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Find out if you are a good candidate for liposuction or abdominoplasty by contacting my Palo Alto practice in the Bay Area today.
Lauren Greenberg, M.D.
BOARD CERTIFIED, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
750 Welch Road, Suite 117
Palo Alto, CA 94304
p / 650.617.9907
f / 650.617.9909
Abdominoplasty, Liposuction, and Other Body Contouring Procedures in Palo Alto
What is body contouring? Body contouring is a range of cosmetic procedures to reshape the body, thighs, and arms. Liposuction is the most popular of these procedures. For liposuction, I use a combination of ultrasonic and traditional liposuction using the tumescent technique. Other procedures are tummy tucks, both full abdominoplasty and a "miniabdominoplasty," arm lifts, and thigh lifts. Many patients require a combination of these procedures for an optimal result. I am referred patients from all over the Bay Area, as this is an area of specialty in my practice, and I have written a chapter for a plastic surgery textbook about liposuction of the lower extremity. The surgery is performed in an outpatient facility near my office in Palo Alto or a surgicenter in Menlo Park.
- Liposuction
- Liposuction Before and After Photos
- Abdominoplasty
- Abdominoplasty Before and After Photos
- Medial Thigh Lift
- Arm Lift
- Body Lift
Liposuction (Tumescent, SAL, UAL, Ultrasonic, Vaser)
Liposuction is the most common procedure for men and women we perform as plastic surgeons. It is recommended for people stable at a normal weight who want to improve their body contour. The ideal patient is one with pockets of fat, such as "love handles" or "inner thighs," which are resistant to diet and exercise.
There are many terms with liposuction: Tumescent, SAL, Ultrasonic, UAL, Vaser, liposculpting, liposelection. Almost all plastic surgeons use the tumescent technique to help with anesthesia and to reduce blood loss. SAL is the term for traditional liposuction. Many physicians use the term liposculpting - all liposuction, when done well, is sculpting the underlying tissue. Vaser is a kind of ultrasonic machine, and their marketing has coined the term "liposelection." It is liposuction. UAL and ultrasonic are also terms for liposuction using ultrasonic energy to help break up fibrous fat and form smooth contours. I use all of these techniques.
Liposuction is effective in many areas: chin/neck, upper arms, breast/chest (including the male breast or "gynecomastia"), abdomen, waist, hips, buttocks, thighs, knees, calves, and ankles. Liposuction permanently removes fat cells through small incisions. As long as you maintain a stable weight with exercise and nutrition, the fat should not return.
The tumescent liposuction procedure is done in an operating room near my Palo Alto office. The areas to be suctioned are filled with a fluid called "tumescent." Tumescent fluid is made of anesthetic (to numb the local area and reduce the amount of general anesthetic), epinephrine (to reduce blood loss and bruising), and saline. For procedures of the trunk and thighs, I use two positions (from the front and back) in order to have a smooth natural transition from front to back. My bias is to use general anesthesia for patient safety, fluid regulation, and to allow for more fat removal.
It is difficult to redo a liposuction case. I urge you to choose your surgeon wisely, as your first shot is truly your best shot. Liposuction is one of the most common procedures I perform. I have co-authored a chapter on the subject that is published in a plastic surgical textbook. I treat my patients globally, usually addressing multiple areas, to help ensure a smooth, natural contour. This is important to make sure future weight fluctuations don’t create a “funny” body shape. I do all ranges of fat removal, from small touch ups to large volume removal (around 5 liters).
Liposuction may not work well as a stand-alone procedure. If your skin has many stretch marks, fine wrinkling, or drooping, you will likely need skin removal. This may involve abdominoplasty, miniabdominoplasty, medial thigh lift, arm lift, or body lift.
Ultrasonic liposuction, or UAL, uses ultrasonic energy waves to help break up the fat. I find my Palo Alto patients are very athletic - as most Bay Area people are - and they tend to have firm, fibrous fat. UAL is critical in fibrous areas such as the upper abdomen, back, and thighs, and in secondary liposuction cases. Men in general tend to be fibrous, and should use ultrasonic liposuction. I like to use UAL with most patients, as I feel it helps give a smoother result, larger fat volume removal, and better skin retraction. SAL is traditional liposuction. This uses cannulas hooked up to suction. I always follow use of the ultrasonic liposuction with traditional liposuction. As fat removal progresses, I use smaller and finer cannulas to help sculpt and contour.
