Body Contouring with Liposuction

Dr. Bob Basu (00:00): A new company comes out with XYZ lipo, magic lipo, I mean it's getting out of hand. Look, let me make it very basic for you. It's not the technology that matters, it's who the technician or your surgeon is. And if you have a great surgeon who has a great aesthetic eye, who is well-trained, you are going to get a fantastic result. So let's not fall for the technology trap. It's not the technology, it's who your technician is.

Speaker 2 (00:30): This is Behind the Double Doors with Dr. Bob Basu.

Dr. Bob Basu (00:36): The best candidate for liposuction is someone who is very healthy, number one. Number two, they have pretty good skin tone, but they have focal fat deposits that they just can't get rid of. And number three, someone that's committed to the post-operative care plan or compressive therapy, that's super important to make sure you get a good result. Liposuction is not a weight reduction procedure. It is really a contouring procedure. Now, we do remove CCs of fat and that fat does have some weight to it, but we're really talking about maybe two, three, at most four or five pounds of weight that we're removing. And I don't want anyone listening to just think that liposuction is a weight reduction procedure, it is not. It's really a body contouring procedure. So we do 360 liposuction on a weekly basis. And all that means is that we are liposuctioning the front of the tummy, the waist, and the posterior flanks, meaning the lower back area hence the 360 term.

Dr. Bob Basu (01:39): So 360 lipo, it's not a technical term, it's a marketing term, but it really describes us doing liposuction around your waist and torso 360. And sometimes we do add on liposuction in the bra line with the upper back as well. I think everyone has heard about the Brazilian buttock lift or BBL. What that really is, is performing liposuction, oftentimes 360 liposuctioning and concentrating the fat and isolating the fat cells carefully and then transferring that fat into areas where you want to add some volume. Common areas include the buttock area, another common area is the hips, a term that's known as a hip dip or a hip depression where someone wants more curves. So we can actually put that fat to good use to enhance your sculpting from liposuctioning. So there's a lot that we can do with the fat that's removed, depends on the individual's goals.

Dr. Bob Basu (02:35): Plastic surgery particularly aesthetic plastic surgery is a blend of science and artistry. It's not just about sucking out fat. I mean, it's part of it clearly, but it's also about enhancing contour and enhancing shadow lines of the female and male form. I'll give you an example. For women, it's really important to accentuate the obliques, true for men too, but obviously male and female liposuction is done very, very differently in terms of the artistry of how it's done, but for women we're really trying to accentuate curves wherever we can. And to show the S curves that we see in the waist and the hips we're valuing the waist to hip ratios, we're trying to accentuate with some etching, etching has become a very popular term. We're trying to accentuate shadow lines. So it really gives a very feminine, but yet athletic look.

Dr. Bob Basu (03:30): So the artistry of what we do in liposuction really comes into play. I like to use what's called power assisted liposuctioning. I think it is a little less traumatic than traditional lipo, where you've see people kind of sucking out the fat manually. And I've tried a lot of the different other technologies. And I always keep coming back to power assisted liposuctioning. If there is some loose skin, mild loose skin, or if I need to do some more tightening, I will use adjunctive Bodytite. Bodytite is radio-frequency assisted liposuctioning. So for instance, popular areas that I love to get some skin tightening with lipo are the neck, arms, or the bra line, or even the waist and flanks. Because if you get that skin tightening in the arms, you get a much better result because after liposuction, you don't want to be left with loose skin.

Dr. Bob Basu (04:21): And so if I think that there might be some loose skin left behind, I will often add on Bodytite, which is a radio-frequency tool to help tighten loose skin. The results are immediate that in an hour or two after surgery, that's when the swelling starts. And so when they come back to see me a couple of days right after surgery for their first follow-up visit, when we take the garments off because compression garments are very important. We'll get to that in a second. They see their results right away. I mean, it's a no brainer. And I always tell patients if you're happy with your results now, just a couple of days after surgery, you will be ecstatic six to eight weeks later when you're swelling goes away. Equally important to the surgical technique and how much fat is being removed is compression, compression, compression. Patient compliance to compression garments is so, so important to achieving a great result.

Dr. Bob Basu (05:12): And I can't emphasize this enough. We talk about the doctor patient relationship. And when you're going through a surgical journey, as a surgeon, there's only so much I can do. I really need to educate the patient, but the patient needs to also participate in their care and be compliant with compression garments. Because after any surgery, including liposuction, you will experience swelling. And to keep that swelling down and to prevent fluid collections and to prevent contour irregularities, it's really important to wear compression garments. Now you will wake up with compression garments immediately from surgery, we'll put them on you. The compression garments can be an abdominal binder. It can be a special liposuction compression garment that we custom order for you. So it depends on the body type and what we're doing and the number of areas we're treating. Oftentimes I tell patients, you will need to downsize your garments every two to three weeks, because as your swelling goes away, you're going to get skinnier and skinnier.

