tissue
We then insert a small probe that emits ultrasonic energy. The energy travels in high-frequency waves that are dispersed evenly from all sides of the probe. This energy causes the VASER probe to vibrate, selectively breaking apart the fatty tissue on contact. The ultrasonic energy actually works by emulsifying, or liquefying the fatty tissue. As the energy is targeted only toward fat, the surrounding connective tissue, blood vessels, and nerves are preserved. The probe also delivers energy to the under side of the skin, helping tighten loose skin.

Step 5 – Liposuction, Removal of Fatty Tissue
Using small cannulae and a back-and-forth motion, the fat is removed from the body using a gentle suction device or massage. This specialized suction device removes the liquefied fat while minimizing trauma to the surrounding tissues. The VASER Lipo technique preserves these important tissues to promote an enhanced patient experience.

Step 6 – Closure
Sutures are used to close the incisions and a compressive garment is placed.

Traditional liposuction removes unwanted fat through a process called avulsion. This is a physically demanding surgical technique on both the surgeon and the patient. It uses a suction device to tear apart surrounding tissues in order to break up fatty deposits. Any tissues, such as nerves, vessels, or collagen structures in the fatty layer that get pulled into the suction cannula will be torn or damaged. This can lead to increased pain and bruising, and a long recovery time.

VASER Lipo uses state-of-the-art ultrasound technology designed to gently reshape your body. Ultrasound is actually sound energy that travels in waves. What makes this approach unique is that these waves can be targeted specifically to fatty tissue. The high energy waves cause the VASER probe to vibrate and liquefy the fatty tissue on contact. A specially-designed suction device is then used to gently remove the liquefied fat, while preserving the surrounding connective tissue, blood vessels, and nerves.

Why is it important to leave these other tissues in place? If blood vessels and nerves aren't damaged, you experience minimal bruising and pain. Preserving connected tissues enhances healing and promotes good skin retraction. With its minimally-invasive approach, VASER Lipo provides smooth, predictable results and fast patient recovery.

During the healing process, your skin will retract to give you a smooth, natural-looking result.

Doctors report that patients are able to go back to work within days after their VASER Lipo procedure. One patient reported the following of her recovery experience after her VASER Lipo treatment, "Two previous traditional liposuction treatments left me in pain and with considerable bruising, as well as weeks-long recovery. What a difference with my recent VASER Lipo treatment...I had no bruising or swelling...and returned to work the Monday following my Friday procedure."

You should begin to see results within the first few weeks. Your results will continue to improve with time as the tissues in the treatment area heal, with final results revealed between 3 and 6 months.

VASER Lipo FAQ's

Important facts about the safety and risks of Liposuction surgery
The decision to have liposuction is extremely personal and you’ll have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable. In general, the overall risks are small this type of surgery. However, it is common to require additional procedures to manage problems that may arise.

Pain
Pain from liposuction varies from patient to patient. Some are very sore, like after an extremely hard workout. Others have very little discomfort whatsoever. Most pain or discomfort resolves in 48 hours. Patients are given pain pills to alleviate the discomfort.

We will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks and potential complications.

The risks include:

• Surface irregularities
• Fluid accumulation
• Pain or numbness, which may persist
• Possibility of revisional surgery
• Scarring
• Bleeding (hematoma)
• Infection
• Burns of the skin
• Anesthesia risks
• Deep vein thrombosis, cardiac and pulmonary complications

You'll need help
You will need someone to drive you to and from surgery and to stay with you for at least the first night following surgery. If you experience shortness of breath, chest pains, or unusual heartbeats, you should call Dr. Alexander immediately.

You will likely experience a recovery period of 24 to 48 hours and an additional reduced-activity period of a few days. You will experience soreness and swelling for a few weeks.

Exercise and normal activity can resume at approximately 1 week. Over time, post-surgical swelling will decrease and incision lines will fade.

Patients who undergo liposuction at our practice are generally very happy with the results of their procedure. Because dieting and exercise are sometimes not enough to remove fat from specific areas of the abdomen, our patients are pleased to have the option of liposuction to trim and tighten their waistline.

