Body Contouring

Liposuction Related Link: Dr. Zoellner’s Before and After Photos

What is Liposuction?

Liposuction & Body Contouring Services From Pinehurst Plastic Surgery Specialists

Liposuction slims and reshapes specific areas of the body by removing excess fat deposits and improving your body contours and proportion.

Liposuction techniques may be used to reduce localized fat deposits of the:

• Thighs
• Hips and buttocks
• Abdomen and waist
• Upper arms
• Back
• Inner knee
• Chest area
• Cheeks, chin, and neck
• Calves and ankles

Liposuction can be performed alone or along with other plastic surgery procedures, such as a facelift, breast reduction, or a tummy tuck.

Is it right for me?
If you are bothered by excess fat deposits – located anywhere on your body – that don’t respond to diet or exercise, liposuction may be right for you.

Ideal candidates for liposuction are:

• Adults within 30% of their ideal weight who have firm, elastic skin and good muscle tone
• Healthy individuals who do not have a life-threatening illness or medical conditions that can impair healing
• Non-smokers
• Individuals with a positive outlook and specific goals in mind for body contouring

Liposuction is not a treatment for obesity or a substitute for proper diet and exercise. It is also not an effective treatment for cellulite-the dimpled skin that typically appears on the thighs, hips, and buttocks-or loose saggy skin.

During your consultation be prepared to discuss:

• Your surgical goals
• Medical conditions, drug allergies, and medical treatments
• Current medications, vitamins, herbal supplements, alcohol, tobacco, and drug use
• Previous surgeries

Your surgeon will also:

• Evaluate your general health status and any pre-existing health conditions or risk factors
• Take photographs
• Discuss your liposuction options
• Recommend a course of treatment
• Discuss likely outcomes of liposuction and any risks or potential complications

Prior to surgery, you may be asked to:

• Get lab testing or a medical evaluation
• Take certain medications or adjust your current medications
• Stop smoking
• Avoid taking aspirin, anti-inflammatory drugs, and herbal supplements as they can increase bleeding

Liposuction should be performed in an accredited office-based surgical facility, licensed ambulatory surgical center, or a hospital. Be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery.

Be sure to ask questions. It’s very important to ask your plastic surgeon questions about liposuction. It’s natural to feel some anxiety, whether it’s excitement for your anticipated new look or a bit of preoperative stress. Don’t be shy about discussing these feelings with your plastic surgeon.

Step 1 – Anesthesia

Medications are administered for your comfort during the surgical procedure.  The choices include local anesthesia, intravenous sedation, and general anesthesia. Your doctor will recommend the best choice for you.

Step 2 – The incision

Liposuction is performed through small, inconspicuous incisions. First, diluted local anesthesia is infused to reduce bleeding and trauma.

Then a thin hollow tube, or cannula, is inserted through the incisions to loosen excess fat using a controlled back and forth motion. The dislodged fat is then suctioned out of the body using a surgical vacuum or syringe attached to the cannula.

Problem areas that can be addressed with liposuction:

Step 3 – See the results

Your improved body contour will be apparent once the swelling and fluid retention commonly experienced following liposuction subside. With continued practices of healthy diet and fitness, the loss of excess fatty tissue should be permanently maintained. However, substantial weight gain can alter the results.

The decision to have liposuction is extremely personal. You will have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable. You will be asked to sign consent forms to ensure that you fully understand the procedure and any risks and potential complications.

The risks include:

• Anesthesia risks
• Bruising
• Change in skin sensation that may persist
• Damage to deeper structures such as nerves, blood vessels, muscles, lungs, and abdominal organs
• Deep vein thrombosis, cardiac and pulmonary complications
• Fluid accumulation
• Infection
• Irregular contours or asymmetries
• Irregular pigmentation
• Need for revision surgery
• Persistent swelling
• Poor wound healing
• Rippling or loose skin, worsening of cellulite
• Swelling
• Thermal burn or heat injury from ultrasound with the ultrasound-assisted lipoplasty technique model

These risks and others will be fully discussed prior to your consent. It is important that you address all your questions directly with your plastic surgeon.

Once your procedure is completed, a compression garment or elastic bandages may cover treatment areas. These help to control swelling and compress the skin to your new body contours. In addition, small temporary drains may be placed in existing incisions beneath the skin to remove any excess blood or fluid.

You will be given specific instructions that may include how to care for the surgical site and drains, medications to apply or take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in your general health, and when to follow up with your plastic surgeon.

Be sure to ask your plastic surgeon specific questions about what you can expect during your individual recovery period:

• Where will I be taken after my surgery is complete?
• What medication will I be given or prescribed after surgery?
• Will I have dressings/bandages after surgery?
• How long will I wear the compression garment?
• Are stitches removed? When?
• When can I resume normal activity and exercise?When do I return for follow-up care?

It may take several months for the swelling to fully dissipate. As it does, your new contours and enhanced self-image should continue to develop.

Your improved body contour will be apparent when the swelling and fluid retention commonly experienced following liposuction subside.

