The Cosmetic Surgery Blog

Although there are those who would love nothing more than to be rid of areas of body fat forever, and they are most likely aware of liposuction, there is another procedure being bandied about as a new technology. It's called Lipodissolve, or injection lipolysis, and it is billed as a "non-surgical alternative" to liposuction. It basically melts the fat. And, while there are many cosmetic surgeons out there who use the Lipodissolve technology, it is still under scrutiny. In fact, it's not even FDA-approved.

What It Is

There's the rub; there is no standard formula for Lipodissolve, so the ingredients vary. This is probably one of the main issues with the treatment. However, most of the chemical cocktails may include one of two different compounds, or may include both: phosphatidylcholine (PPC) and/or deoxycholate.

• Phosphatidylcholine - a compound extracted from the soy bean.
  
• Deoxycholate - a derivative of bile. Bile is what breaks down fat in our intestines.
  

Other ingredients include multivitamins, enzymes, alpha lipid acid, and plant extracts. Some cosmetic surgeons also include hormones, antibiotics or non-steroidal anti-inflammatory medications to their treatment.

Having said this, there are a number of reputable cosmetic surgeons who use a standard chemical mix whose risks are very small.

What It's For

Lipodissolve, like liposuction, can be used on many parts of the body. Arms, trunk, legs, chin, and other areas are good targets for Lipodissolve. And, because it is done through injections, you don't have to worry about incisions and having a cannula inserted into your body to suck out the fat. Many people would prefer not to go through this kind of healing process, even though the results are scientifically proven.

By injecting you in areas where there are fatty deposits you wish removed, you not only don't have to worry about anesthetic, but the fat is dissolved rather than sucked out. Treatments are done four to six weeks apart, and there is usually no down-time after the procedure. That is, if all goes well.

What Can Happen

There is currently a lawsuit in Illinois, brought forth by a woman who was seriously injured after her Lipodissolve procedure. She had the procedure at a medical spa called Pure Med Spa, which is one of the new cosmetic surgery chains popping up around the country. According to the woman and her lawsuit, she allegedly has rotting flesh on her legs for nearly five months. This is because the concentration of phosphatidycholine/deoxycholate was most likely too high. As one cosmetic surgeon put it, "it's like battery acid. It'll eat through anything." Predictably, Pure Med Spa claims they've done thousands of these procedures, and that their staff is highly trained. (So is the staff at McDonald's, especially the teenagers at the fry counter.)

There are other cases of calcium deposits forming beneath the skin and allergic reactions to the injection. If you are allergic to soy, there is no reason why you should even consider Lipodissolve. In fact, stop reading now.

However, there is potential for Lipodissolve to become one of the main procedures performed in this country. Liposuction is already one of the most popular procedures here, and Lipodissolve has been used in Europe since the '80s. And maybe the risks are truly minimal, as the makers and different cosmetic surgeons claim. But before you decide that Lipodissolve is right for you, you need to grill your cosmetic surgeon with questions about it. If they are a good one, they will answer all of your questions, and be able to point to their success with this procedure.

If you would like more information about Lipodissolve, please contact an experienced cosmetic surgeon in your area.

It was announced today that Nicole Kidman gave birth to a girl. Meanwhile, Angelina Jolie is reportedly in the hospital on the verge of giving birth to twins. Or maybe she's already had them. And bully for them. Being a mother is a life-altering experience, even for the rich and famous. And, just like all those new mothers or mothers-to-be, they've probably found that their bodies have been altered as well.

While mothers in the past had to play the genetic and biological hand dealt to them, mothers today have the option of what has become known as a "mommy makeover." There has even been a book written about it. And, because of the advent of socially acceptable cosmetic surgery, more and more mothers have decided that they want to return to the glory days of what they looked like pre-baby. While many women will stick to a regimen of exercise and diet in order to try to regain their body before it was hijacked by their offspring, there are some who don't see the results they'd like with only these two things. And sometimes not even trainers, like the ones Jolie and Kidman can afford, can work miracles.