When large amounts of fat are removed, patients can see an immediate difference even though there is swelling. For smaller amounts, the swelling may hide the improved contour temporarily. Bruising varies tremendously. Some patients have no bruising, others have significant bruising, which can take a few weeks to resolve.

Swelling subsides over the first two weeks, but takes 3-5 months to resolve completely. Numbness is common but resolves quickly in most patients. Scars are usually very small and difficult to see, once healed.

As long as your weight remains stable, the results of your liposuction surgery will be long lasting. You will find it easier to wear certain styles of clothing and swim suits. Like most patients who have had liposuction, you may also have a boost in self-confidence.

A quote will be provided to you after your consult with Dr. Alexander. Cost is always a consideration in elective surgery. We offer patient financing plans, so be sure to ask.

Costs include:

• Surgeon’s fee
• Operating Room and Supplies
• Prescriptions for medication
• Medical tests
• Anesthesia fees

• Local Anesthesia: the surgical area is numbed up, but the patient is awake. Sometimes a patient will be given an oral medication, like Valium, to help with relaxation.


• Sedation (Twilight) Anesthesia: the patient is given an iv, and is made sleepy with medications given through the iv. The level of sedation can be adjusted, from barely sleep to very sleepy. Sometimes sedation is given by the surgeon, and other times it is administered by an Anesthesiologist.


• General anesthesia: the patient is asleep, requiring that the airway be protected, either by a standard breathing tube, or by a laryngeal mask (LMA), an inflatable mask that goes in the back of the throat but doesn’t go down the trachea. Through the airway, an anesthesiologist gives gases to put the patient asleep. Drugs may also be given through the iv.


• CannulaA small hollow tube used with suction to remove fat from the body.


• Superwet Technique:A method of tumescence, where approximately 1cc is placed for every cc of fat that will be removed. This technique is most commonly used when the patient is under general anesthesia.


• Tumescent Technique: One method of tumescence, which uses A about 3cc for every cc of fat removed. This is done when the procedure is going to be done under local anesthesia.

• Am I a good candidate for the VASER Lipo procedure?
• How much fat can you remove
• When will I see results, and what results are realistic in my case?
• How long is the healing process?
• Are you certified by the American Board of Plastic Surgery?
• Were you trained specifically in the field of plastic surgery?
• How many years of plastic surgery training have you had?
• Do you have hospital privileges to perform this procedure?
• Is the office-based surgical facility accredited by a nationally-or state-recognized accrediting agency, or is it state-licensed or Medicare-certified?
• Am I a good candidate for breast enhancement or breast enlargement?
• What will be expected of me to get the best results?
• Where and how will you perform my breast augmentation surgery?
• What shape, size, surface texturing, incision site and placement site are recommended for me?
• How long of a recovery period can I expect, and what kind of help will I need during my recovery?
• What are the risks and complications associated with my procedure?
• How many additional implant-related operations can I expect over my lifetime?
• How will my ability to breastfeed be affected?
• How can I expect my implanted breasts to look over time?
• What are my options if I am dissatisfied with the cosmetic outcome of my implanted breasts?
• How will my breasts look if I choose to have the implants removed in the future without replacement?
• Do you have breast augmentation before-and-after photos I can look at for this procedure and what results are reasonable for me?
• How are complications handled?

"I would never have considered traditional liposuction, but VASER Lipo made me finally decide to address those problem areas on my body." - Caroline (Colorado)

"I had VASER Lipo on Friday and was back to work on Monday." -Nancy (Wisconsin)

"I would definitely recommend VASER Lipo for anyone who is not able to achieve the fat reduction they want by diet and exercise alone." -Chris (Colorado)

"My self-confidence has risen dramatically - there's just no describing how good it feels to get rid of that one thing you really dislike about your body." -Michael (California)

A: VASER Lipo is an advanced body contouring procedure that selectively removes unwanted body fat. An alternative to the harsh techniques of traditional liposuction, VASER Lipo uses state-of-the-art ultrasound technology designed to gently reshape your body. What distinguishes the VASER Lipo procedure is its ability to differentiate targeted fat from other important tissues - such as nerves, blood vessels and connective tissue. Innovative VASER technology breaks up fat while preserving these other important tissues to promote smooth results and rapid healing.