The results of liposuction will be long lasting, provided that you maintain a stable weight and general fitness. As your body ages, it is natural to lose some firmness, but most of your improvement should be relatively permanent.

Although good results are expected from your procedure, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure and another surgery may be necessary. It is not possible to improve lax skin tone with liposuction.

Following your physician’s instructions is key to the success of your surgery. It’s important that the surgical incisions are not subjected to excessive force, swelling, abrasion, or motion during the time of healing. Your doctor will give you specific instructions on how to care for yourself.

Cost is always a consideration in elective surgery. A surgeon’s cost for liposuction may vary based on his or her experience, the type of procedure used, and geographic office location. Many plastic surgeons offer patient financing plans, so be sure to ask.

Cost may include:

• Surgeon’s fee
• Hospital or surgical facility costs
• Anesthesia fees
• Prescriptions for medication
• Post-surgery garments
• Medical tests

Most health insurance does not cover cosmetic surgery or its complications.

Your satisfaction involves more than a fee:

When choosing a plastic surgeon for liposuction, remember that the surgeon’s experience and your comfort with him or her are just as important as the final cost of the surgery. Plastic surgery involves many choices. The first and most important is selecting member of the American Society of Plastic Surgeons (ASPS) you can trust. ASPS member surgeons meet rigorous standards:

• Board certification by the American Board of Plastic Surgery® (ABPS) or in Canada by The Royal College of Physicians and Surgeons of Canada®
• Complete at least six years of surgical training following medical school with a minimum of three years of plastic surgery residency training
• Pass comprehensive oral and written exams
• Graduate from an accredited medical school
• Complete continuing medical education, including patient safety each year
• Perform surgery in accredited, state-licensed, or Medicare-certified surgical facilities

Do not be confused by other official sounding boards and certifications.

The ABPS is recognized by the American Board of Medical Specialties (ABMS), which has approved medical specialty boards since 1934. There is no ABMS recognized certifying board with “cosmetic surgery” in its name. By choosing a member of The American Society of Plastic Surgeons, you can be assured that you are choosing a qualified, highly trained plastic surgeon who is board-certified by the ABPS or The Royal College of Physicians and Surgeons of Canada.

This procedural information is intended strictly for educational purposes. Only models are depicted in these procedural information pages. It is not intended to make any representations or warranties about the outcome of any procedure. It is not a substitute for a thorough, in-person consultation with a board certified plastic surgeon.

Tummy Tuck Related Link: Dr. Zoellner’s Before and After Photos

What is a Tummy Tuck?

Also known as abdominoplasty, a tummy tuck removes excess fat and skin and, in most cases, restores weakened or separated muscles creating an abdominal profile that is smoother and firmer.

A flat and well-toned abdomen is something many of us strive for through exercise and weight control. Sometimes these methods cannot achieve our goals. Even individuals of otherwise normal body weight and proportion can develop an abdomen that protrudes or is loose and sagging. The most common causes of this include:

• Aging
• Heredity
• Pregnancy
• Prior surgery
• Significant fluctuations in weight

What it won’t do:

A tummy tuck is not a substitute for weight loss or an appropriate exercise program. Although the results of a tummy tuck are technically permanent, the positive outcome can be greatly diminished by significant fluctuations in your weight. For this reason, individuals who are planning substantial weight loss or women who may be considering future pregnancies would be advised to postpone a tummy tuck. Also, a tummy tuck cannot correct stretch marks, although these may be removed or somewhat improved if they are located on the areas of excess skin that will be excised.

The success and safety of your tummy tuck procedure depends very much on your complete candidness during your consultation. You’ll be asked a number of questions about your health, desires and lifestyle.

Is it right for me?
Tummy tuck surgery is a highly individualized procedure and you should do it for yourself, not to fulfill someone else’s desires or to try to fit any sort of ideal image. Abdominoplasty is a good option for you if:

• You are physically healthy and at a stable weight
• You have realistic expectations
• You are a non-smoker
• You are bothered by the appearance of your abdomen

During your consultation be prepared to discuss:

• Your surgical goals
• Medical conditions, drug allergies, and medical treatments
• Current medications, vitamins, herbal supplements, alcohol, tobacco, and drug use
• Previous surgeries

Your surgeon will also:

• Evaluate your general health status and any pre-existing health conditions or risk factors
• Take photographs
• Discuss your options
• Recommend a course of treatment
• Discuss likely outcomes of the tummy tuck and any risks or potential complications

Prior to surgery, you may be asked to:

• Get lab testing or a medical evaluation
• Take certain medications or adjust your current medications
• Stop smoking
• Avoid taking aspirin, anti-inflammatory drugs, and herbal supplements as they can increase bleeding

A tummy tuck may be performed in an accredited office-based surgical facility, licensed ambulatory surgical center, or a hospital. If your tummy tuck is performed on an outpatient basis, be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery.

Step 1 – Anesthesia

Medications are administered for your comfort during the surgical procedures. The choices include intravenous sedation and general anesthesia.  Your doctor will recommend the best choice for you.