Some of the most common concerns women have after childbirth include:

• Weight gain in areas that don't respond to diet and exercise
  
• Sagging or deflated breasts after breast feeding
  
• Stretch marks and excess skin in the abdomen
  
• Excessive fatty deposits in areas you didn't worry about before you got pregnant
  

While it's right that you exercise and eat right after your child is born, a cosmetic surgeon can target those specific areas that you are most concerned about. However, the procedures that make up the typical mommy makeover include liposuction, a tummy tuck, and breast augmentation. Variations might include procedures such as laser treatments to reduce the appearance of varicose veins.

While some women may not desire all procedures at one time, the combination is done to give mothers the confidence they felt before their baby was born. By tightening the abdomen, having liposuction performed on the thighs back, neck, and arms, or getting a breast lift, your cosmetic surgeon is able to give you what you can't get with diet and exercise alone. And, since you're probably running around doing errands that mothers do (shopping, carpooling, childcare and more), you may not have time to stick to the kind of diet and exercise you need to get back to your earlier form.

Congratulations to Nicole Kidman, as well as those of you who have also recently had children. And for those of you who are interested in returning to your earlier form, please contact an experienced cosmetic surgeon in your area to discuss how a mommy makeover can enhance your appearance as you're pushing a stroller, going to soccer practice and keeping your children from swearing in public.

An article first appeared in the April 2007 issue of Plastic and Reconstructive Surgery, the scholarly journal of the American Society of Plastic Surgeons (ASPS), that discusses a side-effect that may, or may not, be welcome to those who have liposuction. Titled "Spontaneous Breast Enlargement following Liposuction of the Abdominal Wall: Does a Link Exist?," the article shows that a small percentage of women have seen an increase in their breast size.

The study looked into a small group of women who received tumescent liposuction of the abdominal wall and/or flanks, as well as those who had undergone abdominoplasty. Those who had undergone previous breast or abdominal surgeries, or had or were currently breast feeding were excluded from the study. This left 48 or 84 patients who had tumescent liposuction procedures, and 53 of 104 abdominoplasty patients.

Results

Of the liposuction patients, 23 of the 48 (48 percent) reported a postoperative increase in size of their breasts. Objective confirmation was reported in 19 (40 percent) of those patients. Eleven (21 percent) of the abdominoplasty patients believed they had an increase in their breast size. This was objectively confirmed in six (11 percent) of the patients.

Because the percentages of women who were able to show that their breasts increased by at least one cup size was large enough, the ASPS believes that patients undergoing liposuction or abdominoplasty should be warned that this is a potential side-effect/risk.

Possible Reasons

The reasons for spontaneous breast enlargement are as much a mystery as to those who this phenomenon affects. Gerald Imber, a cosmetic surgeon in New York, wasn't even sure it was occurring to some of his patients, but upon discovering its reality, stated that it "could be due to a shift in the relationship between estrogen and progesterone" or even "the trauma of surgery" caused it.

Carolyn Chang, a cosmetic surgeon in San Francisco believes that the result is simply one of rearrangement. "It could be the result of weight gain in people after the fat cells have been removed from their abdomens," however it is not predictable.

Whatever the reasons, there are probably as many women hoping for this kind of side-effect as there are those who don't want it. One of the things a narrower or tighter abdomen tends to give women is that their breast size appears larger. And if the women who have undergone liposuction or abdominoplasty still want breast augmentation, this is something they can discuss with their cosmetic surgeon.

If you are interested in liposuction or abdominoplasty, or have questions about their side-effects (both wanted and unwanted), please contact an experienced cosmetic surgeon in your area.

Some of you may remember Brigette Nielsen as the ex-wife of Sylvester Stallone (1985-1987) and her role in Rocky IV, or you may remember her from Red Sonja. Or maybe you just don't have a clue who she is and probably don't care. That may change when she goes through several cosmetic procedures in front of the camera. Why? According to the 44-year-old actress, it has more to do with bursting the secrecy of cosmetic surgery in Hollywood than it does shameless self-promotion - even though she claims to be the first female celebrity in the world to allow herself to be filmed in this way. Nielsen calls the secrecy "annoying" and says, "You can see that the stars do not age naturally. It's not right that the fans, the normal women, are lied to."