Dr. Bob Basu (06:08): You're going to shrink down. And so the garments that you have initially will become loose. And so we may need to downsize you every two to three weeks. That's why some people use the terms phase or stage one, two, three garments, because you're shrinking down so we have to downsize you. Nobody complains about downsizing by the way, because they're seeing their results, they're shrinking down and that's awesome. The garments are very, very important. Typically, I prepare patients that you will be wearing compression garments four to eight weeks. And again, it depends on the number of areas we're treating, the amount of fat we're removing, but compression therapy will be necessary for four, sometimes up to eight weeks or longer. One of the things that I also would love to do with my liposuction techniques is I love to perform fat equalization. What that means is so one of the risks of any liposuction modality is that you can get some contour irregularities or divots.

Dr. Bob Basu (07:01): The surgeon is sucking out fat and they're trying to make it nice and even, but you can get some irregularities from liposuction. It's a known sequelae of liposuction. Fat equalization really helps to minimize that. And I've been doing that for the past several years, and that has really transformed my liposuction results. What fat equalization is, is that we're lipo sucking out this fat, the fat is being stored in a sterile compartment on the back table in the operating room. And so we sterilely catch this fat and the fat is then concentrated and filtered out to purified fat cells. Once I've completed the liposuctioning of a certain area then I actually do a little bit of fat grafting. In other words, I'm actually placing tiny aliquots of fat in the areas that have actually liposuction. Now our listeners may be saying, wait a minute, he just sucked out fat, he's adding it back in?

Dr. Bob Basu (07:54): No, we're not adding the same amount back in. What we're really doing is adding small, tiny amounts of fat in the areas where have liposuctioning, it's called fat grafting. And what that fat does is it helps to smooth out the areas that have liposuctioning. It prevents intrinsic scar tissue that forms in the empty spaces where I've removed fat that minimizes the risk for contour irregularities. So it smooths area out and my results have gotten so much better over the past several years ever since I adopted fat equalization. It's a great technique. And it really transforms my results for my patients. If someone has loose skin, stretch marks, they really need a tummy tuck, I will not perform liposuction on them alone because when you take the fat out, it's going to make their loose skin look worse. And my job is not to create a treatment plan that's going to make my patients worse.

Dr. Bob Basu (08:49): So I say, no, thank you. But I don't recommend liposuctioning. There are some moms that have excess residual fat from having kids and their skin looks okay, not bad. They don't have deep stretch marks. They were blessed they didn't get stretch marks after having kids and they will get an improvement with liposuctioning. However, what liposuctioning cannot do even with the radiofrequency technologies may tighten some skin a little bit, but liposuction modalities don't remove skin like a tummy tuck can. More importantly with post-pregnancy changes, one of the big challenges that moms face after having kids is muscle separation when they were pregnant. Liposuction cannot address muscle separation. Only a tummy tuck can tighten back those muscles and give you that flat washboard belly. So it's really important to talk about what the limitations of liposuction surgery are, but if a patient really needs a tummy tuck, there's only a very small subset of patients that I think will do well with liposuctioning alone.

Dr. Bob Basu (09:49): There are some moms that are blessed that all they need is liposuction after having kids. But that's a very small subset of patients that I see. For mild to moderate deposits of fat, there are some excellent noninvasive options for fat reduction. We love FDA cleared CoolSculpting. It's very effective. It's around. It's very safe and it's cryo lipolysis or freezing the fat. The advantage of CoolSculpting is there's no needles, no downtime, no incisions. And you can go back to the gym right after each treatment. A CoolSculpting, unlike liposuction takes time to see the results. Each CoolSculpting treatment, you'll see about 10 to 20% fat reduction, but you'll probably need about two to three treatments per area. The advantage of CoolSculpting is there's no needles, no downtime, no surgery. So there are some alternatives to liposuction that are quite effective and I think CoolSculpting is a very effective tool. For small fat deposits say underneath the neck Kybella is an option.

Dr. Bob Basu (10:51): It's an injectable fat dissolving agent that is FDA approved, but Kybella is really not for larger fat deposits. So and that's where my team and I will evaluate you to lay out your options and give you the best recommendations. So we have tons of before-after photos, all of my private patients on our website and our photo galleries, which can be found at basuplasticsurgery.com. That's B as in boy, A-S-U plasticsurgery.com. And you can find us on Instagram at Basu plastic surgery. So the first step is to really call our office (713) 799-2278 and ask to speak to one of our friendly and experienced patient care consultants. They're very familiar with the modalities that we offer both surgical and non-surgical for fat reduction, and they can walk you through the different options and talk to you about the costs and the recovery. Of course, a physical exam is necessary. So the most important things to visit with me and one of our office locations, so that we can evaluate you and give you options and my recommendations to what will achieve your goals the best.

Speaker 2 (11:55): Basu Aesthetics + Plastic Surgery is located in Northwest Houston in the Towne Lake area of Cypress. If you'd like to be a guest or ask a question for Dr. Basu to answer on the podcast, go to basuplasticsurgery.com/podcast. On Instagram, follow Dr. Basu and the team at Basu plastic surgery. That's B-A-S-U plastic surgery. Behind the Double Doors is a production of the axis, T-H-E-A-X I-S.io.