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Liposuction (Suction Lipectomy)

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Michael Bermant, MD Board Certified by the American Board of Plastic Surgery

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This is the page where you can review questions and stories from patients, view the opinions of lay persons, and see answers from Dr. Bermant and other physicians. Do you want to ask a question, post an answer, or make a comment? Information E-mailed to me will be considered for posting.

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Information posted in this section does not necessarily reflect the opinion of Dr. Bermant.

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Subj: Re: liposuction

I am interested in having liposuction. Since I would be coming from out of town, I can not come for a pre-opt until right before surgery. I want to have lipo done on my inner and outer thighs, hips (flanks) and stomach. A surgeron told me that they could remove about 10 liters of fat (if that is any help). I was wondering how much the cost would be? I am planning on having the surgery done sometime in October or early November. Thank you.

Dr. Bermant responds:

10,000 cc of fat removal is a very large amount for liposuction surgery. The ASPS has written a position paper pointing out the dangers of removal of more than 5000cc. I do not do such large volume liposuction surgery as I feel it is dangerous (and I have been doing this for many years). Any patient having such plans should be seen by their doctor well before a one day preoperative examination. No thank you, I think I will pass on this one.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD

Subj: Re: lyposuction

Dear Dr.Bermant,
I am interested in having lyposuction performed on my thighs and saddle bag areas. I would like to know a ball park figure on the price of such a procedure. Thank you.

Sincerely,

K please reply to ...

Dr. Bermant responds:

Price depends on what needs to be done, the type of anesthesia and location of the surgery. For a typical problem as you have described, our surgeon's fees can be found here. However certain issues can make that price less, and other issues make the price more. If you want more price details, call our office. The best way to learn about liposuction surgery, the risk, benefits, and if any one patient is a candidate, is during an office consultation and evaluation. Then we can examine the problem, propose surgical options and give specific prices.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD

Subj: Re: lyposuction

Vanderbilt University

I would like to receive more information about the lyposuction process. I am interested in getting lyposuction for the buttock and thigh area. I also am curious if I can get it on my arms. I am not overweight, but have certain areas that have fat that I cannot get rid of with any amount of exercise or diet. What is the approximate cost for these procedures, and where is your office located? Please get back to me as soon as possible.

Dr. Bermant responds:

Preliminary information about liposuction can be found here.

The buttock and thigh areas are common sites of liposuction treatment. Upper arms sometimes can also be treated, but the complication rate is usually higher. It depends on the location of the fat, localized collections are better treated than generalized obesity. The best way to explore what suction lipectomy may have to offer is during an in office consultation and evaluation. My surgeon's fee is approximately per zone can be found here. Additional costs depends on other factors such as extent of surgery, location of surgery, and type of anesthesia.

Our office is located in Richmond Virginia. Maps and other detail are on the website but you can also call our office for more information. We have an extended educational experience as part of our consultation and surgical package.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD

Subj: Re: 3-D Liposuction

I have read about a procedure called "three-dimensional abdominal liposuction." It is said to allow surgeons to create a rippled look for the midruff...It supposedely comes in two variations. Abdominal etching and modified abdominal etching. If you know anything about this procedure ie costs, locations that perform the operation and its success rating please provide me with some further information. Any info is greatly appreciatied...
C

Dr. Bermant responds:

Liposuction is the removal of localized fat. In some cases more aggressive fat removal exaggerating the normal depressions in the skin can produce a pleasing appearance on the male abdominal wall. For the skin to move nicely over the underlying tissues, there has to be enough material between. If the patient does not have enough tissue, over aggressive sculpturing can cause scars that do not move very well. Fat gained in cases of such scars can look really bizarre. We do liposuction and can in some cases provide accentuation of details like you are describing. It really depends on the patient's problem as to what can be done. My surgeon fee for a single zone of liposuction can be found here. OR fees vary depending on what type of anesthesia and where the surgery is done.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD

Subj: Re: liposuct / implants ulcer

Dear Dr. Bermant, I am a 42 year old Quadriplegic and have had several muscle flaps on my butt. Now I am breaking down again and I don't have any more muscle in my butt to move around for padding. I recently went to Jackson Hole, Wyoming for a 4 day vacation. I reclined every 3 hours and would stay reclined for 1 hour each time. My skin still broke down on my butt and I had to spend 6 weeks in bed to get it healed. I was wondering if it was possible to put an implant, like the breast implants, in my butt to give me the padding I need? Or do liphosuction and inject the fat back into my butt? Could you please give me your opinion and let me know if there are any doctors in the Salt Lake City, Utah area that would do something like this.
Thank You

D

Dr. Bermant responds:

Sorry liposuction nor implants are of value for what you seem to be asking to the best of my knowledge.

