Hi Dr Bermandt,
Thanks for the information posted.
You are right that weight gain is a common misconception. Following Lipo procedure, should you experience weight gain or loss, it will tend to be proportionately distributed over your entire body. Once you have fat removed, it is gone and, assuming a healthy lifestyle of proper diet and exercise, it will not return or migrate. However, because fat is necessary to a healthy body, some essential fat layers in any given area remain untreated. If you do gain a significant amount of weight, the remaining fatty tissue will expand. Normal ageing changes can also be expected.
This should not be construed as medical advice. I am a retired Board Certified Plastic Surgeon.
Welcome to our forum discussion. Since you posted the link
contains further information on the Vaser Lipo procedure.
I was interested in what was on that page.
for example was on that site as I assume as an example of the results obtained. A single picture only tells part of the story. I was always concerned about just what the problem was and how good my operations were performing. That is why I evolved my
Standard Gynecomastia Pictures that use multiple standardized views to show the deformity and result of the sculpture. For contouring of the male chest, seeing how this tissue looks during animation is critical. That is why I added Arms up overhead and flexing muscles to see that component, for at least as well as a still picture does show that.
Standard Gynecomastia Videos are even more telling.
For this single image I have concerns that look very much like the many patients I saw over the years unhappy after Vaser liposuction to the chest coming to me for help. I had so many requests for help with
Correction of Liposuction Gynecomastia that I started putting up some of them for others to see. Here is a more complete discussion on
Revision Gynecomastia Forum - Unhappy: VASER Liposuction Did Not Remove Gland.
The lighting and camera technique seem different in the before and after views. There seems to be some contour issues on the left side lateral to the nipple extending out towards the arms that I would prefer to see a more complete analysis of just what the contours were like with the standard views. Most contour probles will become much more noticeable with muscles flexing or arms up overhead. How did the other views look.
On that page you make a number of statements that would be interesting to discuss.
AnesthesiaWe have an extended resouce of patient experiences of
Gynecomastia Surgery Forum - What Type Anesthesia? posted here. I never needed Vaser, and all of these patients were done under local with sedation. From my review of others doing this surgery, some surgeons select general, but most use local with sedation. To claim a distinction of Vaser is that it is done under local while others are under general is just not what I have read in the literature nor experienced.
Hospital StayWhile large volume liposuction patients require extended observation for patient safety, I never offered that option. I am fairly certain standard of care has almost all state of the art liposuction done as out patients ambulatory surgery. Almost all of our patients were done in a state of the art
Ambulatory Surgery Center as outpatients.
Bruising After LiposuctionBruising After Gynecomastia Surgery is best discussed with documentation. Using the same Standard Images, the progression of swelling, bruising, and healing can be recorded. Each example can be selected for a more complete demonstration of that patient's recovery, swelling, and bruising. I did many revision operations to sculpt the deformities after Vaser liposuction. Patients typically told me that their experiences with my more extensive revision surgery had much less swelling, bruising, and discomfort than their original operations Vaser included.
Comfort and Downtime After SurgeryComfort After Gynecomastia Surgery is very much technique related. Although I prescribed a strong pain pill for my patients, they typically told me that plain Tylenol alone was enough for their comfort after surgery. My typical patient was back to minimal activities the day after surgery. Here is a more complete discussion about recovery such as
Recovery How Soon Can I Get Back To The Gym? With less swelling, bruising, and pain, there should be a faster recovery.
It is my impression from the many unhappy patients I saw after surgery done elsewhere, that the Vaser and ultrasonic patients were the most uncomfortable. This is not sufficient to prove it does not work. It does mean the public should go beyond words and verbal claims alone and look for actual proof and demonstrations. I have never read any study proving the opposite, that Vaser patients were more comfortable or returned to work or activities sooner. However, I think this is more surgeon and tool related than anything else which is why I carefully documented what I saw for my techniques. It is my opinion that others should back their claims with such careful analysis.
Check our tools here on how to evaluate pictures and surgeons using the navigation bar below.
Hope this helps,
Michael Bermant, MD
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