For Bay Area patients to find out what combination of traditional, ultrasonic, and tumescent liposuction provides the right body contouring for your individual body type, contact my Palo Alto plastic surgery practice today.
Liposuction Before and After Photos
Abdominoplasty (Tummy Tuck)
You may notice with the passage of time you have formed a tummy. This can be due to many factors: excess or loose skin, excess fat, or stretching of the abdominal fascia/musculature. Significant weight loss and pregnancy can stretch the abdominal muscles and skin beyond the point they can return to normal. A healthy diet and regular workouts may not correct the problem.
An abdominoplasty works in two ways. First, under the skin the abdominal musculature is tightened, like an internal 'corset.' The muscles loosen during pregnancy, and a separation of the rectus muscles forms. This separation is called a “diastasis.” (A hernia is an actual hole in the fascia, and is less common.) You cannot fix a diastasis by sit ups, as the muscles do not cross the midline. I find you can really notice this looseness when you “suck it in” and still cannot get your belly as flat as before children.
Second, an abdominoplasty removes excess skin and fat, frequently removing all the skin between the belly button and the pubis. The scar looks like a C-section scar with a scar around the belly button. The length of the scar depends on the amount of skin and fat removed. Removing skin will rid stretch marks and wrinkling of the lower abdomen, and flatten and tighten the contour of the entire abdomen.
The abdominoplasty procedure is done under general anesthesia in one of two surgical facilities near my office in Palo Alto. The surgery facility in Palo Alto is outpatient; the Menlo Park facility has the capability of an overnight stay. Surgery lasts about three hours. I frequently combine abdominoplasty with liposuction or other cosmetic surgery procedures such as breast augmentation, breast reduction, breast lift, or eyelid surgery. Depending upon the length and size of surgery, an overnight stay may be required. Abdominoplasty can be combined with non-cosmetic procedures, such as hysterectomy or umbilical and ventral hernia repair. When this is done, the surgery is done usually at Stanford or Sequoia Hospital. Recovery takes two to three weeks. People who are still losing significant weight or who are planning another pregnancy should wait.
To schedule your consultation for a body contouring treatment such as liposuction or abdominoplasty, contact my Bay Area practice in Palo Alto.
Abdominoplasty Before and After Photos
Mini Abdominoplasty
What is a Mini abdominoplasty? Many women I see have just a little bit of extra - enough skin to be loose when wearing form fitting jeans, causing that annoying bulge at the waistline. Often these patients have little fat. The problem is the result of stretched skin from pregnancy or major weight loss. For these patients, a full abdominoplasty can't be done, as they don't have enough looseness in the skin to remove all the tissue between the belly button and the pubic area. I also see this problem in women with high belly buttons, or who are very short-waisted. A mini abdominoplasty removes a wedge of skin and fat from the lower belly to tighten and contour the abdomen. The scar looks like an extended C section scar. There is no scar at the belly button. An advantage to this procedure is that I can safely combine it with aggressive liposuction, and for many women their abdominal tissue is more excess fat than it is excess skin, but liposuction alone could leave their skin hanging.
Medial Thigh Lift
A medial thigh lift involves the excision of excess skin. This may be in conjunction with liposuction of excess fat. If you are over the age of 50, the skin tone of the medial thigh tends to be poor. You need to decide the tradeoff of slightly loose skin versus a scar. The medial thigh lift scar runs along the groin crease, and its length is proportional to the amount of excess skin removed.
Arm Lift (Brachioplasty)
An arm lift involves the excision of excess skin. This may be combined with a liposuction procedure to remove excess fat. This is done for people with poor skin tone and excess skin who won't wear short-sleeved shirts or tank tops due to the laxity of their upper arm skin. As this is a cosmetic body contouring procedure, I try to hide and minimize the scar in the armpit only. For people who have undergone significant weight loss, a larger scar may be necessary.
Body Lift (Lower body lift)
A body lift is needed when the lateral thigh and buttock area have laxity and have fallen. This is primarily a skin tone problem, although excess fat may be a problem as well. It is seen commonly in those who have undergone significant weight loss. A body lift is usually combined with an abdominoplasty, leaving you with a scar along the beltline going around the body. It is a significant procedure, so unless the skin laxity and sagging are marked, other methods are used for cosmetic improvement.
To learn more about abdominoplasty, tumescent and ultrasonic liposuction, or another body contouring procedure at my Bay Area practice, contact the Palo Alto office of Lauren Greenberg, M.D., today