Michael Bermant, MD

Subj: Re: Liposuction

Hello Dr. Bermant

I am a twenty year old male, I am about 5'10" and weigh about 275lbs. I have tried diets, and exercise, and also am very active in sports. I am looking for a way to get rid of my excess fat and this is my last resort. I probably will be spending a lot of money but I think it is worth it. I need fat removed from my thighs, abdomen(from front to back) and from my pectorals. I also probably need skin removed and stretch marks removed. If you could please respond to me I would be most appreciative. I am from New York and I would want to know approximately how much money I would be looking at and how long of a stay I would be looking at? I know this may sound a little ridiculious but I would like to be around 170 after the surgery.

Thank You for taking the time to read my letter to you and I hope I hear back from you.

Thank You once again

Dr. Bermant responds:

Liposuction is not for general fat or weight loss. It is used for localized fat collections, and resculpture of those areas. Excess skin and fat are treated with other operations such as a tummy tuck (abdominoplasty). No reasonable surgery will offer a weight loss from 275 to 170 pounds. Other options may be available working with your family doctor. Once you have stabilized at your new weight, plastic surgery may become an option for fine tuning those changes.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD

Subj: Re: Ultrasonic Lipo

Dear Dr. Bermant,

I haven't seen any new posts on your bulletin board since May, but I thought I'd try this anyway.....

I had ultrasonic lipo on outer thighs, flank areas, & lower abdomen during the first week of April. I was 5'4" & weighed 130 lbs at time of surgery. The main reason I had the surgery performed was my saddle bag area. They have been a problem area ever since I was young (now 40) & I have never been able to wear straight skirts without getting them at least 2 sizes too big in waste area & then they usually looked funny, so I'd always have to wear a jacket.

Anyway, I had a horrible time recovering from the ultrasonic procedure. My surgeon is board certified & performs may of these procedures, but unfortunately His "before surgery" bedside manner is much better than his "after surgery" bedside manner. I was in such terrible "nerve type" pain still after 3 weeks post-op that I finally went to my General Practitioner & got an RX for the horrible burning, blistering pain I was still experiencing. After about 2 weeks the pain got a bit better. I remained on the RX for 1 1/2 months. Finally at about 2 1/2 months post op, I could finally wear clothing without the protection of tight biking shorts underneath.

I have seen pretty good results in my lower abdomen (which I added in to the surgery the week before). But, I have no results at all in outer thighs. I went back to my plastic surgeon & was scared to death that the nurse would measure me smaller or use a different measuring tape or something, but, to my surprise, she too measured one thigh the exact same & the other only 1/2 inch smaller. The doctor immediately looked at my chart & said that he removed 3100 cc's of fat, which should weight about 6 lbs. At the time of this visit I weighed 4 lbs more than day of surgery. So, he told me I should weigh 10 lbs less & blamed the "No Results" on this. I explained to him that I hadn't weighed 124 for many years & don't want to weigh that. (If I lost 10 lbs now I'm sure I'd only lose in my breasts anyway). Everything I have ever read says this is not a WEIGHT LOSS surgery, anyway! I hardly think that my gaining 4 lbs over 5 months made the difference between some results or no results anyway. He also seemed very "ticked off" when I told him of the difficulties I had with the ultrasonic procedure & that I had to go to my other doctor to get some relief (many calls to his office & nurses & extra visits to him about the problems led me no where). I remember at his seminar I went to with over 200 people there when someone asked about the possibility of burns from ultrasonic he replied, "I have never burned anyone, if you move the cannula around quickly enough it only makes sense you won't burn the patient" I knew then why he can say that, he never listens to his patients AFTER the surgery, so he can maintain his perfect record.

Anyway, I am truly sorry for rambling on so. But my main question to you is this. The same plastic surgeon has agreed that if I get down to my pre-surgery weight (4 lbs. less) he will do a touch up surgery (for the mere price of $500) and he will only use the tumescent technique on me. My outer thighs now seem very soft. I can tell fat was removed because the thick feeling is gone & the feel much softer, although they are still the same diameter. I have terrible cellulite & they almost seem to have folds in my thighs. Although I think this was also there before. Do you think a touch-up lipo would help me? Or, just make my thighs sage more & really make fold lines. Is there anything that will help skin retraction?

Your advice would be greatly appreciated! I hope to hear from you soon. Thanks.