A: First, the area to be reshaped is filled with a tumescent saline solution that helps numb the site and shrink the blood vessels (to minimize blood loss and reduce bruising). This solution wets and fills the area to be treated, making it easier to break up fatty tissue with the VASER Lipo System's ultrasound energy. Then a small probe transmits sound energy to break up (liquefy) fat on contact while preserving other important tissues. Finally, the liquefied fat is removed through a gentle suction process designed to minimize trauma to surrounding tissue structures such as nerves, blood vessels and other connective tissues.

A: We have experienced great success in treating all of the following areas: abdomen, thighs, knees, ankles, calves, buttocks, hips, back, arms, male and female breasts, love handles, chin, face and just about any other body part you need treated.

A: VASER Lipo allows physicians to treat multiple body areas at one time. We will be able to give you a better idea of what is right for you and how much fat will be taken out during your procedure. Bear in mind that this procedure is not intended as a weight loss solution. The goal is to create a slimmer silhouette. You may not notice a significant amount of weight loss, but you should be pleased with your slimmer new shape.

A: VASER Lipo is performed in our surgery center in a clean, sterile environment.

A: The procedure can be performed under local anesthesia (awake), IV sedation, or general anesthesia. Most often we recommend general anesthesia. It helps you be more comfortable and helps us do a better job without causing you pain.

A: This varies with the extensiveness of the procedure - the amount of fat removed, the number of areas treated, and so on. Many patients report that they see results immediately after the procedure with the final result showing around 3 to 6 months.

A: This is a common misperception. Following your VASER Lipo procedure, should you experience weight gain or loss, it will tend to be proportionately distributed over your entire body. Once you have fat removed, it is gone and, assuming a healthy lifestyle of proper diet and exercise, it will not return or migrate. However, because fat is necessary to a healthy body, some essential fat layers in any given area remain untreated. If you do gain a significant amount of weight, the remaining fatty tissue will expand. Normal aging changes can also be expected.

A: If you are frustrated by the resistance of certain body areas to diet and exercise, VASER Lipo can provide a solution. If you are healthy and seeking a fast, low-pain solution to losing stubborn fat deposits, the VASER Lipo procedure could be your answer. Although there are limits to the amount of fat that can be removed, your doctor can assist you with your decision about potential areas for sculpting, anticipated results, and the recovery process.

A: VASER Hi Definition Liposculpture is an advanced body sculpting technique. The procedure creates a sculpted, athletic appearance in males and females by precisely removing both superficial and deep fat around muscle groups in order to enhance the visibility of the underlying musculature. Similar to 3-dimensional sculpting, VASER Hi Def takes into account the shape and form of structures underneath the skin that create body contours.

VASER Hi Def is performed using the VASER Lipo System to selectively sculpt and remove fat in the desired treatment area. VASER Hi Def is designed to be a sculpting procedure rather than a debulking technique. Therefore, the procedure is intended for generally fit men and women who have good muscle tone without excessive amounts of fat or excess skin. The typical patient maintains a healthy lifestyle through diet and exercise, but is unable to achieve the desired definition. VASER Hi Def can be performed on multiple body areas including the abdomen, female breast, male chest, back, arms, thighs, buttocks, hips and waist.

• Predictable results
• Smooth contouring
• Minimal trauma
• Demonstrated safety
• Fast recovery
• Minimal pain and bruising
• Uses gentle, ultrasonic energy
• Tissue selective - preserves important tissue structures like nerves, blood vessels and collagen
• Improved skin retraction reported
• Designed to precisely sculpt both common, as well as delicate areas such as arms, chins and inner thighs