Q: My neck appears full on profile and yet the skin is not hanging. I am in my early twenties and wonder what can be done.

A: On examination it is determined if there is ample fat that can be removed by liposuction. This often is an inherited trait. Also, the general anatomy of the neck is determined to see the angle near the cartilage of the neck as some people are born with this being so forward in position that they can’t get a great cosmetic result from neck liposuction. The position of the chin in relation to the tip of the nose and upper lip are also important on profile and those patients who have a chin that is too far back or a small chin, can obtain a better or sharper angle by having chin augmentation. The chin can be enlarged by a plastic surgeon implanting a prosthesis or by having fat injections. Fat injections can be done at times immediately after the liposuction by processing the fat that was just removed.

Q: I have fat that hangs like curtain drapes on my upper back. Can liposuction help me?

A: Some patients derive good improvement from liposuction for this area. In some people the dermis is extra thick and powered liposuction, Smart Lipo and ultrasonic and Vaser liposuction have been used. One treatment is not necessarily better than the other but there are some patients whose back rolls are more of a function of sagging thick skin from gravity than an accumulation of fat and liposuction doesn’t help these people. We can try Thermage™ or Zeltiq™ Coolsculpting if this is very bothersome to the person and they wish to try whatever they can to reduce these bulges. Both Thermage™ and Zeltiq™ do not produce any downtime for most patients.

Q: I really want to get an excellent result in liposuction so I’m wondering if I should get laser liposuction and ultrasonic liposuction at the same time. 

A: Having two traumatic procedures done may increase the total amount of trauma to the tissues to such a significant degree that you might have a prolonged recovery with great swelling and more serious risks. It’s not worth taking a risk with your body.

Q: Does wearing a compression garment after liposuction guarantee a better result?

A: Some patients may not wear a compression garment and obtain a fabulous result after liposuction, but I do recommend for all my patients that undergo liposuction to wear a garment for several weeks. The compression garment may minimize bruising and make the area flatter and smoother faster. Many of my patients have noted that when they wear the garment, the typical immediate post-operative soreness feels better, similar to wearing an Ace wrap on a strained joint.

Q: If I need to lose 40 to 50 pounds, which liposuction is best for me, Smart Lipo, Tumescent Liposuction, Vaser, or Powered Liposuction?

A: The type of liposuction is not important. It is the surgeon’s skill and the patient selection. Losing 50 pounds is not a result expected from liposuction. You need exercise and a healthy diet. As fat is very light in weight, you would need such a volume of removal to make up the 50 pounds that it would be unhealthy. If exercise and dietary counseling via a nutritionist can not help you, then you might consider consulting with a general surgeon who does stomach stapling. This however has considerable risk and you would need to meet strict criteria prior to undergoing such a procedure.

Liposuction is indicated when there is a stubborn depot of fat that is not easily lost with diet and exercise. Your condition causing you to be obese, unless corrected, would cause you to gain weight after liposuction. You need to correct the underlying problem and then when you are more healthy, liposuction may be done on that last stubborn area.

Q: I have lost 30 pounds but I am left with an indented fold in my belly. Can liposuction help this?

A: You would need to be examined, but usually liposuction can’t help lift creases that have been present for a while and are bound down rigidly. It is possible that if the liposuction were done with a cannula performing subcision underneath the crease, that it might lift up, but it can reattach very soon after surgery. Some surgeons might consider injecting fat underneath the crease to lift it up, but you may be a candidate for an abdominoplasty. You should see a plastic surgeon for an evaluation.