M

Dr. Bermant responds:

There is only so many hours in the day and I do not get the time to post all of my email responses nor get to every email.

Liposuction fat sculpture surgery may leave the patient weighing more for several reasons. Initially there may be some swelling from the extra fluid used during surgery and especially with the tumescent method. Although most of this extra fluid is handled by the body fairly quickly, some residual swelling may take a little longer to subside. Other patients do gain weight from other means, such as less exercise or changed eating habits.

Many liposuction operations are designed to finely change a local contour, not massively reduce a diameter of a thigh or abdomen. You are correct, I teach my patients this is not weight loss surgery. I do not understand the "no result" concept when you say that the thick feeling of the thighs are gone. The extra fat there that had made them tighter now gone is what gave that relief. Waiting for several months also gives the tissue some time to heal and will give you a better perspective what the results will look like before considering more surgery.

Nerve injury (burning sensation during the healing stages) CAN happen during liposuction. Such hypersensitivity of nerves can be more common with the internal ultrasonic method than standard methods. Most liposuction patients do not experience such discomfort during healing. As nerves regenerate the discomfort and sensitivity are often difficult to treat and deal with other than being patient and trying not to stimulate them too much. Many pain and anti-inflammatory medications do not work as well with this healing "burning" sensation. Your doctor saying he does not "burn" patients has another meaning. An ultrasonic probe can physically BURN the skin if not moved about adequately during surgery. Such burns can mean blisters, dead tissue and scars and are much different than what you were describing.

I cannot comment if further liposuction surgery will be of any benefit to ANY patient who I have not examined and evaluated in person. Realistic expectations are essential to any happy outcome. Skin retraction problems need to be assessed during a consultation, I need to see how the problem area moves to advise if there are treatment options and probability of success. Cellulite in general does not often improve with liposuction alone.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD

Subj: Re: Liposuction

Hi! I know you are busy, but I have an important question. I had abdominal liposuction in May-I am 5'7'' and have a thin frame, all except my abdomen, which tend to be rounded and protrude out. I eat pretty well and I have been going to a gym regularly for 7months doing step 1 aerobics, nautilus, weight training and treadmill. My question is, why am I starting to get my round stomach back? I looked great 3 months after the suregery, better than I did 6 months afterward when the swelling had gone down. I had a very reputable surgeon in my area, but I was under the impression this was fairly permanent if you took care of yourself. I am in the best shapI've been in since I was 12-what is the problem? I went in debt literally $3000.00, and I hate to think I wasted my money! Any reasons or suggestions to get rid of this problem would be GREATLY appreciated! Thank you for your time! K

Dr. Bermant responds:

Liposuction removes fat cells in an attempt to reshape local areas. Protrusion can be from many different problems. If from localized fat collections, although liposuction can recontour that area, remaining fat cells can still put on extra fat. Suction lipectomy does not stop the process of fat storage nor gaining weight. Bulges can be however from other problems such as the contour of the abdominal muscles. A diastasis recti is a condition where the "sit up" muscles bulge spread out in the connection between them. A repair can improve the position of these muscles that no amount of conditioning will help. Fat BEHIND the stomach wall can make the abdomen bulge. No amount of muscle strengthening, surgical tightening, nor liposuction will lessen protrusion from this pressure. It really depends what the underlying problem is - and that needs an in office consultation and evaluation. Without such an exam, any reasons or suggestions would be PURE speculation and conjecture. Your doctor should have before surgery photographs that can help in a discussion about this issue. Go ask you doctor to help you understand what is going on. If you were my patient, I would want to know that you still had questions.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD

Subj: Re: Liposuction

Hello Dr Bermant:

I have been very impressed by your site and I have a question. You say often that "Liposuction is not very good at general weight reduction, it is good for localized fat collections." How much localized fat can one expect to be removed with this procedure? I have plenty of fat in my hips, thighs and stomach, but very little
elsewhere.

Thank you,
M

Dr. Bermant responds:

It is difficult to impossible to advise any one individual if they are candidate for liposuction by email or bulletin board posting. That is best reserved for the in office examination, consultation, and evaluation. Some patients have not just extra fat, but fat AND skin. So much skin that it cannot adjust by itself to a smaller size after the fat removal. Other surgical options need to be explored in such situations. Suction lipectomy is best reserved for sculpture refinement of the human form, not massive fat removal.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD

Subj: Re: liposuction

i had breast implants and lipo done in the middle of june. at the time i surgery i weighed 128lbs one month after surgery i weighed 13 lbs heavier and now i am 148lbs a full 20lbs heavier. i am 5'5. have you ever heard of this happening and how was it treated? please help me if you can. my dr had never heard of it and i am so discouraged.