Step 2 – The incision

A full tummy tuck requires a horizontally-oriented incision in the area between the pubic hairline and belly button. The shape and length of the incision will be determined by the amount of excess skin. Once the abdominal skin is lifted, the underlying weakened abdominal muscles are repaired.

A second incision around the navel may be necessary to remove excess skin in the upper abdomen. The upper abdominal skin is pulled down like a window shade. The excess skin is trimmed and the remaining skin is sutured together. A new opening for the belly button is created. The belly button is popped through to the surface and sutured into position.

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(2-2)

(2-3)

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(4) Before

(4) After

Step 3 – Closing the incisions
Sutures, skin adhesives, tapes or clips close the skin incisions.

Step 4 – See the results
Your tummy tuck will result in a flatter, firmer abdominal contour that is more proportionate with your body type and weight. The final results may be initially obscured by swelling and your inability to stand fully upright until internal healing is complete.  Within a week or two, you should be standing tall and confident in your new slimmer profile.

The decision to have a tummy tuck 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. You will be asked to sign consent forms to ensure that you fully understand the procedure and any risks.

The risks include:

• Anesthesia risks
• Bleeding
• Infection
• Fluid accumulation (seroma)
• Poor wound healing
• Skin loss
• Numbness or other changes in skin sensation
• Skin discoloration and/or prolonged swelling
• Unfavorable scarring
• Recurrent looseness of skin
• Fatty tissue found deep in the skin might die (fat necrosis)
• Deep vein thrombosis, cardiac and pulmonary complications
• Asymmetry
• Suboptimal aesthetic result
• Possibility of revisional surgery
• Persistent pain

These risks and others will be fully discussed prior to your consent. It’s important that you address all your questions directly with your plastic surgeon.

Following your surgery, dressings or bandages may be applied to your incisions, and you may be wrapped in an elastic bandage or a compression garment to minimize swelling and support your abdomen as it heals. Small, thin tubes may be temporarily placed under the skin to drain any excess blood or fluid that may collect.

You will be given specific instructions that may include how to care for the surgical site and drains, medications to apply or take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in your general health, and when to follow up with your plastic surgeon.

Be sure to ask your plastic surgeon specific questions about what you can expect during your individual recovery period:

• Where will I be taken after my surgery is complete?
• What medication will I be given or prescribed after surgery?
• Will I have dressings/bandages after surgery?
• When will they be removed?
• When will the stitches be removed?
• How will I bathe?
• How long will I wear the pressure garment?
• When can I resume normal activity and exercise?
• When do I return for follow-up care?

The final results of your tummy tuck may be initially obscured by swelling and your inability to stand fully upright until internal healing is complete. Your tummy tuck will result in a flatter, firmer abdominal contour that is more proportionate with your body type and weight. Previous abdominal surgery may limit the potential results of a tummy tuck. In women who have undergone cesarean section, the existing scars may be incorporated into the new scar. Scar may take several months to a year to fade as much as they will.

Although good results are expected from your procedure, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure and another surgery may be necessary.

Following your physician’s instructions is essential to the success of your surgery. It’s important that the surgical incisions are not subjected to excessive force, swelling, abrasion, or motion during the time of healing. Your doctor will give you specific instructions on how to care for yourself.

Prices for tummy tuck procedures can vary. A surgeon’s cost may be based on his or her experience, the type of procedure used, and the geographic location of the office. Many plastic surgeons offer patient financing plans, so be sure to ask.

Cost may include:

• Anesthesia fees
• Hospital or surgical facility costs
• Medical tests
• Post-surgery garments
• Prescriptions for medication
• Surgeon’s fee

Most health insurance does not cover cosmetic surgery or related complications. You must carefully review your health insurance policy.

Your satisfaction involves more than a fee:

When choosing a plastic surgeon for tummy tuck, remember that the surgeon’s experience and your comfort with him or her is just as important as the final cost of the surgery.

Plastic surgery involves many choices. The first and most important is selecting an American Society of Plastic Surgeons (ASPS) member you can trust. ASPS member surgeons meet rigorous standards:

• Board certification by the American Board of Plastic Surgery® (ABPS) or in Canada by The Royal College of Physicians and Surgeons of Canada®
• Complete at least six years of surgical training following medical school with a minimum of three years of plastic surgery residency training
• Pass comprehensive oral and written exams
• Graduate from an accredited medical school
• Complete continuing medical education, including patient safety each year
• Perform surgery in accredited, state-licensed, or Medicare-certified surgical facilities

Do not be confused by other official sounding boards and certifications.

The ABPS is recognized by the American Board of Medical Specialties (ABMS), which has approved medical specialty boards since 1934. There is no ABMS recognized certifying board with “cosmetic surgery” in its name. By choosing a member of The American Society of Plastic Surgeons, you can be assured that you are choosing a qualified, highly trained plastic surgeon who is board-certified by the ABPS or The Royal College of Physicians and Surgeons of Canada.

This procedural information is intended strictly for educational purposes. Only models are depicted in these procedural information pages. It is not intended to make any representations or warranties about the outcome of any procedure. It is not a substitute for a thorough, in-person consultation with a board certified plastic surgeon.