So, in a three-part series scheduled for German television next month, all the "normal women," as well as their spouses and children, can watch Nielsen undergo procedures for a face lift, eye lift, fat injections, liposuction, as well as dental work. Her goal is to look 30 again (because she feels 30). Not only that, but Nielsen, who appeared in Playboy 20 years ago, will do so again later this year to show off her new body. Remember, no secrets. However, Nielsen also hopes that by doing this, she will provoke discussion about her, what she's done, and her belief that we should be in on what Hollywood is doing.

If you are one of the "normal women" or perhaps men, and you are interested in cosmetic surgery, please contact an experienced cosmetic surgeon in your area.

Though summer is officially six weeks away, most people are probably already looking forward to it (especially if you live in a place whose winter was exhibit A for global warming deniers). Along with the thought of summer come thoughts of shedding winter clothes and maybe even wondering if you need a new bathing suit. Maybe you do. However, before you throw down the money to buy one, you might want to try on your old one first. As you stand before the mirror, you might see just where all those Christmas cookies and all that eggnog went. Or you may find out that your workout regimen to prepare you for summer hasn't quite taken care of all those areas around your midsection you thought it might. And, finally, you may see a few other places on your body that you have no intention of showing anyone this summer. So, with some sadness, you put your bathing suit away and decide that money you were going to spend on a new suit might as well go to something else reserved for the shut-in you've decided to become. Because no one wants to see the whale you feel you've become.

Maybe you should turn that painbow into a rainbow. One of the options you still have is liposuction.

Liposuction, also known as liposculpture, is the removal of fat tissue through small incisions approximately one-fifth to one-third of an inch in length. A thin metal tube or cannula is attached to a vacuum which literally sucks the fat from your body. It happens to also be one of the most common cosmetic surgical procedures performed. Furthermore, once the fat cells have been sucked from your body, they are gone forever. One note on this: overeating and lack of exercise can add to your weight even after liposuction.

We have certain areas on our body where the fat collects and is not easily eliminated, even with exercise. As a result, the areas where liposuction works best is on the knees, hips, buttocks, outer thighs, lower abdomen, waist and flanks (love handles), male breasts (gynecomastia), and upper legs. It also can be performed on the face and neck in conjunction with a facelift.

Types of Liposuction

Liposuction procedures have come a long way since their inception. Rather than simply sticking a tube in you and sucking out the fat, as you've most likely been led to believe, there are also tumescent liposuction and ultrasonic liposuction.

Tumescent liposuction involves injecting fluid into the area to be suctioned. This increases the space between the muscle and the fat where it becomes firm and swollen (tumescent). This allows the cosmetic surgeon easier access and produces smoother results.

Ultrasonic liposuction, or ultrasound-assisted liposuction (UAL), is like tumescent liposuction, but the cannula used transmits ultrasonic vibrations. These vibrations break down the walls of the fat cells and liquefy the fat. This makes it easier to suction out.

Risks

Just as with any kind of surgery, liposuction carries a small amount of risk. Some of the risks include rippling or loose skin, clots, uneven contouring, scarring, numbness, infection, and more. Discuss these risks with your cosmetic surgeon before you go through with the procedure.

If you would like to know more about how liposuction can make you bathing suit worthy, please contact an experienced cosmetic surgeon in your area.

Luiz Carlos Ribeiro pleaded guilty in the death of 24-year-old Fabiola DePaula in Middlesex Superior Court in Cambridge, Massachusetts on Tuesday, and was sentenced to three years in prison. DePaula went to Ribeiro for a nose job on July 27^th, and returned for liposuction three days later. An autopsy showed DePaula died of complications, namely pulmonary fat emboli (fat in the lungs).

Ribeiro is accused of conducting underground cosmetic surgery out of the home of Ana Celia Pena Sielemann. He allegedly performed Botox injections, rhinoplasty, and liposuction for years in Framingham where there is a large Brazilian immigrant community. Cosmetic surgery is popular among the women here. However, Ribeiro did not have a license to practice medicine in this country. He also allegedly performed DePaula's procedure on a massage table in unsanitary conditions. There was no qualified professional there to monitor DePaula's vital signs.

