Large-volume liposuction is not a pill you take nor is it a magic wand. It is real surgery like any other surgery. And just like any surgery it carries potential risks; therefore, the decision to undergo such surgery should be taken seriously.

In order to keep you safe and to minimize any surgical risks you should follow the following advice.

You need to let your doctor know of any diet pills, herbs, or vitamins that you might be taking; because some of them might adversely affect you during surgery. All my patients get a pre-operative evaluation at our office or by their doctor or specialist, in order to be cleared for surgery. This evaluation usually includes blood testing as well as an electrocardiogram to check the heart. I only perform large-volume Liposuction after patients are found to be of satisfactory medical condition to undergo surgery. Often times I get asked if having diabetes, thyroid disease, asthma, or hypertension, preclude them from being able to undergo such surgery. The answer is no. None of these medical conditions preclude having safe surgery, as long as your condition is under control by your doctor, and as long as our anesthesiologist is made aware of these conditions so that he can make necessary provisions. In fact, it has been shown in the medical literature that large-volume liposuction often times improves a person's overall medical condition by reducing their cholesterol and insulin requirements. By significantly reducing your total body fat either by liposuction or by other means of fat loss, you are actually making your body healthier, and reducing your chance of heart disease.

Besides being cleared for surgery it is also important to have your procedure performed at a safe surgery center, and under the supervision of an anesthesiologist.

Often times; I become perplexed when consulting people who are more concerned about saving a few dollars in surgery cost than having their surgery performed by a qualified surgeon and anesthesiologist at an accredited surgery facility. I believe that having a good anesthesiologist is just as important as having a good surgeon. After all it is the anesthesiologist who is keeping you alive during the surgery. Although they are many nurse anesthetists that are very qualified, in general if I was going to undergo surgery I would choose a Board Certified Anesthesiologist. Why, possibly compromise ones health for just a few dollars?

Let's talk about surgical facilities. Don't judge a book by its cover! Just because a doctors office has a fancy waiting area or exam room, or is in Beverly Hills, it does not mean that their surgery facility is accredited or up to the highest standards. I have seen many such places that have operating room and anesthesia equipment that are antiquated, obsolete, or are marginally safe. These issues are just as important as having a talented plastic surgeon. So ask if the surgery facility is accredited by one of the legitimate accreditation organizations such as the AAAHC.org, AAAASF.org, or Medicare.

Last but not least, know who is going to be doing your surgery? Is your doctor a "cosmetic" surgeon or a board certified plastic surgeon? Many people don't know the difference between these two! Now a day almost anyone from a dentist to a foot doctor can take a limited liposuction course and get a certificate of being a "cosmetic surgeon". The American Board of Medical Specialties ( www.abms.org) does NOT recognize the "Board of Cosmetic Surgery". The only recognized one is that of the "American Board of Plastic Surgery". You can verify if your "cosmetic or Plastic surgeon" is a Board Certified Plastic Surgeon by visiting www.plasticsurgery.org.
Now, let's talk about the large-volume liposuction procedure. There are a variety of liposuction techniques available such as tumescent, ultrasonic, and laser liposuction. Tumescent liposuction involves infiltrating a combination of saline, anesthetic, and vasoconstrictive fluids into the fatty areas prior to liposuction. This helps to numb the area, as well as constricts the blood vessels to minimize blood loss. It is this innovation that enables plastic surgeons to remove large volumes of fat with minimal blood loss and maximum safety. With standard tumescent liposuction, after infusing the tumescent fluid, the surgeon sucks out the fat and contours the body with a liposuction machine. In ultrasonic liposuction an ultrasonic probe is used to break up the fat cells before suctioning. Although this method could expedite fat removal, it has been shown to have a higher complication rate than the standard tumescent liposuction, by possibly creating skin burns, areas of skin nerve damage, and fluid buildup. For these reasons, I personally do not favor this technique. Laser liposuction is similar to ultrasonic liposuction but uses the laser beam to break up the fat cells. Please note that no matter what type of liposuction you might have, it is ultimately your surgeon's skills and experience that is of outmost importance. It is important to see if your plastic surgeon has had experience with large-volume liposuction. Some surgeons typically don't remove more than the volume of a coke bottle at one setting. This might not be considered a large enough volume to make a significant difference in your size. Also, don't be shy about asking to see their previous results. When visiting our office, I would personally review with you typical before-and-after patient photos. Then, after your examination, I will try to give you a realistic view of what I think I can deliver for you. You are also welcome to talk to my previous patients to share their experience. My staff and I will review with you the logistics of having such surgery; such as recuperation time, activity limitations, when you can resume exercising, along with detailed pre- and post-operative instructions.

Ask your doctor about the limitations of this procedure. You might need to undergo more than one procedure to achieve the optimal result. Unlike what you see on "extreme makeover", I don't believe that it is safe to have multiple lengthy procedures performed at one time. If you are doing large-volume fat removal from one area, such as the abdomen, you might have to come back another time to have other areas such as the thighs done. Remember that there is a generally a safe volume limit of fat that can be removed at one setting depending on your medical condition and your blood count. Fortunately, skin shrinks quite dramatically after large-volume liposuction, but depending on your skin elasticity and body area, some people might need to have excess skin removed at a later time. This might be in the form of tummy tuck (abdominoplasty), arm tuck (brachioplasty), body lift, or thigh lift.

What you have read so far, is only a limited introduction. Never the less, I hope that I have been able to point out some of the important issues about undergoing large-volume liposuction. You can review the details about undergoing liposuction by visiting our main Los Angeles Plastic Surgeon web site. Also you can view several before-and-after pictures here or on our main web site: www.beautifulfigure.com.

Do your homework and feel good about doing something positive for yourself.

Truly yours,
S. Sean Younai, MD, FACS