Dr. Bermant responds:

No I have not seen it with my patients. The most common cause of weight gain after liposuction (after the small initial fluid stabilization) is more calories eaten than used. Some exercise less. Others eat more feeling that the liposuction has stopped possible weight gain (it does not). There may be other causes and your doctor who has examined you has a much better chance of explaining the situation than one with little information about you.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD

Subj: Re: lipo

Hi I would like you to send me some readind on lipo. surgury and a video if you could

Dr. Bermant responds:

There are pages of liposuction patient education on the website and we have the ASPS patient education brochures for those patients visiting us. Here in the office there is a video for those patients who want to see it, but my normal educational experience that I provide for my patients in my office considering liposuction is better than any video I have found so far.

Preliminary information about liposuction can be found here.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD

Subj: Re: Liposuction

Dear Dr. Bermant,

Today, I've been reading your bulletin board and have some questions because I'm considering Tumescent Liposuction on multiple areas (inner & outer thighs, hips, knees and tummy) with "twilight" sedation next month.

In some documentation I've read on the Internet, there is mention of considerable drainage of the incision sites and one article actually advised people to bring along an old shower curtain to line the car seat on the drive home from the surgeon's office. Is this for real? I can understand that these sites will drain fluid, but to that extent?

My other question relates to a letter on your bulletin board. One olive skinned woman wrote how the redness around her scars has not disappeared in nine months. Is this true of all olive-skinned people? Does complexion (light or olive) have something to do with the nature of the healing that takes place?

In your response to her you stated something about "meticulous wound closure".
What does that mean? In the Tumescent method, I'm told that there are no stitches in order to allow all the residual blood and fluid to leave the body. So, really the wound won't be closed, right? I'm finding all this rather confusing.

Also, will I be able to manage the first post-op night on my own? The nurse at the doctor's office said yes, but I'd like your unbiased opinion. Please advise. I need to decide this week whether to get this done next month.

Thank you!

P

Dr. Bermant responds:

There are many types of liposuction. Even tumescent liposuction has many variations with different amounts of fluid used. Drainage after surgery depends on the size of the operative site, the amount of fluid and type used, and the amount removed. The surgeon's technique also varies. Massive fluid drainage after surgery can happen in certain techniques.

Skin closed primarily tends to heal with less scarring and deformity. Some patients can form nasty scars with secondary healing. Darker skin can have problems with hyperpigmentation (darker scars). I sometimes vary my technique to one where less fluid is used or partial or total closure of sites permit drainage yet better healing. Improper drainage can also cause problems. In some cases I actually place drains through the wounds for a short time and then close with steristrips after the drains are removed.

Care after liposuction depends on the degree of surgery. In large volume suction lipectomy cases, the patient is better hospitalized to monitor their potential large fluid shifts. In less aggressive cases the care varies depending how much, where on the body, and many other factors. For our patients who have heavy sedation, we prefer at least the first night to have someone stay with them. It is less of an issue with light sedation cases. For each patient a specific after surgery care plan is recommended by our office.

My surgery is designed for a specific problem and patient. With so many possibilities, my patients receive individualized information depending on their own situation and deformity. I have no idea what your anatomic problems are nor what your surgeon is planning and so cannot comment on your case. Our office emphasizes the education of our patients. When surgery is contemplated by another doctor, the patient is better off learning what that doctor wants, plans, or what difficulties are anticipated. If you were my patient, I would certainly want to know about questions that were not addressed to your satisfaction during my office educational experience.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD

Subj: Re: Liposuction

Dear Dr. Bermant,

Thank you so much for answering all my questions so promptly. It was really very helpful to get your opinion. I now feel better informed about how to proceed and what additional questions I need to ask my doctor.

Thanks again!

P

Subj: Re: Liposuction and Sex

Dear Dr. Bermant,

Great website! I learned more here than from my doctor! When can I start having sex with my husband after my liposuction surgery?

B.

Dr. Bermant responds:

This is really a question better answered by your surgeon. There are different degrees of surgery and patients with different potential risk factors. If you were my patient, I would want to know about any unanswered questions before surgery.

In general a patient is sore after this surgery. I advise my patients not doing an activity until they feel comfortable. It is better to avoid pressure / rubbing on the operative site for about 2 weeks. Very early vigorous activity can cause bleeding and more swelling.

I hope this information proves of value.

Michael Bermant, MD
Board Certified
American Board of Plastic Surgery

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