Ribeiro's ex-wife, Ana Maria Miranda Ribeiro, admitted she acted as a nurse during Depaula's liposuction and pleaded guilty to manslaughter in September. She was deported after serving a one year sentence. Sielemann, the homeowner, was charged as an accessory. She allegedly recruited the women Ribeiro performed cosmetic surgery on. She was deported before she could be brought to trial.

Ribeiro has already served 20 months in prison since his arrest. He may be eligible for release in January 2009, and will likely be deported when he is released.

A Cautionary Tale

Fabiola DePaula went to a dingy Massachusetts basement to get a procedure she thought would improve her looks and her life. This decision killed her.

It would be nice to know that Ribeiro is the only basement cosmetic surgeon in the country, and that his imprisonment has solved this problem. However, where there's one, there are several more who practice without a license, or who believe they can perform difficult procedures without proper training. Liposuction is a little more sophisticated than simply sticking a vacuum into someone and sucking out their fat.

There are always risks with surgery. However, with an experienced cosmetic surgeon who knows what they're doing and cares about your welfare, the risks are low. If you are interested in finding out more about liposuction, please contact a licensed cosmetic surgeon. They will knowledgably answer any questions you have about this, or any other procedure.

The picture of men and their breast size hit the pop culture circuit on Seinfeld when Kramer and Frank Costanza decided to market bras for older men. The argument over what to call it ("The Bro" or "The Manzier"), as well as the scene of Kramer helping Mr. Costanza put the bra on, was just a tiny part of what made the show so great. However, there may have been lots of guys out there watching the episode who didn't think it was so funny.

Gynecomastia, a condition in which there is excessive development of the breast tissue, affects an estimated 40 to 60 percent of men. It is more commonly occurs in infants, but it usually goes away. However, it may come back when boys hit puberty and there is a small chance that it is there to stay. Gynecomastia is due to an imbalance in the estrogen-to-androgen hormone ratio, where estrogen has the higher balance of the two.

This condition can cause extreme embarrassment and psychological issues in teenagers who are affected. Because society puts a high premium on the way we look and kids are figuring this out at younger and younger ages, it isn't just teenage girls who pay attention to the way their breasts are developing. And puberty is just one of the causes for male breast enlargement in teens.

Other Potential Causes

• Steroid abuse
  
• Obesity
  
• Marijuana use
  
• Tumors
  
• Genetic disorders
  
• Castration
  
• Side effects of other medications
  

It can be argued that some of these, obesity (when caused by diet), steroid abuse, and using marijuana, are personal choices, but the other causes are out of the kids' hands - though it could also be argued that teens who abuse steroids and marijuana probably don't want gynecomastia, either. And one remedy for obesity is to lose weight, but this may not solve the problem 100% of the time.

Because feelings of shame, embarrassment, and humiliation are common with this condition, and because we live in a society that has its ideas of masculinity firmly embedded in its' psyche, teenage boys may hide themselves away. Sure, we can tell them over and over that beauty is only skin deep, and that worrying about the way they look isn't "what guys do," but this isn't realistic. One option, which some teenage boys have taken advantage of, is male breast reduction surgery.

Male Breast Reduction Surgery

According to the American Society for Aesthetic Plastic Surgery, male breast reduction surgery was one of the five most popular cosmetic surgical procedures for men last year. Just over 20,000 men went through this procedure.

If the procedure involves the removal of glandular tissue, a cosmetic surgeon will use a scalpel. If the cosmetic surgeon is removing fatty tissue, liposuction may be required. Sometimes male breast reduction procedures require the removal of both glandular and fatty tissue. The excess skin is then removed to give the chest a more natural, or "masculine" appearance.

Many teenage boys will suffer in silence with gynecomastia, and maybe not all of them would choose male breast reduction surgery even if they knew about it. But the option to help guys with their self-esteem is out there.

If you have questions about male breast reduction surgery, and would like to know more about it, please contact an experienced cosmetic surgeon.